Search results for: medication error

Authors: Shih-Pin Chen, Shih-Syuan You

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This study proposes a regression model with flexible spreads for fuzzy input-output data to cope with the situation that the existing measures cannot reflect the actual estimation error. The main idea is that a dissemblance index (DI) is carefully identified and defined for precisely measuring the actual estimation error. Moreover, the graded mean integration (GMI) representation is adopted for determining more representative numeric regression coefficients. Notably, to comprehensively compare the performance of the proposed model with other ones, three different criteria are adopted. The results from commonly used test numerical examples and an application to Taiwan's business monitoring indicator illustrate that the proposed dissemblance index method not only produces valid fuzzy regression models for fuzzy input-output data, but also has satisfactory and stable performance in terms of the total estimation error based on these three criteria.

Keywords: dissemblance index, forecasting, fuzzy sets, linear regression

Procedia PDF Downloads 330

Authors: Nikolaos Georgoulopoulos, Alkis Hatzopoulos, Konstantinos Karamitsios, Konstantinos Kotrotsios, Alexandros I. Metsai

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In modern server systems, business critical applications run in different types of infrastructure, such as cloud systems, physical machines and virtualization. Often, due to high load and over time, various hardware faults occur in servers that translate to errors, resulting to malfunction or even server breakdown. CPU, RAM and hard drive (HDD) are the hardware parts that concern server administrators the most regarding errors. In this work, selected RAM, HDD and CPU errors, that have been observed or can be simulated in kernel ring buffer log files from two groups of Linux servers, are investigated. Moreover, a severity characterization is given for each error type. Better understanding of such errors can lead to more efficient analysis of kernel logs that are usually exploited for fault diagnosis and prediction. In addition, this work summarizes ways of simulating hardware errors in RAM and HDD, in order to test the error detection and correction mechanisms of a Linux server.

Keywords: hardware errors, Kernel logs, Linux servers, RAM, hard disk, CPU

Procedia PDF Downloads 123

Authors: Md Shohidul Islam, Jongmyon Kim, Ui-pil Chong

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Medical image is an integral part of e-health care and e-diagnosis system. Medical image watermarking is widely used to protect patients’ information from malicious alteration and manipulation. The watermarked medical images are transmitted over the internet among patients, primary and referred physicians. The images are highly prone to corruption in the wireless transmission medium due to various noises, deflection, and refractions. Distortion in the received images leads to faulty watermark detection and inappropriate disease diagnosis. To address the issue, this paper utilizes error correction code (ECC) with (8, 4) Hamming code in an existing watermarking system. In addition, we implement the high complex ECC on a graphics processing units (GPU) to accelerate and support real-time requirement. Experimental results show that GPU achieves considerable speedup over the sequential CPU implementation, while maintaining 100% ECC efficiency.

Keywords: medical image watermarking, e-health system, error correction, Hamming code, GPU

Procedia PDF Downloads 262

Authors: Samuel Oluwafemi Oyamakin, Angela Unna Chukwu

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Richrads growth equation being a generalized logistic growth equation was improved upon by introducing an allometric parameter using the hyperbolic sine function. The integral solution to this was called hyperbolic Richards growth model having transformed the solution from deterministic to a stochastic growth model. Its ability in model prediction was compared with the classical Richards growth model an approach which mimicked the natural variability of heights/diameter increment with respect to age and therefore provides a more realistic height/diameter predictions using the coefficient of determination (R2), Mean Absolute Error (MAE) and Mean Square Error (MSE) results. The Kolmogorov-Smirnov test and Shapiro-Wilk test was also used to test the behavior of the error term for possible violations. The mean function of top height/Dbh over age using the two models under study predicted closely the observed values of top height/Dbh in the hyperbolic Richards nonlinear growth models better than the classical Richards growth model.

Keywords: height, diameter at breast height, DBH, hyperbolic sine function, Pinus caribaea, Richards' growth model

Procedia PDF Downloads 366

Authors: Saru Arora, Anurag Sharma, Harsukhpreet Singh

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To meet the growing need of high data rate and bandwidth, various efforts has been made nowadays for the efficient communication systems. Optical Code Division Multiple Access over Free space optics communication system seems an effective role for providing transmission at high data rate with low bit error rate and low amount of multiple access interference. This paper demonstrates the OCDMA over FSO communication system up to the range of 7000 m at a data rate of 5 Gbps. Initially, the 8 user OCDMA-FSO system is simulated and pseudo orthogonal codes are used for encoding. Also, the simulative analysis of various performance parameters like power and core effective area that are having an effect on the Bit error rate (BER) of the system is carried out. The simulative analysis reveals that the length of the transmission is limited by the multi-access interference (MAI) effect which arises when the number of users increases in the system.

Keywords: FSO, PSO, bit error rate (BER), opti system simulation, multiple access interference (MAI), q-factor

Procedia PDF Downloads 344

Authors: Sanaa Mekdad, Leenah Alsayed

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Pharmacists play an important role in the CDTM in the care of patients with heart failure (HF). CDTM allows specialized, dedicated clinical pharmacists in a formal agreement in collaborative practice with physicians. Thus, the aim of this study is to investigate the role of cardiology clinical pharmacists in CDTM in decreasing hospitalization and cost. We studied patients with left ventricular systolic dysfunction in a cluster-randomized selection in a tertiary care center. We allocated 296 patients to pharmacist intervention from 1480 patients. Results: With an acceptance rate of 86%, we documented 696 interventions carried out by clinical pharmacists in cardiology. The average intervention was 2.4 patients, and the admission after interventions decreased from 0.79 to. 0.24 (p value = 0.001). Conclusions: In HF CDTM, clinical pharmacists play a crucial role in enhancing medication management, patient education, and lifestyle modification of patients with chronic heart failure. These efforts improve patients' outcomes and lower costs by reducing hospitalization and other associated expenses.

Keywords: cardiology, medication management, heart failure, outpatient therapy, pharmacist-based services, chronic heart failure, heart failure recommendations, CDTM, Middle East, pharmacist-based services, quality of life, pharmacist

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Authors: Juan F. Gutierrez, Jesus M. Quintero, Diego Sandoval

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An important feature of LED technology is the fast on-off commutation, which allows data transmission. Visible Light Communication (VLC) is a wireless method to transmit data with visible light. Modulation formats such as On-Off Keying (OOK) and Color Shift Keying (CSK) are used in VLC. Since CSK is based on three color bands uses red, green, and blue monochromatic LED (RGB-LED) to define a pattern of chromaticities. This type of CSK provides poor color quality in the illuminated area. This work presents the design and implementation of a VLC system using RGB-based CSK with 16, 8, and 4 color points, mixing with a steady baseline of a phosphor white-LED, to improve the color quality of the LED-Fixture. The experimental system was assessed in terms of the Color Rendering Index (CRI) and the Symbol Error Rate (SER). Good color quality performance of the LED-Fixture was obtained with an acceptable SER. The laboratory setup used to characterize and calibrate an LED-Fixture is described.

Keywords: VLC, indoor lighting, color quality, symbol error rate, color shift keying

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Authors: Subhajit Das, Nirjhar Dhang

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Structural damage detection is a challenging work in the field of structural health monitoring (SHM). The damage detection methods mainly focused on the determination of the location and severity of the damage. Model updating is a well known method to locate and quantify the damage. In this method, an error function is defined in terms of difference between the signal measured from ‘experiment’ and signal obtained from undamaged finite element model. This error function is minimised with a proper algorithm, and the finite element model is updated accordingly to match the measured response. Thus, the damage location and severity can be identified from the updated model. In this paper, an error function is defined in terms of modal data viz. frequencies and modal assurance criteria (MAC). MAC is derived from Eigen vectors. This error function is minimized by teaching-learning-based optimization (TLBO) algorithm, and the finite element model is updated accordingly to locate and quantify the damage. Damage is introduced in the model by reduction of stiffness of the structural member. The ‘experimental’ data is simulated by the finite element modelling. The error due to experimental measurement is introduced in the synthetic ‘experimental’ data by adding random noise, which follows Gaussian distribution. The efficiency and robustness of this method are explained through three examples e.g., one truss, one beam and one frame problem. The result shows that TLBO algorithm is efficient to detect the damage location as well as the severity of damage using modal data.

Keywords: damage detection, finite element model updating, modal assurance criteria, structural health monitoring, teaching learning based optimization

Procedia PDF Downloads 188

Authors: Mohaammad Ahmadpanah, Amineh Akhondi, Mohammad Haghighi, Ali Ghaleiha, Leila Jahangard, Elham Salari

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Background: Working memory includes the capability to keep and manipulate information in a short period of time. This capability is the basis of complicated judgments and has been attended to as the specific and constant character of individuals. Children with attention deficit and hyperactivity are among the people suffering from deficiency in the active memory, and this deficiency has been attributed to the problem of frontal lobe. This study utilizes a new approach with suitable tasks and methods for training active memory and assessment of the effects of the trainings. Participants: The children participating in this study were of 7-15 year age, who were diagnosed by the psychiatrist and psychologist as hyperactive and attention deficit based on DSM-IV criteria. The intervention group was consisted of 8 boys and 6 girls with the average age of 11 years and standard deviation of 2, and the control group was consisted of 2 girls and 5 boys with an average age of 11.4 and standard deviation of 3. Three children in the test group and two in the control group were under medicinal therapy. Results: Working memory training meaningfully improved the performance in not-trained areas as visual-spatial working memory as well as the performance in Raven progressive tests which are a perfect example of non-verbal, complicated reasoning tasks. In addition, motional activities – measured based on the number of head movements during computerized measuring program – was meaningfully reduced in the medication group. The results of the second test showed that training similar exercise to teenagers and adults results in the improvement of cognition functions, as in hyperactive people. Discussion: The results of this study showed that the performance of working memory is improved through training, and these trainings are extended and generalized in other areas of cognition functions not receiving any training. Trainings resulted in the improvement of performance in the tasks related to prefrontal. They had also a positive and meaningful impact on the moving activities of hyperactive children.

Keywords: attention deficit hyperactivity disorder, working memory, non-medical treatment, children

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Authors: Chor Nejmeddine, Ines Ben Omrane, Mohamed Abdelwahed

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In this paper, we present a posteriori analysis of the discretization of the heat equation by spectral element method. We apply Euler's implicit scheme in time and spectral method in space. We propose two families of error indicators, both of which are built from the residual of the equation and we prove that they satisfy some optimal estimates. We present some numerical results which are coherent with the theoretical ones.

Keywords: heat equation, spectral elements discretization, error indicators, Euler

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Authors: Andrew Anis Fakhrey Mosaad

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The goal of this study is to compare the efficacy of polarised light therapy with low-intensity laser therapy in treating oral mucositis brought on by chemotherapy in cancer patients. Evaluation procedures are the measurement of the WHO oral mucositis scale and the Common toxicity criteria scale. Techniques: Cancer patients (men and women) who had oral mucositis, ulceration, and discomfort and whose ages varied from 30 to 55 years were separated into two groups and received 40 chemotherapy treatments. Twenty patients in Group (A) received low-level laser therapy (LLLT) along with their regular oral mucositis medication treatment, while twenty patients in Group (B) received Bioptron light therapy (BLT) along with their regular oral mucositis medication treatment. Both treatments were applied for 10 minutes each day for 30 days. Conclusion and results: This study showed that the use of both BLT and LLLT on oral mucositis in cancer patients following chemotherapy greatly improved, as seen by the sharp falls in both the WHO oral mucositis scale (OMS) and the common toxicity criteria scale (CTCS). However, low-intensity laser therapy (LLLT) was superior to Bioptron light therapy in terms of benefits (BLT).

Keywords: Bioptron light therapy, low level laser therapy, oral mucositis, WHO oral mucositis scale, common toxicity criteria scale

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Authors: Anupam Sibal

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Apollo Quality Program(AQP) was launched across the Apollo Group of Hospitals to address the four patient safety areas; Safety during Clinical Handovers, Medication Safety, Surgical Safety and the six International Patient Safety Goals(IPSGs) of JCI. A measurable, online, quality dashboard covering 20 process and outcome parameters was devised for monthly monitoring. The expected outcomes were also defined and categorized into green, yellow and red ranges. An audit methodology was also devised to check the processes for the measurable dashboard. Documented clinical handovers were introduced for the first time at many locations for in-house patient transfer, nursing-handover, and physician-handover. Prototype forms using the SBAR format were made. Patient-identifiers, read-back for verbal orders, safety of high-alert medications, site marking and time-outs and falls risk-assessment were introduced for all hospitals irrespective of accreditation status. Measurement of Surgical-Site-Infection (SSI) for 30 days postoperatively, was done. All hospitals now tracked the time of administration of antimicrobial prophylaxis before surgery. Situations with high risk of retention of foreign body were delineated and precautionary measures instituted. Audit of medications prescribed in the discharge summaries was made uniform. Formularies, prescription-audits and other means for reduction of medication errors were implemented. There is a marked increase in the compliance to processes and patient safety outcomes. Compliance to read-back for verbal orders rose from 86.83% in April’11 to 96.95% in June’15, to policy for high alert medications from 87.83% to 98.82%, to use of measures to prevent wrong-site, wrong-patient, wrong procedure surgery from 85.75% to 97.66%, to hand-washing from 69.18% to 92.54%, to antimicrobial prophylaxis within one hour before incision from 79.43% to 93.46%. Percentage of patients excluded from SSI calculation due to lack of follow-up for the requisite time frame decreased from 21.25% to 10.25%. The average AQP scores for all Apollo Hospitals improved from 62 in April’11 to 87.7 in Jun’15.

Keywords: clinical handovers, international patient safety goals, medication safety, surgical safety

Procedia PDF Downloads 235

Authors: Ahmed A. Abd El Rahim, Andrew Anis Fakhrey Mosaad

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Background: An important psychological issue that has an impact on both mental and physical function is anxiety disorders. The general consensus is that aerobic exercise and physical activity are good for lowering anxiety and mood. Purpose: This study's goal was to look into how patients with anxiety disorders responded to aerobic exercise. Subjects: Anxiety disorders were identified in 30 individuals from the psychiatric hospital at Sohag University who were chosen based on inclusive criteria and had ages ranging from 25 to 45. Methods: Patients were split into two equal groups at random: For four weeks, three sessions per week, fifteen patients in group A (the study group), seven men and eight women, underwent medication therapy and aerobic exercise. Age (28.4 ± 2.11 years), weight (72.5 ± 10.06 kg), height (164.8 ± 9.64 cm), and BMI (26.65 ± 2.68 kg/m2) were all mean SD values. And in Group B (Control Group), only medication therapy was administered to 15 patients (9 males and 6 females). Age (29.6 ± 3.68), weight (75 ± 7.07 kg), height (166.9 ± 6.75) cm, and BMI (26.87 ± 1.11) kg/m2 were the mean SD values. Before and after the treatment, the Hamilton Anxiety Scale was used to gauge the patient's degree of anxiety. Results: Within the two groups, there were significant differences both before and after the treatment. Following therapy, there was a significant difference between the two groups; the study group displayed better improvement on the Hamilton Anxiety Scale. Conclusion: Patients with anxiety problems can benefit from aerobic activities and antianxiety drugs as effective treatments for lowering anxiety levels.

Keywords: aerobic exercises, anxiety disorders, antianxiety medications, Hamilton anxiety scale

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Authors: Alaa Abdullah Altaee

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This paper presents an adaptive decision feedback equalizer (ADFE) for multi-Gbps serial links utilizing a fix-step error signal extracted from cross-points of received data symbols. The extracted signal is generated based on violation of received data symbols with minimum detection requirements at the clock and data recovery (CDR) stage. The iterations of the adaptation process search for the optimum feedback tap coefficients to maximize the data eye-opening and minimize the adaptation convergence time. The effectiveness of the proposed architecture is validated using the simulation results of a serial link designed in an IBM 130 nm 1.2V CMOS technology. The data link with variable channel lengths is analyzed using Spectre from Cadence Design Systems with BSIM4 device models.

Keywords: adaptive DFE, CMOS equalizer, error detection, serial links, timing jitter, wire-line communication

Procedia PDF Downloads 89

Authors: Hechmi Saidi, Noureddine Hamdi

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The performance of hybrid amplify and forward - decode and forward (AF-DF) hybrid radio frequency/free space optical (RF/FSO) communication system, that adopts M-ary pulse position modulation (MPPM) techniques, is analyzed. Both exact and approximate symbol-error rates (SERs) are derived. The random variations of the received optical irradiance, produced by the atmospheric turbulence, is modeled by the gamma-gamma (GG) statistical distribution. A closed-form expression for the probability density function (PDF) is derived for the whole above system is obtained. Thanks to the use of hybrid AF-DF hybrid RF/FSO configuration and MPPM, the effects of atmospheric turbulence is mitigated; hence the capacity of combating atmospheric turbulence and the transmissitted signal quality are improved.

Keywords: free space optical, gamma gamma channel, radio frequency, decode and forward, error pointing, M-ary pulse position modulation, symbol error rate

Procedia PDF Downloads 255

Authors: Jaechoul Shin, Juhwan Hwang

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In case of applying the BIM method to the civil engineering in the area of free formed structure, we can expect comparatively high rate of construction productivity as it is in the building engineering area. In this research, we developed quantity calculation error applying it to earthwork and bridge construction (e.g. PSC-I type segmental girder bridge amd integrated bridge of steel I-girders and inverted-Tee bent cap), NATM (New Austrian Tunneling Method) tunnel construction, retaining wall construction, culvert construction and implemented BIM based 3D modeling quantity survey. we confirmed high reliability of the BIM-based method in structure work in which errors occurred in range between -6% ~ +5%. Especially, understanding of the problem and improvement of the existing 2D-CAD based of quantity calculation through rock type quantity calculation error in range of -14% ~ +13% of earthwork quantity calculation. It is benefit and applicability of BIM method in civil engineering. In addition, routine method for quantity of earthwork has the same error tolerance negligible for that of structure work. But, rock type's quantity calculated as the error appears significantly to the reliability of 2D-based volume calculation shows that the problem could be. Through the estimating quantity of earthwork based 3D-BIM, proposed method has better reliability than routine method. BIM, as well as the design, construction, maintenance levels of information when you consider the benefits of integration, the introduction of BIM design in civil engineering and the possibility of applying for the effectiveness was confirmed.

Keywords: BIM, 3D modeling, 3D-BIM, quantity of earthwork

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Authors: Chen-Yin Kuo, Yung-Hsin Lee

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Previous studies applying residual income valuation (RIV) model generally use panel data and single-equation model to forecast stock prices. Unlike these, this paper uses Taiwan longitudinal data to estimate multi-equation time-series models such as Vector Autoregressive (VAR), Vector Error Correction Model (VECM), and conduct out-of-sample forecasting. Further, this work assesses their forecasting performance by two instruments. In favor of extant research, the major finding shows that VECM outperforms other three models in forecasting for three stock sectors over entire horizons. It implies that an error correction term containing long-run information contributes to improve forecasting accuracy. Moreover, the pattern of composite shows that at longer horizon, VECM produces the greater reduction in errors, and performs substantially better than VAR.

Keywords: residual income valuation model, vector error correction model, out of sample forecasting, forecasting accuracy

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Authors: Andrey V. Timofeev, Dmitry V. Egorov

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This paper introduces an original method of parametric optimization of the structure for multimodal decision-level fusion scheme which combines the results of the partial solution of the classification task obtained from assembly of the mono-modal classifiers. As a result, a multimodal fusion classifier which has the minimum value of the total error rate has been obtained.

Keywords: classification accuracy, fusion solution, total error rate, multimodal fusion classifier

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Authors: Krishang Surapaneni

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The goal of this project is to determine how to predict important aspects of options, including the ask price. We want to compare different machine learning models to learn the best model and the best hyperparameters for that model for this purpose and data set. Option pricing is a relatively new field, and it can be very complicated and intimidating, especially to inexperienced people, so we want to create a machine learning model that can predict important aspects of an option stock, which can aid in future research. We tested multiple different models and experimented with hyperparameter tuning, trying to find some of the best parameters for a machine-learning model. We tested three different models: a Random Forest Regressor, a linear regressor, and an MLP (multi-layer perceptron) regressor. The most important feature in this experiment is the ask price; this is what we were trying to predict. In the field of stock pricing prediction, there is a large potential for error, so we are unable to determine the accuracy of the models based on if they predict the pricing perfectly. Due to this factor, we determined the accuracy of the model by finding the average percentage difference between the predicted and actual values. We tested the accuracy of the machine learning models by comparing the actual results in the testing data and the predictions made by the models. The linear regression model performed worst, with an average percentage error of 17.46%. The MLP regressor had an average percentage error of 11.45%, and the random forest regressor had an average percentage error of 7.42%

Keywords: finance, linear regression model, machine learning model, neural network, stock price

Procedia PDF Downloads 54

Authors: Fagner Luiz P. Salles, Janaina C. Oliveira, Ivair P. Cesar

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Statement of the Problem: Auriculotherapy (AT) is a TCM technique, which uses seeds instead of needles, based physiologically on the mechanical stimulation of the cranial nerves. In the context of understanding the new concept of health of the WHO, the AT is an integrative approach for achieving Global Health Care so as to achieve the global health care concerns. This study aimed to evaluate the effect of auriculotherapy on pain and sleep quality in patients with chronic pain. Methodology and Theoretical Orientation: This study was performed between February and March 2017 at the Faculdade Estácio de Sá de Vitória, Brazil. The pain evaluation was through VAS in 4 periods: maximum, minimum, average and at the time of evaluation; the evaluation of sleep quality was used the Pittsburgh Sleep Quality Index. Socio-demographic data included: gender, age, use of medication and BMI. All data are presented as mean (standard deviation), Teste Mann-Whitney and T-student with P-values < 0.05 were regarded as significant. Findings: Participated in this study thirty-two individuals with age (M = 43.18, SD = 17.86), the time with pain in years (M = 3.67, SD = 3.68), 81.7% were female, 75% of the individuals used medication and BMI (M = 26.67; SD = 6.20). The pain presented improvement in the maximum level and the average of the pain and sleep quality before did not have statistically significant results. Conclusion and Significance: This study showed that TA is efficacy for reduction levels of pain. However, AT was not effective in improving sleep quality.

Keywords: auriculotherapy, chronic pain, sleep quality, integrative approach

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Authors: Ju-Hong Lee, Ching-Wei Liao

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Owing to close antenna spacing between antenna sensors within a compact space, a part of data in one antenna sensor would outflow to other antenna sensors when the antenna sensors in an antenna array operate simultaneously. This phenomenon is called mutual coupling effect (MCE). It has been shown that the performance of antenna array systems can be degraded when the antenna sensors are in close proximity. Especially, in a systems equipped with massive antenna sensors, the degradation of beamforming performance due to the MCE is significantly inevitable. Moreover, it has been shown that even a small angle error between the true direction angle of the desired signal and the steering angle deteriorates the effectiveness of an array beamforming system. However, the true direction vector of the desired signal may not be exactly known in some applications, e.g., the application in land mobile-cellular wireless systems. Therefore, it is worth developing robust techniques to deal with the problem due to the MCE and steering angle error for array beamforming systems. In this paper, we present an efficient technique for performing adaptive beamforming with robust capabilities against the MCE and the steering angle error. Only the data vector received by an antenna array is required by the proposed technique. By using the received array data vector, a correlation matrix is constructed to replace the original correlation matrix associated with the received array data vector. Then, the mutual coupling matrix due to the MCE on the antenna array is estimated through a recursive algorithm. An appropriate estimate of the direction angle of the desired signal can also be obtained during the recursive process. Based on the estimated mutual coupling matrix, the estimated direction angle, and the reconstructed correlation matrix, the proposed technique can effectively cure the performance degradation due to steering angle error and MCE. The novelty of the proposed technique is that the implementation procedure is very simple and the resulting adaptive beamforming performance is satisfactory. Simulation results show that the proposed technique provides much better beamforming performance without requiring complicated complexity as compared with the existing robust techniques.

Keywords: adaptive beamforming, mutual coupling effect, recursive algorithm, steering angle error

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Authors: Xiang Zhang, David Rey, S. Travis Waller

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Stochastic User Equilibrium (SUE) model is a widely used traffic assignment model in transportation planning, which is regarded more advanced than Deterministic User Equilibrium (DUE) model. However, a problem exists that the performance of the SUE model depends on its error term parameter. The objective of this paper is to propose a systematic method of determining the appropriate error term parameter value for the SUE model. First, the significance of the parameter is explored through a numerical example. Second, the parameter calibration method is developed based on the Logit-based route choice model. The calibration process is realized through multiple nonlinear regression, using sequential quadratic programming combined with least square method. Finally, case analysis is conducted to demonstrate the application of the calibration process and validate the better performance of the SUE model calibrated by the proposed method compared to the SUE models under other parameter values and the DUE model.

Keywords: parameter calibration, sequential quadratic programming, stochastic user equilibrium, traffic assignment, transportation planning

Procedia PDF Downloads 263

Authors: Mohd Taufiq bin Azmy, Yahaya Hassan, Shubashini Gnanasan, Loganathan Fahrni

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Inappropriate prescribing in older patients has been associated with resource utilization and adverse drug events (ADE) such as hospitalization, morbidity and mortality. Globally, there is a lack of published data on ADE induced by inappropriate prescribing. Our study is specific to an older population and is aimed at identifying risk factors for ADE and to develop a model that will link ADE to inappropriate prescribing. The design of the study was prospective whereby computerized medical records of 302 hospitalized elderly aged 65 years and above in 3 public hospitals in Malaysia (Hospital Serdang, Hospital Selayang and Hospital Sungai Buloh) were studied over a 7 month period from September 2013 until March 2014. Potentially inappropriate medications and potential prescribing omissions were determined using the published and validated START-STOPP criteria. Patients who had at least one inappropriate medication were included in Phase II of the study where ADE were identified by local expert consensus panel based on the published and validated Naranjo ADR probability scale. The panel also assessed whether ADE were causal or contributory to current hospitalization. The association between inappropriate prescribing and ADE (hospitalization, mortality and adverse drug reactions) was determined by identifying whether or not the former was causal or contributory to the latter. Rate of ADE avoidability was also determined. Our findings revealed that the prevalence of potential inappropriate prescribing was 58.6%. A total of ADEs were detected in 31 of 105 patients (29.5%) when STOPP criteria were used to identify potentially inappropriate medication; All of the 31 ADE (100%) were considered causal or contributory to admission. Of the 31 ADEs, 28 (90.3%) were considered avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when a potentially inappropriate medication was prescribed (odds ratio, 11.18; 95% confidence interval [CI], 5.014 - 24.93; p < .001). The medications identified by STOPP criteria, are significantly associated with avoidable ADE in older people that cause or contribute to urgent hospitalization but contributed less towards morbidity and mortality. Findings of the study underscore the importance of preventing inappropriate prescribing.

Keywords: adverse drug events, appropriate prescribing, health services research

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Authors: Rujijan Vichivanives

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This research aims to create a knowledge-based system as a database for self-healthcare analysis, diagnosis of simple illnesses, and the use of Thai herbs instead of modern medicine by using principles of Thai traditional medication theory. These were disseminated by website network programs within Suan Sunandha Rajabhat University. The population used in this study was divided into two groups: the first group consisted of four experts of Thai traditional medication and the second group was 300 website users. The methods used for collecting data were paper questionnaires and poll questionnaires on the website. The statistics used for analyzing data was at an average level. The results were divided into three parts: the first part was the development of a knowledge-based system and the second part was applied programs on website. Both parts could be fulfilled and achieved according to the set goal. The third part was the evaluation of the study: The evaluation of the viewpoints of the experts towards website designs were evaluated at a good level of 4.20. The satisfaction evaluation of the users was found at a good level of average satisfactory level at 4.24. It was found that the young population of those under the age of 16 had less cares about their health than the population of other teenagers, working age adults and those of older age. The research findings should be extended in order to encourage the lifestyle modifications to people of all ages by using the self-healthcare principles.

Keywords: developing, herbs, knowledge-based system, medical treatment

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Authors: Akbar Darouie, Mamak Joulaie

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In regard of phonological skills development importance and its influence on other aspects of language, this study has been performed. Determination of some phonological indexes in children with hearing impairment and comparison with hearing children was the objective. A sample of convenience was selected from a rehabilitation center and a kindergarten in Karaj, Iran. Participants consisted of 12 hearing impaired and 12 hearing children (age range: 5 years and 6 months to 6 years and 6 months old). Hearing impaired children suffered from severe to profound hearing loss while three of them were cochlear implanted and the others were wearing hearing aids. Conversational speech of these children was recorded and 50 first utterances were selected to analyze. Percentage of consonant correct (PCC) and vowel correct (PVC), initial and final consonant omission error, cluster consonant omission error and syllabic structure variety were compared in two groups. Data were analyzed with t test (version 16th SPSS). Comparison between PCC and PVC averages in two groups showed a significant difference (P< 0/01). There was a significant difference about final consonant emission error (P<0/001) and initial consonant emission error (P<0/01) too. Also, the differences between two groups on cluster consonant omission were significant (P<0/001). Therefore, some changes were seen in syllabic structures in children with hearing impairment compared to typical group. This study demonstrates some phonological differences in Farsi language between two groups of children. Therefore, it seems, in clinical practices we must notice this issue.

Keywords: hearing impairment, phonology, vowel, consonant

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Authors: Theodore Grosch, Felipe Koji Godinho Hoshino

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In wireless communications, 3GPP LTE is one of the solutions to meet the greater transmission data rate demand. One issue inherent to this technology is the PAPR (Peak-to-Average Power Ratio) of OFDM (Orthogonal Frequency Division Multiplexing) modulation. This high PAPR affects the efficiency of power amplifiers. One approach to mitigate this effect is the Crest Factor Reduction (CFR) technique. In this work, we simulate the impact of Hard Limited Clipping Crest Factor Reduction technique on BER (Bit Error Rate) in OFDM based Systems. In general, the results showed that CFR has more effects on higher digital modulation schemes, as expected. More importantly, we show the worst-case degradation due to CFR on QPSK, 16QAM, and 64QAM signals in a linear system. For example, hard clipping of 9 dB results in a 2 dB increase in signal to noise energy at a 1% BER for 64-QAM modulation.

Keywords: bit error rate, crest factor reduction, OFDM, physical layer simulation

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Authors: E. Ghayoula, M. Haj Taieb, A. Bouallegue, J. Y. Chouinard, R. Ghayoula

Abstract:

This paper evaluates the bit error rate (BER) performance of MIMO systems for wireless communication. MIMO uses multiple transmitting antennas, multiple receiving antennas and the space-time block codes to provide diversity. MIMO transmits signal encoded by space-time block (STBC) encoder through different transmitting antennas. These signals arrive at the receiver at slightly different times. Spatially separated multiple receiving antennas are employed to provide diversity reception to combat the effect of fading in the channel. This paper presents a detailed study of diversity coding for MIMO systems. STBC techniques are implemented and simulation results in terms of the BER performance with varying number of MIMO transmitting and receiving antennas are presented. Our results show how increasing the number of both transmit and receive antenna improves system performance and reduces the bit error rate.

Keywords: MIMO systems, diversity, BER, MRRC, SIMO, MISO, STBC, alamouti, SNR

Procedia PDF Downloads 467

Authors: Nana Benma Osei

Abstract:

Patient discharge can be a hectic process. Patients are sometimes sent to the wrong location or forgotten in lounges in the waiting room. This ends up compromising patient care because the delay in picking the patients can affect how they adhere to medication. Patients may fail to take their medication, and this will lead to negative outcomes. The situation highlights the demands of modern-day healthcare, and the use of technology can help in reducing such challenges and in enhancing the patient’s experience, leading to greater satisfaction with the care provided. The paper contains the proposed changes to a healthcare facility by introducing the clinical decision support system, which will be needed to improve coordination and communication during patient discharge. This will be done under Kurt Lewin’s Change Management Model, which recognizes the different phases in the change process. A pilot program is proposed initially before the program can be implemented in the entire organization. This allows for the identification of challenges and ways of managing them. The paper anticipates some of the possible challenges that may arise during implementation, and a multi-disciplinary approach is considered the most effective. Opposition to the change is likely to arise because staff members may lack information on how the changes will affect them and the skills they will need to learn to use the new system. Training will occur before the technology can be implemented. Every member will go for training, and adequate time is allocated for training purposes. A comparison of data will determine whether the project has succeeded.

Keywords: patient discharge, clinical decision support system, communication, collaboration

Procedia PDF Downloads 72

Authors: Christine Eickhoff, Alyssa Adams, Alaine Duncan

Abstract:

The Washington, DC Veterans Affairs Medical Center (DC VAMC) offers complementary and integrative health (CIH) services such as acupuncture, yoga, meditation, and nutrition education through a coordinated outpatient clinic. The primary population utilizing CIH services are veterans with chronic pain. Acupuncture is one of the most popular of the CIH services available at the DC VAMC. As interest and availability grows, it is important to measure health outcomes associated with CIH service utilization. The purpose of this study was to investigate pain and mental health outcomes for veterans with chronic pain enrolled in individual acupuncture services in the DC VAMC. Veterans at the DC VAMC with self-identified chronic pain and no prior acupuncture experience were recruited for the study (n=70). Veterans were referred for services by a medical provider and completed baseline assessments at the program orientation prior to participating in any CIH services. Veterans received four individual, full-body acupuncture appointments within four weeks of study enrollment. After the first month, participants were scheduled for six appointments that occurred every two weeks and then eight more sessions that were scheduled one month apart. Follow-up assessments were administered at 2, 4, 6, 8, and 12 months. The findings reported will include completed time points at two and four months. Measures include a demographics survey, the Measure Yourself Medical Outcome Profile-2 (MYMOP-2), The Beck Depression Inventory (BDI-II), the Defense Veterans Pain Rating Scale (DVPRS), and the Pain Disability Questionnaire (PDQ). In this sample, 67% identified a pain condition as their primary health concern. Between baseline and two-month follow-up, there were significant improvements in participants’ primary health concern (MYMOP-2 p=0.010), general wellbeing (MYMOP-2 p=0.011), and a significant decrease in the use of medication (MYMOP-2 p<0.000). Between 2 and 4-month follow-up, pain disability (PDQ p=0.035), pain rating (DVPRS p=0.027), and depression (BDI-II p=0.003) significantly improved. Preliminary findings indicate that individual acupuncture therapy can be effective at improving health outcomes, well-being, and decreasing medication use in U.S. military veterans with chronic pain. Findings also suggest that individual acupuncture therapy can improve pain ratings, pain disability, and depression in veterans with chronic pain.

Keywords: acupuncture, chronic pain, depression, integrative health, medication use, military, pain, veterans, wellbeing

Procedia PDF Downloads 232

Authors: Marwa A. Nasser

Abstract:

This is an empirical study that provides an investigation of the most significant errors of Egyptian learners in producing English consonants and Arabic consonants, and advice on how these can be remedied. The study adopts a descriptive approach and the analysis is based on audio recordings of two groups of people. The first group includes six volunteers of Egyptian learners belonging to the English Department at Faculty of Women who learn English as a foreign language. The other group includes six Egyptian learners who are studying Tajweed (how to recite Quran correctly). The audio recordings were examined, and sounds were analyzed in an attempt to highlight the most common error done by the learners while reading English or reading (or reciting) Quran. Results show that the two groups of learners have problems with certain phonemic contrasts. Both groups share common errors although both languages are different and not related (e.g. pre-aspiration of fortis stops, incorrect articulation of consonants and velarization of certain sounds).

Keywords: consonant articulations, Egyptian learners of English, Egyptian learners of Quran, empirical study, error analysis, pronunciation problems

Procedia PDF Downloads 244