Search results for: orthopedic procedure

Authors: Guilherme Gomes, Jose Lebre de Freitas

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The rules of Civil Procedure that are defined in the Portuguese Civil Procedure Code of 2013 particularly their articles 552 to 626- represent the model that the legislator thought that would be more suitable for national civil litigation, from the moment the action is brought by the plaintiff to the moment when the sentence is issued. However, procedural legalism is no longer a reality in the Portuguese Civil Procedural Law. According to the article 547 of the code of 2013, the civil judge has a duty to adopt the procedure that better suits the circumstances of the case, whether or not it is the one defined by law. The main goal of our paper is to answer the question whether the formal adequation imposed by this article diminishes the importance of the Portuguese rules of Civil Procedure and their daily application by national civil judges. We will start by explaining the appearance of the abovementioned rules in the Civil Procedure Code of 2013. Then we will analyse, using specific examples that were obtained by the books we read, how the legal procedure defined in the abovementioned code does not suit the circumstances of some specific cases and is totally inefficient in some situations. After that, we will, by using the data obtained in the practical research that we are conducting in the Portuguese civil courts within the scope of our Ph.D. thesis (until now, we have been able to consult 150 civil lawsuits), verify whether and how judges and parties make the procedure more efficient and effective in the case sub judice. In the scope of our research, we have already reached some preliminary findings: 1) despite the fact that the legal procedure does not suit the circumstances of some civil lawsuits, there are only two situations of frequent use of formal adequation (the judge allowing the plaintiff to respond to the procedural exceptions deduced in the written defense and the exemption from prior hearing for the judges who never summon it), 2) the other aspects of procedural adequation (anticipation of the production of expert evidence, waiving of oral argument at the final hearing, written allegations, dismissal of the dispatch on the controversial facts and the examination of witnesses at the domicile of one of the lawyers) are still little used and 3) formal adequation tends to happen by initiative of the judge, as plaintiffs and defendants are afraid of celebrating procedural agreements in most situations. In short, we can say that, in the Portuguese legal order of the 21st century, the flexibility of the legal procedure, as it is defined in the law and applied by procedural subjects, does not affect the importance of the rules of Civil Procedure of the code of 2013.

Keywords: casuistic adequation, civil procedure code of 2013, procedural subjects, rules of civil procedure

Procedia PDF Downloads 102

Authors: T. Giansetto, E. Pierrot, P. Picavet, M. Lefebvre, S. Claeys, M. Balligand

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Objective: To test the low sensitivity of the Allberg and Miles index to the stifle opening angle, to evaluate the displacement of the patella after a Modified Maquet Technique using this index, and to assess the incidence of patella luxation post-Modified Maquet Technique in dogs. Materials and methods: Medical records were reviewed from 2012 to 2017. Allberg Miles index was determined for each stifle pre and post-operatively, as well as the stifle joint opening of each case. The occurrence of patella luxation was recorded. Results: 137 stifles on 116 dogs were reviewed. The stifle opening angle did not influence the Allberg Miles index (p=0.41). Pre and post-operative index showed a distal displacement of the patella after a Modified Maquet Procedure, especially at a 90° of stifle opening angle. Only 1/137 cases demonstrated patella luxation after the surgery. Conclusion: The Allberg Miles radiographic index is largely independent of the stifle opening angle and can be used to assess the proximo-distal position of the patella in relation to the femoral trochlear groove. If patella baja is clearly induced by the Modified Maquet Technique, the latter does not seem to predispose patients to post-operative patella luxation in a large variety of dog breeds.

Keywords: rlca, modified Maquet technique, patella luxation, orthopedic

Procedia PDF Downloads 94

Authors: A. Razavykia, A. Esmaeilzadeh, S. Iranmanesh

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Many orthopedic implants like proximal humerus cases require lower surface roughness and almost immediate/short lead time surgery. Thus, rapid response from the manufacturer is very crucial. Tool path strategy of milling process has a direct influence on the surface roughness and lead time of medical implant. High-speed milling as promised process would improve the machined surface quality, but conventional or super-abrasive grinding still required which imposes some drawbacks such as additional costs and time. Currently, many CAD/CAM software offers some different tool path strategies to milling free form surfaces. Nevertheless, the users must identify how to choose the strategies according to cutting tool geometry, geometry complexity, and their effects on the machined surface. This study investigates the effect of different tool path strategies for milling a proximal humerus head during finishing operation on stainless steel 316L. Experiments have been performed using MAHO MH700 S vertical milling machine and four machining strategies, namely, spiral outward, spiral inward, and radial as well as zig-zag. In all cases, the obtained surfaces were analyzed in terms of roughness and dimension accuracy compared with those obtained by simulation. The findings provide evidence that surface roughness, dimensional accuracy, and machining time have been affected by the considered tool path strategy.

Keywords: CAD/CAM software, milling, orthopedic implants, tool path strategy

Procedia PDF Downloads 190

Authors: Rahma Fitriani, Zerlita Fahdha Pusdiktasari, Herman Cahyo Diartho

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Spatial panel model is commonly used to specify more complicated behavior of economic agent distributed in space at an individual-spatial unit level. There are several spatial panel models which can be adapted based on certain assumptions. A package called splm in R has several functions, ranging from the estimation procedure, specification tests, and model selection tests. In the absence of prior assumptions, a comprehensive procedure which utilizes the available functions in splm must be formed, which is the objective of this study. In this way, the best specification and model can be fitted based on data. The implementation of the procedure works well. It specifies SARAR-FE as the best model for agricultural productivity growth of the 38 East Java’s Regencies/Municipalities.

Keywords: spatial panel, specification, splm, agricultural productivity growth

Procedia PDF Downloads 146

Authors: Abdelfatah Elsenosy, Mahmoud Ebrahim

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Background: Distal radius fractures are commonly encountered in orthopedic practice, especially in elderly patients. A number of clinical papers have supported the idea that anatomic restoration of the distal end of the radius is essential to gain superior results. Aim and objectives: The aim of the study is to systematically review the literature for the management of distal end radius in elderly persons (conservative treatment versus percutaneous wire fixation) as regards radiological and functional outcomes. Subjects and methods: Studies were identified from the Medline, Cochrane, EMBASE, and Google Scholar databases were searched until 2019 using combinations of the following search terms: distal radius fracture, conservative treatment, non-operative treatment, and nonsurgical treatment, surgical treatment, operative, elderly, and older. Reference lists of relevant studies were manually searched. Results: There was no statistical significance difference between CI and PKF groups’ frequency of complication in all of the selected studies. Based on the results, we recommend more analysis regarding every parameter of the radiographic and functional results and specific complications related to each fixation need to be accomplished, which requires more Randomized controlled trials (RCTs) with high quality. Conclusion: Surgical treatment seems to be more effective distal radius fracture compared with conservative treatment when the radiographic outcomes were analyzed, and no significant differences were detected in the functional outcomes and complication rate.

Keywords: radius, fracture, surgical, RCTs, conservative, radiographic, outcomes, orthopedic

Procedia PDF Downloads 126

Authors: V. Schmidt, L. Janovák, N. Wiegand, B. Patczai, K. Turzó

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Large bone defects are not able to heal spontaneously. Bioactive glasses seem to be appropriate (bio)materials for bone reconstruction. Bioactive glasses are osteoconductive and osteoinductive, therefore, play a useful role in bony regeneration and repair. Because of their not optimal mechanical properties (e.g., brittleness, low bending strength, and fracture toughness), their applications are limited. Bioactive glass can be used as a coating material applied on metal surfaces. In this way -when using them as implants- the excellent mechanical properties of metals and the biocompatibility and bioactivity of glasses will be utilized. Furthermore, ion release effects of bioactive glasses regarding osteogenic and angiogenic responses have been shown. Silicate bioactive glasses (45S5 Bioglass) induce the release and exchange of soluble Si, Ca, P, and Na ions on the material surface. This will lead to special cellular responses inducing bone formation, which is favorable in the biointegration of the orthopedic prosthesis. The incorporation of other additional elements in the silicate network such as fluorine, magnesium, iron, silver, potassium, or zinc has been shown, as the local delivery of these ions is able to enhance specific cell functions. Although hip and knee prostheses present a high success rate, bacterial infections -mainly implant associated- are serious and frequent complications. Infection can also develop after implantation of hip prostheses, the elimination of which means more surgeries for the patient and additional costs for the clinic. Prosthesis-related infection is a severe complication of orthopedic surgery, which often causes prolonged illness, pain, and functional loss. While international efforts are made to reduce the risk of these infections, orthopedic surgical infections (SSIs) continue to occur in high numbers. It is currently estimated that up to 2.5% of primary hip and knee surgeries and up to 20% of revision arthroplasties are complicated by periprosthetic joint infection (PJIs). According to some authors, these numbers are underestimated, and they are also increasing. Staphylococcus aureus is the leading cause of both SSIs and PJIs, and the prevalence of methicillin-resistant S. aureus (MRSA) is on the rise, particularly in the United States. These deep infections lead to implant removal and consequently increase morbidity and mortality. The study targets this clinical problem using our experience so far with the Ag-doped polymer coatings on Titanium implants. Non-modified or modified (e.g., doped with antibacterial agents, like Ag) bioactive glasses could play a role in the prevention of infections or the therapy of infected tissues. Bioactive glasses have excellent biocompatibility, proved by in vitro cell culture studies of human osteoblast-like MG-63 cells. Ag-doped bioactive glass-scaffold has a good antibacterial ability against Escherichia coli and other bacteria. It may be concluded that these scaffolds have great potential in the prevention and therapy of implant-associated bone infection.

Keywords: antibacterial agents, bioactive glass, hip and knee prosthesis, medical implants

Procedia PDF Downloads 152

Authors: Hayder Shanbara, Felicite Ruddock, William Atherton, Ali Al-Rifaie

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In highways construction, Hot Mix Asphalt (HMA) is used predominantly as a paving material from many years. Around 90 percent of the world road network is laid by flexible pavements. However, there are some restrictions on paving hot mix asphalt such as immoderate greenhouse gas emission, rainy season difficulties, fuel and energy consumption and cost. Therefore, Cold Bitumen Emulsion Mixture (CBEM) is considered an alternative mix to the HMA. CBEM is the popular type of Cold Mix Asphalt (CMA). It is unheated emulsion, aggregate and filler mixtures, which can be prepared and mixed at ambient temperature. This research presents a simple and more practicable design procedure of CBEM and discusses limitations of this design. CBEM is a mixture of bitumen emulsion and aggregates that mixed and produced at ambient temperature. It is relatively easy to produce, but the design procedure that provided by Asphalt Institute (Manual Series 14 (1989)) pose some issues in its practical application.

Keywords: cold bitumen, emulsion mixture, design procedure, pavement

Procedia PDF Downloads 221

Authors: David Halley, Tyra Oseng-Rees, Luca Pagano, Juan A Ferriz-Papi

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Recycled glass material is made from 100% recycled bottle glass and consumes less energy than re-melt technology. It also uses no additives in the manufacturing process allowing the recycled glass material, in principal, to go back to the recycling stream after end-of-use, contributing to the circular economy with a low ecological impact. The aim of this paper is to investigate the procedure for testing the recycled glass material for impact resistance, so it can be applied to pavements and other surfaces which are at risk of impact during service. A review of different impact test procedures for construction materials was undertaken, comparing methodologies and international standards applied to other materials such as natural stone, ceramics and glass. A drop weight impact testing machine was designed and manufactured in-house to perform these tests. As a case study, samples of the recycled glass material were manufactured with two different thicknesses and tested. The impact energy was calculated theoretically, obtaining results with 5 and 10 J. The results on the material were subsequently discussed. Improvements on the procedure can be made using high speed video technology to calculate velocity just before and immediately after the impact to know the absorbed energy. The initial results obtained in this procedure were positive although repeatability needs to be developed to obtain a correlation of results and finally be able to validate the procedure. The experiment with samples showed the practicality of this procedure and application to the recycled glass material impact testing although further research needs to be developed.

Keywords: construction materials, drop weight impact, impact testing, recycled glass

Procedia PDF Downloads 264

Authors: Lars Laußat, Manfred Helmus, Kamil Szczesny, Markus König

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As one result of the project “Reactive Construction Project Scheduling using Real Time Construction Logistic Data and Simulation”, a procedure for using data about uncertain resource availability assumptions in reactive scheduling processes has been developed. Prediction data about resource availability is generated in a formalized way using real-time monitoring data e.g. from auto-ID systems on the construction site and in the supply chains. The paper focuses on the formalization of the procedure for monitoring construction logistic processes, for the detection of disturbance and for generating of new and uncertain scheduling assumptions for the reactive resource constrained simulation procedure that is and will be further described in other papers.

Keywords: auto-ID, construction logistic, fuzzy, monitoring, RFID, scheduling

Procedia PDF Downloads 483

Authors: A. M. Prasad

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Knowledge of variations of nerves of gluteal region is important for clinicians administering intramuscular injections, for orthopedic surgeons dealing with the hip surgeries, possibly for physiotherapists managing the painful conditions and paralysis of this region. Herein, we report multiple variations of the nerves of gluteal region. In the current case, the sciatic nerve was absent. The common peroneal and tibial nerves arose from sacral plexus and reached the gluteal region through greater sciatic foramen above and below piriformis respectively. The common peroneal nerve gave a muscular branch to the gluteus maximus. The inferior gluteal nerve and posterior cutaneous nerve of the thigh arose from a common trunk. The common trunk was formed by three roots. Upper and middle roots arose from sacral plexus and entered gluteal region through greater sciatic foramen respectively above and below piriformis. The lower root arose from the pudendal nerve and joined the common trunk. These variations were seen in the right gluteal region of an adult male cadaver aged approximately 70 years. Innervation of gluteus maximus by common peroneal nerve and presence of a common trunk of inferior gluteal nerve and posterior cutaneous nerve of the thigh make this case unique. The variant nerves may be subjected to iatrogenic injuries during surgical approach to the hip. They may also get compressed if there is a hypertrophy of the piriformis syndrome. Hence, the knowledge of these variations is of importance to clinicians, orthopedic surgeons and possibly for physiotherapists.

Keywords: gluteal region, multiple variations, nerve injury, sciatic nerve

Procedia PDF Downloads 321

Authors: Oleg Sapelnikov, Ruslan Latypov, Darina Ardus, Samvel Aivazian, Andrey Shiryaev, Renat Akchurin

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OBJECTIVE: MAZE procedure is one of the most effective surgical methods in atrial fibrillation (AF) treatment. Nowadays we are all aware of its modifications. In our study we conducted clinical analysis of “Box lesion+” approach during MAZE procedure in two-year follow-up. METHODS: We studied the results of the open-heart on-pump procedures performed in our hospital from 2017 to 2018 years. Thirty-two (32) patients with atrial fibrillation (AF) were included in this study. Fifteen (15) patients had concomitant coronary bypass grafting and seventeen (17) patients had mitral valve repair. Mean age was 62.3±8.7 years; prevalence of men was admitted (56.1%). Mean duration of AF was 4.75±5.44 and 7.07±8.14 years. In all cases, we performed endocardial Cryo-MAZE procedure with one-time myocardium revascularization or mitral-valve surgery. All patients of this study underwent pulmonary vein (PV) isolation and ablation of mitral isthmus with additional isolation of LA posterior wall (Box-lesion+ procedure). Mean follow-up was 2 years. RESULTS: All cases were performed without any complications. Additional isolation of posterior wall did not prolong the operative time and artificial circulation significantly. Cryo-MAZE procedure directly lasted 20±2.1 min, the whole operation time was 192±24 min and artificial circulation time was 103±12 min. According to design of the study, we performed clinical investigation of the patients in 12 months and in 2 years from the initial procedure. In 12 months, the number of AF free patients 81.8% and 75.8% in two years of follow-up. CONCLUSIONS: Isolation of the left atrial posterior wall and perimitral area may considerably improve the efficacy of surgical treatment, which was demonstrated in significant decrease of AF recurrences during the whole period of follow-up.

Keywords: atrial fibrillation, cryoablation, left atrium isolation, open heart procedure

Procedia PDF Downloads 102

Authors: Eda Yakit Ak, Ergül Aslan

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The study was conducted using the quasi-experimental design to determine the influence of the nursing support program prepared according to the Health Belief Model on reproductive health behaviors of orthopedically disabled women in the physical therapy and rehabilitation clinic at a university hospital between August 2019-October, 2020. The research sample included 50 women (35 in the control group and 15 in the experimental group with orthopedic disability). A 3-week nursing support program was applied to the experimental group of women. To collect the data, Introductory Information Form and Scale for Determining the Protective Attitudes of Married Women towards Reproductive Health (SDPAMW) were applied. The evaluation was made with a follow-up form for four months. In the first evaluation, the total SDPAMW scores were 119.93±20.59 for the experimental group and 122.20±16.71 for the control group. In the final evaluation, the total SDPAMW scores were 144.27±11.95 for the experimental group and 118.00±16.43 for the control group. The difference between the groups regarding the first and final evaluations for the total SDPAMW scores was statistically significant (p<0.01). In the experimental group, between the first and final evaluations regarding the sub-dimensions of SDPAMW, an increase was found in the behavior of seeing the doctor on reproductive health issues, protection from reproductive organ and breast cancer, general health behaviors to protect reproductive health, and protection from genital tract infections (p<0.05). Consequently, the nursing support program based on the Health Belief Model applied to orthopedically disabled women positively affected reproductive health behaviors.

Keywords: orthopedically disabled, woman, reproductive health, nursing support program, health belief model

Procedia PDF Downloads 120

Authors: I.-A. Ciobotaru, I.-E. Ciobotaru, D.-I. Vaireanu

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Currently, an ascending trend of battery use may be observed, together with an increase of the generated amount of waste. Efforts have been focused on the recycling of batteries; however, extending their lifetime may be a more adequate alternative, and the development of such methods may prove to be more cost efficient as compared to recycling. In this context, this paper presents the analysis of a proposed process for the reconditioning of some lithium-ions batteries. The analysis is performed based on two criteria, the first one referring to the technical aspect of the reconditioning process and the second to the economic aspects. The main technical parameters taken into consideration are the values of capacitance and internal resistance of the lithium-ion batteries. The economic criterion refers to the evaluation of the efficiency of the reconditioning procedure reported to its total cost for the investigated lithium-ion batteries. Based on the cost analysis, one introduced a novel coefficient that correlates the efficiency of the aforementioned process and its corresponding costs. The reconditioning procedure for the lithium-ion batteries proposed in this paper proved to be valid, efficient, and with reasonable costs.

Keywords: cost assessment, lithium-ion battery, reconditioning coefficient, reconditioning procedure

Procedia PDF Downloads 96

Authors: C. Catalina Zapata, Z. Claudia Montoya

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Transplant from hematopoietic parents (THP) or medulla (MT) is a procedure used to replace the medulla that does not work as part of a disease or when it is destroyed either by a treatment of high medication doses against cancer or by radiation. The transplant process has three stages, a stage prior to transplant, during and after the transplant. It is held with the help of an interdisciplinary team, including nursing, carrying out mainly educative procedures to warrant the adhesion and the changes in lifestyles needed to whom will undergo this procedure. The aim of the study was to assess the results of an educative procedure by nursing, on adult patients subjected to a transplant from hematopoietic parents at a high complexity institution of Medellin city, Colombia. This study had an observational longitudinal design. According to the rules of protocol, the educative activity must be held on all patients joining the procedure. Four instruments were designed in order to collect all the information. One of them to measure the sociodemographic variables, another one to measure self-care practices, another one to measure transplant knowledge and its cares and the other one to measure the 30-day post-transplant complications. The last three instruments were applied before and after the educative procedure. A univaried analysis was carried out but the bivaried analysis was not carried out since there were not statistically meaningful differences before and after. Within the results, ten patients were evaluated. The average age was 38.2 (13.38 SD – standard deviation), 8/10 were men. Some self-care practices such us having pets and plants and consuming some specific food as well as little use of UV protection are all present in this type of patients and are not modified after the procedure. In measuring the knowledge, something stands out among the answers. It is the fact that some patients do not know what the medulla is, the nature of separating wastes at home and the need to consult about vomit and nausea. The most frequent complications during the first thirty days were: nausea, vomit, fever, and rash. They are considered to be expected within this period. Patients do not exhibit differences in their level of knowledge before and after the educative procedure by nursing. The patients’ self-care practices do not involve all the necessary ones to avoid complications. During the first 30 days, most of the complications are typical of the transplant process from hematopoietic parents.

Keywords: bone marrow transplant, education, family, nursing, patients, Transplantation of hematopoietic progenitors

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Authors: L. Korpinen, P. Taskinen, P. Rautio

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This study aimed to describe procedures that we developed to use in the quantitative, bone-specific SPECT/CT at our hospital. Our procedures included the following questions for choosing imaging protocols, which were based on a clinical doctor's referral: (1) Is she/he a cancer patient or not? (2) Are there any indications of inflammatory rheumatoid arthritis? We performed about 1,106 skeletal scintigraphies over two years. About 394 patients were studied with quantitative bone-specific single-photon emission computed tomography/computerized tomography (SPECT/CT) (i.e., about 36% of all bone scintigraphies). Approximately 64% of the patients were studied using the conventional Anterior-Posterior/Posterior-Anterior imaging. Our procedure has improved efficiency and decreased cycle times.

Keywords: skeletal scintigraphy, SPECT/CT, imaging, procedure

Procedia PDF Downloads 128

Authors: Amaal Almigal

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Neurotypical children learn to ask questions from natural exposure and this skill is fundamental for their academic success. However, children with autism spectrum disorder may not learn to ask in the same way due to earlier communication impairments, and some may need to use Augmentative and Alternative Communication systems (AAC) to ask questions. This paper aims to highlight issues related to questioning skills in children with autism giving a specific attention to asking questions within preverbal or minimally verbal children. Different procedures have been employed to teach these children, including AAC users, to ask questions. Therefore, these procedures will also be discussed to administrate how they were used and what they were aimed to teach. This paper also provides a suggested procedure to assist preverbal or minimally verbal children to ask questions using an iPad application for communication (Proloquo2Go) as AAC. This suggested procedure was used with 3 children with autism. Initial results will be discussed to clarify ways in which this procedure was used with each child based on his skills and which questioning skills each child has acquired using this procedure.

Keywords: AAC, autism, communication, information, iPad, requesting

Procedia PDF Downloads 153

Authors: Afshan Saad, Muhammad Saad, Shah Muhammad Emaduddin

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Nowadays the business condition is so quick paced that enhancing ourselves consistently has turned into a huge factor for the presence of an undertaking. We can check this for structural building and significantly more so in the quick-paced universe of data innovation and programming designing. The lithe philosophies, similar to Scrum, have a devoted advance in the process that objectives the enhancement of the improvement procedure and programming items. Pivotal to process enhancement is to pick up data that grants you to assess the condition of the procedure and its items. From the status data, you can design activities for the upgrade and furthermore assess the accomplishment of those activities. This investigation builds a model that measures the product nature of the improvement procedure. The product quality is dependent on the useful and auxiliary nature of the product items, besides the nature of the advancement procedure is likewise vital to enhance programming quality. Utilitarian quality covers the adherence to client prerequisites, while the auxiliary quality tends to the structure of the product item's source code with reference to its practicality. The procedure quality is identified with the consistency and expectedness of the improvement procedure. The product quality model is connected in a business setting by social occasion the information for the product measurements in the model. To assess the product quality model, we investigate the information and present it to the general population engaged with the light-footed programming improvement process. The outcomes from the application and the client input recommend that the model empowers a reasonable evaluation of the product quality and that it very well may be utilized to help the persistent enhancement of the advancement procedure and programming items.

Keywords: Agile SDLC Tools, Agile Software development, business value, enterprise applications, IBM, IBM Rational Team Concert, RTC, software quality, software metrics

Procedia PDF Downloads 142

Authors: Tarek Aly

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The shoulder is the most mobile joint whose stability requires the interaction of both dynamic and static stabilizers. Its wide range of movement predisposes to a high susceptibility to dislocation, accounting for nearly 50% of all dislocations. This trauma typically results in ligament injury (e.g., labral tear, capsular strain) or bony fracture (e.g., loss of glenoid or humeral head bone), which frequently causes recurrent instability. Patients with significant glenoid defects may require Latarjet procedure, which involves transferring the coracoid to the antero-inferior glenoid rim. In spite of outstanding results, 15 to 30% of cases suffer complications. In this article, we discuss the diagnosis of recurrent shoulder instability, the surgical technique and various complications of Latarjet procedure.

Keywords: recurrent, anterior gleno-humeral instability, latarjet, unstable shoulder

Procedia PDF Downloads 37

Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

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Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

Procedia PDF Downloads 59

Authors: W. Hajuthman, R. Warner, S. Rahman, M. Abraham, H. Helliwell, D. Bodiwala

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Context: Prostate cancer is a prevalent cancer in males in Europe and the US, with diagnosis primarily relying on PSA testing, mpMRI, and subsequent biopsies. However, this diagnostic strategy may lead to complications for patients. Research Aim: The aim of this study is to assess compliance with trust guidelines for antibiotic prophylaxis in patients undergoing transperineal template biopsies of the prostate and evaluate the rate of post-procedure complications. Methodology: This study is conducted retrospectively over an 8-month period. Data collection includes patient demographics, compliance with trust guidelines, associated risk factors, and post-procedure complications such as infection, haematuria, and urinary retention. Findings: The audit includes 100 patients with a median age of 66.11. The compliance with pre-procedure antibiotics was 98%, while compliance with antibiotic prophylaxis recommended by trust guidelines was 68%. Among the patients, 3% developed post-procedure sepsis, with 2 requiring admission for intravenous antibiotics. No evident risk factors were identified in these cases. Additionally, post-procedure urinary retention occurred in 3% of patients and post-procedure haematuria in 2%. Theoretical Importance: This study highlights the increasing use of transperineal template biopsies across UK centres and suggests that having a standardized protocol and compliance with guidelines can reduce confusion, ensure appropriate administration of antibiotics, and mitigate post-procedure complications. Data Collection and Analysis Procedures: Data for this study is collected retrospectively, involving the extraction and analysis of relevant information from patient records over the specified 8-month period. Question Addressed: This study addresses the following research questions: (1) What is the compliance rate with trust guidelines for antibiotic prophylaxis in transperineal template biopsies of the prostate? (2) What is the rate of post-procedure complications, such as infection, haematuria, and urinary retention? Conclusion: Transperineal template biopsies are becoming increasingly prevalent in the UK. Implementing a standardized protocol and ensuring compliance with guidelines can reduce confusion, ensure proper administration of antibiotics, and potentially minimize post-procedure complications. Additionally, considering that studies show no difference in outcomes when prophylactic antibiotics are not used, the reminder to follow trust guidelines may prompt a re-evaluation of antibiotic prescribing practices.

Keywords: prostate, transperineal template biopsies of prostate, antibiotics, complications, microbiology, guidelines

Procedia PDF Downloads 43

Authors: Maryam Shayan

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Programming frameworks have been utilized as a part of chemical industry process safety operation and configuration to enhance its effectiveness. This paper gives a brief survey and investigation of the best in class and effects of programming frameworks in process security. A study was completed by talking staff accountable for procedure wellbeing practices in the Iranian chemical process industry and diving into writing of innovation for procedure security. This article investigates the useful and operational attributes of programming frameworks for security and endeavors to sort the product as indicated by its level of effect in the administration chain of importance. The study adds to better comprehension of the parts of Information Communication Technology in procedure security, the future patterns and conceivable gaps for innovative work.

Keywords: programming frameworks, chemical industry process, process security, administration chain, information communication technology

Procedia PDF Downloads 338

Authors: Ki Hwa Lee, Eunsu Kang, Jae Hong Park

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Background: Interventional neuroradiology (INR) has been a rapidly growing and evolving neurosurgical part during the past few decades. Sevoflurane and propofol are both suitable anesthetics for INR procedure. Monitoring of depth of anesthesia is being used very widely. SEDLine™ monitor, a 4-channel processed EEG monitor, uses a proprietary algorithm to analyze the raw EEG signal and displays the Patient State Index (PSI) values. There are only a fewer studies examining the PSI in the neuro-anesthesia. We aimed to investigate the difference of PSI values and hemodynamic variables between sevoflurane and propofol anesthesia during INR procedure. Methods: We reviewed the medical records of patients who scheduled to undergo embolization of non-ruptured intracranial aneurysm by a single operator from May 2013 to December 2014, retrospectively. Sixty-five patients were categorized into two groups; sevoflurane (n = 33) vs propofol (n = 32) group. The PSI values, hemodynamic variables, and the use of hemodynamic drugs were analyzed. Results: Significant differences were seen between PSI values obtained during different perioperative stages in both two groups (P < 0.0001). The PSI values of propofol group were lower than that of sevoflurane group during INR procedure (P < 0.01). The patients in propofol group had more prolonged time of extubation and more phenylephrine requirement than sevoflurane group (p < 0.05). Anti-hypertensive drug was more administered to the patients during extubation in sevoflurane group (p < 0.05). Conclusions: The PSI can detect depth of anesthesia and changes of concentration of anesthetics during INR procedure. Extubation was faster in sevoflurane group, but smooth recovery was shown in propofol group.

Keywords: interventional neuroradiology, patient state index, propofol, sevoflurane

Procedia PDF Downloads 152

Authors: Jeong-Hwan Choi, Hyo-Sang Park, Tae-Hyung Lee

Abstract:

The transmission tower is one of the crucial lifeline structures in a modern society, and it needs to be protected against extreme loading conditions. However, the transmission tower is a very complex structure and, therefore, it is very difficult to simulate the actual damage and the collapse behavior of the tower structure. In this study, the actual collapse behavior of the transmission tower due to lateral loading conditions such as wind load is evaluated through the computational simulation. For that, a progressive collapse procedure is applied to the simulation. In this procedure, after running the simulation, if a member of the tower structure fails, the failed member is removed and the simulation run again. The 154kV transmission tower is selected for this study. The simulation is performed by nonlinear static analysis procedure, namely pushover analysis, using OpenSEES, an earthquake simulation platform. Three-dimensional finite element models of those towers are developed.

Keywords: transmission tower, OpenSEES, pushover, progressive collapse

Procedia PDF Downloads 325

Authors: Benjamin Newman

Abstract:

The picture of an adverse contest between two parties has often been used as an archetypal description of the Anglo-American adversarial criminal trial. However, in actuality, guilty pleas and plea-bargains have been dominating the procedure for over the last half-a-century. Characterised by two adverse parties, the court adjudicative system in the Anglo-American world adhere to the adversarial procedure, and while further features have been attributed and the values that are embedded within the procedure vary, it is a system that we have no adequate theory. Damaska had argued that the adversarial conflict-resolution mode of administration of justice stems from a liberal laissez-faire concept of a value neutral liberal state. Having said that, the court’s neutrality has been additionally rationalised in light of its liberal end as a safeguard from the state’s coercive force. Both conceptions of the court’s neutrality conflict in cases where the by-standing role disposes of its liberal duty in safeguarding the individual. Such is noticeable in plea bargains, where the defendant has the liberty to plead guilty, despite concerns over wrongful convictions and deprivation of liberty. It is an inner liberal tension within the notion of criminal adversarialism, between the laissez-faire mode which grants autonomy to the parties and the safeguarding liberal end of the trial. Langbein had asserted that the adversarial system is a criminal procedure for which we have no adequate theory, and it is by reference to political and moral theories that the research aims to articulate a normative account. The paper contemplates on the above liberal-tension, and by reference to Duff’s ‘calling-to-account’ theory, argues that autonomy is of inherent value to the criminal process, being considered a constitutive element in the process of being called to account. While the aspiration is that the defendant’s guilty plea should be genuine, the guilty-plea decision must be voluntary if it is to be considered a performative act of accountability. Thus, by valuing procedural autonomy as a necessary element within the criminal adjudicative process, it assimilates a liberal procedure, whilst maintaining the liberal end by holding the defendant to account.

Keywords: liberal theory, adversarial criminal procedure, criminal law theory, liberal perfectionism, political liberalism

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Authors: H. Samadiyeh, R. Khajavi

Abstract:

A new FD-based procedure, modal finite difference method (MFDM), is proposed for seismic wave propagation modeling, in which simulation is dealt with in the modal space. The method employs eigenvalues of a characteristic matrix formed by appropriate time-space FD stencils. Since MFD runs for different modes are totally independent of each other, MFDM can easily be parallelized while considerable simplicity in parallel-algorithm is also achieved. There is no requirement to any domain-decomposition procedure and inter-core data exchange. More important is the possibility to skip processing of less-significant modes, which enables one to adjust the procedure up to the level of accuracy needed. Thus, in addition to considerable ease of parallel programming, computation and storage costs are significantly reduced. The method is qualified for its efficiency by some numerical examples.

Keywords: Finite Difference Method, Graphics Processing Unit (GPU), Message Passing Interface (MPI), Modal, Wave propagation

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Authors: Emin Gundogar, Aysegul Yilmaz

Abstract:

Strategic performance control is a significant procedure in management. There are various methods to improve this procedure. This study introduces an information system that is developed to score performance for municipal management. The application of the system is clarified by exemplifying municipal processes.

Keywords: management information system, municipal management, performance control

Procedia PDF Downloads 443

Authors: Omar Abdillah, Mirna Adriani

Abstract:

In this work, we perform new approach for analyzing public sentiment towards the presidential candidate in the 2014 Indonesian election that expressed in Twitter. In this study we propose such procedure for analyzing sentiment over Indonesian political message by understanding the behavior of Indonesian society in sending message on Twitter. We took different approach from previous works by utilizing punctuation mark and Indonesian sentiment lexicon that completed with the new procedure in determining sentiment towards the candidates. Our experiment shows the performance that yields up to 83.31% of average precision. In brief, this work makes two contributions: first, this work is the preliminary study of sentiment analysis in the domain of political message that has not been addressed yet before. Second, we propose such method to conduct sentiment analysis by creating decision making procedure in which it is in line with the characteristic of Indonesian message on Twitter.

Keywords: unsupervised sentiment analysis, political message, lexicon based, user behavior understanding

Procedia PDF Downloads 448

Authors: Seyda Donmez, Oya Aydin Urucu, Ece Kok Yetimoglu

Abstract:

Solidified floating organic drop microextraction was used for a preconcentration method of trace amount of lead. The analyte was complexed with 1-(2-pyridylazo)-2-naphtol and 1-undecanol, acetonitrile was added as an extraction and dispersive solvent respectively. The influences of some analytical parameters pH, volumes of extraction and disperser solvent, concentration of chelating agent, and concentration of salt were optimized. Under the optimum conditions the detection limits of Pb (II) was determined. The procedure was validated for the analysis of NCS DC 73347a hair standard reference material with satisfactory result. The developed procedure was successfully applied to food and water samples for detection of Pb (II) ions.

Keywords: analytical methods, graphite furnace atomic absorption spectrometry, heavy metals, solidified floating organic drop microextraction

Procedia PDF Downloads 242

Authors: Yang Xiong, Hua Cheng

Abstract:

In this paper, for the basic problem of wireless sensor network topology control and deployment, the Roesser model in rectangular grid sensor networks is presented. In addition, a general constructive realization procedure will be proposed. The procedure enables a distributed implementation of linear systems on a sensor network. A non-trivial example is illustrated.

Keywords: grid sensor networks, Roesser model, state-space realization, multidimensional systems

Procedia PDF Downloads 625

Authors: A. Al-Rifaie, Z. W. Guan, S. W. Jones

Abstract:

This paper presents a method for modelling and analysing end plate beam-to-column connections to obtain the quasi-static behaviour using non-linear dynamic explicit integration. In addition to its importance to study the static behaviour of a structural member, quasi-static behaviour is largely needed to be compared with the dynamic behaviour of such members in order to investigate the dynamic effect by proposing dynamic increase factors (DIFs). The beam-to-column bolted connections contain various contact surfaces at which the implicit procedure may have difficulties converging, resulting in a large number of iterations. Contrary, explicit procedure could deal effectively with complex contacts without converging problems. Hence, finite element modelling using ABAQUS/explicit is used in this study to address the dynamic effect may be produced using explicit procedure. Also, the effect of loading rate and mass scaling are discussed to investigate their effect on the time of analysis. The results show that the explicit procedure is valuable to model the end plate beam-to-column connections in terms of failure mode, load-displacement relationships. Also, it is concluded that loading rate and mass scaling should be carefully selected to avoid the dynamic effect in the solution.

Keywords: quasi-static, end plate, finite elements, connections

Procedia PDF Downloads 276