Search results for: patient state index (PSi)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13012

Search results for: patient state index (PSi)

12862 A Comparative Analysis of an All-Optical Switch Using Chalcogenide Glass and Gallium Arsenide Based on Nonlinear Photonic Crystal

Authors: Priyanka Kumari Gupta, Punya Prasanna Paltani, Shrivishal Tripathi

Abstract:

This paper proposes a nonlinear photonic crystal ring resonator-based all-optical 2 × 2 switch. The nonlinear Kerr effect is used to evaluate the essential 2 x 2 components of the photonic crystal-based optical switch, including the bar and cross states. The photonic crystal comprises a two-dimensional square lattice of dielectric rods in an air background. In the background air, two different dielectric materials are used for this comparison study separately. Initially with chalcogenide glass rods, then with GaAs rods. For both materials, the operating wavelength, bandgap diagram, operating power intensities, and performance parameters, such as the extinction ratio, insertion loss, and cross-talk of an optical switch, have also been estimated using the plane wave expansion and the finite-difference time-domain method. The chalcogenide glass material (Ag20As32Se48) has a high refractive index of 3.1 which is highly suitable for switching operations. This dielectric material is immersed in an air background with a nonlinear Kerr coefficient of 9.1 x 10-17 m2/W. The resonance wavelength is at 1552 nm, with the operating power intensities at the cross-state and bar state around 60 W/μm2 and 690 W/μm2. The extinction ratio, insertion loss, and cross-talk value for the chalcogenide glass at the cross-state are 17.19 dB, 0.051 dB, and -17.14 dB, and the bar state, the values are 11.32 dB, 0.025 dB, and -11.35 dB respectively. The gallium arsenide (GaAs) dielectric material has a high refractive index of 3.4, a direct bandgap semiconductor material highly preferred nowadays for switching operations. This dielectric material is immersed in an air background with a nonlinear Kerr coefficient of 3.1 x 10-16 m2/W. The resonance wavelength is at 1558 nm, with the operating power intensities at the cross-state and bar state around 110 W/μm2 and 200 W/μm2. The extinction ratio, insertion loss, and cross-talk value for the chalcogenide glass at the cross-state are found to be 3.36.19 dB, 2.436 dB, and -5.8 dB, and for the bar state, the values are 15.60 dB, 0.985 dB, and -16.59 dB respectively. This paper proposes an all-optical 2 × 2 switch based on a nonlinear photonic crystal using a ring resonator. The two-dimensional photonic crystal comprises a square lattice of dielectric rods in an air background. The resonance wavelength is in the range of photonic bandgap. Later, another widely used material, GaAs, is also considered, and its performance is compared with the chalcogenide glass. Our presented structure can be potentially applicable in optical integration circuits and information processing.

Keywords: photonic crystal, FDTD, ring resonator, optical switch

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12861 Characterization of Erodibility Using Soil Strength and Stress-Strain Indices for Soils in Some Selected Sites in Enugu State

Authors: C. C. Egwuonwu, N. A. A. Okereke, K. O. Chilakpu, S. O. Ohanyere

Abstract:

In this study, initial soil strength indices (qu) and stress-strain characteristics, namely failure strain (ϵf), area under the stress-strain curve up to failure (Is) and stress-strain modulus between no load and failure (Es) were investigated as potential indicators for characterizing the erosion resistance of two compacted soils, namely sandy clay loam (SCL) and clay loam (CL) in some selected sites in Enugu State, Nigeria. The unconfined compressive strength (used in obtaining strength indices) and stress-strain measurements were obtained as a function of moisture content in percentage (mc %) and dry density (γd). Test were conducted over a range of 8% to 30% moisture content and 1.0 g/cm3 to 2.0 g/cm3 dry density at applied loads of 20, 40, 80, 160 and 320 kPa. Based on the results, it was found out that initial soil strength alone was not a good indicator of erosion resistance. For instance, in the comparison of exponents of mc% and γd for jet index or erosion resistance index (Ji) and the strength measurements, qu and Es agree in signs for mc%, but are opposite in signs for γd. Therefore, there is an inconsistency in exponents making it difficult to develop a relationship between the strength parameters and Ji for this data set. In contrast, the exponents of mc% and γd for Ji and ϵf and Is are opposite in signs, there is potential for an inverse relationship. The measured stress-strain characteristics, however, appeared to have potential in providing useful information on erosion resistance. The models developed for the prediction of the extent or the susceptibility of soils to erosion and subjected to sensitivity test on some selected sites achieved over 90% efficiency in their functions.

Keywords: characterization of erodibility, selected sites in Enugu state, soil strength, stress-strain indices

Procedia PDF Downloads 392
12860 Comparison of the Existing Damage Indices in Steel Moment-Resisting Frame Structures

Authors: Hamid Kazemi, Abbasali Sadeghi

Abstract:

Assessment of seismic behavior of frame structures is just done for evaluating life and financial damages or lost. The new structural seismic behavior assessment methods have been proposed, so it is necessary to define a formulation as a damage index, which the damage amount has been quantified and qualified. In this paper, four new steel moment-resisting frames with intermediate ductility and different height (2, 5, 8, and 12-story) with regular geometry and simple rectangular plan were supposed and designed. The three existing groups’ damage indices were studied, each group consisting of local index (Drift, Maximum Roof Displacement, Banon Failure, Kinematic, Banon Normalized Cumulative Rotation, Cumulative Plastic Rotation and Ductility), global index (Roufaiel and Meyer, Papadopoulos, Sozen, Rosenblueth, Ductility and Base Shear), and story (Banon Failure and Inter-story Rotation). The necessary parameters for these damage indices have been calculated under the effect of far-fault ground motion records by Non-linear Dynamic Time History Analysis. Finally, prioritization of damage indices is defined based on more conservative values in terms of more damageability rate. The results show that the selected damage index has an important effect on estimation of the damage state. Also, failure, drift, and Rosenblueth damage indices are more conservative indices respectively for local, story and global damage indices.

Keywords: damage index, far-fault ground motion records, non-linear time history analysis, SeismoStruct software, steel moment-resisting frame

Procedia PDF Downloads 271
12859 Measuring Development through Extreme Observations: An Archetypal Analysis Approach to Index Construction

Authors: Claudeline D. Cellan

Abstract:

Development is multifaceted, and efforts to hasten growth in all these facets have been gaining traction in recent years. Thus, producing a composite index that is reflective of these multidimensional impacts captures the interests of policymakers. The problem lies in going through a mixture of theoretical, methodological and empirical decisions and complexities which, when done carelessly, can lead to inconsistent and unreliable results. This study looks into index computation from a different and less complex perspective. Borrowing the idea of archetypes or ‘pure types’, archetypal analysis looks for points in the convex hull of the multivariate data set that captures as much information in the data as possible. The archetypes or 'pure types' are estimated such that they are convex combinations of all the observations, which in turn are convex combinations of the archetypes. This ensures that the archetypes are realistically observable, therefore achievable. In the sense of composite indices, we look for the best among these archetypes and use this as a benchmark for index computation. Its straightforward and simplistic approach does away with aggregation and substitutability problems which are commonly encountered in index computation. As an example of the application of archetypal analysis in index construction, the country data for the Human Development Index (HDI 2017) of the United Nations Development Programme (UNDP) is used. The goal of this exercise is not to replicate the result of the UNDP-computed HDI, but to illustrate the usability of archetypal analysis in index construction. Here best is defined in the context of life, education and gross national income sub-indices. Results show that the HDI from the archetypal analysis has a linear relationship with the UNDP-computed HDI.

Keywords: archetypes, composite index, convex combination, development

Procedia PDF Downloads 92
12858 Practical Techniques of Improving State Estimator Solution

Authors: Kiamran Radjabli

Abstract:

State Estimator became an intrinsic part of Energy Management Systems (EMS). The SCADA measurements received from the field are processed by the State Estimator in order to accurately determine the actual operating state of the power systems and provide that information to other real-time network applications. All EMS vendors offer a State Estimator functionality in their baseline products. However, setting up and ensuring that State Estimator consistently produces a reliable solution often consumes a substantial engineering effort. This paper provides generic recommendations and describes a simple practical approach to efficient tuning of State Estimator, based on the working experience with major EMS software platforms and consulting projects in many electrical utilities of the USA.

Keywords: convergence, monitoring, state estimator, performance, troubleshooting, tuning, power systems

Procedia PDF Downloads 132
12857 Oral Health Status in Sickle Cell Anemia Subjects

Authors: Surekha Rathod

Abstract:

Sickle cell disease is a vascular disorder characterized by chronic, ongoing organ damage that is punctuated by episodes of acutely painful vascular complications.1 It is the most common genetic blood disorder in the United States, with about 2000 infants being identified through routine blood screenings annually, and an estimated 104,000-138,000 affected individuals living in the United States. Approximately 0.3%-1.3% of African American are affected by Sickle Cell Diseases (SCD).3 The aim of this paper is to present oral health status of patients with SCD. A total of 200 subjects of both sexes in the age group 18- 40 years were included in this study. The subjects were examined and the following indices were recorded • Oral hygiene index – Simplified (OHI-S). • Probing depths (PD). • Clinical Attachment Levels (CAL). • Gingival Index - Loe and Sillness. • Turesky Gillmore Glickman Modification of the Quigley Hein Plaque Index. (1970) • DMFT index. • Sickle Cell Disease Severity Index. A total of 1478 patients were screened of which 200 subjects were found to be diagnosed with SCD by electrophoresis. The study thus, included 200 subjects (111 females & 89 males) diagnosed with Sickle Cell Disease in the age group of 18-40 years. The probing pocket depths (PPD) were measured in millimeters. 36% had PPD in the range of 2-4mm, 48% had PPD in the range of 4-6mm while 16% had PPD of more than 6mm. Similar results were obtained for the Clinical Attachment Levels (CAL). 29.5 % subjects had CAL 2-4mm, 44.5% had 4-6mm & 26% had CAL 6mm & above. We can thus conclude that although oral health is not a priority for patients with SCD, it is supported by increased plaque accumulation. Because of the chronic anemic state of the patients with SCD, they should be encouraged to pay strict attention to oral hygiene instructions and practice.

Keywords: chronic, genetic, oral, sickle cell disease, vascular

Procedia PDF Downloads 375
12856 Design and Development of a Computerized Medical Record System for Hospitals in Remote Areas

Authors: Grace Omowunmi Soyebi

Abstract:

A computerized medical record system is a collection of medical information about a person that is stored on a computer. One principal problem of most hospitals in rural areas is using the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved, this may cause an unexpected to happen to the patient. This Data Mining application is to be designed using a Structured System Analysis and design method which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the Design and Implementation of a Computerized medical record system. This Computerized system will replace the file management system and help to quickly retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: programming, computing, data, innovation

Procedia PDF Downloads 94
12855 Sleep Apnea Hypopnea Syndrom Diagnosis Using Advanced ANN Techniques

Authors: Sachin Singh, Thomas Penzel, Dinesh Nandan

Abstract:

Accurate identification of Sleep Apnea Hypopnea Syndrom Diagnosis is difficult problem for human expert because of variability among persons and unwanted noise. This paper proposes the diagonosis of Sleep Apnea Hypopnea Syndrome (SAHS) using airflow, ECG, Pulse and SaO2 signals. The features of each type of these signals are extracted using statistical methods and ANN learning methods. These extracted features are used to approximate the patient's Apnea Hypopnea Index(AHI) using sample signals in model. Advance signal processing is also applied to snore sound signal to locate snore event and SaO2 signal is used to support whether determined snore event is true or noise. Finally, Apnea Hypopnea Index (AHI) event is calculated as per true snore event detected. Experiment results shows that the sensitivity can reach up to 96% and specificity to 96% as AHI greater than equal to 5.

Keywords: neural network, AHI, statistical methods, autoregressive models

Procedia PDF Downloads 97
12854 Comparing Literary Publications about Corruption in South Africa to the Legal Position

Authors: Natasha Venter

Abstract:

Recent publications, including Truth to Power by André de Ruyter, Gangster State by Pieter-Louis Myburgh, and Enemy of the People by Pieter du Toit and Adriaan Basson, expose alleged corrupt acts by high-ranking members of State, as well as those in charge of State-owned entities. These literary contributions have gripped the attention of a nation plagued by corruption scandals and the alleged misappropriation of state funds on an almost daily basis. The books, however, leave the populace with the burning question of why “nothing happens” to these individuals who are so directly implicated in the literature. The process followed by the State in the largest successful prosecution of a corrupt state official, Jackie Selebi, sheds some light as to how such high-ranking persons might be brought to book. The Supreme Court of Appeal’s definition of corruption and the interpretation of the facts (as presented by the State prosecutors) by the court is also valuable. Furthermore, some insight into the laws that criminalise corruption in South Africa, as well as applicable international instruments, is necessary. South Africa is ranked as the 70th most corrupt country out of 180 countries by Transparency International’s 2021 Corruption Perceptions Index. This is worrisome as South Africa is a signatory of the United Nations Convention Against Corruption (2004) and, as such, has certain international obligations to fulfil. However, if the political will to prosecute corrupt officials in South Africa exists, there are laws and instruments available to punish these individuals. This would not only vindicate the authors of literature about corruption in the country but also restore the hope of South Africans that, ultimately, crime does not pay.

Keywords: corruption, eskom, state capture, government, literature, united nations, law, legal, Jackie selebi, supreme court of appeal

Procedia PDF Downloads 62
12853 Some Conjectures and Programs about Computing the Detour Index of Molecular Graphs of Nanotubes

Authors: Shokofeh Ebrtahimi

Abstract:

Let G be the chemical graph of a molecule. The matrix D = [dij ] is called the detour matrix of G, if dij is the length of longest path between atoms i and j. The sum of all entries above the main diagonal of D is called the detour index of G.Chemical graph theory is the topology branch of mathematical chemistry which applies graph theory to mathematical modelling of chemical phenomena.[1] The pioneers of the chemical graph theory are Alexandru Balaban, Ante Graovac, Ivan Gutman, Haruo Hosoya, Milan Randić and Nenad TrinajstićLet G be the chemical graph of a molecule. The matrix D = [dij ] is called the detour matrix of G, if dij is the length of longest path between atoms i and j. The sum of all entries above the main diagonal of D is called the detour index of G. In this paper, a new program for computing the detour index of molecular graphs of nanotubes by heptagons is determineded. Some Conjectures about detour index of Molecular graphs of nanotubes is included.

Keywords: chemical graph, detour matrix, Detour index, carbon nanotube

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12852 Tribal Food Security Assessment and Its Measurement Index: A Study of Tribes and Particularly Vulnerable Tribal Groups in Jharkhand, India

Authors: Ambika Prasad Gupta, Harshit Sosan Lakra

Abstract:

Food security is an important issue that has been widely discussed in literature. However, there is a lack of research on the specific food security challenges faced by tribal communities. Tribal food security refers to the ability of indigenous or tribal communities to consistently access and afford an adequate and nutritious supply of food. These communities often have unique cultural, social, and economic contexts that can impact their food security. The study aims to assess the food security status of all thirty-two major tribes, including Particularly Vulnerable Tribal Groups (PVTG) people living in various blocks of Jharkhand State. The methodology of this study focuses on measuring the food security index of indigenous people by developing and redefining a new Tribal Food Security Index (TFSI) as per the indigenous community-level indicators identified by the Global Food Security Index and other indicators relevant to food security. Affordability, availability, quality and safety, and natural resources were the dimensions used to calculate the overall Tribal Food Security Index. A survey was conducted for primary data collection of tribes and PVTGs at the household level in various districts of Jharkhand with a considerable tribal population. The result shows that due to the transition from rural to urban areas, there is a considerable change in TFSI and a decrease in forest dependency of tribal communities. Socioeconomic factors like occupation and household size had a significant correlation with TFSI. Tribal households living in forests have a higher food security index than tribal households residing in urban transition areas. The study also shows that alternative methodology adopted to measure specific community-level food security creates high significant impact than using commonly used indices.

Keywords: indigenous people, tribal food security, particularly vulnerable tribal groups, Jharkhand

Procedia PDF Downloads 42
12851 The Development of Cardiac Tamponade after Spinal Surgery in a Patient with Duchenne Muscular Dystrophy

Authors: Hacer Y. Teke, Sultan Pehlivan, Mustafa Karapırlı, Asude Gökmen, Sait Özsoy

Abstract:

The case is here presented of a patient with DMD with electrocardiograph findings within normal limits who underwent spinal surgery then developed the rarely seen complication of cardiac tamponade which resulted in death. A 17-year old male with DMD was admitted to hospital for spinal surgery. Due to a postoperative drop in hemoglobin, blood transfusion was administered to the patient, no complication developed and he was discharged on the third day. Four days after discharge, the patient worsened at home and an ambulance was called. Before the nearest hospital was reached, the patient died in the ambulance. An autopsy was performed. A fatal but rarely seen complication of Acute Myocardial Infarction (AMI) is myocardial rupture. 85% of ruptures occur in the first week of AMI but just as they can be seen on the day of the infarct, they can also be seen 2 weeks later. The case presented here had infarction findings related to different times and in different areas.

Keywords: duchenne muscular dystrophy, myocardial infarction, myocardial rupture, anesthesia

Procedia PDF Downloads 460
12850 Assessment of Patient Cooperation and Compliance in Three Stages of Orthodontic Treatment in Adult Patients: A Cross-Sectional Study

Authors: Hafsa Qabool, Rashna Sukhia, Mubassar Fida

Abstract:

Introduction: Success of orthodontic mechanotherapy is highly dependent upon patient cooperation and compliance throughout the duration of treatment. This study was conducted to assess the cooperation and compliance of adult orthodontic patients during the leveling and alignment, space closure/molar correction, and finishing stages of tooth movement. Materials and Methods: Patient cooperation and compliance among three stages of orthodontic treatment were assessed using the Orthodontic Patient Cooperation Scale (OPCS) and Clinical Compliance Evaluation (CCE) form. A sample size of 38 was calculated for each stage of treatment; therefore, 114 subjects were included in the study. Shapiro-Wilk test identified that the data were normally distributed. One way ANOVA was used to evaluate the percentage cooperation and compliance among the three stages. Pair-wise comparisons between the three stages were performed using Post-hoc Tukey. Results: Statistically significant difference was seen for scores of patient compliance using CCE (p = 0.01); however, the results of the OPCS showed a non-significant difference for patient cooperation (p = 0.16) among the three stages of treatment. Post-hoc analysis showed significant differences (p = 0.01) in patient cooperation and compliance between space closure and the finishing stage. Highly significant (p < 0.001) decline in oral hygiene was found with the progression of orthodontic treatment. Conclusions: Improvement in the cooperation and compliance levels for adult orthodontic patients was observed during space closure & molar correction stage, which then showed a decline as treatment progressed. Oral hygiene was progressively compromised as orthodontic treatment progressed.

Keywords: patient compliance, adult orthodontics, orthodontic motivation, orthodontic patient adherence

Procedia PDF Downloads 123
12849 Case Report of Intramural Pregnancy

Authors: S. Woźniak, J. Rybka, T. Paszkowski, P. Milart

Abstract:

A 30-year-old patient, who was pregnant for her second 9 weeks, was admitted to the hospital due to a suspected incomplete miscarriage. A fetal egg was found in the uterine cavity near the mouth of the fallopian tube. The patient was qualified for dilatation and curettage. The histopathological examination revealed fragments of the trophoblast. Two months later, the patient was re-admitted to the hospital due to vaginal bleeding and elevated levels of beta-hCG. Additional tests were performed. An intramural pregnancy was suspected. The patient was qualified for embolization of the uterine arteries and then treatment with methotrexate. Three weeks later, during a routine gynecological examination, a detached tumor 4 cm in diameter was found in the vagina. The material was sent for histopathological examination, which showed the presence of trophoblastic cells.

Keywords: ectopic pregnancy, intramural pregnancy, uterine artery embolization, methotrexate

Procedia PDF Downloads 65
12848 Varieties of State Role: Through the Case of East Asia's Broadband Policy

Authors: Heesu Kim

Abstract:

This paper determines the varieties of state roles played in East Asia’s telecommunication market, regarding broadband industry. Technological capacity and the relationship between state and market affect the varieties of state role. In explaining the state’s engagement in the market, technology has always been considered as a necessary and sufficient condition. However technology variable has been useful in only explaining the extent of state’s involvement. This paper contributes by bringing in the political-economic factor, which is the relationship between state and market. This factor aids in distinguishing the varieties of state role played in emerging industries. Interaction between these two variables distinguishes 4 types of state roles played in the broadband industry. These roles are distinguished and characterized by the intensity of state’s intervention and the existence of technological capacity. This paper classifies four types of state role through the case of Singapore, China, Taiwan and Korea’s broadband industrial policy.

Keywords: East Asia, entrpreneurial state, industrial policy, regulatory state, technological capacity

Procedia PDF Downloads 137
12847 Design and Development of a Computerized Medical Record System for Hospitals in Remote Areas

Authors: Grace Omowunmi Soyebi

Abstract:

A computerized medical record system is a collection of medical information about a person that is stored on a computer. One principal problem of most hospitals in rural areas is using the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved; this may cause an unexpected to happen to the patient. This data mining application is to be designed using a structured system analysis and design method which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the design and implementation of a computerized medical record system. This computerized system will replace the file management system and help to quickly retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: programming, data, software development, innovation

Procedia PDF Downloads 56
12846 Assessing the Ecological Status of the Moroccan Mediterranean Sea: An Ecopath Modeling Study

Authors: Salma Aboussalam, Karima Khalil, Khalid Elkalay

Abstract:

In order to understand the structure, functioning, and current state of the Moroccan Mediterranean Sea ecosystem, an Ecopath mass balance model was applied. The model was based on 31 functional groups, which included 21 fish species, 7 invertebrates, 2 primary producers, and one detritus group. The trophic interactions between these groups were analyzed, and the system's average trophic transfer efficiency was found to be 23%. The total primary production and total respiration were calculated to be greater than 1, indicating that the system produces more energy than it respires. The ecosystem was found to have a high level of respiration and consumption flows, and indicators of stability and development showed low values for the Finn cycle index (13.97), system omnivory index (0.18), and average Finn path length (3.09), indicating that the ecosystem is disturbed and has a linear rather than web-like trophic structure. Keystone species were identified using the keystone index and mixed trophic impact analysis, with other demersal invertebrates, zooplankton, and cephalopods found to have a significant impact on other groups.

Keywords: ecopath, food web, trophic flux, moroccan mediterranean sea

Procedia PDF Downloads 46
12845 Determining a Bilingualism Index: Evidence From Lebanese Control Bilinguals

Authors: Rania Kassir, Christophe Dos Santos, Halim Abboud, Olivier Godefroy

Abstract:

The ability to communicate in at least two different languages is shared by a growing number of humans. Recently, many researchers have been studying the elderly bilingual population around the world in neuroscience, and yet, until today there’s no accurate nor universal measure or methodology used to examine bilingualism across these studies which constitute a real challenge for results generalization. This study contributes to the quest of a multidimensional bilingualism index and language proficiency literature by investigating a new bilingualism index from a reliable subjective questionnaire the Language Experience and Proficiency Questionnaire (LEAP-Q), multi-linguistic tests, and a diverse bilingual population all featured in one analysis and one index. One hundred Lebanese subjects aged between 55 and 92 years old divided into three different bilingualism subgroups (Arabic prominent, balanced, and French prominent) were recruited and underwent the LEAP-Q with a set of linguistic and cognitive tests. The analysis of the collected data led to the creation of a robust bilingualism index from speaking and oral understanding scores that underline specifically bilingualism subtype according to cutoffs scored. The practice implications of this index, particularly its use within bilingual populations, are addressed in the conclusion of this work.

Keywords: bilingualism, language dominance, bilingualism index, balanced bilingualism, Arabic first language, Lebanese, Arabic-French bilingualism

Procedia PDF Downloads 101
12844 Good Functional Outcome after Late Surgical Treatment for Traumatic Rotator Cuff Tear, a Retrospective Cohort Study

Authors: Soheila Zhaeentan, Anders Von Heijne, Elisabet Hagert, André Stark, Björn Salomonsson

Abstract:

Recommended treatment for traumatic rotator cuff tear (TRCT) is surgery within a few weeks after injury if the diagnosis is made early, especially if a functional impairment of the shoulder exists. This may lead to the assumption that a poor outcome then can be expected in delayed surgical treatment, when the patient is diagnosed at a later stage. The aim of this study was to investigate if a surgical repair later than three months after injury may result in successful outcomes and patient satisfaction. There is evidence in literature that good results of treatment can be expected up to three months after the injury, but little is known of later treatment with cuff repair. 73 patients (75 shoulders), 58 males/17 females, mean age 59 (range 34-­‐72), who had undergone surgical intervention for TRCT between January 1999 to December 2011 at our clinic, were included in this study. Patients were assessed by MRI investigation, clinical examination, Western Ontario Rotator Cuff index (WORC), Oxford Shoulder Score, Constant-­‐Murley Score, EQ-­‐5D and patient subjective satisfaction at follow-­‐up. The patients treated surgically within three months ( < 12 weeks) after injury (39 cases) were compared with patients treated more than three months ( ≥ 12 weeks) after injury (36 cases). WORC was used as the primary outcome measure and the other variables as secondary. A senior consultant radiologist, blinded to patient category and clinical outcome, evaluated all MRI-­‐images. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy was evaluated in all cases. The average follow-­‐up time was 56 months (range 14-­‐149) and the average time from injury to repair was 16 weeks (range 3-­‐104). No statistically significant differences were found for any of the assessed parameters or scores between the two groups. The mean WORC score was 77 (early group, range 25-­‐ 100 and late group, range 27-­‐100) for both groups (p= 0.86), Constant-­‐Murley Score (p= 0.91), Oxford Shoulder Score (p= 0.79), EQ-­‐5D index (p= 0.86). Re-­‐tear frequency was 24% for both groups, and the patients with re-­‐tear reported less satisfaction with outcome. Discussion and conclusion: This study shows that surgical repair of TRCT performed later than three months after injury may result in good functional outcomes and patient satisfaction. However, this does not motivate an intentional delay in surgery when there is an indication for surgical repair as that delay may adversely affect the possibility to perform a repair. Our results show that surgeons may safely consider surgical repair even if a delay in diagnosis has occurred. A retrospective cohort study on 75 shoulders shows good functional result after traumatic rotator cuff tear (TRCT) treated surgically up to one year after the injury.

Keywords: traumatic rotator cuff injury, time to surgery, surgical outcome, retrospective cohort study

Procedia PDF Downloads 196
12843 Vegetation Index-Deduced Crop Coefficient of Wheat (Triticum aestivum) Using Remote Sensing: Case Study on Four Basins of Golestan Province, Iran

Authors: Hoda Zolfagharnejad, Behnam Kamkar, Omid Abdi

Abstract:

Crop coefficient (Kc) is an important factor contributing to estimation of evapotranspiration, and is also used to determine the irrigation schedule. This study investigated and determined the monthly Kc of winter wheat (Triticum aestivum L.) using five vegetation indices (VIs): Normalized Difference Vegetation Index (NDVI), Difference Vegetation Index (DVI), Soil Adjusted Vegetation Index (SAVI), Infrared Percentage Vegetation Index (IPVI), and Ratio Vegetation Index (RVI) of four basins in Golestan province, Iran. 14 Landsat-8 images according to crop growth stage were used to estimate monthly Kc of wheat. VIs were calculated based on infrared and near infrared bands of Landsat 8 images using Geographical Information System (GIS) software. The best VIs were chosen after establishing a regression relationship among these VIs with FAO Kc and Kc that was modified for the study area by the previous research based on R² and Root Mean Square Error (RMSE). The result showed that local modified SAVI with R²= 0.767 and RMSE= 0.174 was the best index to produce monthly wheat Kc maps.

Keywords: crop coefficient, remote sensing, vegetation indices, wheat

Procedia PDF Downloads 378
12842 Initial Periodontal Therapy and Follow-up in a Periodontitis Patient: A Case Report

Authors: Yasir Karabacak

Abstract:

Objective: The aim of periodontal therapy is to control and eliminate inflammation in order halt disease progression. The initial periodontal therapy (IPT) including scaling and root planing (SRP) can control periodontal disease in most cases of periodontitis; also maintaining good oral hygiene by the patient is fundamental. The aim of this case report is to present IPT and to present 3-month follow-up results in a patient with periodontitis. Materials and Methods IPT of a 63-year-old non-smoker male with generalized periodontitis is presented. The patient had no history of systemic disease. The intraoral examination reveals marked gingival inflammation as well as plaque accumulation and significant calculus deposits. On radiographic examination, severe bone loss was evident. The patient was diagnosed with generalized advanced periodontitis. Initial periodontal therapy including oral hygiene instructions and quadrant-based SRP under local anesthesia was performed using hand and ultrasonic instruments. No antibiotics were prescribed. The patient was recalled 4 weeks after IPT. Results Favorable clinical improvement was obtained. Gingival inflammation was resolved significantly. A reduction of the mean probing depth from 2.4 mm at baseline to 1.9 mm was observed. The patient presented with a good standard of oral hygiene. The plaque scores decreased from 54.0% at baseline to 17.0%. In addition, the percentage of sites with bleeding on probing decreased from 80.0% at baseline to 44.0%. The patient was scheduled for maintenance therapy every three months. Conclusion: The level of oral hygiene has a great impact on periodontal treatment outcome and supports periodontal therapy properly.

Keywords: initial periodontal, therapy and follow-up in a periodontitis, patient, a case report

Procedia PDF Downloads 51
12841 The Ethical and Social Implications of Using AI in Healthcare: A Literature Review

Authors: Deepak Singh

Abstract:

AI technology is rapidly being integrated into the healthcare system, bringing many ethical and social implications. This literature review examines the various aspects of this phenomenon, focusing on the ethical considerations of using AI in healthcare, such as how it might affect patient autonomy, privacy, and doctor-patient relationships. Furthermore, the review considers the potential social implications of AI in Healthcare, such as the potential for automation to reduce the availability of healthcare jobs and the potential to widen existing health inequalities. The literature suggests potential benefits and drawbacks to using AI in healthcare, and it is essential to consider the ethical and social implications before implementation. It is concluded that more research is needed to understand the full implications of using AI in healthcare and that ethical regulations must be in place to ensure patient safety and the technology's responsible use.

Keywords: AI, healthcare, telemedicine, telehealth, ethics, security, privacy, patient, rights, safety

Procedia PDF Downloads 102
12840 Dosimetric Comparison of Conventional Plans versus Three Dimensional Conformal Simultaneously Integrated Boost Plans

Authors: Shoukat Ali, Amjad Hussain, Latif-ur-Rehman, Sehrish Inam

Abstract:

Radiotherapy plays an important role in the management of cancer patients. Approximately 50% of the cancer patients receive radiotherapy at one point or another during the course of treatment. The entire radiotherapy treatment of curative intent is divided into different phases, depending on the histology of the tumor. The established protocols are useful in deciding the total dose, fraction size, and numbers of phases. The objective of this study was to evaluate the dosimetric differences between the conventional treatment protocols and the three-dimensional conformal simultaneously integrated boost (SIB) plans for three different tumors sites (i.e. bladder, breast, and brain). A total of 30 patients with brain, breast and bladder cancers were selected in this retrospective study. All the patients were CT simulated initially. The primary physician contoured PTV1 and PTV2 in the axial slices. The conventional doses prescribed for brain and breast is 60Gy/30 fractions, and 64.8Gy/36 fractions for bladder treatment. For the SIB plans biological effective doses (BED) were calculated for 25 fractions. The two conventional (Phase I and Phase II) and a single SIB plan for each patient were generated on Eclipse™ treatment planning system. Treatment plans were compared and analyzed for coverage index, conformity index, homogeneity index, dose gradient and organs at risk doses.In both plans 95% of PTV volume received a minimum of 95% of the prescribe dose. Dose deviation in the optic chiasm was found to be less than 0.5%. There is no significant difference in lung V20 and heart V30 in the breast plans. In the rectum plans V75%, V50% and V25% were found to be less than 1.2% different. Deviation in the tumor coverage, conformity and homogeneity indices were found to be less than 1%. SIB plans with three dimensional conformal radiotherapy technique reduce the overall treatment time without compromising the target coverage and without increasing dose to the organs at risk. The higher dose per fraction may increase the late effects to some extent. Further studies are required to evaluate the late effects with the intention of standardizing the SIB technique for practical implementation.

Keywords: coverage index, conformity index, dose gradient, homogeneity index, simultaneously integrated boost

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12839 Non-Invasive Assessment of Peripheral Arterial Disease: Automated Ankle Brachial Index Measurement and Pulse Volume Analysis Compared to Ultrasound Duplex Scan

Authors: Jane E. A. Lewis, Paul Williams, Jane H. Davies

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Introduction: There is, at present, a clear and recognized need to optimize the diagnosis of peripheral arterial disease (PAD), particularly in non-specialist settings such as primary care, and this arises from several key facts. Firstly, PAD is a highly prevalent condition. In 2010, it was estimated that globally, PAD affected more than 202 million people and furthermore, this prevalence is predicted to further escalate. The disease itself, although frequently asymptomatic, can cause considerable patient suffering with symptoms such as lower limb pain, ulceration, and gangrene which, in worse case scenarios, can necessitate limb amputation. A further and perhaps the most eminent consequence of PAD arises from the fact that it is a manifestation of systemic atherosclerosis and therefore is a powerful predictor of coronary heart disease and cerebrovascular disease. Objective: This cross sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (i) ankle brachial index (ABI) and (ii) pulse volume waveform (PVW) recorded by the same automated device, with the presence or absence of peripheral arterial disease (PAD) being verified by an Ultrasound Duplex Scan (UDS). Methods: Patients (n = 205) referred for lower limb arterial assessment underwent an ABI and PVW measurement using volume plethysmography followed by a UDS. Presence of PAD was recorded for ABI if < 0.9 (noted if > 1.30) if PVW was graded as 2, 3 or 4 or a hemodynamically significant stenosis > 50% with UDS. Outcome measure was agreement between measured ABI and interpretation of the PVW for PAD diagnosis, using UDS as the reference standard. Results: Sensitivity of ABI was 80%, specificity 91%, and overall accuracy 88%. Cohen’s kappa revealed good agreement between ABI and UDS (k = 0.7, p < .001). PVW sensitivity 97%, specificity 81%, overall accuracy 84%, with a good level of agreement between PVW and UDS (k = 0.67, p < .001). The combined sensitivity of ABI and PVW was 100%, specificity 76%, and overall accuracy 85% (k = 0.67, p < .001). Conclusions: Combing these two diagnostic modalities within one device provided a highly accurate method of ruling out PAD. Such a device could be utilized within the primary care environment to reduce the number of unnecessary referrals to secondary care with concomitant cost savings, reduced patient inconvenience, and prioritization of urgent PAD cases.

Keywords: ankle brachial index, peripheral arterial disease, pulse volume waveform, ultrasound duplex scan

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12838 Measuring the Extent of Equalization in Fiscal Transfers in India: An Index-Based Approach

Authors: Ragini Trehan, D.K. Srivastava

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In the post-planning era, India’s fiscal transfers from the central to state governments are solely determined by the Finance Commissions (FCs). While in some of the well-established federations such as Australia, Canada, and Germany, equalization serves as the guiding principle of fiscal transfers and is constitutionally mandated, in India, it is not explicitly mandated, and FCs attempt to implement it indirectly by a combination of a formula-based share in the divisible pool of central taxes supplemented by a set of grants. In this context, it is important to measure the extent of equalization that is achieved through FC transfers with a view to improving the design of such transfers. This study uses an index-based methodology for measuring the degree of equalization achieved through FC-transfers covering the period from FC12 to the first year of FC15 spanning from 2005-06 to 2020-21. The ‘Index of Equalization’ shows that the extent of equalization has remained low in the range of 30% to 37% for the four Commission periods under review. The highest degree of equalization at 36.7% was witnessed in the FC12 period and the lowest equalization at 29.5% was achieved during the FC15(1) period. The equalizing efficiency of recommended transfers also shows a consistent fall from 11.4% in the FC12 period to 7.5% by the FC15 (1) period. Further, considering progressivity in fiscal transfers as a special case of equalizing transfers, this study shows that the scheme of per capita total transfers when determined using the equalization approach is more progressive and is characterized by minimal deviations as compared to the profile of transfers recommended by recent FCs.

Keywords: fiscal transfers, index of equalization, equalizing efficiency, fiscal capacity, expenditure needs, finance Commission, tax effort

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12837 Mine Production Index (MPi): New Method to Evaluate Effectiveness of Mining Machinery

Authors: Amol Lanke, Hadi Hoseinie, Behzad Ghodrati

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OEE has been used in many industries as measure of performance. However due to limitations of original OEE, it has been modified by various researchers. OEE for mining application is special version of classic equation, carries these limitation over. In this paper it has been aimed to modify the OEE for mining application by introducing the weights to the elements of it and termed as Mine Production index (MPi). As a special application of new index MPi shovel has been developed by team of experts and researchers for evaluating the shovel effectiveness. Based on analysis, utilization followed by performance and availability were ranked in this order. To check the applicability of this index, a case study was done on four electrical and one hydraulic shovel in a Swedish mine. The results shows that MPishovelcan properly evaluate production effectiveness of shovels and determine effectiveness values in optimistic view compared to OEE. MPi with calculation not only give the effectiveness but also can predict which elements should be focused for improving the productivity.

Keywords: mining, overall equipment efficiency (OEE), mine production index, shovels

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12836 Disability Prevalence and Health among 60+ Population in India

Authors: Surendra Kumar Patel

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Disability is not just a health problem; it is a complex phenomenon, reflecting the interaction between features of a person’s age and physiology. Population ageing is a major demographic issue for India in the 21st century. Older population of India constituted 8% of total population, while 5.19% has affected by disability of older age group. Objective of the present research paper is to examine the state wise differential in disability among 60+ population and to access the health care of disabled population especially the 60+ disabled persons. The data sources of the present paper are census 2001 and 2011. For analyzing the state wise differentials by disability types and comparative advantage of data, rate, ratio, and percentage have been used. The Standardized Index of Diversity of Disability (SIDD) studies differential and diversity in disability. The results show that there are 5.19% persons have disability among 60+ population and sex differential not very significant, as it is 5.3 % of male and 5.05% in female in India but place of residence shows significant variation from 2001 to 2011 census. There is huge diversity in disability prevalence among 60+ in India, highest in Sikkim followed by Rajasthan, approximately, they comprise 11%, and the lowest found in Tamil Nadu as 2.53%. This huge gap in prevalence percentage shows the health care needs of highly prevailing states.

Keywords: disability, Standardized Index of Diversity of Disability (SIDD), differential and diversity in disability, 60+ population

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12835 Glioblastoma: Prognostic Value of Clinical, Histopathological and Immunohistochemical (p53, EGFR, VEGF, MDM2, Ki67) Parameters

Authors: Sujata Chaturvedi, Ishita Pant, Deepak Kumar Jha, Vinod Kumar Singh Gautam, Chandra Bhushan Tripathi

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Objective: To describe clinical, histopathological and immunohistochemical profile of glioblastoma in patients and to correlate these findings with patient survival. Material and methods: 30 cases of histopathologically diagnosed glioblastomas were included in this study. These cases were analysed in detail for certain clinical and histopathological parameters. Immunohistochemical staining for p53, epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), mouse double minute 2 homolog (MDM2) and Ki67 was done and scores were calculated. Results of these findings were correlated with patient survival. Results: A retrospective analysis of the histopathology records and clinical case files was done in 30 cases of glioblastoma (WHO grade IV). The mean age of presentation was 50.6 years with a male predilection. The most common involved site was the frontal lobe. Amongst the clinical parameters, age of the patient and extent of surgical resection showed a significant correlation with the patient survival. Histopathological parameters showed no significant correlation with the patient survival, while amongst the immunohistochemical parameters expression of MDM2 showed a significant correlation with the patient survival. Conclusion: In this study incorporating clinical, histopathological and basic panel of immunohistochemistry, age of the patient, extent of the surgical resection and expression of MDM2 showed significant correlation with the patient survival.

Keywords: glioblastoma, p53, EGFR, VEGF, MDM2, Ki67

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12834 The OverStitch and OverStitch SX Endoscopic Suturing System in Bariatric Surgery, Closing Perforations and Fistulas and Revision Procedures

Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

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Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

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12833 Case Presentation Ectopic Cushing's Syndrome Secondary to Thymic Neuroendocrine Tumors Secreting ACTH

Authors: Hasan Frookh Jamal

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This is a case of a 36-year-old Bahraini gentleman diagnosed to have Cushing's Syndrome with a large anterior mediastinal mass. He was sent abroad to the Speciality hospital in Jordan, where he underwent diagnostic video-assisted thoracoscopy, partial thymectomy and pericardial fat excision. Histopathology of the mass was reported to be an Atypical carcinoid tumor with a low Ki67 proliferation index of 5%, the mitotic activity of 4 MF/10HPF and pathological stage classification(pTNM): pT1aN1. MRI of the pituitary gland showed an ill-defined non-enhancing focus of about 3mm on the Rt side of the pituitary on coronal images, with a similar but smaller one on the left side, which could be due to enhancing pattern rather than a real lesion as reported. The patient underwent Ga68 Dotate PET/CT scan post-operatively, which showed multiple somatostatin receptor-positive lesions seen within the tail, body and head of the pancreas and positive somatostatin receptor lymph nodes located between the pancreatic head and IVC. There was no uptake detected at the anterior mediastinum nor at the site of thymic mass resection. There was no evidence of any positive somatostatin uptake at the soft tissue or lymph nodes. The patient underwent IPSS, which proved that the source is, in fact, an ectopic source of ACTH secretion. Unfortunately, the patient's serum cortisol remained elevated after surgery and failed to be suppressed by 1 mg ODST and by 2 days LLDST with a high ACTH value. The patient was started on Osilodrostat for treatment of hypercortisolism for the time being and his future treatment plan with Lutetium-177 Dotate therapy vs. bilateral adrenalectomy is to be considered in an MDT meeting.

Keywords: cushing syndrome, neuroendocrine tumur, carcinoid tumor, Thymoma

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