Search results for: sepsis bundle protocol
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1266

Search results for: sepsis bundle protocol

1056 Care: A Cluster Based Approach for Reliable and Efficient Routing Protocol in Wireless Sensor Networks

Authors: K. Prasanth, S. Hafeezullah Khan, B. Haribalakrishnan, D. Arun, S. Jayapriya, S. Dhivya, N. Vijayarangan

Abstract:

The main goal of our approach is to find the optimum positions for the sensor nodes, reinforcing the communications in points where certain lack of connectivity is found. Routing is the major problem in sensor network’s data transfer between nodes. We are going to provide an efficient routing technique to make data signal transfer to reach the base station soon without any interruption. Clustering and routing are the two important key factors to be considered in case of WSN. To carry out the communication from the nodes to their cluster head, we propose a parameterizable protocol so that the developer can indicate if the routing has to be sensitive to either the link quality of the nodes or the their battery levels.

Keywords: clusters, routing, wireless sensor networks, three phases, sensor networks

Procedia PDF Downloads 465
1055 A Closed Loop Audit of Pre-operative Transfusion Samples in Orthopaedic Patients at a Major Trauma Centre

Authors: Tony Feng, Rea Thomson, Kathryn Greenslade, Ross Medine, Jennifer Easterbrook, Calum Arthur, Matilda Powell-bowns

Abstract:

There are clear guidelines on taking group and screen samples (G&S) for elective arthroplasty and major trauma. However, there is limited guidance on blood grouping for other trauma patients. The purpose of this study was to review the level of blood grouping at a major trauma centre and validate a protocol that limits the expensive processing of G&S samples. After reviewing the national guidance on transfusion samples in orthopaedic patients, data was prospectively collected for all orthopaedic admissions in the Royal Infirmary of Edinburgh between January to February 2023. The cause of admission, number of G&S samples processed on arrival and need for red cells was collected using the hospital blood bank. A new protocol was devised based on a multidisciplinary meeting which limited the requirement for G&S samples only to presentations in “category X”, including neck-of-femur fractures (NOFs), pelvic fractures and major trauma. A re-audit was completed between April and May after departmental education and institution of this protocol. 759 patients were admitted under orthopaedics in the major trauma centre across two separate months. 47% of patients were admitted with presentations falling in category X (354/759) and patients in this category accounted for 88% (92/104) of those requiring post-operative red cell transfusions. Of these, 51% were attributed to NOFs (47/92). In the initial audit, 50% of trauma patients outwith category X had samples sent (116/230), estimated to cost £3800. Of these 230 patients, 3% required post-operative transfusions (7/230). In the re-audit, 23% of patients outwith category X had samples sent (40/173), estimated to cost £1400, of which 3% (5/173) required transfusions. None of the transfusions in these patients in either audit were related to their operation and the protocol achieved an estimated cost saving of £2400 over one month. This study highlights the importance of sending samples for patients with certain categories of orthopaedic trauma (category X) due to the high demand for post-operative transfusions. However, the absence of transfusion requirements in other presentations suggests over-testing. While implementation of the new protocol has markedly reduced over-testing, additional interventions are required to reduce this further.

Keywords: blood transfusion, quality improvement, orthopaedics, trauma

Procedia PDF Downloads 46
1054 Performance Analysis and Energy Consumption of Routing Protocol in Manet Using Grid Topology

Authors: Vivek Kumar Singh, Tripti Singh

Abstract:

An ad hoc wireless network consists of mobile networks which creates an underlying architecture for communication without the help of traditional fixed-position routers. Ad-hoc On-demand Distance Vector (AODV) is a routing protocol used for Mobile Ad hoc Network (MANET). Nevertheless, the architecture must maintain communication routes although the hosts are mobile and they have limited transmission range. There are different protocols for handling the routing in the mobile environment. Routing protocols used in fixed infrastructure networks cannot be efficiently used for mobile ad-hoc networks, so that MANET requires different protocols. This paper presents the performance analysis of the routing protocols used various parameter-patterns with Two-ray model.

Keywords: AODV, packet transmission rate, pause time, ZRP, QualNet 6.1

Procedia PDF Downloads 793
1053 Coding of RMAC and Its Theoretical and Simulation-Based Performance Comparison with SMAC

Authors: Hamida Qumber Ali, Waseem Muhammad Arain, Shama Siddiqui, Sayeed Ghani

Abstract:

We present an implementing of RMAC in TinyOS 1.x. RMAC is a cross layer and Duty-cycle MAC protocols that was proposed to provide energy efficient transmission services for wireless sensor networks. The protocol has a unique and efficient packet transmission scheduling mechanism that enables it to overcome delivery latency and overcome traffic congestion. Design details and implementation challenges are divulged. Experiments are conducted to show the correctness of our implementation with numerous assumptions. Simulations are performed to compare the performance of RMAC and SMAC. Our results show that RMAC outperforms SMAC in energy efficiency and delay.

Keywords: MAC protocol, performance, RMAC, wireless sensor networks

Procedia PDF Downloads 293
1052 Adaptive Certificate-Based Mutual Authentication Protocol for Mobile Grid Infrastructure

Authors: H. Parveen Begam, M. A. Maluk Mohamed

Abstract:

Mobile Grid Computing is an environment that allows sharing and coordinated use of diverse resources in dynamic, heterogeneous and distributed environment using different types of electronic portable devices. In a grid environment the security issues are like authentication, authorization, message protection and delegation handled by GSI (Grid Security Infrastructure). Proving better security between mobile devices and grid infrastructure is a major issue, because of the open nature of wireless networks, heterogeneous and distributed environments. In a mobile grid environment, the individual computing devices may be resource-limited in isolation, as an aggregated sum, they have the potential to play a vital role within the mobile grid environment. Some adaptive methodology or solution is needed to solve the issues like authentication of a base station, security of information flowing between a mobile user and a base station, prevention of attacks within a base station, hand-over of authentication information, communication cost of establishing a session key between mobile user and base station, computing complexity of achieving authenticity and security. The sharing of resources of the devices can be achieved only through the trusted relationships between the mobile hosts (MHs). Before accessing the grid service, the mobile devices should be proven authentic. This paper proposes the dynamic certificate based mutual authentication protocol between two mobile hosts in a mobile grid environment. The certificate generation process is done by CA (Certificate Authority) for all the authenticated MHs. Security (because of validity period of the certificate) and dynamicity (transmission time) can be achieved through the secure service certificates. Authentication protocol is built on communication services to provide cryptographically secured mechanisms for verifying the identity of users and resources.

Keywords: mobile grid computing, certificate authority (CA), SSL/TLS protocol, secured service certificates

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1051 A Lightweight Authentication and Key Exchange Protocol Design for Smart Homes

Authors: Zhifu Li, Lei Li, Wanting Zhou, Yuanhang He

Abstract:

This paper proposed a lightweight certificate-less authentication and key exchange protocol (Light-CL-PKC) based on elliptic curve cryptography and the Chinese Remainder Theorem for smart home scenarios. Light-CL-PKC can efficiently reduce the computational cost of both sides of authentication by forgoing time-consuming bilinear pair operations and making full use of point-addition and point-multiplication operations on elliptic curves. The authentication and key exchange processes in this system are also completed in a a single round of communication between the two parties. The analysis result demonstrates that it can significantly minimize the communication overhead of more than 32.14% compared with the referenced protocols, while the runtime for both authentication and key exchange have also been significantly reduced.

Keywords: authentication, key exchange, certificateless public key cryptography, elliptic curve cryptography

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1050 An Energy Holes Avoidance Routing Protocol for Underwater Wireless Sensor Networks

Authors: A. Khan, H. Mahmood

Abstract:

In Underwater Wireless Sensor Networks (UWSNs), sensor nodes close to water surface (final destination) are often preferred for selection as forwarders. However, their frequent selection makes them depleted of their limited battery power. In consequence, these nodes die during early stage of network operation and create energy holes where forwarders are not available for packets forwarding. These holes severely affect network throughput. As a result, system performance significantly degrades. In this paper, a routing protocol is proposed to avoid energy holes during packets forwarding. The proposed protocol does not require the conventional position information (localization) of holes to avoid them. Localization is cumbersome; energy is inefficient and difficult to achieve in underwater environment where sensor nodes change their positions with water currents. Forwarders with the lowest water pressure level and the maximum number of neighbors are preferred to forward packets. These two parameters together minimize packet drop by following the paths where maximum forwarders are available. To avoid interference along the paths with the maximum forwarders, a packet holding time is defined for each forwarder. Simulation results reveal superior performance of the proposed scheme than the counterpart technique.

Keywords: energy holes, interference, routing, underwater

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1049 Covid-19 Pandemic: Another Lesson Learned by a Military Hospital

Authors: Mariana Floria, Elena-Diana Năfureanu, Diana-Mihaela Gălăţanu, Anca-Ecaterina Grumeza, Cristina Gorea-Bocîncă, Diana-Elena Iov, Aurelian-Corneliu Moraru, Dragoș-Marian Popescu

Abstract:

SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs.

Keywords: Covid-19, costs, hospital stay, military hospital

Procedia PDF Downloads 148
1048 BAN Logic Proof of E-passport Authentication Protocol

Authors: Safa Saoudi, Souheib Yousfi, Riadh Robbana

Abstract:

E-passport is a relatively new electronic document which maintains the passport features and provides better security. It deploys new technologies such as biometrics and Radio Frequency identification (RFID). The international civil aviation organization (ICAO) and the European union define mechanisms and protocols to provide security but their solutions present many threats. In this paper, a new mechanism is presented to strengthen e-passport security and authentication process. We propose a new protocol based on Elliptic curve, identity based encryption and shared secret between entities. Authentication in our contribution is formally proved with BAN Logic verification language. This proposal aims to provide a secure data storage and authentication.

Keywords: e-passport, elliptic curve cryptography, identity based encryption, shared secret, BAN Logic

Procedia PDF Downloads 403
1047 Implantology Failure: Epidemiological Survey among Tunisian Dentists

Authors: Faten Khanfir, Mohamed Tlili, Ali Medeb Hamrouni, Raki Selmi, M. S. Khalfi, Faten Ben Amor

Abstract:

Introduction: dental implant failure is a major concern for the clinician and the patient. Objectives: The aim of our study is to investigate the way in which 100 Tunisian dentists carried implant treatment for their patients from the early phase of planning and selection of patients to the placement of the implant in order to look for the implant failure factors. Results: significant correlations were found between failure rates > 5 and their corresponding factors as the number of implants placed (p = 0.001<0, 05), smoking (0.046 <0.05), unbalanced diabetes (0.03<0.05), aseptic protocol (= 0.004< 0.05) and the drilling speed (0,002<0.05) Conclusion: It seems that the number of implant placed, smoking, diabetes, aseptic protocol, and the drilling speed may contribute to dental implant failure.

Keywords: failure, implants, survey, risk, osseointegration

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1046 Design Channel Non Persistent CSMA MAC Protocol Model for Complex Wireless Systems Based on SoC

Authors: Ibrahim A. Aref, Tarek El-Mihoub, Khadiga Ben Musa

Abstract:

This paper presents Carrier Sense Multiple Access (CSMA) communication model based on SoC design methodology. Such model can be used to support the modelling of the complex wireless communication systems, therefore use of such communication model is an important technique in the construction of high performance communication. SystemC has been chosen because it provides a homogeneous design flow for complex designs (i.e. SoC and IP based design). We use a swarm system to validate CSMA designed model and to show how advantages of incorporating communication early in the design process. The wireless communication created through the modeling of CSMA protocol that can be used to achieve communication between all the agents and to coordinate access to the shared medium (channel).

Keywords: systemC, modelling, simulation, CSMA

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1045 Carbon Credits in Voluntary Carbon Markets: A Proposal for Iran

Authors: Saeed Mohammadirad

Abstract:

During the first commitment period of the Kyoto Protocol, many developed countries were forced to restrict carbon emissions. Although Iran was one of the countries of Kyoto protocol, due to some special conditions, it was not required to restrict its carbon emissions. Flexible mechanisms were developed to assist countries responsible for reducing their carbon emissions, and regulated carbon markets were introduced. Carbon credits which are provided by organizations in countries with no responsibility to restrict their carbon emissions are traded in voluntary markets. This study focuses on how to measure and report the carbon allowances and carbon credits from accounting view point under both regulated and voluntary markets.

Keywords: carbon credits, carbon markets, accounting, flexible mechanisms

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1044 A Retrospective Study on the Spectrum of Infection and Emerging Antimicrobial Resistance in Type 2 Diabetes Mellitus

Authors: Pampita Chakraborty, Sukumar Mukherjee

Abstract:

People with diabetes mellitus are more susceptible to developing infections, as high blood sugar levels can weaken the patient's immune system defences. People with diabetes are more adversely affected when they get an infection than someone without the disease, because you have weakened immune defences in diabetes. People who have minimally elevated blood sugar levels experience worse outcomes with infections. Diabetic patients in hospitals do not necessarily have a higher mortality rate due to infections, but they do face longer hospitalisation and recovery times. A study was done in a tertiary care unit in eastern India. Patients with type 2 diabetes mellitus infection were recruited in the study. A total of 520 cases of Type 2 Diabetes Mellitus were recorded out of which 200 infectious cases was included in the study. All subjects underwent detailed history & clinical examination. Microbiological samples were collected from respective site of the infection for microbial culture and antibiotic sensitivity test. Out of the 200 infectious cases urinary tract infection(UTI) was found in majority of the cases followed by diabetic foot ulcer (DFU), respiratory tract infection(RTI) and sepsis. It was observed that Escherichia coli was the most commonest pathogen isolated from UTI cases and Staphylococcus aureus was predominant in foot ulcers followed by other organisms. Klebsiella pneumonia was the major organism isolated from RTI and Enterobacter aerogenes was commonly observed in patients with sepsis. Isolated bacteria showed differential sensitivity pattern against commonly used antibiotics. The majority of the isolates were resistant to several antibiotics that are usually prescribed on an empirical basis. These observations are important, especially for patient management and the development of antibiotic treatment guidelines. It is recommended that diabetic patients receive pneumococcal and influenza vaccine annually to reduce morbidity and mortality. Appropriate usage of antibiotics based on local antibiogram pattern can certainly help the clinician in reducing the burden of infections.

Keywords: antimicrobial resistance, diabetic foot ulcer, respiratory tract infection, urinary tract infection

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1043 Energy Efficient Heterogeneous System for Wireless Sensor Networks (WSN)

Authors: José Anderson Rodrigues de Souza, Teles de Sales Bezerra, Saulo Aislan da Silva Eleuterio, Jeronimo Silva Rocha

Abstract:

Mobile devices are increasingly occupying sectors of society and one of its most important features is mobility. However, the use of mobile devices is subject to the lifetime of the batteries. Thus, the use of energy batteries has become an important issue in the study of wireless network technologies. In this context, new solutions that enable aggregate energy efficiency not only through energy saving, and principally they are evaluated from a more realistic model of energy discharge, if easy adaptation to existing protocols. This paper presents a study on the energy needed and the lifetime for Wireless Sensor Networks (WSN) using a heterogeneous network and applying the LEACH protocol.

Keywords: wireless sensor networks, energy efficiency, heterogeneous, LEACH protocol

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1042 Mobility Management via Software Defined Networks (SDN) in Vehicular Ad Hoc Networks (VANETs)

Authors: Bilal Haider, Farhan Aadil

Abstract:

A Vehicular Ad hoc Network (VANET) provides various services to end-users traveling on the road at high speeds. However, this high-speed mobility of mobile nodes can cause frequent service disruptions. Various mobility management protocols exist for managing node mobility, but due to their centralized nature, they tend to suffer in the VANET environment. In this research, we proposed a distributed mobility management protocol using software-defined networks (SDN) for VANETs. Instead of relying on a centralized mobility anchor, the mobility functionality is distributed at multiple infrastructural nodes. The protocol is based on the classical Proxy Mobile IP version 6 (PMIPv6). It is evident from simulation results that this work has improved the network performance with respect to nodes throughput, delay, and packet loss.

Keywords: SDN, VANET, mobility management, optimization

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1041 A Secure Proxy Signature Scheme with Fault Tolerance Based on RSA System

Authors: H. El-Kamchouchi, Heba Gaber, Fatma Ahmed, Dalia H. El-Kamchouchi

Abstract:

Due to the rapid growth in modern communication systems, fault tolerance and data security are two important issues in a secure transaction. During the transmission of data between the sender and receiver, errors may occur frequently. Therefore, the sender must re-transmit the data to the receiver in order to correct these errors, which makes the system very feeble. To improve the scalability of the scheme, we present a secure proxy signature scheme with fault tolerance over an efficient and secure authenticated key agreement protocol based on RSA system. Authenticated key agreement protocols have an important role in building a secure communications network between the two parties.

Keywords: proxy signature, fault tolerance, rsa, key agreement protocol

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1040 Micro-Electrical Discharge Machining (µEDM): Effect of the Electrochemical Etching Parameters on the Fabrication of Cylindrical Tungsten Micro-Tools

Authors: Asmae Tafraouti, Yasmina Layouni

Abstract:

The fabrication of cylindrical Tungsten micro-tools with a high aspect ratio is a real challenge because of several constraints that come into during their manufacture. In this paper, we will describe the process used to fabricate these micro-tools. It consists of using electrochemical etching. We will also present the optimal protocol that makes it possible to fabricate micro-tools with a high aspect ratio in a reproducible way. Next, we will show the limit of the experimental parameters chosen to manufacture micro-tools from a wire with an initial diameter of Φ_0=250µm. The protocol used allows obtaining an average diameter of Φ=88µm ±1 µm over a length of L=3.5mm.

Keywords: drop-off effect, electrochemical etching, micro-electrical discharge machining, tungsten micro-tools

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1039 Time Synchronization between the eNBs in E-UTRAN under the Asymmetric IP Network

Authors: M. Kollar, A. Zieba

Abstract:

In this paper, we present a method for a time synchronization between the two eNodeBs (eNBs) in E-UTRAN (Evolved Universal Terrestrial Radio Access) network. The two eNBs are cooperating in so-called inter eNB CA (Carrier Aggregation) case and connected via asymmetrical IP network. We solve the problem by using broadcasting signals generated in E-UTRAN as synchronization signals. The results show that the time synchronization with the proposed method is possible with the error significantly less than 1 ms which is sufficient considering the time transmission interval is 1 ms in E-UTRAN. This makes this method (with low complexity) more suitable than Network Time Protocol (NTP) in the mobile applications with generated broadcasting signals where time synchronization in asymmetrical network is required.

Keywords: IP scheduled throughput, E-UTRAN, Evolved Universal Terrestrial Radio Access Network, NTP, Network Time Protocol, assymetric network, delay

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1038 Efficacy and Safety Profile of Biosimilar PEG-Asparaginase (Asviia) in Patients with Acute Leukaemia: A Retrospective Study from Kashmir

Authors: Faisal Guru Rashid, Syed Nisar, Mohammad Hussain Mir, Ulfat Ara, Richa Tripathi

Abstract:

Background: Biosimilar pegylated L-asparaginase is a potential alternative to the innovator version for treating acute lymphoblastic leukaemia (ALL) in Indian children, addressing issues of availability and cost. Biosimilar offers a viable solution, ensuring wider access to essential treatment in resource-limited settings like India. With this in mind, we conducted a study to assess the efficacy and toxicity of Biosimilar Pegaspargase (Asviia) in patients with Acute Leukaemia at our centre. Materials and methods: A retrospective study was conducted to assess the efficacy and safety of biosimilar PEG-asparaginase (Asviia) in newly diagnosed paediatric acute lymphoblastic leukaemia patients at the Paediatric Oncology unit of Department of Medical Oncology at Sher-I-Kashmir Institute of Medical Sciences, SKIMS Srinagar. The study included patients of ALL treated at our centre between January 2021- and December 2023. Each patient received 2 induction doses of pegaspargenase. Results: 45 patients (16 females and 29 males) were included in the study who received biosimilar PEG-asparaginase (Asviia) as a part of the treatment protocol. The age range of patients was between 1 and 16 years with a median age was 7.5 years. Median PEG Asparaginase dose received was 1175 IU (1125-3750 IU). The majority of patients were Pre-B ALL. There was considerable improvement in the haematological parameters, like haemoglobin levels rising by 1.39 and platelet counts rising by 30,402 after the patients received the first dose of Peg-ASP. Biosimilar Pegaspargase in Acute Leukaemia patients showed a tolerable safety profile with no life-threatening events. 13% of patients exhibited allergic reactions, and 17% had sepsis. Two patients (4.4%) had pancreatitis and Transaminitis events. At the end of induction, out of 45 patients, 40 (88.89%) patients had complete remission with Minimal Residual Disease (MRD) negativity, while 5 patients were MRD positive. Conclusion: Biosimilar PEG-Asparaginase (Asviia) demonstrated a tolerable safety profile and good efficacy, with nearly 90% of patients having complete Remission with MRD negativity.

Keywords: acute lymphoblastic leukaemia, biosimilar, PEG-asparaginase, minimal residual disease, remission

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1037 The Second Generation of Tyrosine Kinase Inhibitor Afatinib Controls Inflammation by Regulating NLRP3 Inflammasome Activation

Authors: Shujun Xie, Shirong Zhang, Shenglin Ma

Abstract:

Background: Chronic inflammation might lead to many malignancies, and inadequate resolution could play a crucial role in tumor invasion, progression, and metastases. A randomised, double-blind, placebo-controlled trial shows that IL-1β inhibition with canakinumab could reduce incident lung cancer and lung cancer mortality in patients with atherosclerosis. The process and secretion of proinflammatory cytokine IL-1β are controlled by the inflammasome. Here we showed the correlation of the innate immune system and afatinib, a tyrosine kinase inhibitor targeting epidermal growth factor receptor (EGFR) in non-small cell lung cancer. Methods: Murine Bone marrow derived macrophages (BMDMs), peritoneal macrophages (PMs) and THP-1 were used to check the effect of afatinib on the activation of NLRP3 inflammasome. The assembly of NLRP3 inflammasome was check by co-immunoprecipitation of NLRP3 and apoptosis-associated speck-like protein containing CARD (ASC), disuccinimidyl suberate (DSS)-cross link of ASC. Lipopolysaccharide (LPS)-induced sepsis and Alum-induced peritonitis were conducted to confirm that afatinib could inhibit the activation of NLRP3 in vivo. Peripheral blood mononuclear cells (PBMCs) from non-small cell lung cancer (NSCLC) patients before or after taking afatinib were used to check that afatinib inhibits inflammation in NSCLC therapy. Results: Our data showed that afatinib could inhibit the secretion of IL-1β in a dose-dependent manner in macrophage. Moreover, afatinib could inhibit the maturation of IL-1β and caspase-1 without affecting the precursors of IL-1β and caspase-1. Next, we found that afatinib could block the assembly of NLRP3 inflammasome and the ASC speck by blocking the interaction of the sensor protein NLRP3 and the adaptor protein ASC. We also found that afatinib was able to alleviate the LPS-induced sepsis in vivo. Conclusion: Our study found that afatinib could inhibit the activation of NLRP3 inflammasome in macrophage, providing new evidence that afatinib could target the innate immune system to control chronic inflammation. These investigations will provide significant experimental evidence in afatinib as therapeutic drug for non-small cell lung cancer or other tumors and NLRP3-related diseases and will explore new targets for afatinib.

Keywords: inflammasome, afatinib, inflammation, tyrosine kinase inhibitor

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1036 Case Report on Anaesthesia for Ruptured Ectopic with Severe Pulmonary Hypertension in a Mute Patient

Authors: Pamela Chia, Tay Yoong Chuan

Abstract:

Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing.

Keywords: pulmonary hypertension, case report, warfarin reversal, emergency surgery

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1035 Secure Optical Communication System Using Quantum Cryptography

Authors: Ehab AbdulRazzaq Hussein

Abstract:

Quantum cryptography (QC) is an emerging technology for secure key distribution with single-photon transmissions. In contrast to classical cryptographic schemes, the security of QC schemes is guaranteed by the fundamental laws of nature. Their security stems from the impossibility to distinguish non-orthogonal quantum states with certainty. A potential eavesdropper introduces errors in the transmissions, which can later be discovered by the legitimate participants of the communication. In this paper, the modeling approach is proposed for QC protocol BB84 using polarization coding. The single-photon system is assumed to be used in the designed models. Thus, Eve cannot use beam-splitting strategy to eavesdrop on the quantum channel transmission. The only eavesdropping strategy possible to Eve is the intercept/resend strategy. After quantum transmission of the QC protocol, the quantum bit error rate (QBER) is estimated and compared with a threshold value. If it is above this value the procedure must be stopped and performed later again.

Keywords: security, key distribution, cryptography, quantum protocols, Quantum Cryptography (QC), Quantum Key Distribution (QKD).

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1034 An In Situ Exploration of Practising Rugby Coaches’ Cognitions, Higher Psychological Functions and Actions Using Think Aloud Protocol

Authors: Simon Quick, John Lyle

Abstract:

Psychology-based research has been a characteristic of empirical enquiry in sport coaching for over fifty years and cognitive function is widely accepted as a fundamental component of sport coaching expertise. Within the academic literature, much empirical research on coaches’ cognitions has tended to adopt retrospective approaches, such as post-session interviews or stimulated recall, thus capturing coaches’ cognitions after the incident, training session or competition. Such methods are prone to a variety of issues, including memory decay and the reordering of accounts. The aim of this research was to overcome the limitations that exist with retrospective approaches and, rather, to capture coaching cognitions in situ using Think Aloud Protocol. Data that were captured was broken down into meaning units and analysed using a Thematic Analysis. Situated in the practice of 6 experienced rugby coaches, findings revealed that Think Aloud Protocol generated rich data, although problematic in a site of enquiry confounded by multiple social interactions and requiring coaches to provide frequent instruction and feedback. The resultant interaction between cognition and action is conceptualised by the tentative offering of a model that situates these elements in conjunction with cognitive triggers and thresholds. The implications of these findings can help academics and coaches to understand the dynamic relationship between types of coaching cognitions and the complexity of the coaching environment.

Keywords: sports coaching, Psychology, Pedagogy, cognition

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1033 New Thromboprophylaxis Regime for Knee Arthroplasties

Authors: H. Noureddine, P. Rao, R. Guru, A. Chandratreya

Abstract:

The nice guidance for elective total knee replacements states that patients should be given mechanical thrombo-prophylaxis, and if no contraindications chemical thromboprophylaxis in the form of Dabigatran etexilate, Rivaroxiban, UFH, LMWH, or Fondaparinux sodium (CG92, 1.5.14, January 2010). In Practice administering oral agents has been the dominant practice as it reduces the nursing needs, and shortens hospital stay and is generally received better by patients. However, there are well documented associated bleeding risks, and their effects are difficult to reverse in case of major bleeding. Our experience with oral factor 10 inhibitors used for thromboprophylaxis was marked with several patients developing complications necessitating return to the theatre for wound washouts. This has led us to try a different protocol for thromboprophylaxis that we applied on our patients undergoing total and unicondylar knee replacements. We applied mechanical thromboprophylaxis in the form of intermittent pneumatic pressure devices, and chemical thromboprophylaxis in the form of a dose of prophylactic LMWH pre-op, then 150 mg of Aspirin to start 24 hours after the surgery and to continue for 6 weeks, alongside GI cover with PPIs or antihistamines. We also administered local anaesthetics intra-operatively in line with the ERAS protocol thus encouraging early mobilization. We have identified a cohort of 133 patients who underwent one of the aforementioned procedures in the same trust, and by the same surgeon, where this protocol was applied and examined their medical notes retrospectively with a mean follow-up period of 14 months, to identify the rate and percentage of patients who had thrombo-embolic events in the post-operative period.

Keywords: aspirin, heparin, knee arthroplasty, thromboprophylaxis

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1032 IACOP - Route Optimization in Wireless Networks Using Improved Ant Colony Optimization Protocol

Authors: S. Vasundra, D. Venkatesh

Abstract:

Wireless networks have gone through an extraordinary growth in the past few years, and will keep on playing a crucial role in future data communication. The present wireless networks aim to make communication possible anywhere and anytime. With the converging of mobile and wireless communications with Internet services, the boundary between mobile personal telecommunications and wireless computer networks is disappearing. Wireless networks of the next generation need the support of all the advances on new architectures, standards, and protocols. Since an ad hoc network may consist of a large number of mobile hosts, this imposes a significant challenge on the design of an effective and efficient routing protocol that can work well in an environment with frequent topological changes. This paper proposes improved ant colony optimization (IACO) technique. It also maintains load balancing in wireless networks. The simulation results show that the proposed IACO performs better than existing routing techniques.

Keywords: wireless networks, ant colony optimization, load balancing, architecture

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1031 Performance Evaluation of Soft RoCE over 1 Gigabit Ethernet

Authors: Gurkirat Kaur, Manoj Kumar, Manju Bala

Abstract:

Ethernet is the most influential and widely used technology in the world. With the growing demand of low latency and high throughput technologies like InfiniBand and RoCE, unique features viz. RDMA (Remote Direct Memory Access) have evolved. RDMA is an effective technology which is used for reducing system load and improving performance. InfiniBand is a well known technology which provides high-bandwidth and low-latency and makes optimal use of in-built features like RDMA. With the rapid evolution of InfiniBand technology and Ethernet lacking the RDMA and zero copy protocol, the Ethernet community has came out with a new enhancements that bridges the gap between InfiniBand and Ethernet. By adding the RDMA and zero copy protocol to the Ethernet a new networking technology is evolved, called RDMA over Converged Ethernet (RoCE). RoCE is a standard released by the IBTA standardization body to define RDMA protocol over Ethernet. With the emergence of lossless Ethernet, RoCE uses InfiniBand’s efficient transport to provide the platform for deploying RDMA technology in mainstream data centres over 10GigE, 40GigE and beyond. RoCE provide all of the InfiniBand benefits transport benefits and well established RDMA ecosystem combined with converged Ethernet. In this paper, we evaluate the heterogeneous Linux cluster, having multi nodes with fast interconnects i.e. gigabit Ethernet and Soft RoCE. This paper presents the heterogeneous Linux cluster configuration and evaluates its performance using Intel’s MPI Benchmarks. Our result shows that Soft RoCE is performing better than Ethernet in various performance metrics like bandwidth, latency and throughput.

Keywords: ethernet, InfiniBand, RoCE, RDMA, MPI, Soft RoCE

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1030 NFC Communications with Mutual Authentication Based on Limited-Use Session Keys

Authors: Chalee Thammarat

Abstract:

Mobile phones are equipped with increased short-range communication functionality called Near Field Communication (or NFC for short). NFC needs no pairing between devices but suitable for little amounts of data in a very restricted area. A number of researchers presented authentication techniques for NFC communications, however, they still lack necessary authentication, particularly mutual authentication and security qualifications. This paper suggests a new authentication protocol for NFC communication that gives mutual authentication between devices. The mutual authentication is a one of property, of security that protects replay and man-in-the-middle (MitM) attack. The proposed protocols deploy a limited-use offline session key generation and use of distribution technique to increase security and make our protocol lightweight. There are four sub-protocols: NFCAuthv1 is suitable for identification and access control and NFCAuthv2 is suitable for the NFC-enhanced phone by a POS terminal for digital and physical goods and services.

Keywords: cryptographic protocols, NFC, near field communications, security protocols, mutual authentication, network security

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1029 A Model of Teacher Leadership in History Instruction

Authors: Poramatdha Chutimant

Abstract:

The objective of the research was to propose a model of teacher leadership in history instruction for utilization. Everett M. Rogers’ Diffusion of Innovations Theory is applied as theoretical framework. Qualitative method is to be used in the study, and the interview protocol used as an instrument to collect primary data from best practices who awarded by Office of National Education Commission (ONEC). Open-end questions will be used in interview protocol in order to gather the various data. Then, information according to international context of history instruction is the secondary data used to support in the summarizing process (Content Analysis). Dendrogram is a key to interpret and synthesize the primary data. Thus, secondary data comes as the supportive issue in explanation and elaboration. In-depth interview is to be used to collected information from seven experts in educational field. The focal point is to validate a draft model in term of future utilization finally.

Keywords: history study, nationalism, patriotism, responsible citizenship, teacher leadership

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1028 Communication in a Heterogeneous Ad Hoc Network

Authors: C. Benjbara, A. Habbani

Abstract:

Wireless networks are getting more and more used in every new technology or feature, especially those without infrastructure (Ad hoc mode) which provide a low cost alternative to the infrastructure mode wireless networks and a great flexibility for application domains such as environmental monitoring, smart cities, precision agriculture, and so on. These application domains present a common characteristic which is the need of coexistence and intercommunication between modules belonging to different types of ad hoc networks like wireless sensor networks, mesh networks, mobile ad hoc networks, vehicular ad hoc networks, etc. This vision to bring to life such heterogeneous networks will make humanity duties easier but its development path is full of challenges. One of these challenges is the communication complexity between its components due to the lack of common or compatible protocols standard. This article proposes a new patented routing protocol based on the OLSR standard in order to resolve the heterogeneous ad hoc networks communication issue. This new protocol is applied on a specific network architecture composed of MANET, VANET, and FANET.

Keywords: Ad hoc, heterogeneous, ID-Node, OLSR

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1027 Design and Implementation Wireless System by Using Microcontrollers.Application for Drive Acquisition System with Multiple Sensors

Authors: H. Fekhar

Abstract:

Design and implementation acquisition system using radio frequency (RF) ASK module and micro controllers PIC is proposed in this work. The paper includes hardware and software design. The design tools are divided into two units , namely the sender MCU and receiver.The system was designed to measure temperatures of two furnaces and pressure pneumatic process. The wireless transmitter unit use the 433.95 MHz band directly interfaced to micro controller PIC18F4620. The sender unit consists of temperatures-pressure sensors , conditioning circuits , keypad GLCD display and RF module.Signal conditioner converts the output of the sensors into an electric quantity suitable for operation of the display and recording system.The measurements circuits are connected directly to 10 bits multiplexed A/D converter.The graphic liquid crystal display (GLCD) is used . The receiver (RF) module connected to a second microcontroller ,receive the signal via RF receiver , decode the Address/data and reproduces the original data . The strategy adopted for establishing communication between the sender MCU and receiver uses the specific protocol “Header, Address and data”.The communication protocol dealing with transmission and reception have been successfully implemented . Some experimental results are provided to demonstrate the effectiveness of the proposed wireless system. This embedded system track temperatures – pressure signal reasonably well with a small error.

Keywords: microcontrollers, sensors, graphic liquid cristal display, protocol, temperature, pressure

Procedia PDF Downloads 423