Search results for: terminal care

Authors: Eunkyo Kang, Jihye Lee, Jiyeon Choo

Abstract:

Background: Pediatric palliative care has been increasing, and the number of studies has focused on the age at which pediatric patient can be notified their terminal illness, pediatric advanced care planning (ACP) and palliative care. However, there is a lack of research on health professionals’ perception. Aim: We aimed to investigate the perceptions of healthcare professionals about appropriate age disclosing terminal illness, awareness of ACP, and the relationship between ACP knowledge and the preference for palliative care for children. Methods: We administered nationwide questionnaires to 928 physicians from the 12 hospitals and the Korean Medical Association and 1,241 individuals of the general Korean population. We asked about the age at which the pediatric patients could be notified of their terminal illness, by 4 groups; 4 years old or older, 12 years old or older, 15 years old or older, or not. In addition, we surveyed the questionnaires about the knowledge of ACP of the medical staff, the preference of the pediatric hospice palliative care, aggressive treatment, and life-sustaining treatment preference. Results: In the appropriate age disclosing terminal illness, there were more respondents in the physicians than in the general population who thought that it was possible even at a younger age. Palliative care preference in pediatric patients who were expected to expire within months was higher when health care professionals had knowledge of ACPs compared to those without knowledge. The same results were obtained when deaths were expected within weeks or days. The age of the terminal status notification, the health care professionals who thought to be available at a lower age have a higher preference for palliative care and has less preference for aggressive treatment and life-sustaining treatment. Conclusion: Despite the importance of pediatric palliative care, our study confirmed that there is a difference in the preference of the health care professionals for pediatric palliative care according to the ACP knowledge of the medical staff or the appropriate age disclosing terminal illness. Future research should focus on strategies for inducing changes in perceptions of health care professionals and identifying other obstacles for the pediatric palliative care.

Keywords: pediatric palliative care, disclosing terminal illness, palliative care, advanced care planning

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Authors: Aditya Manna, Lalit Kumar Khanra, Shyamal Kumar Sarkar

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Introduction: Here in India almost 75% of cancer patient die a sad death of neglect due to lack of awareness about palliative care and low economic level. Surveys in India show that two third of cancer patient do not get proper care during the terminal phase of their life. Palliative care through volunteers can make a significant difference in this respect. Objective: To identify and try to solve, to the extent possible, the main difficulties in giving palliative care to the terminal cancer patients of the area. And evaluate the impact of volunteer’s direct care of palliative patients and their families. Methods: Feedback from patients and their relatives regarding the palliative care they receive from nursing home and from volunteers and compare the two. Also feedback from volunteers regarding their positive and negative experience while delivering palliative care service. Then evaluate the data to compare and improve the quality of service. Results: We carried out two studies. One study was undertaken in nursing home palliative care and another was in home setting by volunteers. Both studies were in adult palliative care services. Since January 2015, 496 cases were studied to enquire about their experience in both home based care and nursing home care. Both the studies fulfilled our quality appraisal criteria. One found that those families and patients who received home visits from volunteers were significantly more satisfied. The study highlighted the value of the role of volunteers in better satisfaction of patients and their families. Conclusions: Further research is needed to evaluate the role of volunteers in palliative care and how it can be delivered appropriately and effectively. We also wish to compare our findings with similar studies elsewhere.

Keywords: palliative care, terminal care, cancer, home care

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Authors: Mohamed Sanad, Noha Hassan

Abstract:

A broadband resonant terminal antenna has been developed. It can be used in different MIMO arrangements such as 2x2, 4x4, 8x8, or even 12x12 MIMO configurations. The antenna covers the whole LTE and WiFi bands besides the existing 2G/3G bands (700-5800 MHz), without using any matching/tuning circuits. Matching circuits significantly reduce the efficiency of any antenna and reduce the battery life. They also reduce the bandwidth because they are frequency dependent. The antenna can be implemented in smartphone handsets, tablets, laptops, notebooks or any other terminal. It is also suitable for different IoT and vehicle applications. The antenna is manufactured from a flexible material and can be bent or folded and shaped in any form to fit any available space in any terminal. It is self-contained and does not need to use the ground plane, the chassis or any other component of the terminal. Hence, it can be mounted on any terminal at different positions and configurations. Its performance does not get affected by the terminal, regardless of its type, shape or size. Moreover, its performance does not get affected by the human body of the terminal’s users. Because of all these unique features of the antenna, multiples of them can be simultaneously used for MIMO diversity coverage in any terminal device with a high isolation and a low correlation factor between them.

Keywords: IOT, LTE, MIMO, terminal antenna, WiFi

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Authors: Elzbieta Sikorska-Simmons

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Dementia is a progressive terminal disease. Despite this recognition, research shows that most family caregivers do not know it, and it is unclear how this knowledge affects the quality of patient care. The aim of this qualitative study of 20 family caregivers for patients with advanced dementia is to examine how the caregiver's knowledge about dementia affects the quality of patient care in the context of healthcare decision-making, advanced care planning, and access to adequate support systems. Knowledge about dementia implies family caregivers' understanding of dementia trajectories, common symptoms/complications, and alternative treatment options (e.g., comfort feeding versus tube feeding). Data were collected in semi-structured interviews with 20 family caregivers. The interviews were conducted in person by the author and designed to elicit rich descriptions of family caregivers' experiences with healthcare decision-making and the management of common symptoms/complications of end-stage dementia as patient healthcare proxies. The study findings suggest that caregivers who recognize that dementia is a terminal disease are less likely to opt for life-extending treatments during the advanced stages. They are also more likely to seek palliative/hospice care, and consequently, they are better able to avoid unnecessary hospitalizations or medical procedures. For example, those who know that dementia is a terminal disease tend to opt for "comfort feeding" rather than "tube feeding" in managing the swallowing difficulties that accompany advanced dementia. In the context of advance care planning, family caregivers who know that dementia is a terminal disease tend to have more meaningful advance directives (e.g., Power of Attorney and Do Not Resuscitate orders). They are better prepared to anticipate common problems and pursue treatments that foster the best quality of patient life and care. Greater knowledge about advanced dementia helps them make more informed decisions that focus on enhancing the quality of patient life rather than just survival. In addition, those who know that dementia is a terminal disease are more likely to establish adequate support systems to help them cope with the complex demands of caregiving. For example, they are more likely to seek dementia-oriented primary care programs that offer house visits or respite services. Based on the study findings, knowledge about dementia as a terminal disease is critical in the optimal management of patient care needs and the establishment of adequate support systems. More research is needed to better understand what caregivers need to know to better prepare them for the complex demands of dementia caregiving.

Keywords: dementia education, family caregiver, management of dementia, quality of care

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Authors: H. N. S. Silva, S. N. Silva

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Introduction: 88.3% of physicians decided to choose a ‘no-code’ or a DNR order if hospitalized and would choose to die less aggressively at home. However, their wishes were mostly over ridden. Objective: To assess the attitudes of nurses towards the end-of-the-life care they would like to receive for themselves and their attitudes towards terminal illnesses. Methods: A mixed method approach was used. A closed and open-ended questionnaire was administered to 73 participants and 5 registered nurses, who have more than 10 years of experience, working in hospitals both in Sri Lanka and abroad, were interviewed. Results: 94.1% of the participants stated that they would like to die at home, spending their last hours at home surrounded by their loved ones and engaging in religious activities but 57.7% of unmarried nurse said they would agree on euthanasia if they had a terminal disease, and also 66.2% of them stated they would agree in DNR order if they happen to be admitted to the ICU, but 82.5% wanted to diagnose if they had a terminal illness or cancer but did not agree on euthanasia. Qualitative analysis confirmed the findings and revealed that despite having adequate confidence about the hospital care, nurses would choose to die at home, surrounded by their loved once and engaging in religious activities. Euthanasia was believed to be inappropriate as it is religiously incorrect and as death is a natural process. Conclusion: The perception of death among nurses depends on their religious belief.

Keywords: death, do not resuscitate, euthanasia, nurses

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Authors: Emni Omar Daw Hussin, Pathmawathi Subramanian, Wong Li Ping

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Background: To provide quality care at the end of life, nurses should possess knowledge and skills to provide effective end-of-life care, as well as develop the attitudes and interpersonal competence to provide compassionate care. Aim: This study aimed to assess nurses’ knowledge and attitude towards end of life care and caring for terminal ill patients and to examine relationships among demographic variables and nurse’s knowledge and attitudes toward end of life care and caring for terminal ill patients. Method: a cross-sectional study was conducted at 1 tertiary hospital located in Kuala Lumpur, Malaysia. Self-administrative questionnaire was used to collect data from 553 nurses from over all departments except emergency department, operation theater and outpatient clinic. Two tools were used in this study, the Frommelt’s Attitude Toward Care of the Dying (FATCOD) Scale to assess the nurses’ attitude and End of Life Knowledge Assessment to assess the nurses’ knowledge. Result: the result of this study yielded that, the majority of participants (54.8%) and (54.4%) have less positive attitude and knowledge towards end of life care and caring for terminal ill patients respectively. As well as there is no significant relationship were found between nurses’ ethnicity, religion, and the total score of FATCOD scale; End of Life Knowledge Assessment score. On other hand there is significant relationship among nurses’ age, working experience, level of education, attending any post basic courses and the total score of both FATCOD scale and End of Life Knowledge Assessment. Conclusion: A lack of education and experience and post basic course about end of life care and palliative care may contribute to the negative attitudes and poor knowledge regarding end of life care. Providing sufficient courses about end of life care could enhance the nurses’ knowledge towards end of life care, as well as providing a reflective narrative environment in which nurses can express their personal feelings about death and dying could be a potentially effective approach. Implication for Practice: This study elaborates the need for further research to develop an effective educational programs to enhance nurses’ knowledge and to promote positive attitude towards death and dying, as well as enhance communication skills, and coping strategies.

Keywords: knowledge, attitude, nurse, end of life care

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Authors: Jiheon Park, Taekwang Kim, Kwang Ryel Ryu

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Electric automated guided vehicles (AGVs) are becoming popular in many automated container terminals nowadays because they are pollution-free and environmentally friendly vehicles for transporting the containers within the terminal. Since efficient operation of AGVs is critical for the productivity of the container terminal, the replacement of batteries of the AGVs must be conducted in a strategic way to minimize undesirable transportation interruptions. While a too frequent replacement may lead to a loss of terminal productivity by delaying container deliveries, missing the right timing of battery replacement can result in a dead AGV that causes a severer productivity loss due to the extra efforts required to finish post treatment. In this paper, we propose a strategy for battery replacement based on a scoring function of multiple criteria taking into account the current battery level, the distances to different battery stations, and the progress of the terminal job operations. The strategy is optimized using a genetic algorithm with the objectives of minimizing the total time spent for battery replacement as well as maximizing the terminal productivity.

Keywords: AGV operation, automated container terminal, battery replacement, electric AGV, strategy optimization

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Authors: Gamal Abd El-Nasser A. Said, El-Sayed M. El-Horbaty

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Container handling problems at container terminals are NP-hard problems. This paper presents an approach using discrete-event simulation modeling to optimize solution for storage space allocation problem, taking into account all various interrelated container terminal handling activities. The proposed approach is applied on a real case study data of container terminal at Alexandria port. The computational results show the effectiveness of the proposed model for optimization of storage space allocation in container terminal where 54% reduction in containers handling time in port is achieved.

Keywords: container terminal, discrete-event simulation, optimization, storage space allocation

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Authors: Z. Bouchama, N. Essounbouli, A. Hamzaoui, M. N. Harmas

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A new robust finite time synergetic controller is presented based on recently developed synergetic control methodology and a terminal attractor technique. A Fast Terminal Synergetic Control (FTSC) is proposed for controlling DC-DC buck converter. Unlike Synergetic Control (SC) and sliding mode control, the proposed control scheme has the characteristics of finite time convergence and chattering free phenomena. Simulation of stabilization and reference tracking for buck converter systems illustrates the approach effectiveness while stability is assured in the Lyapunov sense and converse Lyapunov results involving scalar differential inequalities are given for finite-time stability.

Keywords: dc-dc buck converter, synergetic control, finite time convergence, terminal synergetic control, fast terminal synergetic control, Lyapunov

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Authors: Vahid Tabrizi, Reza GHasemi, Ahmadreza Vali

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This paper presents robust nonlinear control law for a quadrotor UAV using fast terminal sliding mode control. Fast terminal sliding mode idea is used for introducing a nonlinear sliding variable that guarantees the finite time convergence in sliding phase. Then, in reaching phase for removing chattering and producing smooth control signal, continuous approximation idea is used. Simulation results show that the proposed algorithm is robust against parameter uncertainty and has better performance than conventional sliding mode for controlling a quadrotor UAV.

Keywords: quadrotor UAV, fast terminal sliding mode, second order sliding mode t

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Authors: Asma Bettahar, Imed Eddine Nezli, Sameh Habes

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Groundwater resources in the Oued Righ valley are represented like the parts of the eastern basin of the Algerian Sahara, superposed by two major aquifers: the Intercalary Continental (IC) and the Terminal Complex (TC). From a qualitative point of view, various studies have highlighted that the waters of this region showed excessive mineralization, including the waters of the terminal complex (EC Avg equal 5854.61 S/cm) .The present article is a statistical approach by two multi methods various complementary (ACP, CAH), applied to the analytical data of multilayered aquifer waters Terminal Complex of the Oued Righ valley. The approach is to establish a correlation between the chemical composition of water and the lithological nature of different aquifer levels formations, and predict possible connection between groundwater’s layers. The results show that the mineralization of water is from geological origin. They concern the composition of the layers that make up the complex terminal.

Keywords: complex terminal, mineralization, oued righ, statistical approach

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Authors: Asma Bettahar, Imed Eldine Nezli, Sameh Habes

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Groundwater resources in the Oued Righ valley are represented like the parts of the eastern basin of the Algerian Sahara, superposed by two major aquifers: the Intercalary Continental (IC) and the Terminal Complex (TC). From a qualitative point of view, various studies have highlighted that the waters of this region showed excessive mineralization, including the waters of the terminal complex (EC Avg equal 5854.61 S/cm). The present article is a statistical approach by two multi methods various complementary (ACP CAH), applied to the analytical data of multilayered aquifer waters Terminal Complex of the Oued Righ valley. The approach is to establish a correlation between the chemical composition of water and the lithological nature of different aquifer levels formations, and predict possible connection between groundwater’s layers. The results show that the mineralization of water is from geological origin. They concern the composition of the layers that make up the complex terminal.

Keywords: oued righ, complex terminal, infill continental, mineralization

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Authors: Ewelina Zdebska

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A social worker is an integral part of an interdisciplinary team working with the child and his family in a terminal state. Social support is an integral part of the medical procedure in the care of hospice. This is the basis and prerequisite of full treatment and good care of the child - patient, whose illness often finds at least the expected period of his life when his personal and legal issues are not regulated, and the family burdened with the problem requires care and support specialists - professionals. Hospice for Children in Krakow: a palliative care team operating in the province of Krakow and Malopolska, conducts specialized care for terminally ill children in place of their residence from the time when parents and doctors decided to end of treatment in hospital, allows parents to carry out medical care at home, provides parents social and legal assistance and provides care, psychological support and friendship to families throughout the life of the child's illness and after his death, as long as it is needed. The social worker in a hospice does not bear the burden of solving social problems, which is the responsibility of other authorities, but provides support possible and necessary at the moment. The most common form of assistance is to provide information on benefits, which for the child and his family may be subject to any treatment and fight for the life and health of a child. Employee assists in the preparation and completion of documents, requests to increase the degree of disability because of progressive disease or Allowance care because of the inability to live independently. It works in settling all the issues with the Department of Social Security, as well as with the Municipal and District Team Affairs of disability. Seeking help and support using multi-faceted childcare. With the Centres for Social Welfare contacts are also often on the organization of additional respite care for the sick at home (care), especially in the work of the other members of the family or if the family can not cope with the care and needs extra help. Hospice for Children in Cracow completing construction of Poland's first Respite Care Centre for chronically and terminally ill children, will be an open house where children suffering from chronic and incurable diseases and their families can get professional help, whenever - when they need it. The social worker has to pick up a very important role in caring for a terminally ill child. His presence gives a little patient and family the opportunity to be at this difficult time together while organizing assistance and support.

Keywords: social worker, care, terminal care, hospice

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Authors: Aditya Manna, L. K. Khanra, S. K. Sarkar

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Aim: Due to financial incapability and the absence of manpower-poor families often fail to carry their advanced cancer patients to the nodal centers. This pilot study will explore whether communication by mobile phone can lessen this burden. Method: Initially a plan was generated regarding management of an advanced cancer patient in a nodal center at District Head Quarter. Subsequently every two week a trained social worker attached to the nodal center will follow up and give necessary advice and emotional support to the patients and their families through their registered mobile phone number. Patient’s family were also encouraged to communicate with the team by phone in case of fresh complain and urgency in between. Results: Since initiation in January 2013, 193 cancer patients were contacted by mobile phone every two weeks to enquire about their difficulties. In 76% of the situation trained social workers could give necessary advice by phone regarding management of their physical symptoms. Moreover, patient’s family was really overwhelmed by the emotional support offered by the team over the phone. Only 24% of cancer patients have to attend the nodal center for expert advice from Palliative Care specialists. Conclusion: This novel approach helped: (a) In providing regular physical and emotional support to the patients and their families. (b) In significantly reducing the financial and manpower problems of carrying patients to the nodal units. (c) In improving the quality of life of patients by continuous guidance. More and more team members can take help of this new strategy for better communication and uninterrupted care.

Keywords: palliative care, terminal care, home based palliative care, rural india

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Authors: Shang-Sin Shiu, Shu-I Chin, Hsiu-Ju Chen, Ru-Yu Lien

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The Hospice and Palliative Care Act has undergone three revisions, making it less challenging for terminal patients to withdraw life support systems. However, the adequacy of care before withdraw is a crucial factor in end-of-life medical treatment. The author observed that intensive care unit (ICU) nursing staff often rely on simple flowcharts or word of mouth, leading to inadequate preparation and failure to meet patient needs before withdraw. This results in confusion or hesitation among those executing the process. Therefore, there is a motivation to improve the withdraw of patient care processes, establish standardized procedures, ensure the accuracy of removal execution, enhance end-of-life care self-efficacy for nursing staff, and improve the overall quality of care. The investigation identified key issues: the lack of applicable guidelines for ICU care for withdraw from life-sustaining, insufficient education and training on withdraw and end-of-life care, scattered locations of withdraw-related tools, and inadequate self-efficacy in withdraw from life-sustaining care. Solutions proposed include revising withdraw care processes and guidelines, integrating tools and locations, conducting educational courses, and forming support groups. After the project implementation, the accuracy of removal cognition improved from 78% to 96.5%, self-efficacy in end-of-life care after removal increased from 54.7% to 93.1%, and the correctness of care behavior progressed from 27.7% to 97.8%. It is recommended to regularly conduct courses on removing life support system care and grief consolation to enhance the quality of end-of-life care.

Keywords: the intensive care unit (ICU) patients, nursing staff, withdraw life support systems, self-efficacy

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Authors: H. Abderrezek, M. N. Harmas

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DC-DC converters are widely used as reliable power source for many industrial and military applications, computers and electronic devices. Several control methods were developed for DC-DC converters control mostly with asymptotic convergence. Synergetic control (SC) is a proven robust control approach and will be used here in a so-called terminal scheme to achieve finite time convergence. Lyapunov synthesis is adopted to assure controlled system stability. Furthermore particle swarm optimization (PSO) algorithm, based on an integral time absolute of error (ITAE) criterion will be used to optimize controller parameters. Simulation of terminal synergetic control of a DC-DC converter is carried out for different operating conditions and results are compared to classic synergetic control performance, that which demonstrate the effectiveness and feasibility of the proposed control method.

Keywords: DC-DC converter, PSO, finite time, terminal, synergetic control

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Authors: Hsiao-Lin Fang

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Every life is precious, and comprehensive care should be provided to individuals who are in the final stages of their lives. Hospice-shared care aims to provide optimal symptom control and palliative care to terminal (cancer) patients through the implementation of shared care, and to support patients and their families in making various physical and psychological adjustments in the face of death. This report examines a 10-year-boy diagnosed with Out-of-Hospital Cardiac Arrest (OHCA). The individual fainted when swimming at school and underwent 31 minutes of cardiopulmonary resuscitation (CPR). While receiving treatment at the hospital, the individual received extracorporeal membrane oxygenation(ECMO) due to unstable hemodynamics. Urgent cardiac catheterization found: Suspect acute fulminant myocarditis or underlying cardiomyopathy with acute decompensation, After the active rescue by the medical team, hemodynamics still showed only mean pressure value. With respect to the patient, interdepartmental hospice-shared care was implemented and a do-not-resuscitate (DNR) order was signed after family discussions were conducted. Assistance and instructions were provided as part of the comfort care process. A farewell gathering attended by the patient’s relatives, friends, teachers, and classmates was organized in an intensive care unit (ICU) in order to look back on the patient’s life and the beautiful memories that were created, as well as to alleviate the sorrow felt by family members, including the patient’s father and sister. For example, the patient was presented with drawings and accompanied to a garden to pick flowers. In this manner, the patient was able to say goodbye before death. Finally, the patient’s grandmother and father participated in the clinical hospice care and post-mortem care processes. A hospice-shared care clinician conducted regular follow-ups and provided care to the family of the deceased, supporting family members through the sorrowful period. Birth, old age, sickness, and death are the natural phases of human life. In recent years, growing attention has been paid to human-centered hospice care. Hospice care is individual holistic care provided by a professional team and it involves the provision of comprehensive care to a terminal patient. Hospice care aims to satisfy the physical, psychological, mental, and social needs of patients and their families. It does not involve the cessation of treatment but rather avoids the exacerbation or extension of the suffering endured by patients, thereby preserving the dignity and quality of life during the end-of-life period. Patients enjoy the company of others as they complete the last phase of their lives, and their families also receive guidance on how they can move on with their own lives after the patient’s death.

Keywords: hospice-shared care, extracorporeal membrane oxygenation (ECMO), hospice-shared care, child patient

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Authors: Wei Hu, Wenguang Chen, Chong Dong

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In order to improve the efficiency and safety of photovoltaic power generation devices, this photovoltaic power generation system combines Artificial Intelligence (AI) and the Internet of Things (IoT) to control the chasing photovoltaic power generation device to track the sun to improve power generation efficiency and then convert energy management. The system uses artificial intelligence as the control terminal, the power generation device executive end uses the Linux system, and Exynos4412 is the CPU. The power generating device collects the sun image information through Sony CCD. After several power generating devices feedback the data to the CPU for processing, several CPUs send the data to the artificial intelligence control terminal through the Internet. The control terminal integrates the executive terminal information, time information, and environmental information to decide whether to generate electricity normally and then whether to convert the converted electrical energy into the grid or store it in the battery pack. When the power generation environment is abnormal, the control terminal authorizes the protection strategy, the power generation device executive terminal stops power generation and enters a self-protection posture, and at the same time, the control terminal synchronizes the data with the cloud. At the same time, the system is more intelligent, more adaptive, and longer life.

Keywords: photo-voltaic power generation, the pursuit of light, artificial intelligence, internet of things, photovoltaic array, power management

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Authors: Sana Bembli, Nahla Khraief Haddad, Safya Belghith

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This paper deals with a robust model free terminal sliding mode with gravity compensation approach used to control an exoskeleton-upper limb system. The considered system is a 2-DoF robot in interaction with an upper limb used for rehabilitation. The aim of this paper is to control the flexion/extension movement of the shoulder and the elbow joints in presence of matched disturbances. In the first part, we present the exoskeleton-upper limb system modeling. Then, we controlled the considered system by the model free terminal sliding mode with gravity compensation. A stability study is realized. To prove the controller performance, a robustness analysis was needed. Simulation results are provided to confirm the robustness of the gravity compensation combined with to the Model free terminal sliding mode in presence of uncertainties.

Keywords: exoskeleton- upper limb system, model free terminal sliding mode, gravity compensation, robustness analysis

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Authors: M. H. Korayem, Sh. Ameri, N. Yousefi Lademakhi

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To ensure the stability of closed-loop nonlinear model predictive control (NMPC) within a finite horizon, there is a need for appropriate design terminal ingredients, which can be a time-consuming and challenging effort. Otherwise, in order to ensure the stability of the control system, it is necessary to consider an infinite predictive horizon. Increasing the prediction horizon increases computational demand and slows down the implementation of the method. In this study, a new technique has been proposed to ensure system stability without terminal ingredients. This technique has been employed in the design of the NMPC algorithm, leading to a reduction in the computational complexity of designing terminal ingredients and computational burden. The studied system is a wheeled mobile robot (WMR) subjected to non-holonomic constraints. Simulation has been investigated for two problems: trajectory tracking and adjustment mode.

Keywords: wheeled mobile robot, nonlinear model predictive control, stability, without terminal ingredients

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Authors: Jui-Hung Hung, Ching-Liang Hsieh, Yi-Wen Lin

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Modern medicine highly emphasizes the importance of palliative treatment. The inception of palliative and hospice care recently developed into the concept of caring for the patients’ and families’ physical, psychological and spiritual problems. There are several benefits related to palliative care such as reducing medical expenses, decreasing patients’ suffer, and supporting patient go through the finale of the life. Nowadays, in Taiwan, over 60-70% terminal cancer patients were covered in hospice care, and the coverage rate increased annually. Acupuncture is a well-known therapy used more than thousand years to relieve symptoms of cancer patient. Many reports showed that, even in the Western society, many reputable medical centers can provide Acupuncture therapy for patients. Accordingly, using Acupuncture for cancer patient care is a global trend. There are increased evidences indicate that Acupuncture can relieve the symptoms for cancer patients including pain, reduce the dosage of anesthetic, improve the cancer-related fatigue, relieve the chemotherapy-related nausea and vomiting, ease anxiety mood and even improving the quality of life. Furthermore, some trials show that Acupuncture may help relieve xerostomia, hot flash, sleep disorders, and some GI discomfort and so on. Acupuncture therapy has many advantages for clinical use with effective, low-cost, minimal side effect, suitable for cancer patients and even for elderly population. Especially in nowadays, there are more diversified challenges in modern medicine, all of them will make the higher medical budget. We suggest that Acupuncture will be one of methods for palliative care for cancer patients.

Keywords: Acupuncture, cancer, integrative medicine, palliative care

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Authors: Mir Hussain Nawaz, Lyudmila Nedyalkova, Haizhong Zhu, Wael M. Rabeh

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In this study, we aim to biochemically and structurally characterize the interactions of human HK2 with the mitochondria in addition to the role of its N-terminal domain in catalysis and stability of the full-length enzyme. Here, we solved the crystal structure of human HK2 in complex with glucose and glucose-6-phosphate (PDB code: 2NZT), where it is a homodimer with catalytically active N- and C-terminal domains linked by a seven-turn α-helix. Different from the inactive N-terminal domains of isozymes 1 and 3, the N- domain of HK2 not only capable to catalyze a reaction but it is responsible for the thermodynamic stabilizes of the full-length enzyme. Deletion of first α-helix of the N-domain that binds to the mitochondria altered the stability and catalytic activity of the full-length HK2. In addition, we found the linker helix between the N- and C-terminal domains to play an important role in controlling the catalytic activity of the N-terminal domain. HK2 is a major step in the regulation of glucose metabolism in cancer making it an ideal target for the development of new anticancer therapeutics. Characterizing the structural and molecular mechanisms of human HK2 and its role in cancer metabolism will accelerate the design and development of new cancer therapeutics that are safe and cancer specific.

Keywords: cancer metabolism, enzymology, drug discovery, protein stability

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Authors: V. Tabrizi, A. Vali, R. GHasemi, V. Behnamgol

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In this article, a nonlinear model of an under actuated six degrees of freedom (6 DOF) quadrotor UAV is derived on the basis of the Newton-Euler formula. The derivation comprises determining equations of the motion of the quadrotor in three dimensions and approximating the actuation forces through the modeling of aerodynamic coefficients and electric motor dynamics. The robust nonlinear control strategy includes a smooth second order non-singular terminal sliding mode control which is applied to stabilizing this model. The control method is on the basis of super twisting algorithm for removing the chattering and producing smooth control signal. Also, nonsingular terminal sliding mode idea is used for introducing a nonlinear sliding variable that guarantees the finite time convergence in sliding phase. Simulation results show that the proposed algorithm is robust against uncertainty or disturbance and guarantees a fast and precise control signal.

Keywords: quadrotor UAV, nonsingular terminal sliding mode, second order sliding mode t, electronics, control, signal processing

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Authors: K. Jagannath, Akhilesh Kotian, S. S. Sharma, Achutha Kini U., P. R. Prabhu

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Boiling process is characterized by the rapid formation of vapour bubbles at the solid–liquid interface (nucleate boiling) with pre-existing vapour or gas pockets. Computational fluid dynamics (CFD) is an important tool to study bubble dynamics. In the present study, CFD simulation has been carried out to determine the bubble detachment diameter and its terminal velocity. Volume of fluid method is used to model the bubble and the surrounding by solving single set of momentum equations and tracking the volume fraction of each of the fluids throughout the domain. In the simulation, bubble is generated by allowing water-vapour to enter a cylinder filled with liquid water through an inlet at the bottom. After the bubble is fully formed, the bubble detaches from the surface and rises up during which the bubble accelerates due to the net balance between buoyancy force and viscous drag. Finally when these forces exactly balance each other, it attains a constant terminal velocity. The bubble detachment diameter and the terminal velocity of the bubble are captured by the monitor function provided in FLUENT. The detachment diameter and the terminal velocity obtained is compared with the established results based on the shape of the bubble. A good agreement is obtained between the results obtained from simulation and the equations in comparison with the established results.

Keywords: bubble growth, computational fluid dynamics, detachment diameter, terminal velocity

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Authors: Neetesh Saxena, Narendra S. Chaudhari

Abstract:

Nowadays, SMS is a very popular mobile service and even the poor, illiterate people and those living in rural areas use SMS service very efficiently. Although many mobile operators have already started 3G and 4G services, 2G services are still being used by the people in many countries. In 2G (GSM), only encryption provided is between the MS and the BTS, there is no end-to-end encryption available. Sometimes we all need to send some confidential message to other person containing bank account number, some password, financial details, etc. Normally, a message is sent in plain text only to the recipient and it is not an acceptable standard for transmitting such important and confidential information. Authors propose an end-to-end encryption approach by proposing a terminal for sending/receiving a secure message. An asymmetric key exchange algorithm is used in order to transmit secret shared key securely to the recipient. The proposed approach with terminal device provides authentication, confidentiality, integrity and non-repudiation.

Keywords: AES, DES, Diffie-Hellman, ECDH, A5, SMS

Procedia PDF Downloads 373

Authors: Chur Hee Lee, Ju Sik Kwak, Seung Wan Kim

Abstract:

This paper deals about economics and control of optimal placement of multi-terminal HVDC in Korea. Currently, No.1 and 2 HVDC are installed in Jeju and Mainland, Dangjin Godeok HVDC starts operation in 2020. Jeju No.3 HVDC also starts operation in 2022. HVDC systems in Korea are expanding. Also, super grid projects with China, Japan, and Russia are under consideration. In this situation, it is necessary to study how to install optimal HVDC in Korea and how to control it. After initializing the Optical Polwer Flow (OPF) procudure using lossless economic dispatch, grobal iteration will be set. And then, this will be formed as the Lagrangian function and linearizied. We will also analyze the advantages and disadvantages of each operation mode for optimal operating conditions of voltage and current complex HVDC in Korea.

Keywords: economics, HVDC, multi terminal, optimal

Procedia PDF Downloads 183

Authors: Goldie Lynn Diaz, Ma. Teresa Tricia G. Bautista, Elisabeth Engeljakob, Mary Glaze Rosal

Abstract:

Introduction: Residents are expected to convey unfavorable news, discuss prognoses, and relieve suffering, and address do-not-resuscitate orders, yet some report a lack of competence in providing this type of care. Recognizing this need, Family Medicine residency programs are incorporating end-of-life care from symptom and pain control, counseling, and humanistic qualities as core proficiencies in training. Objective: This study determined the competency of Family Medicine Residents from various institutions in Metro Manila on rendering care for the dying. Materials and Methods: Trainees completed a Palliative Care Evaluation tool to assess their degree of confidence in patient and family interactions, patient management, and attitudes towards hospice care. Results: Remarkably, only a small fraction of participants were confident in performing independent management of terminal delirium and dyspnea. Fewer than 30% of residents can do the following without supervision: discuss medication effects and patient wishes after death, coping with pain, vomiting and constipation, and reacting to limited patient decision-making capacity. Half of the respondents had confidence in supporting the patient or family member when they become upset. Majority expressed confidence in many end-of-life care skills if supervision, coaching and consultation will be provided. Most trainees believed that pain medication should be given as needed to terminally ill patients. There was also uncertainty as to the most appropriate person to make end-of-life decisions. These attitudes may be influenced by personal beliefs rooted in cultural upbringing as well as by personal experiences with death in the family, which may also affect their participation and confidence in caring for the dying. Conclusion: Enhancing the quality and quantity of end-of-life care experiences during residency with sufficient supervision and role modeling may lead to knowledge and skill improvement to ensure quality of care. Fostering bedside learning opportunities during residency is an appropriate venue for teaching interventions in end-of-life care education.

Keywords: end of life care, geriatrics, palliative care, residency training skill

Procedia PDF Downloads 228

Authors: Ahmed Al-Sultan

Abstract:

The check-in area of airport terminal is one of the busiest sections at airports at certain periods. The passengers are subjected to queues and delays during the check-in process. These delays and queues are due to constraints in the capacity of service facilities. In this project, the airport terminal is decomposed into several check-in areas. The airport check-in scheduling problem requires both a deterministic (integer programming) and stochastic (simulation) approach. Integer programming formulations are provided to minimize the total number of counters in each check-in area under the realistic constraint that counters for one and the same flight should be adjacent and the desired number of counters remaining in each area should be fixed during check-in operations. By using simulation, the airport system can be modeled to study the effects of various parameters such as number of passengers on a flight and check-in counter opening and closing time.

Keywords: airport terminal, integer programming, scheduling, simulation

Procedia PDF Downloads 356

Authors: Maximo Cozzetti

Abstract:

The aim is to evaluate the capability of the 'Siberian Husky' (FCI-Standard Nº 270) breed of the common dog (Canis lupus familiaris) to detect terminally-ill human patients undergoing palliative care. A total of 49 such patients that fulfill the 'National Scientific and Technical Research Council–Ethical Principles for the Behavior of the Scientific and Technical Investigator' policy, (mainly affected with Stage IV Hodgkin lymphoma or Stage IV Carcinoma, though various other terminal diseases were present) and 49 controls were enrolled. A total of 13 specimens of Siberian Huskies (Canis lupus familiaris FCI – Standard Nº 270) were selected. After a conditioning training regime in which the canines were rewarded when identifying terminally ill patients and excluding the control subjects, a double-blind experiment was conducted in which the canines were presented with a previously unknown patient through an olfactory-proof plexiglass window for 2-minute intervals. The test subjects correctly identified 89.80% of the humans as either ‘ill’ or ‘healthy’. It is important to note that both groups of humans were selected considering and preventing confounding and self-identifying factors such as age, ethnicity, clothing, posture, skin color, alopecia (chemotherapy-induced or otherwise), etc. The olfactory-proofing of the test area rules out the use of the sense of smell to detect distinctive drugs or bodily odors that may be associated with terminal diseases. Thus, the Siberian Husky breed of the common dog shows the visual capability to detect and identify terminally ill patients undergoing palliative care regardless of age, posture, and quantity of hair. Though the capability of the breed of dog to detect terminally-ill patients was observed thoroughly during the course of the experiments, the exact process by which the canines identify the test subjects remains unknown and further research is encouraged.

Keywords: Canis lupus familiaris, Siberian Husky, visual identification of terminall illness, FCI-Standard Nº270

Procedia PDF Downloads 128

Authors: Jungho Moon, Lae Jeong Park

Abstract:

This paper introduces the development of a firmware downloader for students attending microcontroller-related courses taught by the authors In the courses, AVR microcontroller experiment kits are used for programming exercise and the AVR microcontroller is programmed through a serial communication interface using a bootloader preinstalled on it. To use the bootloader, a matching firmware downloader that runs on a host computer and communicates with the bootloader is also required. When firmware downloading is completed, the serial port used for it needs to be closed. If the downloaded firmware uses serial communication, the serial port needs to be reopened in a serial terminal. As a result, the programmer of the AVR board switches from the downloader program and the serial terminal and vice versa. It is a simple task but quite a hassle to do each time new firmware needs downloading. To provide a more convenient programming environment for the courses, the authors developed a downloader program that includes a serial terminal in it. The program operates in downloader or terminal mode and the mode switching is performed automatically; therefore manual mode switching is not necessary. The feature provides a more convenient development environment by eliminating the need for manual mode switching each time firmware downloading is required.

Keywords: bootloader, firmware downloader, microcontroller, serial communication

Procedia PDF Downloads 159