Search results for: Hospital

Authors: A. Sherif, H. Sabry, A. Elzafarany, M. Gadelhak, R. Arafa, M. Aly

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This paper addresses the design of hospital Intensive Care Unit windows for the achievement of visual comfort and energy savings. The aim was to identify the window size and shading system configurations that could fulfill daylighting adequacy, avoid glare and reduce energy consumption. The study focused on addressing the effect of utilizing different shading systems in association with a range of Window-to-Wall Ratios (WWR) in different orientations under the desert clear-sky of Cairo, Egypt. The results of this study demonstrated that solar penetration is a critical concern affecting the design of ICU windows in desert locations, as in Cairo, Egypt. Use of shading systems was found to be essential in providing acceptable daylight performance and energy saving. Careful positioning of the ICU window towards a proper orientation can dramatically improve performance. It was observed that ICU windows facing the north direction enjoyed the widest range of successful window configuration possibilities at different WWRs. ICU windows facing south enjoyed a reasonable number of configuration options as well. By contrast, the ICU windows facing the east orientation had a very limited number of options that provide acceptable performance. These require additional local shading measures at certain times due to glare incidence. Moreover, use of horizontal sun breakers and solar screens to protect the ICU windows proved to be more successful than the other alternatives in a wide range of Window to Wall Ratios. By contrast, the use of light shelves and vertical shading devices seemed questionable.

Keywords: Daylighting, Desert, Energy Efficiency, Shading.

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Authors: Yujun Zheng, Qin Song, Haihe Shi, and Jinyun Xue

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There are a number of different cars for transferring hundreds of close contacts of swine influenza patients to hospital, and we need to carefully assign the passengers to those cars in order to minimize the risk of influenza spreading during transportation. The paper presents an approach to straightforward obtain the optimal solution of the relaxed problems, and develops two iterative improvement algorithms to effectively tackle the general problem.

Keywords: Influenza spread, discrete optimization, stationary point, iterative improvement

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Authors: G. Feletti, D. Tedesco, P. Trucco

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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of a first phase of revision of the technical-scientific literature concerning the indicators currently in use for the performance measurement of EMS. It emerges that current studies focus on two distinct areas and independent objectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). Conversely, the perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal covers the end-to-end healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid even to EMS aspects that in current literature tend to be neglected or underestimated. In particular, the integration of the two processes enables to evaluate the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering, besides the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating firstly the ones not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draw us to exclude additional indicators due to unavailability of data required for their computation. The final dashboard, that was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness on EDs accessibility in real time. The association of each KPI to the EMS phase it refers to enabled the design of a well-balanced dashboard, covering both efficiency and effectiveness performance objectives of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient care are covered by traditional KPIs. Future developments could be directed to building a hierarchical dashboard, composed by a high-level minimal set of KPIs for measuring the basic performance of the EMS system, at an aggregate level, and lower levels of KPIs that bring additional and more detailed information on specific performance dimensions or EMS phases.

Keywords: Emergency Medical Services, Key Performance Indicators, Dashboard, Decision Support.

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Authors: A. Taqaddas

Abstract:

The following case study presents the management of stage III Differentiated Thyroid Cancer (DTC) patient in an NHS hospital in London, UK during period of 2004-2005.

Keywords: Differentiated Thyroid Cancer, Oncological Management, Papillary, Thyroid Cancer, Stage III.

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Authors: Pei-Chann Chang, Jui-Chien Hsieh, Jyun-Jie Lin, Feng-Ming Yeh

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Atrial Fibrillation is the most common sustained arrhythmia encountered by clinicians. Because of the invisible waveform of atrial fibrillation in atrial activation for human, it is necessary to develop an automatic diagnosis system. 12-Lead ECG now is available in hospital and is appropriate for using Independent Component Analysis to estimate the AA period. In this research, we also adopt a second-order blind identification approach to transform the sources extracted by ICA to more precise signal and then we use frequency domain algorithm to do the classification. In experiment, we gather a significant result of clinical data.

Keywords: 12-Lead ECG, Atrial Fibrillation, Blind SourceSeparation, Kurtosis

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Authors: Marina Gorunescu, Florin Gorunescu, Kenneth Revett

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Hepatocellular carcinoma, also called hepatoma, most commonly appears in a patient with chronic viral hepatitis. In patients with a higher suspicion of HCC, such as small or subtle rising of serum enzymes levels, the best method of diagnosis involves a CT scan of the abdomen, but only at high cost. The aim of this study was to increase the ability of the physician to early detect HCC, using a probabilistic neural network-based approach, in order to save time and hospital resources.

Keywords: Early HCC diagnosis, probabilistic neural network.

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Authors: J. Silva, P. Arezes, R. Schierl, N. Costa

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In order to study environmental contamination by cytostatic drugs in Portugal hospitals, sampling campaigns were conducted in three hospitals in 2015 (112 samples). Platinum containing drugs and fluorouracil were chosen because both were administered in high amounts. The detection limit was 0.01 pg/cm² for platinum and 0.1 pg/cm² for fluorouracil. The results show that spills occur mainly on the patient`s chair, while the most referenced occurrence is due to an inadequately closed wrapper. Day hospitals facilities were detected as having the largest number of contaminated samples and with higher levels of contamination.

Keywords: Antineoplastic, drugs, exposure, surface.

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Authors: Syed Dawood Md. Taimur, Saidur Rahman Khan, Farzana Islam

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To evaluate the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) that is treadmill results and coronary artery findings. This descriptive study was conducted at Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from 1st January, 2014 to 31st August, 2014. All patients who had done ETT (treadmill) for chest pain diagnosis were studied. One hundred and four patients underwent coronary angiogram after positive treadmill result. Patients were divided into two groups depending upon the angiographic findings, i.e. true positive and false positive. Positive treadmill test patients who have coronary artery involvement these are called true positive and who have no involvement they are called false positive group. Both groups were compared with each other. Out of 104 patients, 81 (77.9%) patients had true positive ETT and 23 (22.1%) patients had false positive ETT. The mean age of patients in positive ETT was 53.46± 8.06 years and male mean age was 53.63±8.36 years and female was 52.87±7.0 years. Sixty nine (85.19%) male patients and twelve (14.81%) female patients had true positive ETT, whereas 15 (65.21%) males and 8 (34.79%) females had false positive ETT, this was statistically significant (p<0.032) in the two groups (sex) in comparison of true and false positive ETT. The risk factors of these patients like diabetes mellitus, hypertension, dyslipidemia, family history and smoking were seen among these patients. Hypertensive patients having true positive which were statistically significant (p<0.004) and diabetic, dyslipidemic patients having true positive which were statistically significant (p<0.032 & 0.030).True positive patients had family history were 68(83.95%) and smoking were 52 (64.20%), where family history patients had statistically significant (p<0.017) between two groups of patients and smokers were significant (p<0.012). 46 true positive patients achieved THR which was not statistically significant (P<0.138) and 79 true patients had abnormal resting ECG whether it was significant (p<0.036). Amongst the vessels involvement the most common was LAD 55 (67.90 %) followed by LCX 42 (51.85%), RCA 36 (44.44%), and the LMCA was 9 (11.11%). 40 patients (49.38%) had SVD, 26 (30.10%) had DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. It can be concluded that among the female patients who have positive ETT with normal resting ECG, who had achieved target heart rate are likely to have a false positive test result. Conversely male patients, resting abnormal ECG who had not achieved THR, symptom limited ETT, have a hypertension, diabetes, dyslipidemia, family history and smoking are likely to have a true positive treadmill test result.

Keywords: Exercise tolerance test, Coronary artery disease, Coronary angiography, True positive, False positive.

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Authors: Hsin-Yun Lee

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The previous proposed evacuation routing approaches usually divide the space into multiple interlinked zones. However, it may be harder to clearly and objectively define the margins of each zone. This paper proposes an approach that connects locations of necessary guidance into a spatial network. In doing so, evacuation routes can be constructed based on the links between starting points, turning nodes, and terminal points. This approach more conforms to the real-life evacuation behavior. The feasibility of the proposed approach is evaluated through a case of one floor in a hospital building. Results indicate that the proposed approach provides valuable suggestions for evacuation planning.

Keywords: Evacuation, spatial network, simulation.

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Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

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Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, antibiotic misuse, Iraq, prescribing.

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Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: Data integration, disease-related malnutrition, expert systems, mobile health.

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Authors: Michal Javornik, Otto Dostal, Karel Slavicek

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The purpose of this article is to introduce an advanced system for the support of processing of medical image information, and the terminology related to this system, which can be an important element to a faster transition to a fully digitalized hospital. The core of the system is a set of DICOM compliant applications running over a dedicated computer network. The whole integrated system creates a collaborative platform supporting daily routines in the radiology community, developing communication channels, supporting the exchange of information and special consultations among various medical institutions as well as supporting medical training for practicing radiologists and medical students. It gives the users outside of hospitals the tools to work in almost the same conditions as in the radiology departments.

Keywords: DICOM, Integration, Medical Education, MedicalImaging

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Authors: Sung Ho Ha, Seong Hyeon Joo

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Data mining techniques have been used in medical research for many years and have been known to be effective. In order to solve such problems as long-waiting time, congestion, and delayed patient care, faced by emergency departments, this study concentrates on building a hybrid methodology, combining data mining techniques such as association rules and classification trees. The methodology is applied to real-world emergency data collected from a hospital and is evaluated by comparing with other techniques. The methodology is expected to help physicians to make a faster and more accurate classification of chest pain diseases.

Keywords: Data mining, medical decisions, medical domainknowledge, chest pain.

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Authors: P. Bountris, E. Farantatos, N. Apostolou

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Autofluorescence (AF) bronchoscopy is an established method to detect dysplasia and carcinoma in situ (CIS). For this reason the “Sotiria" Hospital uses the Karl Storz D-light system. However, in early tumor stages the visualization is not that obvious. With the help of a PC, we analyzed the color images we captured by developing certain tools in Matlab®. We used statistical methods based on texture analysis, signal processing methods based on Gabor models and conversion algorithms between devicedependent color spaces. Our belief is that we reduced the error made by the naked eye. The tools we implemented improve the quality of patients' life.

Keywords: Bronchoscopy, digital image processing, lung cancer, texture analysis.

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Authors: Abdulrahim Shamayleh

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In this work, the surgical theater of a local hospital in KSA was analyzed using simulation. The focus was on attempting to answer questions related to how many Operating Rooms (ORs) to open and to analyze the performance of the surgical theater in general and mainly the Post Anesthesia Care Unit (PACU) to assist making decisions regarding PACU staffing. The surgical theater consists of ten operating rooms and the PACU unit which has a maximum capacity of fifteen beds. Different sequencing rules to sequence the surgical cases were tested and the Longest Case First (LCF) were superior to others. The results of the different alternatives developed and tested can be used by the manager as a tool to plan and manage the OR and PACU

Keywords: Operating room, post anesthesia care unit, PACUstaffing, sequencing, healthcare

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Authors: Y. Tiamaz, N. Souissi

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The purpose of this paper is to present a classification of Lean models which aims to capture all the concepts related to this approach and thus facilitate its implementation. This classification allows the identification of the most relevant models according to several dimensions. From this perspective, we present a review and an analysis of Lean models literature and we propose dimensions for the classification of the current proposals while respecting among others the axes of the Lean approach, the maturity of the models as well as their application domains. This classification allowed us to conclude that researchers essentially consider the Lean approach as a toolbox also they design their models to solve problems related to a specific environment. Since Lean approach is no longer intended only for the automotive sector where it was invented, but to all fields (IT, Hospital, ...), we consider that this approach requires a generic model that is capable of being implemented in all areas.

Keywords: Lean approach, lean models, classification, dimensions, holistic view.

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Authors: Sharareh Mirsaeidi Farahani , Gholamreza Chitsaz

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Management Systems are powerful tools for businesses to manage quality , environmental and occupational health and safety requirements . where once these systems were considered as stand alone control mechanisms , industry is now opting to increase the efficiency of these documented systems through a more integrated approach . System integration offers a significant step forward, where there are similarities between system components , reducing duplication and adminstration costs and increasing efficiency . At first , this paper reviews integrated management system structure and its benefits. The second part of this paper focuses on the one example implementation of such a system at Imam Khomeini Hospital and in final part of the paper will be discuss outcomes of that proccess .

Keywords: environmental management , Integratedmanagement systems, occupational healt and safetymanagement , quality management.

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Authors: S. Pathomsiri, P. Sukaboon

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The National Blood Center, Thai Red Cross Society is responsible for providing blood to hospitals all over the country. When any hospital needs blood, it will have to send the vehicle to pick up at the NBC. There are a lot of vehicles to pick up blood at the NBC every day. Each vehicle is usually empty for inbound trip and a little loaded for outbound. The NBC realized such waste or loss and there have been the third party offered to distribute blood and charge for fee. This paper proposes to apply the vehicle routing problem (VRP) for estimating the fair price. The idea is tested with the real data during seven-day period of 6 – 12 July 2010 to estimate the fair price for transporting blood in Bangkok Metropolitan Region.

Keywords: Blood Supply Chain, Vehicle Routing Problem, Heuristic, Saving Algorithm, Fair Price.

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Authors: Chuang-Chun Chiou

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Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: Lean, Service improvement, SERVQUAL, Care home service.

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Authors: Y. N. Phang, E. F. Loh

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The zero truncated model is usually used in modeling count data without zero. It is the opposite of zero inflated model. Zero truncated Poisson and zero truncated negative binomial models are discussed and used by some researchers in analyzing the abundance of rare species and hospital stay. Zero truncated models are used as the base in developing hurdle models. In this study, we developed a new model, the zero truncated strict arcsine model, which can be used as an alternative model in modeling count data without zero and with extra variation. Two simulated and one real life data sets are used and fitted into this developed model. The results show that the model provides a good fit to the data. Maximum likelihood estimation method is used in estimating the parameters.

Keywords: Hurdle models, maximum likelihood estimation method, positive count data.

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Authors: Kevin Fong-Rey Liu, Ken Yeh, Cheng-Wu Chen, Han-Hsi Liang

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This paper proposes the use of Bayesian belief networks (BBN) as a higher level of health risk assessment for a dumping site of lead battery smelter factory. On the basis of the epidemiological studies, the actual hospital attendance records and expert experiences, the BBN is capable of capturing the probabilistic relationships between the hazardous substances and their adverse health effects, and accordingly inferring the morbidity of the adverse health effects. The provision of the morbidity rates of the related diseases is more informative and can alleviate the drawbacks of conventional methods.

Keywords: Bayesian belief networks, lead battery smelter factory, health risk assessment.

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Authors: Atay A, Suer BT

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The aim of this retrospective study was to evaluate the parameters of dental implants such as patient gender, number of implant, failed implant before prosthetic restorations and failed implant after implantation and failed implant after prosthetic restorations. 135 male and 99 female patients, total 234 implant patients which have been treated with 450 implant between 2005- 2009 years in GATA Haydarpasa Training Hospital Dental Service. Twelve implants were failed before prosthetic restorations. Four implant were failed after fixed prosthetic restorations. Cumulative survival rate after prostheses were 97.56 % during 6 years period.

Keywords: Dental implants, implant supported prostheses, single implants, single crown

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Authors: Feng-Chuan Pan, Fang-Yue Liu

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Hospitals in southern Hualien teamed with the Hypertension Joint Care Network. Working with the network, the team provided a special designed health education to the individual who had been identified as a hypertension patient in the outpatient department. Some metabolism improvements achieved. This is a retrospective study by purposively taking 106 patients from a hospital between 2008 and 2010. Records of before and after education intervention of the objects was collected and analyzed to see the how the intervention affected the patients- hypertension control via clinical parameter monitoring. The results showed that the clinical indicators, the LDL-C, the cholesterol and the systolic blood pressure were significantly improved. The study provides evidence for the effectiveness of the network in controlling hypertension.

Keywords: hypertension, joint care management network, cardiovascular diseases, metabolic syndrome.

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Authors: Ayman M. Mansour

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In this paper, we propose an intelligent system that is used for monitoring the health conditions of patients. Monitoring the health condition of patients is a complex problem that involves different medical units and requires continuous monitoring especially in rural areas because of inadequate number of available specialized physicians. The proposed system will improve patient care and drive costs down comparing to the existing system in Jordan. The proposed system will be the start point to faster and improve the communication between different units in the health system in Jordan. Connecting patients and their physicians beyond hospital doors regarding their geographical area is an important issue in developing the health system in Jordan. The ability of making medical decisions, the quality of medical is expected to be improved.

Keywords: GSM, SMS, Patient, Monitoring system, Fuzzy Logic, Multi-agent system.

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Authors: Phanu Waraporn

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This paper discusses the designing of knowledge integration of clinical information extracted from distributed medical ontologies in order to ameliorate a machine learning-based multilabel coding assignment system. The proposed approach is implemented using a decision tree technique of the machine learning on the university hospital data for patients with Coronary Heart Disease (CHD). The preliminary results obtained show a satisfactory finding that the use of medical ontologies improves the overall system performance.

Keywords: Medical Ontology, Knowledge Integration, Machine Learning, Medical Coding, Text Assignment.

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Authors: Lely A. Luengas, Pedro R. Vizcaya, Giovanni Sánchez

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In this paper, a methodology is presented to obtain the Static Alignment Model for any transtibial amputee person. The proposed methodology starts from experimental data collected on the Hospital Militar Central, Bogotá, Colombia. The effects of transtibial prosthesis malalignment on amputees were measured in terms of joint angles, center of pressure (COP) and weight distribution. Some statistical tools are used to obtain the model parameters. Mathematical predictive models of prosthetic alignment were created. The proposed models are validated in amputees and finding promising results for the prosthesis Static Alignment. Static alignment process is unique to each subject; nevertheless the proposed methodology can be used in each transtibial amputee.

Keywords: Information theory, prediction model, prosthetic alignment, transtibial prosthesis.

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Authors: T. Turan, Ç. Erdoğan

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As far as is known, general nursing care practices do not include specific evidence-based practices related to oral care in children. This study aimed to evaluate the evidence based nursing practice for oral care in children. This article is planned as a review article by searching the literature in this field. According to all age groups and the oral care in various specific situations located evidence in the literature were examined. It has been determined that the methods and frequency used in oral care practices performed by nurses in clinics differ from one hospital to another. In addition, it is seen that different solutions are used in basic oral care, oral care practices to prevent ventilator-associated pneumonia and evidence-based practice in mucositis management in children. As a result, a standard should be established in oral care practices for children and education for children is recommended.

Keywords: Children, evidence based practice, nursing, oral care.

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Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, Burns, FLAMES, scoring systems, outcome.

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Authors: Bu Seog Ju, Woo Young Jung

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The cost of damage to the non-structural systems in critical facilities like nuclear power plants and hospitals can exceed 80% of the total cost of damage during an earthquake. The failure of nonstructural components, especially, piping systems led to leakage of water and subsequent shut-down of hospitals immediately after the event. Consequently, the evaluation of performance of these types of structural configurations has become necessary to mitigate the risk and to achieve reliable designs. This paper focuses on a methodology to evaluate the static and dynamic characteristics of complex actual piping system based on NFPA-13 and SMACNA guidelines. The result of this study revealed that current piping system subjected to design lateral force and design spectrum based on UBC-97 was failed in both cases and mode shapes between piping system and building structure were very different

Keywords: Nonstructural component, piping, hospital, seismic, bracing.

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Authors: C. S. Mammas, A. Lazaris, A. S. Mamma-Graham, G. Kostopanagiotou, C. Lemonidou, J. Mantas, E. Patsouris

Abstract:

Introduction: The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the remote evaluation of the grafts. It has been estimated that even in well-organized transplant systems an average of 8% to 14% of the grafts (G) that arrive at the recipient hospitals may be considered as diseased, injured, damaged or improper for transplantation. Digital microscopy adds information on a microscopic level about the grafts in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G, will arrive at the recipient hospital for implantation. Aim: Ergonomics of Digital Microscopy (DM) based on virtual slides, on Telemedicine Systems (TS) for Tele-Pathological (TPE) evaluation of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of Renal Graft (RG), Liver Graft (LG) and Pancreatic Graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying Virtual Slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included: a. Development of an OTE-TS similar Experimental Telemedicine System (Exp.-TS), b. Simulation of the integration of TS with the VS based microscopic TPE of RG, LG and PG applying DM. Simulation of the DM based TPE was performed by 2 specialists on a total of 238 human Renal Graft (RG), 172 Liver Graft (LG) and 108 Pancreatic Graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to diagnose accurately the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a Desktop, followed by the ES of the applied Exp.-TS. Tablet and Mobile-Phone ES seem significantly risky for the application of DM in OT (p<.001). Conclusion: To make the largest reduction in errors and adverse events referring to the quality of the grafts, it will take application of human factors engineering to procurement, design, audit, and aware ness-raising activities. Consequently, it will take an investment in new training, people, and other changes to management activities for DM in OT. The simulating VS based TPE with DM of RG, LG and PG tissues after retrieval; seem feasible and reliable and dependable on the size of the electronic space of the applied TS, for remote prevention of diseased grafts from being retrieved and/or sent to the recipient hospital and for post-grafting and pre-transplant planning.

Keywords: Organ Transplantation, Tele-Pathology, Digital Microscopy, Virtual Slides.

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