Search results for: Absorbed Dose to Patient (ADP).
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 634

Search results for: Absorbed Dose to Patient (ADP).

484 Radiation Workers’ Occupational Doses: Are We Really Careful or Overconscious

Authors: Sajjad A. Memon, Sadaf T. Qureshi, Naeem A. Laghari, Noor M. Khuhro

Abstract:

The present study represents the occupational radiation doses received by selected workers of Nuclear Institute of Medicine and Radiotherapy (NIMRA) Jamshoro Pakistan and conducted to discuss about how we be careful and try to avoid make ourselves overconscious. Film badges with unique identification number were issued to radiation worker to detect occupational radiation doses. In this study, only 08 workers with high radiation doses were assessed amongst 35 radiation workers during the period of January 2012 to December 2012. The selected radiation workers’ occupational doses were according to designated work areas and in the range of 1.21 to 7.78 mSv (mili Sieveret) out of the annual dose limit of 20 mSv. By the comparison of different studies and earth’s HNBR (High Natural Background Radiation) locations’ doses, it is concluded that the worker’s high doses are of magnitude of HNBR Regions and were in the acceptable range of National and International regulatory bodies so we must not to show any type of overconsciousness but be careful in handling the radioactive sources.

Keywords: Natural background radiation, Occupational dose, Overconscious, Personal monitoring.

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483 On the Combination of Patient-Generated Data with Data from a Secure Clinical Network Environment – A Practical Example

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

Abstract:

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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482 Assessing the Impact of High Fidelity Human Patient Simulation on Teamwork among Nursing, Medicine and Pharmacy Undergraduate Students

Authors: S. MacDonald, A. Manuel, R. Law, N. Bandruak, A. Dubrowski, V. Curran, J. Smith-Young, K. Simmons, A. Warren

Abstract:

High fidelity human patient simulation has been used for many years by health sciences education programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork among nursing, medicine and pharmacy undergraduate students. This study compared the impact of high fidelity and low fidelity simulation education on teamwork among nursing, medicine and pharmacy students. For the purpose of this study, two innovative teaching scenarios were developed based on the care of an adult patient experiencing acute anaphylaxis: one high fidelity using a human patient simulator and one low fidelity using case based discussions. A within subjects, pretest-posttest, repeated measures design was used with two-treatment levels and random assignment of individual subjects to teams of two or more professions. A convenience sample of twenty-four (n=24) undergraduate students participated, including: nursing (n=11), medicine (n=9), and pharmacy (n=4). The Interprofessional Teamwork Questionnaire was used to assess for changes in students’ perception of their functionality within the team, importance of interprofessional collaboration, comprehension of roles, and confidence in communication and collaboration. Student satisfaction was also assessed. Students reported significant improvements in their understanding of the importance of interprofessional teamwork and of the roles of nursing and medicine on the team after participation in both the high fidelity and the low fidelity simulation. However, only participants in the high fidelity simulation reported a significant improvement in their ability to function effectively as a member of the team. All students reported that both simulations were a meaningful learning experience and all students would recommend both experiences to other students. These findings suggest there is merit in both high fidelity and low fidelity simulation as a teaching and learning approach to foster teamwork among undergraduate nursing, medicine and pharmacy students. However, participation in high fidelity simulation may provide a more realistic opportunity to practice and function as an effective member of the interprofessional health care team.

Keywords: Acute anaphylaxis, high fidelity human patient simulation, low fidelity simulation, interprofessional education.

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481 Effects of Data Correlation in a Sparse-View Compressive Sensing Based Image Reconstruction

Authors: Sajid Abbas, Joon Pyo Hong, Jung-Ryun Lee, Seungryong Cho

Abstract:

Computed tomography and laminography are heavily investigated in a compressive sensing based image reconstruction framework to reduce the dose to the patients as well as to the radiosensitive devices such as multilayer microelectronic circuit boards. Nowadays researchers are actively working on optimizing the compressive sensing based iterative image reconstruction algorithm to obtain better quality images. However, the effects of the sampled data’s properties on reconstructed the image’s quality, particularly in an insufficient sampled data conditions have not been explored in computed laminography. In this paper, we investigated the effects of two data properties i.e. sampling density and data incoherence on the reconstructed image obtained by conventional computed laminography and a recently proposed method called spherical sinusoidal scanning scheme. We have found that in a compressive sensing based image reconstruction framework, the image quality mainly depends upon the data incoherence when the data is uniformly sampled.

Keywords: Computed tomography, Computed laminography, Compressive sending, Low-dose.

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480 Characterization of Gamma Irradiated PVDF and PVDF/Graphene Oxide Composites by Spectroscopic Techniques

Authors: Juliana V. Pereira, Adriana S. M. Batista, Jefferson P. Nascimento, Clascídia A. Furtado, Luiz O. Faria

Abstract:

The combination of the properties of graphene oxide (OG) and PVDF homopolymer makes their combined composite materials as multifunctional systems with great potential. Knowledge of the molecular structure is essential for better use. In this work, the degradation of PVDF polymer exposed to gamma irradiation in oxygen atmosphere in high dose rate has been studied and compared to degradation of PVDF/OG composites. The samples were irradiated with a Co-60 source at constant dose rate, with doses ranging from 100 kGy to 1,000 kGy. In FTIR data shown that the formation of oxidation products was at the both samples with formation of carbonyl and hydroxyl groups amongst the most prevalent products in the pure PVDF samples. In the other hand, the composites samples exhibit less presence of degradation products with predominant formation of carbonyl groups, these results also seen in the UV-Vis analysis. The results show that the samples of composites may have greater resistance to the irradiation process, since they have less degradation products than pure PVDF samples seen by spectroscopic techniques.

Keywords: Gamma irradiation, PVDF, PVDF/OG composites, spectroscopic techniques.

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479 Application of Simulation and Response Surface to Optimize Hospital Resources

Authors: Shamsuddin Ahmed, Francis Amagoh

Abstract:

This paper presents a case study that uses processoriented simulation to identify bottlenecks in the service delivery system in an emergency department of a hospital in the United Arab Emirates. Using results of the simulation, response surface models were developed to explain patient waiting time and the total time patients spend in the hospital system. Results of the study could be used as a service improvement tool to help hospital management in improving patient throughput and service quality in the hospital system.

Keywords: Simulation, Hospital Service, Resource Utilization, United Arab Emirates.

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478 Electron Beam Processing of Ethylene-Propylene-Terpolymer-Based Rubber Mixtures

Authors: M. D. Stelescu, E. Manaila, G. Craciun, D. Ighigeanu

Abstract:

The goal of the paper is to present the results regarding the influence of the irradiation dose and amount of multifunctional monomer trimethylol-propane trimethacrylate (TMPT) on ethylene-propylene-diene terpolymer rubber (EPDM) mixtures irradiated in electron beam. Blends, molded on an electrically heated laboratory roller mill and compressed in an electrically heated hydraulic press, were irradiated using the ALID 7 of 5.5 MeV linear accelerator in the dose range of 22.6 kGy to 56.5 kGy in atmospheric conditions and at room temperature of 25 °C. The share of cross-linking and degradation reactions was evaluated by means of sol-gel analysis, cross-linking density measurements, FTIR studies and Charlesby-Pinner parameter (p0/q0) calculations. The blends containing different concentrations of TMPT (3 phr and 9 phr) and irradiated with doses in the mentioned range have present the increasing of gel content and cross-linking density. Modified and new bands in FTIR spectra have appeared, because of both cross-linking and chain scission reactions.

Keywords: Electron beam irradiation, EPDM rubber, crosslinking density, gel fraction.

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477 Proprioceptive Neuromuscular Facilitation Exercises of Upper Extremities Assessment Using Microsoft Kinect Sensor and Color Marker in a Virtual Reality Environment

Authors: M. Owlia, M. H. Azarsa, M. Khabbazan, A. Mirbagheri

Abstract:

Proprioceptive neuromuscular facilitation exercises are a series of stretching techniques that are commonly used in rehabilitation and exercise therapy. Assessment of these exercises for true maneuvering requires extensive experience in this field and could not be down with patients themselves. In this paper, we developed software that uses Microsoft Kinect sensor, a spherical color marker, and real-time image processing methods to evaluate patient’s performance in generating true patterns of movements. The software also provides the patient with a visual feedback by showing his/her avatar in a Virtual Reality environment along with the correct path of moving hand, wrist and marker. Primary results during PNF exercise therapy of a patient in a room environment shows the ability of the system to identify any deviation of maneuvering path and direction of the hand from the one that has been performed by an expert physician.

Keywords: Image processing, Microsoft Kinect, proprioceptive neuromuscular facilitation, upper extremities assessment, virtual reality.

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476 The Integration of Patient Health Record Generated from Wearable and Internet of Things Devices into Health Information Exchanges

Authors: Dalvin D. Hill, Hector M. Castro Garcia

Abstract:

A growing number of individuals utilize wearable devices on a daily basis. The usage and functionality of these wearable devices vary from user to user. One popular usage of said devices is to track health-related activities that are typically stored on a device’s memory or uploaded to an account in the cloud; based on the current trend, the data accumulated from the wearable device are stored in a standalone location. In many of these cases, this health related datum is not a factor when considering the holistic view of a user’s health lifestyle or record. This health-related data generated from wearable and Internet of Things (IoT) devices can serve as empirical information to a medical provider, as the standalone data can add value to the holistic health record of a patient. This paper proposes a solution to incorporate the data gathered from these wearable and IoT devices, with that a patient’s Personal Health Record (PHR) stored within the confines of a Health Information Exchange (HIE).

Keywords: Electronic health record, health information exchanges, Internet of Things, personal health records, wearable devices, wearables.

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475 An Acerbate Psychotics Symptoms, Social Support, Stressful Life Events, Medication Use Self-Efficacy Impact on Social Dysfunction: A Cross Sectional Self-Rated Study of Persons with Schizophrenia Patient and Misusing Methamphetamines

Authors: Ek-Uma Imkome, Jintana Yunibhand, Waraporn Chaiyawat

Abstract:

Background: Persons with schizophrenia patient and misusing methamphetamines suffering from social dysfunction that impact on their quality of life. Knowledge of factors related to social dysfunction will guide the effective intervention. Objectives: To determine the direct effect, indirect effect and total effect of an acerbate Psychotics’ Symptoms, Social Support, Stressful life events, Medication use self-efficacy impact on social dysfunction in Thai schizophrenic patient and methamphetamine misuse. Methods: Data were collected from schizophrenic and methamphetamine misuse patient by self report. A linear structural relationship was used to test the hypothesized path model. Results: The hypothesized model was found to fit the empirical data and explained 54% of the variance of the psychotic symptoms (X2 = 114.35, df = 92, p-value = 0.05, X2 /df = 1.24, GFI = 0.96, AGFI = 0.92, CFI = 1.00, NFI = 0.99, NNFI = 0.99, RMSEA = 0.02). The highest total effect on social dysfunction was psychotic symptoms (0.67, p<0.05). Medication use self-efficacy had a direct effect on psychotic symptoms (-0.25, p<0.01), and social support had direct effect on medication use self efficacy (0.36, p <0.01). Conclusions: Psychotic symptoms and stressful life events were the significance factors that influenced direct on social dysfunctioning. Therefore, interventions that are designed to manage these factors are crucial in order to enhance social functioning in this population.

Keywords: Psychotic symptoms, methamphetamine, schizophrenia, stressful life events, social dysfunction, social support, medication use self-efficacy.

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474 Training Isolated Respiratory in Rehabilitation

Authors: Marketa Kotova, Jana Kolarova, Ludek Zalud, Petr Dobsak

Abstract:

A game for training of breath (TRABR) for continuous monitoring of pulmonary ventilation during the patients’ therapy focuses especially on monitoring of their ventilation processes. It is necessary to detect, monitor and differentiate abdominal and thoracic breathing during the therapy. It is a fun form of rehabilitation where the patient plays and also practicing isolated breathing. Finally the game to practice breath was designed to evaluate whether the patient uses two types of breathing or not.

Keywords: Pulmonary ventilation, thoracic breathing, abdominal breathing, breath monitoring using pressure sensors, game TRABR (TRAining of BReath).

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473 Improving Decision Support for Organ Transplant

Authors: I. McCulloh, A. Placona, D. Stewart, D. Gause, K. Kiernan, M. Stuart, C. Zinner, L. Cartwright

Abstract:

We find in our data that an alarming number of viable deceased donor kidneys are discarded every year in the US, while waitlisted candidates are dying every day. We observe as many as 85% of transplanted organs are refused at least once for a patient that scored higher on the match list. There are hundreds of clinical variables involved in making a clinical transplant decision and there is rarely an ideal match. Decision makers exhibit an optimism bias where they may refuse an organ offer assuming a better match is imminent. We propose a semi-parametric Cox proportional hazard model, augmented by an accelerated failure time model based on patient-specific suitable organ supply and demand to estimate a time-to-next-offer. Performance is assessed with Cox-Snell residuals and decision curve analysis, demonstrating improved decision support for up to a 5-year outlook. Providing clinical decision-makers with quantitative evidence of likely patient outcomes (e.g., time to next offer and the mortality associated with waiting) may improve decisions and reduce optimism bias, thus reducing discarded organs and matching more patients on the waitlist.

Keywords: Decision science, KDPI, optimism bias, organ transplant.

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472 An Intelligent System for Knee and Ankle Rehabilitation

Authors: Dimitar Karastoyanov, Vladimir Monov

Abstract:

The paper is concerned with the state examination as well as the problems during the post surgical (orthopedic) rehabilitation of the knee and ankle joint. An observation of the current appliances for a passive rehabilitation devices is presented. The major necessary and basic features of the intelligent rehabilitation devices are considered. An approach for a new intelligent appliance is suggested. The main advantages of the device are: both active as well as passive rehabilitation of the patient based on the human - patient reactions and a real time feedback. The basic components: controller; electrical motor; encoder, force – torque sensor are discussed in details. The main modes of operation of the device are considered.

Keywords: Ankle, knee, rehabilitation, computer control.

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471 Reducing Stock-out Incidents at a Hospital Using Six Sigma

Authors: Lina Al-Qatawneh, Abdallah Abdallah, Salam Zalloum

Abstract:

In managing healthcare logistics, cost is not the only factor to be considered. The level of items- criticality used in patient care services plays an important role as well. A stock-out incident of a high critical item could threaten a patient's life. In this paper, the DMAIC (Define-Measure-Analyze-Improve-Control) methodology is used to drive improvement projects based on customer driven critical to quality characteristics at a Jordanian hospital. This paper shows how the application of Six Sigma improves the performance of the case hospital logistics system by reducing the number of stock-out incidents.

Keywords: Criticality level, Healthcare, Logistics, and Six Sigma.

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470 Use of Heliox during Spontaneous Ventilation: Model Study

Authors: Martin Rozanek, Karel Roubik

Abstract:

The study deals with the modelling of the gas flow during heliox therapy. A special model has been developed to study the effect of the helium upon the gas flow in the airways during the spontaneous breathing. Lower density of helium compared with air decreases the Reynolds number and it allows improving the flow during the spontaneous breathing. In the cases, where the flow becomes turbulent while the patient inspires air the flow is still laminar when the patient inspires heliox. The use of heliox decreases the work of breathing and improves ventilation. It allows in some cases to prevent the intubation of the patients.

Keywords: Gas flow, heliox, Reynolds number, turbulent flow.

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469 In vitro Cytotoxic and Genotoxic Effects of Arsenic Trioxide on Human Keratinocytes

Authors: H. Bouaziz, M. Sefi, J. de Lapuente, M. Borras, N. Zeghal

Abstract:

Although, arsenic trioxide has been the subject of toxicological research, in vitro cytotoxicity and genotoxicity studies using relevant cell models and uniform methodology are not well elucidated. Hence, the aim of the present study was to evaluate the cytotoxicity and genotoxicity induced by arsenic trioxide in human keratinocytes (HaCaT) using the MTT [3-(4, 5-dimethylthiazol-2-yl)- 2,5-diphenyltetrazolium bromide] and alkaline single cell gel electrophoresis (Comet) assays, respectively. Human keratinocytes were treated with different doses of arsenic trioxide for 4 h prior to cytogenetic assessment. Data obtained from the MTT assay indicated that arsenic trioxide significantly reduced the viability of HaCaT cells in a dose-dependent manner, showing an IC50 value of 34.18 ± 0.6 μM. Data generated from the comet assay also indicated a significant dose-dependent increase in DNA damage in HaCaT cells associated with arsenic trioxide exposure. We observed a significant increase in comet tail length and tail moment, showing an evidence of arsenic trioxide -induced genotoxic damage in HaCaT cells. This study confirms that the comet assay is a sensitive and effective method to detect DNA damage caused by arsenic.

Keywords: Arsenic trioxide, cytotoxixity, genotoxicity, HaCaT.

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468 Relationship between Trauma and Acute Scrotum: Test Torsion and Epididymal Appendix Torsion

Authors: Saimir Heta, Kastriot Haxhirexha, Virtut Velmishi, Nevila Alliu, Ilma Robo

Abstract:

Background: Testicular rotation can occur at any age. The possibility to save the testicle is the fastest possible surgical intervention which is indicated by the presence of acute pain even at rest. The time element is more important to diagnose and proceed further with surgical intervention. Testicular damage is a consequence which mainly depends on the moment of onset of symptoms, at the time when the symptoms are diagnosed, the earliest action to be performed is surgical intervention. Sometimes medical tests are needed to confirm a diagnosis, or to help identify another cause for symptoms; for example, the urine test, that is used to check for infection, associated with the scrotal ultrasound test. Control of blood flow to the longitudinal supply vessels of the testicles is indicated. The sign that indicates testicular rotation is a reduction in blood flow. This is the element which is distinguished from ultrasound examination. Surgery may be needed to determine if the patient’s symptoms are caused by the rotation of the testis or any other condition. Discussion: As a surgical intervention of the emergency, the torsion of the test depends very much on the duration of the torsion, as the success in the life of the testicle depends on the fastest surgical intervention. From the previous clinic, it is noted that in any case presented to the pediatric patient diagnosed with testicular rotation, there is always a link with personal history that the patient refers to the presence of a previous episode of testicular trauma. Literature supports this fact very logically. Conclusions: Salvation without testicular atrophy depends closely on establishing the diagnosis of testicular rotation as soon as possible. Following the logic above, it can be said that the diagnosis for rotation should be performed as soon as possible, to avoid consequences that will not be favorable for the patient.

Keywords: Acute scrotum, testicular torsion, newborns, infants, clinical presentation.

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467 Banana Peels as an Eco-Sorbent for Manganese Ions

Authors: M. S. Mahmoud

Abstract:

This study was conducted to evaluate the manganese removal from aqueous solution using Banana peels activated carbon (BPAC). Batch experiments have been carried out to determine the influence of parameters such as pH, biosorbent dose, initial metal ion concentrations and contact times on the biosorption process. From these investigations, a significant increase in percentage removal of manganese 97.4% is observed at pH value 5.0, biosorbent dose 0.8 g, initial concentration 20 ppm, temperature 25 ± 2°C, stirring rate 200 rpm and contact time 2h. The equilibrium concentration and the adsorption capacity at equilibrium of the experimental results were fitted to the Langmuir and Freundlich isotherm models; the Langmuir isotherm was found to well represent the measured adsorption data implying BPAC had heterogeneous surface. A raw groundwater samples were collected from Baharmos groundwater treatment plant network at Embaba and Manshiet Elkanater City/District-Giza, Egypt, for treatment at the best conditions that reached at first phase by BPAC. The treatment with BPAC could reduce iron and manganese value of raw groundwater by 91.4% and 97.1%, respectively and the effect of the treatment process on the microbiological properties of groundwater sample showed decrease of total bacterial count either at 22°C or at 37°C to 85.7% and 82.4%, respectively. Also, BPAC was characterized using SEM and FTIR spectroscopy.

Keywords: Biosorption, banana peels, isothermal models, manganese.

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466 Cephalometric Changes of Patient with Class II Division 1 [Malocclusion] Post Orthodontic Treatment with Growth Stimulation: A Case Report

Authors: Pricillia Priska Sianita

Abstract:

An aesthetic facial profile is one of the goals in Orthodontics treatment. However, this is not easily achieved, especially in patients with Class II Division 1 malocclusion who have the clinical characteristics of convex profile and significant skeletal discrepancy due to mandibular growth deficiency. Malocclusion with skeletal problems require proper treatment timing for growth stimulation, and it must be done in early age and in need of good cooperation from the patient. If this is not done and the patient has passed the growth period, the ideal treatment is orthognathic surgery which is more complicated and more painful. The growth stimulation of skeletal malocclusion requires a careful cephalometric evaluation ranging from diagnosis to determine the parts that require stimulation to post-treatment evaluation to see the success achieved through changes in the measurement of the skeletal parameters shown in the cephalometric analysis. This case report aims to describe skeletal changes cephalometrically that were achieved through orthodontic treatment in growing period. Material and method: Lateral Cephalograms, pre-treatment, and post-treatment of cases of Class II Division 1 malocclusion is selected from a collection of cephalometric radiographic in a private clinic. The Cephalogram is then traced and measured for the skeletal parameters. The result is noted as skeletal condition data of pre-treatment and post-treatment. Furthermore, superimposition is done to see the changes achieved. The results show that growth stimulation through orthodontic treatment can solve the skeletal problem of Class II Division 1 malocclusion and the skeletal changes that occur can be verified through cephalometric analysis. The skeletal changes have an impact on the improvement of patient's facial profile. To sum up, the treatment timing on a skeletal malocclusion is very important to obtain satisfactory results for the improvement of the aesthetic facial profile, and skeletal changes can be verified through cephalometric evaluation of pre- and post-treatment.

Keywords: Cephalometric evaluation, Class II Division 1 malocclusion, growth stimulation, skeletal changes, skeletal problems.

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465 The in vitro Effects of Various Immunomodulatory Nutritional Compounds on Antigen-Stimulated Whole-Blood Culture Cytokine Production

Authors: Ayu S. Muhamad, Michael Gleeson

Abstract:

Immunomodulators are substances that alter immune system via dynamic regulation of messenger molecules. It can be divided into immunostimulant and immunosuppressant. It can help to increase immunity of people with a low immune system, and also can help to normalize an overactive immune system. Aim of this study is to investigate the effects of in vitro exposure to low and high doses of several immunomodulators which include caffeine, kaloba and quercetin on antigen-stimulated whole blood culture cytokine production. Whole blood samples were taken from 5 healthy males (age: 32 ± 12 years; weight: 75.7 ± 6.1 kg; BMI: 24.3 ± 1.5 kg/m2) following an overnight fast with no vigorous activity during the preceding 24 h. The whole blood was then stimulated with 50 μl of 100 x diluted Pediacel vaccine and low or high dose of immunomodulators in the culture plate. After 20 h incubation (5% CO2, 37°C), it was analysed using the Evidence Investigator to determine the production of cytokines including IL-2, IL-4, IL-10, IFN-γ, and IL-1α. Caffeine and quercetin showed a tendency towards decrease cytokine production as the doses were increased. On the other hand, an upward trend was evident with kaloba, where a high dose of kaloba seemed to increase the cytokine production. In conclusion, we found that caffeine and quercetin have potential as immunosuppressant and kaloba as immunostimulant.

Keywords: Caffeine, cytokine, immunomodulators, kaloba, quercetin.

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464 Technical Aspects of Closing the Loop in Depth-of-Anesthesia Control

Authors: Gorazd Karer

Abstract:

When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents is one of the main tasks of the anesthesiologist. That being said, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. This paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a User-Datagram-Protocol-based (UDP-based) communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of medical-device manufacturer and is implemented in MATLAB-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: Closed-loop control, Depth of Anesthesia, DoA, optical signal acquisition, Patient State index, PSi, UDP communication protocol.

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463 Clique and Clan Analysis of Patient-Sharing Physician Collaborations

Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

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The collaboration among physicians during episodes of care for a hospitalised patient has a significant contribution towards effective health outcome. This research aims at improving this health outcome by analysing the attributes of patient-sharing physician collaboration network (PCN) on hospital data. To accomplish this goal, we present a research framework that explores the impact of several types of attributes (such as clique and clan) of PCN on hospitalisation cost and hospital length of stay. We use electronic health insurance claim dataset to construct and explore PCNs. Each PCN is categorised as ‘low’ and ‘high’ in terms of hospitalisation cost and length of stay. The results from the proposed model show that the clique and clan of PCNs affect the hospitalisation cost and length of stay. The clique and clan of PCNs show the difference between ‘low’ and ‘high’ PCNs in terms of hospitalisation cost and length of stay. The findings and insights from this research can potentially help the healthcare stakeholders to better formulate the policy in order to improve quality of care while reducing cost.

Keywords: Clique, clan, electronic health records, physician collaboration.

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462 Study and Design of Patient Flow at the Medicine Department of a University Hospital

Authors: P. Prudtikul, S. Pathomsiri

Abstract:

Most, if not all, public hospitals in Thailand have encountered a common problem regarding the increasing demand for medical services. The increasing number of patients causes so much strain on the hospital-s services, over-crowded, overloaded working hours, staff fatigue, medical error and long waiting time. This research studied the characteristics of operational processes of the medical care services at the medicine department in a large public university hospital. The research focuses on details regarding methods, procedures, processes, resources, and time management in overall processes. The simulation model is used as a tool to analyze the impact of various improvement strategies.

Keywords: Patient flow, medicine department, simulation, outpatient department.

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461 Modeling of Dielectric Heating in Radio- Frequency Applicator Optimized for Uniform Temperature by Means of Genetic Algorithms

Authors: Camelia Petrescu, Lavinia Ferariu

Abstract:

The paper presents an optimization study based on genetic algorithms (GA-s) for a radio-frequency applicator used in heating dielectric band products. The weakly coupled electro-thermal problem is analyzed using 2D-FEM. The design variables in the optimization process are: the voltage of a supplementary “guard" electrode and six geometric parameters of the applicator. Two objective functions are used: temperature uniformity and total active power absorbed by the dielectric. Both mono-objective and multiobjective formulations are implemented in GA optimization.

Keywords: Dielectric heating, genetic algorithms, optimization, RF applicators.

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460 The Appropriateness of Antibiotic Prescribing within Dundee Dental Hospital

Authors: Salma Ainine, Colin Ritchie, Tracey McFee

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Background: The societal impact of antibiotic resistance is a major public health concern. The increase in incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently crosschecked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014 – September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: Antibiotic resistance, antibiotic stewardship, dental infection and hygiene standards.

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459 Use of Agricultural Waste for the Removal of Nickel Ions from Aqueous Solutions: Equilibrium and Kinetics Studies

Authors: Manjeet Bansal, Diwan Singh, V.K.Garg, Pawan Rose

Abstract:

The potential of economically cheaper cellulose containing natural materials like rice husk was assessed for nickel adsorption from aqueous solutions. The effects of pH, contact time, sorbent dose, initial metal ion concentration and temperature on the uptake of nickel were studied in batch process. The removal of nickel was dependent on the physico-chemical characteristics of the adsorbent, adsorbate concentration and other studied process parameters. The sorption data has been correlated with Langmuir, Freundlich and Dubinin-Radush kevich (D-R) adsorption models. It was found that Freundlich and Langmuir isotherms fitted well to the data. Maximum nickel removal was observed at pH 6.0. The efficiency of rice husk for nickel removal was 51.8% for dilute solutions at 20 g L-1 adsorbent dose. FTIR, SEM and EDAX were recorded before and after adsorption to explore the number and position of the functional groups available for nickel binding on to the studied adsorbent and changes in surface morphology and elemental constitution of the adsorbent. Pseudo-second order model explains the nickel kinetics more effectively. Reusability of the adsorbent was examined by desorption in which HCl eluted 78.93% nickel. The results revealed that nickel is considerably adsorbed on rice husk and it could be and economic method for the removal of nickel from aqueous solutions.

Keywords: Adsorption, nickel, SEM, EDAX.

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458 Effect of L-Arginine on Neuromuscular Transmission of the Chick Biventer Cervicis Muscle

Authors: S. Asadzadeh Vostakolaei

Abstract:

In this study, the effect of L-arginine was examined at the neuromuscular junction of the chick biventer cervicis muscle. LArginine at 500 μg/ ml, decreased twitch response to electerical stimulation, and produced rightward shift of the dose- response curve for acetylcholine or carbachol. L-Arginine at 1000μg/ ml produced a strong shift to the right of the dose – response curve for acetylcholine or carbachol with a reduction in the efficacy. The inhibitory effect of L-arginine on the twitch response was blocked by caffeine (200μg/ ml). NO levels were also measured in the chick biventer cervicis muscle homogenates, using spectrophotometric method for the direct detection of NO, nitrite and nitrate. Total nitrite (nitrite + nitrate) was measured by a spectrophotometer at 540 nm after the conversion of nitrate to nitrite by copperized cadmium granules. NO levels were found to be significantly increased in concentrations 500 and 1000μg/ ml of L-arginine in comparison with the control group (p<0.001). These findings indicate a possible role of increased NO levels in the suppressive action of L-arginine on the twitch response. In addition, the results indicate that the post- junctional antagonistic action of L-arginine is probably the result of impaired sarcoplasmic reticulum (SR) Ca+2 releases.

Keywords: Chick, L-Arginine, Nitric Oxide, Skeletal muscle.

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457 Virtual E-Medic: A Cloud Based Medical Aid

Authors: Madiajagan Muthaiyan, Neha Goel, Deepti Sunder Prakash

Abstract:

This paper discusses about an intelligent system to be installed in ambulances providing professional support to the paramedics on board. A video conferencing device over mobile 4G services enables specialists virtually attending the patient being transferred to the hospital. The data centre holds detailed databases on the patients past medical history and hospitals with the specialists. It also hosts various software modules that compute the shortest traffic –less path to the closest hospital with the required facilities, on inputting the symptoms of the patient, on a real time basis.

Keywords: 4G mobile services, cloud computing, data centre, intelligent system, optimization, real time traffic reporting, SaaS, video conferencing.

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456 Integration of Image and Patient Data, Software and International Coding Systems for Use in a Mammography Research Project

Authors: V. Balanica, W. I. D. Rae, M. Caramihai, S. Acho, C. P. Herbst

Abstract:

Mammographic images and data analysis to facilitate modelling or computer aided diagnostic (CAD) software development should best be done using a common database that can handle various mammographic image file formats and relate these to other patient information. This would optimize the use of the data as both primary reporting and enhanced information extraction of research data could be performed from the single dataset. One desired improvement is the integration of DICOM file header information into the database, as an efficient and reliable source of supplementary patient information intrinsically available in the images. The purpose of this paper was to design a suitable database to link and integrate different types of image files and gather common information that can be further used for research purposes. An interface was developed for accessing, adding, updating, modifying and extracting data from the common database, enhancing the future possible application of the data in CAD processing. Technically, future developments envisaged include the creation of an advanced search function to selects image files based on descriptor combinations. Results can be further used for specific CAD processing and other research. Design of a user friendly configuration utility for importing of the required fields from the DICOM files must be done.

Keywords: Database Integration, Mammogram Classification, Tumour Classification, Computer Aided Diagnosis.

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455 Introduction to Electron Spectroscopy for Surfaces Characterization

Authors: Abdelkader Benzian

Abstract:

Spectroscopy is the study of the spectrum produced by the radiation-matter interaction which requires the study of electromagnetic radiation (or electrons) emitted, absorbed, or scattered by matter. Thus, the spectral analysis is using spectrometers which enables us to obtain curves that express the distribution of the energy emitted (spectrum). Analysis of emission spectra can therefore constitute several methods depending on the range of radiation energy. The most common methods used are Auger electron spectroscopy (AES) and Electron Energy Losses Spectroscopy (EELS), which allow the determination of the atomic structure on the surface. This paper focalized essentially on the Electron Energy Loss Spectroscopy.

Keywords: Dielectric, plasmon, mean free path, spectroscopy of electron energy losses.

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