Ambulance-based assessment of NIH Stroke Scale with telemedicine: A feasibility pilot study

2016 ◽  
Vol 23 (4) ◽  
pp. 476-483 ◽  
Author(s):  
Kevin M Barrett ◽  
Michael A Pizzi ◽  
Vivek Kesari ◽  
Sarvam P TerKonda ◽  
Elizabeth A Mauricio ◽  
...  
Keyword(s):  
Pilot Study ◽  
National Institutes Of Health ◽  
Simulated Patients ◽  
Second Phase ◽  
Proof Of Concept ◽  
Improved Outcomes ◽  
Assessment Time ◽  
Two Phases ◽  
The One ◽  
4G Lte

Background Ischemic stroke is a time-sensitive disease, with improved outcomes associated with decreased time from onset to treatment. It was hypothesised that ambulance-based assessment of the National Institutes of Health Stroke Scale (NIHSS) using a Health Insurance Portability and Accountability Act (HIPAA)–compliant mobile platform immediately prior to arrival is feasible. Methods This is a proof-of-concept feasibility pilot study in two phases. The first phase consisted of an ambulance-equipped HIPAA-compliant video platform for remote NIHSS assessment of a simulated stroke patient. The second phase consisted of remote NIHSS assessment by a hospital-based neurologist of acute stroke patients en route to our facility. Five ambulances were equipped with a 4G/LTE-enabled tablet preloaded with a secure HIPAA-compliant telemedicine application. Secondary outcomes assessed satisfaction of staff with the remote platform. Results Phase one was successful in the assessment of three out of three simulated patients. Phase two was successful in the assessment of 10 out of 11 (91%) cases. One video attempt was unsuccessful because local LTE was turned off on the device. The video signal was dropped transiently due to weather, which delayed NIHSS assessment in one case. Average NIHSS assessment time was 7.6 minutes (range 3–9.8 minutes). Neurologists rated 83% of encounters as ‘satisfied’ to ‘very satisfied’, and the emergency medical service (EMS) rated 90% of encounters as ‘satisfied’ to ‘very satisfied’. The one failed video attempt was associated with ‘poor’ EMS satisfaction. Conclusion This proof-of-concept pilot demonstrates that remote ambulance-based NIHSS assessment is feasible. This model could reduce door-to-needle times by conducting prehospital data collection.

scholarly journals Clinical Simulation in pediatrics and neonatology using EDISON: an educational innovation project

2021 ◽  
Author(s):  
José María Blasco ◽  
Evelin Balaguer-López ◽  
Pablo García-Molina ◽  
Enrique Sanchis-Sánchez ◽  
Pablo Buck-Sainz-Rozas ◽  
...  
Keyword(s):  
Educational Innovation ◽  
Training Intervention ◽  
Second Phase ◽  
Experimental Phase ◽  
Clinical Simulation ◽  
Safe Spaces ◽  
Innovation Project ◽  
Quasi Experimental ◽  
Two Phases ◽  
The One

Introduction: Clinical simulation is a tool that allows creating controlled and safe spaces that mimic reality, where students can acquire skills and abilities prior to facing real situations. Methodology: This is a study with two phases. The first quasi-experimental phase where 3 questionnaires were used; two of them to assess knowledge (pretest - posttest) and the other one to assess the satisfaction of the training action. And the second phase was analytical, where the effectiveness of a training intervention in a confinement context based on the use of audiovisual materials created through EDISON was evaluated. Results: In 2019 the average satisfaction of the students was 9.22 (SD 0.72) out of 10. The most valued item was the one related to the domain that the instructors had regarding the knowledge imparted, with 9.79 out of 10. The students' knowledge improved in 9 of the 11 questions. Conclusions: The satisfaction of the students and the knowledge acquired were remarkable, being clinical simulation a methodology that helps to consolidate the knowledge and skills put into practice.

scholarly journals Neighbor Similarity Based Agglomerative Method for Community Detection in Networks

Complexity ◽  
2019 ◽  
Vol 2019 ◽  
pp. 1-16 ◽  
Author(s):  
Jianjun Cheng ◽  
Xing Su ◽  
Haijuan Yang ◽  
Longjie Li ◽  
Jingming Zhang ◽  
...  
Keyword(s):  
Community Structure ◽  
Community Detection ◽  
Second Phase ◽  
Community Structures ◽  
Node Similarity ◽  
Local Methods ◽  
Two Phases ◽  
Comparison Algorithms ◽  
New Community ◽  
The One

Community structures can reveal organizations and functional properties of complex networks; hence, detecting communities from networks is of great importance. With the surge of large networks in recent years, the efficiency of community detection is demanded critically. Therefore, many local methods have emerged. In this paper, we propose a node similarity based community detection method, which is also a local one consisted of two phases. In the first phase, we first take out the node with the largest degree from the network to take it as an exemplar of the first community and insert its most similar neighbor node into the community as well. Then, the one with the largest degree in the remainder nodes is selected; if its most similar neighbor has not been classified into any community yet, we create a new community for the selected node and its most similar neighbor. Otherwise, if its most similar neighbor has been classified into a certain community, we insert the selected node into the community to which its most similar neighbor belongs. This procedure is repeated until every node in the network is assigned to a community; at that time, we obtain a series of preliminary communities. However, some of them might be too small or too sparse; edges connecting to outside of them might go beyond the ones inside them. Keeping them as the final ones will lead to a low-quality community structure. Therefore, we merge some of them in an efficient approach in the second phase to improve the quality of the resulting community structure. To testify the performance of our proposed method, extensive experiments are performed on both some artificial networks and some real-world networks. The results show that the proposed method can detect high-quality community structures from networks steadily and efficiently and outperform the comparison algorithms significantly.

scholarly journals Therapeutic efficacy and pharmacological safety of parenteral supplementation of different concentrations of copper in cows

2012 ◽  
Vol 55 (1) ◽  
pp. 25-35
Author(s):  
J. R. García-Díaz ◽  
H. Munyori-Nderitu ◽  
M. Cuesta-Mazorra ◽  
R. Quiñones-Ramos ◽  
J. M. Figueredo-Ross ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Blood Serum ◽  
Control Group ◽  
Second Phase ◽  
Hepatic Enzymes ◽  
Physiological Level ◽  
Before And After ◽  
Two Phases ◽  
The One ◽  
The Impact

Abstract. The objective of the present study was to determine the parenteral dosage of the trace mineral copper (Cu) which re-establishes serum and hepatic levels in hypocupperhemic animals without causing intoxication in the liver or residuals in milk. The experiment was carried out in two phases; in the first phase, 20 hypocupperhemic animals were used. Those were divided into 4 groups of 5 cows each: 3 groups which received 25, 50 and 100 mg of Cu respectively and 1 control group without supplementation, but with induced copraemia 5 days before and after the treatment. The milk of the cows treated with 100 mg Cu was examined for residuals of this element for one month. In the second phase, 25 animals were selected and divided into 5 groups of 5 cows each: 1 control group and 4 groups which received 25, 50, 100 and 200 mg of Cu respectively. The impact of this Cu dosages on liver reserves of this element, on hepatic enzymes (alanine-amine-transaminase, aspartate-amine-transferase, alkaline phosphatase and glutamate dehydrogenase) and on bilirubin was analyzed. The groups treated with 50 and 100 mg Cu showed increased levels in blood serum and hepatic tissues (P<0.05) in comparison to the control group and the one treated with 25 mg, obtaining the physiological level considered normal in cows during 60 days without an effect to the level of Cu in milk or to the liver’s enzymatic activity. We conclude that treatment with this dosage results in a restoration of the Cu concentration in blood serum and hepatic tissues without toxic effects or residuals.

Influence of Indented Wire Geometry and Concrete Parameters on the Transfer Length in Prestressed Concrete Crossties

2013 ◽  
Author(s):  
Naga Narendra B. Bodapati ◽  
Weixin Zhao ◽  
Robert J. Peterman ◽  
Chih-Hang John Wu ◽  
B. Terry Beck ◽  
...  
Keyword(s):  
Prestressed Concrete ◽  
Second Phase ◽  
Transfer Length ◽  
Manufacturing Plants ◽  
Concrete Members ◽  
Select Group ◽  
Two Phases ◽  
The One ◽  
Jacking Force ◽  
Release Method

A study was conducted to determine the variation in the transfer length of prestressed concrete railroad ties with different indented wire geometries and different concrete properties, including slump and release strength. The study included 12 different reinforcement wire types that are used in concrete railroad ties worldwide. This paper presents the results from transfer length measurements on 96 pretensioned concrete members that were cast in the laboratory. In order to replicate the wire-to-concrete proportions commonly used in prestressed concrete railroad ties, small (3 1/2″ (88.9 mm) × 3 1/2″ (88.9 mm)) prestressed concrete prisms were fabricated and each contained four 5.32-mm-diameter indented wires. A special jacking arrangement was used to ensure that each of the wires was tensioned to the same jacking force. The wires were initially tensioned to 7000 pounds (31.14 kN) each, and the transfer of prestress force into the members was accomplished by a gradual release method replicating the one used in most prestressed concrete crosstie manufacturing plants. The study consisted of two phases. In the first phase, 36 concrete prisms were cast to investigate the effect of different wire indent geometry in a 6-inch (152.4mm) slump concrete mix with 4500 psi (31.03 MPa) release strength. In the second phase, a total of 60 prisms were used to investigate the effect of 4 different concrete parameters with a select group of 5 indented wire types. The second phase included concrete release strengths of 3500 psi (24.13 MPa) and 6000 psi (41.37 MPa), and concrete consistencies (slumps) of 3 (76.2) and 9 inches (228.6 mm). The results have shown that there is a significant variation in transfer lengths for the different indented wires at the same release strength. Additionally, the results show that the transfer lengths decreased significantly with modest increases in the concrete release strength. However, there was no correlation observed between transfer lengths and different concrete slumps for mixes having the same water-to-cementitious (w/c) ratio. For each concrete pour, the splitting tensile strength and modulus of elasticity were measured at the time of prestress transfer. All wire indents were measured according to ASTM A-881 [1] and the results of both phases are presented.

ACQUISITION OF SCIENTIFIC AND PEDAGOGY COMPETENCES BY PRIMARY PRE-SERVICE TEACHERS: MYTH OR REALITY?

2015 ◽  
Author(s):  
Abdeljalil Métioui ◽  
◽  
Louis Trudel ◽  
Keyword(s):  
Primary School ◽  
Student Teachers ◽  
Key Words ◽  
Primary Teachers ◽  
Pedagogical Knowledge ◽  
Second Phase ◽  
School Knowledge ◽  
The Government ◽  
Two Phases ◽  
The One

In the present research of a qualitative type, we present the results of an experimentation led with 94 pre-service primary teachers from Quebec in Canada. The experimentation, which lasts four months at the rate of three hours per week, took place in two phases. The first phase took place in 4 steps in order to help student teachers to acquire knowledge competency in science and pedagogical knowledge competency, in accordance with the curriculum of the ministry of the education of the government of Quebec. In the second phase, the students had to prepare two teaching sequences centered on laboratory experimentations to the intention of their future pupils of the first, second or third cycle (please note that each cycle lasts for two years). For it, they had to follow an approach similar to the one experienced in the first phase. Finally, they had to complete a questionnaire to specify the difficulties of a scientific or pedagogical nature that they encountered during the conceptions of their teaching sequences. The analysis of the sequences constructed and of the data of the questionnaire shows an effort important on their behalf, in spite of the difficulties they met and that will be presented. Key words: training, pre-service teachers, primary school, knowledge competence, pedagogical knowledge competence.

DESIGNING A VEHICLE ALARM NOTIFICATION SYSTEM USING GSM NETWORK

2016 ◽  
Vol 78 (9-3) ◽  
Author(s):  
Sofea Azrina Azizan ◽  
Izzatdin Abdul Aziz ◽  
Nazleeni Samiha Haron ◽  
Jafreezal Jaafar ◽  
Izzatdin Abdul Aziz ◽  
...  
Keyword(s):  
False Alarm ◽  
Second Phase ◽  
Alarm System ◽  
Proof Of Concept ◽  
Notification System ◽  
Vehicle Owner ◽  
Long Time ◽  
Gsm Network ◽  
Scale Experiment ◽  
Two Phases

This paper focuses on studying and designing of vehicle alarm by using GSM network as well as to provide the user with information via SMS on whether an intrusion or some other possible factors have triggered the alarm. Nowadays, all vehicles are equipped with an alarm system that will alert the vehicle owner if there is any intrusion detected. However, when the vehicle alarm is triggered, the vehicle owner is unaware of the siren. They might be somewhere far away from their vehicle parking and sometimes there is no intrusion instead there is a false alarm. Alarm trigger for a long time will cause the vehicle’s battery to decrease and will annoy the passers-by. This paper is subdivided into two phases. First, the study on how to integrate GSM devices to send SMS to the vehicle owner's mobile phone. The second phase of this paper is to design and develop a mechanism that can alert the vehicle owner from a remote location by using GSM. As a proof of concept, the proposed mechanism is then validated through a lab scale experiment. This paper is expected to enhance the existing alarm system to benefit all users in order to protect their vehicle.

CBED study of low-temperature InP grown by gas source MBE

1993 ◽  
Vol 51 ◽  
pp. 810-811
Author(s):  
R. Rajesh ◽  
M.J. Kim ◽  
J.S. Bow ◽  
R.W. Carpenter ◽  
G.N. Maracas
Keyword(s):  
Low Temperature ◽  
Second Phase ◽  
Material System ◽  
Ion Milling ◽  
Electrical Measurements ◽  
Gas Source ◽  
Structural And Electrical Properties ◽  
The One ◽  
Lt Inp ◽  
Gas Source Mbe

In our previous work on MBE grown low temperature (LT) InP, attempts had been made to understand the relationships between the structural and electrical properties of this material system. Electrical measurements had established an enhancement of the resistivity of the phosphorus-rich LT InP layers with annealing under a P2 flux, which was directly correlated with the presence of second-phase particles. Further investigations, however, have revealed the presence of two fundamentally different types of precipitates. The first type are the surface particles, essentially an artefact of argon ion milling and containing mostly pure indium. The second type and the one more important to the study are the dense precipitates in the bulk of the annealed layers. These are phosphorus-rich and are believed to contribute to the improvement in the resistivity of the material.The observation of metallic indium islands solely in the annealed LT layers warranted further study in order to better understand the exact reasons for their formation.

Political Islam in an Ethnic Jewish State: Historical Evolution, Contemporary Challenges and Future Prospects

2004 ◽  
Vol 3 (1) ◽  
pp. 69-92 ◽  
Author(s):  
Nohad ‘Ali
Keyword(s):  
Historical Evolution ◽  
Jewish State ◽  
Islamic Revival ◽  
Islamic Movement ◽  
Revival Movements ◽  
Phases Of Development ◽  
Two Phases ◽  
The One ◽  
Five Phases ◽  
Islamic Revivalism

This paper argues that, although the shared and universal ideology of the Islamic revival movements was adopted by the Islamic movement in Israel, the movement has been trying to embody it in diverse and distinctive ways. In principle there is a conflict between commitment to the principle of Islamic revivalism on the one hand, and being so committed in the specific context of the ethnic Jewish state, on the other. The Jewish context of the State of Israel continues to bedevil the development of the Islamic movement in Israel. Since the 1930s, Islamic revivalism in Palestine has undergone five phases of development: the Egyptian, Israeli, Palestinian, and the two phases of ‘adaptation’ and ‘post-adaptation’. These phases reflect ideological developments, rather than simply a historical evolution. They are also the outcome of three sets of constraints: structural, ideological and domestic.

Accurate Detection and Quantization of Leaf- Diseases through Soft Computing

2018 ◽  
Vol 1 (1) ◽  
pp. 236-247
Author(s):  
Divya Srivastava ◽  
Rajitha B. ◽  
Suneeta Agarwal
Keyword(s):  
Machine Learning ◽  
Image Processing ◽  
Agricultural Production ◽  
Bacterial Blight ◽  
Early Stage ◽  
Second Phase ◽  
Computationally Efficient ◽  
Stage Of Disease ◽  
Accurate Detection ◽  
Two Phases

Diseases in leaves can cause the significant reduction in both quality and quantity of agricultural production. If early and accurate detection of disease/diseases in leaves can be automated, then the proper remedy can be taken timely. A simple and computationally efficient approach is presented in this paper for disease/diseases detection on leaves. Only detecting the disease is not beneficial without knowing the stage of disease thus the paper also determine the stage of disease/diseases by quantizing the affected of the leaves by using digital image processing and machine learning. Though there exists a variety of diseases on leaves, but the bacterial and fungal spots (Early Scorch, Late Scorch, and Leaf Spot) are the most prominent diseases found on leaves. Keeping this in mind the paper deals with the detection of Bacterial Blight and Fungal Spot both at an early stage (Early Scorch) and late stage (Late Scorch) on the variety of leaves. The proposed approach is divided into two phases, in the first phase, it identifies one or more disease/diseases existing on leaves. In the second phase, amount of area affected by the disease/diseases is calculated. The experimental results obtained showed 97% accuracy using the proposed approach.

Representação e simbolismo: artes visuais na fronteira Brasil/Bolívia

2020 ◽  
Vol 4 (3) ◽  
pp. 286
Author(s):  
Paulo César Antonini de Souza ◽  
Derick Trindade Bezerra
Keyword(s):  
Visual Arts ◽  
Social Order ◽  
Research Field ◽  
Border Region ◽  
Second Phase ◽  
Two Dimensional ◽  
Santa Cruz ◽  
Cultural Conditions ◽  
Two Phases ◽  
America Latina

ResumoTendo por campo de investigação o Festival da América do Sul Pantanal (FASP) em 2018, na cidade de Corumbá (Brasil), objetiva-se identificar a materialidade e conceitos que permeiam as manifestações artísticas bidimensionais nesta região de fronteira, a partir da percepção de artistas da Bolívia. A pesquisa se organizou em duas fases: na primeira foi realizado um levantamento em plataformas online de produções acadêmicas em artes visuais, com foco no trabalho bidimensional, utilizando os descritores “arte popular” e “estética latina” resultando em três artigos. Na segunda fase foram selecionados dois trabalhos de uma artista da Bolívia, participante da mostra “Conexão Santa Cruz”, realizada durante o FASP 2018, que foram analisados em seus níveis representacional e simbólico. Pela interpretação das imagens foi possível construir uma leitura sobre a perspectiva da artista a respeito de suas condições culturais dentro da ordenação social em que se encontra situada.Palavras-chave: Artes Visuais. Arte Popular. Arte Regional. América Latina. Representation and symbolism: visual arts on the Brazil/Bolivia frontierAbstractHaving as research field the Festival da América do Sul Pantanal (FASP) in 2018, in the city of Corumbá (Brazil), the objective is to identify the materiality and concepts that permeate the two-dimensional artistic manifestations in this border region, from the perception of artists from Bolivia. The research was organized in two phases: in the first, a survey was carried out on online platforms of academic productions in visual arts, focusing on two-dimensional work, using the descriptors “arte popular” and “estética latina” resulting in three articles. In the second phase, two works were selected by an artist from Bolivia, participating in the exhibition “Conexão Santa Cruz”, held during FASP 2018, which were analyzed at their representational and symbolic levels. Through the interpretation of the images, it was possible to construct a reading on the artist’s perspective regarding her cultural conditions within the social order in which she is located.Keywords: Visual Arts. Folk Art. Regional Art. Latin America.Representación y simbolismo: artes visuales en la frontera de Brasil/BoliviaResumenTeniendo como campo de investigación el Festival de Sudamérica Pantanal (FASP) en 2018, en la ciudad de Corumbá (Brasil), el objetivo es identificar la materialidad y conceptos que permean las manifestaciones artísticas bidimensionales en esta región fronteriza, desde la percepción de artistas de Bolivia. La investigación se organizó en dos fases: en la primera, se realizó una encuesta en plataformas online de producciones académicas en artes visuales, con foco en el trabajo bidimensional, utilizando los descriptores “arte popular” y “estética latina” dando como resultado tres artículos. En la segunda fase, dos obras fueron seleccionadas por un artista de Bolivia, participante de la exposición “Conexão Santa Cruz”, realizada durante FASP 2018, que fueron analizadas en sus niveles representativos y simbólicos. A través de la interpretación de las imágenes, fue posible construir una lectura sobre la perspectiva de la artista sobre sus condiciones culturales dentro del orden social en el que se ubica.Palabras clave: Artes Visuales. Arte Popular. Arte Regional. América Latina.

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