96小時重置周邊靜脈導管之效應：資料庫分析

<p>目的：透過異常通報資料庫分析，探討96小時對照72小時重置周邊靜脈導管，對於靜脈炎發生率之影響。</p> <p>方法：方便取樣臺灣南部某醫學中心之異常通報資料庫，分析2011年9月1日至2014年8月31日之72小時重置組，與2014年9月1日至2017年8月31日之96小時重置組，2個時期之住院個案的靜脈炎發生率。</p> <p>結果：96小時對照72小時重置周邊靜脈導管，並未增加靜脈炎發生率。靜脈炎總發生率（勝算比[odds ratio,OR] = 0.70, p=.0290）與細菌性靜脈炎發生率(OR= 0.11, p=.0097)顯著減少，化學性與機械性靜脈炎發生率則無顯著差異。</p> <p>結論：本土性資料庫分析結果為在臺灣熱帶海島型潮濕氣候，三班評估無靜脈炎症狀下，96小時重置周邊靜脈導管並不會顯著增加靜脈炎風險，建議醫療機構可據此調整臨床作業規範，落實實證知識轉譯。</p> <p>&nbsp;</p><p>&quot;Purpose: To compare the effect of replacement of peripheral venous catheters at 96-hour intervals on the incidence of phlebitis with that at 72-hour intervals through analysis of an incident-reporting database.</p> <p>Methods: Convenience sampling of records from the incident-reporting database of a medical center in southern Taiwan was used to analyze the incidence of phlebitis among hospitalized patients with replacement of peripheral venous catheters at 72-hour intervals (from September 1, 2011, to August 31, 2014) or 96-hour intervals (from September 1, 2014, to August 31, 2017).</p> <p>Result: The analysis revealed that replacing peripheral venous catheters every 96 hours rather than every 72 hours did not increase the incidence of phlebitis. The total incidence of phlebitis (odds ratio [OR]=0.70, p=.0290) and the incidence of bacterial phlebitis (OR=0.11, p=.0097) decreased significantly, and no significant differences in the incidence rates of chemical or mechanical phlebitis were identified.</p> <p>Conclusion: According to the analysis results of a local database, under the humid tropical insular climate of Taiwan, replacement of peripheral venous catheters at 96-hour intervals did not significantly increase the risk of phlebitis in patients who exhibited no symptoms of phlebitis as assessed in three shifts. Medical institutions can adjust their clinical operation standards and implement knowledge translation accordingly.</p> <p>&nbsp;</p>

EP.WE.409Stoma forming surgery – has lockdown changed our operative practice during COVID 19

Aims This study aimed to establish whether the initial lockdown resulted in a shift towards emergency surgery, changes in stoma formation and in rate of surgery with curative intent. Methods A retrospective data collection was performed. Patients were identified using a local database of all patients with stomas. Data was collected from 16/03/20 to 16/09/20. A comparison data set was taken (16/03/19 to 16/09/19). Data was collected on whether the case was performed as an emergency; the type of stoma formed and whether the operation was performed with curative intent. Results Seventeen patients were identified in the 2020 cohort (age: 51-84, mean age: 67.6, M:F 10:7). Fourteen cases (82.4%) were performed as emergencies, three electively (17.6%). Six (35.3%) had end colostomies, three (17.6%) had loop colostomies, one (5.9%) had a caecostomy, four (23.5%) had an end ileostomy and three (17.6%) had a loop ileostomy. Ten operations were for patients with cancer, three (30%) were performed with curative intent. 38 patients were identified in the 2019 cohort (age: 28-85, mean age: 63.0, M:F 17:21). 23 (60.5%) were emergencies, fifteen (39.5%) were performed electively. Nine (23.7%) had end colostomies, eight (21.1%) had loop colostomies, three (7.9%) had caecostomies, ten (26.3%) had end ileostomies and nine (23.7%) had loop ileostomies. There were nineteen operations for cancer, eight (42.1%) were with curative intent. Conclusions Cessation of elective activity caused a shift towards emergency operating, with an associated shift towards surgery with non-curative intent. The distribution of stomas formed has not changed.

EP.TU.870Challenges of Surgical Site Infections (SSIs) and Stoma

Aims Surgical site infection (SSI) is a costly health burden and is frequently observed in patients who undergo large bowel surgeries with stoma formation. The use of PICO has been associated with reduced rate of SSI and its use is encouraged by NICE. Method We identified patients who underwent elective or emergency large bowel surgeries, between 2014-2018, using the local database collected for national SSI surveillance. PICO order forms were cross-referenced with SSI database. Analysed data is presented as percentages, and variable testing is performed using Chi Square test. Results The overall rate of SSIs was 12.7%. 6.8% of the cohort developed an incisional SSI, while 5.9% developed an organ/space SSI. The presence of stoma had a significant impact in the rate of incisional SSI (10.3% v 4.2%; p = 0.000179). Amongst all patients with PICO dressing applied, stoma formation was associated with a higher rate of incisional SSI (15.2% vs 6.9%, p = 0.042). 28.7% patients with stoma formation had PICO applied. The use of PICO in this group of patients was associated with statistically significant improvement in the rate of incisional SSI (4.4% v 8.4%; p = 0.026) but not in the rate of organ/ space SSI (2.1% v 4.5%; p = 0.18). Similar findings were not observed when considering elective and emergency cases separately. Conclusion The risk of incisional SSIs is high in patients with stoma formation, even in those who had PICO dressing fitted. Tricky fitting of PICO dressing in the presence of stoma could be one hurdle in reducing SSIs.

Prospects for the use of IT for the selection and assessment of suppliers of materials and components

The purpose of this work is to use information technology to help management decisions. The crux of the problem is the choice of suppliers of materials and components for mechanical engineering companies. Periodically, in the procurement process, suppliers should be assessed on a number of criteria. The importance of rating is due to the fact that in today's market there are a large number of suppliers of the same material resources. Purchase is made from the most competitive suppliers, constantly confirming their status as a reliable business partner. The company developed a method of evaluating suppliers based on the system of management of the bases of the bath Microsoft Office Access. MS Access works in the Windows operating environment and allows users to organize a local database (DB). The local Access database has its own tables, forms, reports and other DB facilities of the organization with a relatively small amount of data. With the help of the scoring method, suppliers are ranked by their level of reliability. The relationship is terminated with a supplier that does not meet the required level of reliability. In this way, management solutions for logistics of supply receive a tool to hang the efficiency and get good results of the enterprise, to achieve its market stability.

Rapid detection by MALDI-TOF MS of isolates from cystic fibrosis patients belonging to the epidemic clones Achromobacter xylosoxidans ST137 or Achromobacter ruhlandii DES.

Objective: Achromobacter spp. are increasingly reported among cystic fibrosis patients. Genotyping requires time consuming methods such as Multilocus-Sequence-Typing or Pulsed-Field-Gel-Electrophoresis. Therefore, data on the prevalence of the multiresistant epidemic clones, especially A. xylosoxidans ST137 (AxST137) and the Danish Epidemic Strain A. ruhlandii (DES) are lacking. We recently developed and published a database for Achromobacter species identification by matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS, Bruker Daltonics). The aim of this study was to evaluate the ability of the MALDI-TOF MS to distinguish these multiresistant epidemic clones within Achromobacter species. Methods: All the spectra of A.xylosoxidans (n=1571) and A.ruhlandii (n=174) used to build the local database were analysed by ClinProTools™, MALDI Biotyper® PCA, MALDI Biotyper ® dendrogram and flexAnalysis™ softwares for biomarker peaks detection. Two-hundred-two isolates (including 48 isolates of AxST137 and 7 of DES) were tested. Results: Specific biomarker peaks were identified: absent peak at m/z 6651 for AxST137 isolates and present peak at m/z 9438 for DES isolates. All tested isolates were well typed by our local database and clustered within distinct groups (ST137 or non-ST137 and DES or non-DES) no matter the MALDI-TOF software or only by simple visual inspection of the spectra by any user. Conclusions: The use of MALDI-TOF MS allowed identifying isolates of A. xylosoxidans belonging to the AxST137 clone which spread in France and Belgium (the Belgian epidemic clone) and of A. ruhlandii belonging to the DES clone. This tool will help implementation of segregation measures to avoid inter-patient transmission of these resistant clones.

A new automated smart cart system for modern shopping centres

Modern shopping centres are undoubtedly a beehive of intense shopping activities. However, customers are often plagued by salient challenges, which may include fatigue derived from pushing trolleys around the mall and prolonged sorting of bills by the cashier. These shopping challenges could be daunting for the elderly, disabled, pregnant and nursing mothers. In this paper, we addressed these shopping challenges by developing an autonomous shopping cart with the following characteristics; (1) it follows the customer’s movement relieving the need to push a cart, (2) it bills automatically all stock placed in the cart, (3) it prompts the customer to make payment and updates each stock via a local database. Our design adopts a Raspberry Pi, a camera and a few direct current motors programmed to achieve autonomy. We used an open-source cross platform software called XAMPP to create the database and used RFID tags to bill the items placed in the cart automatically. The system updates payments and communicates these transactions to a local database via nRF24 wireless transceivers. The experimental tests conducted demonstrate that our system successfully followed customers accurately within the mall. We consider our design a major contribution to the vision of automated shopping systems for the near future.

Sistem Integrasi BOT Register Terhadap Website Pengolah Data Menggunakan Akses NGROK

This information system is based on a website that functions as a data processor obtained from the bot register. The integration of the system uses NGROK access which can unify local public access routes or in one go. The use of XAMPP as a web server can support the use of NGROK. NGROK server has a time duration in one use, which is about 8 hours. Users will get a domain URL when accessing NGROK. This domain URL is so unique that each session will change. The case study we are using leads to the registration system for new members of the East Java Veteran UPN robotics community, which so far still uses Google Form as a means of registering and spreadsheets as data storage media. The need for an innovation which can simplify work, especially during the Covid-19 period, therefore we created an innovation in the form of a bot register that can integrate with the website through NGROK access combined with the MySQL Local Database so that this software is expected to provide access registration directly without having to fear data loss and can also provide secure data management.

Outcomes of examination under anaesthesia of post-nasal space and grommet insertion in adults presenting with otitis media with effusion

Background In adults, otitis media with effusion causes considerable morbidity and has poorly established outcomes. A small number of nasopharyngeal carcinoma patients present with isolated ear-related symptoms. The investigation of choice for these patients is a point of debate. Methods A retrospective cohort study was conducted using a local database of adult patients who underwent examination under anaesthesia of the post-nasal space with grommet insertion for otitis media with effusion between January 2014 and January 2016. Results Ninety-eight patients met the inclusion criteria. Follow-up duration ranged from 39 to 63 months. Complications of grommets were present in 36 out of 98 patients (36.73 per cent). The findings of examination under anaesthesia of the post-nasal space were documented as abnormal in three patients. No patient was diagnosed with nasopharyngeal carcinoma. Conclusion Grommets in adults with otitis media with effusion as the sole presenting feature carry a high complication rate, especially in those with previously inserted grommets. Examination under anaesthesia of the post-nasal space offers a low yield. A magnetic resonance imaging scan of the post-nasal space may be a more sensitive alternative.

Using Internet of Things Techniques to Measure Parameters of Oil Tanks

Systems change currently response to the requirements of modern society where theemergence of a lot of sensors and controllers in all forms it led to the use of IoT thatmake things connect with Internet These technologies provide advanced functionalityfor enterprises and oil installations to transmit data in real time to avoid flood and firesituations in oil Tanks.The system consists of two stations: the tank station and the control station formonitoring and controlling the level and temperature of the products and the detectionof fire. Where, the tank station is equipped with three sensors, which are level,temperature, fire sensors.The connection between the tank station and the control station is wireless connectionby XBee. The control station is to display data to the user via graphical user interfacethat were programmed by Visual Basic.net and stored in a local database designed bySQL Server simultaneously sending data to the Think Speak so that authorized personscan access the data remotely.The system tested for several months proved during this period that it has the abilityto address some problems such as floods and fires where it gives alerts before theproblem occurs.

Intelligent recognition of dance training movements based on machine learning and embedded system

Recognizing human movement is an important research topic in the field of human-computer interaction, and people expect it to be used in smart homes, virtual reality, and electronic games. Based on the interaction between humans and computers, more and more attention has been paid, especially in the field of smart home action recognition. Through observation, people can understand the intention of intelligent interaction is included in the main part. However, the current recognition algorithms still cannot meet the actual requirements of the accuracy, real-time and robustness of human motion recognition. Especially in order to recognize complex human movements in real time, it is imperative to solve several problems in motion capture and recognition. Establishing the feature parameter angle of the feature vector space of motion data, using the pre-recognition algorithm is based on multi-class support vector machines. The motion recognition algorithm takes advantage of the accurate and fast classification function of svm. Based on the structural differences of the motion data, most of the data can be correctly identified. The optimal motion recognition algorithm uses hmm to correct the svm error recognition result through the random constraint relationship between the error recognition data and the actual label. Based on data simulation and analysis, each variable determined by the grid search algorithm has the highest accuracy in the optimization of each variable of the support vector machine. Finally, a smart home simulation experiment interactive system was built, and a local database was created, including 1,300 processes. The real-time algorithm uses the data in the local database for training and testing. Experimental results show that the motion recognition algorithm in this paper improves the accuracy and robustness of complex motion recognition. While meeting the real-time recognition conditions, the correct answer rate of the final operation can reach 9.6%. The human motion trajectory recognition system uses the three-dimensional trajectory of gestures to recognize motion. The information in the three-dimensional space is more comprehensive, and the orbit recognition is more robust.