Sistema web basado en el patrón MVC para mejorar la gestión de la Clínica Odontológica Sotomayor

En nuestro trabajo de investigación, se detalló el desarrollo e implementación de un sistema web,tuvo el objetivo de Determinar la mejora que causa en la gestión de la clínica odontológica Sotomayor de la localidad de Huaycán, debido a que se identificó una mala gestión con deficiencias en varios procesos de la clínica dental. La investigación fue de tipo aplicada, enfoque cuantitativo, de nivel explicativo y con un diseño experimental de grado pre experimental. Además, se usó tecnologías como el patrón de diseño MVC, PHP y JavaScript como lenguaje de programación, MySQL como base de datos y Programación extrema (XP) como metodología de desarrollo. En los resultados se procesaron el pre test ypost test de los indicadores, usando t de student para el TPRM y prueba de signosde Wilcoxon para TPRC y TPBH. Rechazando la hipótesis nula de las pruebas de normalidad procesadas. Los resultados mostraron que TPRC: Tiempo promedio en el registro de citas de pacientes disminuyo en un 95.86% con la implementación delsistema web, el TPBH: Tiempo promedio en la búsqueda de historias clínicas de pacientes disminuyo en un 95.83% después de implementar el sistema web y TPRM: Tiempo promedio en el registro de materiales de almacén disminuyo en un90.59% con la implementación del sistema web

A wearable microwave instrument can detect and monitor traumatic abdominal injuries in a porcine model

Abdominal injury is a frequent cause of death for trauma patients, and early recognition is essential to limit fatalities. There is a need for a wearable sensor system for prehospital settings that can detect and monitor bleeding in the abdomen (hemoperitoneum). This study evaluates the potential for microwave technology to fill that gap. A simple prototype of a wearable microwave sensor was constructed using eight antennas. A realistic porcine model of hemoperitoneum was developed using anesthetized pigs. Ten animals were measured at healthy state and at two sizes of bleeding. Statistical tests and a machine learning method were used to evaluate blood detection sensitivity. All subjects presented similar changes due to accumulation of blood, which dampened the microwave signal (p<0.05). The machine learning analysis yielded an area under the receiver operating characteristic (ROC) curve (AUC) of 0.93, showing 100% sensitivity at 90% specificity. Large inter-individual variability of the healthy state signal complicated differentiation of bleedings from healthy state. A wearable microwave instrument has potential for accurate detection and monitoring of hemoperitoneum, with automated analysis making the instrument easy-to-use. Future hardware development is necessary to suppress measurement system variability and enable detection of smaller bleedings.publishedVersio

A wearable microwave detector for diagnosing thoracic injuries-test on a porcine pneumothorax model

In the prehospital setting, a point-of-care diagnostic test is needed to diagnose pneumothorax (PTX) and monitor its progression to prevent unnecessary patient morbidity and mortality. Ultrasonography is more sensitive than supine chest x-ray for diagnosing PTX, but the accuracy depends on the experience of the operator. Therefore, a non-operator dependent instrument would be valuable for detection and continuous monitoring of an evolving PTX

Improvements in Bioimpedance SpectroscopyData Analysis : Artefact Correction, ColeParameters, and Body Fluid Estimation

The estimation of body fluids is a useful and common practice in the status assessment of diseasemechanisms and treatments. Electrical bioimpedance spectroscopy (EBIS) methods are non-invasive,inexpensive, and efficient alternatives for the estimation of body fluids. However, these methods areindirect, and their robustness and validity are unclear.Regarding the recording of measurements, a controversy developed regarding a spectrum deviationin the impedance plane, which is caused by capacitive leakage. This deviation is frequentlycompensated for by the extended Cole model, which lacks a theoretical basis; however, there is nomethod published to estimate the parameters. In this thesis, a simplified model to correct thedeviation was proposed and tested. The model consists of an equivalent capacitance in parallel withthe load.Subsequently, two other measurement artefacts were considered. Both artefacts were frequentlydisregarded with regard to total body and segmental EBIS measurements as their influence isinsignificant with suitable skin-electrode contact. However, this case is not always valid, particularlyfrom a textile-enabled measurement system perspective. In the estimation of body fluids, EBIS dataare fitted to a model to obtain resistances at low and high frequencies. These resistances can berelated to body fluid volumes. In order to minimise the influence of all three artefacts on theestimation of body fluids and improve the robustness and suitability of the model fitting the differentdomains of immittance were used and tested. The conductance in a reduced frequency spectrum wasproposed as the most robust domain against the artefacts considered.The robustness and accuracy of the method did not increase, even though resistances at low and highfrequencies can be robustly estimated against measurement artefacts. Thus, there is likely error in therelation between the resistances and volumes. Based on a theoretical analysis, state of the artmethods were reviewed and their limitations were identified. New methods were also proposed. Allmethods were tested using a clinical database of patients involved in growth hormone replacementtherapy. The results indicated EBIS are accurate methods to estimate body fluids, however they haverobustness limits. It is hypothesized that those limits in extra-cellular fluid are primarily due toanisotropy, in total body fluid they are primarily due to the uncertainty ρi, and errors in intra-cellularfluid are primarily due to the addition of errors in extracellular and total body fluid. Currently, theseerrors cannot be prevented or minimised. Thus, the limitations for robustness must be predicted priorto applying EBIS to estimate body fluids.QC 20130917</p

Cole Parameter Estimation from the Modulus of the Electrical Bioimpeadance for Assessment of Body Composition : A Full Spectroscopy Approach

Activities around applications of Electrical Bioimpedance Spectroscopy (EBIS) have proliferated in the past decade significantly. Most of these activities have been focused in the analysis of the EBIS measurements, which eventually might enable novel applications. In Body Composition Assessment (BCA) the most common analysis approach currently used in EBIS is based on the Cole function, which most often requires curve fitting. One of the most implemented approaches for obtaining the Cole parameters is performed in the impedance plane through the geometrical properties that the Cole function exhibit in such domain as depressed semi-circle. To fit the measured impedance data to a semi-circle in the impedance plane, obtaining the Cole parameters in an indirect and sequential manner has several drawbacks. Applying a Non-Linear Least Square (NLLS) iterative fitting on the spectroscopy measurement, obtains the Cole parameters considering the frequency information contained in the measurement. In this work, from experimental total right side EBIS measurements, the BCA parameters have been obtained to assess the amount and distribution of whole body fluids. The values for the BCA parameters have been obtained using values for the Cole parameters estimated with both approaches: circular fitting on the impedance plane and NLLS impedance-only fitting. The comparison of the values obtained for the BCA parameters with both methods confirms that the NLLS impedance-only is an effective alternative as Cole parameter estimation method in BCA from EBIS measurements. Using the modulus of the Cole function as the model for the fitting would eliminate the need for performing a phase detection in the acquisition process, simplifying the hardware specifications of the measurement instrumentation when implementing a bioimpedance spectrometer.QC 2012021