Development of An In Vivo Robotic Camera for Dexterous Manipulation and Clear Imaging

Minimally invasive surgeriy (MIS) techniques are becoming more popular as replacements for traditional open surgeries. These methods benefit patients with lowering blood loss and post-operative pain, reducing recovery period and hospital stay time, decreasing surgical area scarring and cosmetic issues, and lessening the treatment costs, hence greater patient satisfaction would be earned. Manipulating surgical instruments from outside of abdomen and performing surgery needs precise hand-eye coordination which is provided by insertable cameras. The traditional MIS insertable cameras suffer from port complexity and reduced manipulation dexterity, which leads to defection in Hand-eye coordination and surgical flow. Fully insertable robotic camera systems emerged as a promising solution in MIS. Implementing robotic camera systems faces multiple challenges in fixation, manipulation, orientation control, tool-tissue interaction, in vivo illumination and clear imaging.In this dissertation a novel actuation and control mechanism is developed and validated for an insertable laparoscopic camera. This design uses permanent magnets and coils as force/torque generators in an external control unit to manipulate an in vivo camera capsule. The motorless design of this capsule reduces the, wight, size and power consumption of the driven unit. In order to guarantee the smooth motion of the camera inside the abdominal cavity, an interaction force control method was proposed and validated.Optimizing the system\u27s design, through minimizing the control unit size and power consumption and extending maneuverability of insertable camera, was achieved by a novel transformable design, which uses a single permanent magnet in the control unit. The camera robot uses a permanent magnet as fixation and translation unit, and two embedded motor for tilt motion actuation, as well as illumination actuation. Transformable design provides superior imaging quality through an optimized illumination unit and a cleaning module. The illumination module uses freeform optical lenses to control light beams from the LEDs to achieve optimized illumination over surgical zone. The cleaning module prevents lens contamination through a pump actuated debris prevention system, while mechanically wipes the lens in case of contamination. The performance of transformable design and its modules have been assessed experimentally

The Effect of Uric Acid as a Predisposing Factor on Polyneuropathy in Patients with Type 2 Diabetes Mellitus

Background: Since serum uric acid is a controllable and modifiable factor in diabetic patients, identifying the risk factors and accelerating the incidence of neuropathy in these patients plays an important role, and can reduce its level, and the patient's disability, as well as additional therapeutic costs for the patient and the health system in the country. Method: In this retrospective cohort study conducted at the Golestan Hospital in 2015-2017, the study population was 100 type 2 diabetic patients based on NCS of 54 patients with polyneuropathy. First, the demographic data on clinical examinations, lab tests, and uric acid levels in these patients were recorded on a checklist. Then, in 2017, patients were reassessed for clinical investigations and lab tests, and all data entered on the previous checklist. Finally, all the data were analyzed using the SPSS v23. Results: The mean age of patients with polyneuropathy was 51.77 years, and there was a significant relationship between age, BMI and duration of diabetes with neuropathy, but there was no significant difference in gender, smoking and hypertension. The mean serum level of uric acid in the two years ago was 3.85 mg/dl, and at the time of the study, it was 4.18 ±1.55 mg/dl. There was no significant difference in serum levels of this substance after two years of follow up in patients with polyneuropathy (P=0.139). The incidence of polyneuropathy was reported by NCS findings of 54%. In other words, 54% of diabetic patients developed diabetic polyneuropathy for two years. Conclusion: Polyneuropathy is a common complication in diabetic patients, and the serum levels of uric acid over time cannot have a significant effect on the incidence of this disorder

Barriers to Knowledge Sharing among Nurses in Educational Hospitals of Kerman City, Iran

Introduction: Considering the importance of knowledge sharing in recent years and the nurses' need to act based on research in order to use their findings, experiences, and information for conscious decision making in clinical practices and in interaction with others, this study aimed to identify barriers to knowledge sharing among nurses in order to examine the challenges facing it. Method: This qualitative study was conducted using semi-structured interviews with 21 nurses in educational hospitals of Kerman City, Iran. All the interviews were recorded and then transcribed line by line and finally analyzed using Colaizzi method. Results: The barriers were identified in six main categories including "culture", "financial facilities", "politics, rules and regulations", "communications", "human resources", and "management process". Conclusion: Effective knowledge sharing among nurses with the aim of increasing knowledge level and enhancing their services in the hospitals is essential. In addition, it is necessary to use strategies to face challenges and this requires management and policymaking more than before. Keywords: Knowledge management, Nurses, Barriers, Educational hospitals, Ira

SYNTHESIS AND CHARACTERIZATION OF BIOACTIVE GLASS/FORSTERITE NANOCOMPOSITES FOR BONE AND DENTAL IMPLANTS

In this research, bioactive glass (BG) of the type CaO–P2O5–SiO2 and nanocrystalline forsterite (NF) bioceramic were successfully synthesized via sol–gel processing method. Heat-treatment process was done to obtain phase-pure nanopowders. After characterization of each sample, the nanocomposite samples were prepared by cold pressing method and sintered at 1000°C. The samples were fully characterized by X-ray powder diffraction (XRD), scanning electron microscope (SEM), energy dispersive spectroscopy (EDX), Fourier transform infrared spectroscopy (FTIR) analyses. The average nanocrystallite size was determined using the Debye-Scherrer’s formula 19.6 nm. The bioactivity was examined in vitro with respect to the ability of hydroxyapatite (HAp) layer to form on the surfaces as a result of contact with simulated body fluid (SBF). According to the obtained results, the prepared nanocomposite enhances the fracture toughness of the BG matrix without deteriorating its intrinsic properties as bioactivity

Effect of an Educational Program based on Health Belief Model on Medication Adherence in Elderly Patients with Hypertension

Background: Aging population growth is accompanied by the risk of cardiovascular diseases and hypertension. Medication nonadherence is one of the problems affecting patients, especially elderly individuals with high blood pressure. Aim: The present study aimed to determine the effect of an educational program based on the Health Belief Model (HBM) on medication adherence in older adults suffering from hypertension. Methods: This randomized controlled clinical trial was conducted on 60-year-old elderly people referring to health centers in Mashhad, Iran, during 2017. To this end, the intervention group received education on medication adherence while the control group was only subjected to typical routine services. The data were analyzed in SPSS Software (Version 20) through the independent t-test, Chi-square test, and Fisher’s exact test. Results: The mean ages of the participants in the intervention and control groups were 69.1±8.3 and 63.9±6.7 years, respectively. The post-test mean score of medication adherence obtained by the intervention group was 6.7±0.5 that was significantly higher than that of the control group (3.7±1.0) (P˂0.001). Moreover, the mean score of medication adherence in the intervention group had significantly increased in the post-test phase (P˂0.001) based on the within-group results of the paired t-test. Implications for Practice: The HBM might improve medication adherence in elderly individuals with hypertension by changing their beliefs. Therefore, it was recommended to use this model for teaching self-care to older adults suffering from chronic illnesses and also in other senior healthcare centers

An analysis of resident & non-resident air passenger behavior of origin airport choice

ABSTRACT: Increasing number of air travellers in recent years and the emergence of multi-airport cities throughout the world has made the behaviour of travellers regarding the choice of the origin airport even more important. Analysis of this behaviour helps for a better future planning and development of competing airports as an important element of their demand prediction. In this paper, particular emphasis is stressed on the behaviour of resident and non-resident passengers in choosing between the origin airport through the empirical case study of the two airports of Tehran multi-airport system, namely Imam Khomeini (IKIA) and Mehrabad International Airport (MIA) in Iran. The 24- hour and one-week survey was conducted in May 2011 and a total number of 2980 questionnaires were collected from the two airports. Binary Logit was used to model the origin airport choice of resident and non-resident travellers from the city of Tehran. Results show that the difference in the two groups is affected by “age”, “Income”, “Travel Destination”, “Trip Purpose” and “Marital Status”. Further model results show that variables “Public Access”, “Flight Frequency” and “Airport Tax” are more important for non-resident air travellers in choosing their origin airport

Evaluation of Survival Rate and Pattern of Risk Factors and Recurrence Rate in Patients with Triple-Negative Breast Cancer with other Subtypes

Introduction: Breast cancer nowadays is one the major health issue especially in industrial population. Despite excessive researches in this regard, there is still no detailed and relevant information on the association between the risk factors of this cancer and its many outcomes. Due to increasing rate of breast cancer in Iran, including Yazd city, the present study was designed to evaluate the relationship between survival and recurrence rate with pattern of risk factors in breast cancer patients.Methods: This analytical study was conducted retrospectively on 333 patients with breast cancer during 8 years (2005-2013). Total survival and recurrence rates recorded in month for all samples, and then were analyzed and compared other obtained data. Chi-square and log rank were selected tests for analyzing and Kaplan-Meier was applicable curve for survival analyzing.Results: The mean age of subjects was 57.02 ± 12.32 years. The mean total survival rate was 93.15 ± 1.25 months (97.9%). The mean total recurrence rate was 84.59 ± 1.91 months (89.8%). The subgroups of breast cancer had no significant relationship with risk factors (P>0.05) though BMI and recurrence rate had significant relationship (P=0.045). Other risk factors had no significant relationship with total survival and recurrence rates. The mean duration of OCP (oral contraceptive pill) consumption was significantly more in the patients with ER-PR-Her2+ subgroup than other groups (P=0.03).  Conclusion: According the findings, BMI lower than 25 is strong prognostic factor for recurrence rate in patients with triple-negative breast cancer. Because of high survival rate of patients with breast cancer during eight years, it is recommended to study on high survival period with larger sample sizes for accessing reliable evidence.