simulation
در نشریات گروه پزشکی-
Introduction
In tissue engineering, the interaction among three primary elements, namely cells, material scaffolds, and stimuli, plays a pivotal role in determining the fate of cells and the formation of new tissue. Understanding the characteristics of these components and their interplay through various methodologies can significantly enhance the efficiency of the designed tissue engineering system. In silico methods, such as molecular dynamics (MD) simulation, use mathematical calculations to investigate molecular properties and can overcome the limitations of laboratory methods in delivering adequate molecular-level information.
MethodsThe studies that used molecular dynamics simulation, either alone or in combination with other techniques, have been reviewed in this paper.
ResultsThe review explores the use of molecular dynamics simulations in studying substrate formation mechanism and its optimization. It highlights MD simulations' role in predicting biomolecule binding strength, understanding substrate properties' impact on biological activity, and factors influencing cell attachment and proliferation. Despite limited studies, MD simulations are considered a reliable tool for identifying ideal substrates for cell proliferation. The review also touches on MD simulations' contribution to cell differentiation studies, emphasizing their role in designing engineered extracellular matrix for desired cell fates.
ConclusionMolecular dynamics simulation as a non-laboratory tool has many capabilities in providing basic and practical information about the behavior of the molecular components of the cell as well as the interaction of the cell and its components with the surrounding environment. Using this information along with other information obtained from laboratory tools can ultimately lead to the advancement of tissue engineering through the development of more appropriate and efficient methods.
Keywords: Tissue Engineering, Molecular Dynamics, Simulation, Modeling -
مقدمهتوسعه ی روش های فعال و استدلالی با هدف توسعه ی مهارت های تصمیم گیری دانشجویان در مدیریت شرایط بحرانی اهمیت دارد. این مطالعه با هدف تعیین تاثیر آموزش با استفاده از روش سناریونویسی بر رضایتمندی و یادگیری اصول مدیریت بحران دانشجویان نسبت به سخنرانی انجام شد.روش هامطالعه ی مداخله ای نیمه تجربی که در دانشکده ی بهداشت دانشگاه علوم پزشکی یزد انجام گردید. 60 نفر از دانشجویان بر اساس فرمول حجم نمونه در دو گروه مداخله و شاهد وارد شدند. آموزش در گروه مداخله با روش سناریو نویسی و در گروه شاهد با روش سخنرانی تعاملی انجام شد. یادگیری با استفاده از آزمون ویژگی های کلیدی (سوالات تشریحی تغییریافته) و رضایت دانشجویان با پرسشنامه ی 10 سوالی ارزیابی شد. داده ها با استفاده از آمار توصیفی (میانگین، درصد و انحراف معیار) و استنباطی (Student T-Test) تحلیل شد.یافته هامیانگین نمرات یادگیری در گروه مداخله 1/09 ± 18/8 از 20 و میانگین نمرات گروه شاهد 1/8 ± 16/1 بود (0/001 = P). رضایتمندی دانشجویان از روش سناریونویسی 1/03 ± 9/18 و در 100/78 ± 7/64 بود (0/01 = P).نتیجه گیرینتایج این پژوهش نشان داد، روش سناریونویسی، موجب رضایت و یادگیری بهتر دانشجویان شده است. روش سناریونویسی با ایجاد فرصت تدوین سناریو و توجه به همه ابعاد پدیده و تحلیل آن، فرصت رشد مهارت های تصمیم گیری و مدیریت موقیعت های دشوار را فراهم می کند. پیشنهاد می گردد روش استدلالی سناریونویسی در آموزش مدیریت بحران و بلایا در دانشگاه های علوم پزشکی مورد استفاده قرار گیرد.کلید واژگان: شبیه سازی، آموزش، مدیریت بلا، بلایا، سخنرانی، فوریتBackgroundDeveloping active methods to develop students' decision-making skills in managing crises is momentous. This study aimed to determine the effect of training using the script development method on students' satisfaction and learning of crisis management principles compared to lectures.MethodsA quasi-experimental study was conducted at the Faculty of Public Health, Shahid Sadoughi University of Medical Sciences. Sixty students were divided into intervention and control groups based on the sample size formula. Education in the intervention group was conducted using the script development method, and in the control group, using the interactive lecture method. Learning was assessed using a key characteristics test (modified descriptive questions), and student satisfaction was assessed with a 10-question questionnaire. Data were analyzed using descriptive statistics (mean, percentage, and standard deviation) and inferential statistics (Student T-Test).FindingsThe learning scores in the intervention group were 18.8 ± 1.09 out of 20, and the scores in the control group were 16.1 ± 1.8. (P = 0.001). Students' satisfaction with the scenario writing method was 9.18 ± 1.03 and 7.64 ± 100.78. (P = 0.001).ConclusionThe results showed that the script development method improved student satisfaction and learning. The script development method provides the opportunity to develop decision-making skills and manage difficult situations by creating the opportunity to develop scenarios and pay attention to all aspects of the phenomenon and its analysis. It is suggested that the script development method be used in disaster management education in medical universities.Keywords: Simulation, Speech, Disasters, Disaster Management, Training, Emergency
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The term “in silico”, which is used to differentiate from “in vitro” (bench-top) and “in vivo” (animals or clinical studies), refers to the original studies conducted on computers using algorithms. Such studies have found vast applications in biological, medical, and pharmaceutical sciences, from genetics to computer-aided drug discovery (CADD), vaccine development, and even clinical trial design and analysis. They enable research with fewer resources and budget by using data obtained from past in-vitro and invivo experiments and can help study complicated cases that may be impossible or very difficult to perform in real life (1). For example, they may assist in developing drugs for rare diseases and pediatrics. In silico biology also helps accelerate research conduction. A familiar example is the COVID-19 mRNA vaccine design, performed quickly by bioinformatic tools, as announced by Moderna and Pfizer companies (2).
Keywords: In Silico, Bioinformatics, Computational Biology, Simulation, Artificial Intelligence -
زمینه و هدف
با جایگزینی روش های نوین آموزشی به جای روش های سنتی، آموزش پزشکی نیز نیازمند تحول است. این مطالعه باهدف طراحی نرم افزار آموزشی تعاملی اطلس بیماری های پستان برای دانشجویان پزشکی و بررسی دیدگاه و رضایت آن ها انجام شد.
روش هااین مطالعه از نوع طراحی و توسعه آموزشی بود که باهدف شبیه سازی موارد بالینی بر روی وب و تلفن همراه اجرا شد. اطلس طراحی شده در اختیار 20 دانشجوی بالینی علوم پزشکی جهرم که در حال گذراندن بخش جراحی بودند، قرار گرفت. دیدگاه دانشجویان با استفاده از یک پرسش نامه 10 سوالی در 5 سطح لیکرت و رضایت مندی آن ها در طیف 10 بخشی ارزیابی شد.
نتایجبیشترین درصد پاسخ دهندگان (60 تا 80 درصد) تاثیر اپلیکیشن بر یادگیری و کاریرد آن را در سطح عالی و خوب ارزیابی کردند. 31/6 درصد دانشجویان رضایتمندی کامل از اطلس طراحی شده داشتند و 73/7 درصد از شرکت کنندگان نمره ی 7 یا بالاتر دادند. همچنین بررسی رضایتمندی افراد از کاربست اپلیکیشن نیز نشان داد که 84/3 درصد از دانشجویان از کاربست اپلیکیشن رضایت داشتند؛ به گونه ای که نمره 8 و بالاتر را انتخاب کردند.
نتیجه گیریشبیه ساز اطلس بیماری های پستان می تواند تاثیرات مثبتی بر یادگیری و رضایت دانشجویان داشته باشد. استفاده از این اطلس تعاملی با محتوای واقعی، به عنوان یک ابزار آموزشی موثر، در آموزش علوم پزشکی و سایر گروه ها قابل تعمیم است.
کلید واژگان: اطلس، یادگیری فعال، شبیه سازی، دانشجویان پزشکی، آموزش پزشکی، الکترونیک، بیماری های پستانBackground & AimBy replacing traditional teaching methods with modern educational approaches, medical education also requires transformation. This study aimed to design an interactive educational software atlas of breast diseases for medical students and assessing their perspectives and satisfaction.
MethodsThis study was a design and development project aimed at stimulating clinical cases on both web and mobile devices. The designed atlas was provided to 20 clinical medical students from Jahrom University who were undergoing their surgical rotation. The students' perspectives were evaluated using a 10-question questionnaire on a 5-point Likert scale, while their satisfaction was assessed on a 10-point scale.
ResultsThe highest percentage of respondents, ranging from 60 to 80 percent, rated the application's impact on learning and its applicability as excellent or good. 31.6 percent of students were completely satisfied with the designed atlas, while 73.7 percent of participants rated it 7 or higher. Additionally, the survey results revealed that 84.3 percent of students were highly satisfied, giving a score of 8 or above.
ConclusionThe breast disease atlas simulator has the potential to positively impact student learning and satisfaction. By utilizing this interactive atlas, which contains real content, as an effective educational tool, it can be applied in various fields, including medical education.
Keywords: Atlas, Active Learning, Simulation, Medical Students, Medical Education, Electronics, Breast Diseases -
زمینه و هدف
بهینه سازی دز اشعه در درمان های پرتودرمانی اهمیت زیادی دارد. شبیه سازی شتاب دهنده های خطی پزشکی با روش های مونت کارلو به منظور افزایش دقت و اطمینان در طرح های درمانی، کاهش خطرات تابش، بهبود کیفیت و اثربخشی درمان ، و صرفه جویی در زمان و منابع، ابزار اصلی به شمار می رود.
روش هادر این تحقیق، اجزای سر درمانی شتاب دهنده خطی واریان 2100 Clinacبا استفاده از کد/ GATE 4 GEANT نسخه ی 2/8 و نرم افزار شبیه سازی PRIMO نسخه ی 1814.(32-64).3.0 مدل سازی شدند. مدل توسعه یافته برای اعتبارسنجی پرتو فوتون MeV 6 با تکنیک فضای فاز در کدهای PRIMO و GATE و روش مرسوم محاسبات دز در GATE استفاده شد. نتایج محاسبات با اندازه گیری های انجام شده در یک فانتوم آب با ابعاد 30×50×50 cm3 در فاصله چشمه تا سطحcm 100 مقایسه شدند. درصد دز عمقی و پروفایل های عرضی در عمق cm 10 و عمق بیشینه دز برای اندازه ی میدان هایcm2 5×5 ، cm215×15و cm230×30 محاسبه شدند.
نتایجدزیمتری با استفاده از اندازه ی وکسل cm32×2×2 برای درصد دز عمقی وmm3 2×5×5 برای پروفایل عرضی انجام شد. پارامترهای بهینه مربوط به انرژی متوسط پرتو الکترونیMeV 2/6 ، انحراف استانداردMeV 17/0 و اندازه چشمه الکترونیmm 2 بودند ، که توافق خوبی بین نتایج شبیه سازی و اندازه گیری مشاهده شد.
نتیجه گیرینتایج نشان دادند که انحراف میانگین نقطه به نقطه کمتر از % 2/5 است و % 95/56 از نقاط ارزیابی شده، معیار شاخص گامایmm % 3/3 را برآورده می کنند. این مطالعه قابلیت کدهای PRIMO و GATE را در پرتودرمانی تائید می کند.
کلید واژگان: پرتودرمانی، شبیه سازی، مونت کارلو، گیت، پریموImproving dose accuracy in radiation therapy: Validating monte carlo simulations with GATE and PRIMOBackground & AimOptimizing radiation dose in radiotherapy treatments is of great importance. Monte Carlo simulation of medical linear accelerators is a key tool for enhancing precision and reliability in treatment planning, reducing radiation risks, improving treatment quality and effectiveness, and saving time and resources.
MethodsIn this study, the treatment head components of a Varian Clinac 2100 linear accelerator were modeled using the GATE/ GEANT 4 code (version 8.2) and the PRIMO simulation software (version 0.3.64.1841). The developed model was validated for a 6 MeV photon beam using the phase-space technique in both PRIMO and GATE codes, as well as the conventional dose calculation method in GATE. The calculated results were compared with measurements conducted in a water phantom with dimensions of 50 × 50 × 30 cm³ at a source-to-surface distance (SSD) of 100 cm. Percentage depth dose (PDD) and transverse profiles were calculated at a depth of 10 cm and at the depth of maximum dose for field sizes of 5 × 5 cm², 15 × 15 cm², and 30 × 30 cm².
ResultsDosimetry was performed using voxel sizes of 2 × 2 × 2 cm³ for percentage depth dose and 5 × 5 × 2 mm³ for transverse profiles. The optimal parameters, including an average electron beam energy of 6.2 MeV, a standard deviation of 0.17 MeV, and an electron source size of 2 mm, were determined, showing good agreement between simulation and measurement results.
ConclusionThe results indicated that the mean point-to-point deviation was less than 2.5%, and 95.56% of the evaluated points met the gamma index criterion of 3/3% mm. This study confirms the capability of the PRIMO and GATE codes in radiotherapy applications.
Keywords: Radiation Therapy, Simulation, Monte Carlo, GATE, PRIMO -
مقدمه
آتش سوزی یکی از خطرناک ترین پدیده هایی است که خسارات جانی و مالی عمده ای را به وجود می آورد. بیمارستان ها و مراکز درمانی، از جمله مکان هایی هستند که سالانه تعداد زیادی حریق در آن ها اتفاق می افتد و به همین دلیل، تخلیه بیماران، افراد ناتوان و کارکنان از اهمیت بالایی برخوردار است. هدف از انجام پژوهش حاضر، شبیه سازی و تخلیه اضطراری افراد در زمان آتش سوزی در یکی از بیمارستان های شیراز بود.
روش هااین مطالعه در ساختمان درمانی یک بیمارستان بدون خروجی اضطراری صورت گرفت. شبیه سازی تخلیه در دو حالت حریق و بدون حریق جهت بررسی تاثیر دود و محصولات احتراقی بر روی زمان تخلیه افراد انجام شد. به منظور شبیه سازی حریق و تخلیه، از نرم افزار Fire Dynamics Simulator+Evac (FDS) و PyroSim استفاده گردید.
یافته هانتایج شبیه سازی تخلیه اضطراری نشان داد که میانگین زمان تخلیه در شرایط عادی (بدون حریق) 815 ثانیه بود و در این زمان تمام 295 نفر تخلیه شدند. در زمان حریق هنگامی که سیستم های تهویه روشن یا خاموش بودند، به ترتیب 10 و 32 نفر از 295 نفر قادر به تخلیه ساختمان در مدت زمان 900 ثانیه نبودند.
نتیجه گیرینتایج به دست آمده حاکی از نقش مهم سیستم های تهویه در جلوگیری از رسیدن دود به طبقات پایین تر از طریق در دسترس قرار دادن درب های خروج اضطراری بود.
کلید واژگان: شبیه سازی، حریق ها، تخلیه اضطراری، مراکز درمانیBackgroundFire is one of the most perilous phenomena, resulting in human and financial losses. Hospitals and medical centers are among the places where a large number of fires occur every year, making the timely evacuation of patients, individuals with disabilities, and staff crucial. The aim of this study was to simulate and analyze the emergency evacuation of individuals in a hospital in Shiraz City, Iran.
MethodsThis study was performed in the treatment building of a hospital that lacked emergency exits. Evacuation simulations were performed in both fire and non-fire modes to investigate the impact of smoke and combustion products on the evacuation time of individuals. Fire Dynamics Simulator (FDS)+Evac and PyroSim software were applied to simulate fire and evacuation.
FindingsThe results of the emergency evacuation simulation showed that under normal conditions (without a fire), the average evacuation time was 815 seconds, during which 295 individuals successfully evacuated. In contrast, during the fire scenario, when the ventilation system was either operational or non-operational, 10 and 32 individuals, respectively, were unable to exit the building after 900 seconds.
ConclusionThe results of this study demonstrate the crucial role of ventilation systems in preventing smoke from reaching the floors, by making emergency exit doors available.
Keywords: Simulation, Fires, Emergency Evacuation, Medical Center -
زمینه و هدف
آمادگی اضطراری برای حوادث پرتوی ضروری است و بر لزوم طراحی و تسهیل انواع تمرین های پیشرونده برای افزایش آمادگی در این حوادث تاکید شده است. استفاده از روش نمایش با استفاده از شبیه سازی، روش موثری برای آموزش در این زمینه است. به همین منظور جهت آموزش تعدادی از دانشجویان کارشناسی ارشد پرستاری نظامی در زمینه مراقبت از مصدومین پرتوی، برنامه ریزی جهت بازدید از یک کلینیک تخصصی مراقبت از مصدومین پرتوی انجام و دانشجویان آموزش های لازم در این زمینه را به روش شبیه سازی دریافت کردند.
روش هااین مقاله حاصل یک مطالعه موردی است که از طریق انجام عملیات میدانی، سازماندهی و توصیف داده ها انجام شده و در آن محقق، در جریان طبیعی یک رویداد به جمع آوری اطلاعات پرداخت. در این مطالعه مشاهده و توصیف، عنصر اصلی را تشکیل می دهد و از تکنیک های مشاهده و مصاحبه جهت دست یابی به دانش موردنظر و فرایندهای اندیشیدن درباره اطلاعات استفاده شده است.
یافته هاآموزش مراقبت از مصدوم پرتوی به روش شبیه سازی با مولاژ مصدوم ترکیبی (تروما و آلودگی پرتوی) توسط کارشناس متخصص کلینیک مراقبت پرتوی، به دانشجویان ارائه گردید. مصدوم فرضی پس از تریاژ و رفع آلودگی کامل، جهت پایش علائم بالینی و دریافت مراقبت های پزشکی و پرستاری لازم به بخش بستری منتقل گردید. طراحی مراکز تخصصی مراقبت و درمان مصدومین هسته ای و پرتوی، نسبت به سایر بیمارستان ها و مراکز درمانی، مقداری متفاوت است و این مراکز دارای قسمتی خاص جهت نصب وسایل آلودگی زدایی و سیستم فاضلاب جدا برای ذخیره آب آلوده می باشند. همچنین کارکنان درگیر در ارائه مراقبت های درمانی به مصدومین پرتوی باید به توانایی علمی و مهارت های عملی مورد نیاز مجهز باشند و آمادگی مواجهه با حوادث پرتوی را داشته باشند.
نتیجه گیریبا توجه به اهمیت و لزوم آموزش های میدانی و حضور در عرصه های واقعی مواجهه با شرایط بحرانی و جنگ و به منظور ارتقاء سطح آموزش و مهارت دانشجویان کارشناسی ارشد پرستاری نظامی، توصیه می گردد برنامه ریزی و هماهنگی های لازم جهت حضور و مشارکت دانشجویان فوق الذکر در مراکز درمانی و موسسات مربوطه و ماموریت های مشابه در آینده به عمل آید.
کلید واژگان: پرستار، رادیواکتیو، شبیه سازی، مصدوم پرتویJournal of Military Medicine, Volume:26 Issue: 5, 2024, PP 2527 -2533Background and AimEmergency preparedness for radiation accidents is essential, and the need to design and facilitate various progressive exercises to increase preparedness in these accidents has been emphasized. Using the demonstration method with simulation is an effective teaching method in this field. To train military nursing master's students in caring for radiation victims, a plan was made to visit a specialized clinic for radiation victim care. The students received necessary training through simulation.
MethodsThis article presents the findings of a case study conducted through field operations, data organization, and description of data collected during the natural course of an event by researchers. Observation and description were the primary elements of this study, and observation and interview techniques were utilized to gather the necessary knowledge and insights about the information.
ResultsRadiation casualty care training was presented to the students using a simulation method with combined casualties (trauma and radiation contamination) by an expert from the radiation care clinic. After triage and complete decontamination, the hypothetical victim was transferred to the inpatient ward to monitor clinical symptoms and receive the necessary medical and nursing care. The design of specialized centers for the care and treatment of nuclear and radiation victims is somewhat different from other hospitals and medical centers. These centers have a special section for installing decontamination devices and a separate sewage system for storing polluted water. Also, the staff involved in providing medical care to radiation victims should be equipped with the required scientific ability and practical skills and be prepared to face radiation accidents.
ConclusionConsidering the importance and necessity of field training and presence in real arenas facing critical conditions and war, and in order to improve the level of education and skills of military nursing master's students, it is recommended that necessary planning and coordination be made for the presence and participation of students in medical centers, related institutions, and similar missions in the future.
Keywords: Nurse, Radioactive, Simulation, Radiation Victim -
مقدمه
آموزش طب اورژانس به عنوان یک واحد حیاتی، از اهمیت ویژه ای در آموزش پزشکی برخوردار است. امروزه استفاده از بازی سازی ها در آموزش به عنوان فناوری های ارتقاءدهنده یادگیری کاربرد بیشتری یافته است. هدف این مطالعه طراحی، اجرا و ارزشیابی شبیه سازی درس طب اورژانس در قالب بازی جدی است.
روش کاراین مطالعه یک تحقیق نیمه تجربی با گروه کنترل است که بر روی 60 نفر از دانشجویان پزشکی در مقطع بالینی (اکسترن و اینترن) و با نمونه گیری آسان، در یک دوره دو ماهه واحد طب اورژانس انجام شد. روش نمونه گیری به صورت سرشماری بود. برنامه آموزشی در قالب نرم افزار بازی با قابلیت اجرا بر روی سیستم وب و موبایل به آدرس (http://emergencygame.ir)در سال 1402 توسعه یافت. یادگیری دانشجو از طریق تفاوت میانگین نمره کتبی نهایی با استفاده از آزمون تی مستقل ارزیابی شد. سطح رضایتمندی از طریق پرسشنامه آنلاین در یک طیف 10 بخشی بررسی گردید. نظرات دانشجویان در خصوص کاربرد نرم افزار بازی به روش کیفی همراه با سوال باز پاسخ و استخراج مضامین براساس بیشترین تکرار استخراج گردید.
نتایجمیانگین نمرات دانشجویان دو گروه مداخله و کنترل نشان داد مداخله بر یادگیری دانشجویان موثر بوده است (0.01= P). میانگین نمره دانشجویان گروه مداخله (1.78±7.93)، نشان دهنده رضایتمندی بالای گروه مداخله از اجرای آن بود. همچنین دانشجویان تاثیرات بازی سازی بر شاخص های یادگیری را در ارزشیابی کیفی مثبت ارزیابی کردند.
نتیجه گیریبا توجه به تاثیر بازی سازی بر رضایتمندی و شاخص های یادگیری دانشجویان و علاقه مندی آن ها به تکنولوژی های نوظهور، این روش در آموزش علوم پزشکی توصیه می شود.
کلید واژگان: شبیه سازی، طب اورژانس، بازی در آموزش، یادگیری فعال، آموزش پزشکیIntroductionThe teaching of emergency medicine as an important subject is of particular importance in medical education. The use of games and gamification in education as a technology to enhance learning is of great importance today and its effects on learning in a fun and motivating environment can help improve the teaching of medical sciences. The main objective of this thesis is to design, implement and evaluate a simulation of an emergency medicine course in the form of a serious game.
Materials & MethodsThis study is a quasi-experimental survey conducted on 60 external and internal students with easy sampling and all students in July, August, September and October in the emergency medicine unit in the form of a census .Thirty participants from the intervention group (Emergency Medicine students from September and August) and the control group (Emergency Medicine students from June and July) were recruited.The game was developed as a game application, capable of running on systems and mobile devices at (https: //emergencygame.ir/?p=134) to evaluate each step of student learning through writing scores and satisfaction on a 10-part scale, and their opinions were examined through interviews and extracted semantic codes. Descriptive and analytic statistics was used to analysis.
ResultsThe average scores of the students of the two groups showed the effect of the intervention on students' learning (t-test: -2.47, P=0.01). Students' satisfaction with (7.93±1.78) indicates a good satisfaction with its implementation and the average time spent 142.80 showed that the intervention was able to attract students' concentration and interest. Students positively evaluated the effects of gamification on learning indicators in qualitative evaluation through interviews.
ConclusionConsidering the impact of gamification on students' satisfaction and learning indicators and their interest in emerging technologies, this method is recommended in medical science education.
Keywords: Emergency Medicine, Simulation, Active Learning, Game Based Learning -
مجله علمی دانشگاه علوم پزشکی کردستان، سال بیست و نهم شماره 4 (پیاپی 133، مهر و آبان 1403)، صص 107 -122زمینه و هدف
امروزه مدیریت پسماند یکی از ارکان مهم مدیریت منابع در بیمارستان می باشد .هدف از مطالعه حاضر شناسایی عوامل موثر در مدیریت پسماندهای بیمارستانی در مبداء تولید، به منظور تجزیه و تحلیل این عوامل و تعیین موثرترین آن ها جهت بهبود کیفیت مدیریت اینگونه پسماندها بود.
مواد و روش هادر پژوهش کاربردی حاضر از مبانی و مولفه های پویایی سیستم ها برای بررسی عملکرد مدیریت پسماندهای بیمارستانی در این زمینه استفاده شد.با توجه به مدل نمودن سیستم مدیریت پسماندهای مورد اشاره، جامعه آماری مراکز طرف قرارداد در سال 1400 یا سازمان مدیریت پسماند شهرداری تهران است. بدین منظور شاخص های اصلی عملکرد سازمان از ادبیات پژوهش و همچنین اخذ نظر از خبرگان با استفاده از تکنیک دلفی فازی استخراج گردید و با استفاده از مفاهیم پویایی سیستم ها تاثیر این عوامل در قالب نمودارهای علت و معلول نمایش داده شد. برای بیین کارکرد مدل پیشنهادی، متغیرهای پژوهش در قالب سناریوهای مختلف با استفاده از نرم افزار ونسیم بررسی شدند تا میزان اثرگذاری هریک در شرایط مختلف مشخص شود.
یافته هابا توجه به دیاگرام جریان ارائه شده و سناریوهای پیشنهادی، مشخص شد که با به کارگیری سناریو بهینه، متغیرهای مختلف پژوهش ازجمله نرخ بی خطر سازی، جمع آوری و ورود غیر مجاز به مخازن پسماند شهری، از طریق روابط تبیین شده مدل در حدود 15 تا 40 درصد بهبود پیدا می کند.
نتیجه گیرینتایج به دست آمده در این پژوهش در نهایت منجر به کاهش خطرات زیست محیطی و همچنین کاهش تولید پسماندهای خطرناک می گردد که می تواند مبنایی برای تبیین استراتژی های مدیریت پسماند در مراکز درمانی قرار بگیرد.
کلید واژگان: شاخص های مدیریتی، پسماند بیمارستانی، شبیه سازی، بهینه سازی، پویایی سیستمScientific Journal of Kurdistan University of Medical Sciences, Volume:29 Issue: 4, 2024, PP 107 -122Background and aimsToday, waste management is one of the important pillars of resource management in hospitals. The purpose of this study was to identify the effective factors in the management of special medical wastes at the source of their production, to analyze these factors, and to determine the most effective ones to improve the quality of management of such wastes.
Materials and MethodsIn this research, the basics and dynamic components of systems were used to investigate the performance of hospital waste management in this field. For this purpose, the main indicators of the organization's performance were extracted from the research literature. Then, using the concepts of system dynamics, the effect of these factors was shown in the form of cause and effect diagrams. To explain the function of the proposed model, research variables were examined in the form of different scenarios to determine the effectiveness of each in different conditions.
ResultsAccording to the presented flow diagram and the proposed scenarios, it was found that by using the optimal scenario, the various variables of the research, such as decontamination rate, collection, and unauthorized entry into urban waste reservoirs, through the explained relationships of the model in it improves about 15 to 40 percent.
ConclusionThe results obtained in this research ultimately lead to the reduction of environmental risks as well as the reduction of hazardous waste production, which can be a basis for explaining waste management strategies in medical centers.
Keywords: Management Indicators, Hospital Waste, Simulation, Optimization, System Dynamics -
Background and Objectives
Simulated patient applications are integral to healthcare training, providing realistic scenarios for skill enhancement. This study evaluated the impact of simulated patient application on anxiety levels and occupational health perceptions in paramedic training.
MethodsThis quasi-experimental study was conducted at a public university between June and December 2023, with 69 second-year paramedic students who had completed relevant courses. Data were collected at three points: before the training, immediately after, and six months later, using sociodemographic forms, the Generalized Anxiety Disorder Scale (GAD-7), and the Perceived Occupational Health and Safety Competence Scale (POHSCS). Paired t-tests and Pearson correlation analyses were used for statistical analysis, with significance set at p<0.05.
ResultsThe mean pre-test GAD-7 score was 8.69 ± 4.88, increasing to 9.05 ± 5.09 post-test, and decreasing to 8.34 ± 5.23 at follow-up. The mean OHSCPS score was 94.50 ± 26.94 pre-test, 96.39 ± 25.25 post-test, and 99.28 ± 28.11 at follow-up. Strong correlations were found in OHSCPS pre-test to post-test (r=0.624, p<0.001), pre-test to follow-up (r=0.544, p<0.01), and post-test to follow-up (r=0.712, p<0.001). For GAD-7, correlations included pre-test to post-test (r=0.776, p<0.001), pre-test to follow-up (r=0.606, p<0.01), and post-test to follow-up (r=0.527, p<0.05).
ConclusionThis study indicates the potential of simulation-based training to reduce anxiety and enhance occupational health perceptions among paramedic students. Future research with larger sample sizes is needed to provide stronger evidence.
Keywords: Anxiety, Occupational Health, Paramedic, Simulation, Training -
BackgroundThe COVID-19 virus has created many problems for human beings in the real world, particularly in the health sector. One of the issues is in emergency hospitals, which are vital pillars of the healthcare system in every country. Providing timely treatment and access to healthcare facilities is a major problem in developing countries.ObjectivesThe aim of the study was to simulate a hospital emergency department under COVID-19 conditions.MethodsThis study simulates the operations of an emergency department in a hospital under COVID-19 conditions as a case study in Iran. This study considers several assumptions about hospital facilities, including doctors, nurses, and patients. The patients are divided into two categories: some require immediate examination, while others wait in line for appropriate services.ResultsA flow diagram for the department is provided and converted into a model, which is implemented using GPSS software. The model is then run multiple times, and the outputs are collected. The outputs of the simulation and their statistical distributions are analyzed, and the performance of various statistical tests is examined. Finally, recommendations for improving the performance of the emergency system are presented.ConclusionThe findings of this study can be used as the first step in preparing this tool. Accordingly, this study was conducted to identify existing and valid tools for measuring hospital readiness against the COVID-19 virus, translate those tools, and compare them.Keywords: Simulation, COVID-19, Emergency, Hospital, Modeling
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Background
Simulation training, a novel learning method, provides medical students with opportunities to practice managing stressful situations as if they were experiencing them in reality. Recently, there has been increased recognition of the value of simulation-based education. This study aimed to evaluate the most effective approach for providing feedback during a simulation program.
MethodsIn this interventional study, a total of 43 obstetrics and gynecology residents were recruited and stratified into three groups based on their residency stage. These residents participated in a simulation-based program focused on the management of post-partum hemorrhage (PPH). The program involved handling a PPH scenario, during which they received feedback either during the task (in-task; IT) or after completing the task (end-task; ET). Following the simulation, a post-test was administered, and the results were compared between the IT and ET feedback groups.
ResultsDemographic variables did not differ significantly between the ET and IT groups. Generally, there were no significant differences in secondary knowledge (P=0.232) or secondary performance (P=0.196) following the simulation program between the two groups. However, Among second-year residents, the change in primary and secondary performance was not significant in either the ET (P=0.76) or IT (P=0.74) group, while the IT group showed a significant improvement in knowledge (P=0.04). For third-year residents, the point change in primary and secondary knowledge and performance was not statistically significant in either the ET or IT groups.
ConclusionThe final knowledge and performance following simulation programs do not significantly differ between the IT and ET groups. However, second-year residents experienced an improvement in knowledge.
Keywords: Simulation, Resident, Learning -
Leveling up orthodontic education: Game-based learning as the new frontier in orthodontic curriculum
Game-based learning (GBL) is becoming a focal point in contemporary orthodontic dental education. This study examines GBL’s ability to provide immersive experiences simulating real-world orthodontic practice. Leveraging technologies like virtual reality (VR), augmented reality (AR), 3D modeling, and advanced e-learning platforms, GBL enhances active learning, critical thinking, and decision-making skills. While promising, GBL adoption faces challenges like high costs, technical demands, and curriculum integration hurdles. However, ongoing innovations, personalized learning paradigms, and artificial intelligence (AI) are mitigating these. This research highlights GBL’s measurable impact on student engagement, information retention, and translating theory into orthodontic practice. Through GBL’s lens, orthodontic education undergoes a paradigm shift where students construct comprehensive treatment plans for simulated patients, fulfilling modern orthodontic pedagogy’s evolving requirements.
Keywords: Active Learning, Education, Game-Based Learning, Orthodontics, Simulation, Virtual Reality -
مقدمه
بررسی تغییرات دمایی و توزیع حرارتی در برهمکنش لیزرهای مختلف با مواد متفاوت همیشه مورد توجه محققین بوده است. در این مطالعه، با استفاده از نرم افزار کامسول، توزیع حرارتی و تغییر دمای بافت های پوست، چربی و بافت عضلانی در برهمکنش با طول موج های متفاوت لیزر در تکنیک لیزر درمانی برای ترمیم آسیب های اسکلتی عضلانی ، تخمین زده شد.
مواد و روش هایک مدل سه بعدی اولیه از هندسه و ابعاد و ضخامت مواد در لایه های مجزا در فضای شبیه سازی نرم افزار، تعریف شد و سپس پارامترهای اپتیکی و حرارتی برای هر بافت در طول موج های مختلف مشخص شد. در ادامه فرآیند مدلسازی، از فیزیک انتقال حرارت در بافت بیولوژیک برای بررسی توزیع حرارتی استفاده شد. همچنین، انرژی تابیده شده به وسیله پرتو لیزر در طول موج مختلف، به عنوان منبع حرارتی تابشی در نظر گرفته شد.
یافته هانتایج محاسبات به وسیله نرم افزار نشان داد که طول موج های متفاوت از لیزر می تواند دمای پوست را تا 8/38 درجه سانتیگراد تغییر دهد. اما در بافت های عمقی تر مانند بافت عضلانی تغییرات دمایی محسوس مشاهده نشد.
نتیجه گیریدر روش های درمانی با استفاده از لیزر به منظور ترمیم بافت، تغیرات دمایی و حرارتی هیچ گونه اثری ندارند و فرآیند ترمیم در اثر پدیده های فوتوشیمیایی رخ می دهد که در این مطالعه در فضای شبیه سازی نشان داده شد که تغییرات دمایی چشمگیری در بافت ها رخ نمی دهد.
کلید واژگان: برهمکنش لیزر و بافت، لیزر کم توان، مدلسازی، نرم افزار کامسولBackgroundInvestigating temperature changes and thermal distribution in the interaction of different lasers with various materials has always interested researchers. This study estimated thermal distribution and temperature change of skin, fat, and muscle tissue in interaction with different wavelengths of laser in laser therapy technique for repairing musculoskeletal injuries using COMSOL Multi-physics software.
MethodsA three-dimensional cube with separate layers and various thicknesses was determined, and then the optical and thermal parameters were determined for materials in different wavelengths. Bio-heat transfer physics in biological tissue was utilized to investigate thermal distribution. In addition, the energy radiated by the laser beam at different wavelengths was considered as a radiant heat source.
ResultsThe results of the calculations by the software showed that different wavelengths of the laser could change the skin temperature up to 38.8 degrees Celsius. However, no noticeable temperature changes were observed in deeper tissues such as muscle tissue.
ConclusionIn laser therapy methods for tissue repairing, photochemical phenomena are important, not thermal processes. In the present study, it was proven that temperature changes in tissues are not significant.
Keywords: Simulation, COMSOL Multi-Physics Software, Laser Therapy -
International Journal of Medical Toxicology and Forensic Medicine, Volume:14 Issue: 2, Spring 2024, P 4Background
In Iran, one of the main duties of forensic psychiatrists is to accurately diagnose post-traumatic stress disorder (PTSD). In order to achieve a more accurate diagnosis and reduce the possibility of deception, the autonomic reactions of patients with PTSD were investigated through virtual reconstructed trauma.
MethodsThe autonomic activities of 80 patients who were diagnosed with PTSD by psychiatric interview based on the diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) and PTSD checklist for DSM-5 (PCL-5) checklists, were recorded by an electronic wristband through virtual trauma exposure. Data were collected and analyzed by SPSS software, version 16.
ResultsThe galvanic skin response, heart rate, and body temperature can be the most reliable automatic reactions to diagnose true cases of PTSD.
ConclusionThe findings of this study along with psychometric tests can be used to distinguish between true cases of PTSD and fake cases.
Keywords: Post Traumatic Stress Disorder (PTSD), Simulation, Autonomic Reaction, Virtual Reconstruction -
Interdisciplinary Journal of Virtual Learning in Medical Sciences, Volume:15 Issue: 2, Jun 2024, PP 117 -125Historically, most interprofessional simulations with standardized patients have occurred via face-to-face encounters; however, the COVID-19 pandemic necessitated rapid pivoting to (re)create meaningful, online experiences for individuals separated due to social distancing. This study integrated e-learning strategies into a simulation scenario where interprofessional learners worked collaboratively online to care for a standardized patient presenting with subacute stroke symptoms. E-learning strategies emphasized “real world” applicability (e.g., telehealth), encouraged asynchronous self-directed learning, required learners to incorporate previous educational knowledge, built communities of learning, necessitated completion of team-based deliverables, and included “elements of surprise” to evoke emotions. A total of 376 students participated in the online simulation, from medicine, nursing, occupational therapy, physical therapy, physician assistant, and social work programs. Matched pre- and post-session responses to a validated instrument assessing interprofessional values and interactions were available for 319 students (85%). Statistically significant advancements in self-reported skills were apparent in students’ pre- to post-session responses for both the interprofessional interactions and values domains of the Interprofessional Education Collaborative (IPEC) self-assessment tool (P<0.001). Incorporating e-learning strategies into a complex simulation conducted online via Zoom was effective in helping students achieve desired interprofessional competencies.Keywords: Education, Medical, Distance, Interprofessional Education, Simulation, Standardized Patients, Medical Education
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Background
Computed tomography (CT) imaging has a large portion in the dose of patients from radiological procedures; therefore, accurate calculation of radiation risk estimation in this modality is inevitable. In this study, a method for determining the patient‑specific effective dose using the dose–length product (DLP) index in lung CT scan using Monte Carlo (MC) simulation is introduced.
MethodsEGSnrc/BEAMnrc MC code was used to simulate a CT scanner. The DOSxyznrc simulation code was used to simulate a specific voxelized phantom from the patient’s lungs and irradiate it according to X‑ray parameter of routing lung CT scan, and dose delivered to thorax organs was calculated. Three types of phantoms were simulated according to three different body habits (slim, standard, and fat patients) in two groups of men and women. A factor was used to convert the relative dose per particle in MC code to the absolute dose. The dose was calculated in all lung organs, and the effective dose was calculated for all three groups of patient body habits. DLP index and volume CT dose index (CTDIvol) were extracted from the patient’s dose report in the CT scanner. The DLP to effective dose conversion factor (k‑factor) for patients with different body habitus was calculated.
ResultsLung radiation dose in slim, standard, and fat patients in men was 0.164, 0.103, and 0.078 mGy/mAs and in women was 0.164, 0.105, and 0.079 mGy/mAs, respectively. The k‑factor in the group of slim patients, especially in women, was higher than in other groups.
ConclusionsCT scan dose indexes for slim patients are reported to be underestimated in studies. The dose report in CT scan systems should be modified in proportion to the patient’s body habitus, to accurately estimate the radiation risk.
Keywords: Computed tomography scan, dose–length product, effective dose, organ dose, simulation -
Introduction
Simulation-based education (SBE) is an instructional approach that aims to accurately recreate real-life scenarios and engage learners in the practical application of lesson content. By replicating critical elements of clinical situations, SBE facilitates a deeper understanding and better preparation for managing such conditions in actual clinical practice. SBE offers promising prospects for improving medical education and patient care in various settings,such as outpatient clinics. Therefore, this scoping review aims to determine to what extent the most effective components and standards of the simulation have been considered in outpatient education.
MethodsThe present scoping review adheres to the guidelines outlined in the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMAScR) checklist” and the “Joanna Briggs Institute (JBI) Reviewers’ Manual”. This review focused on articles that specifically focused on the use of simulation in outpatient education. Google Scholar, PubMed, Scopus, Embase, and ERIC were searched for keywords related to simulation, ambulatory care, outpatient clinics, and medical education from January 1, 2001, to August 12, 2023.
ResultsThe search indicated 513 articles, which were narrowed down by title and abstract relatedness. Twenty-nine articles entered the study’s second phase, and after reviewing their full text, nine articles that explicitly reported simulation use in outpatient education remained. Based on the findings of eligible articles, the ten most frequent components of SBE that should be considered and followed discussed. These features were training facilitators, pre-briefing sessions, the type of simulation techniques, the site of simulation participation, the simulation duration, unit of participation, extent of direct participation, Simulation fidelity, feedback, and debriefing and reflection.
ConclusionSBE is a contemporary method of practical training for medical students that involves realistic modeling or simulation of clinical situations. It enhances learning effectiveness andprovides a safe, educational atmosphere for teaching and learning. Designing simulations adhering to established standards and carefully considering essential components improves efficiencyand effectiveness.
Keywords: Simulation, Patient simulation, Medical education, Outpatient -
Background & Objective
Regarding the urgent needs of students for an efficient teaching methodology, it is necessary to use self-directed and self-centered teaching methods that encourage the power of reasoning and judgment. This study aimed to investigate the effect of using the game-based Appendectomy Surgical Simulation software on the academic achievement of undergraduate operating room students in Khomein, Iran.
Materials & MethodsThis quasi-experimental study was conducted during the COVID-19 pandemic. Forty undergraduate operating room students who were in the second semester of the first year of the operating room undergraduate program participated in this quasi-experimental single-blind study. The participants were assigned randomly to the control and intervention groups after their consent was obtained. Following the use of the game-based Appendectomy Surgical Simulation software for the intervention group and lecture-based classes on a specific academic learning software for the control group, the data were collected using a researcher-made questionnaire concerning academic achievement, whose validity and reliability were approved. The data were then analyzed using descriptive and analytical tests in IBM SPSS (version 22) at a significance level of P<0.05.
ResultsThe average score of academic achievement was significantly higher in the intervention group (58.35±2.38) than in the control group (35.65±4.14) (P<0.05).
ConclusionUsing the game-based Appendectomy Surgical Simulation software has been effective in improving the academic achievement of students during the COVID-19 pandemic and afterward. Therefore, it can be used in academic and educational programs.
Keywords: academic achievement, COVID-19, gamification, medical education, operating room, simulation -
زمینه و هدف
بخش اورژانس بیمارستان به منزله ی قلب بیمارستان می باشد و گردش منظم امور در این واحد می تواند جان انسان های بسیاری را نجات دهد. هدف از این پژوهش کاهش زمان انتظار بیماران بخش اورژانس با استفاده از تکنیک شبیه سازی می باشد.
مواد و روش هاپژوهش حاضر یک مطالعه توصیفی-تحلیلی است و به صورت مقطعی در سال 1399 در بیمارستان قائم مشهد انجام پذیرفت. در این پژوهش سعی شد تا با زمان سنجی صحیح و با استفاده از فرآیند شبیه سازی و استفاده از نرم افزار Arena، جریان فرآیند بیماران در بخش اورژانس بیمارستان قائم مشهد مقدس مدل سازی شود. به منظور ارزیابی وضعیت سیستم، شاخص هایی از جمله زمان انتظار بیماران، تعداد بیماران ترخیص شده (خروجی سیستم)، طول مدت اقامت و عملکرد مفید منابع و بهبود بخش اورژانس مورد بررسی قرار گرفت.
نتایجنتایج حاصل از اجرای مدل شبیه سازی نشان داد که به ترتیب بخش های آزمایشگاه، معاینه توسط پزشک متخصص و داروخانه دارای بیشترین زمان انتظار در این بخش می باشند.
نتیجه گیریبرای کاهش زمان انتظار بیماران و بهبود وضعیت، مناسب ترین و به صرفه ترین راهکار، اضافه کردن یک نیروی تکنسین آزمایشگاه به بخش آزمایشگاه در شیفت]15-23[بیمارستان قائم مشهد می باشد که زمان انتظار بیماران به میزان 66 دقیقه کاهش می یابد.
کلید واژگان: شبیه سازی، زمان انتظار، اورژانس، نرم افزار ARENAHospital, Volume:22 Issue: 2, 2024, PP 53 -70Background and purposeThe emergency department of a hospital is akin to its heart, where smooth operations can save many lives. This research aims to reduce patient waiting time in the emergency department using simulation techniques.
MethodsThis descriptive-analytical study was conducted cross-sectionally in 2019 at the Qaim Hospital in Mashhad. The study focused on accurately modeling the patient flow process in the emergency department using simulation techniques and Arena software. Key performance indicators such as patient waiting time, number of discharged patients (system output), length of stay, resource efficiency, and improvements in the emergency department were evaluated.
ResultsThe simulation model's results indicated that the laboratory, specialist doctor examination, and pharmacy departments had the longest waiting times in this department, respectively.
ConclusionTo reduce patient waiting times and improve conditions, the most effective and cost-efficient solution is to add a laboratory technician to the laboratory department during the [15-23] shift at Qaim Hospital in Mashhad, which is projected to decrease patient waiting times by 66 minutes.
Keywords: Simulation, Patient Waiting Time, Emergency Department, ARENA Software
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