Special Device Research Articles

Mortality rate of percutaneous coronary interventions in st-segment elevation myocardial infarction patients under the public health insurance schemes of thailand

Abstract Background ST-elevation myocardial infarction (STEMI) presents a critical public health challenge internationally, including in Thailand. Currently, standard therapeutic interventions, particularly primary percutaneous coronary interventions (pPCI), are administered to Thai citizens. However, selected healthcare systems restrict access to specific pharmaceuticals and medical devices, causing inequalities in the quality of medical care amongst different healthcare systems. Such inequalities have the potential to significantly impact the quality of life of patients, particularly in the long term. Purpose The primary objective is to compare mortality rates within one year of STEMI patients after treatment with pPCI among the public health insurance schemes of Thailand. The secondary objective is to study prognostic determinants for one-year mortality rates among patients diagnosed with STEMI who have undergone pPCI. Methodology This study is a single-centre retrospective analysis of patients with STEMI treated with pPCI. It involves patients utilising various state health insurance schemes in Thailand from 1 January 2010 to 31 December 2020. Data collection occurred through the hospital's computerised management system and the registration administration office of the Department of Provincial Administration. The data analysis employed the Kaplan-Meier survival analysis, log-rank test, and Cox proportional hazards regression modelling method. Results The study involved 1,077 patients, categorised into three groups based on their state health insurance: Universal Health Coverage (UC) (546 patients, 50.7%), Social Security System (SS) (199 patients, 18.5%), and Civil Service Reimbursement (CS) (332 patients, 62.6%). The one-year mortality rates in these groups were 10.57%, 4.21%, and 6.47%, respectively (p=0.010). In the unadjusted model, the SS group showed a lower risk of one-year mortality rate (HR 0.38, 95% CI 0.18-0.80, p=0.011), and the CS group also demonstrated a lower risk (HR 0.59, 95% CI 0.35-0.99, p=0.047) compared to the UC group. In the adjusted model, only the CS group significantly reduced the risk of one-year mortality. Other factors that affected one-year mortality were age ≥65 years, a Killip score of 3-4, pre-discharge prescription of angiotensin-converting enzyme inhibitors, occlusion in the left anterior descending artery, and pericardial effusion. Conclusion Healthcare schemes play a significant role in influencing one-year mortality rates among STEMI patients treated with pPCI. The use of civil service reimbursement is a protective factor for the one-year mortality rate in STEMI patients. This information would be crucial for developing strategies and programs to aid healthcare policymakers at both regional and international levels in reducing morbidity and mortality.

Anatomical classification of patent foramen ovale before percutaneous closure

Abstract Introduction Anatomical characteristics of patent foramen ovale (PFO) vary a lot, potentially impacting the embolic risk, selection of the device and the final sealing results of the closure procedure. Objective To categorize the different PFO anatomies and evaluate the consequence on the type of device used and the incidence of residual shunt. Methods 624 consecutive patients who underwent PFO percutaneous closure with transoesophageal echocardiography (TEE) guidance were retrospectively reviewed. Four types of PFO were identified once a rigid wire was in place using per-procedural TEE. This new classification was based on the PFO sheathed tunnel’s length and width, presence of concomitant atrial septal aneurysm (ASA) or additional defect (ASD), width of the septum secundum (SS) and aortic enlargement (Figure 1). Type I, or "single PFO" was defined by the absence of ASA or ASD, a tunnel width ≤ 4mm, SS’s width ≤ 10mm and no aortic enlargement (i.e., aortic root diameter <21mm/m², distorted anatomy or scoliosis). Type II or "dominant septal aneurysm" was defined by the presence of an ASA, with a distinction between subtype IIa (long PFO tunnel with length ≥10mm) and subtype IIb (short PFO tunnel with length <10mm). Type III or "modified PFO" was defined by SS’s width > 10 mm, aortic enlargement, or severe scoliosis, and type IV or "multi perforated" was defined by the presence of a concomitant ASD or a multifenestrated septal wall. In case of concomitant criteria, the predominant order was IV, then IIb, then III. For each category, the presence of residual shunt was evaluated after Valsalva manoeuvres with contrast echocardiogram 6 months after the procedure. Results Our population had a median age of 51 [41-59] years and included 43.8% women. The type II PFO was the most frequently encountered, with 42% of the patients (Table 1). A total of 44 (7.1%) patients presented multiple types concomitantly (mostly type II and III). PFO occluders were the most implanted devices overall, particularly with type I and IIb, while ASD occluder were more frequently used with types IV and IIb. Cribriform/Uni™ devices were more frequently used with type IV. Large devices (i.e., left disc’s diameter >25 mm) were predominantly used with type III and IV, but scarcely employed with type I and II. Within type II anatomies, large devices were significantly more frequently used with type IIb. Fluoroscopy duration was significantly higher with type IV. At 6 months ultrasound evaluation, large right-to-left residual shunt was significantly more frequent with type IV anatomy and with patients presenting multiple types concomitantly (18/34 - 40.9%). No significant differences were observed regarding clinical outcomes during follow-up. Conclusion Based on specific anatomical characteristics, four types of PFO may be identified, presenting with increasing procedural complexity, and requesting specific closure devices.

The Role of GABA Receptors in Anesthesia and Sedation: An Updated Review.

GABA (γ-aminobutyric acid) receptors are constituents of many inhibitory synapses within the central nervous system. They are formed by 5 subunits out of 19 various subunits: α1-6, β1-3, γ1-3, δ, ε, θ, π, and ρ1-3. Two main subtypes of GABA receptors have been identified, namely GABAA and GABAB. The GABAA receptor (GABAAR) is formed by a variety of combinations of five subunits, although both α and β subunits must be included to produce a GABA-gated ion channel. Other subunits are γ, δ, ε, π, and ϴ. GABAAR has many isoforms, that dictate, among other properties, their differing affinities and conductance. Drugs acting on GABAAR form the cornerstone of anesthesia and sedation practice. Some such GABAAR agonists used in anesthesia practice are propofol, etomidate, methohexital, thiopental, isoflurane, sevoflurane, and desflurane. Ketamine, nitrous oxide, and xenon are not GABAR agonists and instead inhibit glutamate receptors-mainly NMDA receptors. Inspite of its many drawbacks such as pain in injection, quick and uncontrolled conversion from sedation to general anesthesia and dose-related cardiovascular depression, propofol remains the most popular GABAR agonist employed by anesthesia providers. In addition, being formulated in a lipid emulsion, contamination and bacterial growth is possible. Literature is rife with newer propofol formulations, aiming to address many of these drawbacks, and with some degree of success. A nonemulsion propofol formulation has been developed with cyclodextrins, which form inclusion complexes with drugs having lipophilic properties while maintaining aqueous solubility. Inhalational anesthetics are also GABA agonists. The binding sites are primarily located within α+/β- and β+/α- subunit interfaces, with residues in the α+/γ- interface. Isoflurane and sevoflurane might have slightly different binding sites providing unexpected degree of selectivity. Methoxyflurane has made a comeback in Europe for rapid provision of analgesia in the emergency departments. Penthrox (Galen, UK) is the special device designed for its administration. With better understanding of pharmacology of GABAAR agonists, newer sedative agents have been developed, which utilize "soft pharmacology," a term pertaining to agents that are rapidly metabolized into inactive metabolites after producing desired therapeutic effect(s). These newer "soft" GABAAR agonists have many properties of ideal sedative agents, as they can offer well-controlled, titratable activity and ultrashort action. Remimazolam, a modified midazolam and methoxycarbonyl-etomidate (MOC-etomidate), an ultrashort-acting etomidate analog are two such examples. Cyclopropyl methoxycarbonyl metomidate is another second-generation soft etomidate analog that has a greater potency and longer half-life than MOC-etomidate. Additionally, it might not cause adrenal axis suppression. Carboetomidate is another soft analog of etomidate with low affinity for 11β-hydroxylase and is, therefore, unlikely to have clinically significant adrenocortical suppressant effects. Alphaxalone, a GABAAR agonist, is recently formulated in combination with 7-sulfobutylether-β-cyclodextrin (SBECD), which has a low hypersensitivity profile.

SpiroTiger and KS Brief Stimulator: Specific Devices for Breathing and Well-Being in Post-COVID-19 Patients

SpiroTiger and KS Brief Stimulator: Specific Devices for Breathing and Well-Being in Post-COVID-19 Patients

Green means go: The effect of a visualization tool towards increased use of renewable energy in households

There is a need to further develop digital and hardware tools to support consumers in the adaptation of their energy use to, for example, integrate renewable sources into it and/or reduce expenses. This paper presents an evaluation study of a tool, including its hardware and software versions, that supports consumers in their electricity consumption optimization, most notably concerning renewable energies for specific devices. We conducted a six-week study in Oldenburg, Germany involving 43 participants divided into three groups: one hardware and one digital variant each of an energy visualization tool, as well as a control group. We furthermore collected quantitative data on energy usage patterns and qualitative insights through semi-structured interviews. Here the participants received information about the percentage of renewable energy currently in the grid, and were asked to document their washing machine and dishwasher use. This paper provides insights into the perception of the proposed visualization tools achieved through semi-structured interviews, comparing the digital and hardware versions, while outlining the challenges of and possibilities for changing energy use behavior, especially regarding the time of day of an appliance's use. Even though the measurable influences of the tool were limited due to thresholds being reached too easily as a result of e.g. high wind levels generating higher-than-anticipated amounts of renewable energy, in terms of the amount of renewable energy use, slight improvements in the two test groups were observed compared to the control group. Regarding consumer behavior, changes in the appliances' use time show slightly higher improvement compared to the control group.

The rhetoric of norm evasion and its social psychological underpinnings: The case of colonial redress

Abstract The growing focus on the agency of norm violators has led to new insights on various rhetorical strategies that states accused of norm violation deploy. However, few studies have simultaneously examined both specific rhetorical devices that enable norm evasion and their social psychological underpinnings. Building on International Relations (IR) research on norm evasion and social psychological research on in-group wrongdoings, this paper conceptualises states’ rhetoric of norm evasion as a social psychological coping strategy: aimed at protecting in-group esteem. Empirically, the paper offers a systematic analysis of Japan’s rhetoric of norm evasion regarding its colonial and wartime past, as well as its social psychological underpinnings. Five rhetorical strategies of norm evasion are identified: (1) claiming legality, (2) claiming the inapplicability of relevant treaties, (3) claiming the inapplicability of relevant norms, (4) equivocating, and (5) citing non-disparagement pledges. These strategies, as well as the psychological disengagement they enable, have culminated in the promotion of non-remembrance, or behavioural manifestations of norm regress.

Time-Encoded Information Encryption with pH Clock Guided Broad-Spectrum Emission by Dynamic Assemblies.

With growing threats from counterfeiting-based security breaches, multi-level and specific stimuli-responsive anti-counterfeiting devices and message encryption methods have attracted immense research interest. Fluorescence-based encryption from aggregation-induced emission (AIE)-based materials solves the problems to a considerable extent. However, the development of smarter patterns with hierarchical security levels alongside dynamic display is still challenging. To screen out this complication, we bring forward a pH-switchable fluorescent assembly of an AIEgen and an aliphatic acid. We later temporally direct the molecular assembly with the aid of a chemical trigger-regulated pH clock, generating a transitory multicolor emission, including transient white light generation. The pH-dependent emissions were further implemented in constructing smart multi-input fluorescent chemical AND gates. Subsequently, we integrate the time-gated emissive system to develop an advanced multi-dimensionally secure data encryption strategy. This novel approach enhances anti-counterfeiting measures by introducing an additional layer of security based on temporal characteristics.

Radiation therapy in the hypofractionation mode on the Halcyon elite linear accelerator: the first experience of St. Petersburg city clinical oncology dispensary

Stereotactic radiation therapy in the hypofractionation mode is a method in which high doses of ionizing radiation (more than 3 Gy per fraction) are delivered in a small number of fractions (from 2 to 5). Treatment and the process of preparation for it are carried out using special fixing devices, dosimetric planning techniques of high conformity, with control of the treatment position using x-ray imaging. which makes it possible to ensure the required irradiation accuracy. The advantages are a shorter course of treatment compared to standard fractionation, a high biologically effective dose, a reduced effect of tumor repopulation, greater efficiency under hypoxic conditions, and satisfactory results when irradiating radioresistant tumors. The article presents clinical cases of the use of hypofractionation modes on the Halcyon elite linear accelerator.

Non-ischemic cerebral enhancing (NICE) lesions after flow diversion for intracranial aneurysms: a multicenter study

BackgroundNon-ischemic cerebral enhancing (NICE) lesions have been reported as a rare complication of various neuroendovascular procedures, but information on their incidence after flow diversion is scant. It is unclear if...

Improvement of the method of diagnostics and treatment of injuries and diseases of the maxillofacial region

This study aims to describe and apply a special endolift device in the treatment of various injuries to the zygomatic-orbital-facial complex as a means of forming an endoscopic space. A patented technique of creating an endoscopic area using an endolift device in the field of maxillofacial surgery, registered under the number 2082 dated 31.07.2018 in the Kyrgyz Republic, on the example of a clinical case, was presented. The endolift is a metal two-piece device that consists of a horizontal round mini plate up to 10 mm in diameter and a perpendicularly located hollow tube up to 4 mm in diameter in the centre of the plate with two holes at the top. The method of endoscopic space formation using endolift was used in 15 patients with various traumas to the maxillofacial region. An example of a clinical case is presented by patient J.B., 36 years old, who underwent endoscopic minimally invasive surgery to reconstruct a mandibular fracture. The course of the operation included a small incision in the submandibular region, soft tissue separation, skeletonization of the jaw, and the formation of a tunnel, for the endolift. The endolift was inserted into the tunnel and an endoscope was inserted through it for visualisation. After alignment of the bone fragments and fixation with a miniplate through the endolift, the wound was sutured, and a dressing was applied. There were no complications during or after surgery in all 15 cases of surgery. Patients were discharged 3 days after the operation in satisfactory condition. The sutures were removed on the 7th day. Functional and cosmetic results were evaluated as satisfactory. The use of this method of treatment ultimately determines the degree of effectiveness, safety, and quality of life of the performed manipulations for patients, especially in countries with low levels of economic development.

Implementation of Software for Learning Message Transmission Using Morse Code

The article presents the implementation of software for training message transmission using Morse code. This is a method of sign coding when letters of the alphabet, numbers, punctuation marks and other symbols are represented as sequences of short and long signals called dots and dashes. It is intended for transmission over serial communication channels. A unique feature of Morse code is the ability to be encoded and decoded by humans without the use of special terminal devices. The paper shows a software implementation of processing input characters using a telegraphic key, it includes: various mathematical requirements and conditions that allow you adjusting to each user, provided that his input speed will either fall or remain unchanged. However, it is possible to adjust the minimum duration threshold in such a way that the system will slowly adapt to a slow increase in input speed. At the same time, the higher the value of the minimum threshold, the faster the adaptation is; however, it will fall within the limit of the maximum input speed that the device can recognize. During the implementation of the program, a flow chart of message transliteration, signal reception and transmission was developed. The whole program implements the following functions: a simple and intuitive translator, with audio output, a simulator for consolidating the skill of entering Morse code using a key; consolidating the skills of recognition and decoding by ear. To create the final application for training, the Processing toolkit was chosen, since its key parameter when choosing a development tool has a simple writing syntax to increase the speed of writing code, as well as the ability of the environment to work with the communication channel of the microcontroller.

Taguchi Method Statistical Analysis on Characterization and Optimization of 18-nm Double Gate MOSFETs

A bi-layer graphene with a multigate structure was intensified and analysed on an 18-nm Metal Oxide Semiconductor Field-Effect Transistor (MOSFET) device to obtain an optimal performance parameter. The device has a gate structure made of Titanium Dioxide (TiO2) that serves as a high-k material and a metal gate made of Tungsten Silicide (WSix). The Silvaco TCAD Software which are ATHENA and ATLAS modules were used to enhance the fabrication process of virtual devices and to verify the electrical properties of a specific device. According to the International Technology Roadmap Semiconductor (ITRS) specifications of 0.179 V ± 12.7% for threshold voltage (VTH) and 20 nA/m for leakage current (ILEAK), the Taguchi L9 orthogonal array strategy was used to improve the device process parameters for optimum VTH and ILEAK. For the NMOS device, the process parameter of VTH Adjust Implant Dose was used as the dominant factor while Source/Drain (S/D) Implant Energy was used as the adjustment factor whereby for PMOS device, S/D Implant Energy was the dominant factor while S/D Implant Tilt was the adjustment factor in order to achieve a robust design through the Taguchi method implementation. The percentage affecting the process parameter is then applied to the results of the signal to noise ratio (SNR) of Nominal-the-best (NTB) for VTH and Smaller-the-better (STB) for ILEAK.

Changes in freezing parameters and temperature distribution of beef induced by AC electric field: Alleviation on freezing damage and myowater loss

In this study, a specialized experimental device integrating infrared thermal imaging, real-visual photography, and a time-temperature data collector was designed to investigate the effects of alternating electric field (AEF) assisted freezing on the temperature histories and freezing parameters in different layers of beef as well as the freezing damage and myowater loss. The findings revealed distinct differences in the freezing curves (e.g., slope) and parameters (e.g., Tnuc, TF, tptand Fmiz) between the surface, middle, and inner layers of beef cubes under both AEF and traditional freezing conditions. AEF treatment regulated the freezing curves and key parameters of middle and surface layers, influencing ice crystallization. The equivalent ice areas for the surface, middle, and inner samples under AEF treatment were 8.16, 14.40, and 20.56%, respectively, significantly lower than those in traditional freezing (15.87, 24.60, and 28.8%). Compared to traditional freezing, AEF-assisted freezing decreased myofibrillar fragmentation index (MFI) of beef muscle, preserving its texture integrity. AEF treatment inhibited water migration and reduced water-holding capacity (WHC) loss. In conclusion, AEF-assisted freezing changed ice formation characteristics and alleviated freezing damage by regulating the freezing curve traits and parameters.

Investigation of the effect of forced precipitation of working fluid on a vineyard sprayer for weed control

BACKGROUND: A distinctive feature of the sprayer presented is the possibility of more effective penetration of the working solution into the middle and lower tiers of weeds, as well as on the lower (abaxial) side of the leaf. This is ensured by the use of an air-liquid jet, which significantly increases the effectiveness of the applied chemical method of weed control. AIMS: Analysis of the effect of air jets on the deposition of chemicals on the surface of leaves of weeds. The penetration of the drug into the middle and lower tiers of plants, as well as deposition on the adaxial and abaxial sides of the leaves, is taken into account. METHODS: To combat unwanted vegetation, a special device was used, which was used in field research without air support, and with its use. With the help of the developed technique, spraying was carried out on indicator cards fixed on the upper, middle and lower tiers of the plant RESULTS: For the first time, an innovative technology based on the use of a flexible air distribution sleeve as part of a herbicide sprayer was proposed to combat weeds in vineyards. This sleeve ensures the precise supply of air flow from the fan to the spraying area of the working fluid. The result of such an air-liquid flow is improved efficiency and monodispersity of herbicide droplets, which, in turn, ensures uniform coverage of the lower tiers and the abaxial surface of the leaves of weeds. This innovative solution opens up new prospects in the fight against unwanted vegetation in the vineyards. CONCLUSIONS: The practical value of the proposed weed control technology is to increase the quality of the technological operation due to the forced precipitation of the working solution.

Multi-cation doped CuCrO[formula omitted] crystallite matrix: Exploring bandgap tunability through Ni-Zn and Ni-Zn-Mg doping for optoelectronic application

Bandgap tuning is a key approach to optimizing materials for advanced technologies, enabling the development of more efficient and specialized devices. In this study, we demonstrate the tunability of the bandgap of CuCrO2 from 2.38 to 4.37 eV via single cation-doping with Ni and Zn, and multi-cation doping with Ni-Zn and Ni-Zn-Mg. XRD analysis reveals structural changes due to lattice distortions by cationic substitution, while FESEM shows the impact of doping on particle size, surface morphology, and crystallinity. The lamellar structure observed with multi-cation doping in FESEM investigations indicates increased structural disorder and defects, causing tailing above the valence band and below the conduction band, significantly reducing the bandgap. The effect of Zn-Ni doping on the lattice is reversed with Mg2+ insertion due to p-p orbital interactions between Mg2+-O, replacing the d-p interaction in the Cr3＋-O bond, as confirmed by optical studies. UV–Vis and photoluminescence analyses reveal significant shifts in bandgaps and emission spectra, with Ni doping yielding a bandgap of 3.97 eV, Zn doping 3.16 eV, Zn-Ni doping expanding it to 4.37 eV, and Zn-Ni-Mg doping reducing it to 2.38 eV. The dopants also affect emission characteristics, including band edge and deep-level emissions. This study provides valuable insights into the relationship between cationic doping and material properties, guiding the design of CuCrO2-based materials with tailored functionalities.

Characterization by key performance indicators of SFERA-III project to ALTAYR packed-bed prototype

The objective of this study is to assess the viability of implementing the methodology proposed in the SFERA-III project for the assessment of key performance indicators (KPIs) of thermal storage prototypes in a specific packed-bed device. SFERA-III project is an EU funded project aiming, among others, to upgrade the infrastructures and services related to Concentrating Solar Thermal technologies. In order to improve the quality of services in relation to the testing of thermal energy storage prototypes, a protocol and KPIs were defined and validated with different types of devices, though none of them was a packed-bed. This study elucidates the challenges encountered in the implementation of the protocol on a packed-bed prototype, alongside the proposed alternative solutions and their influence on the resulting KPIs. The analysis demonstrates that the SFERA-III Key Performance Indicators are an appropriate means of evaluating packed bed thermal energy storage prototypes. Consequently, the use of these KPIs as a standard is supported.

Benchmarking Heat-driven Adsorption Carbon Pumps (HACP): A Thermodynamic Perspective

Benchmarking is pivotal in standardizing industrial devices, leading to notable performance enhancements in fields such as heating pump air conditioning, photovoltaic devices, and more. The significance of treating the CO2 capture system in small/medium size was emphasized in this work as a standalone device from a thermodynamic perspective, which facilitates the creation of a comprehensive benchmarking methodology. In this study, we studied the heat-driven adsorption carbon pump (HACP) as a typical case for benchmarking. The benchmarking methodology proposed is structured through a five-step process: defining boundaries, determining indicators, establishing calculation processes, collecting and analyzing data, and ultimately evaluating and optimizing performance. By utilizing thermodynamic principles, the energy efficiency of HACP devices was assessed. Through the combination of standardized tests and theoretical calculations, this work enables a quantitative evaluation of energy consumption and the thermodynamic perfection of specific HACP devices.

A simple CT scan protocol for planning of total hip arthroplasty in patients with femoral neck fractures

We describe a method for planning total hip arthroplasty (THA) in patients with a displaced femoral neck fracture based on a simple CT scan protocol of the contralateral hip. This protocol was used on 22 consecutive patients during the inclusion period, followed by reconstruction and 2D templating to predict the implant size and positioning. The exact planned size was achieved in 21/22 (95%) cups, 14/22 (64%) femoral stems and 14/22 (64%) femoral heads. There were no intra- or postoperative fractures. After surgery in which this planning method had been applied, the differences in length and lateral offset were less than 5 mm on average relative to the opposite side (mean postoperative leg length difference of −2 mm (−8 to +3 mm) and lateralization of −4 mm (−14 to +3 mm)). While this technique exposes the patient to additional radiation, it does not require any specific devices or surgical approach and could be used in most hospitals. Level of evidenceIV.

КЕРАМИЧЕСКИЕ ИЗДЕЛИЯ ИЗ СРЕДНЕВЕКОВОГО ГОРОДИЩА ЖАЙЫК(по материалам раскопок 2015 г.)

The presented article is devoted to one of the most common artifacts of archaeological complexes – ceramics. Based on the archaeological analysis of the products, the morphology and technical characteristics of some types are briefly revealed. The research base of the article consists of materials from the archaeological excavation of the Zhaiyk settlement, carried out during the 2015 field season. Ceramic production, as one of the specialized types of craft, has a certain set of special technical means and devices. Generalization of data on technology and, above all, the design of roasting furnaces over a certain, rather long, chronological period within one region makes it possible to trace the evolution of special roasting devices. This, in turn, allows us to make a conclusion about the level of ceramic production technology in a particular period, as well as judge the degree of specialization of the craft at various stages of the development of pottery. In addition, a detailed analysis of the design of the forges makes it possible to identify mutual influences, and often direct borrowings in pottery technology. For the medieval settlements of the North-Eastern Caspian region, this is all the more relevant, since based on the analysis of the earliest structures, it is possible to resolve the issue of the time and ways of the appearance of the region and the direction of its further evolution.

Analysis on addressing the threats to cloud computing on the basis of security safeguards for sap cloud services

Cloud computing has become an integral part of combination/multi-cloud infrastructures due to its many benefits, including quick deployment, flexibility, cheap costs, and scalability, which have attracted businesses of all sizes. New possibilities and threats in terms of security flaws are cropping up in this field, even if cloud storage provides substantial advantages and inexpensive choices for IT administration and growth. When we talk about safeguarding cloud infrastructure systems, we're referring to a set of rules, regulations, and systematic procedures. This is also known as cloud computing security. The purpose of implementing these security measures is to safeguard cloud-based data, facilitate the enforcement of legislation, ensure the privacy of consumer information, and set standards for encryption in specific devices and applications. Modern cloud computing and security concerns throughout the cloud's many layers are addressed in this study. Within this context, the current study would make a substantial contribution to lowering the frequency of security breaches in cloud computing, paving the way for the continued provision of safe and reliable services. Storage of databases on the cloud is expanding rapidly in the IT industry, including SAP networks. Because enterprises are ultimately responsible for the security of their data, migrating databases to cloud computing environments brings with it a plethora of security risks. To guarantee data integrity, availability, and secrecy, appropriate security measures should be put in place before a company migrates its sensitive data to the cloud. When data is at rest, it is most vulnerable to unauthorized access; when it is in transit, it must be subject to strict supervision.