Search results for: diagnostic tool
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5882

Search results for: diagnostic tool

5582 Adaptation of the Scenario Test for Greek-speaking People with Aphasia: Reliability and Validity Study

Authors: Marina Charalambous, Phivos Phylactou, Thekla Elriz, Loukia Psychogios, Jean-Marie Annoni

Abstract:

Background: Evidence-based practices for the evaluation and treatment of people with aphasia (PWA) in Greek are mainly impairment-based. Functional and multimodal communication is usually under assessed and neglected by clinicians. This study explores the adaptation and psychometric testing of the Greek (GR) version of The Scenario Test. The Scenario Test assesses the everyday functional communication of PWA in an interactive multimodal communication setting with the support of an active communication facilitator. Aims: To define the reliability and validity of The Scenario Test GR and discuss its clinical value. Methods & Procedures: The Scenario Test-GR was administered to 54 people with chronic stroke (6+ months post-stroke): 32 PWA and 22 people with stroke without aphasia. Participants were recruited from Greece and Cyprus. All measures were performed in an interview format. Standard psychometric criteria were applied to evaluate reliability (internal consistency, test-retest, and interrater reliability) and validity (construct and known – groups validity) of the Scenario Test GR. Video analysis was performed for the qualitative examination of the communication modes used. Outcomes & Results: The Scenario Test-GR shows high levels of reliability and validity. High scores of internal consistency (Cronbach’s α = .95), test-retest reliability (ICC = .99), and interrater reliability (ICC = .99) were found. Interrater agreement in scores on individual items fell between good and excellent levels of agreement. Correlations with a tool measuring language function in aphasia (the Aphasia Severity Rating Scale of the Boston Diagnostic Aphasia Examination), a measure of functional communication (the Communicative Effectiveness Index), and two instruments examining the psychosocial impact of aphasia (the Stroke and Aphasia Quality of Life questionnaire and the Aphasia Impact Questionnaire) revealed good convergent validity (all ps< .05). Results showed good known – groups validity (Mann-Whitney U = 96.5, p < .001), with significantly higher scores for participants without aphasia compared to those with aphasia. Conclusions: The psychometric qualities of The Scenario Test-GR support the reliability and validity of the tool for the assessment of functional communication for Greek-speaking PWA. The Scenario Test-GR can be used to assess multimodal functional communication, orient aphasia rehabilitation goal setting towards the activity and participation level, and be used as an outcome measure of everyday communication. Future studies will focus on the measurement of sensitivity to change in PWA with severe non-fluent aphasia.

Keywords: the scenario test GR, functional communication assessment, people with aphasia (PWA), tool validation

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5581 Dielectric Response Analysis Measurement for Diagnostic Oil-Paper Insulation System on Aged Inter Bus Transformer 3x10 MVA

Authors: Eki Farlen, Akas

Abstract:

Condition assessment of oil-paper-insulated power transformers, particularly of water content, is becoming increasingly important for aged transformers. As insulation ages, it can produce water, which reduces its dielectric strength, accelerates the cellulose ageing process, and causes gas bubbles to form at high temperatures. This paper mainly assesses the life condition of oil-paper insulation system of Inter Bus Transformer (IBT) 30 MVA, 150/30 kV in PT PLN-Substation Jelok that has been operating for 41 years, since 1974. Valuable information about the condition of high voltage insulation may be obtained by measuring its dielectric response. This paper describes in detail the interpretation of Dielectric Response Analysis (DIRANA) measurements and the test result compared to other insulation tests to get deep information for diagnostic, such as Tan delta test, oil characteristic test and Dissolve Gas Analysis (DGA) test. This paper mainly discusses the parameter relationship between moisture content, water content, acidity, oil conductivity and dissipation factor. The result and analysis show that IBT 30 MVA Jelok phase U and W had just been ageing due to high acidity level (>0.2 mgKOH/g) which cause high moisture in cellulose/paper (%) are in wet category about 4.7% and 5% and water content in oil (ppm) about 3.13 ppm and 3.33 ppm at temperature 20°C. High acidity level can make oxidation process and produce water in paper and particle which can decrease the value of Interfacial Tension (IFT) below 22 mN/m (poor category) for both phase U and W. Even if paper insulation of transformer are in wet condition, dissipation factor and capacitance at the same frequency (50 Hz) from both measurement DIRANA test and Tangent delta test give the same result (almost), the results are 0.69% and 0.71% (<1%), it may be acceptable and should not be investigated. The DGA results show that TDCG are in level one (1) condition and there are no found a Key Gases, it means that transformers had no failure during operation like arching, partial discharge and thermal in oil or cellulose.

Keywords: diagnostic, inter-bus transformer, oil-paper insulation, moisture, dissipation factor

Procedia PDF Downloads 279
5580 Modeling of Tool Flank Wear in Finish Hard Turning of AISI D2 Using Genetic Programming

Authors: V. Pourmostaghimi, M. Zadshakoyan

Abstract:

Efficiency and productivity of the finish hard turning can be enhanced impressively by utilizing accurate predictive models for cutting tool wear. However, the ability of genetic programming in presenting an accurate analytical model is a notable characteristic which makes it more applicable than other predictive modeling methods. In this paper, the genetic equation for modeling of tool flank wear is developed with the use of the experimentally measured flank wear values and genetic programming during finish turning of hardened AISI D2. Series of tests were conducted over a range of cutting parameters and the values of tool flank wear were measured. On the basis of obtained results, genetic model presenting connection between cutting parameters and tool flank wear were extracted. The accuracy of the genetically obtained model was assessed by using two statistical measures, which were root mean square error (RMSE) and coefficient of determination (R²). Evaluation results revealed that presented genetic model predicted flank wear over the study area accurately (R² = 0.9902 and RMSE = 0.0102). These results allow concluding that the proposed genetic equation corresponds well with experimental data and can be implemented in real industrial applications.

Keywords: cutting parameters, flank wear, genetic programming, hard turning

Procedia PDF Downloads 179
5579 ADHD: Assessment of Pragmatic Skills in Adults

Authors: Elena Even-Simkin

Abstract:

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequently diagnosed disorders in children, but in many cases, the diagnosis is not provided until adulthood. Diagnosing adults with ADHD faces different obstacles due to numerous factors, such as educational or under-resourced familial environment, high intelligence compensating for stress-inducing difficulties, and additional comorbidities. Undiagnosed children and adolescents with ADHD may become undiagnosed adults with ADHD, who miss out on the early treatment and may experience significant social and pragmatic difficulties, leading to functional problems that subsequently affect their lifestyle, education, and occupational functioning. The proposed study presents a cost-effective and unique consideration of the pragmatic aspect among adults with ADHD. It provides a systematic and standardized evaluation of the pragmatic level in adults with ADHD, based on a comprehensive approach introduced by Arcara & Bambini (2016) for the assessment of pragmatic abilities in neuro-typical individuals. This assessment tool can promote the inclusion of pragmatic skills in the cognitive profile in the diagnostic practice of ADHD, and, thus, the proposed instrument can help not only identify the pragmatic difficulties in the ADHD population but also advance effective intervention programs that specifically focus on pragmatic skills in the targeted population.

Keywords: ADHD, adults, assessment, pragmatics

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5578 Retrospective Analysis Demonstrates No Difference in Percutaneous Native Renal Biopsy Adequacy Between Nephrologists and Radiologists in University Hospital Crosshouse

Authors: Nicole Harley, Mahmoud Eid, Abdurahman Tarmal, Vishal Dey

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Histological sampling plays an integral role in the diagnostic process of renal diseases. Percutaneous native renal biopsy is typically performed under ultrasound guidance, with this service usually being provided by nephrologists. In some centers, there is a role for radiologists in performing renal biopsies. Previous comparative studies have demonstrated non-inferiority between outcomes of percutaneous native renal biopsies performed by nephrologists compared with radiologists. We sought to compare biopsy adequacy between nephrologists and radiologists in University Hospital Crosshouse. The online system SERPR (Scottish Electronic Renal Patient Record) contains information pertaining to patients who have undergone renal biopsies. An online search was performed to acquire a list of all patients who underwent renal biopsy between 2013 and 2020 in University Hospital Crosshouse. 355 native renal biopsies were performed in total across this 7-year period. A retrospective analysis was performed on these cases, with records and reports being assessed for: the total number of glomeruli obtained per biopsy, whether the number of glomeruli obtained was adequate for diagnosis, as per an internationally agreed standard, and whether a histological diagnosis was achieved. Nephrologists performed 43.9% of native renal biopsies (n=156) and radiologists performed 56.1% (n=199). The mean number of glomeruli obtained by nephrologists was 17.16+/-10.31. The mean number of glomeruli obtained by radiologists was 18.38+/-10.55. T-test demonstrated no statistically significant difference between specialties comparatively (p-value 0.277). Native renal biopsies are required to obtain at least 8 glomeruli to be diagnostic as per internationally agreed criteria. Nephrologists met these criteria in 88.5% of native renal biopsies (n=138) and radiologists met this criteria in 89.5% (n=178). T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.663 and 0.922, respectively). Biopsies performed by nephrologists yielded tissue that was diagnostic in 91.0% (n=142) of sampling. Biopsies performed by radiologists yielded tissue that was diagnostic in 92.4% (n=184) of sampling. T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.625 and 0.889, respectively). This project demonstrates that at University Hospital Crosshouse, there is no statistical difference between radiologists and nephrologists in terms of glomeruli acquisition or samples achieving a histological diagnosis. Given the non-inferiority between specialties demonstrated by previous studies and this project, this evidence could support the restructuring of services to allow more renal biopsies to be performed by renal services and allow reallocation of radiology department resources.

Keywords: biopsy, medical imaging, nephrology, radiology

Procedia PDF Downloads 82
5577 Endoscopic Depiction and Treatment Evaluation of Spirocerca lupi in Dogs

Authors: ELdessouky Sheta, Sayed Elzomor, Haithem Farghali, Kawkab A. Ahmed, Naglaa A. Abd Elkader

Abstract:

The present investigation has been dealt with Spirocerca (S.) lupi infested mongrel dogs. This parasitic disease is highly infective to human beings and carnivores. The diagnosis march has been comprised the lateral contrast thoracic radiographs, fecal examination, blood profile, endoscopic examination and histopathological sections of deep seated pinch biopsies. These infested dogs have been put under an adopted treatment with Ivermectin injection combined with oral prednisolone. The obtained results reveal an absence of the pessimistic recognitions particularly after 3 weeks from the onset of treatment. Endoscopically the presented esophageal nodules are marked out in the distal third of infested dogs' esophagus as masses assigned into the esophageal lumen and fundus of stomach. The endoscopic outlook of Spirocerca lupi lesions has been considered an integral procedure of the diagnostic march and for evaluation of treatment follow up. The diagnostic procedures and the recommended treatment are the vet's guidance to care for Spirocerca lupi in dogs, hoping in future to prevent this disease from being spread among human beings and other carnivores.

Keywords: endoscopy, esophagus, stomach spirocercosis, dogs

Procedia PDF Downloads 395
5576 Poetry as Valuable Tool for Tackling Climate Change and Environmental Pollution

Authors: Benjamin Anabaraonye

Abstract:

Our environment is our entitlement, and it is our duty to guard it for the safety of our society. It is, therefore, in our best interest to explore the necessary tools required to tackle the issues of environmental pollution which are major causes of climate change. Poetry has been discovered through our study as a valuable tool for tackling climate change and environmental pollution. This study explores the science of poetry and how important it is for scientists and engineers to develop their creativity to obtain relevant skills needed to tackle these global challenges. Poetry has been discovered as a great tool for climate change education which in turn brings about climate change adaptation and mitigation. This paper is, therefore, a clarion and urgent call for us to rise to our responsibility for a sustainable future.

Keywords: climate change, education, environment, poetry

Procedia PDF Downloads 206
5575 Theology of Science and Technology as a Tool for Peace Education

Authors: Jonas Chikelue Ogbuefi

Abstract:

Science and Technology have a major impact on societal peace, it offers support to teaching and learning, cuts costs, and offers solutions to the current agitations and militancy in Nigeria today. Christianity, for instance, did not only change and form the western world in the past 2022 but still has a substantial role to play in society through liquid ecclesiology. This paper interrogated the impact of the theology of Science and Technology as a tool for peace sustainability through peace education in Nigeria. The method adopted is a historical and descriptive method of analysis. It was discovered that a larger number of Nigerian citizens lack almost all the basic things needed for the standard of living, such as Shelter, meaningful employment, and clothing, which is the root course of all agitations in Nigeria. Based on the above findings, the paper contends that the government alone cannot restore Peace in Nigeria. Hence the inability of the government to restore peace calls for all religious actors to be involved. The main thrust and recommendation of this paper are to challenge the religious actors to implement the Theology of Science and Technology as a tool for peace restoration and should network with both the government and the private sectors to make funds available to budding and existing entrepreneurs using Science and Technology as a tool for Peace and economic sustainability. This paper viewed the theology of Science and Technology as a tool for Peace and economic sustainability in Nigeria.

Keywords: theology, science, technology, peace education

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5574 Proposal of a Damage Inspection Tool After Earthquakes: Case of Algerian Buildings

Authors: Akkouche Karim, Nekmouche Aghiles, Bouzid Leyla

Abstract:

This study focuses on the development of a multifunctional Expert System (ES) called post-seismic damage inspection tool (PSDIT), a powerful tool which allows the evaluation, the processing and the archiving of the collected data stock after earthquakes. PSDIT can be operated by two user types; an ordinary user (engineer, expert or architect) for the damage visual inspection and an administrative user for updating the knowledge and / or for adding or removing the ordinary user. The knowledge acquisition is driven by a hierarchical knowledge model, the Information from investigation reports and those acquired through feedback from expert / engineer questionnaires are part.

Keywords: buildings, earthquake, seismic damage, damage assessment, expert system

Procedia PDF Downloads 87
5573 Investigation of Suspected Viral Hepatitis Outbreaks in North India

Authors: Mini P. Singh, Manasi Majumdar, Kapil Goyal, Pvm Lakshmi, Deepak Bhatia, Radha Kanta Ratho

Abstract:

India is endemic for Hepatitis E virus and frequent water borne outbreaks are reported. The conventional diagnosis rests on the detection of serum anti-HEV IgM antibodies which may take 7-10 days to develop. Early diagnosis in such a situation is desirable for the initiation of prompt control measures. The present study compared three diagnostic methods in 60 samples collected during two suspected HEV outbreaks in the vicinity of Chandigarh, India. The anti-HEV IgM, HEV antigen and HEV-RNA could be detected in serum samples of 52 (86.66%), 16 (26.66%) and 18 (30%) patients respectively. The suitability of saliva samples for antibody detection was also evaluated in 21 paired serum- saliva samples. A total of 15 serum samples showed the presence of anti HEV IgM antibodies, out of which 10 (10/15; 66.6%) were also positive for these antibodies in saliva samples (χ2 = 7.636, p < 0.0057), thus showing a concordance of 76.91%. The positivity of reverse transcriptase PCR and HEV antigen detection was 100% within one week of illness which declined to 5-10% thereafter. The outbreak was attributed to HEV Genotype 1, Subtype 1a and the clinical and environmental strains clustered together. HEV antigen and RNA were found to be an early diagnostic marker with 96.66% concordance. The results indicate that the saliva samples can be used as an alternative to serum samples in an outbreak situation.

Keywords: HEV-antigen, outbreak, phylogenetic analysis, saliva

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5572 Audit of Urgent and Non-Urgent Patient Visits to the Emergency: A Case-Control Study

Authors: Peri Harish Kumar, Rafique Umer Harvitkar

Abstract:

Background: The emergency department mandates maximum efficacy in the utilization of the available resources. Non-urgent patient visits pose a serious concern to the treatment, patient triage, and resources available. Aims and Objectives: We conducted a retrospective case-control study of the emergency department patient list from October 2019 to November 2022. A total of 839 patients formed part of the study. Somatic complaints, vital signs, diagnostic test results, admission to the hospital, etc., were some of the criteria used for the categorization of patients. Results: The proportion of non-urgent visits varied from 7.2% to 43%, with a median of 21%. Somatic complaints were the least associated with further hospital admissions (n=28%), while diagnostic test results were the most significant indicator of further hospital admissions (n=74%). Effective triage helped minimize emergency department admissions by 36%. Conclusion: Our study shows that effective triaging, patient counselling, and round-the-clock consumable monitoring helped in the effective management of patients admitted and also significantly helped provide treatment to the patients most in need.

Keywords: urgent visits, non-urgent visits, traiging, emergency department admissions

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5571 Role of Grey Scale Ultrasound Including Elastography in Grading the Severity of Carpal Tunnel Syndrome - A Comparative Cross-sectional Study

Authors: Arjun Prakash, Vinutha H., Karthik N.

Abstract:

BACKGROUND: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with an estimated prevalence of 0.6 - 5.8% in the general adult population. It is caused by compression of the Median Nerve (MN) at the wrist as it passes through a narrow osteofibrous canal. Presently, the diagnosis is established by the clinical symptoms and physical examination and Nerve conduction study (NCS) is used to assess its severity. However, it is considered to be painful, time consuming and expensive, with a false-negative rate between 16 - 34%. Ultrasonography (USG) is now increasingly used as a diagnostic tool in CTS due to its non-invasive nature, increased accessibility and relatively low cost. Elastography is a newer modality in USG which helps to assess stiffness of tissues. However, there is limited available literature about its applications in peripheral nerves. OBJECTIVES: Our objectives were to measure the Cross-Sectional Area (CSA) and elasticity of MN at the carpal tunnel using Grey scale Ultrasonography (USG), Strain Elastography (SE) and Shear Wave Elastography (SWE). We also made an attempt to independently evaluate the role of Gray scale USG, SE and SWE in grading the severity of CTS, keeping NCS as the gold standard. MATERIALS AND METHODS: After approval from the Institutional Ethics Review Board, we conducted a comparative cross sectional study for a period of 18 months. The participants were divided into two groups. Group A consisted of 54 patients with clinically diagnosed CTS who underwent NCS, and Group B consisted of 50 controls without any clinical symptoms of CTS. All Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound machine with 2 - 9 Mega Hertz linear probe. In both groups, CSA of the MN was measured on Grey scale USG, and its elasticity was measured at the carpal tunnel (in terms of Strain ratio and Shear Modulus). The variables were compared between both groups by using ‘Independent t test’, and subgroup analyses were performed using one-way analysis of variance. Receiver operating characteristic curves were used to evaluate the diagnostic performance of each variable. RESULTS: The mean CSA of the MN was 13.60 + 3.201 mm2 and 9.17 + 1.665 mm2 in Group A and Group B, respectively (p < 0.001). The mean SWE was 30.65 + 12.996 kPa and 17.33 + 2.919 kPa in Group A and Group B, respectively (p < 0.001), and the mean Strain ratio was 7.545 + 2.017 and 5.802 + 1.153 in Group A and Group B respectively (p < 0.001). CONCLUSION: The combined use of Gray scale USG, SE and SWE is extremely useful in grading the severity of CTS and can be used as a painless and cost-effective alternative to NCS. Early diagnosis and grading of CTS and effective treatment is essential to avoid permanent nerve damage and functional disability.

Keywords: carpal tunnel, ultrasound, elastography, nerve conduction study

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5570 Tool Wear Monitoring of High Speed Milling Based on Vibratory Signal Processing

Authors: Hadjadj Abdechafik, Kious Mecheri, Ameur Aissa

Abstract:

The objective of this study is to develop a process of treatment of the vibratory signals generated during a horizontal high speed milling process without applying any coolant in order to establish a monitoring system able to improve the machining performance. Thus, many tests were carried out on the horizontal high speed centre (PCI Météor 10), in given cutting conditions, by using a milling cutter with only one insert and measured its frontal wear from its new state that is considered as a reference state until a worn state that is considered as unsuitable for the tool to be used. The results obtained show that the first harmonic follow well the evolution of frontal wear, on another hand a wavelet transform is used for signal processing and is found to be useful for observing the evolution of the wavelet approximations through the cutting tool life. The power and the Root Mean Square (RMS) values of the wavelet transformed signal gave the best results and can be used for tool wear estimation. All this features can constitute the suitable indicators for an effective detection of tool wear and then used for the input parameters of an online monitoring system. Although we noted the remarkable influence of the machining cycle on the quality of measurements by the introduction of a bias on the signal, this phenomenon appears in particular in horizontal milling and in the majority of studies is ignored.

Keywords: flank wear, vibration, milling, signal processing, monitoring

Procedia PDF Downloads 598
5569 Humeral Head and Scapula Detection in Proton Density Weighted Magnetic Resonance Images Using YOLOv8

Authors: Aysun Sezer

Abstract:

Magnetic Resonance Imaging (MRI) is one of the advanced diagnostic tools for evaluating shoulder pathologies. Proton Density (PD)-weighted MRI sequences prove highly effective in detecting edema. However, they are deficient in the anatomical identification of bones due to a trauma-induced decrease in signal-to-noise ratio and blur in the traumatized cortices. Computer-based diagnostic systems require precise segmentation, identification, and localization of anatomical regions in medical imagery. Deep learning-based object detection algorithms exhibit remarkable proficiency in real-time object identification and localization. In this study, the YOLOv8 model was employed to detect humeral head and scapular regions in 665 axial PD-weighted MR images. The YOLOv8 configuration achieved an overall success rate of 99.60% and 89.90% for detecting the humeral head and scapula, respectively, with an intersection over union (IoU) of 0.5. Our findings indicate a significant promise of employing YOLOv8-based detection for the humerus and scapula regions, particularly in the context of PD-weighted images affected by both noise and intensity inhomogeneity.

Keywords: YOLOv8, object detection, humerus, scapula, IRM

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5568 Evaluation of Green Logistics Performance: An Application of Analytic Hierarchy Process Method for Ranking Environmental Indicators

Authors: Eduarda Dutra De Souza, Gabriela Hammes, Marina Bouzon, Carlos M. Taboada Rodriguez

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The search for minimizing harmful impacts on the environment has become the focus of global society, affecting mainly how to manage organizations. Thus, companies have sought to transform their activities into environmentally friendly initiatives by applying green practices throughout their supply chains. In the logistics domain, the implementation of environmentally sound practices is still in its infancy in emerging countries such as Brazil. Given the need to reduce these environmental damages, this study aims to evaluate the performance of green logistics (GL) in the plastics industry sector in order to help to improve environmental performance within organizations and reduce the impact caused by their activities. The performance tool was based on theoretical research and the use of experts in the field. The Analytic Hierarchy Process (AHP) was used to prioritize green practices and assign weight to the indicators contained in the proposed tool. The tool also allows the co-production of a single indicator. The developed tool was applied in an industry of the plastic packaging sector. However, this tool may be applied in different industry sectors, and it is adaptable to different sizes of companies. Besides the contributions to the literature, this work also presents future paths of research in the field of green logistics.

Keywords: AHP, green logistics, green supply chain, performance evaluation

Procedia PDF Downloads 159
5567 Use of Focus Group Interviews to Design a Health Impact Measurement Tool: A Volunteering Case Study

Authors: Valentine Seymour

Abstract:

Environmental volunteering organisations use questionnaires to explore the relationship between environmental volunteers and their health. To the author’s best knowledge, no one has explored volunteers’ health perception, which could be considered when designing a health impact measurement tool used to increase effective communication. This paper examines environmental volunteers' perceptions of health, knowledge which can be used to design a health impact measurement tool. This study uses focus group interviews, content analysis, and a general inductive approach to explore the health perceptions of volunteers who engage in environmental volunteering activities from the perspective of UK charity The Conservation Volunteers. Findings showed that volunteer groups presented were relatively similar in how they defined the term health, with their overall conceptual model closely resembling that of the World Health Organization 1948 definition. This suggests that future health impact measurement tools in the environmental volunteering sector could base their design around the World Health Organization’s definition.

Keywords: health perception, impact measurement, mental models, tool development

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5566 Rapid and Cheap Test for Detection of Streptococcus pyogenes and Streptococcus pneumoniae with Antibiotic Resistance Identification

Authors: Marta Skwarecka, Patrycja Bloch, Rafal Walkusz, Oliwia Urbanowicz, Grzegorz Zielinski, Sabina Zoledowska, Dawid Nidzworski

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Upper respiratory tract infections are one of the most common reasons for visiting a general doctor. Streptococci are the most common bacterial etiological factors in these infections. There are many different types of Streptococci and infections vary in severity from mild throat infections to pneumonia. For example, S. pyogenes mainly contributes to acute pharyngitis, palatine tonsils and scarlet fever, whereas S. Streptococcus pneumoniae is responsible for several invasive diseases like sepsis, meningitis or pneumonia with high mortality and dangerous complications. There are only a few diagnostic tests designed for detection Streptococci from the infected throat of patients. However, they are mostly based on lateral flow techniques, and they are not used as a standard due to their low sensitivity. The diagnostic standard is to culture patients throat swab on semi selective media in order to multiply pure etiological agent of infection and subsequently to perform antibiogram, which takes several days from the patients visit in the clinic. Therefore, the aim of our studies is to develop and implement to the market a Point of Care device for the rapid identification of Streptococcus pyogenes and Streptococcus pneumoniae with simultaneous identification of antibiotic resistance genes. In the course of our research, we successfully selected genes for to-species identification of Streptococci and genes encoding antibiotic resistance proteins. We have developed a reaction to amplify these genes, which allows detecting the presence of S. pyogenes or S. pneumoniae followed by testing their resistance to erythromycin, chloramphenicol and tetracycline. What is more, the detection of β-lactamase-encoding genes that could protect Streptococci against antibiotics from the ampicillin group, which are widely used in the treatment of this type of infection is also developed. The test is carried out directly from the patients' swab, and the results are available after 20 to 30 minutes after sample subjection, which could be performed during the medical visit.

Keywords: antibiotic resistance, Streptococci, respiratory infections, diagnostic test

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5565 Experimental Study and Neural Network Modeling in Prediction of Surface Roughness on Dry Turning Using Two Different Cutting Tool Nose Radii

Authors: Deba Kumar Sarma, Sanjib Kr. Rajbongshi

Abstract:

Surface finish is an important product quality in machining. At first, experiments were carried out to investigate the effect of the cutting tool nose radius (considering 1mm and 0.65mm) in prediction of surface finish with process parameters of cutting speed, feed and depth of cut. For all possible cutting conditions, full factorial design was considered as two levels four parameters. Commercial Mild Steel bar and High Speed Steel (HSS) material were considered as work-piece and cutting tool material respectively. In order to obtain functional relationship between process parameters and surface roughness, neural network was used which was found to be capable for the prediction of surface roughness within a reasonable degree of accuracy. It was observed that tool nose radius of 1mm provides better surface finish in comparison to 0.65 mm. Also, it was observed that feed rate has a significant influence on surface finish.

Keywords: full factorial design, neural network, nose radius, surface finish

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5564 Urinary Volatile Organic Compound Testing in Fast-Track Patients with Suspected Colorectal Cancer

Authors: Godwin Dennison, C. E. Boulind, O. Gould, B. de Lacy Costello, J. Allison, P. White, P. Ewings, A. Wicaksono, N. J. Curtis, A. Pullyblank, D. Jayne, J. A. Covington, N. Ratcliffe, N. K. Francis

Abstract:

Background: Colorectal symptoms are common but only infrequently represent serious pathology, including colorectal cancer (CRC). A large number of invasive tests are presently performed for reassurance. We investigated the feasibility of urinary volatile organic compound (VOC) testing as a potential triage tool in patients fast-tracked for assessment for possible CRC. Methods: A prospective, multi-centre, observational feasibility study was performed across three sites. Patients referred on NHS fast-track pathways for potential CRC provided a urine sample which underwent Gas Chromatography Mass Spectrometry (GC-MS), Field Asymmetric Ion Mobility Spectrometry (FAIMS) and Selected Ion Flow Tube Mass Spectrometry (SIFT-MS) analysis. Patients underwent colonoscopy and/or CT colonography and were grouped as either CRC, adenomatous polyp(s), or controls to explore the diagnostic accuracy of VOC output data supported by an artificial neural network (ANN) model. Results: 558 patients participated with 23 (4.1%) CRC diagnosed. 59% of colonoscopies and 86% of CT colonographies showed no abnormalities. Urinary VOC testing was feasible, acceptable to patients, and applicable within the clinical fast track pathway. GC-MS showed the highest clinical utility for CRC and polyp detection vs. controls (sensitivity=0.878, specificity=0.882, AUROC=0.884). Conclusion: Urinary VOC testing and analysis are feasible within NHS fast-track CRC pathways. Clinically meaningful differences between patients with cancer, polyps, or no pathology were identified therefore suggesting VOC analysis may have future utility as a triage tool. Acknowledgment: Funding: NIHR Research for Patient Benefit grant (ref: PB-PG-0416-20022).

Keywords: colorectal cancer, volatile organic compound, gas chromatography mass spectrometry, field asymmetric ion mobility spectrometry, selected ion flow tube mass spectrometry

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5563 MSIpred: A Python 2 Package for the Classification of Tumor Microsatellite Instability from Tumor Mutation Annotation Data Using a Support Vector Machine

Authors: Chen Wang, Chun Liang

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Microsatellite instability (MSI) is characterized by high degree of polymorphism in microsatellite (MS) length due to a deficiency in mismatch repair (MMR) system. MSI is associated with several tumor types and its status can be considered as an important indicator for tumor prognostic. Conventional clinical diagnosis of MSI examines PCR products of a panel of MS markers using electrophoresis (MSI-PCR) which is laborious, time consuming, and less reliable. MSIpred, a python 2 package for automatic classification of MSI was released by this study. It computes important somatic mutation features from files in mutation annotation format (MAF) generated from paired tumor-normal exome sequencing data, subsequently using these to predict tumor MSI status with a support vector machine (SVM) classifier trained by MAF files of 1074 tumors belonging to four types. Evaluation of MSIpred on an independent 358-tumor test set achieved overall accuracy of over 98% and area under receiver operating characteristic (ROC) curve of 0.967. These results indicated that MSIpred is a robust pan-cancer MSI classification tool and can serve as a complementary diagnostic to MSI-PCR in MSI diagnosis.

Keywords: microsatellite instability, pan-cancer classification, somatic mutation, support vector machine

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5562 A Study on the Annual Doses Received by the Workers of Some Medical Practices

Authors: Eltayeb Hamad Elneel Yousif

Abstract:

This paper describes occupational radiation doses of workers in non-destructive testing (NDT) and some medical practices during the year 2007. The annual doses received by the workers of a public hospital are presented in this report. The Department is facilitated with HARSHAW Reader model 6600 and assigned the rule of personal monitoring to contribute in controlling and reducing the doses received by radiation workers. TLD cards with two TLD chips type LiF: Mg, Ti (TLD-100) were calibrated to measure the personal dose equivalent Hp(10). Around 150 medical radiation workers were monitored throughout the year. Each worker received a single TLD card worn on the chest above lead apron and returned for laboratory reading every two months. The average annual doses received by the workers of radiotherapy, nuclear medicine and diagnostic radiology were evaluated. The annual doses for individual radiation workers ranged between 0.55-4.42 mSv, 0.48-1.86 mSv, and 0.48-0.91 mSv for the workers of radiotherapy, nuclear medicine and diagnostic radiology, respectively. The mean dose per worker was 1.29±1, 1.03±0.4, and 0.69±0.2 mSv, respectively. The results showed compliance with international dose limits. Our results reconfirm the importance of personal dosimetry service in assuring the radiation protection of medical staff in developing countries.

Keywords: radiation medicine, non-destructive testing, TLD, public hospital

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5561 Enhancing Single Channel Minimum Quantity Lubrication through Bypass Controlled Design for Deep Hole Drilling with Small Diameter Tool

Authors: Yongrong Li, Ralf Domroes

Abstract:

Due to significant energy savings, enablement of higher machining speed as well as environmentally friendly features, Minimum Quantity Lubrication (MQL) has been used for many machining processes efficiently. However, in the deep hole drilling field (small tool diameter D < 5 mm) and long tool (length L > 25xD) it is always a bottle neck for a single channel MQL system. The single channel MQL, based on the Venturi principle, faces a lack of enough oil quantity caused by dropped pressure difference during the deep hole drilling process. In this paper, a system concept based on a bypass design has explored its possibility to dynamically reach the required pressure difference between the air inlet and the inside of aerosol generator, so that the deep hole drilling demanded volume of oil can be generated and delivered to tool tips. The system concept has been investigated in static and dynamic laboratory testing. In the static test, the oil volume with and without bypass control were measured. This shows an oil quantity increasing potential up to 1000%. A spray pattern test has demonstrated the differences of aerosol particle size, aerosol distribution and reaction time between single channel and bypass controlled single channel MQL systems. A dynamic trial machining test of deep hole drilling (drill tool D=4.5mm, L= 40xD) has been carried out with the proposed system on a difficult machining material AlSi7Mg. The tool wear along a 100 meter drilling was tracked and analyzed. The result shows that the single channel MQL with a bypass control can overcome the limitation and enhance deep hole drilling with a small tool. The optimized combination of inlet air pressure and bypass control results in a high quality oil delivery to tool tips with a uniform and continuous aerosol flow.

Keywords: deep hole drilling, green production, Minimum Quantity Lubrication (MQL), near dry machining

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5560 Auditory Rehabilitation via an VR Serious Game for Children with Cochlear Implants: Bio-Behavioral Outcomes

Authors: Areti Okalidou, Paul D. Hatzigiannakoglou, Aikaterini Vatou, George Kyriafinis

Abstract:

Young children are nowadays adept at using technology. Hence, computer-based auditory training programs (CBATPs) have become increasingly popular in aural rehabilitation for children with hearing loss and/or with cochlear implants (CI). Yet, their clinical utility for prognostic, diagnostic, and monitoring purposes has not been explored. The purposes of the study were: a) to develop an updated version of the auditory rehabilitation tool for Greek-speaking children with cochlear implants, b) to develop a database for behavioral responses, and c) to compare accuracy rates and reaction times in children differing in hearing status and other medical and demographic characteristics, in order to assess the tool’s clinical utility in prognosis, diagnosis, and progress monitoring. The updated version of the auditory rehabilitation tool was developed on a tablet, retaining the User-Centered Design approach and the elements of the Virtual Reality (VR) serious game. The visual stimuli were farm animals acting in simple game scenarios designed to trigger children’s responses to animal sounds, names, and relevant sentences. Based on an extended version of Erber’s auditory development model, the VR game consisted of six stages, i.e., sound detection, sound discrimination, word discrimination, identification, comprehension of words in a carrier phrase, and comprehension of sentences. A familiarization stage (learning) was set prior to the game. Children’s tactile responses were recorded as correct, false, or impulsive, following a child-dependent set up of a valid delay time after stimulus offset for valid responses. Reaction times were also recorded, and the database was in Εxcel format. The tablet version of the auditory rehabilitation tool was piloted in 22 preschool children with Νormal Ηearing (ΝΗ), which led to improvements. The study took place in clinical settings or at children’s homes. Fifteen children with CI, aged 5;7-12;3 years with post-implantation 0;11-5;1 years used the auditory rehabilitation tool. Eight children with CI were monolingual, two were bilingual and five had additional disabilities. The control groups consisted of 13 children with ΝΗ, aged 2;6-9;11 years. A comparison of both accuracy rates, as percent correct, and reaction times (in sec) was made at each stage, across hearing status, age, and also, within the CI group, based on presence of additional disability and bilingualism. Both monolingual Greek-speaking children with CI with no additional disabilities and hearing peers showed high accuracy rates at all stages, with performances falling above the 3rd quartile. However, children with normal hearing scored higher than the children with CI, especially in the detection and word discrimination tasks. The reaction time differences between the two groups decreased in language-based tasks. Results for children with CI with additional disability or bilingualism varied. Finally, older children scored higher than younger ones in both groups (CI, NH), but larger differences occurred in children with CI. The interactions between familiarization of the software, age, hearing status and demographic characteristics are discussed. Overall, the VR game is a promising tool for tracking the development of auditory skills, as it provides multi-level longitudinal empirical data. Acknowledgment: This work is part of a project that has received funding from the Research Committee of the University of Macedonia under the Basic Research 2020-21 funding programme.

Keywords: VR serious games, auditory rehabilitation, auditory training, children with cochlear implants

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5559 A Risk Management Approach to the Diagnosis of Attention Deficit-Hyperactivity Disorder

Authors: Lloyd A. Taylor

Abstract:

An increase in the prevalence of Attention Deficit-Hyperactivity Disorder (ADHD) highlights the need to consider factors that may be exacerbating symptom presentation. Traditional diagnostic criteria provide a little framework for healthcare providers to consider as they attempt to diagnose and treat children with behavioral problems. In fact, aside from exclusion criteria, limited alternative considerations are available, and approaches fail to consider the impact of outside factors that could increase or decrease the likelihood of appropriate diagnosis and success of interventions. This paper will consider specific systems-based factors that influence behavior and intervention successes that, when not considered, could account for the upsurge of diagnoses. These include understanding (1) challenges in the healthcare system, (2) the influence and impact of educators and the educational system, (3) technology use, and (4) patient and parental attitudes about the diagnosis of ADHD. These factors must be considered both individually and as a whole when considering both the increase in diagnoses and the subsequent increases in prescriptions for psychostimulant medication. A theoretical model based on a risk management approach will be presented. Finally, data will be presented that demonstrates pediatric provider satisfaction with this approach to diagnoses and treatment of ADHD as it relates to practice trends.

Keywords: ADHD, diagnostic criteria, risk management model, pediatricians

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5558 Nano-Plasmonic Diagnostic Sensor Using Ultraflat Single-Crystalline Au Nanoplate and Cysteine-Tagged Protein G

Authors: Hwang Ahreum, Kang Taejoon, Kim Bongsoo

Abstract:

Nanosensors for high sensitive detection of diseases have been widely studied to improve the quality of life. Here, we suggest robust nano-plasmonic diagnostic sensor using cysteine tagged protein G (Cys3-protein G) and ultraflat, ultraclean and single-crystalline Au nanoplates. Protein G formed on an ultraflat Au surface provides ideal background for dense and uniform immobilization of antibodies. The Au is highly stable in diverse biochemical environment and can immobilize antibodies easily through Au-S bonding, having been widely used for various biosensing applications. Especially, atomically smooth single-crystalline Au nanomaterials synthesized using chemical vapor transport (CVT) method are very suitable to fabricate reproducible sensitive sensors. As the C-reactive protein (CRP) is a nonspecific biomarker of inflammation and infection, it can be used as a predictive or prognostic marker for various cardiovascular diseases. Cys3-protein G immobilized uniformly on the Au nanoplate enable CRP antibody (anti-CRP) to be ordered in a correct orientation, making their binding capacity be maximized for CRP detection. Immobilization condition for the Cys3-protein G and anti-CRP on the Au nanoplate is optimized visually by AFM analysis. Au nanoparticle - Au nanoplate (NPs-on-Au nanoplate) assembly fabricated from sandwich immunoassay for CRP can reduce zero-signal extremely caused by nonspecific bindings, providing a distinct surface-enhanced Raman scattering (SERS) enhancement still in 10-18 M of CRP concentration. Moreover, the NP-on-Au nanoplate sensor shows an excellent selectivity against non-target proteins with high concentration. In addition, comparing with control experiments employing a Au film fabricated by e-beam assisted deposition and linker molecule, we validate clearly contribution of the Au nanoplate for the attomolar sensitive detection of CRP. We expect that the devised platform employing the complex of single-crystalline Au nanoplates and Cys3-protein G can be applied for detection of many other cancer biomarkers.

Keywords: Au nanoplate, biomarker, diagnostic sensor, protein G, SERS

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5557 Experimental Investigation on Over-Cut in Ultrasonic Machining of WC-Co Composite

Authors: Ravinder Kataria, Jatinder Kumar, B. S. Pabla

Abstract:

Ultrasonic machining is one of the most widely used non-traditional machining processes for machining of materials that are relatively brittle, hard, and fragile such as advanced ceramics, refractories, crystals, quartz etc. Present article has been targeted at investigating the impact of different experimental conditions (power rating, cobalt content, tool material, thickness of work piece, tool geometry, and abrasive grit size) on over cut in ultrasonic drilling of WC-Co composite material. Taguchi’s L-36 orthogonal array has been employed for conducting the experiments. Significant factors have been identified using analysis of variance (ANOVA) test. The experimental results revealed that abrasive grit size and tool material are most significant factors for over cut.

Keywords: ANOVA, abrasive grit size, Taguchi, WC-Co, ultrasonic machining

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5556 Description and Evaluation of the Epidemiological Surveillance System for Meningitis in the Province of Taza Between 2016 and 2020

Authors: Bennasser Samira

Abstract:

Meningitis, especially the meningococcal one, is a serious problem of public health. A system of vigilanceand surveillance is in place to allow effective actions to be taken on actual or potential health problems caused by all forms of meningitis. Objectives: 1. Describe the epidemiological surveillance system for meningitis in the province of Taza. 2. Evaluate the quality and responsiveness of the epidemiological surveillance system for meningitis in the province of Taza. 3. Propose measures to improve this system at the provincial level. Methods: This was a descriptive study with a purely quantitative approach by evaluating the quality and responsiveness of the system during 5 years between January 2016 and December 2020. We usedfor that the investigation files of meningitis cases and the provincial database of meningitis. We calculated some quality indicators of surveillance system already defined by the National Program for the Prevention and Control of Meningitis. Results: The notification is passive, the completeness of the data is quite good (94%), and the timeliness don’t exceed 71%. The quality of the data is acceptable (91% agreement). The systematic and rapid performance of lumbar punctures increases the diagnostic capabilities of the system. The local response actions are effected in 100%. Conclusion: The improvement of this surveillance system depends on strengthening the staff skills in diagnostic, reviewing surveillance tools, and encouraging judicious use of the data.

Keywords: evaluation, meningitis, system, taza, morocco

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5555 Assessing Diagnostic and Evaluation Tools for Use in Urban Immunisation Programming: A Critical Narrative Review and Proposed Framework

Authors: Tim Crocker-Buque, Sandra Mounier-Jack, Natasha Howard

Abstract:

Background: Due to both the increasing scale and speed of urbanisation, urban areas in low and middle-income countries (LMICs) host increasingly large populations of under-immunized children, with the additional associated risks of rapid disease transmission in high-density living environments. Multiple interdependent factors are associated with these coverage disparities in urban areas and most evidence comes from relatively few countries, e.g., predominantly India, Kenya, Nigeria, and some from Pakistan, Iran, and Brazil. This study aimed to identify, describe, and assess the main tools used to measure or improve coverage of immunisation services in poor urban areas. Methods: Authors used a qualitative review design, including academic and non-academic literature, to identify tools used to improve coverage of public health interventions in urban areas. Authors selected and extracted sources that provided good examples of specific tools, or categories of tools, used in a context relevant to urban immunization. Diagnostic (e.g., for data collection, analysis, and insight generation) and programme tools (e.g., for investigating or improving ongoing programmes) and interventions (e.g., multi-component or stand-alone with evidence) were selected for inclusion to provide a range of type and availability of relevant tools. These were then prioritised using a decision-analysis framework and a tool selection guide for programme managers developed. Results: Authors reviewed tools used in urban immunisation contexts and tools designed for (i) non-immunization and/or non-health interventions in urban areas, and (ii) immunisation in rural contexts that had relevance for urban areas (e.g., Reaching every District/Child/ Zone). Many approaches combined several tools and methods, which authors categorised as diagnostic, programme, and intervention. The most common diagnostic tools were cross-sectional surveys, key informant interviews, focus group discussions, secondary analysis of routine data, and geographical mapping of outcomes, resources, and services. Programme tools involved multiple stages of data collection, analysis, insight generation, and intervention planning and included guidance documents from WHO (World Health Organisation), UNICEF (United Nations Children's Fund), USAID (United States Agency for International Development), and governments, and articles reporting on diagnostics, interventions, and/or evaluations to improve urban immunisation. Interventions involved service improvement, education, reminder/recall, incentives, outreach, mass-media, or were multi-component. The main gaps in existing tools were an assessment of macro/policy-level factors, exploration of effective immunization communication channels, and measuring in/out-migration. The proposed framework uses a problem tree approach to suggest tools to address five common challenges (i.e. identifying populations, understanding communities, issues with service access and use, improving services, improving coverage) based on context and available data. Conclusion: This study identified many tools relevant to evaluating urban LMIC immunisation programmes, including significant crossover between tools. This was encouraging in terms of supporting the identification of common areas, but problematic as data volumes, instructions, and activities could overwhelm managers and tools are not always suitably applied to suitable contexts. Further research is needed on how best to combine tools and methods to suit local contexts. Authors’ initial framework can be tested and developed further.

Keywords: health equity, immunisation, low and middle-income countries, poverty, urban health

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5554 Development of a Device for Detecting Fluids in the Esophagus

Authors: F. J. Puertas, M. Castro, A. Tebar, P. J. Fito, R. Gadea, J. M. Monzó, R. J. Colom

Abstract:

There is a great diversity of diseases that affect the integrity of the walls of the esophagus, generally of a digestive nature. Among them, gastroesophageal reflux is a common disease in the general population, affecting the patient's quality of life; however, there are still unmet diagnostic and therapeutic issues. The consequences of untreated or asymptomatic acid reflux on the esophageal mucosa are not only pain, heartburn, and acid regurgitation but also an increased risk of esophageal cancer. Currently, the diagnostic methods to detect problems in the esophageal tract are invasive and annoying, as 24-hour impedance-pH monitoring forces the patient to be uncomfortable for hours to be able to make a correct diagnosis. In this work, the development of a sensor able to measure in depth is proposed, allowing the detection of liquids circulating in the esophageal tract. The multisensor detection system is based on radiofrequency photospectrometry. At an experimental level, consumers representative of the population in terms of sex and age have been used, placing the sensors between the trachea and the diaphragm analyzing the measurements in vacuum, water, orange juice and saline medium. The results obtained have allowed us to detect the appearance of different liquid media in the esophagus, segregating them based on their ionic content.

Keywords: bioimpedance, dielectric spectroscopy, gastroesophageal reflux, GERD

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5553 Inflammatory Cytokine (Interleukin-8): A Diagnostic Marker in Leukemia

Authors: Sandeep Pandey, Nimra Habib, Ranjana Singh, Abbas Ali Mahdi

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Leukemia is a malignancy of blood that mainly affects children and young adults; while advancement in the early diagnosis will have the potential to improve the outcome of diseases. A wide range of disease including leukemia shows inflammatory signals in their pathogenesis. In a pilot study conducted in our laboratory, 52 people were screened, of which 26 had leukemia and 26 were free from any kind of malignancy. We performed the estimation of the inflammatory cytokine Interleukin-8 and it was found significantly raised in all the leukemia patients concerning healthy volunteers who participated in the study. Flow cytometry had been performed for the confirmation of leukemia and further genomic, and proteomic, analyses of the sample revealed that IL-8 levels showed a positive correlation in patients with leukemia. The results had shown constitutive secretion of interleukin-8 by leukemia cells. So, our finding demonstrated that IL-8 is considered to have a role in the pathogenesis of leukemia, and quantification of IL-8 levels in leukemia conditions might be more useful and feasible in the clinical setting for the prediction of drug responses where it may represent a putative target for innovative diagnostic toward effective therapeutic approaches. However, further research explorations in this area are needed that include a greater number of patients with all different forms of leukemia, and estimating their IL-8 levels may hold the key for the additional predictive values on the recurrence of leukemia and its prognosis.

Keywords: T-ALL, IL-8, leukemia pathogenesis, cancer therapeutics

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