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Authors: Yael Wolff Sagy, Yiska Loewenberg Weisband, Vered Kaufman Shriqui, Michal Krieger, Arie Ben Yehuda, Ronit Calderon Margalit

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Background: Obesity is both a risk factor and common comorbidity of diabetes. Obesity impedes the achievement of glycemic control, and enhances damage caused by hyperglycemia to blood vessels; thus it increases diabetes-related complications. This study assessed the prevalence of obesity and morbid obesity among Israeli adults with diabetes, and estimated disparities associated with sex and socioeconomic position (SEP). Methods: A cross-sectional study was conducted in the setting of the Israeli National Program for Quality Indicators in Community Healthcare. Data on all the Israeli population is retrieved from electronic medical records of the four health maintenance organizations (HMOs). The study population included all Israeli patients with diabetes aged 20-64 with documented body mass index (BMI) in 2016 (N=180,451). Diabetes was defined as the existence of one or more of the following criteria: (a) Plasma glucose level >200 mg% in at least two tests conducted at least one month apart in the previous year; (b) HbA1c>6.5% at least once in the previous year (c) at least three prescriptions of diabetes medications were dispensed during the previous year. Two measures were included: the prevalence of obesity (defined as last BMI≥ 30 kg/m2 and <35 kg/m2) and the prevalence of morbid obesity (defined as last BMI≥ 35 kg/m2) in individuals aged 20-64 with diabetes. The cut-off value for morbid obesity was set in accordance with the eligibility criteria for bariatric surgery in diabetics. Data were collected by the HMOs and aggregated by age, sex and SEP. SEP was based on statistical areas ranking by the Israeli Central Bureau of Statistics and divided into 4 categories, ranking from 1 (lowest) to 4 (highest). Results: BMI documentation among adults with diabetes was 84.9% in 2016. The prevalence of obesity in the study population was 30.5%. Although the overall rate was similar in both sexes (30.8% in females, 30.3% in males), SEP disparities were stronger in females (32.7% in SEP level 1 vs. 27.7% in SEP level 4; 18.1% relative difference) compared to males (30.6% in SEP level 1 vs. 29.3% in SEP level 4; 4.4% relative difference). The overall prevalence of morbid obesity in this population was 20.8% in 2016. The rate among females was almost double compared to the rate in males (28.1% and 14.6%, respectively). In both sexes, the prevalence of morbid obesity was strongly associated with lower SEP. However, in females, disparities between SEP levels were much stronger (34.3% in SEP level 1 vs. 18.7% in SEP level 4; 83.4% relative difference) compared to SEP-disparities in males (15.7% in SEP level 1 vs. 12.3% in SEP level 4; 27.6% relative difference). Conclusions: The overall prevalence of BMI≥ 30 kg/m2 among adults with diabetes in Israel exceeds 50%; and the prevalence of morbid obesity suggests that 20% meet the BMI-criteria for bariatric surgery. Prevalence rates show major SEP- and sex-disparities; especially strong SEP disparities in morbid obesity among females. These findings highlight the need for greater consideration of different population groups when implementing interventions.

Keywords: diabetes, health disparities, health policy, obesity, socio-economic position

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Authors: Hui-Hsin Huang, Sheng-Tung Huang, Chi-Ming Lee, Chiao-Han Yen, Chun-Mao Lin

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At initiation stage, there are no symptoms at initiation stage; however, at late stage, patients suffer symptoms as soon as ovarian cancer metastasis. Moreover, ovarian cancer cells are resistant to some anti-ovarian cancer drugs in clinical. Thus, it is very important to find an effective treatment for resistant ovarian cancer. Anthraquinone derivatives are able to induce DNA damage and lead to cell apoptosis, so several derivatives have been used for clinical application. Therefore, to explore more effective anti-ovarian cancer drugs, this study investigates the mechanism of three new anthraquinone compounds bearing different functional groups to camptothecin-resistance ovarian cell line A2780R2000. Cell viability was determined by MTT assay after treating A2780R2000 with the three new anthraquinone compounds. The results indicated that IC50 values are 33.44μM (Compound I), 25.77μM (Compound II) and 24.59μM (Compound III). Next, through cell cycle analysis, the results demonstrated that three new anthraquinone compounds not only induced A2780R2000 cell cycle arrest at early stage but also apoptosis at late stage. Besides, through apoptosis assay, the results indicated new anthraquinone compound induced apoptosis at late stage. Furthermore, the results of western blot show that the three new anthraquinone compounds lead to A2780R2000 apoptosis through intrinsic pathway. Theses results suggested that three new anthraquinone compounds may be potential new drugs for clinical cancer treatment in the future.

Keywords: anthraquinone, camptothecin, resistance, ovarian cancer

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Authors: H. K. Esfahani, B. Datta

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Groundwater is one of the most important natural resources in many parts of the world; however it is widely polluted due to human activities. Currently, effective and reliable groundwater management and remediation strategies are obtained using characterization of groundwater pollution sources, where the measured data in monitoring locations are utilized to estimate the unknown pollutant source location and magnitude. However, accurately identifying characteristics of contaminant sources is a challenging task due to uncertainties in terms of predicting source flux injection, hydro-geological and geo-chemical parameters, and the concentration field measurement. Reactive transport of chemical species in contaminated groundwater systems, especially with multiple species, is a complex and highly non-linear geochemical process. Although sufficient concentration measurement data is essential to accurately identify sources characteristics, available data are often sparse and limited in quantity. Therefore, this inverse problem-solving method for characterizing unknown groundwater pollution sources is often considered ill-posed, complex and non- unique. Different methods have been utilized to identify pollution sources; however, the linked simulation-optimization approach is one effective method to obtain acceptable results under uncertainties in complex real life scenarios. With this approach, the numerical flow and contaminant transport simulation models are externally linked to an optimization algorithm, with the objective of minimizing the difference between measured concentration and estimated pollutant concentration at observation locations. Concentration measurement data are very important to accurately estimate pollution source properties; therefore, optimal design of the monitoring network is essential to gather adequate measured data at desired times and locations. Due to budget and physical restrictions, an efficient and effective approach for groundwater pollutant source characterization is to design an optimal monitoring network, especially when only inadequate and arbitrary concentration measurement data are initially available. In this approach, preliminary concentration observation data are utilized for preliminary source location, magnitude and duration of source activity identification, and these results are utilized for monitoring network design. Further, feedback information from the monitoring network is used as inputs for sequential monitoring network design, to improve the identification of unknown source characteristics. To design an effective monitoring network of observation wells, optimization and interpolation techniques are used. A simulation model should be utilized to accurately describe the aquifer properties in terms of hydro-geochemical parameters and boundary conditions. However, the simulation of the transport processes becomes complex when the pollutants are chemically reactive. Three dimensional transient flow and reactive contaminant transport process is considered. The proposed methodology uses HYDROGEOCHEM 5.0 (HGCH) as the simulation model for flow and transport processes with chemically multiple reactive species. Adaptive Simulated Annealing (ASA) is used as optimization algorithm in linked simulation-optimization methodology to identify the unknown source characteristics. Therefore, the aim of the present study is to develop a methodology to optimally design an effective monitoring network for pollution source characterization with reactive species in polluted aquifers. The performance of the developed methodology will be evaluated for an illustrative polluted aquifer sites, for example an abandoned mine site in Queensland, Australia.

Keywords: monitoring network design, source characterization, chemical reactive transport process, contaminated mine site

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Authors: Susan Ka Yee Chow

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Effective clinical preceptorship is affecting students’ competence and fostering their growth in applying theoretical knowledge and skills in clinical settings. Any difference between the expected and actual learning experience will reduce nursing students’ interest in clinical practices and having a negative consequence with their clinical performance. This cross-sectional study is an attempt to compare the differences between preferred and actual preceptorship experience of final year nursing students, and to examine the relationship between the actual preceptorship experience and perceived clinical competence of the students in a tertiary institution. Participants of the study were final year bachelor nursing students of a self-financing tertiary institution in Hong Kong. The instruments used to measure the effectiveness of clinical preceptorship was developed by the participating institution. The scale consisted of five items in a 5-point likert scale. The questions including goals development, critical thinking, learning objectives, asking questions and providing feedback to students. The “Clinical Competence Questionnaire” by Liou & Cheng (2014) was used to examine students’ perceived clinical competences. The scale consisted of 47 items categorized into four domains, namely nursing professional behaviours; skill competence: general performance; skill competence: core nursing skills and skill competence: advanced nursing skills. There were 193 questionnaires returned with a response rate of 89%. The paired t-test was used to compare the differences between preferred and actual preceptorship experiences of students. The results showed significant differences (p<0.001) for the five questions. The mean for the preferred scores is higher than the actual scores resulting statistically significance. The maximum mean difference was accepted goal and the highest mean different was giving feedback. The Pearson Correlation Coefficient was used to examine the relationship. The results showed moderate correlations between nursing professional behaviours with asking questions and providing feedback. Providing useful feedback to students is having moderate correlations with all domains of the Clinical Competence Questionnaire (r=0.269 – 0.345). It is concluded that nursing students do not have a positive perception of the clinical preceptorship. Their perceptions are significantly different from their expected preceptorship. If students were given more opportunities to ask questions in a pedagogical atmosphere, their perceived clinical competence and learning outcomes could be improved as a result.

Keywords: clinical preceptor, clinical competence, clinical practicum, nursing students

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Authors: Reda Abdel Azim

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Gas conning phenomenon considered one of the prevalent matter in oil field applications as it significantly affects the amount of produced oil, increase cost of production operation and it has a direct effect on oil reservoirs recovery efficiency as well. Therefore, evaluation of such phenomenon and study the reservoir mechanisms that may strongly affect invading gas to the producing formation is crucial. Gas conning is a result of an imbalance between two major forces controlling the oil production: gravitational and viscous forces especially in naturally fractured reservoirs where the capillary pressure forces are negligible. Once the gas invading the producing formation near the wellbore due to large producing oil rate, the oil gas contact will change and such reservoirs are prone to gas conning. Moreover, the oil volume expected to be produced requires the use of long horizontal perforated well. This work presents a numerical simulation study to predict and propose solutions to gas coning in naturally fractured oil reservoirs. The simulation work is based on discrete fractures and permeability tensors approaches. The governing equations are discretized using finite element approach and Galerkin’s least square technique (GLS) is employed to stabilize the equation solutions. The developed simulator is validated against Eclipse-100 using horizontal fractures. The matrix and fracture properties are modelled. Critical rate, breakthrough time and GOR are determined to be used in investigation of the effect of matrix and fracture properties on gas coning. Results show that fracture distribution in terms of diverse dip and azimuth has a great effect on conning occurring. In addition, fracture porosity, anisotropy ratio, and fracture aperture.

Keywords: gas conning, finite element, fractured reservoirs, multiphase

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Authors: Lae-Jeong Park

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The paper presents a method that utilizes figure-ground color segmentation to extract effective global feature in terms of false positive reduction in the head-shoulder detection. Conventional detectors that rely on local features such as HOG due to real-time operation suffer from false positives. Color cue in an input image provides salient information on a global characteristic which is necessary to alleviate the false positives of the local feature based detectors. An effective approach that uses figure-ground color segmentation has been presented in an effort to reduce the false positives in object detection. In this paper, an extended version of the approach is presented that adopts separate multipart foregrounds instead of a single prior foreground and performs the figure-ground color segmentation with each of the foregrounds. The multipart foregrounds include the parts of the head-shoulder shape and additional auxiliary foregrounds being optimized by a search algorithm. A classifier is constructed with the feature that consists of a set of the multiple resulting segmentations. Experimental results show that the presented method can discriminate more false positive than the single prior shape-based classifier as well as detectors with the local features. The improvement is possible because the presented approach can reduce the false positives that have the same colors in the head and shoulder foregrounds.

Keywords: pedestrian detection, color segmentation, false positive, feature extraction

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Authors: Trevor R. Higgins

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The aim of this study was to compare muscle activation of the latissimus dorsi between pin-loaded machine (Lat Pull Down), resistance band (Lat Pull Down) and body-weight (Chin Up) exercises. A convenient sample of male college students with >2 years resistance training experience volunteered for the study. A paired t-test with repeated measures designs was carried out on results from EMG analysis. EMG analysis was conducted with Trigno wireless sensors (Delsys) placed laterally on the latissimus dorsi (left and right) of each participant. By conventional criteria the two-tailed P value suggested that differences between pin-loaded and body-weight was not significantly different (p = 0.93) and differences between pin-loaded and resistance band was not significantly different (p = 0.17) in muscle activity. In relation to conventional criteria the two-tailed P value suggested differences between body-weight and resistance band was not quite significantly different (p = 0.06) in muscle activity. However, effect size trends indicated that both body-weight and pin-loaded exercises where more effective in stimulating muscle electrical activity than a resistance band with male college athletes with >2 years resistance training experience. Although, resistance bands have increased in popularity in health and fitness centres, that for well-trained participants, they may not be effective in stimulating muscles of the latissimus dorsi. Therefore, when considering equipment and exercise selection for experienced resistance training participants pin-loaded machines and body-weight should be prescribed.

Keywords: pin-loaded, resistance bands, body weight, EMG analysis

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Authors: Lukman Thalib, Luis Furuya-Kanamori, Rachel Walker, Brigid Gillespie, Suhail Doi

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Background and objectives: There are many topical treatments available for Pressure Injury (PI) treatment, yet there is a lack of evidence with regards to the most effective treatment. The objective of this study was to compare the effect of various topical treatments and identify the best treatment choice(s) for PI healing. Methods: Network meta-analysis of published randomized controlled trials that compared the two or more of the following dressing groups: basic, foam, active, hydroactive, and other wound dressings. The outcome complete healing following treatment and the generalised pair-wise modelling framework was used to generate mixed treatment effects against hydroactive wound dressing, currently the standard of treatment for PIs. All treatments were then ranked by their point estimates. Main Results: 40 studies (1,757 participants) comparing 5 dressing groups were included in the analysis. All dressings groups ranked better than basic (i.e. saline gauze or similar inert dressing). The foam (RR 1.18; 95%CI 0.95-1.48) and active wound dressing (RR 1.16; 95%CI 0.92-1.47) ranked better than hydroactive wound dressing in terms of healing of PIs when the latter was used as the reference group. Conclusion & Recommendations: There was considerable uncertainty around the estimates, yet, the use of hydroactive wound dressings appear to perform better than basic dressings. Foam and active wound dressing groups show promise and need further investigation. High-quality research on clinical effectiveness of the topical treatments are warranted to identify if foam and active wound dressings do provide advantages over hydroactive dressings.

Keywords: Net work Meta Analysis, Pressure Injury, Dresssing, Pressure Ulcer

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Authors: Ahmad Rabby

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The demographic trend analyses of Bombay-duck from time series catch data using CMSY and BSM for the first time in Bangladesh. During 2000-2018, CMSY indicates average lowest production in 2000 and highest in 2018. This has been used in the estimation of prior biomass by the default rules. Possible 31030 viable trajectories for 3422 r-k pairs were found by the CMSY analysis and the final estimates for intrinsic rate of population increase (r) was 1.19 year-1 with 95% CL= 0.957-1.48 year-1. The carrying capacity(k) of Bombay-duck was 283×103 tons with 95% CL=173×103 - 464×103 tons and MSY was 84.3×103tons year-1, 95% CL=49.1×103-145×103 tons year-1. Results from Bayesian state-space implementation of the Schaefer production model (BSM) using catch & CPUE data, found catchabilitiy coefficient(q) was 1.63 ×10-6 from lcl=1.27×10-6 to ucl=2.10×10-6 and r= 1.06 year-1 with 95% CL= 0.727 - 1.55 year-1, k was 226×103 tons with 95% CL=170×103-301×103 tons and MSY was 60×103 tons year-1 with 95% CL=49.9 ×103- 72.2 ×103 tons year-1. Results for Bombay-duck fishery management based on BSM assessment from time series catch data illustrated that, Fmsy=0.531 with 95% CL =0.364 - 0.775 (if B > 1/2 Bmsy then Fmsy =0.5r); Fmsy=0.531 with 95% CL =0.364-0.775 (r and Fmsy are linearly reduced if B < 1/2Bmsy). Biomass in 2018 was 110×103 tons with 2.5th to 97.5th percentile=82.3-155×103 tons. Relative biomass (B/Bmsy) in last year was 0.972 from 2.5th percentile to 97.5th percentile=0.728 -1.37. Fishing mortality in last year was 0.738 with 2.5th-97.5th percentile=0.525-1.37. Exploitation F/Fmsy was 1.39, from 2.5th to 97.5th percentile it was 0.988 -1.86. The biological reference points of B/BMSY was smaller than 1.0, while F/FMSY was higher than 1.0 revealed an over-exploitation of the fishery, indicating that more conservative management strategies are required for Bombay-duck fishery.

Keywords: biological reference points, catchability coefficient, carrying capacity, intrinsic rate of population increase

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Authors: Abdulaziz Kikanga, Kellen Muchira, Styvers Kathuni, Paul Saitoti

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Background: Provision of adequate levels of water, sanitation, and hygiene in schools is a strategic objective in achieving universal primary education among children in low and middle-income countries. However, lack of proper sanitation and hygiene practices in schools, especially those in informal settlement has resulted to an increased rate of school absenteeism thereby affecting the education and health outcomes of the children in those setting. Intervention or Response: Catholic Relief Services in Kenya supports five schools in informal settlements of Nairobi by painting of key hygiene messages on school walls to promote proper hygiene and sanitation practices among the school children. The mural exhibitions depict the essence of proper hygiene practices, proper latrine use, and hand washing after visiting the latrine. The artwork is context specific and its aimed at improving the uptake of proper hygiene and sanitation practices among the school children. Review of project related documents was conducted including interviews with the school children. Thematic analysis was used to interpret the qualitative information generated. Results and Lessons Learnt: 12 school children have interviewed on proper hygiene and sanitation practices and the exercise revealed that painted murals were the best communication platforms for creating awareness on proper sanitation on issues relating to water, sanitation, and hygiene in schools. The painting mural provided a strong knowledge base for the formation of healthy habits in both the school and informal settlement. In addition, these sanitation messages on the school walls empower the children to share these practices with their siblings, parents, and other family members thereby acting as agents of change to proper hygiene and sanitation in those informal settlements. The findings revealed that by adopting proper sanitation and hygiene practices, there has been a reduction of school absenteeism due to a decrease in disease related to inadequate sanitation and hygiene in schools. Conclusion: The adoption of proper sanitation in schools entails more than just a painted mural wall. Insights revealed that to have a lasting sanitation and hygiene intervention, there is a need to invest in effective hygiene educational programming that encourages the formation of proper hygiene habits and promotes changes in behavior.

Keywords: education outcomes, informal settlement, mural exhibition, school hygiene and sanitation

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Authors: Sruti Akula

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Assessment criteria are mostly used for assessing skills like writing and speaking. However, they could be used as a pedagogic tool to develop writing skills. A study was conducted with higher secondary learners (Class XII Kendriya Vidyalaya) to investigate the effectiveness of assessment criteria to develop argumentative essay writing. In order to raise awareness about the features of argumentative essay, assessment criteria were shared with the learners. Along with that, self-evaluation checklists were given to the learners to guide them through the writing process. During the study learners wrote multiple drafts with the help of assessment criteria, self-evaluation checklists and teacher feedback at different stages of their writing. It was observed that learners became more aware of the features of argumentative essay which in turn improved their argumentative essay writing. In addition the self evaluation checklists imporved their ability to reflect on their work there by increasing learner autonomy in the class. Hence, it can be claimed that both assessment criteria and self evaluation checklists are effective pedagogic tools to develop argumentative essay writing. Thus, teachers can be trained to create and use tools like assessment criteria and self-evaluation checklists to develop learners’ writing skills in an effective way. The presentation would discuss the approach adopted in the study to teach argumentative essay writing along with the rationale. The tools used in the study would be shared and the data collected in the form of written scripts, self-evaluation checklists and student interviews will be analyzed to validate the claims. Finally, the practical implication of the study like the ways of using assessment criteria and checklists to raise learner awareness and autonomy, using such tools to keep the learners informed about the task requirements and genre features, and the like will be put forward.

Keywords: argumentative essay writing, assessment criteria, self evaluation checklists, pedagogic

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Authors: Venkat Kamavaram, Ravi Pare

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Modern warfighters experience extreme environmental conditions in many of their operational and training activities. In temperatures exceeding 95°F, the body’s temperature regulation can no longer cool through convection and radiation. In this case, the only cooling mechanism is evaporation. However, evaporative cooling is often compromised by excessive humidity. Natural cooling mechanisms can be further compromised by clothing and protective gear, which trap hot air and moisture close to the body. Creating an efficient heat extraction apparel system that is also lightweight without hindering dexterity or mobility of personnel working in extreme temperatures is a difficult technical challenge and one that needs to be addressed to increase the probability for the future success of the US military. To address this challenge, Oceanit Laboratories, Inc. has developed and patented a Liquid Cooled Garment (LCG) more effective than any on the market today. Oceanit’s LCG is a form-fitting garment with a network of thermally conductive tubes that extracts body heat and can be worn under all authorized and chemical/biological protective clothing. Oceanit specifically designed and developed ThermoCore®, a thermally conductive polymer, for use in this apparel, optimizing the product for thermal conductivity, mechanical properties, manufacturability, and performance temperatures. Thermal Manikin tests were conducted in accordance with the ASTM test method, ASTM F2371, Standard Test Method for Measuring the Heat Removal Rate of Personal Cooling Systems Using a Sweating Heated Manikin, in an environmental chamber using a 20-zone sweating thermal manikin. Manikin test results have shown that Oceanit’s LCG provides significantly higher heat extraction under the same environmental conditions than the currently fielded Environmental Control Vest (ECV) while at the same time reducing the weight. Oceanit’s LCG vests performed nearly 30% better in extracting body heat while weighing 15% less than the ECV. There are NO cooling garments in the market that provide the same thermal extraction performance, form-factor, and reduced weight as Oceanit’s LCG. The two cooling garments that are commercially available and most commonly used are the Environmental Control Vest (ECV) and the Microclimate Cooling Garment (MCG).

Keywords: thermally conductive composite, tubing, garment design, form fitting vest, thermocore

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Authors: Chih Jou Hsiao, Chung Ming Lo, Li Chun Hsieh

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Brain tumor is not the cancer having high incidence rate, but its high mortality rate and poor prognosis still make it as a big concern. On clinical examination, the grading of brain tumors depends on pathological features. However, there are some weak points of histopathological analysis which can cause misgrading. For example, the interpretations can be various without a well-known definition. Furthermore, the heterogeneity of malignant tumors is a challenge to extract meaningful tissues under surgical biopsy. With the development of magnetic resonance imaging (MRI), tumor grading can be accomplished by a noninvasive procedure. To improve the diagnostic accuracy further, this study proposed a computer-aided diagnosis (CAD) system based on MRI features to provide suggestions of tumor grading. Gliomas are the most common type of malignant brain tumors (about 70%). This study collected 34 glioblastomas (GBMs) and 73 lower-grade gliomas (LGGs) from The Cancer Imaging Archive. After defining the region-of-interests in MRI images, multiple quantitative morphological features such as region perimeter, region area, compactness, the mean and standard deviation of the normalized radial length, and moment features were extracted from the tumors for classification. As results, two of five morphological features and three of four image moment features achieved p values of <0.001, and the remaining moment feature had p value <0.05. Performance of the CAD system using the combination of all features achieved the accuracy of 83.18% in classifying the gliomas into LGG and GBM. The sensitivity is 70.59% and the specificity is 89.04%. The proposed system can become a second viewer on clinical examinations for radiologists.

Keywords: brain tumor, computer-aided diagnosis, gliomas, magnetic resonance imaging

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Authors: Sachin Latiyan, T. S. Sampath Kumar, Mukesh Doble

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Natural polymer based nanofibrous wound dressings have gained increased attention because of their high surface area, bioactivity, biodegradability and resemblance to extracellular matrix. Agarose (a natural polymer) have been used largely for angiogenesis, cartilage formation and wound healing applications. However, electrospinning of agarose is tedious thereby rendering limited studies on fabrication and evaluation of agarose based nanofibrous wound dressings. Thus, present study focuses on the fabrication of agarose (10% w/v)/ polyvinyl alcohol (12% w/v) based multifunctional nanofibrous scaffolds. Zinc citrate (1, 3 and 5% w/w of the polymer) was added as a potential antibacterial agent to combat wound infections. The fabricated scaffolds exhibit ~500% swelling (in phosphate buffer saline) with enhanced mechanical strength which is suitable for most of the wound healing applications. In vitro studies were found to reveal an increased migration and proliferation of L929 mouse fibroblasts with agarose blends w.r.t to the control. The fabricated dressings were found to be effective against both Escherichia coli (Gram-negative) and Staphylococcus aureus (Gram-positive) bacterial strains. Hence, a multifunctional (as provides effective swelling and mechanical support along with antibacterial property), natural product based, eco-friendly scaffold was successfully fabricated to serve as a potential wound dressing material.

Keywords: antibacterial dressings, benign solvent, nanofibrous agarose, biocompatibility, enhanced swelling and mechanical strength, biopolymeric dressings

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Authors: Pitigalage Chamath Chandira Peiris

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A widely researched domain in the field of image processing in recent times has been single image super-resolution, which tries to restore a high-resolution image from a single low-resolution image. Many more single image super-resolution efforts have been completed utilizing equally traditional and deep learning methodologies, as well as a variety of other methodologies. Deep learning-based super-resolution methods, in particular, have received significant interest. As of now, the most advanced image restoration approaches are based on convolutional neural networks; nevertheless, only a few efforts have been performed using Transformers, which have demonstrated excellent performance on high-level vision tasks. The effectiveness of CNN-based algorithms in image super-resolution has been impressive. However, these methods cannot completely capture the non-local features of the data. Enhancer is a simple yet powerful Transformer-based approach for enhancing the resolution of images. A method for single image super-resolution was developed in this study, which utilized an efficient and effective transformer design. This proposed architecture makes use of a locally enhanced window transformer block to alleviate the enormous computational load associated with non-overlapping window-based self-attention. Additionally, it incorporates depth-wise convolution in the feed-forward network to enhance its ability to capture local context. This study is assessed by comparing the results obtained for popular datasets to those obtained by other techniques in the domain.

Keywords: single image super resolution, computer vision, vision transformers, image restoration

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Authors: Anastasios Ntousas

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The purpose of the following paper is to analyze the relationship between the lexical quality and the self-teaching hypothesis and their impact on the reading ability. The following questions emerged, is there a correlation between the effective reading experience that the lexical quality hypothesis proposes and the self-teaching hypothesis, would the ability to read by analogy facilitate and create stable, synchronized four-word representational, and would word morphological knowledge be a possible extension of the self-teaching hypothesis. The lexical quality hypothesis speculates that words include four representational attributes, phonology, orthography, morpho-syntax, and meaning. Those four-word representations work together to make word reading an effective task. A possible lack of knowledge in one of the representations might disrupt reading comprehension. The degree that the four-word features connect together makes high and low lexical word quality representations. When the four-word representational attributes connect together effectively, readers have a high lexical quality of words; however, when they hardly have a strong connection with each other, readers have a low lexical quality of words. Furthermore, the self-teaching hypothesis proposes that phonological recoding enables printed word learning. Phonological knowledge and reading experience facilitate the acquisition and consolidation of specific-word orthographies. The reading experience is related to strong reading comprehension. The more readers have contact with texts, the better readers they become. Therefore, their phonological knowledge, as the self-teaching hypothesis suggests, might have a facilitative impact on the consolidation of the orthographical, morphological-syntax and meaning representations of unknown words. The phonology of known words might activate effectively the rest of the representational features of words. Readers use their existing phonological knowledge of similarly spelt words to pronounce unknown words; a possible transference of this ability to read by analogy will appear with readers’ morphological knowledge. Morphemes might facilitate readers’ ability to pronounce and spell new unknown words in which they do not have lexical access. Readers will encounter unknown words with similarly phonemes and morphemes but with different meanings. Knowledge of phonology and morphology might support and increase reading comprehension. There was a careful selection, discussion of theoretical material and comparison of the two existing theories. Evidence shows that morphological knowledge improves reading ability and comprehension, so morphological knowledge might be a possible extension of the self-teaching hypothesis, the fundamental skill to read by analogy can be implemented to the consolidation of word – specific orthographies via readers’ morphological knowledge, and there is a positive correlation between effective reading experience and self-teaching hypothesis.

Keywords: morphology, orthography, reading ability, reading comprehension

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Authors: Khoo Shin Yee, Lian Yee Cheng, Ong Zhi Chao, Zubaidah Ismail, Siamak Noroozi

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Structural frequency response testing is accurate in identifying the dynamic characteristic of a machinery structure. In practical perspective, conventional structural frequency response testing such as experimental modal analysis with impulse technique (also known as “impulse testing”) has limitation especially on its long acquisition time. The high acquisition time is mainly due to the redundancy procedure where the engineer has to repeatedly perform the test in 3 directions, namely the axial-, horizontal- and vertical-axis, in order to comprehensively define the dynamic behavior of a 3D structure. This is unfavorable to numerous industries where the downtime cost is high. This study proposes to reduce the testing time by using oblique impact. Theoretically, a single oblique impact can induce significant vibration responses and vibration modes in all the 3 directions. Hence, the acquisition time with the implementation of the oblique impulse technique can be reduced by a factor of three (i.e. for a 3D dynamic system). This study initiates an experimental investigation of impulse testing with oblique excitation. A motor-driven test rig has been used for the testing purpose. Its dynamic characteristic has been identified using the impulse testing with the conventional normal impact and the proposed oblique impact respectively. The results show that the proposed oblique impulse testing is able to obtain all the desired natural frequencies in all 3 directions and thus providing a feasible solution for a fast and time effective way of conducting the impulse testing.

Keywords: frequency response function, impact testing, modal analysis, oblique angle, oblique impact

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Authors: Mohammed W. Abdulrahman

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In the thermochemical water splitting process by Cu-Cl cycle, oxygen gas is produced by an endothermic thermolysis process at a temperature of 530^oC. Oxygen production reactor is a three-phase reactor involving cuprous chloride molten salt, copper oxychloride solid reactant and oxygen gas. To perform optimal performance, the oxygen reactor requires accurate control of heat transfer to the molten salt and decomposing solid particles within the thermolysis reactor. In this paper, the scale up analysis of the oxygen reactor that is heated by an internal helical tube is performed from the perspective of heat transfer. A heat balance of the oxygen reactor is investigated to analyze the size of the reactor that provides the required heat input for different rates of hydrogen production. It is found that the helical tube wall and the service side constitute the largest thermal resistances of the oxygen reactor system. In the analysis of this paper, the Cu-Cl cycle is assumed to be heated by two types of nuclear reactor, which are HTGR and CANDU SCWR. It is concluded that using CANDU SCWR requires more heat transfer rate by 3-4 times than that when using HTGR. The effect of the reactor aspect ratio is also studied and it is found that increasing the aspect ratio decreases the number of reactors and the rate of decrease in the number of reactors decreases by increasing the aspect ratio. Comparisons between the results of this study and pervious results of material balances in the oxygen reactor show that the size of the oxygen reactor is dominated by the heat balance rather than the material balance.

Keywords: heat transfer, Cu-Cl cycle, hydrogen production, oxygen, clean energy

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Authors: Jae-Hyun Choi, Sung-Soo Bae, Sangyoung Yoon, Hong-Ku Yun, Jiyoung Kwahk

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This study was conducted to investigate the effect of ocular dominance on recognition performance using a single-lens smart display designed for cycling. A total of 36 bicycle riders who have been cycling consistently were recruited and participated in the experiment. The participants were asked to perform tasks riding a bicycle on a stationary stand for safety reasons. Independent variables of interest include ocular dominance, bike usage, age group, and information layout. Recognition time (i.e., the time required to identify specific information measured with an eye-tracker), error rate (i.e. false answer or failure to identify the information in 5 seconds), and user preference scores were measured and statistical tests were conducted to identify significant results. Recognition time and error ratio showed significant difference by ocular dominance factor, while the preference score did not. Recognition time was faster when the single-lens see-through display on the dominant eye (average 1.12sec) than on the non-dominant eye (average 1.38sec). Error ratio of the information recognition task was significantly lower when the see-through display was worn on the dominant eye (average 4.86%) than on the non-dominant eye (average 14.04%). The interaction effect of ocular dominance and age group was significant with respect to recognition time and error ratio. The recognition time of the users in their 40s was significantly longer than the other age groups when the display was placed on the non-dominant eye, while no difference was observed on the dominant eye. Error ratio also showed the same pattern. Although no difference was observed for the main effect of ocular dominance and bike usage, the interaction effect between the two variables was significant with respect to preference score. Preference score of daily bike users was higher when the display was placed on the dominant eye, whereas participants who use bikes for leisure purposes showed the opposite preference patterns. It was found more effective and efficient to wear a see-through display on the dominant eye than on the non-dominant eye, although user preference was not affected by ocular dominance. It is recommended to wear a see-through display on the dominant eye since it is safer by helping the user recognize the presented information faster and more accurately, even if the user may not notice the difference.

Keywords: eye tracking, information recognition, ocular dominance, smart headware, wearable device

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Authors: Kuhorfah Emmanuel Mawuli

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Generally, for firms to enhance their operational efficiency of logistics, it is imperative to assess the logistics function. The cost of logistics conventionally represents a key consideration in the pricing decisions of firms, which suggests that cost efficiency in logistics can go a long way to improve margins. Warehousing, which is a key part of logistics operations, has the prospect of influencing operational efficiency in logistics management as well as customer value, but this potential has often not been recognized. It has been found that there is a paucity of research that evaluates the efficiency of warehouses. Indeed, limited research has been conducted to examine potential barriers to effective warehousing management. Due to this paucity of research, there is limited knowledge on how to address the obstacles associated with warehousing management. In order for warehousing management to become profitable, there is the need to integrate, balance, and manage the economic inputs and outputs of the entire warehouse operations, something that many firms tend to ignore. Management of warehousing is not solely related to storage functions. Instead, effective warehousing management requires such practices as maximum possible mechanization and automation of operations, optimal use of space and capacity of storage facilities, organization through "continuous flow" of goods, a planned system of storage operations, and safety of goods. For example, there is an important need for space utilization of the warehouse surface as it is a good way to evaluate the storing operation and pick items per hour. In the setting of Mantrac Ghana, not much knowledge regarding the management of the warehouses exists. The researcher has personally observed many gaps in the management of the warehouse facilities in the case organization Mantrac Ghana. It is important, therefore, to assess the warehouse facility management of the case company with the objective of identifying weaknesses for improvement. The study employs an in-depth qualitative research approach using interviews as a mode of data collection. Respondents in the study mainly comprised warehouse facility managers in the studied company. A total of 10 participants were selected for the study using a purposive sampling strategy. Results emanating from the study demonstrate limited warehousing effectiveness in the case company. Findings further reveal that the major barriers to effective warehousing facility management comprise poor layout, poor picking optimization, labour costs, and inaccurate orders; policy implications of the study findings are finally outlined.

Keywords: assessing, warehousing, facility, management

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Authors: Masica Jordan Alston, Angela N. Bullock, Angela S. Henderson, Stephanie Strianse, Sade Dunn, Joseph Hackett, Alaysia Black Hackett, Marcus Mason

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The Energy Model of Cumulative Grief was created in 2018. The Energy Model of Cumulative Grief utilizes historic models of grief stage theories. The innovative model is additionally unique due to its focus on cultural responsiveness. The Energy Model of Cumulative Grief helps to train practitioners who work with clients dealing with grief and loss. This paper assists in introducing the world to this innovative model and exploring how this model positively impacted a convenience sample of 140 practitioners and individuals experiencing grief and loss. Respondents participated in Webinars provided by the National Grief and Loss Center of America (NGLCA). Participants in this cross-sectional research design study completed one of three Grief and Loss Surveys created by the Grief and Loss Centers of America. Data analysis for this study was conducted via SPSS and Survey Hero to examine survey results for respondents. Results indicate that the Energy Model of Cumulative Grief was an effective resource for participants in addressing grief and loss. The majority of participants found the Webinars to be helpful and a conduit to providing them with higher levels of hope. The findings suggest that using The Energy Model of Cumulative Grief is effective in providing culturally responsive grief and loss resources to practitioners and clients. There are far reaching implications with the use of technology to provide hope to those suffering from grief and loss worldwide through The Energy Model of Cumulative Grief.

Keywords: grief, loss, grief energy, grieving brain

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Authors: S. Thaiudom, W. Toommuangpak

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Yoghurt ice cream (YIC) containing prebiotics and probiotics seems to be much more recognized among consumers who concern for their health. Not only can it be a benefit on consumers’ health but also its taste and freshness provide people easily accept. However, the survival of such probiotic especially Bifidobacterium longum, found in human gastrointestinal tract and to be benefit to human gut, was still needed to study in the severe condition as whipping and freezing in ice cream process. Low and full-fat yoghurt ice cream containing 2 and 10% (w/w) fat content (LYIC and FYIC), respectively was produced by mixing 20% yoghurt containing B. longum into milk ice cream mix. Fructo-oligosaccharides (FOS) or galacto-oligosaccharides (GOS) at 0, 1, and 2% (w/w) were separately used as prebiotic in order to improve the survival of B. longum. Survival of this bacteria as a function of ice cream storage time and ice cream properties were investigated. The results showed that prebiotic; especially FOS could improve viable count of B. longum. The more concentration of prebiotic used, the more is the survival of B. Longum. These prebiotics could prolong the survival of B. longum up to 60 days, and the amount of survival number was still in the recommended level (106 cfu per gram). Fat content and prebiotic did not significantly affect the total acidity and the overrun of all samples, but an increase of fat content significantly increased the fat particle size which might be because of partial coalescence found in FYIC rather than in LYIC. However, addition of GOS or FOS could reduce the fat particle size, especially in FYIC. GOS seemed to reduce the hardness of YIC rather than FOS. High fat content (10% fat) significantly influenced on lowering the melting rate of YIC better than 2% fat content due to the 3-dimension networks of fat partial coalescence theoretically occurring more in FYIC than in LYIC. However, FOS seemed to retard the melting rate of ice cream better than GOS. In conclusion, GOS and FOS in YIC with different fat content can enhance the survival of B. longum and affect physical and chemical properties of such yoghurt ice cream.

Keywords: Bifidobacterium longum, prebiotic, survival, yoghurt ice cream

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Authors: Mukhtiar Singh, Sumeet Nagar

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Vehicle routing problem (VRP) is a combinatorial optimization and nonlinear programming problem aiming to optimize decisions regarding given set of routes for a fleet of vehicles in order to provide cost-effective and efficient delivery of both services and goods to the intended customers. This paper proposes the application of integrated particle swarm optimization (PSO) and genetic optimization algorithm (GA) to address the Vehicle routing problem in sugarcane industry in India. Suger industry is very prominent agro-based industry in India due to its impacts on rural livelihood and estimated to be employing around 5 lakhs workers directly in sugar mills. Due to various inadequacies, inefficiencies and inappropriateness associated with the current vehicle routing model it costs huge money loss to the industry which needs to be addressed in proper context. The proposed algorithm utilizes the crossover operation that originally appears in genetic algorithm (GA) to improve its flexibility and manipulation more readily and avoid being trapped in local optimum, and simultaneously for improving the convergence speed of the algorithm, level set theory is also added to it. We employ the hybrid approach to an example of VRP and compare its result with those generated by PSO, GA, and parallel PSO algorithms. The experimental comparison results indicate that the performance of hybrid algorithm is superior to others, and it will become an effective approach for solving discrete combinatory problems.

Keywords: fuzzy logic, genetic algorithm, particle swarm optimization, vehicle routing problem

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Authors: Esther Chiramal, Kelvin Soh Boon Kai

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Explainable AI is a strong strategy implemented to understand complex black-box model predictions in a human-interpretable language. It provides the evidence required to execute the use of trustworthy and reliable AI systems. On the other hand, however, it also opens the door to locating possible vulnerabilities in an AI model. Traditional adversarial text attack uses word substitution, data augmentation techniques, and gradient-based attacks on powerful pre-trained Bidirectional Encoder Representations from Transformers (BERT) variants to generate adversarial sentences. These attacks are generally white-box in nature and not practical as they can be easily detected by humans e.g., Changing the word from “Poor” to “Rich”. We proposed a simple yet effective Grey-box cum Black-box approach that does not require the knowledge of the model while using a set of surrogate Transformer/BERT models to perform the attack using Explainable AI techniques. As Transformers are the current state-of-the-art models for almost all Natural Language Processing (NLP) tasks, an attack generated from BERT1 is transferable to BERT2. This transferability is made possible due to the attention mechanism in the transformer that allows the model to capture long-range dependencies in a sequence. Using the power of BERT generalisation via attention, we attempt to exploit how transformers learn by attacking a few surrogate transformer variants which are all based on a different architecture. We demonstrate that this approach is highly effective to generate semantically good sentences by changing as little as one word that is not detectable by humans while still fooling other BERT models.

Keywords: BERT, explainable AI, Grey-box text attack, transformer

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Authors: H.Karnezi, K. Tierney

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Childhood fears that persist over time and interfere with the children’s normal functioning may have detrimental effects on their social and emotional development. Cognitive behavior therapy is considered highly effective in treating fears and anxieties. However, given that many childhood fears are based on fantasy, the applicability of CBT may be hindered by cognitive immaturity. Furthermore, a lack of motivation to engage in therapy is another commonly encountered obstacle. The purpose of this study was to introduce and evaluate a more developmentally appropriate intervention model, specifically designed to provide phobic children with the motivation to overcome their fears. To this end, principles and techniques from cognitive and behavior therapies are incorporated into the ‘Drama in Education’ model. The Cognitive Behaviour Drama (CBD) method involves using the phobic children’s creativity to involve them in the therapeutic process. The children are invited to engage in exciting fictional scenarios tailored around their strengths and special interests. Once their commitment to the drama is established, a problem that they will feel motivated to solve is introduced. To resolve it, the children will have to overcome a number of obstacles culminating in an in vivo confrontation with the fear stimulus. The study examined the application of the CBD model in three single cases. Results in all three cases shown complete elimination of all fear-related symptoms. Preliminary results justify further evaluation of the Cognitive Behaviour Drama model. It is time and cost-effective, ensuring the clients' immediate engagement in the therapeutic process.

Keywords: phobias, autism, intervention, drama

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Authors: H. Sütçü, C. Efe

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In this study, pyrolysis characteristics of Dursunbey-Balıkesir lignite and its pyrolysis kinetics are examined. The pyrolysis experiments carried out at three different heating rates are performed by using thermogravimetric method. Kinetic parameters are calculated by Coats & Redfern kinetic model and the degree of pyrolysis process is determined for each of the heating rate.

Keywords: lignite, thermogravimetric analysis, pyrolysis, kinetics

Procedia PDF Downloads 344

Authors: Amruta Rout, Golak Bihari Mahanta, Gunji Bala Murali, Bibhuti Bhusan Biswal, B. B. V. L. Deepak

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The use of industrial robots for performing welding operation is one of the chief sign of contemporary welding in these days. The weld joint parameter and weld process parameter modeling is one of the most crucial aspects of robotic welding. As weld process parameters affect the weld joint parameters differently, a multi-objective optimization technique has to be utilized to obtain optimal setting of weld process parameter. In this paper, a hybrid optimization technique, i.e., Principal Component Analysis (PCA) combined with fuzzy logic has been proposed to get optimal setting of weld process parameters like wire feed rate, welding current. Gas flow rate, welding speed and nozzle tip to plate distance. The weld joint parameters considered for optimization are the depth of penetration, yield strength, and ultimate strength. PCA is a very efficient multi-objective technique for converting the correlated and dependent parameters into uncorrelated and independent variables like the weld joint parameters. Also in this approach, no need for checking the correlation among responses as no individual weight has been assigned to responses. Fuzzy Inference Engine can efficiently consider these aspects into an internal hierarchy of it thereby overcoming various limitations of existing optimization approaches. At last Taguchi method is used to get the optimal setting of weld process parameters. Therefore, it has been concluded the hybrid technique has its own advantages which can be used for quality improvement in industrial applications.

Keywords: robotic arc welding, weld process parameters, weld joint parameters, principal component analysis, fuzzy logic, Taguchi method

Procedia PDF Downloads 168

Authors: Young Jae Choung, Seoung Bum Kim

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Statistical Process Control (SPC) is a popular technique for process monitoring. A widely used tool in SPC is a control chart, which is used to detect the abnormal status of a process and maintain the controlled status of the process. Traditional control charts, such as Hotelling’s T2 control chart, are effective techniques to detect abnormal observations and monitor processes. However, many complicated manufacturing systems exhibit nonlinearity because of the different demands of the market. In this case, the unregulated use of a traditional linear modeling approach may not be effective. In reality, many industrial processes contain the nonlinear and time-varying properties because of the fluctuation of process raw materials, slowing shift of the set points, aging of the main process components, seasoning effects, and catalyst deactivation. The use of traditional SPC techniques with time-varying data will degrade the performance of the monitoring scheme. To address these issues, in the present study, we propose a parameterless self-organizing map (PLSOM)-based control chart. The PLSOM-based control chart not only can manage a situation where the distribution or parameter of the target observations changes, but also address the nonlinearity of modern manufacturing systems. The control limits of the proposed PLSOM chart are established by estimating the empirical level of significance on the percentile using a bootstrap method. Experimental results with simulated data and actual process data from a thin-film transistor-liquid crystal display process demonstrated the effectiveness and usefulness of the proposed chart.

Keywords: control chart, parameter-less self-organizing map, self-organizing map, time-varying property

Procedia PDF Downloads 256

Authors: Sree Bash Chandra Debnath, Didier Tonneau, Carole Fauquet, Agnes Tallet, Julien Darreon

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Purpose: Inorganic scintillating dosimetry is the most recent promising technique to solve several dosimetric issues and provide quality assurance in radiation therapy. Despite several advantages, the major issue of using scintillating detectors is the Cerenkov effect, typically induced in the visible emission range. In this context, the purpose of this research work is to evaluate the performance of a novel infrared inorganic scintillator detector (IR-ISD) in the radiation therapy treatment to ensure Cerenkov free signal and the best matches between the delivered and prescribed doses during treatment. Methods: A simple and small-scale infrared inorganic scintillating detector of 100 µm diameter with a sensitive scintillating volume of 2x10-6 mm3 was developed. A prototype of the dose verification system has been introduced based on PTIR1470/F (provided by Phosphor Technology®) material used in the proposed novel IR-ISD. The detector was tested on an Elekta LINAC system tuned at 6 MV/15MV and a brachytherapy source (Ir-192) used in the patient treatment protocol. The associated dose rate was measured in count rate (photons/s) using a highly sensitive photon counter (sensitivity ~20ph/s). Overall measurements were performed in IBATM water tank phantoms by following international Technical Reports series recommendations (TRS 381) for radiotherapy and TG43U1 recommendations for brachytherapy. The performance of the detector was tested through several dosimetric parameters such as PDD, beam profiling, Cerenkov measurement, dose linearity, dose rate linearity repeatability, and scintillator stability. Finally, a comparative study is also shown using a reference microdiamond dosimeter, Monte-Carlo (MC) simulation, and data from recent literature. Results: This study is highlighting the complete removal of the Cerenkov effect especially for small field radiation beam characterization. The detector provides an entire linear response with the dose in the 4cGy to 800 cGy range, independently of the field size selected from 5 x 5 cm² down to 0.5 x 0.5 cm². A perfect repeatability (0.2 % variation from average) with day-to-day reproducibility (0.3% variation) was observed. Measurements demonstrated that ISD has superlinear behavior with dose rate (R2=1) varying from 50 cGy/s to 1000 cGy/s. PDD profiles obtained in water present identical behavior with a build-up maximum depth dose at 15 mm for different small fields irradiation. A low dimension of 0.5 x 0.5 cm² field profiles have been characterized, and the field cross profile presents a Gaussian-like shape. The standard deviation (1σ) of the scintillating signal remains within 0.02% while having a very low convolution effect, thanks to lower sensitive volume. Finally, during brachytherapy, a comparison with MC simulations shows that considering energy dependency, measurement agrees within 0.8% till 0.2 cm source to detector distance. Conclusion: The proposed scintillating detector in this study shows no- Cerenkov radiation and efficient performance for several radiation therapy measurement parameters. Therefore, it is anticipated that the IR-ISD system can be promoted to validate with direct clinical investigations, such as appropriate dose verification and quality control in the Treatment Planning System (TPS).

Keywords: IR-Scintillating detector, dose measurement, micro-scintillators, Cerenkov effect

Procedia PDF Downloads 167

Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi

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Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.

Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery

Procedia PDF Downloads 218