Search results for: clinical simulation

Authors: Alejandra Sierra, Gloria Valadez, Adriana Dávalos, Mirliana Ramírez

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For years, the Pan American Health Organization/World Health Organization and other organizations have made efforts to the improve access and the quality of prenatal care as part of comprehensive programs for maternal and neonatal health, the standards of care have been renewed in order to migrate from a medical perspective to a holistic perspective. However, despite the efforts currently antenatal care models have not been verified by a scientific evaluation in order to determine their effectiveness. The teenage pregnancy is considered as a very important phenomenon since it has been strongly associated with inequalities, poverty and the lack of gender quality; therefore it is important to analyze the antenatal care that’s been given, including not only the clinical intervention but also the activities surrounding the advertising and the health education. In this study, the objective was to describe if the previously established activities (on the prenatal care models) are being performed in the care of pregnant teenagers attending prenatal care in health institutions in two cities in México and Chile during 2013. Methods: Observational and descriptive study, of a transversal cohort. 170 pregnant women (13-19 years) were included in prenatal care in two health institutions (100 women from León-Mexico and 70 from Chile-Coquimbo). Data collection: direct survey, perinatal clinical record card which was used as checklists: WHO antenatal care model WHO-2003, Official Mexican Standard NOM-007-SSA2-1993 and Personalized Service Manual on Reproductive Process- Chile Crece Contigo; for data analysis descriptive statistics were used. The project was approved by the relevant ethics committees. Results: Regarding the fulfillment of interventions focused on physical, gynecological exam, immunizations, monitoring signs and biochemical parameters in both groups was met by more than 84%; the activities of guidance and counseling pregnant teenagers in Leon compliance rates were below 50%, on the other hand, although pregnant women in Coquimbo had a higher percentage of compliance, no one reached 100%. The topics that less was oriented were: family planning, signs and symptoms of complications and labor. Conclusions: Although the coverage of the interventions indicated in the prenatal care models was high, there were still shortcomings in the fulfillment of activities to orientation, education and health promotion. Deficiencies in adherence to prenatal care guidelines could be due to different circumstances such as lack of registration or incomplete filling of medical records, lack of medical supplies or health personnel, absences of people at prenatal check-up appointments, among many others. Therefore, studies are required to evaluate the quality of prenatal care and the effectiveness of existing models, considering the role of the different actors (pregnant women, professionals and health institutions) involved in the functionality and quality of prenatal care models, in order to create strategies to design or improve the application of a complete process of promotion and prevention of maternal and child health as well as sexual and reproductive health in general.

Keywords: adolescent health, health systems, maternal health, primary health care

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Authors: Young June Yoon

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We will present four different topics in estimating the mechanical properties of biological tissues. First we elucidate the viscoelastic behavior of collagen molecules whose diameter is a couple of nanometers. By using the molecular dynamics simulation, we observed the viscoelastic behavior in different pulling velocity. Second, the protein layer, so called ‘sheath’ in enamel microstructure reduces the stress concentration in enamel minerals. We examined the result by using the finite element methods. Third, the anisotropic elastic constants of dentin are estimated by micromechanical analysis and estimated results are close to the experimentally measured data. Last, new formulation between the fabric tensor and the wave velocity is established for calcaneus by employing the poroelasticity. This formulation can be simply used for future experiments.

Keywords: tissues, mechanics, mechanical properties, wave propagation

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Authors: Kais Manai

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The main part of this work focuses on the study of pion/muon separation at low energy using a nuclear Emulsion Cloud Chamber (ECC) made of lead and nuclear emulsion films. The work consists of two parts: particle reconstruction algorithm and a Neural Network that assigns to each reconstructed particle the probability to be a muon or a pion. The pion/muon separation algorithm has been optimized by using a detailed Monte Carlo simulation of the ECC and tested on real data. The algorithm allows to achieve a 60% muon identification efficiency with a pion misidentification smaller than 3%.

Keywords: nuclear emulsion, particle identification, tracking, neural network

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Authors: Min Kyung An, Hyuk Cho

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In this paper, we study the Minimum Latency Broadcast Scheduling (MLBS) problem in wireless sensor networks (WSNs). The main issue of the MLBS problem is to compute schedules with the minimum number of timeslots such that a base station can broadcast data to all other sensor nodes with no collisions. Unlike existing works that utilize the traditional omni-directional WSNs, we target the directional WSNs where nodes can collaboratively determine and orientate their antenna directions. We first develop a 7-approximation algorithm, adopting directional WSNs. Our ratio is currently the best, to the best of our knowledge. We then validate the performance of the proposed algorithm through simulation.

Keywords: broadcast, collision-free, directional antenna, approximation, wireless sensor networks

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Authors: Ravi Teja Mandapaka, Prasanna Kumar Kukkamalla

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Poor absorption of calcium, elevated levels in serum and loss of bone are major problems of astronauts during space travel. Supplementation of calcium could not reveal this problem. In normal condition only 33% of calcium is absorbed from dietary sources. In this paper effect of space environment on calcium metabolism was discussed. Many surprising study findings were found during literature survey. Clinical trials on ovariectomized mice showed that reduction of calcium particles to nano level make them more absorbable and bioavailable. Control of bone loss in astronauts in critical important In Fortification of milk with nana calcium particles showed reduces urinary pyridinoline, deoxypyridinoline levels. Dietary calcium and supplementation do not show much retention of calcium in zero gravity environment where absorption is limited. So, the fortification of foods with nano calcium particles seemed beneficial for astronauts during and after space travel in their speedy recovery.

Keywords: nano calcium, astronauts, fortification, supplementation

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Authors: An-Shik Yang, Chin-Ting Kuo, Yung-Chun Yang, Wen-Hsin Hsieh, Chiang-Ho Cheng

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Optical biosensors have become a powerful detection and analysis tool for wide-ranging applications in biomedical research, pharmaceuticals and environmental monitoring. This study carried out the computational fluid dynamics (CFD)-based simulations to explore the dispersion phenomenon in the microchannel of a optical biosensor. The predicted time sequences of concentration contours were utilized to better understand the dispersion development occurred in different geometric shapes of microchannels. The simulation results showed the surface concentrations at the sensing probe (with the best performance of a grating coupler) in respect of time to appraise the dispersion effect and therefore identify the design configurations resulting in minimum dispersion.

Keywords: CFD simulations, dispersion, microfluidic, optical waveguide sensors

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Authors: Talha Ali Khan

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This paper presents an adaptive neuro-fuzzy interference system (ANFIS), which is applied to a hybrid stepper motor (HSM) to regulate its speed. The dynamic response of the HSM with the ANFIS controller is studied during the starting process and under different load disturbance. The effectiveness of the proposed controller is compared with that of the conventional PI controller. The proposed method solves the problem of nonlinearities and load changes of the HSM drives. The proposed controller ensures fast and precise dynamic response with an excellent steady state performance. Matlab/Simulink program is used for this dynamic simulation study.

Keywords: stepper motor, hybrid, ANFIS, speed control

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Authors: S. Srinivasan, E. Cretu

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The information flow (e.g. block-diagram or signal flow graph) paradigm for the design and simulation of Microelectromechanical (MEMS)-based systems allows to model MEMS devices using causal transfer functions easily, and interface them with electronic subsystems for fast system-level explorations of design alternatives and optimization. Nevertheless, the physical bi-directional coupling between different energy domains is not easily captured in causal signal flow modeling. Moreover, models of fundamental components acting as building blocks (e.g. gap-varying MEMS capacitor structures) depend not only on the component, but also on the specific excitation mode (e.g. voltage or charge-actuation). In contrast, the energy flow modeling paradigm in terms of generalized across-through variables offers an acausal perspective, separating clearly the physical model from the boundary conditions. This promotes reusability and the use of primitive physical models for assembling MEMS devices from primitive structures, based on the interconnection topology in generalized circuits. The physical modeling capabilities of Simscape have been used in the present work in order to develop a MEMS library containing parameterized fundamental building blocks (area and gap-varying MEMS capacitors, nonlinear springs, displacement stoppers, etc.) for the design, simulation and optimization of MEMS inertial sensors. The models capture both the nonlinear electromechanical interactions and geometrical nonlinearities and can be used for both small and large signal analyses, including the numerical computation of pull-in voltages (stability loss). Simscape behavioral modeling language was used for the implementation of reduced-order macro models, that present the advantage of a seamless interface with Simulink blocks, for creating hybrid information/energy flow system models. Test bench simulations of the library models compare favorably with both analytical results and with more in-depth finite element simulations performed in ANSYS. Separate MEMS-electronic integration tests were done on closed-loop MEMS accelerometers, where Simscape was used for modeling the MEMS device and Simulink for the electronic subsystem.

Keywords: across-through variables, electromechanical coupling, energy flow, information flow, Matlab/Simulink, MEMS, nonlinear, pull-in instability, reduced order macro models, Simscape

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Authors: H. Al-Hajeri

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The computation of the effectiveness of turbulence enhancement surface features, such as ribs as means of promoting mixing and hence heat transfer, has attracted the continued attention of the engineering community. In this study, the simulation of a three-dimensional cooling passage is carried out employing a number of turbulence models including Durbin model. The cooling passage consists of a square section duct whose upper and lower surfaces feature staggered cuboid ribs. The main objective of this paper is to provide comparisons of the performance of the v2-f model against other established turbulence models as implemented in the commercial CFD code Ansys Fluent. The present study demonstrates that the v2-f model can successfully capture the isothermal air flow phenomena in flow over obstacles.

Keywords: CFD, cooling passage, Durbin model, turbulence model

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Authors: Tassadit Tabouche

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Water sprays pattern, and water droplets size (different droplets diameter) are a key factors in the success of the suppression by water spray. The effects of the two important factors are investigated in this study. However, the fire extinguishing mechanism in such devices is not well understood due to the complexity of the physical and chemical interactions between water spray and fire plume. in this study, 3D, unsteady, two phase flow CFD simulation approach is introduced to provide a quantitative analysis of the complex interactions occurring between water spray and fire plume. Lagrangian Discrete Phase Model (DPM) was used for water droplets and a global one-step reaction mechanism in combustion model was used for fire plume.

Keywords: droplets, water spray, water droplets size, 3D

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Authors: Mert Turanli, Hakan Temeltas

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In this paper, we propose a new approach to coverage control problem by using adaptive coordination and power aware control laws. Nonholonomic mobile nodes position themselves suboptimally according to a time-varying density function using Centroidal Voronoi Tesellations. The Lyapunov stability analysis of the adaptive and decentralized approach is given. A linear consensus protocol is used to establish synchronization among the mobile nodes. Also, repulsive forces prevent nodes from collision. Simulation results show that by using power aware control laws, energy consumption of the nodes can be reduced.

Keywords: power aware, coverage control, adaptive, consensus, nonholonomic, coordination

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Authors: Adil Rasheed, Mandar Tabib

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The paper describes the ability of a high-resolution Computational Fluid Dynamics model to predict terrain-induced turbulence and wind shear close to the ground. Various sensitivity studies to choose the optimal simulation setup for modeling the flow characteristics in a complex terrain are presented. The capabilities of the model are demonstrated by applying it to the Sandnessjøen Airport, Stokka in Norway, an airport that is located in a mountainous area. The model is able to forecast turbulence in real time and trigger an alert when atmospheric conditions might result in high wind shear and turbulence.

Keywords: aviation safety, terrain-induced turbulence, atmospheric flow, alert system

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Authors: Mehran Dizbadi, Daniyal Safarzadeh, Behrooz Arastoo, Ansgar Brunn

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Rapid and uncontrolled expansion of cities has led to unplanned aerial development. In this way, modeling and predicting the urban growth of a city helps decision-makers. In this study, the aspect of sustainable urban development has been studied for the city of Mashhad. In general, the prediction of urban aerial development is one of the most important topics of modern town management. In this research, using the Cellular Automaton (CA) model developed for geo data of Geographic Information Systems (GIS) and presenting a simple and powerful model, a simulation of complex urban processes has been done.

Keywords: urban modeling, sustainable development, fuzzy cellular automaton, geo-information system

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Authors: Nur Irmawati, H. A. Mohammed

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In the present study, mixed convection in a horizontal rectangular duct using Al2O3 is numerically investigated. The effects of different Rayleigh number, Reynolds number and radiation on flow and heat transfer characteristics were studied in detail. This study covers Rayleigh number in the range of 2×106≤Ra≤2×107 and Reynolds number in the range of 100≤Re≤1100. Results reveal that the Nusselt number increases as Reynolds and Rayleigh numbers increase. It was also found that the dimensionless temperature distribution increases as Rayleigh number increases.

Keywords: numerical simulation, mixed convection, horizontal rectangular duct, nanofluids

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Authors: Ren Zuo Wang

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In this paper, in order to investigate the behavior of the wood structure, the non-linearity of wood material model in LS-DYNA is adopted. It is difficult and less efficient to conduct the experiment of the ancient wood structure, hence LS-DYNA software can be used to simulate nonlinear responses of ancient wood structure. In LS-DYNA software, there is material model called *MAT_WOOD or *MAT_143. This model is to simulate a single-element response of the wood subjected to tension and compression under the parallel and the perpendicular material directions. Comparing with the exact solution and numerical simulations results using LS-DYNA, it demonstrates the accuracy and the efficiency of the proposed simulation method.

Keywords: LS-DYNA, wood structure, single-element simulations, MAT_143

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Authors: Hsin-Yi Kathy Cheng, Yan-Ying JU, Wann-Yun Shieh, Chin-Man Wang

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Although the coordination of swallowing and respiration has been discussed widely, the influence of the positioning angle on swallowing and respiration during feeding has rarely been investigated. This study aimed to investigate the timing and coordination of swallowing and respiration in different seat inclination angles, with liquid and bolus, to provide suggestions and guidelines for the design and develop a feedback-controlled seat angle adjustment device for the back-adjustable wheelchair. Twenty-six participants aged between 15-30 years old without any signs of swallowing difficulty were included. The combination of seat inclinations and food types was randomly assigned, with three repetitions in each combination. The trunk inclination angle was adjusted by a commercialized positioning wheelchair. A total of 36 swallows were done, with at least 30 seconds of rest between each swallow. We used a self-developed wearable device to measure the submandibular muscle surface EMG, the movement of the thyroid cartilage, and the respiratory status of the nasal cavity. Our program auto-analyzed the onset and offset of duration, and the excursion and strength of thyroid cartilage when it was moving, coordination between breathing and swallowing were also included. Variables measured include the EMG duration (DsEMG), swallowing apnea duration (SAD), total excursion time (TET), duration of 2nd deflection, FSR amplitude, Onset latency, DsEMG onset, DsEMG offset, FSR onset, and FSR offset. These measurements were done in four-seat inclination angles (5。, 15。, 30。, 45。) and three food contents (1ml water, 10ml water, and 5ml pudding bolus) for each subject. The data collected between different contents were compared. Descriptive statistics were used to describe the basic features of the data. Repeated measure ANOVAs were used to analyze the differences for the dependent variables in different seat inclination and food content combinations. The results indicated significant differences in seat inclination, mostly between 5。 and 45。, in all variables except FSR amplitude. It also indicated significant differences in food contents almost among all variables. Significant interactions between seat inclination and food contents were only found in FSR offsets. The same protocol will be applied to participants with disabilities. The results of this study would serve as clinical guidance for proper feeding positions with different food contents. The ergonomic data would also provide references for assistive technology professionals and practitioners in device design and development. In summary, the current results indicated that it is easier for a subject to lean backward during swallowing than when sitting upright and swallowing water is easier than swallowing pudding. The results of this study would serve as the clinical guidance for proper feeding position (such as wheelchair back angle adjustment) with different food contents. The same protocol can be applied to elderly participants or participants with physical disabilities. The ergonomic data would also provide references for assistive technology professionals and practitioners in device design and development.

Keywords: swallowing, positioning, assistive device, disability

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Authors: Tertia Delia Nova, Masaji Watanabge

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Infection of bird flu within a poultry farm involves hosts, virus, and medium. Intrusion of bird flu into a poultry farm divides the population into two groups; healthy and susceptible chickens and infected chickens. A healthy and susceptible bird is infected to become an infected bird. Bird flu viruses spread among chickens through medium such as air and droppings, and increase in hosts. A model for an infection process of bird flu within a poultry farm is described, numerical techniques are illustrated, and numerical results are introduced.

Keywords: bird flu, poultry farm, model for an infection process, flu viruses

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Authors: Khalid A. Alsaif, Mosaad A. Foda

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The primary objective of this study is to develop the first round of road traffic noise maps for Riyadh City using Geographical Information Systems (GIS) and software LimA 7810 predictor. The road traffic data were measured or estimated as accurate as possible in order to obtain reliable noise maps. Meanwhile, the attributes of the roads and buildings are automatically exported from GIS. The simulation results at some chosen locations are validated by actual field measurements, which are obtained by a system that consists of a sound level meter, a GPS receiver and a database to manage the measured data. The results show that the average error between the predicted and measured noise levels is below 3.0 dB.

Keywords: noise pollution, road traffic noise, LimA predictor, GIS

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Authors: T. Mohammed Chikouche, K. Hartani

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In order to solve the instantaneous power ripple and achieve better performance of direct power control (DPC) for a three-phase PWM rectifier, a control method is proposed in this paper. This control method is applied to overcome the instantaneous power ripple, to eliminate line current harmonics and therefore reduce the total harmonic distortion and to improve the power factor. A switching table is based on the analysis on the change of instantaneous active and reactive power, to select the optimum switching state of the three-phase PWM rectifier. The simulation result shows feasibility of this control method.

Keywords: power quality, direct power control, power ripple, switching table, unity power factor

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Authors: Engin Metin Kaplan, Kemal Yaman

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In this study, the crash of a medium heavy vehicle onto a designed Road blocker (vehicle barrier) is studied numerically. Structural integrity of the Road blocker is studied by nonlinear dynamic methods under the loading conditions which are defined in the standards. NASTRAN® and LS-DYNA® which are commercial software are used to solve the problem. Outer geometry determination, alignment of the inner part and material properties of the road blocker are studied linearly to yield design parameters. Best design parameters are determined to achieve the most structurally optimized road blocker. Strain and stress values of the vehicle barrier are obtained by solving the partial differential equations.

Keywords: vehicle barrier, truck collision, road blocker, crash analysis

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Authors: Hazem M. Al-Mofleh, John E. Daniels, Joseph W. McKean

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In this paper numerous robust fitting procedures are considered in estimating spatial variograms. In spatial statistics, the conventional variogram fitting procedure (non-linear weighted least squares) suffers from the same outlier problem that has plagued this method from its inception. Even a 3-parameter model, like the variogram, can be adversely affected by a single outlier. This paper uses the Hogg-Type adaptive procedures to select an optimal score function for a rank-based estimator for these non-linear models. Numeric examples and simulation studies will demonstrate the robustness, utility, efficiency, and validity of these estimates.

Keywords: asymptotic relative efficiency, non-linear rank-based, rank estimates, variogram

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Authors: Farhat Hajer, Khir Tahar, Ammar Ben Brahim

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This work presents a study on the influence of the main operating variables on the gas turbine cycle. A numerical simulation of a gas turbine cycle is performed for a real net power of 100 MW. A calculation code is developed using EES software. The operating variables are taken in conformity with the local environmental conditions adopted by the Tunisian Society of Electricity and Gas. Results show that the increase of ambient temperature leads to an increase of Tpz and NO_x emissions rate and a decrease of cycle efficiency and UHC emissions. The CO emissions decrease with the raise of residence time, while NO_x emissions rate increases and UHC emissions rate decreases. Furthermore, both of cycle efficiency and NOx emissions increase with the increase of the pressure ratio.

Keywords: Carbon monoxide, Efficiency, Emissions, Gas Turbine, Nox, UHC

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Authors: Rim Frikha, Nouha Bouayed, Afifa Sellami, Nozha Chakroun, Salima Douad, Leila Keskes, Tarek Rebai

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Recurrent pregnancy loss (RPL), classically defined as the occurrence of two or more failed pregnancies, is a serious reproductive problem, in which, chromosomal rearrangements in either carrier are a major cause; mainly the chromosome aneuploidy. This study was conducted to determine the frequency and contribution of X-chromosome aneuploidy in recurrent pregnancy loss. A retrospective study was carried out among 100 couples with more than 2 miscarriages, referred to our genetic counseling. In all the cases the detailed reproductive histories were taken. Chromosomal analysis was performed using RHG banding in peripheral blood. Of a total of 100 couples; 3 patients with a detected X-chromosome aneuploidy were identified with an overall frequency of 3%. Chromosome abnormalities are as below: a Turner syndrome with 45, X/46, XX mosaicism, a 47, XXX, and a Klinefelter syndrome with 46, XY/47, XXY. These data show a high incidence of X-chromosome aneuploidy; mainly with mosaicism; in RPL. Thus, couples with such chromosomal abnormality should be referred to a clinical geneticist with whom the option of pre-implantation genetic diagnosis in subsequent pregnancy should be discussed.

Keywords: aneuploidy, genetic testing, recurrent pregnancy loss, X-chromosome

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Authors: Ilker Ali Ozkan

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In this study, an artificial neural network model has been developed to estimate chronic kidney failure which is a common disease. The patients’ age, their blood and biochemical values, and 24 input data which consists of various chronic diseases are used for the estimation process. The input data have been subjected to preprocessing because they contain both missing values and nominal values. 147 patient data which was obtained from the preprocessing have been divided into as 70% training and 30% testing data. As a result of the study, artificial neural network model with 25 neurons in the hidden layer has been found as the model with the lowest error value. Chronic kidney failure disease has been able to be estimated accurately at the rate of 99.3% using this artificial neural network model. The developed artificial neural network has been found successful for the estimation of chronic kidney failure disease using clinical data.

Keywords: estimation, artificial neural network, chronic kidney failure disease, disease diagnosis

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Authors: Usha Barahmand, Ali Khazaee, Goudarz Sadeghi Hashjin

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The purpose of this study is to assess the relative mediating effects of impulsivity and internalizing problems in the relationship between childhood neglect and motives for opiate use. Seventy-two adolescent opiate users were recruited for the study. Participants completed assessments of childhood abuse history, distress, impulsiveness and motives for substance use as well as a socio-demographic information sheet. Findings from bootstrap mediator analyses indicated that distress, but not impulsiveness, mediated the relationship between childhood emotional abuse and expansion and enhancement motives for substance use. The current study provides preliminary evidence that internalizing problems may function as a mechanism linking prior childhood experiences of emotional neglect to subsequent motives for substance use. Clinical implications of these findings suggest that targeting emotion dysregulation problems may be an effective adjunct in the treatment of adolescents with a history of childhood maltreatment that are at risk for substance use.

Keywords: childhood neglect, impulsiveness, internalizing problems, substance use motives

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Authors: Roxana Maria Angelescu, Raluca Ion, Anişoara Cîmpean, Doina Răducanu, Mariana Lucia Angelescu

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In an attempt to find titanium alloys that fulfill the requirements for mechanical and biological compatibility, laboratory and material related tests were performed during the years, as well as preclinical and clinical trials. The multidisciplinary scientific research facilitates the global evaluation of biocompatibility and osseointegration regarding the dental implant alloys. The aim of this study was to determine the in vitro biocompatibility of three modern titanium alloys: Ti-31.7Nb-6.21Zr-1.4Fe-0.16O (wt%), Ti-36.5Nb-4.5Zr-3Ta-0.16O (wt%) and Ti-20Nb-5Ta (wt%), in order to establish whether the use of these titanium alloys can have any toxic or injurious effects on biological systems. The commonly used Ti-6Al-4V alloy was investigated as a reference material. The behavior of MC3T3-E1 pre-osteoblasts on all these four metallic surfaces was evaluated. The tests of immunofluorescence, cytotoxicity and cellular proliferation lead to the conclusion that the newly-developed titanium alloys elicit a good cellular response in terms of cellular survival, adhesion, morphology and proliferative potential as well.

Keywords: biocompatibility tests, dental implants, titanium alloys, biomedical engineering

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Authors: Ghania Zidani, Said Drid, Larbi Chrifi-Alaoui, Abdeslam Benmakhlouf, Souad Chaouch

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In this paper, we focus on the study for path tracking control of unicycle-type Wheeled Mobile Robots (WMR), by applying the Backstepping technic. The latter is a relatively new technic for nonlinear systems. To solve the problem of constraints nonholonomics met in the path tracking of such robots, an adaptive Backstepping based nonlinear controller is developed. The stability of the controller is guaranteed, using the Lyapunov theory. Simulation results show that the proposed controller achieves the objective and ensures good path tracking.

Keywords: Backstepping control, kinematic and dynamic controllers, Lyapunov methods, nonlinear control systems, Wheeled Mobile Robot (WMR).

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Authors: D. Estrella, A. Silva, R. Zapata, H. Rubio

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A total of 100 primary caregivers (mothers, fathers, grandparents) with at least one child or grandchild with a diagnosis of congenital bilateral profound deafness were assessed in order to evaluate the functionality of families with a deaf member, who was evaluated by specialists in audiology, molecular biology, genetics and psychology. After confirmation of the clinical diagnosis, DNA from the patients and parents were analyzed in search of the 35delG deletion of the GJB2 gene to determine who possessed the mutation. All primary caregivers were provided psychological support, regardless of whether or not they had the mutation, and prior and subsequent, the family APGAR test was applied. All parents, grandparents were informed of the results of the genetic analysis during the psychological intervention. The family APGAR, after psychological and genetic counseling, showed that 14% perceived their families as functional, 62% moderately functional and 24% dysfunctional. This shows the importance of psychological support in family functionality that has a direct impact on the quality of life of these families.

Keywords: deafness, psychological support, family, adaptation to disability

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Authors: M. G. Nasuruddin, S. Ishak

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This paper deals with the traditional Malay healing ritualistic ceremony known as Main Puteri. This non-invasive intervention uses the vehicle of performance to administer the healing process. It employs the performance elements of Makyung, that is, music, movements/dance, and dramatic dialogue to heal psychosomatic maladies. There are two perspectives to this therapeutic healing process, one traditional and the other scientific. From the traditional perspective, the psychosomatic illness is attributed to the infestations/possessions by malevolent spirits. To heal such patients, these spirits must be exorcised through placating them by making offerings. From the scientific perspective, the music (sonic orders), movements (kinetic energy), and smell (olfactory) connect with the brain waves to release the chemicals that would activate the internal healing energy. Currently, in Main Puteri, the therapeutic healing ritual is no longer relevant as modern clinical medicine has proven to be more effective. Thus, Main Puteri is an anachronism in today’s technologically advanced Malaysia.

Keywords: exorcism, main puteri, shamans, therapeutic healing

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Authors: Angelis P. Barlampas

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The aim of this work is to denote that during an emergency state, an examination study may not be accomplished by state-of-the-art of imaging and, therefore, cannot obviously reveal all the existing findings. But, such a situation may have disastrous consequences for the patient. When interpreting radiological images, one must try to be as meticulous as possible, especially if the patient has alerting clinical symptoms. A case may be missed because its findings are not so obvious in rapid uncompleted radiological imaging. A thirty-seven years old female patient visited the emergency department because of a headache and hemiparesis of her left leg. Firstly, a CT examination without contrast was done, and mild serpentinous hyperintensities were depicted at the right parietal lobe. In addition to that, there was a linear, mildly hyperattenuating structure resembling a vessel in the nearby middle line. At first, an AVM was suspected, so an MRI examination with i.v. Gd was prescribed. The patient returned a few days later, not having done the MRI and complaining of persisting symptomatology. A new CT examination without and with i.v.c administration was done that showed no hyperintensities but a type-enhancing vessel in the posterior interhemispheric fissure. The latest findings are consistent with a venous malformation with previous bleeding.

Keywords: bleeding, brain, CNS, hemorrhage, CT, venous malformation

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