Search results for: simulated patient

Authors: Vijay Shankar

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In the era of water scarcity, effective use of water via irrigation requires good methods for determining crop water needs. Implementation of irrigation scheduling programs requires an accurate estimate of water use by the crop. Moisture depletion from the root zone represents the consequent crop evapotranspiration (ET). A numerical model for simulating soil water depletion in the root zone has been developed by taking into consideration soil physical properties, crop and climatic parameters. The governing differential equation for unsaturated flow of water in the soil is solved numerically using the fully implicit finite difference technique. The water uptake by plants is simulated by using three different sink functions. The non-linear model predictions are in good agreement with field data and thus it is possible to schedule irrigations more effectively. The present paper describes irrigation scheduling based on moisture depletion from the different layers of the root zone, obtained using different sink functions for three cash, oil and forage crops: cotton, safflower and barley, respectively. The soil is considered at a moisture level equal to field capacity prior to planting. Two soil moisture regimes are then imposed for irrigated treatment, one wherein irrigation is applied whenever soil moisture content is reduced to 50% of available soil water; and other wherein irrigation is applied whenever soil moisture content is reduced to 75% of available soil water. For both the soil moisture regimes it has been found that the model incorporating a non-linear sink function which provides best agreement of computed root zone moisture depletion with field data, is most effective in scheduling irrigations. Simulation runs with this moisture uptake function result in saving 27.3 to 45.5% & 18.7 to 37.5%, 12.5 to 25% % &16.7 to 33.3% and 16.7 to 33.3% & 20 to 40% irrigation water for cotton, safflower and barley respectively, under 50 & 75% moisture depletion regimes over other moisture uptake functions considered in the study. Simulation developed can be used for an optimized irrigation planning for different crops, choosing a suitable soil moisture regime depending upon the irrigation water availability and crop requirements.

Keywords: irrigation water, evapotranspiration, root uptake models, water scarcity

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Authors: Bartosz Kedra, Robert Malkowski

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This paper provides description and presentation of laboratory test unit built basing on 150 kVA power frequency converter and Simulink RealTime platform. Assumptions, based on criteria which load and generator types may be simulated using discussed device, are presented, as well as control algorithm structure. As laboratory setup contains transformer with thyristor controlled tap changer, a wider scope of setup capabilities is presented. Information about used communication interface, data maintenance, and storage solution as well as used Simulink real-time features is presented. List and description of all measurements are provided. Potential of laboratory setup modifications is evaluated. For purposes of Rapid Control Prototyping, a dedicated environment was used Simulink RealTime. Therefore, load model Functional Unit Controller is based on a PC computer with I/O cards and Simulink RealTime software. Simulink RealTime was used to create real-time applications directly from Simulink models. In the next step, applications were loaded on a target computer connected to physical devices that provided opportunity to perform Hardware in the Loop (HIL) tests, as well as the mentioned Rapid Control Prototyping process. With Simulink RealTime, Simulink models were extended with I/O cards driver blocks that made automatic generation of real-time applications and performing interactive or automated runs on a dedicated target computer equipped with a real-time kernel, multicore CPU, and I/O cards possible. Results of performed laboratory tests are presented. Different load configurations are described and experimental results are presented. This includes simulation of under frequency load shedding, frequency and voltage dependent characteristics of groups of load units, time characteristics of group of different load units in a chosen area and arbitrary active and reactive power regulation basing on defined schedule.

Keywords: MATLAB, power converter, Simulink Real-Time, thyristor-controlled tap changer

Procedia PDF Downloads 321

Authors: Sugeng Rianto, P.W. Arinto Yudi, Soemarno Muhammad Nurhuda

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A computation of a 3D compressible fluid flow for virtual environment with haptic interaction can be a non-trivial issue. This is especially how to reach good performances and balancing between visualization, tactile feedback interaction, and computations. In this paper, we describe our approach of computation methods based on parallel programming on a GPU. The 3D fluid flow solvers have been developed for smoke dispersion simulation by using combinations of the cubic interpolated propagation (CIP) based fluid flow solvers and the advantages of the parallelism and programmability of the GPU. The fluid flow solver is generated in the GPU-CPU message passing scheme to get rapid development of haptic feedback modes for fluid dynamic data. A rapid solution in fluid flow solvers is developed by applying cubic interpolated propagation (CIP) fluid flow solvers. From this scheme, multiphase fluid flow equations can be solved simultaneously. To get more acceleration in the computation, the Navier-Stoke Equations (NSEs) is packed into channels of texel, where computation models are performed on pixels that can be considered to be a grid of cells. Therefore, despite of the complexity of the obstacle geometry, processing on multiple vertices and pixels can be done simultaneously in parallel. The data are also shared in global memory for CPU to control the haptic in providing kinaesthetic interaction and felling. The results show that GPU based parallel computation approaches provide effective simulation of compressible fluid flow model for real-time interaction in 3D computer graphic for PC platform. This report has shown the feasibility of a new approach of solving the compressible fluid flow equations on the GPU. The experimental tests proved that the compressible fluid flowing on various obstacles with haptic interactions on the few model obstacles can be effectively and efficiently simulated on the reasonable frame rate with a realistic visualization. These results confirm that good performances and balancing between visualization, tactile feedback interaction, and computations can be applied successfully.

Keywords: CIP, compressible fluid, GPU programming, parallel computation, real-time visualisation

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Authors: Xin Qi Dong, Melissa Simon

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Aims: Elder mistreatment and suicidal ideation are important public health concerns among aging populations. This study will examine the association between elder mistreatment and suicidal ideation among Chinese older adults in the USA. Methods: Guided by a community-based participatory research approach, in this study we conducted in-person interviews with Chinese older adults aged 60 years and older in the Greater Chicago area from 2011 to 2013. Elder mistreatment was assessed by a 10-item instrument derived from the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Results: Overall, 3,159 Chinese older adults participated in this study, and their mean age was 72.8 years. After controlling for age, gender, education, income, medical comorbidities, depressive symptoms, and social support, elder mistreatment was significantly associated with 2-week suicidal ideation (OR 2.46, 95% CI 1.52--4.01) and 12-month suicidal ideation (OR 2.46, 95% CI 1.62--3.73). With respect to gender differences, the study found that the association remained significant for older women but not for older men after adjusting for all confounding factors. Conclusion: As the largest epidemiology study conducted among Chinese older adults in the USA, this study suggests that elder mistreatment is significantly associated with 2-week and 12-month suicidal ideation in older women but not in older men. Longitudinal studies should be conducted to explore the mechanisms through which elder mistreatment links with suicidal ideation.

Keywords: suicidal ideation, elder abuse, family violence, Asian health equity

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Authors: Ritwik Dutta, Marylin Wolf

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This paper describes the trade-offs and the design from scratch of a self-contained, easy-to-use health dashboard software system that provides customizable data tracking for patients in smart homes. The system is made up of different software modules and comprises a front-end and a back-end component. Built with HTML, CSS, and JavaScript, the front-end allows adding users, logging into the system, selecting metrics, and specifying health goals. The back-end consists of a NoSQL Mongo database, a Python script, and a SimpleHTTPServer written in Python. The database stores user profiles and health data in JSON format. The Python script makes use of the PyMongo driver library to query the database and displays formatted data as a daily snapshot of user health metrics against target goals. Any number of standard and custom metrics can be added to the system, and corresponding health data can be fed automatically, via sensor APIs or manually, as text or picture data files. A real-time METAR request API permits correlating weather data with patient health, and an advanced query system is implemented to allow trend analysis of selected health metrics over custom time intervals. Available on the GitHub repository system, the project is free to use for academic purposes of learning and experimenting, or practical purposes by building on it.

Keywords: flask, Java, JavaScript, health monitoring, long-term care, Mongo, Python, smart home, software engineering, webserver

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Authors: Saeideh Lotfi Nikoo, Azadeh Ghaheri, Reza Omani Samani

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Context: In most cultures around the globe, infertility is recognized as a crisis and exposed infertile couples are under psychosocial pressure. Indeed, the quality of life (QoL) for infertile women is lower in comparison with fertile control. Objective, The purpose of this study, was to investigate the impact of social support and hope on QoL in women undergoing infertility treatment. Methods: A cross-sectional study. Patient(s): In this cross-sectional study, 350 infertile women were recruited who were referred to an infertility clinic for the first time and had no history of Assisted Reproductive Techniques (ART) failure. Intervention(s): Questionnaires on the Fertility Quality of Life (FertiQoL), Multi-dimensional Scale of Perceived Social Support (family and friends), and Snyder Hope Scale (pathway and agency) were used to collect data. Data analysis was done by univariate and multivariate analysis. P value <0.05 was considered statistically significant. Result(s): Multivariate analysis indicated that infertile women with a higher score of social support (by family & friends) (b= 0.59 (CI 95%: 0.03, 1.15) (P = 0.040), b= 0.61 (CI 95%: 0.17, 1.04) (P = 0.006)) and hope (pathway & agency) (b= 0.94 (CI 95%: 0.29, 1.59) (P = 0.005), b= 1.13 (CI 95%: 0.45, 1.82) (P = 0.001) respectively) have significantly better Core FertiQoL. The result revealed that social support and hope are significantly and positively associated with other subscales of FertiQoL as well. Conclusions: According to the results, lifestyle interventions such as receiving social support, building a sound family with effective communication, and providing appropriate health education are of crucial importance to address psychological distress and improve the fertility QoL of women experiencing fertility problems.

Keywords: inertility, social support, infertile women, hope

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Authors: Gabriela Rivadeneyra-Romero, Claudia del C. Gutierrez Torres, Sergio A. Martinez-Delgadillo, Victor X. Mendoza-Escamilla, Alejandro Alonzo-Garcia

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Ultrasonic degradation is currently being used in sonochemical reactors to degrade pollutant compounds from aqueous media, as emerging contaminants (e.g. pharmaceuticals, drugs and personal care products.) because they can produce possible ecological impacts on the environment. For this reason, it is important to develop appropriate water and wastewater treatments able to reduce pollution and increase reuse. Pollutants such as textile dyes, aromatic and phenolic compounds, cholorobenzene, bisphenol-A and carboxylic acid and other organic pollutants, can be removed from wastewaters by sonochemical oxidation. The effect on the removal of pollutants depends on the type of the ultrasonic frequency used; however, not much studies have been done related to the behavior of the fluid into the sonoreactors operated at different ultrasonic frequencies. Based on the above, it is necessary to study the hydrodynamic behavior of the liquid generated by the ultrasonic irradiation to design efficient sonoreactors to reduce treatment times and costs. In this work, it was studied the hydrodynamic behavior of the fluid in sonochemical reactors at different frequencies (250 kHz, 500 kHz and 1000 kHz). The performances of the sonoreactors at those frequencies were simulated using computational fluid dynamics (CFD). Due to there is great sound speed gradient between piezoelectric and fluid, k-e models were used. Piezoelectric was defined as a vibration surface, to evaluate the different frequencies effect on the fluid into sonochemical reactor. Structured hexahedral cells were used to mesh the computational liquid domain, and fine triangular cells were used to mesh the piezoelectric transducers. Unsteady state conditions were used in the solver. Estimation of the dissipation rate, flow field velocities, Reynolds stress and turbulent quantities were evaluated by CFD and 2D-PIV measurements. Test results show that there is no necessary correlation between an increase of the ultrasonic frequency and the pollutant degradation, moreover, the reactor geometry and power density are important factors that should be considered in the sonochemical reactor design.

Keywords: CFD, reactor, ultrasound, wastewater

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Authors: Esra Danaci, Tugba Kavalali Erdogan, Sevil Masat, Selin Keskin Kiziltepe, Tugba Cinarli, Zeliha Koc

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This study was conducted in a descriptive and cross-sectional manner to determine that factors that influence the self-efficacy and self-sufficiency levels among oncology patients. The research was conducted between January 24, 2017 and September 24, 2017 in the oncology and hematology departments of a university hospital in Turkey with 179 voluntary inpatients. The data were collected through the Self-Sufficiency/Self-Efficacy Scale and a 29-question survey, which was prepared in order to determine the sociodemographic and clinical properties of the patients. The Self-Sufficiency/Self-Efficacy Scale is a Likert-type scale with 23 articles. The scale scores range between 23 and 115. A high final score indicates a good self-sufficiency/self-efficacy perception for the individual. The data were analyzed using percentage analysis, one-way ANOVA, Mann Whitney U-test, Kruskal Wallis test and Tukey test. The demographic data of the subjects were as follows: 57.5% were male and 42.5% were female, 82.7% were married, 46.4% were primary school graduate, 36.3% were housewives, 19% were employed, 93.3% had social security, 52.5% had matching expenses and incomes, 49.2% lived in the center of the city. The mean age was 57.1±14.6. It was determined that 22.3% of the patients had lung cancer, 19.6% had leukemia, and 43.6% had a good overall condition. The mean self-sufficiency/self-efficacy score was 83,00 (41-115). It was determined that the patients' self-sufficiency/self-efficacy scores were influenced by some of their socio-demographic and clinical properties. This study has found that the patients had high self-sufficiency/self-efficacy scores. It is recommended that the nursing care plans should be developed to improve their self-sufficiency/self-efficacy levels in the light of the patients' sociodemographic and clinical properties.

Keywords: oncology, patient, self-efficacy, self-sufficiency

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Authors: Kieren Luellman, Makenzi Rockwell, Eduardo Callegari, Nichole Haag, Chun Wu

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Multiple sclerosis (MS) is an autoimmune disorder that damages the myelin sheath of neurons in the central nervous system. The presence of Acinetobacter bacteria and anti-Acinetobacter antibodies in MS patients has led to the hypothesis that the bacteria may contribute to MS pathogenesis. In this study, the protein sequences of Acinetobacter baumannii were compared to five peptides from three mammalian myelin proteins, i.e., Proteolipid Protein (PLP): PLP 139-151, PLP 178-191, Myelin Basic Protein (MBP): MBP 84-104 and Myelin Oligodendrocyte Glycoprotein (MOG): MOG 35-55 and MOG 92-106 respectively, known to induce experimental autoimmune encephalomyelitis (EAE), a condition similar to MS. We found 11 hits (i.e., with five or more amino acid sequence similarity) in Acinetobacter baumannii, which are identical or similar to PLP139-151, 32 hits to PLP178-191, 35 to MBP 84-104, 41 hits to MOG 35-55 and 26 hits to MOG92-106. In addition, Western blotting was used to assess possible interaction between the bacterial proteins and human anti-MBP, anti-MOG, and anti-PLP antibodies produced in rabbits, corresponding to MBP 84-104, MOG 35-55, and PLP 139-151, respectively. We found that both human Polyclonal anti-MOG antibody and anti-PLP antibody recognized a protein or more proteins of the same molecular mass of around 25 kDa. in Acinetobacter baumannii. The results suggested that this/these protein(s) might potentially serve as antigen(s) to induce anti-MOG antibody and anti-PLP antibody production in mammalian B cells. The proteomic study identified 433 hits, among which the sequence of Acinetobacter baumannii protein 491 subunit A matches a previously published enzyme Acinetobacter 3-Oxoadipate CoA-Transferase, in which a fragment of its peptide was observed to recognize MS patient serum via ELISA method. Our findings might pave the road to understanding one of the pathogenesis mechanisms of MS.

Keywords: multiple sclerosis, pathogenesis, Acinetobacter baumannii, antibody recognition

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Authors: Fenni Sim

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Objectives: The purpose of the study is to examine the relationship between family functioning and level of self-efficacy: how family functioning can potentially affect self-efficacy which will eventually lead to better clinical outcomes. The hypothesis was ‘Patients on haemodialysis with perceived higher family functioning are more likely to have higher perceived level of self-efficacy’. Methods: The study was conducted with a mixed methodology of quantitative and qualitative data collection of survey and semi-structured interview respectively. The General Self-Efficacy scale and SCORE-15 were self-administered by participants. The data will be analysed with correlation analysis method using Microsoft Excel. 79 patients were recruited for the study through random sampling. 6 participants whose results did not reflect the hypothesis were then recruited for the qualitative study. Interpretive phemenological analysis was then used to analyse the qualitative data. Findings: The hypothesis was accepted that higher family functioning leads to higher perceived self-efficacy. The correlation coefficient of -0.21 suggested a mild correlation between the two variables. However, only 4.6% of the variation in perceived self-efficacy is accounted by the variation in family functioning. The qualitative study extrapolated three themes that might explain the variations in the outliers: (1) level of physical functioning affects perceived self-efficacy, (2) instrumental support from family influenced perceived level of family functioning, and self-efficacy, (3) acceptance of illness reflects higher level of self-efficacy. Conclusion: While family functioning does have an impact on perceived self-efficacy, there are many intrapersonal and physical factors that may affect self-efficacy. The concepts of family functioning and self-efficacy are more appropriately seen as complementing each other to help a patient in managing his illness. Healthcare social workers can look at how family functioning is supporting the individual needs of patients with different trajectory of ESRD and the support we can provide to improve one’s self-efficacy.

Keywords: chronic kidney disease, coping of illness, family functioning, self efficacy

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Authors: Paweł Konieczka, Lech Raczyński, Wojciech Wiślicki, Oleksandr Fedoruk, Konrad Klimaszewski, Przemysław Kopka, Wojciech Krzemień, Roman Shopa, Jakub Baran, Aurélien Coussat, Neha Chug, Catalina Curceanu, Eryk Czerwiński, Meysam Dadgar, Kamil Dulski, Aleksander Gajos, Beatrix C. Hiesmayr, Krzysztof Kacprzak, łukasz Kapłon, Grzegorz Korcyl, Tomasz Kozik, Deepak Kumar, Szymon Niedźwiecki, Dominik Panek, Szymon Parzych, Elena Pérez Del Río, Sushil Sharma, Shivani Shivani, Magdalena Skurzok, Ewa łucja Stępień, Faranak Tayefi, Paweł Moskal

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This paper develops the transformation of non-image data into 2-dimensional matrices, as a preparation stage for classification based on convolutional neural networks (CNNs). In positron emission tomography (PET) studies, CNN may be applied directly to the reconstructed distribution of radioactive tracers injected into the patient's body, as a pattern recognition tool. Nonetheless, much PET data still exists in non-image format and this fact opens a question on whether they can be used for training CNN. In this contribution, the main focus of this paper is the problem of processing vectors with a small number of features in comparison to the number of pixels in the output images. The proposed methodology was applied to the classification of PET coincidence events.

Keywords: convolutional neural network, kernel principal component analysis, medical imaging, positron emission tomography

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Authors: Cely D. Magpantay, Geolynne Marie Adel, Cire-rine Mae Concepcion, Dessa Jean Orcajada, Jorgette Andrea Santos, Orian Laurace Canaman

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Mental illness initiative is very relevant in promoting the Mental Health Bill act of 2017. In the Philippines alone, the public is more open and receptive to people at risks with a mental condition. Although it is uncommon that parents can become more psychologically unfit compared to their children, research shows that parents who are suffering from mental illness have a more significant negative effect than another family member. The impact of parent’s mental health can put their children more susceptible to acquire the same disorder. The aim of the study is to explore the lived experiences of children whose parents suffered from mental illness. It discusses how their parent's mental condition in, anyway, affects their psychological development. Using Phenomenological Qualitative Research, an in-depth, interview was conducted to five (5) consenting adults who lived with their parents diagnosed with a mental disorder. Results are clustered into four themes. The first theme is the negative emotion towards parents, the second theme is the psychosocial dynamics in caring for the patient, third is accepting the disease, and fourth is a general perspective on the family. Each themes is validated by experts and the participants. This theme generates subcomponent like isolation, shallow relationship and debt of gratitude. Along with these themes comes the fear of having a family emerged. There is a growing need to strengthen the family ties even more because of parent’s mental illness. Therefore, parental mental illness has an effect on the children’s psychological and social development.

Keywords: lived experience in Philippines, mental health, parental mental illness, psychosocial dynamics

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Authors: Amir Moslemi, Amir movafeghi, Shahab Moradi

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One of the most important challenging factors in medical images is nominated as noise.Image denoising refers to the improvement of a digital medical image that has been infected by Additive White Gaussian Noise (AWGN). The digital medical image or video can be affected by different types of noises. They are impulse noise, Poisson noise and AWGN. Computed tomography (CT) images are subjected to low quality due to the noise. The quality of CT images is dependent on the absorbed dose to patients directly in such a way that increase in absorbed radiation, consequently absorbed dose to patients (ADP), enhances the CT images quality. In this manner, noise reduction techniques on the purpose of images quality enhancement exposing no excess radiation to patients is one the challenging problems for CT images processing. In this work, noise reduction in CT images was performed using two different directional 2 dimensional (2D) transformations; i.e., Curvelet and Contourlet and Discrete wavelet transform(DWT) thresholding methods of BayesShrink and AdaptShrink, compared to each other and we proposed a new threshold in wavelet domain for not only noise reduction but also edge retaining, consequently the proposed method retains the modified coefficients significantly that result in good visual quality. Data evaluations were accomplished by using two criterions; namely, peak signal to noise ratio (PSNR) and Structure similarity (Ssim).

Keywords: computed tomography (CT), noise reduction, curve-let, contour-let, signal to noise peak-peak ratio (PSNR), structure similarity (Ssim), absorbed dose to patient (ADP)

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Authors: Husham Bayazed

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Immune responses following surgical trauma play a pivotal role in predicting postoperative outcomes from healing and recovery to postoperative complications. Postoperative complications, including infections and protracted recovery, occur in a significant number of about 300 million surgeries performed annually worldwide. Complications cause personal suffering along with a significant economic burden on the healthcare system in any community. The accurate prediction of postoperative complications and patient-targeted interventions for their prevention remain major clinical provocations. Recent Findings: Recent studies are focusing on immune dysregulation mechanisms that occur in response to surgical trauma as a key determinant of postoperative complications. Antecedent studies mainly were plunging into the detection of inflammatory plasma markers, which facilitate in providing important clues regarding their pathogenesis. However, recent Single-cell technologies, such as mass cytometry or single-cell RNA sequencing, have markedly enhanced our ability to understand the immunological basis of postoperative immunological trauma complications and to identify their prognostic biological signatures. Summary: The advent of proteomic technologies has significantly advanced our ability to predict the risk of postoperative complications. Multiomic modeling of patients' immune states holds promise for the discovery of preoperative predictive biomarkers and providing patients and surgeons with information to improve surgical outcomes. However, more studies are required to accurately predict the risk of postoperative complications in individual patients.

Keywords: immune dysregulation, postoperative complications, surgical trauma, flow cytometry

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Authors: Zehra Betül Karakoç

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Aim: The aim of our study is to determine the changement pf plantar pressure after extracorporeal shock wave therapy (ESWT) in a patient with calcaneal spur (CS). Method: Thirty patients with CS who received ESWT treatment at Kartal Yavuz Selim State Hospital between May 2020 and November 2022 participated in this study. Demographic information of the cases was obtained. Pain levels and plantar pressure were measured with Visuel Analog Scale (VAS) and pedobarography, respectively. Pedobarography measured the maximal strength, peak pressure level, and contact area values of the hind, middle, forefoot, and toes. The cases were re-evaluated 4 weeks after the application of 15 Hz, 2-3 bar, 2,000 beats ESWT for 3 sessions. 22 cases participated in the second evaluation. The data of all patients were evaluated bilaterally. Results: Pain intensity levels after treatment were statistically significantly decreased compared to before treatment (p=0.012). Maximum force and contact area values of total foot and forefoot increased significantly (p < 0.05). Conclusion: We consider that the increased max force value of total foot and forefoot area after ESWT is due to the normal walking rate gained related to decreased pain. ESWT treatment may have positive effects on foot pressure distribution and body biomechanics. In order to interpret the results of our study more clearly, randomized controlled studies with a larger number of cases were planned in the future.

Keywords: calcaneal spur, ESWT, plantar pressure, pain

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Authors: Wissem Abdaoui, Nizar M. Mhaidat, Ilhem Mokhtari, Adel Gouri

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Colorectal cancer (CRC) is one of the most common tumors all over the world. Obesity, considered a risk factor of CRC, is characterized by a high level of secreted cytokines from adipose tissue. Among these inflammatory molecules, leptin is considered the key mediator for CRC cancer development and progression by activation of mitogenic and anti apoptotic signaling pathways. Gene expression can be significantly modulated by alterations in DNA methylation patterns. The aim of this study is to investigate the impact of leptin gene methylation on CRC prognosis and sensitivity to chemotherapy. The study involved 70 CRC tissue samples collected from King Abdullah University Hospital (KAUH) from which only 53 was analyzed because of bisulfate fragmentation and low yield of DNA extracted from FFPE tissues. A total of 22 blood samples were collected from healthy volunteers and enrolled as a control group. Leptin promoter methylation was analyzed by methylation specific PCR after bisulfate conversion. Results revealed that the incidence of leptin gene methylation was significantly higher in CRC patients in comparison to that of controls (P < 0.05). The correlation between patient’s demographics and leptin gene methylation was not significant (P < 0.05). However, a significant correlation between leptin gene methylation status and early cancer stages (I, II and III) was found in male but not in female (p < 0.05). Moreover, a significant correlation was found between leptin promoter methylation and early tumor localization T1-2 (p < 0.05). The correlation between epigenetic regulation of leptin and chemosensitivity was not significant. Taken together, these results suggest the possibility to use leptin gene methylation as a biomarker for the evaluation of CRC prognosis and metastasis.

Keywords: colorectal cancer, obesity, leptin, DNA methylation, disease prognosis, bisulfate conversion, chemoresistance

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Authors: Mohsin Ali Baloch, Saira Baloch

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Objective: To analyze hematological changes in patients of oral cancer with history of smokable and chewable tobacco use, and to compare them with healthy controls. Study Design: Descriptive type of study survey. Setting: This study was conducted at the Department of Oral and Maxillofacial Surgery, LUMHS, Jamshoro. Study Period: One year July, 2013 to July, 2014. Subject and Methods: Histopathologically confirmed hundred cases of oral cancer with the history of smokable and non-smokable tobacco were selected to analyze the hematological variation. Inclusion Criteria: Histopathologically diagnosed patients of oral squamous cell carcinoma, with history of smokable and non-smokable tobacco. Exclusion Criteria: Patient with any systemic medically compromising problem, terminally ill patients, radio or chemotherapeutically treated patients, patients with metastasis to lungs or any distant metastasis, patients with the history of more than one well-defined etiological factor involved. Results: There were 73% patients of oral cancer reported with anemic. Significantly lower values of Hb, platelet, and higher mean values of ESR, TLC, and were observed in both groups of oral cancer patients; tobacco smokers and tobacco chewers as compared to non-smokers healthy controls. There was more decline in the level of haemoglobin and incline in the level of ESR observed in tobacco chewer oral cancer patients as compared to tobacco smokers patients, while TLC was more observed in smokers. Conclusion: Oral cancer patients with a history of chewable/smokable tobacco have likely worse hematological profile, which increases the anesthetic and surgical challenges for maxillofacial surgeons, which have a significant impact on treatment planning as well.

Keywords: oral cancer, hematological variations, tobacco, smokers

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Authors: Hossein Miri, Zhou YongQi, Chan Bormei-Suy

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The development of advanced technologies and innovative solutions has opened up exciting new possibilities for revolutionizing healthcare systems. One such emerging concept is the use of virtual and holographic health information platforms that aim to provide interactive and personalized medical information to users. This paper provides a review of notable virtual and holographic health information platforms. It begins by highlighting the need for information visualization and 3D representation in healthcare. It then proceeds to provide background knowledge on information visualization and historical developments in 3D visualization technology. Additional domain knowledge concerning holography, holographic computing, and mixed reality is then introduced, followed by highlighting some of their common applications and use cases. After setting the scene and defining the context, the need and importance of virtual and holographic visualization in medicine are discussed. Subsequently, some of the current research areas and applications of digital holography and holographic technology are explored, alongside the importance and role of virtual and holographic visualization in genetics and genomics. An analysis of the key principles and concepts underlying virtual and holographic health information systems is presented, as well as their potential implications for healthcare are pointed out. The paper concludes by examining the most notable existing mixed-reality applications and systems that help doctors visualize diagnostic and genetic data and assist in patient education and communication. This paper is intended to be a valuable resource for researchers, developers, and healthcare professionals who are interested in the use of virtual and holographic technologies to improve healthcare.

Keywords: virtual, holographic, health information platform, personalized interactive medical information

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Authors: Cheng-Yu Tsai, Wen-Te Liu, Shin-Mei Hsu, Yin-Tzu Lin, Chi Wu

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Background: Obstructive Sleep apnea syndrome (OSAS) is a common respiratory disorder during sleep. In addition, Body parameters were identified high predictive importance for OSAS severity. However, the effects of body parameters on OSAS severity remain unclear. Objective: In this study, the objective is to establish a prediction model for OSAS by using body parameters and investigate the effects of body parameters in OSAS. Methodologies: Severity was quantified as the polysomnography and the mean hourly number of greater than 3% dips in oxygen saturation during examination in a hospital in New Taipei City (Taiwan). Four levels of OSAS severity were classified by the apnea and hypopnea index (AHI) with American Academy of Sleep Medicine (AASM) guideline. Body parameters, including neck circumference, waist size, and body mass index (BMI) were obtained from questionnaire. Next, dividing the collecting subjects into two groups: training and testing groups. The training group was used to establish the random forest (RF) to predicting, and test group was used to evaluated the accuracy of classification. Results: There were 3330 subjects recruited in this study, whom had been done polysomnography for evaluating severity for OSAS. A RF of 1000 trees achieved correctly classified 79.94 % of test cases. When further evaluated on the test cohort, RF showed the waist and BMI as the high import factors in OSAS. Conclusion It is possible to provide patient with prescreening by body parameters which can pre-evaluate the health risks.

Keywords: apnea and hypopnea index, Body parameters, obstructive sleep apnea syndrome, Random Forest

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Authors: Zhaopeng Zhu, Xianzhi Song, Gensheng Li

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Transports of solid particles through the drill pipe, drill string-hole annulus and hydraulically generated fractures are important dynamic processes encountered in oil and gas well drilling and completion operations. Different from particle transport in infinite space, the transports of cuttings, proppants and formation sand are hindered by a finite boundary. Therefore, an accurate description of the particle transport behavior under the bounded wall conditions encountered in drilling and hydraulic fracturing operations is needed to improve drilling safety and efficiency. In this study, the particle settling experiments were carried out to investigate the particle settling behavior in the pipe, annulus and between the parallel plates filled with power-law fluids. Experimental conditions simulated the particle Reynolds number ranges of 0.01-123.87, the dimensionless diameter ranges of 0.20-0.80 and the fluid flow behavior index ranges of 0.48-0.69. Firstly, the wall effect of the annulus is revealed by analyzing the settling process of the particles in the annular geometry with variable inner pipe diameter. Then, the geometric continuity among the pipe, annulus and parallel plates was determined by introducing the ratio of inner diameter to an outer diameter of the annulus. Further, a unified dimensionless diameter was defined to confirm the relationship between the three different geometry in terms of the wall effect. In addition, a dimensionless term independent from the settling velocity was introduced to establish a unified explicit settling velocity model applicable to pipes, annulus and fractures with a mean relative error of 8.71%. An example case study was provided to demonstrate the application of the unified model for predicting particle settling velocity. This paper is the first study of annulus wall effects based on the geometric continuity concept and the unified model presented here will provide theoretical guidance for improved hydraulic design of cuttings transport, proppant placement and sand management operations.

Keywords: wall effect, particle settling velocity, cuttings transport, proppant transport in fracture

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Authors: Moses Mwangi, Geert Verbeke, Geert Molenberghs

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Cross-over designs are commonly used in randomized clinical trials to estimate efficacy of a new treatment with respect to a reference treatment (placebo or standard). The main advantage of using cross-over design over conventional parallel design is its flexibility, where every subject become its own control, thereby reducing confounding effect. Jones & Kenward, discuss in detail more recent developments in the analysis of cross-over trials. We revisit the simple piecewise linear mixed-effects model, proposed by Mwangi et. al, (in press) for its first application in the analysis of cross-over trials. We compared performance of the proposed piecewise linear mixed-effects model with two commonly cited statistical models namely, (1) Grizzle model; and (2) Jones & Kenward model, used in estimation of the treatment effect, in the analysis of randomized cross-over trial. We estimate two performance measurements (mean square error (MSE) and coverage probability) for the three methods, using data simulated from the proposed piecewise linear mixed-effects model. Piecewise linear mixed-effects model yielded lowest MSE estimates compared to Grizzle and Jones & Kenward models for both small (Nobs=20) and large (Nobs=600) sample sizes. It’s coverage probability were highest compared to Grizzle and Jones & Kenward models for both small and large sample sizes. A piecewise linear mixed-effects model is a better estimator of treatment effect than its two competing estimators (Grizzle and Jones & Kenward models) in the analysis of cross-over trials. The data generating mechanism used in this paper captures two time periods for a simple 2-Treatments x 2-Periods cross-over design. Its application is extendible to more complex cross-over designs with multiple treatments and periods. In addition, it is important to note that, even for single response models, adding more random effects increases the complexity of the model and thus may be difficult or impossible to fit in some cases.

Keywords: Evaluation, Grizzle model, Jones & Kenward model, Performance measures, Simulation

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Authors: Ferdinando Montemari, Antonio Vitale, Nicola Genito, Giovanni Cuciniello

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The introduction of tilt-rotor aircraft into the existing civilian air transportation system will provide beneficial effects due to tilt-rotor capability to combine the characteristics of a helicopter and a fixed-wing aircraft into one vehicle. The disposability of reliable tilt-rotor simulation models supports the development of such vehicle. Indeed, simulation models are required to design automatic control systems that increase safety, reduce pilot's workload and stress, and ensure the optimal aircraft configuration with respect to flight envelope limits, especially during the most critical flight phases such as conversion from helicopter to aircraft mode and vice versa. This article presents a process to build a simplified tilt-rotor simulation model, derived from the analysis of flight data. The model aims to reproduce the complex dynamics of tilt-rotor during the in-flight conversion phase. It uses a set of scheduled linear transfer functions to relate the autopilot reference inputs to the most relevant rigid body state variables. The model also computes information about the rotor flapping dynamics, which are useful to evaluate the aircraft control margin in terms of rotor collective and cyclic commands. The rotor flapping model is derived through a mixed theoretical-empirical approach, which includes physical analytical equations (applicable to helicopter configuration) and parametric corrective functions. The latter are introduced to best fit the actual rotor behavior and balance the differences existing between helicopter and tilt-rotor during flight. Time-domain system identification from flight data is exploited to optimize the model structure and to estimate the model parameters. The presented model-building process was applied to simulated flight data of the ERICA Tilt-Rotor, generated by using a high fidelity simulation model implemented in FlightLab environment. The validation of the obtained model was very satisfying, confirming the validity of the proposed approach.

Keywords: flapping dynamics, flight dynamics, system identification, tilt-rotor modeling and simulation

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Authors: Ilma Robo, Saimir Heta, Greta Plaka, Vera Ostreni

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Purpose: Drug gingival hyperplasia is an uncommon pathology encountered during routine work in dental units. The purpose of this paper is to present the clinical appearance of gingival hyperplasia caused by medications. There are already three classes of medications that cause hyperplasia and based on data from the literature, the clinical cases encountered and included in this study have been compared. Materials and Methods: The study was conducted in a total of 311 patients, out of which 182 patients were included in our study, meeting the inclusion criteria. After each patient's history was recorded and it was found that patients were in their knowledge of chronic illness, undergoing treatment of gingivitis hypertrophic drugs was performed with a clinical examination of oral cavity and assessment by vertical and horizontal evaluation according to the periodontal indexes. Results: Of the data collected during the study, it was observed that 97% of patients with gingival hyperplasia are treated with nifedipine. 84% of patients treated with selected medicines and gingival hyperplasia in the oral cavity has been exposed at time period for more than 1 year and 1 month. According to the GOI, in the first rank of this index are about 21% of patients, in the second rank are 52%, in the third rank are 24% and in the fourth grade are 3%. According to the horizontal growth index of gingival hyperplasia, grade 1 included about 61% of patients and grade 2 included about 39% of patients with gingival hyperplasia. Bacterial index divides patients by degrees: grading 0 - 8.2%, grading 1 - 32.4%, grading 2 - 14% and grading 3 - 45.1%. Conclusions: The highest percentage of gingival hyperplasia caused by drugs is due to dosing of nifedipine for a duration of dosing and application for systemic healing for more than 1 year.

Keywords: drug gingival hyperplasia, horizontal growth index, vertical growth index

Procedia PDF Downloads 174

Authors: Debjani Ghosh, Goutam Chowdhury, Prosenjit Samanta, Asish Kumar Mukhopadhyay

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Acute diarrhoea caused by diarrheagenic Escherichia coli (DEC) is one of the major public health problem in developing countries, mainly in Asia and Africa. DEC consists of six pathogroups, but the majority of the cases were associated with the three pathogropus, enterotoxigenic E. coli (ETEC), enteroaggregative E. coli (EAEC), and enteropathogenic E. coli (EPEC). Hence, we studied the prevalence and antimicrobial resistance of these three major DEC pathogroups in hospitalized diarrheal patients in Kolkata, India, during 2012-2019 with a large sample size. 8,891 stool samples were processed, and 7.8% of them was identified as DEC infection screened by multiplex PCR, in which ETEC was most common (47.7%) followed by EAEC (38.4%) and EPEC (13.9%). Clinical patient history suggested that children <5 years of age were mostly affected with ETEC and EAEC, whereas people within >5-14 years of age were significantly associated with EPEC and ETEC infections. Antibiogram profile showed a high prevalence of multidrug resistant (MDR) isolates among DEC (56.9%), in which 9% were resistant to antibiotics of six different antimicrobial classes. Screening of the antibiotic resistance conferring genes in DEC showed the presence of blaCTX-M (30.2%) in highest number followed by blaTEM (27.5%), tetB (18%), sul2 (12.6%), strA (11.8%), aadA1 (9.8%), blaOXA-1 (9%), dfrA1 (1.6%) and blaSHV (1.2%) which indicates the existence of mobile genetic elements in those isolates. Therefore, the presence of MDR DEC strains in higher number alarms the public health authorities to take preventive measures before the upsurge of the DEC caused diarrhea cases in near future.

Keywords: diarrheagenic escherichia coli, ETEC, EAEC, EPEC

Procedia PDF Downloads 160

Authors: Ana Fouto

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Background: Continuing Personal Development (CPD) enables professionals to keep up to date with the professional requirements, broadening their knowledge and expertise. However, much of the research explores the registered professionals’ experiences and the factors that influence their choice of engaging, despite the unregistered staff providing the majority of the direct patient care. Aim: To explore the Nursing/Midwifery Assistants’ (NAs) perception of the concept of CPD, as well as explore the factors that influence the NAs to engage (or not) with CPD experiences. Methodology: This pilot study used a qualitative approach through a case study, where a semi-structured interview was applied to three NAs to explore the factors that influence the decision-making of process of CPD engagement. Thematic analysis was used to analyse their answers and interpret patterns and associations. Findings: All the participants agreed that CPD is important and relevant to their practice and personal lives. Five main categories were identified: NAs’ scope of practice, the impact of CPD; decision-making process; challenges; changes required. Although similar findings to the registered nurses were identified, the lack of CPD regulation for NAs and the rapid evolution of their role make the CPD engagement more problematic. Conclusion: Engagement with CPD is influenced by a wide range of professional (organisational and national) and personal factors. NAs perceive lack of management support at different stages of the CPD activities as a main influence. Organisations should be more flexible in the recruitment, offer of CPD choices, content, delivery, and contractual arrangements of NAs, which may increase engagement.

Keywords: nursing assistants, engagement, factors, pilot, continuing professional development (CPD)

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Authors: Jake Tempo, Taylor Smithurst, Jen Leah, Skye Waddingham, Amanda Catlin, Richard Cetti

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Introduction: Percutaneous nephrolithotomy (PCNL) is the gold-standard procedure for removing large or complex renal stones. Many operating positions can be used, and the debate over the ideal position continues. PCNL can be a long procedure during which patients can sustain pressure injuries. These injuries are often underreported in the literature. Interface pressure mapping records the pressure loading between a surface and the patient. High pressures with prolonged loading result in ischaemia, muscle deformation, and reperfusion which can cause skin breakdown and muscular injury. We compared the peak pressure indexes of common PCNL positions to identify positions which may be at high risk of pressure injuries. We hope the data can be used to adapt high-risk positions so that the PPI can be lessened by either adapting the positions or by using adjuncts to lower PPI. Materials and Methods: We placed a 23-year-old male subject in fourteen different PCNL positions while performing interface pressure mapping. The subject was 179 cm with a weight of 63.3 kg, BMI 19.8kg/m². Results: Supine positions had a higher mean PPI (119mmHg (41-137)) compared to prone positions (64mmHg (32-89)) (p=0.046 two tailed t-test). The supine flexed position with a bolster under the flank produced the highest PPI (194mmHg), and this was at the sacrum. Peak pressure indexes >100mmHg were recorded in eight PCNL positions. Conclusion: Supine PCNL positions produce higher PPI than prone PCNL positions. Our study shows where ‘at risk’ bony prominences are for each PCNL position. Surgeons must ensure these areas are protected during prolonged operations.

Keywords: PCNL, pressure ulcer, interface pressure mapping, surgery

Procedia PDF Downloads 81

Authors: Saimir Heta, Rialda Xhizdari, Kers Kapaj, Ilma Robo

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Background: The interests of both individuals involved, both the dentist with his professionalism, and the patient who claims and expects the proper professional dental service, are determined in cases of dental malpractice. The latter is a phenomenon that is also wearing the "cloak" of bilateral manipulations, which in themselves require strong legal control to regulate the relations between the involved parties. The two individuals are involved both individually and even professionally and emotionally, with support in the "ultimate" interests of the two people, which in the case of conflicts or grievances, which as a result are transported to the family or society of the affected individual. Main text: The reason for malpractice is the most difficult part to find and then to interpret. It can be professional in the view of "so much I know how to do, so much done", or in the view of the impossibility of individual health conditions to achieve high professional expectations. But, the reason can also be individual with the intention of doing bad without reason or with the source of an unhealthy mind and the source of malicious thinking. The professional himself is a human being and as such may be under the effect of individual treatments or vices, therefore causing misuse, a case that must be distinguished from intentional misuse and which must be judged for the results or damages caused by the professional based on criminal law. Conclusions: Malpractice in some cases may be unavoidable, beyond the good intention of the dental intervention, which should be well understood by both parties involved in this relationship. Malpractice is not necessarily related only to difficult clinical cases, but sometimes also appears as a random deviation of a dental treatment with a welldefined professional protocol. The legal support in the interpretation of malpractice cases should be much more specific according to previous cases, this practice specifically, perhaps also according to different religious states.

Keywords: dental ethics, malpractice, professional dental service, legal support

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Authors: Serkan Solmaz, Jean-Baptiste Gouriet, Nicolas Van de Wyer, Christophe Schram

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Efficiency of the cooling process for cryogenic propellant boiling in engine cooling channels on space applications is relentlessly affected by the phase change occurs during the boiling. The effectiveness of the cooling process strongly pertains to the type of the boiling regime such as nucleate and film. Geometric constraints like a non-transparent cooling channel unable to use any of visualization methods. The ultrasonic (US) technique as a non-destructive method (NDT) has therefore been applied almost in every engineering field for different purposes. Basically, the discontinuities emerge between mediums like boundaries among different phases. The sound wave emitted by the US transducer is both transmitted and reflected through a gas-liquid interface which makes able to detect different phases. Due to the thermal and structural concerns, it is impractical to sustain a direct contact between the US transducer and working fluid. Hence the transducer should be located outside of the cooling channel which results in additional interfaces and creates ambiguities on the applicability of the present method. In this work, an exploratory research is prompted so as to determine detection ability and applicability of the US technique on the cryogenic boiling process for a cooling cycle where the US transducer is taken place outside of the channel. Boiling of the cryogenics is a complex phenomenon which mainly brings several hindrances for experimental protocol because of thermal properties. Thus substitute materials are purposefully selected based on such parameters to simplify experiments. Aside from that, nucleate and film boiling regimes emerging during the boiling process are simply simulated using non-deformable stainless steel balls, air-bubble injection apparatuses and air clearances instead of conducting a real-time boiling process. A versatile detection algorithm is perennially developed concerning exploratory studies afterward. According to the algorithm developed, the phases can be distinguished 99% as no-phase, air-bubble, and air-film presences. The results show the detection ability and applicability of the US technique for an exploratory purpose.

Keywords: Ultrasound, ultrasonic, multiphase flow, boiling, cryogenics, detection algorithm

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Authors: Hansraj Riteesh Bookun, Emily Maree Stevens, Jarryd Leigh Solomon, Anthony Chan

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Objective: This was a retrospective cross-sectional study evaluating the safety and efficacy of femoral endarterectomy using the eversion technique with transection as opposed to the conventional endarterectomy technique with either vein or synthetic patch arterioplasty. Methods: Between 2010 to mid 2017, 19 patients with mean age of 75.4 years, underwent eversion femoral endarterectomy with transection by a single surgeon. There were 13 males (68.4%), and the comorbid burden was as follows: ischaemic heart disease (53.3%), diabetes (43.8%), stage 4 kidney impairment (13.3%) and current or ex-smoking (73.3%). The indications were claudication (45.5%), rest pain (18.2%) and tissue loss (36.3%). Results: The technical success rate was 100%. One patient required a blood transfusion following bleeding from intraoperative losses. Two patients required blood transfusions from low post operative haemogloblin concentrations – one of them in the context of myelodysplastic syndrome. There were no unexpected returns to theatre. The mean length of stay was 11.5 days with two patients having inpatient stays of 36 and 50 days respectively due to the need for rehabilitation. There was one death unrelated to the operation. Conclusion: The eversion technique with transection is safe and effective with low complication rates and a normally expected length of stay. It poses the advantage of not requiring a synthetic patch. This technique features minimal extraneous dissection as there is no need to harvest vein for a patch. Additionally, future endovascular interventions can be performed by puncturing the native vessel. There is no change to the femoral bifurcation anatomy after this technique. We posit that this is a useful adjunct to the surgeon’s panoply of vascular surgical techniques.

Keywords: endarterectomy, eversion, femoral, vascular

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Authors: M. McHugh, D. Lillis

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Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.

Keywords: agile, applications, FDA, medical, mobile, regulations, software engineering, standards

Procedia PDF Downloads 358