Search results for: contrast sensitivity

Authors: John Paul Q. Tomas, Mark Wilson L. de los Reyes, Kirsten Joyce P. Vasquez

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The most frequent type of fracture is a wrist fracture, which often makes it difficult for medical professionals to find and locate. In this study, fractures in wrist x-ray pictures were located and identified using deep learning and computer vision. The researchers used image filtering, masking, morphological operations, and data augmentation for the image preprocessing and trained the RetinaNet and Faster R-CNN models with ResNet50 backbones and Adam optimizers separately for each image filtering technique and projection. The RetinaNet model with Anisotropic Diffusion Smoothing filter trained with 50 epochs has obtained the greatest accuracy of 99.14%, precision of 100%, sensitivity/recall of 98.41%, specificity of 100%, and an IoU score of 56.44% for the Posteroanterior projection utilizing augmented data. For the Lateral projection using augmented data, the RetinaNet model with an Anisotropic Diffusion filter trained with 50 epochs has produced the highest accuracy of 98.40%, precision of 98.36%, sensitivity/recall of 98.36%, specificity of 98.43%, and an IoU score of 58.69%. When comparing the test results of the different individual projections, models, and image filtering techniques, the Anisotropic Diffusion filter trained with 50 epochs has produced the best classification and regression scores for both projections.

Keywords: Artificial Intelligence, Computer Vision, Wrist Fracture, Deep Learning

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Authors: Rasaq Bello, Grace Akintola Sunday, Yemi Sikiru Onifade

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Groundwater is required for the continuity of life and sustainability of the ecosystem. Hence, this research was purposed to assess groundwater quality for domestic use in Kaltungo Local Government Area, Gombe State. The work was also aimed at determining the thickness and resistivity of the topsoil, areas suitable for borehole construction, quality and potentials of groundwater in the study area. The study area extends from latitude N10015’38” - E11008’01” and longitude N10019’29” - E11013’05”. The data was acquired using the Vertical Electrical Sounding (VES) method and processed using IP12win software. Twenty (20) Vertical Electrical Soundings were carried out with a maximum current electrode separation (AB) of 150m. The VES curves generated from the data reveal that all the VES points have five to six subsurface layers. The first layer has a resistivity value of 7.5 to 364.1 Ωm and a thickness ranging from 0.8 to 7.4m, and the second layer has a resistivity value of 1.8 to 600.3 Ωm thickness ranging from 2.6 to 31.4m, the third layer has resistivity value of 23.3 to 564.4 Ωm thickness ranging from 10.3 to 77.8m, the fourth layer has resistivity value of 19.7 to 640.2 Ωm thickness ranging from 8.2m to 120.0m, the fifth layer has resistivity value of 27 to 234 Ωm thickness ranging from 8.2 to 53.7m and the six-layer is the layer that extended beyond the probing depth. The VES curves generated from the data revealed KQHA curve type for VES 1, HKQQ curve for VES 4, HKQ curve for VES 5, KHA curve for VES 11, QQHK curve for VES 12, HAA curve for VES 6 and VES 19, HAKH curve for VES 7, VES 8, VES 10 and VES 18, HKH curve for VES 2, VES 3, VES 9, VES 13, VES 14, VES 15, VES 16, VES 17 and VES 20. Values of the Coefficient of Anisotropy, Reflection Coefficient, and Resistivity Contrast obtained from the Dar-Zarrouk parameters indicated good water prospects for all the VES points in this study, with VES points 4, 9 and 18 having the highest prospects for groundwater exploration.

Keywords: formation parameters, groundwater, resistivity, resistivity contrast, vertical electrical sounding

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Authors: Wanlapha Phraibueng, Patrick Sentis, Geraldine Riviere-Giordano

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Corporate Social Responsibility (CSR) initiatives have been widely discussed especially in investor-oriented firms. In contrast, cooperatives pay less attention to CSR because their activities have integrated the responsibility and the solidity of social, economic and environment. On the other hand, by adopting ownership theory and agency theory – cooperatives ignore CSR investment due to unclarified decision control in the governance and the limitation to acquire the capital financed. The unique governance and financial structures in cooperatives lead to the conflict among the stakeholders and long-term investment which have an impact on firm financial performance. As an illustration of cooperatives dilemmas, we address the question of Whether or not cooperatives in term of governance and financial structures are the constraints on implementing CSR policies. We find that the governance and financial structures in large cooperatives are the influence factors which predispose cooperatives to invest on CSR. In contrast, in the startup or small cooperatives, its governance and financial structures are the constraints on implementing CSR policies. We propose the alternative financial structure based on the trade-off between debt and equity which aims to relax the restrictions in cooperatives’ governance and allow cooperatives to acquire the capital financed either from its members or non-members. We suggest that engaging equity as a financial structure induces cooperatives to invest on CSR policies. Alternative financial structure eliminates not only cooperative ownership control problem but also the constraints in capital acquisition. By implementing CSR activities consistent with the alternative financial choice, cooperatives can increase firm’s value and reduce the conflict among their stakeholders.

Keywords: cooperatives, corporate social responsibility, financial, governance

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Authors: Florian Wagner, Christoph Schmidt, Vincent Bagnoud

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Understanding the interaction of ultra-intense laser pulses with overcritical targets is of major interest for many applications such as laser-driven ion acceleration, fast ignition in the frame of inertial confinement fusion or high harmonic generation and the creation of attosecond pulses. One particular aspect of this interaction is the shift of the critical surface, where the laser pulse is stopped and the absorption is at maximum, due to the radiation pressure induced by the laser pulse, also referred to as laser hole boring. We investigate laser-hole boring experimentally by measuring the backscattered spectrum which is doppler-broadened because of the movement of the reflecting surface. Using the high-power, high-energy laser system PHELIX in Darmstadt, we gathered an extensive set of data for different laser intensities ranging from 10^18 W/cm2 to 10^21 W/cm2, two different levels of the nanosecond temporal contrast (10^6 vs. 10^11), elliptical and linear polarization and varying target configurations. In this contribution we discuss how the maximum velocity of the critical surface depends on these parameters. In particular we show that by increasing the temporal contrast the maximum hole boring velocity is decreased by more than a factor of three. Our experimental findings are backed by a basic analytical model based on momentum and mass conservation as well as particle in cell simulations. These results are of particular importance for fast ignition since they contribute to a better understanding of the transport of the ignitor pulse into the overdense region.

Keywords: laser-hole boring, interaction of ultra-intense lasers with overcritical targets, fast ignition, relativistic laser motter interaction

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Authors: Ga-Young Lee, Hyun-Man Kim

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The modulation of the cell-cell junction is critical in epithelial-mesenchymal transition during tumorigenesis. As RhoA activity is known to be up-regulated to dissociate cell-cell junction by contracting acto-myosin complex in various cancer cells, the present study investigated if RhoA activity was also associated with the disruption of the cell-cell junction of oral cancer cells. We studied SCC-25 cells which are established from oral squamous cell carcinoma if their E-cadherin junction (ECJ) was under control of RhoA. Interestingly, development of ECJ of SCC-25 cells depended on the amount of fibronectin (FN) coated on the culture dishes. Seeded cells promptly aggregated to develop ECJ on the substrates coated with a low amount of FN, whereas they were retarded in the development of ECJ on the substrates coated with a high amount of FN. However, it was an unexpected finding that total RhoA activity was lower in the dissociated cells on the substrates of high FN than in the aggregated cells on the substrates of low FN. Treating the dissociated cells on the substrates of high FN with LPA, a RhoA activator, promoted the development to ECJ. In contrast, treating the aggregated cells on the substrates of low FN with Clostridium botulinum C3, a toxin decreasing RhoA activity, dissociated cells concomitant with the disruption of ECJ. Genetical knockdown of RhoA expression by transfecting RhoA siRNA also down-regulated the development of ECJ in SCC-25 cells. Furthermore, PMA, an activator of protein kinase C (PKC), down-regulated the development of ECJ junction of SCC-25 cells on the substrates coated with low FN. In contrast, GO6976, a PKC inhibitor, up-regulated the development of ECJ of SCC-25 cells with the activation of RhoA on the substrates coated with high FN. In conclusion, in the present study, we demonstrated unexpected results that the activation of RhoA promotes the development of ECJ, whereas the inhibition of RhoA retards the development of ECJ in SCC-25 cells.

Keywords: E-cadherin junction, oral squamous cell carcinoma, PKC, RhoA, SCC-25

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Authors: Jitendra Pratap, Daphne Prybyszcuk, Luke Elliott, Arnold Ng

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Introduction: Coronary CT angiography is a non-invasive imaging technique for the assessment of coronary artery disease and has high sensitivity and negative predictive value. However, the correlation between the degree of CT coronary stenosis and the significance of hemodynamic obstruction is poor. The assessment of myocardial perfusion has mostly been undertaken by Nuclear Medicine (SPECT), but it is now possible to perform stress myocardial CT perfusion (CTP) scans quickly and effectively using CT scanners with high temporal resolution. Myocardial CTP is in many ways similar to neuro perfusion imaging technique, where radiopaque iodinated contrast is injected intravenously, transits the pulmonary and cardiac structures, and then perfuses through the coronary arteries into the myocardium. On the Siemens Force CT scanner, a myocardial perfusion scan is performed using a dynamic axial acquisition, where the scanner shuffles in and out every 1-3 seconds (heart rate dependent) to be able to cover the heart in the z plane. This is usually performed over 38 seconds. Report: A CT myocardial perfusion scan can be utilised to complement the findings of a CT Coronary Angiogram. Implementing a CT Myocardial Perfusion study as part of a routine CT Coronary Angiogram procedure provides a ‘One Stop Shop’ for diagnosis of coronary artery disease. This case study demonstrates that although the CT Coronary Angiogram was within normal limits, the perfusion scan provided additional, clinically significant information in regards to the haemodynamics within the myocardium of a patient with Hypertrophic Obstructive Cardio Myopathy (HOCM). This negated the need for further diagnostics studies such as cardiac ECHO or Nuclear Medicine Stress tests. Conclusion: CT coronary angiography with adenosine stress myocardial CTP was utilised in this case to specifically exclude coronary artery disease in conjunction with accessing perfusion within the hypertrophic myocardium. Adenosine stress myocardial CTP demonstrated the reduced myocardial blood flow within the hypertrophic myocardium, but the coronary arteries did not show any obstructive disease. A CT coronary angiogram scan protocol that incorporates myocardial perfusion can provide diagnostic information on the haemodynamic significance of any coronary artery stenosis and has the potential to be a “One Stop Shop” for cardiac imaging.

Keywords: CT, cardiac, myocardium, perfusion

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Authors: Andrey V. Malyshev, Anna B. Petrova, Anatoly P. Surzhikov

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The article presents the results of the influence of diamagnetic additives on the defects level of ferrite ceramics. For this purpose, we use a previously developed method based on the mathematical analysis of experimental temperature dependences of the initial permeability. A phenomenological expression for the description of such dependence was suggested and an interpretation of its main parameters was given. It was shown, that the main criterion of the integral defects level of ferrite ceramics is the relation of two parameters correlating with elastic stress value in a material. Model samples containing a controlled number of intergranular phase inclusions served to prove the validity of the proposed method, as well as to assess its sensitivity in comparison with the traditional XRD (X-ray diffraction) analysis. The broadening data of diffraction reflexes of model samples have served for such comparison. The defects level data obtained by the proposed method are in good agreement with the X-ray data. The method showed high sensitivity. Therefore, the legitimacy of the selection relationship β/α parameters of phenomenological expression as a characteristic of the elastic state of the ferrite ceramics confirmed. In addition, the obtained data can be used in the detection of non-magnetic phases and testing the optimal sintering production technology of soft magnetic ferrites.

Keywords: cure point, initial permeability, integral defects level, homogeneity

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Authors: Yousaf Tariq

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There are many reasons which are involved in electronic equipment failure i.e. temperature, humidity, dust, smoke etc. Corrosive gases are also one of the factor which may involve in failure of equipment. Sensitivity of electronic equipment increased when “lead-free” regulation enforced on manufacturers. In data center, equipment like hard disk, servers, printed circuit boards etc. have been exposed to gaseous contamination due to increase in sensitivity. There is a worldwide standard to protect electronic industrial electronic from corrosive gases. It is well known as “ANSI/ISA S71.04 – 1985 - Environmental Conditions for Control Systems: Airborne Contaminants. ASHRAE Technical Committee (TC) 9.9 members also recommended ISA standard in their whitepaper on Gaseous and Particulate Contamination Guideline for data centers. TC 9.9 members represented some of the major IT equipment manufacturers e.g. IBM, HP, Cisco etc. As per standard practices, first step is to monitor air quality in data center. If contamination level shows more than G1, it means that gas-phase air filtration is required other than dust/smoke air filtration. It is important that outside fresh air entering in data center should have pressurization/re-circulated process in order to absorb corrosive gases and to maintain level within specified limit. It is also important that air quality monitoring should be conducted once in a year. Temperature and humidity should also be monitored as per standard practices to maintain level within specified limit.

Keywords: corrosive gases, corrosion, electronic equipment failure, ASHRAE, hard disk

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Authors: Kusuma Urs M. B., Navakant Bhat, Vinayak B. Kamble

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Metal oxide semiconductors (MOS) are known to be excellent candidates for solid-state gas sensor devices. However, in spite of high sensitivities, their high operating temperatures and lack of selectivity is a big concern limiting their practical applications. A lot of research has been devoted so far to enhance their sensitivity and selectivity, often empirically. Some of the promising routes to achieve the same are reducing dimensionality and formation of heterostructures. These heterostructures offer improved sensitivity, selectivity even at relatively low operating temperatures compared to bare metal oxides. Thus, a combination of n-type and p-type metal oxides leads to the formation of p-n junction at the interface resulting in the diffusion of the carriers across the barrier along with the surface adsorption. In order to achieve this and to study their sensing mechanism, we have designed and lithographically fabricated a suspended nanobeam of NiO, which is a p-type semiconductor. The response of the same has been studied for various gases and is found to exhibit selective response towards hydrogen gas at room temperature. Further, the same has been radially coated with TiO₂ shell of varying thicknesses, in order to study the effect of radial p-n junction thus formed. Subsequently, efforts have been made to study the effect of shell thickness on the space charge region and to shed some light on the basic mechanism involved in gas sensing of MOS sensors.

Keywords: gas sensing, heterostructure, metal oxide semiconductor, space charge region

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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Diabetes Mellitus (DM) is commonly encountered metabolic disorder in clinical practice. An estimated 25 percent of DM patients develop foot problems. Foot ulceration and infection are one of the major causes of morbidity, hospitalization or even amputation. Objective: To isolate and identify bacterial pathogens in Diabetic Foot Ulcer (DFU) and to observe its antimicrobial sensitivity pattern. Methodology: A prospective study was conducted for a period of 9 months at the Department of Microbiology, GD Hospital & Diabetes Institute, Kolkata. 75 DFU patients were recruited in the study. Specimens for microbiological studies obtained from ulcer base were examined as gram stained smear and was cultured aerobically on Nutrient agar, Blood agar and MacConkey agar plates. Antimicrobial sensitivity test was performed by disc diffusion techniques according to CLSI guidelines. Result: In this study out of 75cases, 73% (55/75) were male and 27% (20/75) were females with mean (SD) age of 51.11(±10) years. Out of 75 pus cultures, 63(84%) showed growth of microorganism making total of 81 bacterial isolates with 71.42% of monomicrobial infection and 28.57% of polymicrobial infection. Out of 81 isolates 53(65.43%) were gram negative and 21(25.92%) were gram positive. E.coli was relatively common isolate 21(26%) followed by Staphylococcus aureus 15(18.5%), Klebsiella pneumonia 14(17.28%), Pseudomonas aeruginosa 12 (14.81%), Proteus spp. 3 (3.70%), and Enterococcus faecalis 6 (7.40%). 75% of Gram-negative microorganism were extended Beta-lactamase enzyme (ESBL) producer and around 20 % of Klebsiella and Proteus spp. were carbapenemase enzyme producer. Among Gram positive, around 50% of S.aureus was MRSA, sensitive only to Vancomycin, Teicoplanin & Linezolid. Conclusion: More prevalence of monomicrobial gram-negative bacteria than gram-positive bacteria in DFU was observed. This study emphasizes that Beta-Lactam group of antibiotics should not be the empirical treatment of choice for Gram-negative isolates; instead alternatives like Carbapenems, Amikacin could be a better option. On the other hand, Vancomycin and Linezolid are preferred for most of the infection with gram-positive aerobes. Continuous surveillance of resistant bacteria is required for empiric therapy.

Keywords: antibiotic resistant, antimicrobial susceptibility, diabetic foot ulcer, surveillance

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Authors: Diego Carrasco, Catarina Freitas, Hugo Rio Tinto, Ricardo Rio Tinto, Nuno Couto, Joaquim Gago, Carlos Carvalho

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Introduction: Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) to drain the gallbladder can be a palliative care procedure for non-surgical oncologic patients with cholelithiasis and cholangitis process. Case description: A 59-years old Caucasian male diagnosed with extrahepatic cholangiocarcinoma with multiple liver, lung and peritoneum metastasis, unresponsive to treatment with gemcitabine/cisplatin, presented in the institution with fever, hypotension, and severe upper right abdominal pain secondary to cholelithiasis and cholangitis process. The patient was admitted and started on large spectrum antibiotics plus fluid-challenge. Afterward, a percutaneous transhepatic biliary drainage (PTBD) was performed to drain the gallbladder. This procedure temporarily stabilized the patient. However, the definitive solution required gallbladder removal. Since the patient exhibited an advanced oncologic disease and poor response to the chemotherapy, he was not a candidate for surgical intervention. Diagnostic Pathways: A self-expanding metal stent was placed from the duodenum into the bile duct by endoscopic ultrasound-guided. The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure. Conclusion and Discussion: The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure and successfully reversed the cholangitis process. EUS-CD is an effective and safe technique and can be used as a palliative care procedure for non-surgical oncologic patients.

Keywords: palliative care, cholangiocarcinoma, choledochoduodenostomy, endoscopic ultrasound-guided

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Authors: Lee Yujin, Han Jiye, Oh Jin-Woo

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The adverse effects of endocrine disrupting chemicals (EDCs) has attracted considerable public interests. The benzene-like EDCs structure mimics the mechanisms of hormones naturally occurring in vivo, and alters physiological function of the endocrine system. Although, some of the most representative EDCs such as polychlorinated biphenyls (PCBs) and phthalates compounds already have been prohibited to produce and use in many countries, however, PCBs and phthalates in plastic products as flame retardant and plasticizer are still circulated nowadays. EDCs can be released from products while using and discarding, and it causes serious environmental and health issues. Here, we developed virus-based structurally coloured nanostructure that can detect minute EDCs concentration sensitively and selectively. These structurally coloured nanostructure exhibits characteristic angel-independent colors due to the regular virus bundle structure formation through simple pulling technique. The designed number of different colour bands can be formed through controlling concentration of virus solution and pulling speed. The virus, M-13 bacteriophage, was genetically engineered to react with specific ECDs, typically PCBs and phthalates. M-13 bacteriophage surface (pVIII major coat protein) was decorated with benzene derivative binding peptides (WHW) through phage library method. In the initial assessment, virus-based color sensor was exposed to several organic chemicals including benzene, toluene, phenol, chlorobenzene, and phthalic anhydride. Along with the selectivity evaluation of virus-based colour sensor, it also been tested for sensitivity. 10 to 300 ppm of phthalic anhydride and chlorobenzene were detected by colour sensor, and showed the significant sensitivity with about 90 of dissociation constant. Noteworthy, all measurements were analyzed through principal component analysis (PCA) and linear discrimination analysis (LDA), and exhibited clear discrimination ability upon exposure to 2 categories of EDCs (PCBs and phthalates). Because of its easy fabrication, high sensitivity, and the superior selectivity, M-13 bacteriophage-based color sensor could be a simple and reliable portable sensing system for environmental monitoring, healthcare, social security, and so on.

Keywords: M-13 bacteriophage, colour sensor, genetic engineering, EDCs

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Authors: Samira Khalaji, , Fenneke Klein Jan, Kay-E. Gottschalk, Eugenia Makrantonaki, Karin Scharffetter-Kochanek

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Biological aging is a multi-dimensional process that takes place over a whole range of scales from the nanoscopic alterations within individual cells, over transformations in tissues and organs and to changes of the whole organism. On the single cell level, aging involves mutation of genes, differences in gene expression levels as well as altered posttranslational modifications of proteins. A variety of proteins is affected, including proteins of the cell cytoskeleton and migration machinery. Previous work quantified the expression of cytoskeleton proteins on the gene and protein levels in senescent and young fibroblasts. Their results show that senescent skin fibroblasts have an upregulated expression of the intermediate filament (IF) protein vimentin in contrast to actin and tubulin, which are downregulated. IFs play an important role in providing mechanical stability of cells. However, the mechanical properties of IFs depending on cellular senescence or age of the donor has not been studied so far. Hence, we employed passive microrheology on primary human dermal fibroblasts from female donors with age of 28 years (young) and 86 years (old) as model of in vivo aging and human normal dermal fibroblast from 11-year old male with CPD 17-35 (young) and CPD 58-59 (senescence) as a model of in vitro replicative senescence. In contrast to the expectations, our primary results show no significant differences in the viscoelastic properties of fibroblasts depending on age of the donor or cellular replicative senescence.

Keywords: aging, cytoskeleton, fibroblast, mechanical properties

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Authors: E. A. Alshaafi, A. Prakash

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Oil-water emulsions are commonly encountered in various industrial operations and at different stages of crude oil production and processing. Emulsions are often difficult to track and treat and can cause a number of costly problems which need to be avoided. The characteristics of the emulsion phase can vary with crude composition and types of impurities present in oil. The objectives of this study are the development of ultrasonic techniques to track and characterize emulsion phase generated during production and cleaning of crude oil. The position of emulsion layer is monitored with the help of ultrasonic probes suitably placed in the vessel. The sensitivity of the technique and its potential has been demonstrated based on extensive testing with different oil samples. The technique is also being developed to monitor emulsion phase characteristics such as stability, composition, and droplet size distribution. The ultrasonic parameters recorded are changes in acoustic velocity, signal attenuation and its frequency spectrum. Emulsion has been prepared with light mineral oil sample and the effects of various factors including mixing speed, temperature, surfactant, and solid particles concentrations have been investigated. The applied frequency for ultrasonic waves has been varied from 1 to 5 MHz to carry out a sensitivity analysis. Emulsion droplet structure is observed with optical microscopy and stability is examined by tracking the changes in ultrasonic parameters with time. A model based on ultrasonic attenuation spectroscopy is being developed and tested to track changes in droplet size distribution with time.

Keywords: ultrasonic techniques, emulsion, characterization, droplet size

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Authors: Michael R. Shurin, Galina Shurin, Vladimir A. Kirichenko

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Background. Visibility of hepatic malignancies is poor on non-contrast imaging for daily verification of liver malignancies prior to radiation therapy on MRI-guided Linear Accelerators (MR-Linac). Ferumoxytol® (Feraheme, AMAG Pharmaceuticals, Waltham, MA) is a SPION agent that is increasingly utilized off-label as hepatic MRI contrast. This agent has the advantage of providing a functional assessment of the liver based upon its uptake by hepatic Kupffer cells proportionate to vascular perfusion, resulting in strong T1, T2 and T2* relaxation effects and enhanced contrast of malignant tumors, which lack Kupffer cells. The latter characteristic has been recently utilized for MRI-guided radiotherapy planning with precision targeting of liver malignancies. However potential radiotoxicity of SPION has never been addressed for its safe use as an MRI-contrast agent during liver radiotherapy on MRI-Linac. This study defines the radiomodulating properties of SPIONs in vitro on human monocyte and macrophage cell lines exposed to 60Go gamma-rays within clinical radiotherapy dose range. Methods. Human monocyte and macrophages cell line in cultures were loaded with a clinically relevant concentration of Ferumoxytol (30µg/ml) for 2 and 24 h and irradiated to 3Gy, 5Gy and 10Gy. Cells were washed and cultured for additional 24 and 48 h prior to assessing their phenotypic activation by flow cytometry and function, including viability (Annexin V/PI assay), proliferation (MTT assay) and cytokine expression (Luminex assay). Results. Our results reveled that SPION affected both human monocytes and macrophages in vitro. Specifically, iron oxide nanoparticles decreased radiation-induced apoptosis and prevented radiation-induced inhibition of human monocyte proliferative activity. Furthermore, Ferumoxytol protected monocytes from radiation-induced modulation of phenotype. For instance, while irradiation decreased polarization of monocytes to CD11b+CD14+ and CD11bnegCD14neg phenotype, Ferumoxytol prevented these effects. In macrophages, Ferumoxytol counteracted the ability of radiation to up-regulate cell polarization to CD11b+CD14+ phenotype and prevented radiation-induced down-regulation of expression of HLA-DR and CD86 molecules. Finally, Ferumoxytol uptake by human monocytes down-regulated expression of pro-inflammatory chemokines MIP-1α (Macrophage inflammatory protein 1α), MIP-1β (CCL4) and RANTES (CCL5). In macrophages, Ferumoxytol reversed the expression of IL-1RA, IL-8, IP-10 (CXCL10) and TNF-α, and up-regulates expression of MCP-1 (CCL2) and MIP-1α in irradiated macrophages. Conclusion. SPION agent Ferumoxytol increases resistance of human monocytes to radiation-induced cell death in vitro and supports anti-inflammatory phenotype of human macrophages under radiation. The effect is radiation dose-dependent and depends on the duration of Feraheme uptake. This study also finds strong evidence that SPIONs reversed the effect of radiation on the expression of pro-inflammatory cytokines involved in initiation and development of radiation-induced liver damage. Correlative translational work at our institution will directly assess the cyto-protective effects of Ferumoxytol on human Kupfer cells in vitro and ex vivo analysis of explanted liver specimens in a subset of patients receiving Feraheme-enhanced MRI-guided radiotherapy to the primary liver tumors as a bridge to liver transplant.

Keywords: superparamagnetic iron oxide nanoparticles, radioprotection, magnetic resonance imaging, liver

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Authors: Patricia Portugal Marques de Carvalho Lourenco

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Big Bang is like a dirty martini embroiled in a stew of personal individual scandals that have rocked the group’s image and perception, from G-Dragon’s and T.O.P. marijuana episodes in 2011 and 2016, respectively, to Daesung’s building illicit entertainment activities in 2018to the Burning Sun shebang that led to the Titanic sink of Big Bang’s youngest member Seungri in 2019 and the positive sentiment migration to the antithetical side. BTS, on the other hand, are like a martini, clear, clean, attracting as many crowds to their performances and online content as the Pope attracts believers to Sunday Mass in the Vatican, as exemplified by their latest MVs. Big Bang’s 2022 Still Life achieved 16.4 million views on Youtube in 24hours, whilst BTS Permission to Dance achieved 68.5 million in the same period of time. The difference is significant when added Big Bang’s and BTS overall award wins, a total of 117 in contrast to 460. Both groups are uniquely talented and exceptional performers that have been contributing greatly to the dissemination of Korean Pop Music on a global scale in their own inimitable ways. Both are exceptional in their own right and while the artists cannot, ought not, should not be compared for the grave injustice made in comparing one individual planet with one solar system, a contrast is merited and hence done. The reality, nonetheless, is about disengagement from a group that lives life humanly, learning and evolving with each challenge and mistake without a clean, perfect tag attached to it, demonstrating not only an inability to disassociate the person from the artist and the music but also an inability to understand the difference between a private and public life.

Keywords: K-Pop, big bang, BTS, music, public image, entertainment, korean entertainment

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Authors: Ashfaque Hossain Khan, Brian Thomson, Ratan Debnath, Abhishek Motayed, Mulpuri V. Rao

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Though the efforts had been made, the problem of cross-sensitivity for a single metal oxide-based sensor can’t be fully eliminated. In this work, a sensor array has been designed and fabricated comprising of platinum (Pt), copper (Cu), and silver (Ag) decorated TiO2 and ZnO functionalized GaN nanowires using industry-standard top-down fabrication approach. The metal/metal-oxide combinations within the array have been determined from prior molecular simulation study using first principle calculations based on density functional theory (DFT). The gas responses were obtained for both single and mixture of NO2, SO2, ethanol, and H2 in the presence of H2O and O2 gases under UV light at room temperature. Each gas leaves a unique response footprint across the array sensors by which precise discrimination of cross-sensitive gases has been achieved. An unsupervised principal component analysis (PCA) technique has been implemented on the array response. Results indicate that each gas forms a distinct cluster in the score plot for all the target gases and their mixtures, indicating a clear separation among them. In addition, the developed array device consumes very low power because of ultra-violet (UV) assisted sensing as compared to commercially available metal-oxide sensors. The nanowire sensor array, in combination with PCA, is a potential approach for precise real-time gas monitoring applications.

Keywords: cross-sensitivity, gas sensor, principle component analysis (PCA), sensor array

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Authors: Yuan-Hao Lee, Chia-Wei Lee, Ming-Fang Lin, Tzu-Huei Wu, Chih-Hsiang Ko, Wing P. Chan

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Computed tomography (CT) scan of the head is a good method for investigating cranial lesions. However, radiation-induced oxidative stress can be accumulated in the eyes and promote carcinogenesis and cataract. In this regard, we aimed to protect the eyes with barium sulfate shield(s) during CT scans and investigate the resultant image quality and radiation dose to the eye. Patients who underwent health examinations were selectively enrolled in this study in compliance with the protocol approved by the Ethics Committee of the Joint Institutional Review Board at Taipei Medical University. Participants’ brains were scanned with a water-based marker simultaneously by a multislice CT scanner (SOMATON Definition Flash) under a fixed tube current-time setting or automatic tube current modulation (TCM). The lens dose was measured by Gafchromic films, whose dose response curve was previously fitted using thermoluminescent dosimeters, with or without barium sulfate or bismuth-antimony shield laid above. For the assessment of image quality CT images at slice planes that exhibit the interested regions on the zygomatic, orbital and nasal bones of the head phantom as well as the water-based marker were used for calculating the signal-to-noise and contrast-to-noise ratios. The application of barium sulfate and bismuth-antimony shields decreased 24% and 47% of the lens dose on average, respectively. Under topogram-based TCM, the dose saving power of bismuth-antimony shield was mitigated whereas that of barium sulfate shield was enhanced. On the other hand, the signal-to-noise and contrast-to-noise ratios of DSCT images were decreased separately by barium sulfate and bismuth-antimony shield, resulting in an overall reduction of the CNR. In contrast, the integration of topogram-based TCM elevated signal difference between the ROIs on the zygomatic bones and eyeballs while preferentially decreasing the signal-to-noise ratios upon the use of barium sulfate shield. The results of this study indicate that the balance between eye exposure and image quality can be optimized by combining eye shields with topogram-based TCM on the multislice scanner. Eye shielding could change the photon attenuation characteristics of tissues that are close to the shield. The application of both shields on eye protection hence is not recommended for seeking intraorbital lesions.

Keywords: computed tomography, barium sulfate shield, dose saving, image quality

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Authors: Nastaran Hemmati, Farhad Nikkhahi, Amir Javadi, Sahar Eskandarion, Seyed Mahmuod Amin Marashi

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Neisseria meningitidis, Escherichia coli K, Streptococcus agalactiae, and Streptococcus pneumoniae cause 90% of bacterial meningitis. Almost all infected people die or have irreversible neurological complications. Therefore, it is essential to have a diagnostic kit with the ability to quickly detect these fatal infections. The project involved 212 patients from whom cerebrospinal fluid samples were obtained. After total genome extraction and performing multiplex quantitative polymerase chain reaction (qPCR), the presence or absence of each infectious factor was determined by comparing with standard strains. The specificity, sensitivity, positive predictive value, and negative predictive value calculated were 100%, 92.9%, 50%, and 100%, respectively. So, due to the high specificity and sensitivity of the designed primers, they can be used instead of bacterial culture that takes at least 24 to 48 hours. The remarkable benefit of this method is associated with the speed (up to 3 hours) at which the procedure could be completed. It is also worth noting that this method can reduce the personnel unintentional errors which may occur in the laboratory. On the other hand, as this method simultaneously identifies four common factors that cause bacterial meningitis, it could be used as an auxiliary method diagnostic technique in laboratories particularly in cases of emergency medicine.

Keywords: cerebrospinal fluid, meningitis, quantitative polymerase chain reaction, simultaneous detection, diagnosis testing

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Authors: S. Mantzoukis, M. Gerasimou, P. Christodoulou, N. Varsamis, G. Kolliopoulou, N. Zotos

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Purpose: Patients in Intensive Care Units (ICU) are exposed to a different spectrum of microorganisms relative to the hospital. Due to the fact that the majority of these patients are intubated, bronchial secretions should be examined. Material and Method: Bronchial secretions should be taken with care so as not to be mixed with sputum or saliva. The bronchial secretions are placed in a sterile container and then inoculated into blood, Mac Conkey No2, Chocolate, Mueller Hinton, Chapman and Saboureaud agar. After this period, if any number of microbial colonies are detected, gram staining is performed and then the isolated organisms are identified by biochemical techniques in the automated Microscan system (Siemens) followed by a sensitivity test in the same system using the minimum inhibitory concentration MIC technique. The sensitivity test is verified by a Kirby Bauer test. Results: In 2017 the Laboratory of Microbiology received 365 samples of bronchial secretions from the Intensive Care Unit. 237 were found positive. S. epidermidis was identified in 1 specimen, A. baumannii in 60, K. pneumoniae in 42, P. aeruginosa in 50, C. albicans in 40, P. mirabilis in 4, E. coli in 4, S. maltophilia in 6, S. marcescens in 6, S. aureus in 12, S. pneumoniae in 1, S. haemolyticus in 4, P. fluorescens in 1, E. aerogenes in 1, E. cloacae in 5. Conclusions: The majority of ICU patients appear to be a fertile ground for the development of infections. The nature of the findings suggests that a significant part of the bacteria found comes from the unit (nosocomial infection).

Keywords: bronchial secretions, cultures, infections, intensive care units

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Authors: Meredith Jones, Susan Catapano, Carol McNulty

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Study abroad experiences create unique learning opportunities for preservice teachers to strengthen their reflective thinking practices through applied learning experiences. Not only do study abroad experiences provide opportunities for students to expand their cultural sensitivity, but incorporating applied learning experiences in study abroad trips creates unique opportunities for preservice teachers to engage in critical reflection on their teaching skills. Applied learning experiences are designed to nurture learning and growth through a reflective, experiential process outside the traditional classroom setting. As students participate in applied learning experiences, they engage in critical reflection independently, with their peers, and with university faculty. Critical reflection within applied learning contexts generates, deepens, and documents learning but must be intentionally designed to be effective. Grounded in Dewey’s model of reflection, this qualitative study examines longitudinal data from various study abroad cohorts from a particular university. Reflective data was collected during the study abroad trip, and follow up data on critical reflection of teaching practices were collected six months and a year after the trip. Dewey’s model of reflection requires preservice teachers to make sense of their experiences by reflecting on theoretical knowledge, experiences, and pedagogical knowledge. Guided reflection provides preservice teachers with a framework to respond to questions and ideas critical to the applied learning outcomes. Prompts are used to engage preservice teachers in reflecting on situations they have experienced and how they can be transferred to their teaching. Findings from this study noted that students with previous field experiences, or work in the field, engaged in more critical reflection on pedagogical knowledge throughout their applied learning experience. Preservice teachers with limited experiences in the field benefited from engaging in critical reflection prompted by university faculty during the applied learning experience. However, they were able to independently engage in critical reflection once they began work in the field through university field placements, internships, or student teaching. Finally, students who participated in study abroad applied learning experiences reported their critical reflection on their teaching practices, and cultural sensitivity enhanced their teaching and relationships with children once they formally entered the teaching profession.

Keywords: applied learning experiences, critical reflection, cultural sensitivity, preservice teachers, teacher education

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Authors: Thanooja Naushad, Meena Natarajan, Tushar Vasant Kulkarni

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Background: The Lacey Assessment of Preterm Infants (LAPI) is used in clinical practice to identify premature babies at risk of neuromotor impairments, especially cerebral palsy. This study attempted to find the validity of the Lacey assessment of preterm infants to predict neuromotor outcomes of premature babies at 12 months corrected age and to compare its predictive ability with the brain ultrasound. Methods: This prospective cohort study included 89 preterm infants (45 females and 44 males) born below 35 weeks gestation who were admitted to the neonatal intensive care unit of a government hospital in Dubai. Initial assessment was done using the Lacey assessment after the babies reached 33 weeks postmenstrual age. Follow up assessment on neuromotor outcomes was done at 12 months (± 1 week) corrected age using two standardized outcome measures, i.e., infant neurological international battery and Alberta infant motor scale. Brain ultrasound data were collected retrospectively. Data were statistically analyzed, and the diagnostic accuracy of the Lacey assessment of preterm infants (LAPI) was calculated -when used alone and in combination with the brain ultrasound. Results: On comparison with brain ultrasound, the Lacey assessment showed superior specificity (96% vs. 77%), higher positive predictive value (57% vs. 22%), and higher positive likelihood ratio (18 vs. 3) to predict neuromotor outcomes at one year of age. The sensitivity of Lacey assessment was lower than brain ultrasound (66% vs. 83%), whereas specificity was similar (97% vs. 98%). A combination of Lacey assessment and brain ultrasound results showed higher sensitivity (80%), positive (66%), and negative (98%) predictive values, positive likelihood ratio (24), and test accuracy (95%) than Lacey assessment alone in predicting neurological outcomes. The negative predictive value of the Lacey assessment was similar to that of its combination with brain ultrasound (96%). Conclusion: Results of this study suggest that the Lacey assessment of preterm infants can be used as a supplementary assessment tool for premature babies in the neonatal intensive care unit. Due to its high specificity, Lacey assessment can be used to identify those babies at low risk of abnormal neuromotor outcomes at a later age. When used along with the findings of the brain ultrasound, Lacey assessment has better sensitivity to identify preterm babies at particular risk. These findings have applications in identifying premature babies who may benefit from early intervention services.

Keywords: brain ultrasound, lacey assessment of preterm infants, neuromotor outcomes, preterm

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Authors: Huang Haoxin

Abstract:

Large dark current at room temperature has long been the major bottleneck that impedes the development of high-performance infrared photodetectors towards miniaturization and integration. Although infrared photodetectors based on layered 2D narrow bandgap semiconductors have shown admirable advantages compared with those based on conventional compounds, which typically suffer from expensive cryogenic operations, it is still urgent to develop a simple but effective strategy to further reduce the dark current. Herein, a tellurium (Te) based infrared photodetector is reported with a specifically designed asymmetric electrical contact area. The deliberately introduced asymmetric electrical contact raises the electric field intensity difference in the Te channel near the drain and the source electrodes, resulting in spontaneous asymmetric carrier diffusion under global infrared light illumination under zero bias. Specifically, the Te-based photodetector presents promising detector performance at room temperature, including a low dark current of≈1 nA, an ultrahigh photocurrent/dark current ratio of 1.57×10⁴, a high specific detectivity (D*) of 3.24×10⁹ Jones, and relatively fast response speed of ≈720 μs at zero bias. The results prove that the simple design of asymmetric electrical contact areas can provide a promising solution to high-performance 2D semiconductor-based infrared photodetectors working at room temperature.

Keywords: asymmetrical contact, tellurium, dark current, infrared photodetector, sensitivity

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Authors: Chih-Yi Ho, Tzu-Fang Chang, Chih-Chia Huang, Chia-Yen Lee

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In dental clinics, the dentists use the periapical radiography image to assess the effectiveness of endodontic treatment of teeth with chronic apical periodontitis. Periapical radiography images are taken at different times to assess alveolar bone variation before and after the root canal treatment, and furthermore to judge whether the treatment was successful. Current clinical assessment of apical tissue recovery relies only on dentist personal experience. It is difficult to have the same standard and objective interpretations due to the dentist or radiologist personal background and knowledge. If periapical radiography images at the different time could be registered well, the endodontic treatment could be evaluated. In the image registration area, it is necessary to assign representative control points to the transformation model for good performances of registration results. However, detection of representative control points (feature points) on periapical radiography images is generally very difficult. Regardless of which traditional detection methods are practiced, sufficient feature points may not be detected due to the low-contrast characteristics of the x-ray image. Barnard detector is an algorithm for feature point detection based on grayscale value gradients, which can obtain sufficient feature points in the case of gray-scale contrast is not obvious. However, the Barnard detector would detect too many feature points, and they would be too clustered. This study uses the local extrema of clustering feature points and the suppression radius to overcome the problem, and compared different feature point detection methods. In the preliminary result, the feature points could be detected as representative control points by the proposed method.

Keywords: feature detection, Barnard detector, registration, periapical radiography image, endodontic treatment

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Authors: Maximilian A. Richter

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The public authority needs to understand the role and impacts of autonomous vehicle (AV) on the mobility system. At present, however, research shows that the impact of AV on cities varies. As a consequence, it is difficult to make recommendations to policymakers on how they should prepare for the future when so much remains unknown about this technology. The study aims to provide an overview of the literature on how autonomous vehicles will affect the cities and traffic of the future. To this purpose, the most important studies are first selected, and their results summarized. Further on, it will be clarified which advantages AV have for cities and how it can lead to an improvement in the current problems/challenges of cities. To achieve the research aim and objectives, this paper approaches a literature review. For this purpose, in a first step, the most important studies are extracted. This is limited to studies that are peer-reviewed and have been published in high-ranked journals such as the Journal of Transportation: Part A. In step 2, the most important key performance indicator (KPIs) (such as traffic volume or energy consumption) are selected from the literature research. Due to the fact that different terms are used in the literature for similar statements/KPIs, these must first be clustered. Furthermore, for each cluster, the changes from the respective studies are compiled, as well as their survey methodology. In step 3, a sensitivity analysis per cluster is made. Here, it will be analyzed how the different studies come to their findings and on which assumptions, scenarios, and methods these calculations are based. From the results of the sensitivity analysis, the success factors for the implementation of autonomous vehicles are drawn, and statements are made under which conditions AVs can be successful.

Keywords: autonomous vehicles, city of the future, literature review, traffic simulations

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Authors: Francisco Pedroza-Montero, Jesús Naín Pedroza-Montero, Diego Soto-Puebla, Osiris Alvarez-Bajo, Beatriz Castaneda, Sofía Navarro-Espinoza, Martín Pedroza-Montero

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Nanodiamonds have been widely studied for their physical properties, including chemical inertness, biocompatibility, optical transparency from the ultraviolet to the infrared region, high thermal conductivity, and mechanical strength. In this work, we studied how the fluorescence spectrum of nanodiamonds quenches concerning the concentration in aqueous solutions systematically ranging from 0.1 to 10 mg/mL. Our results demonstrated a non-linear fluorescence quenching as the concentration increases for both of the NV zero-phonon lines; the 5 mg/mL concentration shows the maximum fluorescence emission. Furthermore, this behaviour is theoretically explained as an electronic recombination process that modulates the intensity in the NV centres. Finally, to gain more insight, the FRET methodology is used to determine the fluorescence efficiency in terms of the fluorophores' separation distance. Thus, the concentration level is simulated as follows, a small distance between nanodiamonds would be considered a highly concentrated system, whereas a large distance would mean a low concentrated one. Although the 5 mg/mL concentration shows the maximum intensity, our main interest is focused on the concentration of 0.5 mg/mL, which our studies demonstrate the optimal human cell viability (99%). In this respect, this concentration has the feature of being as biocompatible as water giving the possibility to internalize it in cells without harming the living media. To this end, not only can we track nanodiamonds on the surface or inside the cell with excellent precision due to their fluorescent intensity, but also, we can perform thermometry tests transforming a fluorescence contrast image into a temperature contrast image.

Keywords: nanodiamonds, fluorescence spectroscopy, concentration, bioimaging, thermometry

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Authors: Scott Ashby, Emily Granger, Mark Connellan

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Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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Authors: Chaitanya R. Mali, V. Vinod, Ashwin W. Patwardhan

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Design of long vertical steam generator (SG) tubes in nuclear power plant involves an understanding of different aspects of flow boiling phenomenon such as flow instabilities, flow regimes, dry out, critical heat flux, pressure drop, etc. The knowledge of the prediction of local thermal hydraulic characteristics is necessary to understand these aspects. For this purpose, the methodology has been developed which covers all the flow boiling regimes to model full range flow boiling phenomenon. In this methodology, the vertical tube is divided into four sections based on vapor fraction value at the end of each section. Different modeling strategies have been applied to the different sections of the vertical tube. Computational fluid dynamics simulations have been performed on a vertical SG tube of 0.0126 m inner diameter and 23 m length. The thermal hydraulic parameters such as vapor fraction, liquid temperature, heat transfer coefficient, pressure drop, heat flux distribution have been analyzed for different designed heat duties (1.1 MW (20%) to 3.3 MW (60%)) and flow conditions (10 % to 80 %). The sensitivity of different boiling parameters such as bubble departure diameter, nucleation site density, bubble departure frequency on the thermal hydraulic parameters was also studied. Flow instability has been observed at 20 % designed heat duty and 20 % flow conditions.

Keywords: thermal hydraulics, boiling, vapor fraction, sensitivity

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Authors: Priyal Chikhaliwala, Sudeshna Chandra

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Liver cancer is one of the most common malignant tumors with poor prognosis. This is because liver cancer does not exhibit any symptoms in early stage of disease. Increased serum level of AFP is clinically considered as a diagnostic marker for liver malignancy. The present diagnostic modalities include various types of immunoassays, radiological studies, and biopsy. However, these tests undergo slow response times, require significant sample volumes, achieve limited sensitivity and ultimately become expensive and burdensome to patients. Considering all these aspects, electrochemical biosensors based on dendrimer-magnetic nanoparticles (MNPs) was designed. Dendrimers are novel nano-sized, three-dimensional molecules with monodispersed structures. Poly-amidoamine (PAMAM) dendrimers with eight –NH₂ groups using ethylenediamine as a core molecule were synthesized using Michael addition reaction. Dendrimers provide added the advantage of not only stabilizing Fe₃O₄ NPs but also displays capability of performing multiple electron redox events and binding multiple biological ligands to its dendritic end-surface. Fe₃O₄ NPs due to its superparamagnetic behavior can be exploited for magneto-separation process. Fe₃O₄ NPs were stabilized with PAMAM dendrimer by in situ co-precipitation method. The surface coating was examined by FT-IR, XRD, VSM, and TGA analysis. Electrochemical behavior and kinetic studies were evaluated using CV which revealed that the dendrimer-Fe₃O₄ NPs can be looked upon as electrochemically active materials. Electrochemical immunosensor was designed by immobilizing anti-AFP onto dendrimer-MNPs by gluteraldehyde conjugation reaction. The bioconjugates were then incubated with AFP antigen. The immunosensor was characterized electrochemically indicating successful immuno-binding events. The binding events were also further studied using magnetic particle imaging (MPI) which is a novel imaging modality in which Fe₃O₄ NPs are used as tracer molecules with positive contrast. Multicolor MPI was able to clearly localize AFP antigen and antibody and its binding successfully. Results demonstrate immense potential in terms of biosensing and enabling MPI of AFP in clinical diagnosis.

Keywords: alpha-fetoprotein, dendrimers, electrochemical biosensors, magnetic nanoparticles

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Authors: Prasad Urvashi, Wynn Yezarni, Williams Shehan, Ravindran Arun

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Introduction: Primary health services are often the first point of contact that patients with mental illness have with the healthcare system. A number of tools have been developed to increase detection of depression in the context of primary care. However, one challenge amongst many includes utilizing these tools within the limited primary care consultation timeframe. Therefore, short questionnaires that screen for depression that are just as effective as more comprehensive diagnostic tools may be beneficial in improving detection rates of patients visiting a primary care setting. Objective: To develop and determine the sensitivity and specificity of a 2-Question Questionnaire (2-QQ) to screen for depression in in a suburban primary care clinic in Ragama, Sri Lanka. The purpose is to develop a short screening tool for depression that is culturally adapted in order to increase the detection of depression in the Sri Lankan patient population. Methods: This was a cross-sectional study involving two steps. Step one: verbal administration of 2-QQ to patients by their primary care physician. Step two: completion of the Peradeniya Depression Scale, a validated diagnostic tool for depression, the patient after their consultation with the primary care physician. The results from the PDS were then correlated to the results from the 2-QQ for each patient to determine sensitivity and specificity of the 2-QQ. Results: A score of 1/+ on the 2-QQ was most sensitive but least specific. Thus, setting the threshold at this level is effective for correctly identifying depressed patients, but also inaccurately captures patients who are not depressed. A score of 6 on the 2-QQ was most specific but least sensitive. Setting the threshold at this level is effective for correctly identifying patients without depression, but not very effective at capturing patients with depression. Discussion: In the context of primary care, it may be worthwhile setting the 2-QQ screen at a lower threshold for positivity (such as a score of 1 or above). This would generate a high test sensitivity and thus capture the majority of patients that have depression. On the other hand, by setting a low threshold for positivity, patients who do not have depression but score higher than 1 on the 2-QQ will also be falsely identified as testing positive for depression. However, the benefits of identifying patients who present with depression may outweigh the harms of falsely identifying a non-depressed patient. It is our hope that the 2-QQ will serve as a quick primary screen for depression in the primary care setting and serve as a catalyst to identify and treat individuals with depression.

Keywords: depression, primary care, screening tool, Sri Lanka

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