Search results for: wireless patient monitoring

Authors: Jiji Jose, R. Narayanacharyulu, Molly Mathew, Jisha Prems

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Introduction: Lercanidipine hydrochloride (LD), an effective calcium channel blocker, widely used for the treatment of chronic stable angina and hypertension seems to be potential transdermal therapeutic system candidate, mainly due to its low oral bio availability, short half life and high first-pass metabolism. Objective: To develop transdermal therapeutic systems for LD and to evaluate its in vivo performance in rabbits. Methodology: Transdermal patches of LD were formulated using the polymer blend of eudragit RL100 (ERL) and polyvinyl pyrolidone (PVP) by casting method Propylene glycol (PG) and tween 80 were used as plasticizer and permeation enhancer respectively. The pharmaco kinetic parameters of LD after the administration of transdermal patches was compared with that of oral administration. The study was carried out in a two way crossover design in male New Zealand albino rabbits. Results: The formulation with ERL: PVP ratio 1:4 with 15% w/w PG as plasticizer and 4% w/w tween 80 as permeation enhancer showed the best drug release results. The pharmacokinetic parameters such as Cmax, tmax, mean residence time (MRT) and area under the curve (AUC 0-∞) were significantly different following transdermal administration compared to oral administration. The terminal half life of transdermally administered LD was found to similar that of oral administration. A sustained drug release over a period of 24 hrs was observed after transdermal administration. Conclusion: The fabricated transdermal delivery system have the potential to provide controlled and extended drug release, better bio availability and thus, this may improve the patient compliance.

Keywords: transdermal therapeutic system, lercanidipine hydrochloride, eudragit, skinpermeation

Procedia PDF Downloads 615

Authors: Mohamed Ziyaina, Ahlam Rajab, Khadija Alkhweldi, Wafia Algami, Omer Al. Toumi, Barbara Rasco1

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In recent years, there has been a growing interest in monitoring heavy metal contamination in food products. Spices can improve the taste of food and can also be a source of many bioactive compounds but can unfortunately, also be contaminated with dangerous materials, potentially heavy metals. This study was conducted to investigate lead (Pb) and cadmium (Cd) contamination in selected spices commonly consumed in Libya including Capsicum frutescens (chili pepper) Piper nigrum, (black pepper), Curcuma longa (turmeric), and mixed spices (HRARAT) which consist of a combination of: Alpinia officinarum, Zingiber officinale and Cinnamomum zeylanicum. Spices were analyzed by atomic absorption spectroscopy after digestion with nitric acid/hydrogen peroxide. The highest level of lead (Pb) was found in Curcuma longa and Capsicum frutescens in wholesale markets (1.05 ± 0.01 mg/kg, 0.96 ± 0.06 mg/kg). Cadmium (Cd) levels exceeded FAO/WHO permissible limit. Curcuma longa and Piper nigrum sold in retail markets had a high concentration of Cd (0.36 ± 0.09, 0.35 ± 0.07 mg/kg, respectively) followed by (0.32 ± 0.04 mg/kg) for Capsicum frutescens. Mixed spices purchased from wholesale markets also had high levels of Cd (0.31 ± 0.08 mg/kg). Curcuma longa and Capsicum frutescens may pose a food safety risk due to high levels of lead and cadmium. Cadmium levels exceeded FAO/WHO recommendations (0.2 ppm) for Piper nigrum, Curcuma longa, and mixed spices (HRARAT).

Keywords: heavy metals, lead, cadmium determination, spice

Procedia PDF Downloads 644

Authors: Sinead Impey, Damon Berry, Selma Furtado, Miriam Galvin, Loretto Grogan, Orla Hardiman, Lucy Hederman, Mark Heverin, Vincent Wade, Linda Douris, Declan O'Sullivan, Gaye Stephens

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Healthcare is a knowledge-rich environment. This knowledge, while valuable, is not always accessible outside the borders of individual clinics. This research aims to address part of this problem (at a study site) by constructing a maximal data set (knowledge artefact) for motor neurone disease (MND). This data set is proposed as an initial knowledge base for a concurrent project to develop an MND patient data platform. It represents the domain knowledge at the study site for the duration of the research (12 months). A knowledge elicitation method was also developed from the lessons learned during this process - the WICKED method. WICKED is an anagram of the words: eliciting and confirming data, information, knowledge, wisdom. But it is also a reference to the concept of wicked problems, which are complex and challenging, as is eliciting expert knowledge. The method was evaluated at a second site, and benefits and limitations were noted. Benefits include that the method provided a systematic way to manage data, information, knowledge and wisdom (DIKW) from various sources, including healthcare specialists and existing data sets. Limitations surrounded the time required and how the data set produced only represents DIKW known during the research period. Future work is underway to address these limitations.

Keywords: healthcare, knowledge acquisition, maximal data sets, action design science

Procedia PDF Downloads 367

Authors: Pia Berner Hansson, Robert Murison Anders Lund, Hammar Åsa

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Major Depressive Disorder (MDD) is often associated with high levels of stress and disturbances in the Hypothalamic Pituitary Adrenal (HPA) system, yielding high levels of cortisol, in addition to cognitive dysfunction. Previous studies in this patient group have shown a relationship between cortisol profile and cognitive functioning in the acute phase of MDD and that the patients had significantly less suppression after dexamethasone administration. However, few studies have investigated this relationship over time and in phases of symptom reduction. The aim of the present study was to examine the relationships between cortisol levels after the Dexamethasone Suppression Test (DST) and cognitive function in a long term perspective in MDD patients. Patients meeting the DSM-IV criteria for a MDD were included in the study and tested in symptom reduction. A control group was included. Cortisol was measured in saliva collected with Salivette sampling devices. Saliva samples were collected 4 times during a 24 hours period over two consecutive days: at awakening, after 45 minutes, after 7 hours and at 11 pm. Dexamethasone (1.0 mg) was given on Day 1 at 11 pm. The neuropsychological test battery consisted of standardized tests measuring memory and Executive Functioning (EF). Cortisol levels did not differ significantly between patients and controls on Day 1 or Day 2. Both groups showed significant suppression after Dexamethasone. There were no correlations between cortisol levels or suppression after Dexamethasone and cognitive measures. The results indicate that the HPA-axis functioning normalizes in phases of symptom reduction in MDD patients and that there no relation between cortisol profile and cognitive functioning in memory or EF.

Keywords: depression, MDD, cortisol, suppression, cognitive functioning

Procedia PDF Downloads 333

Authors: Titap Yazicioglu

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Purpose: Losing an eye due to trauma is a challenging situation that reduces the quality of life by causing physical, cosmetic, and serious psychological problems. This study aimed to evaluate the effect of aesthetic rehabilitation on the change in psychological status and quality of life of patients with eye loss resulting in phthisis bulbi. Materials and Methods: The files of 25 males and 15 females with an average age of 27.5 years who had trauma-related phthisic eye and had applied to the Department of Ophthalmology at the Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey, for aesthetic rehabilitation during the years 2015-19 were retrospectively analyzed. The Beck Depression Inventory (BDI), Beck Anxiety Scale(BAS), and Short Form 36 quality-of-life survey (SF-36) were used to collect data on admission and one-year follow-up. Results: Of the patients reviewed, 65% stated that eye loss had caused their avoidance of family and social environments; 30% had moderate anxiety and depression. The post-operative sub-dimension scores of general health, emotional role function, and physical and social functions were statistically significant (p = 0.001; p<0.01), but the variations in the sub-dimension scores of vitality, mental health, and total physical health were not (p>0.05). Conclusion: Lossing an eye is a traumatic event that can affect all aspects of a person’s social and professional life. A patient who has suffered from the psychological damage of physical loss of eye needs a prosthesis that can give the desired function and appearance in different aspects of life.

Keywords: eye loss, phthisis bulbi, quality of life, psychological trauma

Procedia PDF Downloads 127

Authors: Abdelrahman Elsehsah, Abdelazim Negm, Eid Ashour, Mohamed Elsahabi

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Water resources management is a critical field that encompasses the planning, development, conservation, and allocation of water resources to meet societal needs while ensuring environmental sustainability. This paper reviews the key concepts and challenges in water resources management, emphasizing the significance of a holistic approach that integrates social, economic, and environmental factors. Traditional water management practices, characterized by supply-oriented strategies and centralized control, are increasingly inadequate in addressing contemporary challenges such as water scarcity, climate change impacts, and ecosystem degradation. Emerging technologies, particularly machine learning and remote sensing, offer innovative solutions to enhance decision-making processes in water management. Machine learning algorithms facilitate accurate water demand forecasting, quality monitoring, and leak detection, while remote sensing technologies provide vital data for assessing water availability and quality. This review highlights the need for integrated water management strategies that leverage these technologies to promote sustainable practices and foster resilience in water systems. Future research should focus on improving data quality, accessibility, and the integration of diverse datasets to optimize the benefits of these technological advancements.

Keywords: water resources management, water scarcity, climate change, machine learning, remote sensing, water quality, water governance, sustainable practices, ecosystem management

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Authors: Tukundane Hillary

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This research paper analytically evaluates the project control practice levels used by the building construction companies within Kampala, Uganda. The research also assesses the outcome of project control practices on the productivity of the companies. The research was performed to ascertain the current control practices among 160 respondents from various construction companies registered with the Uganda Registration Services Bureau. This research used amalgamation from multiple literature to obtain the variables. The research adopts 34 standard control practices from four vital project control duties: planning, monitoring, analyzing, and reporting. These project control tasks were organized using mean response ratings grounded on their relevance to the construction companies. Results showed that evaluating performance with the use of curves (4.32), timely access to information and encouragement (4.55), report representation using quantitative tools 4.75, and cost value comparison application during analysis (4.76) were rated least among the control practices. On the other hand, the top project control practices included formulation of the project schedule (8.88), Project feasibility validation (8.86), Budgeting for each activity (8.84), Key project route definition (8.81), Team awareness of the budget (8.77), Setting realistic targets for projects (8.50) and Consultation from subcontractors (8.74). From the results obtained by the sample respondents specified, it can be concluded that planning is the most vital project control task practiced in the building construction industry in Uganda. In addition, this research ascertained a substantial relationship between project control practices and the performance of building construction companies. Accordingly, this research recommends that project control practices be effectively observed by both contracting and consulting companies to enhance their overall performance and governance.

Keywords: cost value, project control, cost control, time control, project performance, control practices

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Authors: Yulin Rao, Zhixuan Li, Burra Venkata Durga Kumar

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Intrusion detection refers to monitoring the actions of internal and external intruders on the system and detecting the behaviours that violate security policies in real-time. In intrusion detection, there has been much discussion about the application of neural network technology and artificial immune system (AIS). However, many solutions use static methods (signature-based and stateful protocol analysis) or centralized intrusion detection systems (CIDS), which are unsuitable for real-time intrusion detection systems that need to process large amounts of data and detect unknown intrusions. This article proposes a framework for a distributed intrusion detection system (DIDS) with multi-agents based on the concept of AIS and neural network technology to detect anomalies and intrusions. In this framework, multiple agents are assigned to each host and work together, improving the system's detection efficiency and robustness. The trainer agent in the central server of the framework uses the artificial neural network (ANN) rather than the negative selection algorithm of AIS to generate mature detectors. Mature detectors can distinguish between self-files and non-self-files after learning. Our analyzer agents use genetic algorithms to generate memory cell detectors. This kind of detector will effectively reduce false positive and false negative errors and act quickly on known intrusions.

Keywords: artificial immune system, distributed artificial intelligence, multi-agent, intrusion detection system, neural network

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Authors: Abeer Ahmed Abdelhamed

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Introduction: Postoperative pulmonary complications (PPCs) are the most common complications observed and managed after abdominal or cardiothoracic surgery. Hypoxemia, atelectasis, pleural effusion, or diaphragmatic dysfunction, are often a source of morbidity in cardiac surgery patients, and are more common in patients receiving unilateral or bilateral internal mammary artery (IMT) grafts than patients receiving saphenous vein (SV) grafts alone. Purpose: The aim of this work was to investigate the effect of Threshold load inspiratory muscle training on pulmonary gas exchange and maximum inspiratory pressure (MIP) in patient undergoing coronary revascularization. Subject: Thirty three male patients eligible for coronary revascularization were selected to participate in the study. Method: They were divided into two groups(17 patients in the intervention group and 16 patients in the control group), the interventional group received inspiratory muscle training at 30% of their maximum inspiratory pressure throughout the hospitalization period in addition to routine post operative care. Result: The results of this study showed a significant improvement on maximum inspiratory pressure(MIP), Arterial-alveolar pressure gradient (A-a gradient) and oxygen saturation in the intervention group. Conclusion: Inspiratory muscle training using threshold mode significantly improves maximum inspiratory pressure, pulmonary gas exchange tested by alveolar-arterial gradient and oxygen saturation in Patients undergoing coronary revascularization.

Keywords: coronary revascularization, inspiratory muscle training, maximum inspiratory pressure, pulmonary gas exchange

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Authors: Adnan Ahmad, Yusri Kamin, Asnol Dahar Minghat, Mohd. Khir Nordin, Dayana Farzeha, Ahmad Nabil

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The purpose of this study is to identify the teaching method practices of the practical work subject in Vocational Secondary School. This study examined the practice of Vocational Teaching Method in Automotive Practical Work. The quantitative method used the sets of the questionnaire. 283 students and 63 teachers involved from ten VSS involved in this research. Research finding showed in conducting the introduction session teachers prefer used the demonstration method and questioning technique. While in deliver the content of practical task, teachers applied group monitoring and problem-solving approach. To conclude the task of automotive practical work, teachers choose re-explain and report writing to make sure students really understand all the process of teaching. VTM-APW also involved the competency-based concept to embed in the model. Derived from factors investigated, research produced the combination of elements in teaching skills and vocational skills which could be used as the best teaching method in automotive practical work for school level. As conclusion this study has concluded that the VTM-APW model is able to apply in teaching to make an improvement with current practices in Vocational Secondary School. Hence, teachers are suggested to use this method to enhance student's knowledge in Automotive and teachers will deliver skills to the current and future workforce relevant with the required competency skilled in workplace.

Keywords: vocational teaching method, practical task, teacher preferences, student preferences

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Authors: Azita Ramezani, Ghazal Mashhadiagha, Bahareh Sanabakhsh

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This study researches the combination of Random. Forest classifiers with large language models (LLMs) and natural language processing (NLP) to improve diagnostic accuracy in chest X-ray analysis using the Indiana University dataset. Utilizing advanced NLP techniques, the research preprocesses textual data from radiological reports to extract key features, which are then merged with image-derived data. This improved dataset is analyzed with Random Forest classifiers to predict specific clinical results, focusing on the identification of health issues and the estimation of case urgency. The findings reveal that the combination of NLP, LLMs, and machine learning not only increases diagnostic precision but also reliability, especially in quickly identifying critical conditions. Achieving an accuracy of 99.35%, the model shows significant advancements over conventional diagnostic techniques. The results emphasize the large potential of machine learning in medical imaging, suggesting that these technologies could greatly enhance clinician judgment and patient outcomes by offering quicker and more precise diagnostic approximations.

Keywords: natural language processing (NLP), large language models (LLMs), random forest classifier, chest x-ray analysis, medical imaging, diagnostic accuracy, indiana university dataset, machine learning in healthcare, predictive modeling, clinical decision support systems

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Authors: Tebogo Emma Makaba, Barnabas Ndlovu Gatsheni

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The cities of Johannesburg and Pretoria both located in the Gauteng province are separated by a distance of 58 km. The traffic queues on the Ben Schoeman freeway which connects these two cities can stretch for almost 1.5 km. Vehicle traffic congestion impacts negatively on the business and the commuter’s quality of life. The goal of this paper is to identify variables that influence the flow of traffic and to design a vehicle traffic prediction model, which will predict the traffic flow pattern in advance. The model will unable motorist to be able to make appropriate travel decisions ahead of time. The data used was collected by Mikro’s Traffic Monitoring (MTM). Multi-Layer perceptron (MLP) was used individually to construct the model and the MLP was also combined with Bagging ensemble method to training the data. The cross—validation method was used for evaluating the models. The results obtained from the techniques were compared using predictive and prediction costs. The cost was computed using combination of the loss matrix and the confusion matrix. The predicted models designed shows that the status of the traffic flow on the freeway can be predicted using the following parameters travel time, average speed, traffic volume and day of month. The implications of this work is that commuters will be able to spend less time travelling on the route and spend time with their families. The logistics industry will save more than twice what they are currently spending.

Keywords: bagging ensemble methods, confusion matrix, multi-layer perceptron, vehicle traffic flow

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Authors: Siwanit Autthawuttikul, Prakob Koraneekid, Sayamon Insa-ard

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The purposes of this research were to development creatively integrated teaching skills using Information and Communication Technology (ICT) for professional teacher in schools under the education area of the basic education commission, ministry of education both schools under the office of primary education and those under The office of secondary education in eight western region provinces of Thailand. This is useful in defining a vision for the school strategy and restructuring schools in addition, teachers will have developed skills in teaching creative integrated ICT. The research methodology comprises quantitative and qualitative data collection. The Baseline Survey, focus group for discussions and then the model was developed creatively integrated teaching skills using ICT. The findings showed that 7 elements were important: (1) Academy Transformation (2) Information Technology Infrastructure (3) Personal Development (4) Supervision, Monitoring and Evaluation (5) Motivating and Rewarding (6) Important factor affecting the success of teaching integrated with ICT were knowledge, skills, attitudes and (7) The role of the individual concerned. The comparison creatively integrated teaching skills before and after participating in the overall shows that the average creatively integrated teaching skills using ICT after attending the event is 3.27, and standard deviation was 0.56, higher than before which is 2.60 and the standard deviation was 0.56. There are significant differences significant statistically level of .05. The final average score of the evaluation plan design creatively integrated teaching skills using ICT teachers' average score was 26.94 at the high levels.

Keywords: integrated curriculum, information and communications technology, teachers in the western region, schools

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Authors: Manal Al Bahri, Saif Al Mubahisi, Shamsa Al Shahaimi, Asma Al Qasabi, Jamal Al Aghbari

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Introduction: ILD is a common disease worldwide and in Oman. No previous Omani study was published regarding ILD prognosis based on baseline PFT results and other factors. This study aims to determine the severity of ILD by the baseline PFT, correlate between baseline PFT and outcome, and study other factors that influence disease mortality. Method: It is a retrospective cohort study; data was collected from January 2011 to December 2021 from electronic patient records (EPR). Means, Standard Deviations, frequencies, and Chi-square tests were used to examine the different variables in the study. Results: The total population of the study was 146 patients; 87 (59.6%) were females, and 59 (40.4%) were males. The median age was 59 years. Age at diagnosis, CVA, rheumatological disease, and baseline FVC were found to be statistically significant predictors of mortality .59.6% of the patients are diagnosed with IPF. Most of our study patients had mild disease based on baseline FVC. Death was higher with the more severe disease based on FVC. In mild disease (FVC >70%), 26.9% of the patients died. In moderate disease (FVC 50-69%),55.7% of the patients died, and in the severe group (FVC <50 %), 55.1% died. This was statistically significant with a P value of 0. 001. There is no statistically significant difference in the overall survival distribution between the different groups of DLCO. Conclusion: In our study, we found that ILD is more common among females, but death is more common among males. Based on baseline PFT, we can predict mortality by FVC level, as moderate to severe limitation is associated with a lower survival rate. DLCO was not a statistically significant parameter associated with mortality.

Keywords: PFT, ILD, FVC, DLCO, mortality

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Authors: Kay-Anne Haykal, Issack Biyong

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The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: post-traumatic stress disorder, co-morbidities, diagnosis, mental health disorders

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Authors: Issam Jebreen, Eman Al-Qbelat

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Outsourcing software development projects can be challenging, and there are several common challenges that organizations face. A study was conducted with a sample of 46 papers on outsourcing challenges, and the results show that there are several common challenges faced by organizations when outsourcing software development projects. Poor outsourcing relationship was identified as the most significant challenge, with 35% of the papers referencing it. Lack of quality was the second most significant challenge, with 33% of the papers referencing it. Language and cultural differences were the third most significant challenge, with 24% of the papers referencing it. Non-competitive price was another challenge faced by organizations, with 21% of the papers referencing it. Poor coordination and communication were also identified as a challenge, with 21% of the papers referencing it. Opportunistic behavior, lack of contract negotiation, inadequate user involvement, and constraints due to time zone were also challenges faced by organizations. Other challenges faced by organizations included poor project management, lack of technical capabilities, vendor employee high turnover, poor requirement specification, IPR issues, poor management of budget, schedule, and delay, geopolitical and country instability, the difference in development methodologies, failure to manage end-user expectations, and poor monitoring and control. In conclusion, outsourcing software development projects can be challenging, but organizations can mitigate these challenges by selecting the right outsourcing partner, having a well-defined contract and clear communication, having a clear understanding of the requirements, and implementing effective project management practices.

Keywords: software outsourcing, vendor, outsourcing challenges, quality model, continent, country, global outsourcing, IT workforce outsourcing.

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Authors: L. José, S. Vieira, E. Melo, A. R. Pinheiro

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Objectives: This study aims to characterize the stroke profile and the health care provided for people with a stroke in Luanda, Angola. Methods: A prospective longitudinal study was conducted at two Health centers, from March to November 2023, enrolling stroke patients. Data was gathered using a survey created by the researchers and validated by a health panel of experts from Angola. The analysis focused on demographic and stroke characteristics, as well as the care provided. Ethical approval and informed consent were obtained. Results: Preliminary results of a total of 186 patients are described, 122 from a Central Acute Care Hospital, with a mean age of 51.3±14.35 years old, a BMI of 26.7±4.15 kg/m2, 41% male, and 64 patients from a Rehabilitation Center, with 55.6±11.55 years old, a BMI of 27.0±3.8 kg/m2, 53% male. Ischemic stroke was reported as the most representative type in both centers (71.3% and 70.3%, respectively), though 100% of patients had no imaging diagnosis confirmation, neither data about the subtype was given. For patients admitted to the Hospital, discharge occurred before rehabilitation, and no follow-up was possible. No rehabilitation care was delivered in the first 7 days after the stroke. In the Rehabilitation Center, patient’s rehabilitation started in the late subacute phase, after a mean of 171.8±11.5 days. Conclusions: Stroke diagnosis lacks imaging confirmation, which is decisive for proper treatment, and rehabilitation starts during the late subacute phase, which is too late considering the international guidelines and the best window of opportunity for neuroplasticity and recovery. These results highlight the urgent need for the definition of Stroke-directed Health Care Policies in Angola.

Keywords: stroke, personalized health care, functional recovery, quality of life, health policies

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Authors: Mario Isaza-Ruget, Claudia C. Colmenares-Mejia, Nancy Yomayusa, Camilo A. González, Andres Cely, Jossie Murcia

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Quantification of risks associated with complications development from chronic kidney disease (CKD) through accurate survival models can help with patient management. A retrospective cohort that included patients diagnosed with CKD from a primary care program and followed up between 2013 and 2018 was carried out. Time-dependent and static covariates associated with demographic, clinical, and laboratory factors were included. Deep Learning (DL) survival analyzes were developed for three CKD outcomes: CKD stage progression, >25% decrease in Estimated Glomerular Filtration Rate (eGFR), and Renal Replacement Therapy (RRT). Models were evaluated and compared with Random Survival Forest (RSF) based on concordance index (C-index) metric. 2.143 patients were included. Two models were developed for each outcome, Deep Neural Network (DNN) model reported C-index=0.9867 for CKD stage progression; C-index=0.9905 for reduction in eGFR; C-index=0.9867 for RRT. Regarding the RSF model, C-index=0.6650 was reached for CKD stage progression; decreased eGFR C-index=0.6759; RRT C-index=0.8926. DNN models applied in survival analysis context with considerations of longitudinal covariates at the start of follow-up can predict renal stage progression, a significant decrease in eGFR and RRT. The success of these survival models lies in the appropriate definition of survival times and the analysis of covariates, especially those that vary over time.

Keywords: artificial intelligence, chronic kidney disease, deep neural networks, survival analysis

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Authors: Sandeep Thakur, Ismail Mondal, Phani Bhusan Ghosh, Papita Das, Tarun Kumar De

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Sundarbans Reserve forest of India has been undergoing major transformations in the recent past owing to population pressure and related changes. This has brought about major changes in the spatial landscape of the region especially in the western parts. This study attempts to assess the impacts of the Landcover changes on the mangrove habitats. Time series imageries of Landsat were used to analyze the Normalized Differential Vegetation Index (NDVI) patterns over the western parts of Indian Sundarbans forest in order to assess the heath of the mangroves in the region. The images were subjected to Land use Land cover (LULC) classification using sub-pixel classification techniques in ERDAS Imagine software and the changes were mapped. The spatial proliferation of aquaculture farms during the study period was also mapped. A multivariate regression analysis was carried out between the obtained NDVI values and the LULC classes. Similarly, the observed meteorological data sets (time series rainfall and minimum and maximum temperature) were also statistically correlated for regression. The study demonstrated the application of NDVI in assessing the environmental status of mangroves as the relationship between the changes in the environmental variables and the remote sensing based indices felicitate an efficient evaluation of environmental variables, which can be used in the coastal zone monitoring and development processes.

Keywords: aquaculture farms, LULC, Mangrove, NDVI

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Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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Authors: Aljon Pangan

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The Philippines being an archipelagic country, is surrounded by coastlines (36,289 km), coastal waters (226,000 km²), oceanic waters (1.93 million km²) and territorial waters (2.2 million km²). Studies show that the Philippine coastal ecosystems are the most productive and biologically diverse in the world, however, plagued by degradation problems due to over-exploitation and illegal activities. The existence of coastal degradation issues in the country led to the emergence of Coastal Resource Management (CRM) as an approach to both national and local government in providing solutions for sustainable coastal resource utilization. CRM applies the idea of planning, implementing and monitoring through the lens of collaborative governance. It utilizes collective action and decision-making to achieve sustainable use of coastal resources. The Municipality of Bagac in Bataan is one of the coastal municipalities in the country who crafts its own CRM Program as a solution to coastal resource degradation and problems. Information and Communications Technology (ICT), particularly Integrated Imaging Management System (IIMS) is one approach that can be applied in the formula of collaborative governance which entails the Government, Private Sector, and Civil Society. IIMS can help policymakers, managers, and citizens in managing coastal resources through analyzed spatial data describing the physical, biological, and socioeconomic characteristics of the coastal areas. Moreover, this study will apply the qualitative approach in deciphering possible impacts of the application of IIMS in the Coastal Resource Management policy making and implementation of the Municipality of Bagac.

Keywords: coastal resource management, collaborative governance, integrated imaging management system, information and communication technology

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Authors: J. Constanzo, B. Paquette, G. Charest, L. Masson-Côté, M. Guillot

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Targeted and whole-brain irradiation in humans can result in significant side effects causing decreased patient quality of life. To adequately investigate structural and functional alterations after stereotactic radiosurgery, preclinical studies are needed. The first step is to establish a robust standardized method of targeted irradiation on small regions of the rat brain. Eleven euthanized male Fischer rats were imaged in a stereotactic bed, by computed tomographic (CT), to estimate positioning variations regarding to the bregma skull reference point. Using a rat brain atlas and the stereotactic bregma coordinates assessed from CT images, various regions of the brain were delimited and a treatment plan was generated. A dose of 37 Gy at 30% isodose which corresponds to 100 Gy in 100% of the target volume (X = 98.1; Y = 109.1; Z = 100.0) was set by Leksell Gamma Plan using sectors number 4, 5, 7, and 8 of the Gamma Knife unit with the 4-mm diameter collimators. Effects of positioning accuracy of the rat brain on the dose deposition were simulated by Gamma Plan and validated with dosimetric measurements. Our results showed that 90% of the target volume received 110 ± 4.7 Gy and the maximum of deposited dose was 124 ± 0.6 Gy, which corresponds to an excellent relative standard deviation of 0.5%. This dose deposition calculated with the Gamma Plan was validated with the dosimetric films resulting in a dose-profile agreement within 2%, both in X- and Z-axis,. Our results demonstrate the feasibility to standardize the irradiation procedure of a small volume in the rat brain using a Gamma Knife.

Keywords: brain irradiation, dosimetry, gamma knife, small-animal irradiation, stereotactic radiosurgery (SRS)

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Authors: Nabaweesi Josephine, Namwanje Regina Germina

Abstract:

Antenatal care is referred to as the totality of care given to pregnant women from conception to delivery from a certified health care setting. A number of 8 contacts is recommended throughout pregnancy, according to WHO, 2016. Antenatal services are free in Uganda courtesy of the government of Uganda, though attendance is still very low, which has continued to cause maternal and infant mortality and morbidity from preventable causes. Early booking has an advantage for proper pregnancy information sharing and pregnancy monitoring. The purpose of this study was to determine pregnant women's knowledge, attitudes, and practices towards attendance of antenatal care at Mukono General Hospital. A sample of 60 pregnant women was used, and a descriptive quantitative design was employed. Data was collected using a structured questionnaire consisting of questions about socio-demographic factors, knowledge, attitude, and practice, and this was affected using the structured interview method. Pregnant women had good practice at 90.2%, a positive attitude of 94.6%, and slightly less knowledge of 66.7%. Only 12% were knowledgeable about the number of antenatal care visits recommended, 45% had knowledge about when to initiate first antenatal care visit, and 79% had a positive attitude towards the early booking. We recommend that pregnant women are given all the necessary information regarding antenatal care with special emphasis on the recommended number of visits and when to initiate their first visit and encourage early booking in order to achieve the 8 contacts WHO policy for antenatal care since when we increase knowledge, we increase antenatal care utilization according to Anderson's behavioral model.

Keywords: ANC- antenatal care, contacts, mortality, morbidity

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Authors: Abobaker Mohammed Qasem Farhan, Shangming Yang, Mohammed Al-Nehari

Abstract:

Pneumonia is a kind of lung disease that creates congestion in the chest. Such pneumonic conditions lead to loss of life of the severity of high congestion. Pneumonic lung disease is caused by viral pneumonia, bacterial pneumonia, or Covidi-19 induced pneumonia. The early prediction and classification of such lung diseases help to reduce the mortality rate. We propose the automatic Computer-Aided Diagnosis (CAD) system in this paper using the deep learning approach. The proposed CAD system takes input from raw computerized tomography (CT) scans of the patient's chest and automatically predicts disease classification. We designed the Hybrid Deep Learning Algorithm (HDLA) to improve accuracy and reduce processing requirements. The raw CT scans have pre-processed first to enhance their quality for further analysis. We then applied a hybrid model that consists of automatic feature extraction and classification. We propose the robust 2D Convolutional Neural Network (CNN) model to extract the automatic features from the pre-processed CT image. This CNN model assures feature learning with extremely effective 1D feature extraction for each input CT image. The outcome of the 2D CNN model is then normalized using the Min-Max technique. The second step of the proposed hybrid model is related to training and classification using different classifiers. The simulation outcomes using the publically available dataset prove the robustness and efficiency of the proposed model compared to state-of-art algorithms.

Keywords: CT scan, Covid-19, deep learning, image processing, lung disease classification

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Authors: Jamunarani Appalasamy, Tha Kyi Kyi, Quek Kia Fatt, Joyce Pauline Joseph, Anuar Zaini M. Zain

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Background: The Health Belief Theory had always been associated with chronic disease management. Various health behaviour concepts and perception branching from this Health Belief Theory had involved with medication understanding, use, and self-efficacy which directly link to medication adherence. In a previous quantitative and qualitative study, stroke patients in Malaysia were found to be strongly believing information obtained by various sources such as the internet and social communication. This action leads to lower perception of their stroke preventative medication benefit which in long-term creates non-adherence. Hence, this study intends to pilot an intervention which uses audio-visual concept incorporated with mHealth service to enhance learning and self-reflection among stroke patients to manage their disease. Methods/Design: Twenty patients will be allocated to a proposed intervention whereas another twenty patients are allocated to the usual treatment. The intervention involves a series of developed audio-visual videos sent via mobile phone which later await for responses and feedback from the receiver (patient) via SMS or recorded calls. The primary outcome would be the medication understanding, use and self-efficacy measured over two months pre and post intervention. Secondary outcome is measured from changes of blood parameters and other self-reported questionnaires. Discussion: This study shall also assess uptake/attrition, feasibility, and acceptability of this intervention. Trial Registration: NMRR-15-851-24737 (IIR)

Keywords: health belief, medication understanding, medication use, self-efficacy

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Authors: Ireneusz Majsterek, Dariusz Pytel, J. Alan Diehl

Abstract:

PKR-like ER kinase (PERK) is serine/threonie endoplasmic reticulum (ER) transmembrane kinase activated during ER-stress. PERK can activate signaling pathways known as unfolded protein response (UPR). Attenuation of translation is mediated by PERK via phosphorylation of eukaryotic initiation factor 2α (eIF2α), which is necessary for translation initiation. PERK activation also directly contributes to activation of Nrf2 which regulates expression of anti-oxidant enzymes. An increased phosphorylation of eIF2α has been reported in Alzheimer disease (AD) patient hippocampus, indicating that PERK is activated in this disease. Recent data have revealed activation of PERK signaling in non-Hodgkins lymphomas. Results also revealed that loss of PERK limits mammary tumor cell growth in vitro and in vivo. Consistent with these observations, activation of UPR in vitro increases levels of the amyloid precursor protein (APP), the peptide from which beta-amyloid plaques (AB) fragments are derived. Finally, proteolytic processing of APP, including the cleavages that produce AB, largely occurs in the ER, and localization coincident with PERK activity. Thus, we expect that PERK-dependent signaling is critical for progression of many types of diseases (human cancer, neurodegenerative disease and other). Therefore, modulation of PERK activity may be a useful therapeutic target in the treatment of different diseases that fail to respond to traditional chemotherapeutic strategies, including Alzheimer’s disease. Our goal will be to developed therapeutic modalities targeting PERK activity.

Keywords: PERK kinase, small molecule inhibitor, neurodegenerative disease, Alzheimer’s disease

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Authors: Diaa Othman, Muhammad Adil Khan, Muhammad Riaz

Abstract:

Without an early intervention to correct the unilateral complete cleft lip and palate deformity, nasal architecture can progress to an exaggerated cleft nose deformity. We present the results of a modified unilateral cleft rhinoplasty procedure ‘the Gujrat technique’ to correct this deformity. Ninety pediatric and adult patients with non-syndromic unilateral cleft lip underwent primary and secondary composite cleft rhinoplasty using the Gujrat technique as a single stage operation over a 10-year period. The technique involved an open rhinoplasty with Tennison lip repair, and employed a combination of three autologous cartilage grafts, seven cartilage-molding sutures and a prolene mesh graft for alar base support. Post-operative evaluation of nasal symmetry was undertaken using the validated computer program ‘SymNose’. Functional outcome and patient satisfaction were assessed using the NOSE scale and ROE (rhinoplasty outcome evaluation) questionnaires. The single group study design used the non-parametric matching pairs Wilcoxon Sign test (p < 0.001), and showed overall good to excellent functional and aesthetic outcomes, including nasal projection and tip definition, and higher scores of the digital SymNose grading system. Objective assessment of the Gujrat cleft rhinoplasty technique demonstrates its aesthetic appeal and functional versatility. Overall it is a simple and reproducible technique, with no significant complications.

Keywords: cleft lip and palate, congenital rhinoplasty, nasal deformity, secondary rhinoplasty

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Authors: Richard Molyneux, Christopher Parrott, Kirill Horoshenkov

Abstract:

This paper aims to demonstrate how various algorithms can be implemented within swarms of autonomous robots to provide continuous inspection within underground pipeline networks. Current methods of fault detection within pipes are costly, time consuming and inefficient. As such, solutions tend toward a more reactive approach, repairing faults, as opposed to proactively seeking leaks and blockages. The paper presents an efficient inspection method, showing that autonomous swarm robotics is a viable way of monitoring underground infrastructure. Tailored adaptations of various Vehicle Routing Problems (VRP) and path-planning algorithms provide a customised inspection procedure for complicated networks of underground pipes. The performance of multiple algorithms is compared to determine their effectiveness and feasibility. Notable inspirations come from ant colonies and stigmergy, graph theory, the k-Chinese Postman Problem ( -CPP) and traffic theory. Unlike most swarm behaviours which rely on fast communication between agents, underground pipe networks are a highly challenging communication environment with extremely limited communication ranges. This is due to the extreme variability in the pipe conditions and relatively high attenuation of acoustic and radio waves with which robots would usually communicate. This paper illustrates how to optimise the inspection process and how to increase the frequency with which the robots pass each other, without compromising the routes they are able to take to cover the whole network.

Keywords: autonomous inspection, buried pipes, stigmergy, swarm intelligence, vehicle routing problem

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Authors: Zhu Weimin, Allegorico Carmine, Ruggiero Gionata

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During decades of Baker Hughes (BH) iCenter experience, it is demonstrated that in addition to conventional insights on equipment steady operation conditions, insights on transient conditions can add significant and exclusive value for anomaly detection, downtime saving, and predictive maintenance. Our work shows examples from the BH iCenter experience to introduce the advantages and features of using transient condition analytics: (i) Operation under critical engine conditions: e.g., high level or high change rate of temperature, pressure, flow, vibration, etc., that would not be reachable in normal operation, (ii) Management of dedicated sub-systems or components, many of which are often bottlenecks for reliability and maintenance, (iii) Indirect detection of anomalies in the absence of instrumentation, (iv) Repetitive sequences: if data is properly processed, the engineering features of transients provide not only anomaly detection but also problem characterization and prognostic indicators for predictive maintenance, (v) Engine variables accounting for fatigue analysis. iCenter has been developing and deploying a series of analytics based on transient conditions. They are contributing to exclusive value adding in the following areas: (i) Reliability improvement, (ii) Startup reliability improvement, (iii) Predictive maintenance, (iv) Repair/overhaul cost down. Illustrative examples for each of the above areas are presented in our study, focusing on challenges and adopted techniques ranging from purely statistical approaches to the implementation of machine learning algorithms. The obtained results demonstrate how the value is obtained using transient condition analytics in the BH iCenter experience.

Keywords: analytics, diagnostics, monitoring, turbomachinery

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Authors: Hassan Ali Abood Nassrullah, Jabbar Fadeel Mahdi, Mohammed Salih Mahdi Alkurdi, Ali Al Mousawi, Saad Ibrahim Al-Ghabban, Abdul Amir H. Kadhum, Ahmed Al-Amiery

Abstract:

Background: Q fever is a zoonotic disease characterized by its clinical polymorphism and can present acutely as fever, pneumonia, hepatitis, and chronically as infective endocarditis, arthritis, osteomyelitis, or hepatitis. Objective: The aim of this study is To estimate the prevalence of cases of Q fever in hospitalized febrile patients in Imam Al Hussain Teaching Medical City in Karbala. Methods: One hundred patients with pyrexia were admitted to the medical ward from 1st August to 31st December 2019. Serological procedures fortified by Enzyme-linked Immunosorbent Assay test. Patients were considered to have acute Q fever when the specific antibodies (IgM and IgG) of phase II of Coxiella burnetii were positive. Results: The mean age of the patients was 35.05±12.93 years; females constituted 60% of them. Eighteen patients (18%) showed positive results for IgM, a lower proportion (13% n=13) had positive IgG levels, and 9% showed equivocal results. Statistical analysis revealed a significant association between positive IgM levels of the female gender and in patients consuming unpasteurized milk. One patient (female aged 60 years) died in the hospital, while all other patients were discharged well. Two female patients were pregnant, and one of them had an abortion. Conclusions: Q fever is more common in febrile patients. The study indicates that this disease should not be overlooked in the differential diagnosis of acute fever. Serological testing should be performed in all patients with acute febrile illness with an unsettling diagnosis.

Keywords: antibodies, frequency, immunoglobulin IgM, Q fever

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