Search results for: time to surgery

Authors: Charléa M. Smith, Raiden L. Schodowski, Arletty Pinel

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Due to the COVID-19 pandemic, the Faculty of Medical Sciences of The University of the West Indies (UWI) Mona in Kingston, Jamaica, had to rapidly migrate to digital and blended learning. Students in the preclinical stage of the program transitioned to full-time online learning, while students in the clinical stage experienced decreased daily patient contact and the implementation of a blend of online lectures and virtual clinical practice. Such sudden changes were coupled with the institutional pressure of the need to introduce a novel approach to education without much time for preparation, as well as additional strain endured by the faculty, who were overwhelmed by serving as frontline workers. During the period July 20 to August 23, 2021, this study surveyed preclinical and clinical students to capture their experiences with these changes and their recommendations for future use of digital modalities of learning to enhance medical education. It was conducted with a fellow student of the 2021 cohort of the MultiPod mentoring program. A questionnaire was developed and distributed digitally via WhatsApp to all medical students of the UWI Mona campus to assess students’ experiences and perceptions of the advantages, challenges, and impact on individual knowledge proficiencies brought about by the transition to predominantly digital learning environments. 108 students replied, 53.7% preclinical and 46.3% clinical. 67.6% of the total were female and 30.6 % were male; 1.8% did not identify themselves by gender. 67.2% of preclinical students preferred blended learning and 60.3% considered that the content presented did not prepare them for clinical work. Only 31% considered that the online classes were interactive and encouraged student participation. 84.5% missed socialization with classmates and friends and 79.3% missed a focused environment for learning. 80% of the clinical students felt that they had not learned all that they expected and only 34% had virtual interaction with patients, mostly by telephone and video calls. Observing direct consultations was considered the most useful, yet this was the least-used modality. 96% of the preclinical students and 100% of the clinical ones supplemented their learning with additional online tools. The main recommendations from the survey are the use of interactive teaching strategies, more discussion time with lecturers, and increased virtual interactions with patients. Universities are returning to face-to-face learning, yet it is unlikely that blended education will disappear. This study demonstrates that students’ perceptions of their experience during mobility restrictions must be taken into consideration in creating more effective, inclusive, and efficient blended learning opportunities.

Keywords: blended learning, digital learning, medical education, student perceptions

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Authors: Hwang Ho Kim, Do Gyun Kim, Jin Young Choi, Sang Chul Park

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Since tire production process is very complicated, company-wide management of it is very difficult, necessitating considerable amounts of capital and labors. Thus, productivity should be enhanced and maintained competitive by developing and applying effective production plans. Among major processes for tire manufacturing, consisting of mixing component preparation, building and curing, the mixing process is an essential and important step because the main component of tire, called compound, is formed at this step. Compound as a rubber synthesis with various characteristics plays its own role required for a tire as a finished product. Meanwhile, scheduling tire mixing process is similar to flexible job shop scheduling problem (FJSSP) because various kinds of compounds have their unique orders of operations, and a set of alternative machines can be used to process each operation. In addition, setup time required for different operations may differ due to alteration of additives. In other words, each operation of mixing processes requires different setup time depending on the previous one, and this kind of feature, called sequence dependent setup time (SDST), is a very important issue in traditional scheduling problems such as flexible job shop scheduling problems. However, despite of its importance, there exist few research works dealing with the tire mixing process. Thus, in this paper, we consider the scheduling problem for tire mixing process and suggest an efficient particle swarm optimization (PSO) algorithm to minimize the makespan for completing all the required jobs belonging to the process. Specifically, we design a particle encoding scheme for the considered scheduling problem, including a processing sequence for compounds and machine allocation information for each job operation, and a method for generating a tire mixing schedule from a given particle. At each iteration, the coordination and velocity of particles are updated, and the current solution is compared with new solution. This procedure is repeated until a stopping condition is satisfied. The performance of the proposed algorithm is validated through a numerical experiment by using some small-sized problem instances expressing the tire mixing process. Furthermore, we compare the solution of the proposed algorithm with it obtained by solving a mixed integer linear programming (MILP) model developed in previous research work. As for performance measure, we define an error rate which can evaluate the difference between two solutions. As a result, we show that PSO algorithm proposed in this paper outperforms MILP model with respect to the effectiveness and efficiency. As the direction for future work, we plan to consider scheduling problems in other processes such as building, curing. We can also extend our current work by considering other performance measures such as weighted makespan or processing times affected by aging or learning effects.

Keywords: compound, error rate, flexible job shop scheduling problem, makespan, particle encoding scheme, particle swarm optimization, sequence dependent setup time, tire mixing process

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Authors: Hamidreza Namazi

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Fractal analysis is assessing fractal characteristics of data. It consists of several methods to assign fractal characteristics to a dataset which may be a theoretical dataset or a pattern or signal extracted from phenomena including natural geometric objects, sound, market fluctuations, heart rates, digital images, molecular motion, networks, etc. Fractal analysis is now widely used in all areas of science. An important limitation of fractal analysis is that arriving at an empirically determined fractal dimension does not necessarily prove that a pattern is fractal; rather, other essential characteristics have to be considered. For this purpose a Visual C++ based software called FRATSAN (FRActal Time Series ANalyser) was developed which extract information from signals through three measures. These measures are Fractal Dimensions, Jeffrey’s Measure and Hurst Exponent. After computing these measures, the software plots the graphs for each measure. Besides computing three measures the software can classify whether the signal is fractal or no. In fact, the software uses a dynamic method of analysis for all the measures. A sliding window is selected with a value equal to 10% of the total number of data entries. This sliding window is moved one data entry at a time to obtain all the measures. This makes the computation very sensitive to slight changes in data, thereby giving the user an acute analysis of the data. In order to test the performance of this software a set of EEG signals was given as input and the results were computed and plotted. This software is useful not only for fundamental fractal analysis of signals but can be used for other purposes. For instance by analyzing the Hurst exponent plot of a given EEG signal in patients with epilepsy the onset of seizure can be predicted by noticing the sudden changes in the plot.

Keywords: EEG signals, fractal analysis, fractal dimension, hurst exponent, Jeffrey’s measure

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Authors: Bernhard Widhalm, Cornelia Rieder-Gradinger, Thomas Ters, Ewald Srebotnik, Thomas Kuncinger

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Terpenes are natural components in softwoods and rank among the most frequently emitted volatile organic compounds (VOC) in the wood-processing industry. In this study, the main focus was on α- and β-pinene as well as Δ3-carene, which are the major terpenes in softwoods. To lower the total emission level of wood composites, defined terpene degrading microorganisms were applied to basic raw materials (e.g. pine wood particles and strands) in an optimised and industry-compatible testing procedure. In preliminary laboratory tests, bacterial species suitable for the utilisation of α-pinene as single carbon source in liquid culture were selected and then subjected to wood material inoculation. The two species Pseudomonas putida and Pseudomonas fluorescens were inoculated onto wood particles and strands and incubated at room temperature. Applying specific pre-cultivation and daily ventilation of the samples enabled a reduction of incubation time from six days to one day. SPME measurements and subsequent GC-MS analysis indicated a complete absence of α- and β-pinene emissions after 24 hours from pine wood particles. When using pine wood strands rather than particles, bacterial treatment resulted in a reduction of α- and β-pinene by 50%, while Δ3-carene emissions were reduced by 30% in comparison to untreated strands. Other terpenes were also reduced in the course of the microbial treatment. The method developed here appears to be feasible for industrial application. However, growth parameters such as time and temperature as well as the technical implementation of the inoculation step will have to be adapted for the production process.

Keywords: GC-MS, pseudomonas, SPME, terpenes

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Authors: Olumuyiwa Ayoola Kokapi, Olugbenga Solomon Bello

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Dyes are organic compounds with complex aromatic molecular structure that resulted in fast colour on a substance. Dye effluent found in wastewater generated from the dyeing industries is one of the greatest contributors to water pollution. Groundnut hull (GH) is an agricultural material that constitutes waste in the environment. Environmental contamination by hazardous organic chemicals is an urgent problem, which is partially solved through adsorption technologies. The choice of groundnut hull was promised on the understanding that some materials of agricultural origin have shown potentials to act as Adsorbate for hazardous organic chemicals. The aim of this research is to evaluate the potential of groundnut hull to adsorb Crystal violet dye through kinetic, isotherm and thermodynamic studies. The prepared groundnut hulls was characterized using Brunauer, Emmett and Teller (BET), Fourier transform infrared (FTIR) and scanning electron microscopy (SEM). Operational parameters such as contact time, initial dye concentration, pH, and effect of temperature were studied. Equilibrium time for the adsorption process was attained in 80 minutes. Adsorption isotherms used to test the adsorption data were Langmuir and Freundlich isotherms model. Thermodynamic parameters such as ∆G°, ∆H°, and ∆S° of the adsorption processes were determined. The results showed that the uptake of dye by groundnut hulls occurred at a faster rate, corresponding to an increase in adsorption capacity at equilibrium time of 80 min from 0.78 to 4.45 mg/g and 0.77 to 4.45mg/g with an increase in the initial dye concentration from 10 to 50 mg/L for pH 3.0 and 8.0 respectively. High regression values obtained for pseudo-second-order kinetic model, sum of square error (SSE%) values along with strong agreement between experimental and calculated values of qe proved that pseudo second-order kinetic model fitted more than pseudo first-order kinetic model. The result of Langmuir and Freundlich model showed that the adsorption data fit the Langmuir model more than the Freundlich model. Thermodynamic study demonstrated the feasibility, spontaneous and endothermic nature of the adsorption process due to negative values of free energy change (∆G) at all temperatures and positive value of enthalpy change (∆H) respectively. The positive values of ∆S showed that there was increased disorderliness and randomness at the solid/solution interface of crystal violet dye and groundnut hulls. The present investigation showed that, groundnut hulls (GH) is a good low-cost alternative adsorbent for the removal of Crystal Violet (CV) dye from aqueous solution.

Keywords: adsorption, crystal violet dye, groundnut halls, kinetics

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Authors: Mohamed A. Hammad, Dzul Azri Mohamed Noor, Syed Azhar Syed Sulaiman, Majed Ahmed Al-Mansoub, Muhammad Qamar

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There is a progressive increase in the prevalence of early onset Type 2 diabetes mellitus. Early detection of Type 2 diabetes enhances the length and/or quality of life which might result from a reduction in the severity, frequency or prevent or delay of its long-term complications. The study aims to determine the onset age for the first diagnosis of Type 2 diabetes mellitus. A retrospective study conducted in the endocrine clinic at Hospital Pulau Pinang in Penang, Malaysia, January- December 2016. Records of 519 patients with Type 2 diabetes mellitus were screened to collect demographic data and determine the age of first-time diabetes mellitus diagnosis. Patients classified according to the age of diagnosis, gender, and ethnicity. The study included 519 patients with age (55.6±13.7) years, female 265 (51.1%) and male 254 (48.9%). The ethnicity distribution was Malay 191 (36.8%), Chinese 189 (36.4%) and Indian 139 (26.8%). The age of Type 2 diabetes diagnosis was (42±14.8) years. The female onset of diabetes mellitus was at age (41.5±13.7) years, while male (42.6±13.7) years. Distribution of diabetic onset by ethnicity was Malay at age (40.7±13.7) years, Chinese (43.2±13.7) years and Indian (42.3±13.7) years. Diabetic onset was classified by age as follow; ≤20 years’ cohort was 33 (6.4%) cases. Group >20- ≤40 years was 190 (36.6%) patients, and category >40- ≤60 years was 270 (52%) subjects. On the other hand, the group >60 years was 22 (4.2%) patients. The range of diagnosis was between 10 and 73 years old. Conclusion: Malay and female have an earlier onset of diabetes than Indian, Chinese and male. More than half of the patients had diabetes between 40 and 60 years old. Diabetes mellitus is becoming more common in younger age <40 years. The age at diagnosis of Type 2 diabetes mellitus has decreased with time.

Keywords: age of onset, diabetes diagnosis, diabetes mellitus, Malaysia, outpatients, type 2 diabetes, retrospective study

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Authors: Muhammad Muzamal, Anders Rasmuson

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Wood material is extensively considered as a raw material for the production of bio-polymers, bio-fuels and value-added chemicals. However, the shortcoming in using wood as raw material is that the enzymatic hydrolysis of wood material is difficult because the accessibility of enzymes to hemicelluloses and cellulose is hindered by complex chemical and physical structure of the wood. The steam explosion (SE) pre-treatment improves the digestion of wood material by creating both chemical and physical modifications in wood. In this process, first, wood chips are treated with steam at high pressure and temperature for a certain time in a steam treatment vessel. During this time, the chemical linkages between lignin and polysaccharides are cleaved and stiffness of material decreases. Then the steam discharge valve is rapidly opened and the steam and wood chips exit the vessel at very high speed. These fast moving wood chips collide with each other and with walls of the equipment and disintegrate to small pieces. More damaged and disintegrated wood have larger surface area and increased accessibility to hemicelluloses and cellulose. The energy required for an increase in specific surface area by same value is 70 % more in conventional mechanical technique, i.e. attrition mill as compared to steam explosion process. The mechanism of wood disintegration during the SE pre-treatment is very little studied. In this study, we have simulated collision and impact of wood chips (dimension 20 mm x 20 mm x 4 mm) with each other and with walls of the vessel. The wood chips are simulated as a 3D orthotropic material. Damage and fracture in the wood material have been modelled using 3D Hashin’s damage model. This has been accomplished by developing a user-defined subroutine and implementing it in the FE software ABAQUS. The elastic and strength properties used for simulation are of spruce wood at 12% and 30 % moisture content and at 20 and 160 OC because the impacted wood chips are pre-treated with steam at high temperature and pressure. We have simulated several cases to study the effects of elastic and strength properties of wood, velocity of moving chip and orientation of wood chip at the time of impact on the damage in the wood chips. The disintegration patterns captured by simulations are very similar to those observed in experimentally obtained steam exploded wood. Simulation results show that the wood chips moving with higher velocity disintegrate more. Moisture contents and temperature decreases elastic properties and increases damage. Impact and collision in specific directions cause easy disintegration. This model can be used to efficiently design the steam explosion equipment.

Keywords: dynamic simulation, disintegration of wood, impact, steam explosion pretreatment

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Authors: Mohamed Ouazene

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The insulating properties of the polymers are widely used in electrical engineering for the production of insulators and various supports, as well as for the insulation of electric cables for medium and high voltage, etc. These polymeric materials have significant advantages both technically and economically. However, although the insulation with polymeric materials has advantages, there are also certain disadvantages such as the influence of the heat which can have a detrimental effect on these materials. Polyvinyl chloride (PVC) is one of the polymers used in a plasticized state in the cable insulation to medium and high voltage. The studied material is polyvinyl chloride (PVC 4000 M) from the Algerian national oil company whose formula is: Industrial PVC 4000 M is in the form of white powder. The test sample is a pastille of 1 mm thick and 1 cm in diameter. The consequences of increasing the temperature of a polymer are modifications; some of them are reversible and others irreversible [1]. The reversible changes do not affect the chemical composition of the polymer, or its structure. They are characterized by transitions and relaxations. The glass transition temperature is an important feature of a polymer. Physical aging of PVC is to maintain the material for a longer or shorter time to its glass transition temperature. The aim of this paper is to study this phenomenon by the method of thermally stimulated depolarization currents. Relaxations within the polymer have been recorded in the form of current peaks. We have found that the intensity decreases for more residence time in the polymer along its glass transition temperature. Furthermore, it is inferred from this work that the phenomenon of physical aging can have important consequences on the properties of the polymer. It leads to a more compact rearrangement of the material and a reconstruction or reinforcement of structural connections.

Keywords: depolarization currents, glass transition temperature, physical aging, polyvinyl chloride (PVC)

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Authors: Lei Zhou, Chao Li, Ruiqi Ren, Dan Li, Yali Wang, Daxin Ni, Zijian Feng, Qun Li

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Background: Since the first human infection with avian influenza A(H7N9) case was reported in China on 31 March 2013, five epidemics have been observed in China through February 2013 and September 2017. Though the overall mortality rate of H7N9 has remained as high as around 40% throughout the five epidemics, the specific mortality rate in Mainland China varied by provinces. We conducted a descriptive analysis of mortality rates of H7N9 cases to explore the various severity features of the disease and then to provide clues of further analyses of potential factors associated with the severity of the disease. Methods: The data for analysis originated from the National Notifiable Infectious Disease Report and Surveillance System (NNIDRSS). The surveillance system and identification procedure for H7N9 infection have not changed in China since 2013. The definition of a confirmed H7N9 case is as same as previous reports. Mortality rates of H7N9 cases are described and compared by time and location of reporting, age and sex, and genetic features of H7N9 virus strains. Results: The overall mortality rate, the male and female specific overall rates of H7N9 is 39.6% (608/1533), 40.3% (432/1072) and 38.2% (176/461), respectively. There was no significant difference between the mortality rates of male and female. The age-specific mortality rates are significantly varied by age groups (χ²=38.16, p < 0.001). The mortality of H7N9 cases in the age group between 20 and 60 (33.17%) and age group of over 60 (51.16%) is much higher than that in the age group of under 20 (5.00%). Considering the time of reporting, the mortality rates of cases which were reported in the first (40.57%) and fourth (42.51%) quarters of each year are significantly higher than the mortality of cases which were reported in the second (36.02%) and third (27.27%) quarters (χ²=75.18, p < 0.001). The geographic specific mortality rates vary too. The mortality rates of H7N9 cases reported from the Northeast China (66.67%) and Westeast China (56.52%) are significantly higher than that of H7N9 cases reported from the remained area of mainland China. The mortality rate of H7N9 cases reported from the Central China is the lowest (34.38%). The mortality rates of H7N9 cases reported from rural (37.76%) and urban (38.96%) areas are similar. The mortality rate of H7N9 cases infected with the highly pathogenic avian influenza A(H7N9) virus (48.15%) is higher than the rate of H7N9 cases infected with the low pathogenic avian influenza A(H7N9) virus (37.57%), but the difference is not statistically significant. Preliminary analyses showed that age and some clinical complications such as respiratory failure, heart failure, and septic shock could be potential risk factors associated with the death of H7N9 cases. Conclusions: The mortality rates of H7N9 cases varied by age, sex, time of reporting and geographical location in mainland China. Further in-depth analyses and field investigations of the factors associated with the severity of H7N9 cases need to be considered.

Keywords: H7N9 virus, Avian Influenza, mortality, China

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Authors: Ş. Çiftcioğlu, E. Efe

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In recent years, cancer has been at the top of diseases that cause death in children. Adequate and balanced nutrition plays an important role in the treatment of cancer. Cancer and cancer treatment is affecting food intake, absorption and metabolism, causing nutritional disorders. Appropriate nutrition is very important for the cancerous child to feel well before, during and after the treatment. There are various difficulties in feeding children with cancer. These are the cancer-related factors. Other factors are environmental and behavioral. As health professionals who spend more time with children in the hospital, nurses should be able to support the children on nutrition and help them to have balanced nutrition. This study aimed to evaluate the importance of nursing approaches in the nutrition of children with cancer. This article is planned as a review article by searching the literature on this field. Anorexia may develop due to psychogenic causes or chemotherapeutic agents or accompanying infections and nutrient uptake may be reduced.  In addition, stomatitis, mucositis, taste and odor changes in the mouth, the feeling of nausea, vomiting and diarrhea can also reduce oral intake and result in significant losses in the energy deficit. In assessing the nutritional status of children with cancer, determining weight loss and good nutrition is essential anamnesis of a child.  Some anthropometric measurements and biochemical tests should be used to evaluate the nutrition of the child. The nutritional status of pediatric cancer patients has been studied for a long time and malnutrition, in particular under nutrition, in this population has long been recognized. Yet, its management remains variable with many malnourished children going unrecognized and consequently untreated. Nutritional support is important to pediatric cancer patients and should be integrated into the overall treatment of these children.

Keywords: cancer treatment, children, complication, nutrition, nursing approaches

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Authors: A. A. M. A. S. S. Perera, L. A. Ranasinghe, T. K. H. Nimeshika, D. M. Dhanushka Dissanayake, Namalie Walgampaya

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Nowadays, skin fungal diseases are mostly found in people of tropical countries like Sri Lanka. A skin fungal disease is a particular kind of illness caused by fungus. These diseases have various dangerous effects on the skin and keep on spreading over time. It becomes important to identify these diseases at their initial stage to control it from spreading. This paper presents an automated skin fungal disease identification system implemented to speed up the diagnosis process by identifying skin fungal infections in digital images. An image of the diseased skin lesion is acquired and a comprehensive computer vision and image processing scheme is used to process the image for the disease identification. This includes colour analysis using RGB and HSV colour models, texture classification using Grey Level Run Length Matrix, Grey Level Co-Occurrence Matrix and Local Binary Pattern, Object detection, Shape Identification and many more. This paper presents the approach and its outcome for identification of four most common skin fungal infections, namely, Tinea Corporis, Sporotrichosis, Malassezia and Onychomycosis. The main intention of this research is to provide an automated skin fungal disease identification system that increase the diagnostic quality, shorten the time-to-diagnosis and improve the efficiency of detection and successful treatment for skin fungal diseases.

Keywords: Circularity Index, Grey Level Run Length Matrix, Grey Level Co-Occurrence Matrix, Local Binary Pattern, Object detection, Ring Detection, Shape Identification

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Authors: Agustinus Rudatyo Himamunanto, Anastasia Rita Widiarti

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Transliteration using Javanese manuscripts is one of methods to preserve and legate the wealth of literature in the past for the present generation in Indonesia. The transliteration manual process commonly requires philologists and takes a relatively long time. The automatic transliteration process is expected to shorten the time so as to help the works of philologists. The preprocessing and segmentation stage firstly done is used to manage the document images, thus obtaining image script units that will compile input document images free from noise and have the similarity in properties in the thickness, size, and slope. The next stage of characteristic extraction is used to find unique characteristics that will distinguish each Javanese script image. One of characteristics that is used in this research is the number of black pixels in each image units. Each image of Java scripts contained in the data training will undergo the same process similar to the input characters. The system testing was performed with the data of the book Hamong Tani. The book Hamong Tani was selected due to its content, age and number of pages. Those were considered sufficient as a model experimental input. Based on the results of random page automatic transliteration process testing, it was determined that the maximum percentage correctness obtained was 81.53%. The percentage of success was obtained in 32x32 pixel input image size with the 5x5 image window. With regard to the results, it can be concluded that the automatic transliteration model offered is relatively good.

Keywords: Javanese script, character recognition, statistical, automatic transliteration

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Authors: Mariyah Poonawala, Selvan Ravindran, Anuradha Vaidya

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Despite much progress in understanding the regulatory factors and cytokines that support the maturation of the various cell lineages of the hematopoietic system, factors that govern the self-renewal and proliferation of hematopoietic stem cells (HSCs) is still a grey area of research. Hematopoietic stem cell transplantation (HSCT) has evolved over the years and gained tremendous importance in the treatment of both malignant and non-malignant diseases. However, factors such as graft rejection and multiple organ failure have challenged HSCT from time to time, underscoring the urgent need for development of milder processes for successful hematopoietic transplantation. An emerging concept in the field of stem cell biology states that the interactions between the bone-marrow micro-environment and the hematopoietic stem and progenitor cells is essential for regulation, maintenance, commitment and proliferation of stem cells. Understanding the role of mesenchymal stromal cells in modulating the functionality of HSCs is, therefore, an important area of research. Trans-resveratrol has been extensively studied for its various properties to combat and prevent cancer, diabetes and cardiovascular diseases etc. The aim of the present study was to understand the effect of trans-resveratrol on HSCs using single and co-culture systems. We have used KG1a cells since it is a well accepted hematopoietic stem cell model system. Our preliminary experiments showed that low concentrations of trans-resveratrol stimulated the HSCs to undergo proliferation whereas high concentrations of trans-resveratrol did not stimulate the cells to proliferate. We used a murine fibroblast cell line, M210B4, as a stromal feeder layer. On culturing the KG1a cells with M210B4 cells, we observed that the stimulatory as well as inhibitory effects of trans-resveratrol at low and high concentrations respectively, were enhanced. Our further experiments showed that low concentration of trans-resveratrol reduced the generation of reactive oxygen species (ROS) and nitric oxide (NO) whereas high concentrations increased the oxidative stress in KG1a cells. We speculated that perhaps the oxidative stress was imposing inhibitory effects at high concentration and the same was confirmed by performing an apoptotic assay. Furthermore, cell cycle analysis and growth kinetic experiments provided evidence that low concentration of trans-resveratrol reduced the doubling time of the cells. Our hypothesis is that perhaps at low concentration of trans-resveratrol the cells get pushed into the G0/G1 phase and re-enter the cell cycle resulting in their proliferation, whereas at high concentration the cells are perhaps arrested at G2/M phase or at cytokinesis and therefore undergo apoptosis. Liquid Chromatography-Quantitative-Time of Flight–Mass Spectroscopy (LC-Q-TOF MS) analyses indicated the presence of trans-resveratrol and its metabolite(s) in the supernatant of the co-cultured cells incubated with high concentration of trans-resveratrol. We conjecture that perhaps the metabolites of trans-resveratrol are responsible for the apoptosis observed at the high concentration. Our findings may shed light on the unsolved problems in the in vitro expansion of stem cells and may have implications in the ex vivo manipulation of HSCs for therapeutic purposes.

Keywords: co-culture system, hematopoietic micro-environment, KG1a cell line, M210B4 cell line, trans-resveratrol

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Authors: Eko Liao, Cheryl Zhang

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Employee job crafting refers to employee’s proactive behaviors of making customized changes to their jobs on cognitive, relationship, and task levels. Previous studies have investigated different situations triggering employee’s job crafting. However, much less is known about what would be the consequences for both employee themselves and their work groups. Guided by conservation of resources theory (COR), this study investigates how employees job crafting increases their objective task performance and promotive voice behaviors at work. It is argued that employee would gain more resources when they actively craft their job tasks, which in turn increase their job performance and encourage them to have more constructive speak-up behaviors. Specifically, employee’s psychological resources (i.e., job engagement) and relational resources (i.e., leader-member relationships) would be enhanced from effective crafting behaviors, because employees are more likely to regard their job tasks as meaningful, and their leaders would be more likely to notice and recognize their dedication at work when employees craft their job frequently. To test this research model, around 400 employees from various Chinese organizations from mainland China joins the two-wave data collection stage. Employee’s job crafting behaviors in three aspects are measured at time 1. Perception of resource gain (job engagement and leader-member exchange), voice, and job performance are measured at time 2. The research model is generally supported. This study contributes to the job crafting literature by broadening the theoretical lens to a resource-based perspective. It also has practical implications that organizations should pay more attention to employee crafting behaviors because they are closely related to employees in-role performance and constructive voice behaviors.

Keywords: job crafting, resource-based perspective, voice, job performance

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Authors: T. Costa, D. Narvaez, K. Melo, M. Villalva

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Installation of micro-generators based on renewable energy in power distribution system has increased in recent years, with the main renewable sources being solar and wind. Due to the intermittent nature of renewable energy sources, such micro-generators produce time-varying energy which does not correspond at certain times of the day to the peak energy consumption of end users. For this reason, the use of energy storage units next to the grid contributes to the proper leveling of the buses’ voltage level according to Brazilian energy quality standards. In this work, the effect of the addition of a photovoltaic solar generator and a store of energy in the busbar voltages of an electric system is analyzed. The consumption profile is defined as the average hourly use of appliances in a common residence, and the generation profile is defined as a function of the solar irradiation available in a locality. The power summation method is validated with analytical calculation and is used to calculate the modules and angles of the voltages in the buses of an electrical system based on the IEEE standard, at each hour of the day and with defined load and generation profiles. The results show that bus 5 presents the worst voltage level at the power consumption peaks and stabilizes at the appropriate range with the inclusion of the energy storage during the night time period. Solar generator maintains improvement of the voltage level during the period when it receives solar irradiation, having peaks of production during the 12 pm (without exceeding the appropriate maximum levels of tension).

Keywords: energy storage, power distribution system, solar generator, voltage level

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Authors: Sabrina Rahman

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The Mosque is Islam’s most symbolic structure, as well as the expression of collective identity. From the explicit words of our Prophet, 'The earth has been created for me as a masjid and a place of purity, and whatever man from my Ummah finds himself in need of prayer, let him pray' (anywhere)! it is obvious that a devout Muslim does not require a defined space or structure for divine worship since the whole earth is his prayer house. Yet we see that from time immemorial man throughout the Muslim world has painstakingly erected innumerable mosques. However, mosque design spans time, crosses boundaries, and expresses cultures. It is a cultural manifestation as much as one based on a regional building tradition or a certain interpretation of religion. The trend to express physical signs of religion is not new. Physical forms seem to convey symbolic messages. However, in recent times physical forms of mosque architecture are dominantly demising from mosque architecture projects in Bangladesh. Dome & minaret, the most prominent symbol of the mosque, is replacing by contextual and contemporary improvisation rather than subcontinental mosque architecture practice of early fellows. Thus the recent mosque projects of the last 15 years established the contemporary architectural realm in their design. Contextually, spiritual lighting, the serenity of space, tranquility of outdoor spaces, the texture of materials is widely establishing a new genre of Muslim prayer space. A case study based research will lead to specify its significant factors of modernism. Based on the findings, the paper presents evidence of recent projects as well as a guideline for the future image of contemporary Mosque architecture in Bangladesh.

Keywords: contemporary architecture, modernism, prayer space, symbolism

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Authors: Xizhen Zhou, Yanjie Ji

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In advancing the management of integrated electric vehicle (EV) parking-charging behaviors, this study uses Changshu City in Suzhou as a case study to establish a data association mechanism for parking-charging platforms and to develop a database for EV parking-charging behaviors. Key indicators, such as charging start time, initial state of charge, final state of charge, and parking-charging time difference, are considered. Utilizing the K-S test method, the paper examines the heterogeneity of parking-charging behavior preferences among pure EV and non-pure EV users. The K-means clustering method is employed to analyze the characteristics of parking-charging behaviors for both user groups, thereby enhancing the overall understanding of these behaviors. The findings of this study reveal that using a classification model, the parking-charging behaviors of pure EVs can be classified into five distinct groups, while those of non-pure EVs can be separated into four groups. Among them, both types of EV users exhibit groups with low range anxiety for complete charging with special journeys, complete charging at destination, and partial charging. Additionally, both types have a group with high range anxiety, characterized by pure EV users displaying a preference for complete charging with specific journeys, while non-pure EV users exhibit a preference for complete charging. Notably, pure EV users also display a significant group engaging in nocturnal complete charging. The findings of this study can provide technical support for the scientific and rational layout and management of integrated parking and charging facilities for EVs.

Keywords: traffic engineering, potential preferences, cluster analysis, EV, parking-charging behavior

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Authors: Nicolò Vaiana, Giorgio Serino

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In this paper, a one-dimensional (1d) Parallel Elasto- Plastic Model (PEPM), able to simulate the uniaxial dynamic behavior of seismic isolators having a continuously decreasing tangent stiffness with increasing displacement, is presented. The parallel modeling concept is applied to discretize the continuously decreasing tangent stiffness function, thus allowing to simulate the dynamic behavior of seismic isolation bearings by putting linear elastic and nonlinear elastic-perfectly plastic elements in parallel. The mathematical model has been validated by comparing the experimental force-displacement hysteresis loops, obtained testing a helical wire rope isolator and a recycled rubber-fiber reinforced bearing, with those predicted numerically. Good agreement between the simulated and experimental results shows that the proposed model can be an effective numerical tool to predict the forcedisplacement relationship of seismic isolators within relatively large displacements. Compared to the widely used Bouc-Wen model, the proposed one allows to avoid the numerical solution of a first order ordinary nonlinear differential equation for each time step of a nonlinear time history analysis, thus reducing the computation effort, and requires the evaluation of only three model parameters from experimental tests, namely the initial tangent stiffness, the asymptotic tangent stiffness, and a parameter defining the transition from the initial to the asymptotic tangent stiffness.

Keywords: base isolation, earthquake engineering, parallel elasto-plastic model, seismic isolators, softening hysteresis loops

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Authors: Tengku Sepora Tengku Mahadi

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Where the speed of book writing lags behind the high need for such material for tertiary studies, translation offers a way to enhance the equilibrium in this demand-supply equation. Nevertheless, translation is confronted by obstacles that threaten its effectiveness. The primary challenge to the production of efficient translations may well be related to the text-type and in terms of its complexity. A text that is intricately written with unique rhetorical devices, subject-matter foundation and cultural references will undoubtedly challenge the translator. Longer time and greater effort would be the consequence. To understand these text-related challenges, the present paper set out to analyze a lawbook entitled Learning the Law by David Melinkoff. The book is chosen because it has often been used as a textbook or for reference in many law courses in the United Kingdom and has seen over thirteen editions; therefore, it can be said to be a worthy book for studies in law. Another reason is the existence of a ready translation in Malay. Reference to this translation enables confirmation to some extent of the potential problems that might occur in its translation. Understanding the organization and the language of the book will help translators to prepare themselves better for the task. They can anticipate the research and time that may be needed to produce an effective translation. Another premise here is that this text-type implies certain ways of writing and organization. Accordingly, it seems practicable to adopt the functional theory of language as suggested by Michael Halliday as its theoretical framework. Concepts of the context of culture, the context of situation and measures of the field, tenor and mode form the instruments for analysis. Additional examples from similar materials can also be used to validate the findings. Some interesting findings include the presence of several other text-types or sub-text-types in the book and the dependence on literary discourse and devices to capture the meanings better or add color to the dry field of law. In addition, many elements of culture can be seen, for example, the use of familiar alternatives, allusions, and even terminology and references that date back to various periods of time and languages. Also found are parts which discuss origins of words and terms that may be relevant to readers within the United Kingdom but make little sense to readers of the book in other languages. In conclusion, the textual analysis in terms of its functions and the linguistic and textual devices used to achieve them can then be applied as a guide to determine the effectiveness of the translation that is produced.

Keywords: functional theory of language, lawbook text-type, rhetorical devices, culture

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Authors: Sandra Mitrovic, Gaurav Singh

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In many industries, including telecommunications, churn prediction has been a topic of active research. A lot of attention has been drawn on devising the most informative features, and this area of research has gained even more focus with spread of (social) network analytics. The call detail records (CDRs) have been used to construct customer networks and extract potentially useful features. However, to the best of our knowledge, no studies including network features have yet proposed a generic way of representing network information. Instead, ad-hoc and dataset dependent solutions have been suggested. In this work, we build upon a recently presented method (node2vec) to obtain representations for nodes in observed network. The proposed approach is generic and applicable to any network and domain. Unlike node2vec, which assumes a static network, we consider a dynamic and time-evolving network. To account for this, we propose an approach that constructs the feature representation of each node by generating its node2vec representations at different timestamps, concatenating them and finally compressing using an auto-encoder-like method in order to retain reasonably long and informative feature vectors. We test the proposed method on churn prediction task in telco domain. To predict churners at timestamp ts+1, we construct training and testing datasets consisting of feature vectors from time intervals [t1, ts-1] and [t2, ts] respectively, and use traditional supervised classification models like SVM and Logistic Regression. Observed results show the effectiveness of proposed approach as compared to ad-hoc feature selection based approaches and static node2vec.

Keywords: churn prediction, dynamic networks, node2vec, auto-encoders

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Authors: Cristina Maria Ribeiro Martins Pereira Caridade, Ana Rita Ferreira Morais

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The use of computational tools has become essential in the context of interactive learning, especially in engineering education. In the medical industry, teaching medical image processing techniques is a crucial part of training biomedical engineers, as it has integrated applications with healthcare facilities and hospitals. The aim of this article is to present a teaching-learning simulation tool developed in MATLAB using a graphical user interface for medical image fusion that explores different image fusion methodologies and processes in combination with image pre-processing techniques. The application uses different algorithms and medical fusion techniques in real time, allowing you to view original images and fusion images, compare processed and original images, adjust parameters, and save images. The tool proposed in an innovative teaching and learning environment consists of a dynamic and motivating teaching simulation for biomedical engineering students to acquire knowledge about medical image fusion techniques and necessary skills for the training of biomedical engineers. In conclusion, the developed simulation tool provides real-time visualization of the original and fusion images and the possibility to test, evaluate and progress the student’s knowledge about the fusion of medical images. It also facilitates the exploration of medical imaging applications, specifically image fusion, which is critical in the medical industry. Teachers and students can make adjustments and/or create new functions, making the simulation environment adaptable to new techniques and methodologies.

Keywords: image fusion, image processing, teaching-learning simulation tool, biomedical engineering education

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Authors: Inês N. Peça , A. Bicho, Rui Gardner, M. Margarida Cardoso

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Inorganic/organic nanocomplexes offer tremendous scope for future biomedical applications, including imaging, disease diagnosis and drug delivery. The combination of Fe3O4 with biocompatible polymers to produce smart drug delivery systems for use in pharmaceutical formulation present a powerful tool to target anti-cancer drugs to specific tumor sites through the application of an external magnetic field. In the present study, we focused on the evaluation of the effect of the magnetic field application time on the rate of drug release from iron oxide polymeric nanoparticles. Doxorubicin, an anticancer drug, was selected as the model drug loaded into the nanoparticles. Nanoparticles composed of poly(d-lactide-co-glycolide (PLGA), a biocompatible polymer already approved by FDA, containing iron oxide nanoparticles (MNP) for magnetic targeting and doxorubicin (DOX) were synthesized by the o/w solvent extraction/evaporation method and characterized by scanning electron microscopy (SEM), by dynamic light scattering (DLS), by inductively coupled plasma-atomic emission spectrometry and by Fourier transformed infrared spectroscopy. The produced particles yielded smooth surfaces and spherical shapes exhibiting a size between 400 and 600 nm. The effect of the magnetic doxorubicin loaded PLGA nanoparticles produced on cell viability was investigated in mammalian CHO cell cultures. The results showed that unloaded magnetic PLGA nanoparticles were nontoxic while the magnetic particles without polymeric coating show a high level of toxicity. Concerning the therapeutic activity doxorubicin loaded magnetic particles cause a remarkable enhancement of the cell inhibition rates compared to their non-magnetic counterpart. In vitro drug release studies performed under a non-permanent magnetic field show that the application time and the on/off cycle duration have a great influence with respect to the final amount and to the rate of drug release. In order to determine the mechanism of drug release, the data obtained from the release curves were fitted to the semi-empirical equation of the the Korsmeyer-Peppas model that may be used to describe the Fickian and non-Fickian release behaviour. Doxorubicin release mechanism has shown to be governed mainly by Fickian diffusion. The results obtained show that the rate of drug release from the produced magnetic nanoparticles can be modulated through the magnetic field time application.

Keywords: drug delivery, magnetic nanoparticles, PLGA nanoparticles, controlled release rate

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Authors: Navdeep Goel, Salvador Gabarda

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Digital images are widely used in computer applications. To store or transmit the uncompressed images requires considerable storage capacity and transmission bandwidth. Image compression is a means to perform transmission or storage of visual data in the most economical way. This paper explains about how images can be encoded to be transmitted in a multiplexing time-frequency domain channel. Multiplexing involves packing signals together whose representations are compact in the working domain. In order to optimize transmission resources each 4x4 pixel block of the image is transformed by a suitable polynomial approximation, into a minimal number of coefficients. Less than 4*4 coefficients in one block spares a significant amount of transmitted information, but some information is lost. Different approximations for image transformation have been evaluated as polynomial representation (Vandermonde matrix), least squares + gradient descent, 1-D Chebyshev polynomials, 2-D Chebyshev polynomials or singular value decomposition (SVD). Results have been compared in terms of nominal compression rate (NCR), compression ratio (CR) and peak signal-to-noise ratio (PSNR) in order to minimize the error function defined as the difference between the original pixel gray levels and the approximated polynomial output. Polynomial coefficients have been later encoded and handled for generating chirps in a target rate of about two chirps per 4*4 pixel block and then submitted to a transmission multiplexing operation in the time-frequency domain.

Keywords: chirp signals, image multiplexing, image transformation, linear canonical transform, polynomial approximation

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Authors: Rita Ghosh, Joykrishna Dey

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PEG-based amphiphiles are of tremendous importance for its widespread applications in pharmaceutics, household purposes, and drug delivery. Previously, a number of single PEG-tailed amphiphiles having significant applications have been reported from our group. Therefore, it was of immense interest to explore the properties and application potential of PEG-based double tailed amphiphiles. Herein, for the first time, two novel double PEG-tailed amphiphiles having different PEG chain lengths have been developed. The self-assembly behavior of the newly developed amphiphiles in aqueous buffer (pH 7.0) was thoroughly investigated at 25 oC by a number of techniques including, 1H-NMR, and steady-state and time-dependent fluorescence spectroscopy, dynamic light scattering, transmission electron microscopy, atomic force microscopy, and isothermal titration calorimetry. Despite having two polar PEG chains both molecules were found to have strong tendency to self-assemble in aqueous buffered solution above a very low concentration. Surprisingly, the amphiphiles were shown to form stable vesicles spontaneously at room temperature without any external stimuli. The results of calorimetric measurements showed that the vesicle formation is driven by the hydrophobic effect (positive entropy change) of the system, which is associated with the helix-to-random coil transition of the PEG chain. The spectroscopic data confirmed that the bilayer membrane of the vesicles is constituted by the PEG chains of the amphiphilic molecule. Interestingly, the vesicles were also found to exhibit structural transitions upon addition of salts in solution. These properties of the vesicles enable them as potential candidate for drug delivery.

Keywords: double-tailed amphiphiles, fluorescence, microscopy, PEG, vesicles

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Authors: Adel Edwar Waheeb Louka

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Purpose AI-driven solutions are at the forefront of many pathology and medical imaging methods. Using algorithms designed to better the experience of medical professionals within their respective fields, the efficiency and accuracy of diagnosis can improve. In particular, X-rays are a fast and relatively inexpensive test that can diagnose diseases. In recent years, X-rays have not been widely used to detect and diagnose COVID-19. The under use of Xrays is mainly due to the low diagnostic accuracy and confounding with pneumonia, another respiratory disease. However, research in this field has expressed a possibility that artificial neural networks can successfully diagnose COVID-19 with high accuracy. Models and Data The dataset used is the COVID-19 Radiography Database. This dataset includes images and masks of chest X-rays under the labels of COVID-19, normal, and pneumonia. The classification model developed uses an autoencoder and a pre-trained convolutional neural network (DenseNet201) to provide transfer learning to the model. The model then uses a deep neural network to finalize the feature extraction and predict the diagnosis for the input image. This model was trained on 4035 images and validated on 807 separate images from the ones used for training. The images used to train the classification model include an important feature: the pictures are cropped beforehand to eliminate distractions when training the model. The image segmentation model uses an improved U-Net architecture. This model is used to extract the lung mask from the chest X-ray image. The model is trained on 8577 images and validated on a validation split of 20%. These models are calculated using the external dataset for validation. The models’ accuracy, precision, recall, f1-score, IOU, and loss are calculated. Results The classification model achieved an accuracy of 97.65% and a loss of 0.1234 when differentiating COVID19-infected, pneumonia-infected, and normal lung X-rays. The segmentation model achieved an accuracy of 97.31% and an IOU of 0.928. Conclusion The models proposed can detect COVID-19, pneumonia, and normal lungs with high accuracy and derive the lung mask from a chest X-ray with similarly high accuracy. The hope is for these models to elevate the experience of medical professionals and provide insight into the future of the methods used.

Keywords: artificial intelligence, convolutional neural networks, deeplearning, image processing, machine learningSarapin, intraarticular, chronic knee pain, osteoarthritisFNS, trauma, hip, neck femur fracture, minimally invasive surgery

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Authors: Michael Anton Kraus, Miriam Schuster, Geralt Siebert, Jens Schneider

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Polymers increasingly gained interest in construction materials over the last years in civil engineering applications. As polymeric materials typically show time- and temperature dependent material behavior, which is accounted for in the context of the theory of linear viscoelasticity. Within the context of this paper, the authors show, that some polymeric interlayers for laminated glass can not be considered as thermorheologically simple as they do not follow a simple TTSP, thus a methodology of identifying the thermorheologically complex constitutive bahavioir is needed. ‘Dynamical-Mechanical-Thermal-Analysis’ (DMTA) in tensile and shear mode as well as ‘Differential Scanning Caliometry’ (DSC) tests are carried out on the interlayer material ‘Ethylene-vinyl acetate’ (EVA). A navoel Bayesian framework for the Master Curving Process as well as the detection and parameter identification of the TTSPs along with their associated Prony-series is derived and applied to the EVA material data. To our best knowledge, this is the first time, an uncertainty quantification of the Prony-series in a Bayesian context is shown. Within this paper, we could successfully apply the derived Bayesian methodology to the EVA material data to gather meaningful Master Curves and TTSPs. Uncertainties occurring in this process can be well quantified. We found, that EVA needs two TTSPs with two associated Generalized Maxwell Models. As the methodology is kept general, the derived framework could be also applied to other thermorheologically complex polymers for parameter identification purposes.

Keywords: bayesian parameter identification, generalized Maxwell model, linear viscoelasticity, thermorheological complex

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Authors: Raghuram Kandimalla, Sanjeeb Kalita, Bhaswati Choudhury, Jibon Kotoky

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The quest for developing an ideal suture material prompted our interest to develop a novel suture with advantageous characteristics to market available ones. We developed novel suture biomaterial from muga silk (Antheraea assama) and ramie (Boehmeria nivea) plant fiber. Field emission scanning electron microscopy (FE-SEM), energy-dispersive X-ray spectroscopy (EDX), attenuated total reflection fourier transform infrared spectroscopy (ATR-FTIR) and thermo gravimetric analysis (TGA) results revealed the physicochemical properties of the fibers which supports the suitability of fibers for suture fabrication. Tensile properties of the prepared sutures were comparable with market available sutures and it found to be biocompatible towards human erythrocytes and nontoxic to mammalian cells. The prepared sutures completely healed the superficial deep wound incisions within seven days in adult male wister rats leaving no rash and scar. Histopathology studies supports the wound healing ability of sutures, as rapid synthesis of collagen, connective tissue and other skin adnexal structures were observed within seven days of surgery. Further muga suture surface modified by exposing the suture to oxygen plasma which resulted in formation of nanotopography on suture surface. Broad spectrum antibiotic amoxicillin was functionalized on the suture surface to prepare an advanced antimicrobial muga suture. Surface hydrophilicity induced by oxygen plasma results in an increase in drug-impregnation efficiency of modified muga suture by 16.7%. In vitro drug release profiles showed continuous and prolonged release of amoxicillin from suture up to 336 hours. The advanced muga suture proves to be effective against growth inhibition of Staphylococcus aureus and Escherichia coli, whereas normal muga suture offers no antibacterial activity against both types of bacteria. In vivo histopathology studies and colony-forming unit count data revealed accelerated wound healing activity of advanced suture over normal one through rapid synthesis and proliferation of collagen, hair follicle and connective tissues.

Keywords: sutures, biomaterials, silk, Ramie

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Authors: Sophia Liang Zhou

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For investors, businesses, consumers, and governments, an accurate assessment of future housing prices is crucial to critical decisions in resource allocation, policy formation, and investment strategies. Previous studies are contradictory about macroeconomic determinants of housing price and largely focused on one or two areas using point prediction. This study aims to develop data-driven models to accurately predict future housing market trends in different markets. This work studied five different metropolitan areas representing different market trends and compared three-time lagging situations: no lag, 6-month lag, and 12-month lag. Linear regression (LR), random forest (RF), and artificial neural network (ANN) were employed to model the real estate price using datasets with S&P/Case-Shiller home price index and 12 demographic and macroeconomic features, such as gross domestic product (GDP), resident population, personal income, etc. in five metropolitan areas: Boston, Dallas, New York, Chicago, and San Francisco. The data from March 2005 to December 2018 were collected from the Federal Reserve Bank, FBI, and Freddie Mac. In the original data, some factors are monthly, some quarterly, and some yearly. Thus, two methods to compensate missing values, backfill or interpolation, were compared. The models were evaluated by accuracy, mean absolute error, and root mean square error. The LR and ANN models outperformed the RF model due to RF’s inherent limitations. Both ANN and LR methods generated predictive models with high accuracy ( > 95%). It was found that personal income, GDP, population, and measures of debt consistently appeared as the most important factors. It also showed that technique to compensate missing values in the dataset and implementation of time lag can have a significant influence on the model performance and require further investigation. The best performing models varied for each area, but the backfilled 12-month lag LR models and the interpolated no lag ANN models showed the best stable performance overall, with accuracies > 95% for each city. This study reveals the influence of input variables in different markets. It also provides evidence to support future studies to identify the optimal time lag and data imputing methods for establishing accurate predictive models.

Keywords: linear regression, random forest, artificial neural network, real estate price prediction

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Authors: Kldiashvili Ekaterina, Burduli Archil, Ghortlishvili Gocha

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Introduction – Medical information system (MIS) is at the heart of information technology (IT) implementation policies in healthcare systems around the world. Different architecture and application models of MIS are developed. Despite of obvious advantages and benefits, application of MIS in everyday practice is slow. Objective - On the background of analysis of the existing models of MIS in Georgia has been created a multi-user web-based approach. This presentation will present the architecture of the system and its application for image based second opinion consultations. Methods – The MIS has been created with .Net technology and SQL database architecture. It realizes local (intranet) and remote (internet) access to the system and management of databases. The MIS is fully operational approach, which is successfully used for medical data registration and management as well as for creation, editing and maintenance of the electronic medical records (EMR). Five hundred Georgian language electronic medical records from the cervical screening activity illustrated by images were selected for second opinion consultations. Results – The primary goal of the MIS is patient management. However, the system can be successfully applied for image based second opinion consultations. Discussion – The ideal of healthcare in the information age must be to create a situation where healthcare professionals spend more time creating knowledge from medical information and less time managing medical information. The application of easily available and adaptable technology and improvement of the infrastructure conditions is the basis for eHealth applications. Conclusion - The MIS is perspective and actual technology solution. It can be successfully and effectively used for image based second opinion consultations.

Keywords: digital images, medical information system, second opinion consultations, electronic medical record

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Authors: Rammah Abdlbagi, Similoluwa Biyi, Aakash Pai

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Introduction: Short-term ureteric stents are commonly placed after ureteroscopy procedures. The removal usually entails having a flexible cystoscopy, which entails a further invasive procedure. There are often delays in removing the stent as departments have limited cystoscopy availability. However, if stents with extraction strings are used, the patient or a clinician can remove them. The aim of the study is to assess the safety and effectiveness of the use of a stent with a string. Method: A retrospective, single-institution study was conducted over a three-month period. Twenty consecutive patients had ureteric stents with string insertion. Ten of the patients had a stent removal procedure previously with flexible cystoscopy. A validated questionnaire was used to assess outcomes. Primary outcomes included: dysuria, hematuria, urinary frequency, and disturbance of the patient’s daily activities. Secondary outcomes included pain experience during the stent removal. Result: Fifteen patients (75%) experienced hematuria and frequency. Two patients experienced pain and discomfort during the stent removal (10%). Two patients had experienced a disturbance in their daily activity (10%). All patients who had stent removal before using flexible cystoscopy preferred the removal of the stent using a string. None of the patients had stent displacement. The median stent dwell time was five days. Conclusion: Patient reported outcomes measures for the indwelling period of a stent with extraction string are equivalent to the published data on stents. Extraction strings mean that the stent dwell time can be reduced. The removal of the stent on extraction strings is more tolerable than the conventional stent.

Keywords: ureteric stent, string flexible cystoscopy, stent symptoms, validated questionnaire

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