Search results for: clinical simulation

Authors: Mohamed Hassan Gundu, Jaeseung Lee, Muhammad Faizan Chinannai, Hyunchul Ju

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In this study, we present the effects of bipolar plate design to control the temperature of the cell and ensure effective water management under an excessive amount of air flow and low humidification conditions in the proton exchange membrane fuel cell (PEMFC). The PEMFC model developed and applied to consider a three type of bipolar plate that is defined by ratio of inlet channel width to outlet channel width. Simulation results show that the design which has narrow gas inlet channel and wide gas outlet channel width (wide coolant inlet channel and narrow coolant outlet channel width) make the relative humidity and water concentration increase in the channel and the catalyst layer. Therefore, this study clearly demonstrates that the dehydration phenomenon can be decreased by using design of bipolar plate with narrow gas inlet channel and wide gas outlet channel width (wide coolant inlet channel and narrow coolant outlet channel width).

Keywords: PEMFC, air-cooling, relative humidity, water management, water concentration, oxygen concentration

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Authors: Renata Checiches, Thierry Coche, Nicolas F. Delahaye, Albert Linder, Fernando Ulloa Montoya, Olivier Gruselle, Karen Langfeld, An de Creus, Bart Spiessens, Vincent G. Brichard, Jamila Louahed, Frédéric F. Lehmann

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Background: The RNA-expression levels of cancer-testis antigens MAGE A3 and PRAME were determined in resected tissue from patients with primary non-small-cell lung cancer (NSCLC) and related to clinical outcome. EGFR, KRAS and BRAF mutation status was determined in a subset to investigate associations with MAGE A3 and PRAME expression. Methods: We conducted a single-centre, uncontrolled, retrospective study of 1260 tissue-bank samples from stage IA-III resected NSCLC. The prognostic value of antigen expression (qRT-PCR) was determined by hazard-ratio and Kaplan-Meier curves. Results: Thirty-seven percent (314/844) of tumours expressed MAGE-A3, 66% (723/1092) expressed PRAME and 31% (239/839) expressed both. Respective frequencies in squamous-cell tumours and adenocarcinomas were 43%/30% for MAGE A3 and 80%/44% for PRAME. No correlation with stage, tumour size or patient age was found. Overall, no prognostic value was identified for either antigen. A trend to poorer overall survival was associated with MAGE-A3 in stage IIIB and with PRAME in stage IB. EGFR and KRAS mutations were found in 10.1% (28/311) and 33.8% (97/311) of tumours, respectively. EGFR (but not KRAS) mutation status was negatively associated with PRAME expression. Conclusion: No clear prognostic value for either PRAME or MAGE A3 was observed in the overall population, although some observed trends may warrant further investigation.

Keywords: MAGE A3, PRAME, cancer-testis gene, NSCLC, survival, EGFR

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Authors: Mahmoud Enayati, Sirous Mohammadi

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In this paper, a novel procedure to find the firing angles of the multilevel inverters of supply voltage and, consequently, to decline the total harmonic distortion (THD), has been presented. In order to eliminate more harmonics in the multilevel inverters, its number of levels can be lessened or pulse width modulation waveform, in which more than one switching occur in each level, be used. Both cases complicate the non-algebraic equations and their solution cannot be performed by the conventional methods for the numerical solution of nonlinear equations such as Newton-Raphson method. In this paper, Cuckoo algorithm is used to compute the optimal firing angle of the pulse width modulation voltage waveform in the multilevel inverter. These angles should be calculated in such a way that the voltage amplitude of the fundamental frequency be generated while the total harmonic distortion of the output voltage be small. The simulation and theoretical results for the 9-levels inverter offer the high applicability of the proposed algorithm to identify the suitable firing angles for declining the low order harmonics and generate a waveform whose total harmonic distortion is very small and it is almost a sinusoidal waveform.

Keywords: evolutionary algorithms, multilevel inverters, total harmonic content, Cuckoo Algorithm

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Authors: Khaled M. Alqahtani

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Copy number alterations (CNA) are variations in the structure of the genome, where certain regions deviate from the typical two chromosomal copies. These alterations are pivotal in understanding tumor progression and are indicative of patients' survival outcomes. However, effectively modeling patients' survival based on their genomic CNA profiles while identifying relevant genomic regions remains a statistical challenge. Various methods, such as the Cox proportional hazard (PH) model with ridge, lasso, or elastic net penalties, have been proposed but often overlook the inherent dependencies between genomic regions, leading to results that are hard to interpret. In this study, we enhance the elastic net penalty by incorporating an additional penalty that accounts for these dependencies. This approach yields smooth parameter estimates and facilitates variable selection, resulting in a sparse solution. Our findings demonstrate that this method outperforms other models in predicting survival outcomes, as evidenced by our simulation study. Moreover, it allows for a more meaningful interpretation of genomic regions associated with patients' survival. We demonstrate the efficacy of our approach using both real data from a lung cancer cohort and simulated datasets.

Keywords: copy number alterations, cox proportional hazard, lung cancer, regression, sparse solution

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Authors: Christopher Leung, Assad Zahid

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Mesenteric vasculitis can often mimic abdominal sepsis in a postoperative setting leading to a predicament where steroids could improve mesenteric vasculitis whilst worsening abdominal sepsis. Here this study presents a unique and rare case of perforated sigmoid diverticulitis secondary to systemic vasculitis. A 68-year-old gentleman presented with perforated sigmoid diverticulitis requiring an emergency Hartmann’s procedure. Early in his postoperative course, he had painful and asymmetrical neuropathy that, after a careful history and examination, revealed a patient with mono neuritis multiplex on a background history of longstanding rheumatoid arthritis. On day seven of his postoperative course, he had rising inflammatory markers and a CT abdomen and pelvis showing fluid around the mesentery. Whilst contamination from sigmoid perforation was somewhat congruent with these signs, a diagnosis of polyarteritis nodosa, a common cause of mononeuritis multiplex, is also possible, although involvement of the large bowel in polyarteritis nodosa is extremely rare. The histopathology from the initial Hartmann’s procedure was re-examined, showing medium vessel disease vasculitis. Given his lack of fevers, absence of abdominal pain, and worsening neurology, he was given a provisional diagnosis of polyarteritis nodosa and was treated successfully, not on IV antibiotics but on steroids. Large bowel involvement of polyarteritis nodosa is extremely rare and this is the first case of polyarteritis nodosa causing perforated diverticulitis. The learning point here is to obtain a good clinical picture of a patient to identify mesenteric vasculitis as compared to abdominal sepsis as the treatment of one worsens the other.

Keywords: abdominal sepsis, diverticulitis, mesenteric vasculitis, polyarteritis nodosa

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Authors: Elham Delzendeh, Song Wu, Mustafa Al-Adhami, Rima Alaaeddine

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Over the last 15 years, prediction of energy consumption has become a common practice and necessity at different stages of the building’s lifecycle, particularly, at the design and post-occupancy stages for planning and maintenance purposes. This is due to the ever-growing response of governments to address sustainability and reduction of CO₂ emission in the building sector. However, there is a level of uncertainty in the estimation of energy consumption in buildings. The accuracy of energy consumption predictions is directly related to the precision of the initial inputs used in the energy assessment process. In this study, multiple cases of large non-residential buildings at design, construction, and post-occupancy stages are investigated. The energy consumption process and inputs, and the actual and predicted energy consumption of the cases are analysed. The findings of this study have pointed out and evidenced various parameters that cause uncertainty in the prediction of energy consumption in buildings such as modelling, location data, and occupant behaviour. In addition, unavailability and insufficiency of energy-consumption-related inputs at different stages of the building’s lifecycle are classified and categorized. Understanding the roots of uncertainty in building energy analysis will help energy modellers and energy simulation software developers reach more accurate energy consumption predictions in buildings.

Keywords: building lifecycle, efficiency, energy analysis, energy performance, uncertainty

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Authors: Kernou Nassim

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The current study presents a vulnerability and a reliability-mechanical approach that focuses on evaluating the seismic performance of reinforced concrete structures to determine the probability of failure. In this case, the performance function reflecting the non-linear behavior of the structure is modeled by a response surface to establish an analytical relationship between the random variables (strength of concrete and yield strength of steel) and mechanical responses of the structure (inter-floor displacement) obtained by the pushover results of finite element simulations. The push over-analysis is executed by software SAP2000. The results acquired prove that properly designed frames will perform well under seismic loads. It is a comparative study of the behavior of the existing structure before and after reinforcement using the pushover method. The coupling indirect mechanical reliability by response surface avoids prohibitive calculation times. Finally, the results of the proposed approach are compared with Monte Carlo Simulation. The comparative study shows that the structure is more reliable after the introduction of new shear walls.

Keywords: finite element method, surface response, reliability, reliability mechanical coupling, vulnerability

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Authors: Dana Craciun, Daniela Dascalu, Adriana Isvoran

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Phthalates are a class of plastic additives that are used to enhance the physical properties of plastics and as solvents in paintings and some of them proved to be of particular concern for the human health. There are insufficient data concerning the health risks of phthalates and further research on evaluating their effects in humans is needed. As humans are not volunteers for such experiments, computational analysis may be used to predict the biological effects of phthalates in humans. Within this study we have used some computational approaches (SwissADME, admetSAR, FAFDrugs) for predicting the absorption, distribution, metabolization, excretion and toxicity (ADME-Tox) profiles and pharmacokinetics for the most common used phthalates. These computational tools are based on quantitative structure-activity relationship modeling approach. The predictions are further compared to the known effects of each considered phthalate in humans and correlations between computational results and experimental data are discussed. Our data revealed that phthalates are a class of compounds reflecting high toxicity both when ingested and when inhaled, but by inhalation their toxicity is even greater. The predicted harmful effects of phthalates are: toxicity and irritations of the respiratory and gastrointestinal tracts, dyspnea, skin and eye irritations and disruption of the functions of liver and of the reproductive system. Many of investigated phthalates are predicted to be able to inhibit some of the cytochromes involved in the metabolism of numerous drugs and consequently to affect the efficiency of administrated treatments for many diseases and to intensify the adverse drugs reactions. The obtained predictions are in good agreement with clinical data concerning the observed effects of some phthalates in cases of acute exposures. Our study emphasizes the possible health effects of numerous phthalates and underlines the applicability of computational methods for predicting the biological effects of xenobiotics.

Keywords: phthalates, ADME-Tox, pharmacokinetics, biological effects

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Authors: Kuei-Yu Chien, Hsiu-Yu Chiu, Chia-Nan Chen, Shu-Chen Chen

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Background: Frailty is associated with decreased physical performances that affect mobility of the elderly. Time up and go test (TUG) was the common method to evaluate mobility in the community. The purpose of this study was to compare the parameters in different stages of Time up and go test (TUG) and physical performance between pre-frail elderly (PFE) and non-frail elderly (NFE). We also investigated the relationship between TUG parameters and physical performance. Methods: Ninety-two community-dwelling older adults were as participants in this study. Based on Canadian Study of Health and Aging Clinical Frailty Scale, 22 older adults were classified as PFE (71.77 ± 6.05 yrs.) and 70 were classified as NFE (71.2 ± 5.02 yrs.). We performed body composition and physical performance, including balance, muscular strength/endurance, mobility, cardiorespiratory endurance, and flexibility. Results: Pre-frail elderly took significantly longer time than NFE in TUG test (p=.004). Pre-frail elderly had lower turning average angular velocity (p = .017), turning peak angular velocity (p = .041) and turning-stand to sit peak angular velocity (p = .037) than NFE. The turning related parameters related to open-eye stand on right foot, 30-second chair stand test, back scratch, and 2-min step tests. Conclusions: Turning average angular velocity, turning peak angular velocity and turning-stand to sit peak angular velocity mainly affected the TUG performance. We suggested that static/dynamic balance, agility, flexibility, and muscle strengthening of lower limbs exercise were important to PFE.

Keywords: mobility, aglity, active ageing, functional fitness

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Authors: A. I. Alajtal, H. G. M. Edwards, M. A. Elbagermi

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Raman spectroscopy is currently a part of the instrumentation suite of the ESA ExoMars mission for the remote detection of life signatures in the Martian surface and subsurface. Terrestrial analogues of Martian sites have been identified and the biogeological modifications incurred as a result of extremophilic activity have been studied. Analytical instrumentation protocols for the unequivocal detection of biomarkers in suitable geological matrices are critical for future unmanned explorations, including the forthcoming ESA ExoMars mission to search for life on Mars scheduled for 2018 and Raman spectroscopy is currently a part of the Pasteur instrumentation suite of this mission. Here, Raman spectroscopy using 785nm excitation was evaluated for determining various concentrations of beta-carotene in admixture with polyaromatic hydrocarbons and usnic acid have been investigated by Raman microspectrometry to determine the lowest levels detectable in simulation of their potential identification remotely in geobiological conditions in Martian scenarios. Information from this study will be important for the development of a miniaturized Raman instrument for targetting Martian sites where the biosignatures of relict or extant life could remain in the geological record.

Keywords: raman spectroscopy, mars-analog, beta-carotene, PAHs

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Authors: M. Doumi, A. Miloudi, A.G. Aissaoui, K. Tahir, C. Belfedal, S. Tahir

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The studies on the photovoltaic system are extensively increasing because of a large, secure, essentially exhaustible and broadly available resource as a future energy supply. However, the output power induced in the photovoltaic modules is influenced by an intensity of solar cell radiation, temperature of the solar cells and so on. Therefore, to maximize the efficiency of the photovoltaic system, it is necessary to track the maximum power point of the PV array, for this Maximum Power Point Tracking (MPPT) technique is used. These algorithms are based on the Perturb-Observe, Conductance-Increment and the Fuzzy Logic methods. These techniques vary in many aspects as: simplicity, convergence speed, digital or analogical implementation, sensors required, cost, range of effectiveness, and in other aspects. This paper presents a comparative study of three widely-adopted MPPT algorithms; their performance is evaluated on the energy point of view, by using the simulation tool Simulink®, considering different solar irradiance variations. MPPT using fuzzy logic shows superior performance and more reliable control to the other methods for this application.

Keywords: photovoltaic system, MPPT, perturb and observe (P&O), incremental conductance (INC), Fuzzy Logic (FLC)

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Authors: Li-Te Lin, Chia-Jung Li, Kuan-Hao Tsui

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Cuproptosis, a newly identified cell death mechanism, has attracted attention for its association with various diseases. However, the genetic interplay between cuproptosis and ovarian aging remains largely unexplored. This study aims to address this gap by analyzing datasets related to ovarian aging and cuproptosis. Spatial transcriptome analyses were conducted in the ovaries of both young and aged female mice to elucidate the role of FDX1. Comprehensive bioinformatics analyses, facilitated by R software, identified FDX1 as a potential cuproptosis-related gene with implications for ovarian aging. Clinical infertility biopsies were examined to validate these findings, showing consistent results in elderly infertile patients. Furthermore, pharmacogenomic analyses of ovarian cell lines explored the intricate association between FDX1 expression levels and sensitivity to specific small molecule drugs. Spatial transcriptome analyses revealed a significant reduction in FDX1 expression in aging ovaries, supported by consistent findings in biopsies from elderly infertile patients. Pharmacogenomic investigations indicated that modulating FDX1 could influence drug responses in ovarian-related therapies. This study pioneers the identification of FDX1 as a cuproptosis-related gene linked to ovarian aging. These findings not only contribute to understanding the mechanisms of ovarian aging but also position FDX1 as a potential diagnostic biomarker and therapeutic target. Further research may establish FDX1's pivotal role in advancing precision medicine and therapies for ovarian-related conditions.

Keywords: cuproptosis, FDX1, ovarian aging, biomarker

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Authors: Asma Ahmed, Farah Khalid, Sahlah Sohail, Saira Banusokwalla, Sabiha Banu, Inaara Akbar, Safia Awan, Syed Iqbal Azam

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Background and Objectives: The level of knowledge regarding obesity as a disease condition and health-seeking behavior regarding its management is grossly lacking. We present data from our multidisciplinary obesity clinic at the large tertiary care facility in Karachi, Pakistan, to provide baseline profiles and outcomes of patients attending these clinics. Methods: 260 who attended the obesity clinic between June 2018 to March 2020 were enrolled in this study. The analysis included descriptive and ROC analysis to identify the best cut-offs of theanthropometric measurements to diagnose obesity-related comorbid conditions. Results: The majority of the studied population were women (72.3%) and employed(43.7%) with a mean age of 35.5 years. Mean BMIwas 37.4, waist circumference was 112.4 cm, visceral fat was 11.7%, and HbA1C was 6.9%. The most common comorbidities were HTN & D.M (33 &31%, respectively). The prevalence of MetS was 16.3% in patients and was slightly higher in males. Visceral fat was the main factor in predicting D.M (0.750; 95% CI: 0.665, 0.836) and MetS (0.709; 95% CI: 0.590, 0.838) compared to total body fat, waist circumference, and BMI. The risk of predicting DM &MetS for the visceral fat above 9.5% in women had the highest sensitivity (80% for D.M & 79% for MetS) and an NPV (92.75% for D.M & 95% for MetS). Conclusions: This study describes and establishes characteristics of these obese individuals, which can help inform clinical practices. These practices may involve using visceral fat for earlier identification and counseling-based interventions to prevent more severe surgical interventions down the line.

Keywords: obesity, metabolic syndrome, tertiary care facility, BMI, waist circumference, visceral fat

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Authors: Erhong Sun, Xuchun Ye

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Technophobia, namely the fear or dislike of modern advanced technologies, plays a central role in age-related digital divides and is considered a new risk factor for older adults, which can affect the daily lives of people through low adherence to digital living. Indeed, there is considerable heterogeneity in the group of older adults who feel technophobia. Therefore, the aim of this study was to identify different technophobia typologies of older people and to examine their associations with the subjective age factor. A sample of 704 retired elderly over the age of 55 was recruited in China. Technophobia and subjective age were assessed with a questionnaire, respectively. Latent profile analysis was used to identify technophobia subgroups, using three dimensions including techno-anxiety, techno-paranoia, and privacy concerns as indicators. The association between the identified technophobia subgroups and subjective age was explored. In summary, four different technophobia typologies were identified among older adults in China. Combined with an investigation of personal background characteristics and subjective age, it draws a more nuanced image of the technophobia phenome among older adults in China. First, not all older adults suffer from technophobia, with about half of the elderly subjects belonging to the profiles of “Low-technophobia” and “Medium-technophobia.” Second, privacy concern plays an important role in the classification of technophobia among older adults. Third, subjective age might be a protective factor for technophobia in older adults. Although the causal direction between identified technophobia typologies and subjective age remains uncertain, our suggests that future interventions should better focus on subjective age by breaking the age stereotype of technology to reduce the negative effect of technophobia on older. Future development of this research will involve extensive investigation of the detailed impact of technophobia in senior populations, measurement of the negative outcomes, as well as formulation of innovative educational and clinical pathways.

Keywords: technophobia, older adults, latent profile analysis, subjective age

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Authors: Sophia Shi

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Acute kidney injury (AKI) is the sudden onset of kidney damage in which the kidneys cannot filter waste from the blood, requiring emergency hospitalization. AKI patient mortality rate is high in the ICU and is virtually impossible for doctors to predict because it is so unexpected. Currently, there is no hybrid model predicting AKI that takes advantage of two types of data. De-identified patient data from the MIMIC-III database and de-identified kidney images and corresponding patient records from the Beijing Hospital of the Ministry of Health were collected. Using data features including serum creatinine among others, two numeric models using MIMIC and Beijing Hospital data were built, and with the hospital ultrasounds, an image-only model was built. Convolutional neural networks (CNN) were used, VGG and Resnet for numeric data and Resnet for image data, and they were combined into a hybrid model by concatenating feature maps of both types of models to create a new input. This input enters another CNN block and then two fully connected layers, ending in a binary output after running through Softmax and additional code. The hybrid model successfully predicted AKI and the highest AUROC of the model was 0.953, achieving an accuracy of 90% and F1-score of 0.91. This model can be implemented into urgent clinical settings such as the ICU and aid doctors by assessing the risk of AKI shortly after the patient’s admission to the ICU, so that doctors can take preventative measures and diminish mortality risks and severe kidney damage.

Keywords: Acute kidney injury, Convolutional neural network, Hybrid deep learning, Patient record data, ResNet, Ultrasound kidney images, VGG

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Authors: Ramji Kalidoss, Snekhalatha Umapathy, V. Dhinakaran, J. M. Mathana

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Chemi-resistive sensors used in breathalyzers have become a hotspot between the international breath research communities. These sensors exhibit a significant change in its resistance depending on the temperature it gets heated thus demanding high power leading to non-portable instrumentation. In this work, numerical simulation to identify the suitable combination of substrate and heater profile using COMSOL multiphysics was studied. Ni-Cr and Pt-100 joule resistive heater with various profiles were studied beneath the square and circular alumina substrates. The temperature distribution was uniform throughout the square substrate with the meander shaped pt100 heater with 48 mW power consumption for 200 oC. Moreover, this heater profile induced minimal stress on the substrate with 0.5 mm thick. A novel Graphene based ternary metal oxide nanocomposite (GO/SnO2/TiO2) was coated on the optimized substrate and heater to elucidate the response of diabetes biomarker (acetone). The sensor exhibited superior gas sensing performance towards acetone in the exhaled breath concentration range for diabetes (0.25 – 3 ppm). These results indicated the importance of substrate and heater properties along with sensing material for low power portable breathalyzers.

Keywords: Breath Analysis, Chemical Sensors, Diabetes Mellitus, Graphene Nanocomposites, Heater, Substrate

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Authors: Siddhartha Chauhan, Nitin Kumar Kotania

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Traditional Wireless Sensor Networks (WSNs) generally use static sinks to collect data from the sensor nodes via multiple forwarding. Therefore, network suffers with some problems like long message relay time, bottle neck problem which reduces the performance of the network. Many approaches have been proposed to prevent this problem with the help of mobile sink to collect the data from the sensor nodes, but these approaches still suffer from the buffer overflow problem due to limited memory size of sensor nodes. This paper proposes an energy efficient scheme for data gathering which overcomes the buffer overflow problem. The proposed scheme creates virtual grid structure of heterogeneous nodes. Scheme has been designed for sensor nodes having variable sensing rate. Every node finds out its buffer overflow time and on the basis of this cluster heads are elected. A controlled traversing approach is used by the proposed scheme in order to transmit data to sink. The effectiveness of the proposed scheme is verified by simulation.

Keywords: buffer overflow problem, mobile sink, virtual grid, wireless sensor networks

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Authors: Mahmoud Hassanin, Roshan Thawale, Kiran Yelamati

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Background: During current practice, intraoperative regular endotracheal cuff pressure monitoring is not routine, despite the significant number of clinicians interested in checking it after intubation to ensure a good seal and adequate ventilation. Aims and objectives: to highlight that the current practice has no guidance related to regular intra-operative monitoring of the endotracheal tube cuff pressure, which can improve patient safety and post-operative experience. Methods: local department survey was done targeting anaesthetists' current practice, measuring their knowledge and problem awareness to improve patient satisfaction and change the current approach. Results: The participants were not using the manometer, despite their interest in ensuring that the cuff pressure was high enough and there was a proper seal. More than 50% of the participant don't know the ideal range of the endotracheal tube cuff pressure range, and 32% don't know whether it is available or not in the theatre. Despite the previous finding, 100% of the participants used different methods to ensure adequate cuff pressure. The collected data revealed that at least 26% of the participant confirmed that they had seen patients having post-intubation complications. Conclusion: There is an increasing importance placed on quality assurance. Clinical practice varies widely among practitioners, with the only consistency being the omission of cuff manometers during routine intra-operative management, despite their proven benefit and efficacy. Encourage the anaesthetists and ODPs to use cuff pressure manometers. The availability of portable pressure manometers can help to maintain safe cuff pressures in patients requiring endotracheal intubation.

Keywords: endotracheal cuff pressure, intra-operative monitoring, current practice, patient satisfaction

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Authors: Sungchul Ha, Hyunwoo Kim

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In mobile ad hoc networks, all nodes in a network only have limited resources and calculation ability. Therefore communication topology which have long lifetime is good for all nodes in mobile ad hoc networks. There are a variety of researches on security problems in wireless ad hoc networks. The existing many researches try to make efficient security schemes to reduce network power consumption and enhance network lifetime. Because a new node can join the network at any time, the wireless ad hoc networks are exposed to various threats and can be destroyed by attacks. Resource consumption is absolutely necessary to secure networks, but more resource consumption can be a critical problem to network lifetime. This paper focuses on efficient monitoring node distribution to enhance network lifetime in wireless ad hoc networks. Since the wireless ad hoc networks cannot use centralized infrastructure and security systems of wired networks, a new special IDS scheme is necessary. The scheme should not only cover all nodes in a network but also enhance the network lifetime. In this paper, we propose an efficient IDS node distribution scheme using minimum spanning tree (MST) method. The simulation results show that the proposed algorithm has superior performance in comparison with existing algorithms.

Keywords: MANETs, IDS, power control, minimum spanning tree

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Authors: S. Vadivukkarasi, K. Karthi, M. Karthick, C. Dinesh, S. Santhosh, A. Yogaraj

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The appointment system was designed to minimize patient’s idle time overlooking patients waiting time in hospitals. This is no longer valid in today’s consumer oriented society. Long waiting times for treatment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Queuing theory constitutes a very powerful tool because queuing models require relatively little data and are simple and fast to use. Because of this simplicity and speed, modelers can be used to quickly evaluate and compare various alternatives for providing service. The application of queuing models in the analysis of health care systems is increasingly accepted by health care decision makers. Timely access to care is a key component of high-quality health care. However, patient delays are prevalent throughout health care systems, resulting in dissatisfaction and adverse clinical consequences for patients as well as potentially higher costs and wasted capacity for providers. Arguably, the most critical delays for health care are the ones associated with health care emergencies. The allocation of resources can be divided into three general areas: bed management, staff management, and room facility management. Effective and efficient patient flow is indicated by high patient throughput, low patient waiting times, a short length of stay at the hospital and overtime, while simultaneously maintaining adequate staff utilization rates and low patient’s idle times.

Keywords: appointment system, patient scheduling, bed management, queueing calculation, system analysis

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Authors: Zahra Asgharpour, Eric Renteria, Sebastian De Boodt

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There is a growing trend towards personalization of medical care, as evidenced by the emphasis on outcomes based medicine, the latest developments in CT and MR imaging and personalized treatment in a variety of surgical disciplines. 3D Printing has been introduced and applied in the medical field since 2000. The first applications were in the field of dental implants and custom prosthetics. According to recent publications, 3D printing in the medical field has been used in a wide range of applications which can be organized into several categories including implants, prosthetics, anatomical models and tissue bioprinting. Some of these categories are still in their infancy stage of the concept of proof while others are in application phase such as the design and manufacturing of customized implants and prosthesis. The approach of 3D printing in this category has been successfully used in the health care sector to make both standard and complex implants within a reasonable amount of time. In this study, some of the clinical applications of 3D printing in design and manufacturing of a patient-specific hip implant would be explained. In cases where patients have complex bone geometries or are undergoing a complex revision on hip replacement, the traditional surgical methods are not efficient, and hence these patients require patient-specific approaches. There are major advantages in using this new technology for medical applications, however, in order to get this technology widely accepted in medical device industry, there is a need for gaining more acceptance from the medical device regulatory offices. This is a challenge that is moving onward and will help the technology find its way at the end as an accepted manufacturing method for medical device industry in an international scale. The discussion will conclude with some examples describing the future directions of 3D Medical Printing.

Keywords: CT/MRI, image processing, 3D printing, medical devices, patient specific implants

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Authors: Seon-Young Lee, Harkiran Sagoo, Katherine Whitehurst, Georgina Wellstead, Alexander Fowler, Riaz Agha, Dennis Orgill

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Introduction: Systematic reviews attempt to answer research questions by synthesising the data within primary papers. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research and healthcare policy. We sought to determine the reporting quality of recent systematic reviews in plastic surgery. Methods: This systematic review was conducted in line with the Cochrane handbook, reported in line with the PRISMA statement and registered at the ResearchRegistry (UIN: reviewregistry18). MEDLINE and EMBASE databases were searched in 2013 and 2014 for systematic reviews by five major plastic surgery journals. Screening, identification and data extraction was performed independently by two teams. Results: From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 out of 27 items (59.3%; range 6-26, 95% CI 14-17). Compliance between individual PRISMA items showed high variability. It was poorest for items related to the use of review protocol (item 5; 5%) and presentation of data on risk of bias of each study (item 19; 18%), while being the highest for description of rationale (item 3; 99%) and sources of funding and other support (item 27; 95%), and for structured summary in the abstract (item 2; 95%). Conclusion: The reporting quality of systematic reviews in plastic surgery requires improvement. ‘Hard-wiring’ of compliance through journal submission systems, as well as improved education, awareness and a cohesive strategy among all stakeholders is called for.

Keywords: PRISMA, reporting quality, plastic surgery, systematic review, meta-analysis

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Authors: Elad Vashdi

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It is common to find speech deficit among children diagnosed with Autism. It can be found in the clinical field and recently in research. One of the DSM-V criteria suggests a speech delay (Delay in, or total lack of, the development of spoken language), but doesn't explain the cause of it. A common perception among professionals and families is that the inability to talk results from the autism. Autism is a name for a syndrome which just describes a phenomenon and is defined behaviorally. Since it is not based yet on a physiological gold standard, one can not conclude the nature of a deficit based on the name of the syndrome. A wide retrospective research (n=270) which included children with motor speech difficulties was conducted in Israel. The study analyzed entry evaluations in a private clinic during the years 2006-2013. The data was extracted from the reports. High percentage of children diagnosed with Autism (60%) was found. This result demonstrates the high relationship between Autism and motor speech problem. It also supports recent findings in research of Childhood apraxia of speech (CAS) occurrence among children with ASD. Only small percentage of the participants in this research (10%) were diagnosed with CAS even though their verbal deficits well fitted the guidelines for CAS diagnosis set by ASHA in 2007. This fact raises questions regarding the diagnostic procedure in Israel. The understanding that CAS might highly exist within Autism and can have a remarkable influence on the course of early development should be a guiding tool within the diagnosis procedure. CAS can explain the nature of the speech problem among some of the autistic children and guide the treatment in a more accurate way. Calculating the prevalence of CAS which includes the comorbidity with ASD reveals new numbers and suggests treating differently the CAS population.

Keywords: childhood apraxia of speech, Autism, treatment, speech

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Authors: Chinmay V. Deshpande

Abstract:

Purpose: To assess the efficiency of visual functions and visual skills in strabismic & anisometropic amblyopes and to assess visual acuity and contrast sensitivity in anisometropic amblyopes with spectacles & contact lenses. Method: In a prospective clinical study, 32 children ageing from 5 to 15 years presenting with amblyopia in a pediatric department of Shri Ganapati Netralaya Jalna, India, were assessed for a period of three & half months. Visual acuity was measured with Snellen’s and Bailey-Lovie log MAR charts whereas contrast sensitivity was measured with Pelli-Robson chart with spectacles and contact lenses. Saccadic movements were assessed with SCCO scoring criteria and accommodative facility was checked with ±1.50 DS flippers. Stereopsis was assessed with TNO test. Results: By using Wilcoxon sign rank test p-value < 0.05 (< 0.001), the mean linear visual acuity was 0.29 (≈ 6/21) and mean single optotype visual acuity found to be 0.36 (≈ 6/18). Mean visual acuity of 0.27(≈ 6/21) with spectacles improved to 0.33 (≈ 6/18) with contact lenses in amblyopic eyes. The mean Log MAR visual acuity with spectacles and contact lens were found to be 0.602( ≈6/24) and 0.531(≈ 6/21) respectively. The contrast threshold out of 20 amblyopic eyes shows that mean contrast threshold changed in 9 patients from spectacles 0.27 to contact lens 0.19 respectively. The mean accommodative facility assessed was 5.31(± 2.37). 24 subjects (75%) revealed marked saccadic defects on the test applied. 78% subjects didn’t show even gross stereoscopic ability on TNO test. Conclusion: This study supports the facts about amblyopia and associated deficits in visual skills which are claimed in previous studies. In addition, anisometropic amblyopia can be managed better with contact lenses.

Keywords: strabismus, anisometropia, amblyopia, contrast sensitivity, saccades, stereopsis

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Authors: Chih-Wei Cheng, Wei-Jen Chan, Yu-Han Huang, Yi-Tsung Lin, Yen-Wei Huang, Min-Cheng Chen, Shou-Zen Chang, G. Chern, Yuan-Chieh Tseng

Abstract:

How to develop spin-orbit-torque (SOT) devices with the virtues of field-free, perpendicular magnetic anisotropy (PMA), and low switching current is one of the many challenges in spintronics today. We propose a CoFeB/Ta/CoFeB tri-layer antiferromagnetic SOT device that could meet the above requirements. The device’s PMA was developed by adopting CoFeB–MgO interface. The key to the success of this structure is to ensure that (i)changes of the inter-layer coupling(IEC) and CoFeB anisotropy can occur simultaneously; (ii) one of the CoFeB needs to have a slightly tilted moment in the beginning. When sufficient current is given, the SHEreverses the already-tiltedCoFeB, and the other CoFeB can be reversed simultaneously by the IEC with the field-free nature. Adjusting the thickness of Ta can modify the coupling state to reduce the switching current while the field-free nature was preserved. Micromagnetic simulation suggests that the Néel orange peel effect (NOPE) is non-negligible due to interface roughness and coupling effect in the presence of perpendicular anisotropy. Fortunately, the Néel field induced by the NOPE appears to favor the field-free reversal.

Keywords: CoFeB, spin-orbit torque, antiferromagnetic, MRAM, trilayer

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Authors: Muhammad Farhan Ul Moazzam, Tamkeen Urooj Paracha, Ghani Rahman, Byung Gul Lee, Nasir Farid, Adnan Arshad

Abstract:

The novel coronavirus pandemic disease (COVID-19) affected the whole globe, though there is a lack of clinical studies and its epidemiological features. But as per the observation, it has been seen that most of the COVID-19 infected patients show mild to moderate symptoms, and they get better without any medical assistance due to a better immune system to generate antibodies against the novel coronavirus. In this study, the active cases, serious cases, recovered cases, deaths and total confirmed cases had been analyzed using the geospatial inverse distance weightage technique (IDW) within the time span of 2nd March to 3rd June 2020. As of 3rd June, the total number of COVID-19 cases in Italy were 231,238, total deaths 33,310, serious cases 350, recovered cases 158,951, and active cases were 39,177, which has been reported by the Ministry of Health, Italy. March 2nd-June 3rd, 2020 a sum of 231,238 cases has been reported in Italy out of which 38.68% cases reported in the Lombardia region with a death rate of 18%, which is high from its national mortality rate followed by Emilia-Romagna (14.89% deaths), Piemonte (12.68% deaths), and Vento (10% deaths). As per the total cases in the region, the highest number of recoveries has been observed in Umbria (92.52%), followed by Basilicata (87%), Valle d'Aosta (86.85%), and Trento (84.54%). The COVID-19 evolution in Italy has been particularly found in the major urban area, i.e., Rome, Milan, Naples, Bologna, and Florence. Geospatial technology played a vital role in this pandemic by tracking infected patient, active cases, and recovered cases. Geospatial techniques are very important in terms of monitoring and planning to control the pandemic spread in the country.

Keywords: COVID-19, public health, geospatial analysis, IDW, Italy

Procedia PDF Downloads 158

Authors: Daliyah S. Aljutaili, Redna A. Almutlaq, Suha A. Alharbi, Dina M. Ibrahim

Abstract:

All currencies around the world look very different from each other. For instance, the size, color, and pattern of the paper are different. With the development of modern banking services, automatic methods for paper currency recognition become important in many applications like vending machines. One of the currency recognition architecture’s phases is Feature detection and description. There are many algorithms that are used for this phase, but they still have some disadvantages. This paper proposes a feature detection algorithm, which merges the advantages given in the current SIFT and SURF algorithms, which we call, Speeded up Robust Scale-Invariant Feature Transform (SR-SIFT) algorithm. Our proposed SR-SIFT algorithm overcomes the problems of both the SIFT and SURF algorithms. The proposed algorithm aims to speed up the SIFT feature detection algorithm and keep it robust. Simulation results demonstrate that the proposed SR-SIFT algorithm decreases the average response time, especially in small and minimum number of best key points, increases the distribution of the number of best key points on the surface of the currency. Furthermore, the proposed algorithm increases the accuracy of the true best point distribution inside the currency edge than the other two algorithms.

Keywords: currency recognition, feature detection and description, SIFT algorithm, SURF algorithm, speeded up and robust features

Procedia PDF Downloads 238

Authors: Harish Rajak, Kamlesh Raghuwanshi

Abstract:

Histone deacetylase (HDAC) are promising target for cancer treatment. The panobinostat (Farydak; Novartis; approved by USFDA in 2015) and chidamide (Epidaza; Chipscreen Biosciences; approved by China FDA in 2014) are the novel HDAC inhibitors ratified for the treatment of patients with multiple myeloma and peripheral T cell lymphoma, respectively. On the other hand, two other HDAC inhibitors, Vorinostat (SAHA; approved by USFDA in 2006) and Romidepsin (FK228; approved by USFDA in 2009) are already in market for the treatment of cutaneous T-cell lymphoma. Several hydroxamic acid based HDAC inhibitors i.e., belinostat, givinostat, PCI24781 and JNJ26481585 are in clinical trials. HDAC inhibitors consist of three pharmacophoric features - an aromatic cap group, zinc binding group (ZBG) and a linker chain connecting cap group to ZBG. Herein, we report synthesis, characterization and biological evaluation of HDAC inhibitors possessing substituted isatin moiety as cap group which recognize the surface of active enzyme pocket and thiosemicarbazide moiety incorporated as linker group responsible for connecting cap group to ZBG (hydroxamic acid). Several analogues were found to inhibit HDAC and cellular proliferation of Hela cervical cancer cells with GI50 values in the micro molar range. Some of the compounds exhibited promising results in vitro antiproliferative studies. Attempts were also made to establish the structure activity relationship among synthesized HDAC inhibitors.

Keywords: HDAC inhibitors, hydroxamic acid derivatives, isatin derivatives, antiproliferative activity, docking

Procedia PDF Downloads 311

Authors: K. Hinde, R. Bookun, P. Tran

Abstract:

Percutaneous CT guided biopsies provide a fast, minimally invasive, cost effective and safe method for obtaining tissue for histopathology and culture. Standards for diagnostic yield vary depending on whether the tissue is being obtained for histopathology or culture. We present a retrospective audit from Western Health in Melbourne Australia over a 12-month period which aimed to determine the diagnostic yield, technical success and complication rate for CT guided bone biopsies and identify factors affecting these results. The digital imaging storage program (Synapse Picture Archiving and Communication System – Fujifilm Australia) was analysed with key word searches from October 2015 to October 2016. Nineteen CT guided bone biopsies were performed during this time. The most common referring unit was oncology, work up imaging included CT, MRI, bone scan and PET scan. The complication rate was 0%, overall diagnostic yield was 74% with a technical success of 95%. When performing biopsies for histologic analysis diagnostic yield was 85% and when performing biopsies for bacterial culture diagnostic yield was 60%. There was no significant relationship identified between size of lesion, distance of lesion to skin, lesion appearance on CT, the number of samples taken or gauge of needle to diagnostic yield or technical success. CT guided bone biopsy at Western Health meets the standard reported at other major clinical centres for technical success and safety. It is a useful investigation in identification of primary malignancy in distal bone metastases.

Keywords: bone biopsy, computed tomography, core biopsy, histopathology

Procedia PDF Downloads 201

Authors: Thulodin Mat Lazim, Aminuddin Saat, Ammar Fakhir Abdulwahid, Zaid Sattar Kareem

Abstract:

Film cooling is one of the cooling systems investigated for the application to gas turbine blades. Gas turbines use film cooling in addition to turbulence internal cooling to protect the blades outer surface from hot gases. The present study concentrates on the numerical investigation of film cooling performance for a row of twisted cylindrical holes in modern turbine blade. The adiabatic film effectiveness and the heat transfer coefficient are determined numerical on a flat plate downstream of a row of inclined different cross section area hole exit by using Computational Fluid Dynamics (CFD). The swirling motion of the film coolant was induced the twisted angle of film cooling holes, which inclined an angle of α toward the vertical direction and surface of blade turbine. The holes angle α of the impingement mainstream was changed from 90°, 65°, 45°, 30° and 20°. The film cooling effectiveness on surface of blade turbine wall was measured by using 3D Computational Fluid Dynamics (CFD). Results showed that the effectiveness of rectangular twisted hole has the effectiveness among other cross section area of the hole at blowing ratio (0.5, 1, 1.5 and 2).

Keywords: turbine blade cooling, film cooling, geometry shape of hole, turbulent flow

Procedia PDF Downloads 544