Search results for: deep venous thrombosis

Authors: Basma Hassabo, Sarah Ahmed, Aisha Hameed

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Aims and Objectives: To determine the incidence of maternal mortality amongst pregnant women with sickle cell disease (SCD) in the United Kingdom and to determine exact cause of death in these women. Background: SCD is caused by the ‘sickle’ gene and is characterized by episodes of severe bone pain and other complications like acute chest syndrome, chronic pulmonary hypertension, stroke, retinopathy, chronic renal failure, hepato-splenic crises, avascular bone necrosis, sepsis and leg ulcers. SCD is a continual cause of maternal mortality and fetal complications, and it comprises 1.5% of all Direct and Indirect deaths in the UK. Sepsis following premature rupture of membranes with ascending infection, post-partum infection and pre-labour overwhelming septic shock is one of its leading causes of death. Over the last fifty years of maternal mortality reports in UK, between 1 to 4 pregnant women died in each triennium. Material and Method: This is a retrospective study that involves pregnant women who died from SCD complications in the UK between 1952-2012. Data were collected from the UK Confidential Enquiries into Maternal Death and its causes between 1952–2012. Prior to 1985, exact cause of death in this cohort was not recorded. Results: 33 deaths reported between 1964 and 1984. 17 deaths were reported due to sickle cell disease between 1985 and 2012. Five women in this group died of sickle cell crisis, one woman had liver sequestration crisis, two women died of venous thromboembolism, two had myocardial fibrosis and three died of sepsis. Remaining women died of amniotic fluid embolism, SUDEP, myocardial ischemia and intracranial haemorrhage. Conclusion: The leading causes of death in sickle cell sick pregnant women are sickle cell crises, sepsis, venous thrombosis and thromboembolism. Prenatal care for women with SCD should be managed by a multidisciplinary team that includes an obstetrician, nutritionist, primary care physician, and haematologist. In every sick Sickle Cell woman Sickle Cell crises should be on the top of the list of differential diagnosis. Aggressive treatment of complications with low threshold to commence broad-spectrum antibiotics and LMWH contribute to better outcomes.

Keywords: incidence, maternal mortality, sickle cell disease (SCD), uk

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Authors: Aadil Khan, Yasser Chomayil, P. P. Venugopalan

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Background: Budd-Chiari syndrome is caused by thrombosis of the hepatic veins and/or the thrombosis of the intrahepatic or suprahepatic IVC. The etiology remains idiopathic in 16% -35% of cases. Malignancy, rheumatological disorder, myeloproliferative disease, inheritable coagulopathy, infection or hyperestrogen state can be identified in many cases. Methodology: Review of case records of the patient presented to Aster Medcity, Emergency Department, Cochin. Introduction:17 years old female was presented to ED with fever, jaundice and abdominal distention since 1 week. O/E: Pallor+, icterus+. Abdomen- gross distension+, shifting dullness+, generalized anasarca+. USG abdomen showed hepatomegaly with mild coarse echotexture and moderate to gross ascites. CT abdomen and chest showed hepatomegaly with thrombosis of all three hepatic vein and moderate ascites suggestive of Budd-Chiari syndrome. Patient was taken for catheter vein thrombolysis. Venogram done the next day revealed almost > 50% opening of the right hepatic vein. Concurrent doppler showed colour and doppler signals in middle hepatic veins. She gradually improved and was discharged home on anticoagulant and adviced regular follow up. Conclusion: Being a rare disease in this young population, high suspicion is required when evaluating young patients with abdominal pain and jaundice.

Keywords: Budd-Chiari syndrome, rare disease, abdominal pain, India

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Authors: Jakob Renko, Deja Praprotnik, Kristina Martinovič, Igor Karnjuš

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Introduction: Catheter-related bloodstream infections are a major burden for healthcare and patients. Although infections of this type cannot be completely avoided, they can be reduced by taking preventive measures. The aim of this study is to review and analyze the existing literature on preventive interventions to prevent central venous catheters (CVC) infections. Methods: A systematic literature review was carried out. The international databases CINAHL, Medline, PubMed, and Web of Science were searched using the search strategy: "catheter-related infections" AND "intensive care units" AND "prevention" AND "central venous catheter." Articles that met the inclusion and exclusion criteria were included in the study. The literature search flow is illustrated by the PRISMA diagram. The descriptive research method was used to analyze the data. Results: Out of 554 search results, 22 surveys were included in the final analysis. We identified seven relevant preventive measures to prevent CVC infections: washing the whole body with chlorhexidine gluconate (CHG) solution, disinfecting the CVC entry site with CHG solution, use of CHG or silver dressings, alcohol protective caps, CVC care education, selecting appropriate catheter and multicomponent care bundles. Discussion and conclusions: Both single interventions and multicomponent care bundles have been shown to be currently effective measures to prevent CVC infections in adult patients in the ICU. None of the measures identified stood out in terms of their effectiveness. Prevention work to reduce CVC infections in the ICU is a complex process that requires the simultaneous consideration of several factors.

Keywords: central venous access, critically ill patients, hospital-acquired complications, prevention

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Authors: Grygorii Kostromin, Vladyslav Povoroznyuk

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Chronic venous diseases (CVD) are one of the common, though controversial problems in medicine. It is generally accepted that this pathology predominantly occurs in women. The issue of excessive weight as a risk factor for CVD is still considered debatable. To the author's best knowledge, today in Ukraine, there are barely any studies that describe the relationship between CVD and obesity. Our study aims to determine the association between age, body composition, obesity and CVD in postmenopausal women. The study was conducted in D. F. Chebotarev Institute of Gerontology, National Academy of Medical Sciences of Ukraine. We have examined 96 postmenopausal women aged 46-85 years (mean age – 66.19 ± 0.96 years), who were divided into two groups depending on the presence of CVD. The women were examined by vascular surgeons. For the diagnosis of CVD, we used clinical, anatomic and pathophysiologic classifications. We also performed clinical, ultrasound and densitometry examinations. We found that the CVD frequency in postmenopausal women increased with age (from 72% in those aged 45-59 years to 84% in those aged 75-89 years). A significant correlation between the total fat mass and age was determined in postmenopausal women with CVD. We also observed a significant correlation between the lower extremities’ fat mass and age in both examined groups. A significant correlation between body mass index and age was determined only in postmenopausal women without CVD.

Keywords: chronic venous disease, risk factors, age, obesity, postmenopausal women

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Authors: Sara Mahmood, Omar Ahmed, Youssef Aladham, Moustafa Abdelnaby

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The varied complications of COVID-19 present an ongoing challenge to healthcare professionals. A rare presentation of complicated sinusitis with pre-septal cellulitis and hard palatal necrosis in a COVID-19 patient, was reported. A 52-year-old male was admitted to the hospital with typical COVID manifestations where he had two successive COVID-19 positive swabs. During his admission, he developed symptoms of right orbital complications of sinusitis along with both clinical and radiological evidence of ipsilateral hard palatal necrosis. Imaging confirmed a diagnosis of right pan-sinusitis complicated with right pre-septal infection and hard palatal bony defect on the same side. Intra-operatively, the sphenopalatine artery was found to be thrombosed. This case focuses on the possible association between these manifestations and the known thromboembolic complications of COVID-19. Ongoing management of such complicated rare cases should be through a multidisciplinary team.

Keywords: COVID-19, sinusitis, sphenopalatine artery, thrombosis

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Authors: Chongyang Ye, Rong Liu

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Elastic compression stockings (ECSs) have been widely applied in prophylaxis and treatment of chronic venous insufficiency of lower extremities. The medical function of ECS is to improve venous return and increase muscular pumping action to facilitate blood circulation, which is largely determined by the complex interaction between the ECS and lower limb tissues. Understanding the mechanical transmission of ECS along the skin surface, deeper tissues, and vascular system is essential to assess the effectiveness of the ECSs. In this study, a three-dimensional (3D) finite element (FE) model of the leg-ECS system integrated with a 3D fluid-solid interaction (FSI) model of the leg-vein system was constructed to analyze the biomechanical properties of veins and soft tissues under different ECS compression. The Magnetic Resonance Imaging (MRI) of the human leg was divided into three regions, including soft tissues, bones (tibia and fibula) and veins (peroneal vein, great saphenous vein, and small saphenous vein). The ECSs with pressure ranges from 15 to 26 mmHg (Classes I and II) were adopted in the developed FE-FSI model. The soft tissue was assumed as a Neo-Hookean hyperelastic model with the fixed bones, and the ECSs were regarded as an orthotropic elastic shell. The interfacial pressure and stress transmission were simulated by the FE model, and venous hemodynamics properties were simulated by the FSI model. The experimental validation indicated that the simulated interfacial pressure distributions were in accordance with the pressure measurement results. The developed model can be used to predict interfacial pressure, stress transmission, and venous hemodynamics exerted by ECSs and optimize the structure and materials properties of ECSs design, thus improving the efficiency of compression therapy.

Keywords: elastic compression stockings, fluid-solid interaction, tissue and vein properties, prediction

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Authors: Nuntaporn Aukkanit

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The aim of this study was to determine the effect of oils on chemical, physical, and sensory properties of deep-fried dough stick. Five kinds of vegetable oil which were used for addition and frying consist of: palm oil, soybean oil, sunflower oil, rice bran oil, and canola oil. The results of this study showed that using different kinds of oil made significant difference in the quality of deep-fried dough stick. Deep-fried dough stick fried with the rice bran oil had the lowest moisture loss and oil absorption (p≤0.05), but it had some unsatisfactory physical properties (color, specific volume, density, and texture) and sensory characteristics. Nonetheless, deep-fried dough stick fried with the sunflower oil had moisture loss and oil absorption slightly more than the rice bran oil, but it had almost higher physical and sensory properties. Deep-fried dough sticks together with the sunflower oil did not have different sensory score from the palm oil, commonly used for production of deep-fried dough stick. These results indicated that addition and frying with the sunflower oil are appropriate for the production of deep-fried dough stick.

Keywords: deep-fried dough stick, palm oil, sunflower oil, rice bran oil

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Authors: Fendouli Ines, Zaafrane Nesrine, Mhamdi Hana, Knani Leila, Ghorbel Mohamed

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Introduction: Ocular infiltration of leukemia can involve orbit, uveal tract, retina and optic nerve. It may result from direct ocular infiltration by leukemic cells or indirect ocular involvement resulting from secondary hematologic changes, opportunistic infections and complications of various modalities of therapy. We here in report a case of central venous retinal occlusion associated to optic nerve infiltration as presenting signs of a relapse of acute lymphoblastic leukemia. Case Report: A twelve-year-old male -patient of acute B lymphoblastic leukemia presented with headaches and bilateral blurred vision in the left ee. Ophthalmic examination showed a visual acuity reduced to counting fingers in the right eye and no light perception in the left eye. Funduscopy revealed a voluminous disc edema surrounded by retinal haemorrhages in the right eye, and venous tortusities, papillary edema, and hemorrages suggesting central retinal venous occlusion in the LE. Swept source optical coherence tomography revealed a serous retinal detachment in the RE and .hyperreflective inner layers with macular edema in the left eye. Cerebro-orbital MRI showed bilateral thickened left optic nerve. There were no radiological signs of true papillary edema due to intracranial hypertension secondary to central nervous system involvement. Myelogram and lumbar punction demonstrated blast infiltration and confirmed ocular relapse of the leukemia. Conclusion: Ocular involvement lymphoblastic acute leukemias decreased since the introduction of a systematic prophylactic treatment of central nervous system. Periodic ophthalmic examination is necessary to allow early diagnosis and treatment.

Keywords: acute leukemia, optic nerve, infiltration, relapse

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Authors: Yi Sun, George Ed Rainger, Steve P. Watson

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Background: Beyond the classical roles in haemostasis and thrombosis, platelets are important in the initiation and development of various thrombo-inflammatory diseases. In atherosclerosis and deep vein thrombosis, for example, platelets bridge monocytes with endothelium and form heterotypic aggregates with monocytes in the circulation. This can alter monocyte phenotype by inducing their activation, stimulating adhesion and migration. These interactions involve cell surface receptor-ligand pairs on both cells. This list is likely incomplete as new interactions of importance to platelet biology are continuing to be discovered as illustrated by our discovery of PEAR-1 binding to FcεR1α. Results: We have developed a highly sensitive avidity-based assay to identify novel extracellular interactions among 126 recombinantly-expressed platelet cell surface and secreted proteins involved in platelet aggregation. In this study, we will use this method to identify novel platelet-monocyte interactions. We aim to identify ligands for orphan receptors and novel partners of well-known proteins. Identified interactions will be studied in preliminary functional assays to demonstrate relevance to the inflammatory processes supporting atherogenesis. Conclusions: Platelet-monocyte interactions are essential for the development of thromboinflammatory disease. Up until relatively recently, technologies only allow us to limit our studies on each individual protein interaction at a single time. These studies propose for the first time to study the cell surface platelet-monocyte interactions in a systematic large-scale approach using a reliable screening method we have developed. If successful, this will likely to identify previously unknown ligands for important receptors that will be investigated in details and also provide a list of novel interactions for the field. This should stimulate studies on developing alternative therapeutic strategies to treat vascular inflammatory disorders such as atherosclerosis, DVT and sepsis and other clinically important inflammatory conditions.

Keywords: membrane proteins, large-scale screening, platelets, recombinant expression

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Authors: Farzana Esmailkassam, Usakorn Kunanuvat, Zahraa Mohammed Ali

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Objective: The key barrier in Clozapine treatment of treatment-resistant schizophrenia (TRS) includes frequent bloods draws to monitor neutropenia, the main drug side effect. WBC and ANC monitoring must occur throughout treatment. Accurate WBC and ANC counts are necessary for clinical decisions to halt, modify or continue clozapine treatment. The CSAN Pronto point-of-care (POC) analyzer generates white blood cells (WBC) and absolute neutrophils (ANC) through image analysis of capillary blood. POC monitoring offers significant advantages over central laboratory testing. This study evaluated the performance of the CSAN Pronto against the Beckman DxH900 Hematology laboratory analyzer. Methods: Forty venous samples (EDTA whole blood) with varying concentrations of WBC and ANC as established on the DxH900 analyzer were tested in duplicates on three CSAN Pronto analyzers. Additionally, both venous and capillary samples were concomitantly collected from 20 volunteers and assessed on the CSAN Pronto and the DxH900 analyzer. The analytical performance including precision using liquid quality controls (QCs) as well as patient samples near the medical decision points, and linearity using a mix of high and low patient samples to create five concentrations was also evaluated. Results: In the precision study for QCs and whole blood, WBC and ANC showed CV inside the limits established according to manufacturer and laboratory acceptability standards. WBC and ANC were found to be linear across the measurement range with a correlation of 0.99. WBC and ANC from all analyzers correlated well in venous samples on the DxH900 across the tested sample ranges with a correlation of > 0.95. Mean bias in ANC obtained on the CSAN pronto versus the DxH900 was 0.07× 109 cells/L (95% L.O.A -0.25 to 0.49) for concentrations <4.0 × 109 cells/L, which includes decision-making cut-offs for continuing clozapine treatment. Mean bias in WBC obtained on the CSAN pronto versus the DxH900 was 0.34× 109 cells/L (95% L.O.A -0.13 to 0.72) for concentrations <5.0 × 109 cells/L. The mean bias was higher (-11% for ANC, 5% for WBC) at higher concentrations. The correlations between capillary and venous samples showed more variability with mean bias of 0.20 × 109 cells/L for the ANC. Conclusions: The CSAN pronto showed acceptable performance in WBC and ANC measurements from venous and capillary samples and was approved for clinical use. This testing will facilitate treatment decisions and improve clozapine uptake and compliance.

Keywords: absolute neutrophil counts, clozapine, point of care, white blood cells

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Authors: Ashutosh Mishra, Nikhil Goyal

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A 3D facial emotion recognition model based on deep learning is proposed in this paper. Two convolution layers and a pooling layer are employed in the deep learning architecture. After the convolution process, the pooling is finished. The probabilities for various classes of human faces are calculated using the sigmoid activation function. To verify the efficiency of deep learning-based systems, a set of faces. The Kaggle dataset is used to verify the accuracy of a deep learning-based face recognition model. The model's accuracy is about 65 percent, which is lower than that of other facial expression recognition techniques. Despite significant gains in representation precision due to the nonlinearity of profound image representations.

Keywords: facial recognition, computational intelligence, convolutional neural network, depth map

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Authors: Debneil Saha Roy

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Weather forecasting is a complex topic and is well suited for analysis by deep learning approaches. With the wide availability of weather observation data nowadays, these approaches can be utilized to identify immediate comparisons between historical weather forecasts and current observations. This work explores the application of deep learning techniques to weather forecasting in order to accurately predict the weather over a given forecast hori­zon. Three deep neural networks are used in this study, namely, Multi-Layer Perceptron (MLP), Long Short Tunn Memory Network (LSTM) and a combination of Convolutional Neural Network (CNN) and LSTM. The predictive performance of these models is compared using two evaluation metrics. The results show that forecasting accuracy increases with an increase in the complexity of deep neural networks.

Keywords: convolutional neural network, deep learning, long short term memory, multi-layer perceptron

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Authors: Nouf Al Harthi

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Venous thromboembolism (VTE) is one of the most common causes of hospital-related deaths in critically ill patients. Guidelines recommended VTE prophylaxis with standardized, fixed doses for most patients. The underweight population has limited data to guide the appropriate drug and dosing regimen. The aim of this study was to describe the pattern of VTE prophylaxis dose regimens for underweighted critically ill adult patients and the prevalence of associated VTE and bleeding. This study is a retrospective cohort study, conducted in King Abdulaziz Medical City, Saudi Arabia. It included all critical patients admitted to the intensive care units and were above 14 years old with weight less than 50 kg or BMI of 18.5 kg/m2 or less and were on heparin as VTE prophylaxis for more than 72 hours from January 2016 until January 2020. After screening 270 patients, only 40 patients were included in this study according to our inclusion and exclusion criteria. Only 6 patients (15%) received VTE prophylaxis as an adjusted dose of heparin 2500 U Q12, while the rest of the patients were taking standard dosing of heparin, 5000 U Q12 was given to 21 (52.50%) patients and 5000 U Q8 was given to 13 (32.50%) patients. None of the adjusted doses developed any complications such as VTE or bleeding. There was no significant difference compared with the standard dose group. This study focused on describing the pattern of heparin doses as VTE prophylaxis in underweight patients. We also compared the standard dosing and adjusted dosage of VTE prophylaxis on underweight patients and any complications. There was no significant difference in the complication’s outcome or benefits between the two groups.

Keywords: venous thromboembolism prophylaxis, heparin, underweight patients, adult, critical care units

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Authors: Basiliyos Tilahun Betru, Charles Awono Onana, Bernabe Batchakui

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Recommender systems have become increasingly popular in recent years, and are utilized in numerous areas. Nowadays many web services provide several information for users and recommender systems have been developed as critical element of these web applications to predict choice of preference and provide significant recommendations. With the help of the advantage of deep learning in modeling different types of data and due to the dynamic change of user preference, building a deep model can better understand users demand and further improve quality of recommendation. In this paper, deep neural network models for recommender system are evaluated. Most of deep neural network models in recommender system focus on the classical collaborative filtering user-item setting. Deep learning models demonstrated high level features of complex data can be learned instead of using metadata which can significantly improve accuracy of recommendation. Even though deep learning poses a great impact in various areas, applying the model to a recommender system have not been fully exploited and still a lot of improvements can be done both in collaborative and content-based approach while considering different contextual factors.

Keywords: big data, decision making, deep learning, recommender system

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Authors: M. Abdallah

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Urban development requires deep excavations near buildings and other structures. Deep excavation has become more a necessity for better utilization of space as the population of the world has dramatically increased. In Lebanon, some urban areas are very crowded and lack spaces for new buildings and underground projects, which makes the usage of underground space indispensable. In this paper, a numerical modeling is performed using the finite element method to study the deep excavation-diaphragm wall soil-structure interaction in the case of nonlinear soil behavior. The study is focused on a comparison of the results obtained using different support systems. Furthermore, a parametric study is performed according to the remoteness of the structure.

Keywords: deep excavation, ground anchors, interaction soil-structure, struts

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Authors: Shuen-Tai Wang, Fang-An Kuo, Chau-Yi Chou, Yu-Bin Fang

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2016 has become the year of the Artificial Intelligence explosion. AI technologies are getting more and more matured that most world well-known tech giants are making large investment to increase the capabilities in AI. Machine learning is the science of getting computers to act without being explicitly programmed, and deep learning is a subset of machine learning that uses deep neural network to train a machine to learn  features directly from data. Deep learning realizes many machine learning applications which expand the field of AI. At the present time, deep learning frameworks have been widely deployed on servers for deep learning applications in both academia and industry. In training deep neural networks, there are many standard processes or algorithms, but the performance of different frameworks might be different. In this paper we evaluate the running performance of two state-of-the-art distributed deep learning frameworks that are running training calculation in parallel over multi GPU and multi nodes in our cloud environment. We evaluate the training performance of the frameworks with ResNet-50 convolutional neural network, and we analyze what factors that result in the performance among both distributed frameworks as well. Through the experimental analysis, we identify the overheads which could be further optimized. The main contribution is that the evaluation results provide further optimization directions in both performance tuning and algorithmic design.

Keywords: artificial intelligence, machine learning, deep learning, convolutional neural networks

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Authors: Balasooriya B. M. C. M., Sujeeva N., Thowfeek Z., Siddiqa Omo, Liyanagunawardana J. E., Jayawardana Saiu, Manathunga S. S., Katulanda G. W.

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Introduction and objectives: Adrenal venous sampling (AVS) is the gold standard to discriminate unilateral primary aldosteronism (UPA) from bilateral disease (BPA). AVS is technically demanding and only performed in a limited number of centers worldwide. To the best of our knowledge, Except for one study conducted in India, no other research studies on this area have been conducted in South Asia. This study aimed to evaluate the effectiveness of AVS in the management of primary aldosteronism. Methods: A total of 32 patients who underwent AVS at the National Hospital of Sri Lanka from April 2021 to April 2023 were enrolled. Demographic, clinical and laboratory data were obtained retrospectively. A procedure was considered successful when adequate cannulation of both adrenal veins was demonstrated. Cortisol gradient across the adrenal vein (AV) and the peripheral vein was used to establish the success of venous cannulation. Lateralization was determined by the aldosterone gradient between the two sides. Continuous and categorical variables were summarized with mean, SD, and proportions, respectively. The mean and standard deviation of the contralateral suppression index (CSI) were estimated with an intercept-only Bayesian inference model. Results: Of the 32 patients, the average age was 52.47 +26.14 and 19 (59.4%) were males. Both AVs were successfully cannulated in 12 (37.5%). Among them, lateralization was demonstrated in 11(91.7%), and one was diagnosed as a bilateral disease. There were no total failures. Right AV cannulation was unsuccessful in 18 (56.25%), of which lateralization was demonstrated in 9 (50%), and others were inconclusive. Left AV cannulation was unsuccessful only in 2 (6.25%); one was lateralized, and the other remained inconclusive. The estimated mean of the CSI was 0.33 (89% credible interval 0.11-0.86). Seven patients underwent unilateral adrenalectomy and demonstrated significant improvement in blood pressure during follow-up. Two patients await surgery. Others were treated medically. Conclusions: Despite failure due to procedural difficulties, AVS remained useful in the management of patients with PA. Moreover, the success of the procedure needs experienced hands and advanced equipment to achieve optimal outcomes in PA.

Keywords: adrenal venous sampling, lateralization, contralateral suppression index, primary aldosteronism

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Authors: Ammar Asma, Bouafia Nabiha, Ghammam Rim, Ezzi Olfa, Ben Cheikh Asma, Mahjoub Mohamed, Helali Radhia, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Central venous catheter associated infections (CVC-AI) are among the serious hospital-acquired infections. The aims of this study are to determine the incidence of CVC-AI, and their risk factors among patients followed in a Tunisian medical intensive care unit (ICU). Materials / Methods: A prospective cohort study conducted between September 15th, 2015 and November 15th, 2016 in an 8-bed medical ICU including all patients admitted for more than 48h. CVC-AI were defined according to CDC of ATLANTA criteria. The enrollment was based on clinical and laboratory diagnosis of CVC-AI. For all subjects, age, sex, underlying diseases, SAPS II score, ICU length of stay, exposure to CVC (number of CVC placed, site of insertion and duration catheterization) were recorded. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: Among 192 eligible patients, 144 patients (75%) had a central venous catheter. Twenty-eight patients (19.4%) had developed CVC-AI with density rate incidence 20.02/1000 CVC-days. Among these infections, 60.7% (n=17) were systemic CVC-AI (with negative blood culture), and 35.7% (n=10) were bloodstream CVC-AI. The mean SAPS II of patients with CVC-AI was 32.76 14.48; their mean Charlson index was 1.77 1.55, their mean duration of catheterization was 15.46 10.81 days and the mean duration of one central line was 5.8+/-3.72 days. Gram-negative bacteria was determined in 53.5 % of CVC-AI (n= 15) dominated by multi-drug resistant Acinetobacter baumani (n=7). Staphylococci were isolated in 3 CVC-AI. Fourteen (50%) patients with CVC-AI died. Univariate analysis identified men (p=0.034), the referral from another hospital department (p=0.03), tobacco (p=0.006), duration of sedation (p=0.003) and the duration of catheterization (p=0), as possible risk factors of CVC-AI. Multivariate analysis showed that independent factors of CVC-AI were, male sex; OR= 5.73, IC 95% [2; 16.46], p=0.001, Ramsay score; OR= 1.57, IC 95% [1.036; 2.38], p=0.033, and duration of catheterization; OR=1.093, IC 95% [1.035; 1.15], p=0.001. Conclusion: In a monocenter cohort, CVC-AI had a high density and is associated with poor outcome. Identifying the risk factors is necessary to find solutions for this major health problem.

Keywords: central venous catheter associated infection, intensive care unit, prospective cohort studies, risk factors

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Authors: Jiaqi Huang, Yuheng Wang

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Premises selection, the task of selecting a set of axioms for proving a given conjecture, is a major bottleneck in automated theorem proving. An array of deep-learning-based methods has been established for premises selection, but a perfect performance remains challenging. Our study examines the inaccuracy of deep neural networks in premises selection. Through training network models using encoded conjecture and axiom pairs from the Mizar Mathematical Library, two potential biases are found: the network models classify more premises as necessary than unnecessary, referred to as the ‘positive bias’, and the network models perform better in proving conjectures that paired with more axioms, referred to as ‘length bias’. The ‘positive bias’ and ‘length bias’ discovered could inform the limitation of existing deep neural networks.

Keywords: automated theorem proving, premises selection, deep learning, interpreting deep learning

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Authors: Mannal Tariq

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Construction industry is making progress at a high pace. The trend of the world is getting more biased towards the high rise buildings. Deep beams are one of the most common elements in modern construction having small span to depth ratio. Deep beams are mostly used as transfer girders. This experimental study consists of 16 reinforced concrete (RC) deep beams. These beams were divided into two groups; A and B. Groups A and B consist of eight beams each, having 381 mm (15 in) and 457 mm (18 in) depth respectively. Each group was further subdivided into four sub groups each consisting of two identical beams. Each subgroup was comprised of solid/control beam (without opening), opening above neutral axis (NA), at NA and below NA. Except for control beams, all beams with openings were strengthened with carbon fibre reinforced polymer (CFRP) vertical strips. These eight groups differ from each other based on depth and location of openings. For testing sake, all beams have been loaded with two symmetrical point loads. All beams have been designed based on strut and tie model concept. The outcome of experimental investigation elaborates the difference in the shear behaviour of deep beams based on depth and location of circular openings variation. 457 mm (18 in) deep beam with openings above NA show the highest strength and 381 mm (15 in) deep beam with openings below NA show the least strength. CFRP sheets played a vital role in increasing the shear capacity of beams.

Keywords: CFRP, deep beams, openings in deep beams, strut and tie modal, shear behaviour

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Authors: Seyed Abolhasan Naeini, Saeideh Mohammadi

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Embankment settlement on soft clays has always been problematic due to the high compaction and low shear strength of the soil. Deep soil mixing and geosynthetics are two soil improvement methods in such fields. Here, a numerical study is conducted on the embankment performance on the soft ground improved by deep soil mixing columns and geosynthetics based on the data of a real project. For this purpose, the finite element method is used in the Plaxis 2D software. The Soft Soil Creep model considers the creep phenomenon in the soft clay layer while the Mohr-Columb model simulates other soil layers. Results are verified using the data of an experimental embankment built on deep mixing columns. The effect of depth and diameter of deep mixing columns and the stiffness of geogrid on the vertical and horizontal movements of embankment on clay subsoil will be investigated in the following.

Keywords: PLAXIS 2D, embankment settlement, horizontal movement, deep soil mixing column, geogrid

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Authors: Ruqaya H. Aljabery

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Reinforced Concrete (RC) deep beams are one of the main critical structural elements in terms of safety since significant loads are carried in a short span. The shear capacity of these sections cannot be predicted accurately by the current design codes like ACI and EC2; thus, they must be investigated. In this research, non-linear behavior of RC deep beams strengthened in shear with Fiber Reinforced Polymer (FRP) strips, and the efficiency of FRP in terms of enhancing the shear capacity in RC deep beams are examined using Finite Element Analysis (FEA), which is conducted using the software ABAQUS. The effect of several parameters on the shear capacity of the RC deep beam are studied in this paper as well including the effect of the cross-sectional area of the FRP strip and the shear reinforcement area to the spacing ratio (As/S), and it was found that FRP enhances the shear capacity significantly and can be a substitution of steel stirrups resulting in a more economical design.

Keywords: Abaqus, concrete, deep beam, finite element analysis, FRP, shear strengthening, strut-and-tie

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Authors: Nitin Shravan, Sudarsun Santhiappan, B. Sivaselvan

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Subsection identification, in the context of Electronic Health Records (EHRs), is identifying the important sections for down-stream tasks like auto-coding. In this work, we classify the text present in EHRs according to their information, using machine learning and deep learning techniques. We initially describe briefly about the problem and formulate it as a text classification problem. Then, we discuss upon the methods from the literature. We try two approaches - traditional feature extraction based machine learning methods and deep learning methods. Through experiments on a private dataset, we establish that the deep learning methods perform better than the feature extraction based Machine Learning Models.

Keywords: deep learning, machine learning, semantic clinical classification, subsection identification, text classification

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Authors: Pingping Lin, Xudong Luo, Yifan Fan

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Sentiment analysis is a very active research topic. Every day, Facebook, Twitter, Weibo, and other social media, as well as significant e-commerce websites, generate a massive amount of comments, which can be used to analyse peoples opinions or emotions. The existing methods for sentiment analysis are based mainly on sentiment dictionaries, machine learning, and deep learning. The first two kinds of methods rely on heavily sentiment dictionaries or large amounts of labelled data. The third one overcomes these two problems. So, in this paper, we focus on the third one. Specifically, we survey various sentiment analysis methods based on convolutional neural network, recurrent neural network, long short-term memory, deep neural network, deep belief network, and memory network. We compare their futures, advantages, and disadvantages. Also, we point out the main problems of these methods, which may be worthy of careful studies in the future. Finally, we also examine the application of deep learning in multimodal sentiment analysis and aspect-level sentiment analysis.

Keywords: document analysis, deep learning, multimodal sentiment analysis, natural language processing

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Authors: Mohammad Shameel, Peter K. K. Loh, James H. Ng

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Cybercrime is a new category of crime which poses a different challenge for crime investigators and incident responders. Attackers can mask their identities using a suite of tools and with the help of the deep web, which makes them difficult to track down. Scouring the deep web manually takes time and is inefficient. There is a growing need for a tool to scour the deep web to obtain useful evidence or intel automatically. In this paper, we will explain the background and motivation behind the research, present a survey of existing research on related tools, describe the design of our own crime/threat intelligence hunting tool prototype, demonstrate its capability with some test cases and lastly, conclude with proposals for future enhancements.

Keywords: cybercrime, deep web, threat intelligence, web crawler

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Authors: S. Kershaw, P. J. Barry, K. Webb

Abstract:

Background: Cystic Fibrosis (CF) is a chronic lung disease where patients have chronic lung infection punctuated by acute exacerbations that require intermittent intravenous (IV) antibiotics during their lives. With time, peripheral venous access can become difficult and limited. Accessing these veins can become arduous, traumatic, painful and unworkable. A permanent intravascular access device or Port is a small device that is inserted into the central venous system that allows the delivery of medicine eliminating the need for peripheral venous access. Ports represent a convenient and efficient method when venous access is required on a permanent basis however they are also associated with significant vascular complications. Superior Vena Cava Obstruction (SVCO) is a rare but significant vascular complication of ports in this setting. Objective: We aimed to look at a single CF centre’s experience of port-related SVCO over a thirty year period. Methods: Retrospective data was extracted using patient’s notes, electronic radiological reports and local databases over a period in excess of 30 years from 1982 to 2014. Results: 13 patients were identified with SVCO as a result of their port. 11 patients had CF (9 female, 2 male), one male patient had Primary Ciliary Dyskinesia and one female patient had severe Asthma. The mean port function was 1532 days (range 110 – 4049) and the mean age at SVCO was 24 years (range 11.1 to 36.5 years). The most common symptoms were facial oedema (n=8, 61.5%) and dilated veins (n=6, 46.2%). 7 patients had their Ports removed after SVCO. 6 patients underwent attempted stenting (46.2%) and 6 did not. 4 out of the 6 who underwent stenting required/had re-intervention. 3 of the 6 patients who underwent stenting had symptom resolution, however, 4 of the 6 patients who were not stented had symptom resolution also. Symptom resolution was not guaranteed with stenting and required re-intervention in two-thirds. Conclusion: This case series represents the experience of one of the longest established CF units in the UK and represents the largest cohort ever reported in the literature.

Keywords: ports, Superior Vena Cava Obstruction, cystic fibrosis, access devices

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Authors: Hana' Al-Ghanim, Mu'tasim Abdel-Jaber, Maha Alqam

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This experimental investigation deals with shear strengthening of reinforced concrete (RC) deep beams using the externally bonded carbon fiber-reinforced polymer (CFRP) composites. The current study, therefore, evaluates the effectiveness of four various configurations for shear strengthening of deep beams with two different types of CFRP materials including sheets and laminates. For this purpose, a total of 10 specimens of deep beams were cast and tested. The shear performance of the strengthened beams is assessed with respect to the cracks’ formation, modes of failure, ultimate strength and the overall stiffness. The obtained results demonstrate the effectiveness of using the CFRP technique on enhancing the shear capacity of deep beams; however, the efficiency varies depending on the material used and the strengthening scheme adopted. Among the four investigated schemes, the highest increase in the ultimate strength is recorded by using the continuous wrap of two layers of CFRP sheets, exceeding a value of 86%, whereas an enhancement of about 36% is achieved by the inclined CFRP laminates.

Keywords: deep beams, laminates, shear strengthening, sheets

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Authors: Taurino S. R. Neto, Epitácio D. S. Neto, Flávio Signorelli, Gustavo G. M. Balbi, Alex H. Higashi, Mário Luiz R. Monteiro, Eloisa Bonfá, Danieli C. O. Andrade, Leandro C. Zacharias

Abstract:

Purpose: To perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with healthy individuals. Methods: A complete structural and functional ophthalmological evaluation using OCTA and microperimetry (MP) exam in patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were recorded and then statistical analysis was performed for comparative purposes; p <0.05 was considered statistically significant. Results: 104 eyes of 52 subjects (26 patients with PAPS without ocular complaints and 26 healthy individuals) were included. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. Thrombotic PAPS was the main clinical criteria manifestation (100%); 65.4% had venous and 34.6% had arterial thrombosis. Obstetrical criteria were present in 34.6% of all thrombotic PAPS patients. Lupus anticoagulant was present in all patients. 19.2% of PAPS patients presented ophthalmologic findings against none of the healthy individuals. The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen-like deposits (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (1 patient, 1 eye). Systemic hypertension and hyperlipidaemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together. In the quantitative OCTA evaluation, we found significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) in the high-speed protocol, as well as in the SVC in the high-resolution protocol. In the analysis of the foveal avascular zone (FAZ) parameters, the PAPS group had a larger area of FAZ in the DVC using the high-speed method compared to the control group (p=0.047). In the quantitative analysis of the MP, the PAPS group had lower central (p=0.041) and global (p<0.001) retinal sensitivity compared to the control group, as well as in the sector analysis, with the exception of the inferior sector. In the quantitative evaluation of fixation stability, there was a trend towards worse stability in the PAPS subgroup with PAMM in both studied methods. Conclusions: PAMM was observed in 11.5% of PAPS patients with no previous ocular complaints. Systemic hypertension concomitant with hyperlipidemia was the most commonly associated risk factor for PAMM in patients with PAPS. PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without PAMM.

Keywords: antiphospholipid syndrome, optical coherence angio tomography, optical coherence tomography, retina

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Authors: Xuewei Li, Jingfeng Yuan, Jianliang Zhou

Abstract:

The 21st century has been called the century of human exploitation of underground space. Due to the characteristics of large quantity, tight schedule, low safety reserve and high uncertainty of deep foundation pit engineering, accidents frequently occur in deep foundation pit engineering, causing huge economic losses and casualties. With the successful application of information technology in the construction industry, building information modeling has become a research hotspot in the field of architectural engineering. Therefore, the application of building information modeling (BIM) and other information communication technologies (ICTs) in construction safety management is of great significance to improve the level of safety management. This research summed up the mechanism of the deep foundation pit engineering accident through the fault tree analysis to find the control factors of deep foundation pit engineering safety management, the deficiency existing in the traditional deep foundation pit construction site safety management. According to the accident cause mechanism and the specific process of deep foundation pit construction, the hazard information of deep foundation pit engineering construction site was identified, and the hazard list was obtained, including early warning information. After that, the system framework was constructed by analyzing the early warning information demand and early warning function demand of the safety management system of deep foundation pit. Finally, the safety management system of deep foundation pit construction site based on BIM through combing the database and Web-BIM technology was developed, so as to realize the three functions of real-time positioning of construction site personnel, automatic warning of entering a dangerous area, real-time monitoring of deep foundation pit structure deformation and automatic warning. This study can initially improve the current situation of safety management in the construction site of deep foundation pit. Additionally, the active control before the occurrence of deep foundation pit accidents and the whole process dynamic control in the construction process can be realized so as to prevent and control the occurrence of safety accidents in the construction of deep foundation pit engineering.

Keywords: Web-BIM, safety management, deep foundation pit, construction

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Authors: Joseph Uzuazomaro Oju

Abstract:

The ease at which manipulated media can be created, and the increasing difficulty in identifying fake media makes it a great threat. Most of the applications used for the creation of these high-quality fake videos and images are built with deep learning. Hence, the use of deep learning in creating a detection mechanism cannot be overemphasized. Any successful fake media that is being detected before it reached the populace will save people from the self-doubt of either a content is genuine or fake and will ensure the credibility of videos and images. The methodology introduced in this paper approaches the manipulated media detection challenge using a combo of VGG-19 and a deep capsule network. In the case of videos, they are converted into frames, which, in turn, are resized and cropped to the face region. These preprocessed images/videos are fed to the VGG-19 network to extract the latent features. The extracted latent features are inputted into a deep capsule network enhanced with a 3D -convolution dynamic routing agreement. The 3D –convolution dynamic routing agreement algorithm helps to reduce the linkages between capsules networks. Thereby limiting the poor learning shortcoming of multiple capsule network layers. The resultant output from the deep capsule network will indicate a media to be either genuine or fake.

Keywords: deep capsule network, dynamic routing, fake media detection, manipulated media

Procedia PDF Downloads 101