Search results for: cone contrast sensitivity

Authors: Ge Sun, Monika Trzpis, Robbert J. de Haas, Paul M. A. Broens

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Introduction: Dynamic magnetic resonance defecography is frequently used to assess defecation disorders. We aimed to investigate the usefulness of dynamic magnetic resonance defecography for assessing the severity of defecation disorder. Methods: We included patients retrospectively from our tertiary referral hospital who had undergone dynamic magnetic resonance defecography, anorectal manometry, and anal electrical sensitivity tests to assess defecation disorders between 2014 and 2020. The primary outcome was the association between the dynamic magnetic resonance defecography variables and the severity of defecation disorders. We assessed the severity of fecal incontinence and constipation with the Wexner incontinence and Agachan constipation scores. Results: Out of the 32 patients included, 24 completed the defecation questionnaire. During defecation, the M line length at magnetic resonance correlated with the Agachan score (r = 0.45, p = 0.03) and was associated with anal sphincter pressure (r=0.39, p=0.03) just before defecation. During rest and squeezing, the H line length at imaging correlated with the Wexner incontinence score (r=0.49, p=0.01 and r=0.69, p< 0.001, respectively). H line length also correlated positively with the anal electrical sensation threshold during squeezing (r=0.50, p=0.004) and during rest (r= 0.42, p=0.02). Conclusions: The M and H line lengths at dynamic magnetic resonance defecography can be used to assess the severity of constipation and fecal incontinence respectively and reflect anatomic changes of the pelvic floor. However, as these anatomic changes are generally late-stage and irreversible, anal manometry seems a better diagnostic approach to assess early and potentially reversible changes in patients with defecation disorders.

Keywords: defecation disorders, dynamic magnetic resonance defecography, anorectal manometry, anal electrical sensitivity tests, H line, M line

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Authors: Meera Tandan, Mohan Timilsina, Martin Cormican, Akke Vellinga

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Background: In general practice, many infections are treated empirically without microbiological confirmation. Understanding susceptibility of antimicrobials during empirical prescribing can be helpful to reduce inappropriate prescribing. This study aims to apply a prediction model using a decision tree approach to predict the antimicrobial resistance (AMR) of urinary tract infections (UTI) based on non-clinical features of patients over 65 years. Decision tree models are a novel idea to predict the outcome of AMR at an initial stage. Method: Data was extracted from the database of the microbiological laboratory of the University Hospitals Galway on all antimicrobial susceptibility testing (AST) of urine specimens from patients over the age of 65 from January 2011 to December 2014. The primary endpoint was resistance to common antimicrobials (Nitrofurantoin, trimethoprim, ciprofloxacin, co-amoxiclav and amoxicillin) used to treat UTI. A classification and regression tree (CART) model was generated with the outcome ‘resistant infection’. The importance of each predictor (the number of previous samples, age, gender, location (nursing home, hospital, community) and causative agent) on antimicrobial resistance was estimated. Sensitivity, specificity, negative predictive (NPV) and positive predictive (PPV) values were used to evaluate the performance of the model. Seventy-five percent (75%) of the data were used as a training set and validation of the model was performed with the remaining 25% of the dataset. Results: A total of 9805 UTI patients over 65 years had their urine sample submitted for AST at least once over the four years. E.coli, Klebsiella, Proteus species were the most commonly identified pathogens among the UTI patients without catheter whereas Sertia, Staphylococcus aureus; Enterobacter was common with the catheter. The validated CART model shows slight differences in the sensitivity, specificity, PPV and NPV in between the models with and without the causative organisms. The sensitivity, specificity, PPV and NPV for the model with non-clinical predictors was between 74% and 88% depending on the antimicrobial. Conclusion: The CART models developed using non-clinical predictors have good performance when predicting antimicrobial resistance. These models predict which antimicrobial may be the most appropriate based on non-clinical factors. Other CART models, prospective data collection and validation and an increasing number of non-clinical factors will improve model performance. The presented model provides an alternative approach to decision making on antimicrobial prescribing for UTIs in older patients.

Keywords: antimicrobial resistance, urinary tract infection, prediction, decision tree

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Authors: Jae Ni Jang, SoYoon Park, Sukhee Park, Yumin Song, Jae Won Kim, Keum Nae Kang, Young Uk Kim

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Objectives: Patellofemoral pain syndrome (PFPS) is a common clinical condition characterized by anterior knee pain. Here, we investigated the quadriceps tendon cross-sectional area (QTCSA) as a novel predictor for the diagnosis of PFPS. By examining the association between the QTCSA and PFPS, we aimed to provide a more valuable diagnostic parameter and more equivocal assessment of the diagnostic potential of PFPS by comparing the QTCSA with the quadriceps tendon thickness (QTT), a traditional measure of quadriceps tendon hypertrophy. Patients and Methods: This retrospective study included 30 patients with PFPS and 30 healthy participants who underwent knee magnetic resonance imaging. T1-weighted turbo spin echo transverse magnetic resonance images were obtained. The QTCSA was measured on the axial-angled phases of the images by drawing outlines, and the QTT was measured at the most hypertrophied quadriceps tendon. Results: The average QTT and QTCSA for patients with PFPS (6.33±0.80 mm and 155.77±36.60 mm², respectively) were significantly greater than those for healthy participants (5.77±0.36 mm and 111.90±24.10 mm2, respectively; both P<0.001). We used a receiver operating characteristic curve to confirm the sensitivities and specificities for both the QTT and QTCSA as predictors of PFPS. The optimal diagnostic cutoff value for QTT was 5.98 mm, with a sensitivity of 66.7%, a specificity of 70.0%, and an area under the curve of 0.75 (0.62–0.88). The optimal diagnostic cutoff value for QTCSA was 121.04 mm², with a sensitivity of 73.3%, a specificity of 70.0%, and an area under the curve of 0.83 (0.74–0.93). Conclusion: The QTCSA was found to be a more reliable diagnostic indicator for PFPS than QTT.

Keywords: patellofemoral pain syndrome, quadriceps muscle, hypertrophy, magnetic resonance imaging

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Authors: Qiaofeng Guo

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Aims: Obesity is often accompanied by insulin resistance (IR) and whole-body inflammation. Aerobic exercise is an effective treatment to improve insulin resistance and inflammation. However, the anti-inflammatory mechanisms of exercise on epididymal and subcutaneous adipose remain to be elucidated. Here, we compared the macrophage polarization between epididymal and subcutaneous adipose after aerobic exercise. Methods: Male C57BL/6 mice were fed a normal diet group or a high-fat diet group for 12 weeks and performed aerobic training on a treadmill at 55%~65% VO₂ max for eight weeks. Food intake, body weight, and fasting blood glucose levels were monitored weekly. The intraperitoneal glucose tolerance test was to evaluate the insulin resistance model. Fat mass, blood lipid profile, serum IL-1β, TNF-α levels, and CD31/CD206 rates were analysed after the intervention. Results: FBG (P<0.01), AUCIPGTT (P<0.01), and HOMA-IR (P<0.01) increased significantly for a high-fat diet and decreased significantly after the exercise. Eight weeks of aerobic exercise attenuated HFD-induced weight gain and glucose intolerance and improved insulin sensitivity. Serum IL-1β, TNF-α, CD11C/CD206 expression in subcutaneous adipose tissue were not changed before and after exercise, but not in epididymal adipose tissue (P<0.01). Conclusion: Insulin resistance is not accompanied by chronic inflammation and M1 polarization of subcutaneous adipose tissue macrophages in high-fat diet mice. Aerobic exercise effectively improved lipid metabolism and insulin sensitivity, which may be closely associated with reduced M1 polarization of epididymal adipose macrophages.

Keywords: aerobic exercise, insulin resistance, chronic inflammation, adipose, macrophage polarization

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Authors: Yating Yang, Xue Zhang, Chengli Zhao

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In the increasingly interconnected global environment brought about by globalization, it is crucial for countries to timely grasp the development motivations in relevant research fields of other countries and seize development opportunities. Motivation, as the intrinsic driving force behind actions, is abstract in nature, making it difficult to directly measure and evaluate. Drawing on the ideas of social influence network theory, the research motivations of a country can be understood as the driving force behind the development of its science and technology sector, which is simultaneously influenced by both the country itself and other countries/regions. In response to this issue, this paper improves upon Friedkin's social influence network theory and applies it to motivation description, constructing a dynamic alliance network and hostile network centered around the United States and China, as well as a sensitivity matrix, to remotely assess the changes in national research motivations under the influence of international relations. Taking artificial intelligence as a case study, the research reveals that the motivations of most countries/regions are declining, gradually shifting from a neutral attitude to a negative one. The motivation of the United States is hardly influenced by other countries/regions and remains at a high level, while the motivation of China has been consistently increasing in recent years. By comparing the results with real data, it is found that this model can reflect, to some extent, the trends in national motivations.

Keywords: influence network theory, remote assessment, relation matrix, dynamic sensitivity matrix

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Authors: Zohreh Moghaddas, Morteza Yazdani, Farhad Hosseinzadeh

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Nowadays, data envelopment analysis (DEA) models featuring network structures have gained widespread usage for evaluating the performance of production systems and activities (Decision-Making Units (DMUs)) across diverse fields. By examining the relationships between the internal stages of the network, these models offer valuable insights to managers and decision-makers regarding the performance of each stage and its impact on the overall network. To further empower system decision-makers, the inverse data envelopment analysis (IDEA) model has been introduced. This model allows the estimation of crucial information for estimating parameters while keeping the efficiency score unchanged or improved, enabling analysis of the sensitivity of system inputs or outputs according to managers' preferences. This empowers managers to apply their preferences and policies on resources, such as inputs and outputs, and analyze various aspects like production, resource allocation processes, and resource efficiency enhancement within the system. The results obtained can be instrumental in making informed decisions in the future. The top result of this study is an analysis of infeasibility and incorrect estimation that may arise in the theory and application of the inverse model of data envelopment analysis with network structures. By addressing these pitfalls, novel protocols are proposed to circumvent these shortcomings effectively. Subsequently, several theoretical and applied problems are examined and resolved through insightful case studies.

Keywords: inverse models of data envelopment analysis, series network, estimation of inputs and outputs, efficiency, resource allocation, sensitivity analysis, infeasibility

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Authors: M. Knezevic, V. Marecic, M. Ozanic, I. Kelava, M. Mihelcic, M. Santic

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Francisella tularensis is a highly infectious, gram-negative intracellular bacterium and the causative agent of tularemia. The bacterium has been isolated from more than 250 wild species, including protozoa cells. Since Francisella is very virulent and persists in the environment for years, the aim of this study was to investigate whether Acanthamoeba castellanii-grown F. novicida exhibits an alteration in the resistance to disinfectants. It has been shown by other intracellular pathogens, including Legionella pneumophila that bacteria grown in amoeba exhibit more resistance to disinfectants. However, there is no data showing Francisella viability behaviour after intracellular life cycle in A. castellani. In this study, the bacterial suspensions of A. castellanii-grown or in vitro-grown Francisella were treated with three different disinfectants, and the bacterial viability after disinfection treatment was determined by a colony-forming unit (CFU) counting method, transmission electron microscopy (TEM), fluorescence microscopy as well as the leakage of intracellular fluid. Our results have shown that didecyldimethylammonium chloride (DDAC) combined with isopropyl alcohol was the most effective in bacterial killing; all in vitro-grown and A. castellanii-grown F. novicida were killed after only 10s. Surprisingly, in comparison to in vitro-grown bacteria, A. castellanii-grown F. novicida was more sensitive to decontamination by the benzalkonium chloride combined with DDAC and formic acid and the polyhexamethylene biguanide (PHMB). We can conclude that the tested disinfectants exhibit antimicrobial activity by causing a loss of structural organization and integrity of the Francisella cell wall and membrane and the subsequent leakage of the intracellular contents. Finally, the results of this study clearly demonstrate that Francisella grown in A. castellanii had become more susceptible to many disinfectants.

Keywords: Acanthamoeba, disinfectant, Francisella, sensitivity

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Authors: Timothy L. Porter, T. Randy Dillingham

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Vegetation growth and decomposition, along with soil microbial activity play a complex role in the production of greenhouse gases originating in forest soils. The absorption or emission (respiration) of these gases is a function of many factors relating to the soils themselves, the plants, and the environment in which the plants are growing. For this study, we have constructed a battery-powered, portable field mass spectrometer for use in analyzing gases in the soils surrounding trees, plants, and other areas. We have used the instrument to sample in real-time the greenhouse gases carbon dioxide and methane in soils where plant life may be contributing to the production of gases such as methane. Gases such as isoprene, which may help correlate gas respiration to microbial activity have also been measured. The instrument is composed of a quadrupole mass spectrometer with part per billion or better sensitivity, coupled to battery-powered turbo and diaphragm pumps. A unique ambient air pressure differentially pumped intake apparatus allows for the real-time sampling of gases in the soils from the surface to several inches below the surface. Results show that this instrument is capable of instant, part-per-billion sensitivity measurement of carbon dioxide and methane in the near surface region of various forest soils. We have measured differences in soil respiration resulting from forest thinning, forest burning, and forest logging as compared to pristine, untouched forests. Further studies will include measurements of greenhouse gas respiration as a function of temperature, microbial activity as measured by isoprene production, and forest restoration after fire.

Keywords: forest, soil, greenhouse, quadrupole

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Authors: Seyedeh Mehri Hamidi, Nasrin Asgari, Foozieh Sohrabi, Mohammad Ali Ansari

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New neuro plasmonic sensor based on one dimensional plasmonic nano-grating has been prepared. To record neural activity, the sample has been exposed under different infrared laser and then has been calculated by ellipsometry parameters. Our results show that we have efficient sensitivity to different laser excitation.

Keywords: neural activity, Plasmonic sensor, Nanograting, Gold thin film

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Authors: Z. A. Al Marhoon, H. S. Al Ramis, C. Teodoriu

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Well-integrity is one of the major elements considered for drilling geothermal, oil, and gas wells. Well-integrity is minimizing the risk of unplanned fluid flow in the well bore throughout the well lifetime. Well integrity is maximized by applying technical concepts along with practical practices and strategic planning. These practices are usually governed by standardization and regulation entities. Practices during well construction can affect the integrity of the seal at the time of abandonment. On the other hand, achieving a perfect barrier system is impracticable due to the needed cost. This results in a needed balance between regulations requirements and practical applications. The guidelines are only effective when they are attainable in practical applications. Various governmental regulations and international standards have different guidelines on what constitutes high-quality isolation from unwanted flow. Each regulating or standardization body differ in requirements based on the abandonment objective. Some regulation account more for the environmental impact, water table contamination, and possible leaks. Other regulation might lean towards driving more economical benefits while achieving an acceptable isolation criteria. The research methodology used in this topic is derived from a literature review method combined with a compare and contrast analysis. The literature review on various zonal isolation regulations and standards has been conducted. A review includes guidelines from NORSOK (Norwegian governing entity), BSEE (USA offshore governing entity), API (American Petroleum Institute) combined with ISO (International Standardization Organization). The compare and contrast analysis is conducted by assessing the objective of each abandonment regulations and standardization. The current state of well barrier regulation is in balancing action. From one side of this balance, the environmental impact and complete zonal isolation is considered. The other side of the scale is practical application and associated cost. Some standards provide a fair amount of details concerning technical requirements and are often flexible with the needed associated cost. These guidelines cover environmental impact with laws that prevent major or disastrous environmental effects of improper sealing of wells. Usually these regulations are concerned with the near future of sealing rather than long-term. Consequently, applying these guidelines become more feasible from a cost point of view to the required plugging entities. On the other hand, other regulation have well integrity procedures and regulations that lean toward more restrictions environmentally with an increased associated cost requirements. The environmental impact is detailed and covered with its entirety, including medium to small environmental impact in barrier installing operations. Clear and precise attention to long-term leakage prevention is present in these regulations. The result of the compare and contrast analysis of the literature showed that there are various objectives that might tip the scale from one side of the balance (cost) to the other (sealing quality) especially in reference to zonal isolation. Furthermore, investing in initial well construction is a crucial part of ensuring safe final well abandonment. The safety and the cost saving at the end of the well life cycle is dependent upon a well-constructed isolation systems at the beginning of the life cycle. Long term studies on zonal isolation using various hydraulic or mechanical materials need to take place to further assess permanently abandoned wells to achieve the desired balance. Well drilling and isolation techniques will be more effective when they are operationally feasible and have reasonable associated cost to aid the local economy.

Keywords: plug and abandon, P&A regulation, P&A standards, international guidelines, gap analysis

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Authors: A. ElZawam, D. McLean, A. Tibary

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In alpaca, age at puberty is variable and the factors regulating the pattern of puberty and sexual maturation are a subject of controversy. Plasma testosterone level is often used as an indicator of sexual maturity. Our hypothesis is that hCG treatment will cause an increase in testosterone level that is correlated with animal age. The specific aim was to investigate the testicular tissue response to a single hCG injection by monitoring the serum testosterone concentration. Eighty four (n=84) males ranging in age from 6 to 60 months were used. Alpacas were grouped based on their ages into 15 groups. Each group had three to five male animals. Blood samples were collected from the jugular vein before treatment with hCG and 2 hours after intravenous administration of 3000 IU of hCG (Chorulon®). The serum was harvested and stored at -20ºC until the analysis. The effect of age on basal testosterone level and response to hCG treatment was evaluated by Analysis of Variance. As a result, basal serum testosterone concentrations were very low (<0.1ng/ml) until 9 months of age. Although basal serum testosterone concentrations increased steadily with age there was a significant variation amongst males within the same age group. Administration of 3000 IU of hCG, resulted in an average increase of 50% (P<0.05) in serum testosterone concentration after 2 hours. The percentage increase in serum testosterone in response to hCG stimulation varied from 51 to 81%. There was no correlation between the degree of response and age. However, the response to hCG injection presented two modes of increase depending on the age of animals. The first mode occurred at ages 9 to 14 months and the second mode was observed between 22 and 36 months. In conclusion, our results suggest that testicular growth and sensitivity to LH stimulation may be bimodal in the male alpaca with a rapid increase in growth and sensitivity between 9 and 14 months of age and a second phase of increased responsiveness after 21 months of ages.

Keywords: alpaca, testosterone, hCG, animal science

Procedia PDF Downloads 572

Authors: Fauzi Jarushi, Paul Cosentino, Edward Kalajian, Hadeel Dekhn

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At certain depths during large diameter displacement pile driving, rebound well over 0.25 inches was experienced, followed by a small permanent set during each hammer blow. High pile rebound (HPR) soils may stop the pile driving and results in a limited pile capacity. In some cases, rebound leads to pile damage, delaying the construction project, and the requiring foundations redesign. HPR was evaluated at seven Florida sites, during driving of square precast, prestressed concrete piles driven into saturated, fine silty to clayey sands and sandy clays. Pile Driving Analyzer (PDA) deflection versus time data recorded during installation, was used to develop correlations between cone penetrometer (CPT) pore-water pressures, pile displacements and rebound. At five sites where piles experienced excessive HPR with minimal set, the pore pressure yielded very high positive values of greater than 20 tsf. However, at the site where the pile rebounded, followed by an acceptable permanent set, the measured pore pressure ranged between 5 and 20 tsf. The pore pressure exhibited values of less than 5 tsf at the site where no rebound was noticed. In summary, direct correlations between CPTu pore pressure and rebound were produced, allowing identification of soils that produce HPR.

Keywords: CPTU, pore water pressure, pile rebound

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Authors: Livia Eisler, Cristiane C. B. Alves, Cristina L. F. Ortolani, Kurt Faltin Jr.

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Purpose: This paper proposes a technically simple diagnosis method among orthodontists and maxillofacial surgeons in order to evaluate discrete bone alterations. The methodology consists of a protocol to optimize the diagnosis and minimize the possibility for orthodontic and ortho-surgical retreatment. Materials and Methods: A protocol of image processing and analysis, through ImageJ software and its plugins, was applied to 20 pairs of lateral cephalometric images obtained from cone beam computerized tomographies, before and 1 year after undergoing orthognathic surgery. The optical density of the images was analyzed in the condylar region to determine possible bone alteration after surgical correction. Results: Image density was shown to be altered in all image pairs, especially regarding the condyle contours. According to measures, condyle had a gender-related density reduction for p=0.05 and condylar contours had their alterations registered in mm. Conclusion: A simple, viable and cost-effective technique can be applied to achieve the more detailed image-based diagnosis, not depending on the human eye and therefore, offering more reliable, quantitative results.

Keywords: bone resorption, computer-assisted image processing, orthodontics, orthognathic surgery

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Authors: Leonardo C. Pacheco-Londoño, Nataly J Galan-Freyle, Lisandro Pacheco-Lugo, Antonio Acosta-Hoyos, Elkin Navarro, Gustavo Aroca-Martinez, Karin Rondón-Payares, Alberto C. Espinosa-Garavito, Samuel P. Hernández-Rivera

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At the Life Science Research Center at Simon Bolivar University, a primary focus is the diagnosis of various diseases, and the use of gold nanoparticles (Au-NPs) in diverse biomedical applications is continually expanding. In the present study, Au-NPs were employed as substrates for Surface-Enhanced Raman Spectroscopy (SERS) aimed at diagnosing kidney diseases arising from Lupus Nephritis (LN), preeclampsia (PC), and Hypertension (H). Discrimination models were developed for distinguishing patients with and without kidney diseases based on the SERS signals from urine samples by partial least squares-discriminant analysis (PLS-DA). A comparative study of the Raman signals across the three conditions was conducted, leading to the identification of potential metabolite signals. Model performance was assessed through cross-validation and external validation, determining parameters like sensitivity and specificity. Additionally, a secondary analysis was performed using machine learning (ML) models, wherein different ML algorithms were evaluated for their efficiency. Models’ validation was carried out using cross-validation and external validation, and other parameters were determined, such as sensitivity and specificity; the models showed average values of 0.9 for both parameters. Additionally, it is not possible to highlight this collaborative effort involved two university research centers and two healthcare institutions, ensuring ethical treatment and informed consent of patient samples.

Keywords: SERS, Raman, PLS-DA, kidney diseases

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Authors: Joan Casas-Roma

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Technology has become one of the main channels through which people engage in most of their everyday activities; from working to learning, or even when socializing, technology often acts as both an enabler and a mediator of such activities. Moreover, the affordances and interactions created by those technological tools determine the way in which the users interact with one another, as well as how they relate to the relevant environment, thus favoring certain kinds of actions and behaviors while discouraging others. In this regard, virtue ethics theories place a strong focus on a person's daily practice (understood as their decisions, actions, and behaviors) as the means to develop and enhance their habits and ethical competences --such as their awareness and sensitivity towards certain ethically-desirable principles. Under this understanding of ethics, this set of technologically-enabled affordances and interactions can be seen as the possibility space where the daily practice of their users takes place in a wide plethora of contexts and situations. At this point, the following question pops into mind: could these affordances and interactions be shaped in a way that would promote behaviors and habits basedonethically-desirable principles into their users? In the field of game design, the MDA framework (which stands for Mechanics, Dynamics, Aesthetics) explores how the interactions enabled within the possibility space of a game can lead to creating certain experiences and provoking specific reactions to the players. In this sense, these interactions can be shaped in ways thatcreate experiences to raise the players' awareness and sensitivity towards certain topics or principles. This research brings together the notions of technological affordances, the notions of practice and practical wisdom from virtue ethics, and the MDA framework from game design in order to explore how the possibility space created by technological interactions can be shaped in ways that enable and promote actions and behaviors supporting certain ethically-desirable principles. When shaped accordingly, interactions supporting certain ethically-desirable principlescould allow their users to carry out the kind of practice that, according to virtue ethics theories, provides the grounds to develop and enhance their awareness, sensitivity, and ethical reasoning capabilities. Moreover, and because ethical practice can happen collaterally in almost every context, decision, and action, this additional layer could potentially be applied in a wide variety of technological tools, contexts, and functionalities. This work explores the theoretical background, as well as the initial considerations and steps that would be needed in order to harness the potential ethically-desirable benefits that technology can bring, once it is understood as the space where most of their users' daily practice takes place.

Keywords: ethics, design methodology, human-computer interaction, philosophy of technology

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Authors: Nurul Mazni Abdullah, Saw Kian Cheah, Raha Abdul Rahman, Qurratu 'Aini Musthafa

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Purpose: Candidemia was associated with high mortality in critically ill patients. Early candidemia prediction is imperative for preemptive antifungal treatment. This study aimed to externally validate the candidemia risk prediction scores by Jameran et al. (2021) by identifying risk factors of acute kidney injury, renal replacement therapy, parenteral nutrition, and multifocal candida colonization. Methods: This single-center, retrospective observational study included all critically ill patients admitted to the intensive care unit (ICU) in a tertiary referral center from January 2018 to December 2023. The study evaluated the candidemia risk prediction score performance by analyzing the occurrence of candidemia within the study period. Patients’ demographic characteristics, comorbidities, SOFA scores, and ICU outcomes were analyzed. Patients who were diagnosed with candidemia before ICU admission were excluded. Results: A total of 500 patients were analyzed with 2 dropouts due to incomplete data. Validation analysis showed that the candidemia risk prediction score has a sensitivity of 75.00% (95% CI: 59.66-86.81), specificity of 65.35% (95% CI: 60.78-69.72), positive predictive value of 17.28, and negative predictive value of 96.44. The incidence of candidemia was 8.86% with no significant differences in the demographic and comorbidities except higher SOFA scoring in the candidemia group. The candidemia group showed significantly longer ICU and hospital LOS and higher ICU and in-hospital mortality. Conclusion: This study concluded the candidemia risk prediction score by Jameran et al (2021) had good sensitivity and a high negative prediction value.

Keywords: candidemia, intensive care, clinical prediction rule, incidence

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Authors: Juan Huang, Hugo Ninanya

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Oil has been used as a source of energy and supply to make materials, such as asphalt or rubber for many years. This is the reason why new technologies have been implemented through time. However, research still needs to continue increasing due to new challenges engineers face every day, just like unconventional reservoirs. Various numerical methodologies have been applied in petroleum engineering as tools in order to optimize the production of reservoirs before drilling a wellbore, although not all of these have the same efficiency when talking about studying fracture propagation. Analytical methods like those based on linear elastic fractures mechanics fail to give a reasonable prediction when simulating fracture propagation in ductile materials whereas numerical methods based on the cohesive zone method (CZM) allow to represent the elastoplastic behavior in a reservoir based on a constitutive model; therefore, predictions in terms of displacements and pressure will be more reliable. In this work, a hydro-geomechanical coupled model of horizontal wells in fractured rock was developed using ABAQUS; both extended element method and cohesive elements were used to represent predefined fractures in a model (2-D). A power law for representing the rheological behavior of fluid (shear-thinning, power index <1) through fractures and leak-off rate permeating to the matrix was considered. Results have been showed in terms of aperture and length of the fracture, pressure within fracture and fluid loss. It was showed a high infiltration rate to the matrix as power index decreases. A sensitivity analysis is conclusively performed to identify the most influential factor of fluid loss.

Keywords: fracture, hydro-geomechanical model, non-Newtonian fluid, numerical analysis, sensitivity analysis

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Authors: Belgherbi Aicha, Bessaid Abdelhafid

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In the recent years a great deal of research work has been devoted to the development of semi-automatic and automatic techniques for the analysis of abdominal CT images. The first and fundamental step in all these studies is the semi-automatic liver and spleen segmentation that is still an open problem. In this paper, a semi-automatic liver and spleen segmentation method by the mathematical morphology based on watershed algorithm has been proposed. Our algorithm is currency in two parts. In the first, we seek to determine the region of interest by applying the morphological to extract the liver and spleen. The second step consists to improve the quality of the image gradient. In this step, we propose a method for improving the image gradient to reduce the over-segmentation problem by applying the spatial filters followed by the morphological filters. Thereafter we proceed to the segmentation of the liver, spleen. The aim of this work is to develop a method for semi-automatic segmentation liver and spleen based on watershed algorithm, improve the accuracy and the robustness of the liver and spleen segmentation and evaluate a new semi-automatic approach with the manual for liver segmentation. To validate the segmentation technique proposed, we have tested it on several images. Our segmentation approach is evaluated by comparing our results with the manual segmentation performed by an expert. The experimental results are described in the last part of this work. The system has been evaluated by computing the sensitivity and specificity between the semi-automatically segmented (liver and spleen) contour and the manually contour traced by radiological experts. Liver segmentation has achieved the sensitivity and specificity; sens Liver=96% and specif Liver=99% respectively. Spleen segmentation achieves similar, promising results sens Spleen=95% and specif Spleen=99%.

Keywords: CT images, liver and spleen segmentation, anisotropic diffusion filter, morphological filters, watershed algorithm

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Authors: Sayantika Biswas, Dipanshu Sur, Amitoj Athwal, Ratnabali Chakravorty

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Title: Impact of serum estrogen and progesterone levels in the outcome pregnancy rate in frozen embryo transfer cycles. A prospective cohort study Objective: The aim of the current study was to evaluate the effect of serum estradiol (E2) and progesterone (P4) levels at different time points on pregnancy outcomes in frozen embryo transfer (FET) cycles. Materials & Method: A prospective cohort study was performed in patients undergoing frozen embryo transfer. Patients under age 37 years of age with at least one good blastocyst or three good day 3 embryos were included in the study. For endometrial preparation, 14 days of oral estradiol use (2X2 mg for 5 days. 3X2 mg for 4 days, and 4X2 mg for 5 days) was followed by vaginal progesterone twice a day and 50 mg intramuscular progesterone twice a day. Embryo transfer was scheduled 72-76 hrs or 116-120hrs after the initiation of progesterone. Serum E2 and P4 levels were examined at 4 times a) at the start of the menstrual cycle prior to the hormone supplementation. b) on the day of P4 start. c) on the day of ET. d) on the third day after ET. Result: A total 41 women were included in this study (mean age 31.8; SD 2.8). Clinical pregnancy rate was 65.55%. Serum E2 levels on at the start of the menstrual cycle prior to the hormone supplementation and on the day of P4 start were high in patients who achieved pregnancy compared to who did not (P=0.005 and P=0.019 respectively). P4 levels on on the day of ET were also high in patients with clinical pregnancy. On the day of P4 start, a serum E2 threshold of 186.4 pg/ml had a sensitivity of 82%, and P4 had a sensitivity of 71% for the prediction of clinical pregnancy at the threshold value 16.00 ng/ml. Conclusion: In women undergoing FET with hormone replacement, serum E2 level >186.4 pg/ml on the day of the start of progesterone and serum P4 levels >16.00 ng/ml on embryo transfer day are associated with clinical pregnancy.

Keywords: serum estradiol, serum progesterone, clinical pregnancy, frozen embryo transfer

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.

Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection

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Authors: Abduladim Maitieg, Kevin Lynch, Mark Johnson

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The goal of the Libyan Environmental General Authority (EGA) and National Oil Corporation (Department of Health, Safety & Environment) during the last 5 years has been to adopt a common approach to coastal and marine spatial planning. Protection and planning of the coastal zone is a significant for Libya, due to the length of coast and, the high rate of oil export, and spills’ potential negative impacts on coastal and marine habitats. Coastal resource scenarios constitute an important tool for exploring the long-term and short-term consequences of oil spill impact and available response options that would provide an integrated perspective on mitigation. To investigate that, this paper reviews the Misratah coastal parameters to present the physical and human controls and attributes of coastal habitats as the first step in understanding how they may be damaged by an oil spill. This paper also investigates costal resources, providing a better understanding of the resources and factors that impact the integrity of the ecosystem. Therefore, the study described the potential spatial distribution of oil spill risk and the coastal resources value, and also created spatial maps of coastal resources and their vulnerability to oil spills along the coast. This study proposes an analysis of coastal resources condition at a local level in the Misratah region of the Mediterranean Sea, considering the implementation of coastal and marine spatial planning over time as an indication of the will to manage urban development. Oil spill contamination analysis and their impact on the coastal resources depend on (1) oil spill sequence, (2) oil spill location, (3) oil spill movement near the coastal area. The resulting maps show natural, socio-economic activity, environmental resources along of the coast, and oil spill location. Moreover, the study provides significant geodatabase information which is required for coastal sensitivity index mapping and coastal management studies. The outcome of study provides the information necessary to set an Environmental Sensitivity Index (ESI) for the Misratah shoreline, which can be used for management of coastal resources and setting boundaries for each coastal sensitivity sectors, as well as to help planners measure the impact of oil spills on coastal resources. Geographic Information System (GIS) tools were used in order to store and illustrate the spatial convergence of existing socio-economic activities such as fishing, tourism, and the salt industry, and ecosystem components such as sea turtle nesting area, Sabkha habitats, and migratory birds feeding sites. These geodatabases help planners investigate the vulnerability of coastal resources to an oil spill.

Keywords: coastal and marine spatial planning advancement training, GIS mapping, human uses, ecosystem components, Misratah coast, Libyan, oil spill

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Authors: Wenbo Yu, Zihao Yuan, Zhipeng Guo, Shoumei Xiong

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Under different slow shot speeds in vacuum assisted high pressure die casting (VHPDC) process, plate-shaped specimens of hypereutectic A390 aluminum alloy were produced. According to the results, the vacuum pressure inside the die cavity increased linearly with the increasing slow shot speed at the beginning of mold filling. Meanwhile, it was found that the tensile properties of vacuum die castings were deteriorated by the porosity content. In addition, the average primary Si size varies between 14µm to 23µm, which has a binary functional relationship with the slow shot speeds. Due to the vacuum effect, the castings were treated by T6 heat treatment. After heat treatment, microstructural morphologies revealed that needle-shaped and thin-flaked eutectic Si particles became rounded while Al2Cu dissolved into α-Al matrix. For the as-received sample in-situ tensile test, microcracks firstly initiate at the primary Si particles and propagated along Al matrix with a transgranular fracture mode. In contrast, for the treated sample, the crack initiated at the Al2Cu particles and propagated along Al grain boundaries with an intergranular fracture mode. In-situ three bending test, microcracks firstly formed in the primary Si particles for both samples. Subsequently, the cracks between primary Si linked along Al grain boundaries in as received sample. In contrast, the cracks in primary Si linked through the solid lines in Al matrix. Furthermore, the fractography revealed that the fracture mechanism has evolved from brittle transgranular fracture to a fracture mode with many dimples after heat treatment.

Keywords: A390 aluminum, vacuum assisted high pressure die casting, heat treatment, mechanical properties

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Authors: Surabhi Agrawal Kohli, Sunita Gupta, Esha Khanuja, Parul Garg, P. Gupta

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Background: Adenomyosis is a common gynaecological condition that affects the menstruating women. Uterine enlargement, dysmenorrhoea, and menorrhagia are regarded as the cardinal clinical symptoms of adenomyosis. Classically it was thought, compared with ultrasonography, when adenomyosis is suspected, MRI enables more accurate diagnosis of the disease. Materials and Methods: 172 subjects were enrolled after an informed consent that had complaints of HMB, dyspareunia, dysmenorrhea, and chronic pelvic pain. Detailed history of the enrolled subjects was taken, followed by a clinical examination. These patients were then subjected to TVS where myometrial echo texture, presence of myometrial cysts, blurring of endomyometrial junction was noted. MRI was followed which noted the presence of junctional zone thickness and myometrial cysts. After hysterectomy, histopathological diagnosis was obtained. Results: 78 participants were analysed. The mean age was 44.2 years. 43.5% had parity of 4 or more. heavy menstrual bleeding (HMB) was present in 97.8% and dysmenorrhea in 93.48 % of HPE positive patient. Transvaginal sonography (TVS) and MRI had a sensitivity of 89.13% and 80.43%, specificity of 90.62% and 84.37%, positive likelihood ratio of 9.51 and 5.15, negative likelihood ratio of 0.12 and 0.23, positive predictive value of 93.18% and 88.1%, negative predictive value of 85.29% and 75% and a diagnostic accuracy of 89.74% and 82.5%. Comparison of sensitivity (p=0.289) and specificity (p=0.625) showed no statistically significant difference between TVS and MRI. Conclusion: Prevalence of 30.23%. HMB with dysmenorrhoea and chronic pelvic pain helps in diagnosis. TVS (Endomyometrial junction blurring) is both sensitive and specific in diagnosing adenomyosis without need for additional diagnostic tool. Both TVS and MRI are equally efficient, however because of certain additional advantages of TVS over MRI, it may be used as the first choice of imaging. MRI may be used additionally in difficult cases as well as in patients with existing co-pathologies.

Keywords: adenomyosis, heavy menstrual bleeding, MRI, TVS

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Authors: K. K. A. Bakhti, D. Mottet, J. Froger, I. Laffont

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Background: After a cerebrovascular accident (or stroke), many patients use excessive trunk movements to move their paretic hand towards a target (while the elbow is maintained flexed) even though they can use the upper-limb when the trunk is restrained. This phenomenon is labelled learned non-use and is known to be detrimental to neuroplasticity and recovery. Objective: The aim of this study is to quantify learned non-use of the paretic upper limb during a hand reaching task using 3D movement analysis. Methods: Thirty-four participants post supratentorial stroke were asked to reach a cone placed in front of them at 80% of their arm length. The reaching movement was repeated 5 times with the paretic hand, and then 5 times with the less-impaired hand. This sequence was first performed with the trunk free, then with the trunk restrained. Learned non-use of the upper-limb (LNUUL) was obtained from the difference of the amount of trunk compensation between the free trunk condition and the restrained trunk condition. Results: LNUUL was significantly higher for the paretic hand, with individual values ranging from 1% to 43%, and one-half of the patients with an LNUUL higher than 15%. Conclusions: Quantification of LNUUL can be used to objectively diagnose patients who need trunk rehabilitation. It can be also used for monitoring the rehabilitation progress. Quantification of LNUUL may guide upper-limb rehabilitation towards more optimal motor recovery avoiding maladaptive trunk compensation and its consequences on neuroplasticity.

Keywords: learned non-use, rehabilitation, stroke, upper limb

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Authors: Awais Ahmed, Atif Rana, Haseeb Zia, Maham Jahangir, Rashed Nazir, Faisal Dar

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Purpose: Biliary complications represent the most common cause of morbidity in living related liver donor transplantation and detailed preoperative evaluation of biliary anatomic variants is crucial for safe patient selection and improved surgical outcomes. Purpose of this study is to determine the accuracy of preoperative MRCP in predicting biliary variations when compared to intraoperative cholangiography in living related liver donors. Materials and Methods: From 44 potential donors, 40 consecutive living related liver donors (13 females and 28 males) underwent donor hepatectomy at our centre from April 2012 to August 2013. MRCP and IOC of all patients were retrospectively reviewed separately by two radiologists and a transplant surgeon.MRCP was performed on 1.5 Tesla MR magnets using breath-hold heavily T2 weighted radial slab technique. One patient was excluded due to suboptimal MRCP. The accuracy of MRCP for variant biliary anatomy was calculated. Results: MRCP accurately predicted the biliary anatomy in 38 of 39 cases (97 %). Standard biliary anatomy was predicted by MRCP in 25 (64 %) donors (100% sensitivity). Variant biliary anatomy was noted in 14 (36 %) IOCs of which MRCP predicted precise anatomy of 13 variants (93 % sensitivity). The two most common variations were drainage of the RPSD into the LHD (50%) and the triple confluence of the RASD, RPSD and LHD (21%). Conclusion: MRCP is a sensitive imaging tool for precise pre-operative mapping of biliary variations which is critical to surgical decision making in living related liver transplantation.

Keywords: intraoperative cholangiogram, liver transplantation, living related donors, magnetic resonance cholangio-pancreaticogram (MRCP)

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Authors: El Harraj Abdeslam, Raissouni Naoufal

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The detection of moving objects from a video image sequences is very important for object tracking, activity recognition, and behavior understanding in video surveillance. The most used approach for moving objects detection / tracking is background subtraction algorithms. Many approaches have been suggested for background subtraction. But, these are illumination change sensitive and the solutions proposed to bypass this problem are time consuming. In this paper, we propose a robust yet computationally efficient background subtraction approach and, mainly, focus on the ability to detect moving objects on dynamic scenes, for possible applications in complex and restricted access areas monitoring, where moving and motionless persons must be reliably detected. It consists of three main phases, establishing illumination changes in variance, background/foreground modeling and morphological analysis for noise removing. We handle illumination changes using Contrast Limited Histogram Equalization (CLAHE), which limits the intensity of each pixel to user determined maximum. Thus, it mitigates the degradation due to scene illumination changes and improves the visibility of the video signal. Initially, the background and foreground images are extracted from the video sequence. Then, the background and foreground images are separately enhanced by applying CLAHE. In order to form multi-modal backgrounds we model each channel of a pixel as a mixture of K Gaussians (K=5) using Gaussian Mixture Model (GMM). Finally, we post process the resulting binary foreground mask using morphological erosion and dilation transformations to remove possible noise. For experimental test, we used a standard dataset to challenge the efficiency and accuracy of the proposed method on a diverse set of dynamic scenes.

Keywords: video surveillance, background subtraction, contrast limited histogram equalization, illumination invariance, object tracking, object detection, behavior understanding, dynamic scenes

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Authors: Belkacem Ould Said, Nourddine Retiel, Abdelilah Benazza, Mohamed Aichouni

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In this paper, a numerical study of two-dimensional steady flow has been made of natural convection in a differentially heated vertical conical partially annular space. The heat transfer is assumed to take place by natural convection. The inner and outer surfaces of annulus are maintained at uniform wall temperature. The annulus is filled with air. The CFD FLUENT12.0 code is used to solve the governing equations of mass, momentum and energy using constant properties and the Boussinesq approximation for density variation. The streamlines and the isotherms of the fluid are presented for different annuli with different boundary conditions and Rayleigh numbers. Emphasis is placed on the influences of the height of the inner vertical cone on the flow and the temperature fields. In addition, the effects on the heat transfer are discussed for various values of physical parameters of the fluid and geometric parameters of the annulus. The heat transfer on the hot walls of the annulus is also calculated in order to make comparisons between the cylinder annulus for boundary conditions and several Rayleigh numbers. A good agreement of Nusselt number has been found between the present predictions and reference from the literature data.

Keywords: natural convection, heat transfer, numerical simulation, conical partially, annular space

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Authors: Mehdi Ghatei, Masoomeh Lorestani

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Upstream Tailings Storage Facilities (TSFs) may experience slope instabilities due to soil liquefaction, especially in regions known to be seismically active. In this study, liquefaction susceptibility of an upstream-raised TSF in Western Australia was assessed using two different approaches. The first approach assessed liquefaction susceptibility using Cone Penetration Tests with pore pressure measurement (CPTu) as described by the National Centre for Earthquake Engineering Research (NCEER). This assessment was based on the four CPTu tests that were conducted on the perimeter embankment of the TSF. The second approach used the Finite Element (FE) method with application of an equivalent linear model to predict the undrained cyclic behavior, the pore water pressure and the liquefaction of the materials. The tailings parameters were estimated from the CPTu profiles and from the laboratory tests. The cyclic parameters were estimated from the literature where test results of similar material were available. The results showed that there was a good agreement, in the liquefaction susceptibility of the tailings material, between the NCEER and FE methods with equivalent linear model.

Keywords: liquefaction , CPTU, NCEER, finite element method, equivalent linear model

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Authors: M. O. Bayram, H. B. Gencdal, N. O. Fercan, B. Basbug

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Liquid limit, which is used as a measure of soil strength, can be detected by Casagrande and fall-cone testing methods. The two methods majorly diverge from each other in terms of operator dependency. The Casagrande method that is applied according to ASTM D4318-17 standards may give misleading results, especially if the calibration process is not performed well. To reveal the effect of calibration for drop height and amount of soil paste placement in the Casagrande cup, a series of tests were carried out by multipoint method as it is specified in the ASTM standards. The tests include the combination of 6 mm, 8 mm, 10 mm, and 12 mm drop heights and under-filled, half-filled, and full-filled Casagrande cups by kaolinite samples. It was observed that during successive tests, the drop height of the cup deteriorated; hence the device was recalibrated before and after each test to provide the accuracy of the results. Besides, the tests by under-filled and full-filled samples for higher drop heights revealed lower liquid limit values than the lower drop heights revealed. For the half-filled samples, it was clearly seen that the liquid limit values didn’t change at all as the drop height increased, and this explains the function of standard specifications.

Keywords: calibration, casagrande cup method, drop height, kaolinite, liquid limit, placing form

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Authors: E. Kotrotsiou, A. S. Topsioti, S. Mantzoukas, E. Dragioti, M. Gouva

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Introduction: The literature has demonstrated that individual and psychological factors have a direct effect on the perceptions and attitudes of women with cancer. Objectives: To investigate the relationship between the fear of cancer and anxiety. Aim: To examine the impact of the fear of cancer in women with state and trait anxiety of women. Methods: A community sample of 286 women (mean age 39.6 years, SD = 9.5 ranged 20-60) participated in the current study. The women completed a) State - Trait Anxiety Inventory (STAI) and b) questionnaire concerning socio-demographic information and questions for fear of cancer. Results: The perception of fear in women with cancer is statistically independent from their age (t–test, p = 0.58), their family status (χ2, p = 0.519), their place of residency (χ2, p = 0.148), the manifestation of gynecological cancer (χ2, p = 0.979) or the manifestation of any type of cancer in the family (χ2, p = 0.277). In contrast, it was observed that there was a dependence in relation to a total of phobias (χ2, p = 0.003), the fear of illness (χ2, p< 0.001) and the fear of heights (χ2, p = 0.004). Furthermore, the participants that responded that they feared cancer displayed greater level of stress both as situation (t=-3.462; p=0.001) and as a trait of their personality (t=-4.377; p<0.001), and at the same time they displayed greater levels of depression in comparisons with the other participants. Furthermore, following multiple linear regression analysis it was observed that the participants that responded positively to the question if they feared cancer had 8, 3 units greater stress level as a personality trait in comparison to women that responded negatively to the question if they feared cancer (B=8.3; p=0.016; R2=0.506). Conclusion: Women’s fear of cancer is statistically independent from their age, family status, place of residency, the manifestation of gynaecological cancer and with the manifestation of cancer any type in the family. In contrast, there is a dependency with the total of phobias, fear of illness and fear of heights. Women that state that they have a fear of cancer manifest greater levels of stress from the rest of the participants both as situation and as a trait of their personality (p = 0.001 and p< 0.001 accordingly). In specific, the study demonstrated that the participants that positively to the question if they feared cancer had 8,3 units greater stress level as a personality trait in comparison to women that responded negatively.

Keywords: fear, women health, anxiety, psychology, cancer

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