Search results for: clinical information system
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 27426

Search results for: clinical information system

26766 Organisationmatcher: An Organisation Ranking System for Student Placement Using Preference Weights

Authors: Nor Sahida Ibrahim, Ruhaila Maskat, Aishah Ahmad

Abstract:

Almost all tertiary-level students will undergo some form of training in organisations prior to their graduation. This practice provides the necessary exposure and experience to allow students to cope with actual working environment and culture in the future. Nevertheless, a particular degree of “matching” between what is expected and what can be offered between students and organisations underpins how effective and enriching the experience is. This matching of students and organisations is challenging when preferences from both parties must be satisfied. This work developed a web-based system, namely the OrganisationMatcher, which leverage on the use of preference weights to score each organisation and rank them based on “suitability”. OrganisationMatcher has been implemented on a relational database, designed using object-oriented methods and developed using PHP programming language for browser front-end access. We outline the challenges and limitations of our system and discuss future improvements to the system, specifically in the utilisation of intelligent methods.

Keywords: student industrial placement, information system, web-based, ranking

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26765 Design an Expert System to Assess the Hydraulic System in Thermal and Hydrodynamic Aspect

Authors: Ahmad Abdul-Razzak Aboudi Al-Issa

Abstract:

Thermal and Hydrodynamic are basic aspects in any hydraulic system and therefore, they must be assessed with regard to this aspect before constructing the system. This assessment needs a good expertise in this aspect to obtain an efficient hydraulic system. Therefore, this study aims to build an expert system called Hydraulic System Calculations (HSC) to ensure a smooth operation for the hydraulic system. The expert system (HSC) had been designed and coded in an user-friendly interactive program called Microsoft Visual Basic 2010. The suggested code provides the designer with a number of choices to resolve the problem of hydraulic oil overheating which may arise during the continuous operation of the hydraulic unit. As a result, the HSC can minimize the human errors, effort, time and cost of hydraulic machine design.

Keywords: fluid power, hydraulic system, thermal and hydrodynamic, expert system

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26764 Issues in Implementation of Vertical Greenery System on Existing Government Building in Malaysia

Authors: Jamilah Halina Abdul Halim, Norsiah Hassan, Azlina Aziz, Norhayati Mat Wajid, Mohd Saipul Asrafi

Abstract:

There are various types of vertical greenery system (VGS) in Malaysia, but none is installed at government buildings, although the government is looking into energy efficient building design. This is due to lack of technical information that focus on the maintenance and care, issues, and challenges face by vertical greenery system under tropical climate conditions. This research aim to identify issues in implementation of vertical greenery system on existing government building in Malaysia. The methodology used are literature reviews (desktop study), observation on sites, and case studies. Initial findings indicates that design and maintenance issues of vertical greenery system are the main challenges faced mainly by designer, especially those who involved in decision-making process. It can be concluded that orientation, openings, maintenance, performance, longevity, structural load, access, wind resistance, design failure, system failure, and lack of maintenance foresight are the main factors that need to be considered. These factors should be holistically aligned towards the economic cost, effective time, and quality design in implementation of vertical greenery system on existing government building. A comprehensive implementation of vertical greenery system will lead to greater sustainable investment for government buildings and responsive action to climate change.

Keywords: issues, government building, maintenance, vertical greenery system

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26763 Structured Cross System Planning and Control in Modular Production Systems by Using Agent-Based Control Loops

Authors: Simon Komesker, Achim Wagner, Martin Ruskowski

Abstract:

In times of volatile markets with fluctuating demand and the uncertainty of global supply chains, flexible production systems are the key to an efficient implementation of a desired production program. In this publication, the authors present a holistic information concept taking into account various influencing factors for operating towards the global optimum. Therefore, a strategy for the implementation of multi-level planning for a flexible, reconfigurable production system with an alternative production concept in the automotive industry is developed. The main contribution of this work is a system structure mixing central and decentral planning and control evaluated in a simulation framework. The information system structure in current production systems in the automotive industry is rigidly hierarchically organized in monolithic systems. The production program is created rule-based with the premise of achieving uniform cycle time. This program then provides the information basis for execution in subsystems at the station and process execution level. In today's era of mixed-(car-)model factories, complex conditions and conflicts arise in achieving logistics, quality, and production goals. There is no provision for feedback loops of results from the process execution level (resources) and process supporting (quality and logistics) systems and reconsideration in the planning systems. To enable a robust production flow, the complexity of production system control is artificially reduced by the line structure and results, for example in material-intensive processes (buffers and safety stocks - two container principle also for different variants). The limited degrees of freedom of line production have produced the principle of progress figure control, which results in one-time sequencing, sequential order release, and relatively inflexible capacity control. As a result, modularly structured production systems such as modular production according to known approaches with more degrees of freedom are currently difficult to represent in terms of information technology. The remedy is an information concept that supports cross-system and cross-level information processing for centralized and decentralized decision-making. Through an architecture of hierarchically organized but decoupled subsystems, the paradigm of hybrid control is used, and a holonic manufacturing system is offered, which enables flexible information provisioning and processing support. In this way, the influences from quality, logistics, and production processes can be linked holistically with the advantages of mixed centralized and decentralized planning and control. Modular production systems also require modularly networked information systems with semi-autonomous optimization for a robust production flow. Dynamic prioritization of different key figures between subsystems should lead the production system to an overall optimum. The tasks and goals of quality, logistics, process, resource, and product areas in a cyber-physical production system are designed as an interconnected multi-agent-system. The result is an alternative system structure that executes centralized process planning and decentralized processing. An agent-based manufacturing control is used to enable different flexibility and reconfigurability states and manufacturing strategies in order to find optimal partial solutions of subsystems, that lead to a near global optimum for hybrid planning. This allows a robust near to plan execution with integrated quality control and intralogistics.

Keywords: holonic manufacturing system, modular production system, planning, and control, system structure

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26762 Gendered Effects on Productivity Gap Due to Information Asymmetry in India

Authors: Shruti Sengupta

Abstract:

According to the nationally representative data, about 73% of India's rural workforce is engaged in agriculture. While women make significant contributions to total agriculture production, they contribute to about one-third in India. In terms of gender composition, about 80% of the female and 69% of the male workforce is engaged in agriculture in rural India. Still, it is common to find gender differences in plot management within the household. In the last two and half years, India's agri-food system has undergone several changes due to this pandemic, both the demand and supply side, making agriculture more information and knowledge-intensive. Therefore, this paper investigates, using a nationally representative sample, how information asymmetry affects the net returns per hectare of land between female and male farm managers. Empirical results show that information intensity has a significant positive effect on net farm returns per hectare. Results suggest that if females have the same access to technical information as their male counterparts, their farm income can go up by .96 pp compared to male-headed farms. Results also indicate that literate females have higher farm incomes than non-literate females. The study contributes to the literature by employing gender differentials in farm income due to the information gap.

Keywords: agriculture, gender, information asymmetry, farm income, social bias

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26761 Regulation on the Protection of Personal Data Versus Quality Data Assurance in the Healthcare System Case Report

Authors: Elizabeta Krstić Vukelja

Abstract:

Digitization of personal data is a consequence of the development of information and communication technologies that create a new work environment with many advantages and challenges, but also potential threats to privacy and personal data protection. Regulation (EU) 2016/679 of the European Parliament and of the Council is becoming a law and obligation that should address the issues of personal data protection and information security. The existence of the Regulation leads to the conclusion that national legislation in the field of virtual environment, protection of the rights of EU citizens and processing of their personal data is insufficiently effective. In the health system, special emphasis is placed on the processing of special categories of personal data, such as health data. The healthcare industry is recognized as a particularly sensitive area in which a large amount of medical data is processed, the digitization of which enables quick access and quick identification of the health insured. The protection of the individual requires quality IT solutions that guarantee the technical protection of personal categories. However, the real problems are the technical and human nature and the spatial limitations of the application of the Regulation. Some conclusions will be drawn by analyzing the implementation of the basic principles of the Regulation on the example of the Croatian health care system and comparing it with similar activities in other EU member states.

Keywords: regulation, healthcare system, personal dana protection, quality data assurance

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26760 SISSLE in Consensus-Based Ripple: Some Improvements in Speed, Security, Last Mile Connectivity and Ease of Use

Authors: Mayank Mundhra, Chester Rebeiro

Abstract:

Cryptocurrencies are rapidly finding wide application in areas such as Real Time Gross Settlements and Payments Systems. Ripple is a cryptocurrency that has gained prominence with banks and payment providers. It solves the Byzantine General’s Problem with its Ripple Protocol Consensus Algorithm (RPCA), where each server maintains a list of servers, called Unique Node List (UNL) that represents the network for the server, and will not collectively defraud it. The server believes that the network has come to a consensus when members of the UNL come to a consensus on a transaction. In this paper we improve Ripple to achieve better speed, security, last mile connectivity and ease of use. We implement guidelines and automated systems for building and maintaining UNLs for resilience, robustness, improved security, and efficient information propagation. We enhance the system so as to ensure that each server receives information from across the whole network rather than just from the UNL members. We also introduce the paradigm of UNL overlap as a function of information propagation and the trust a server assigns to its own UNL. Our design not only reduces vulnerabilities such as eclipse attacks, but also makes it easier to identify malicious behaviour and entities attempting to fraudulently Double Spend or stall the system. We provide experimental evidence of the benefits of our approach over the current Ripple scheme. We observe ≥ 4.97x and 98.22x in speedup and success rate for information propagation respectively, and ≥ 3.16x and 51.70x in speedup and success rate in consensus.

Keywords: Ripple, Kelips, unique node list, consensus, information propagation

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26759 Information Literacy Skills of Legal Practitioners in Khyber Pakhtunkhwa-Pakistan: An Empirical Study

Authors: Saeed Ullah Jan, Shaukat Ullah

Abstract:

Purpose of the study: The main theme of this study is to explore the information literacy skills of the law practitioners in Khyber Pakhtunkhwa-Pakistan under the heading "Information Literacy Skills of Legal Practitioners in Khyber Pakhtunkhwa-Pakistan: An Empirical Study." Research Method and Procedure: To conduct this quantitative study, the simple random sample approach is used. An adapted questionnaire is distributed among 254 lawyers of Dera Ismail Khan through personal visits and electronic means. The data collected is analyzed through SPSS (Statistical Package for Social Sciences) software. Delimitations of the study: The study is delimited to the southern district of Khyber Pakhtunkhwa: Dera Ismael Khan. Key Findings: Most of the lawyers of District Dera Ismail Khan of Khyber Pakhtunkhwa can recognize and understand the needed information. A large number of lawyers are capable of presenting information in both written and electronic forms. They are not comfortable with different legal databases and using various searching and keyword techniques. They have less knowledge of Boolean operators for locating online information. Conclusion and Recommendations: Efforts should be made to arrange refresher courses and training workshops on the utilization of different legal databases and different search techniques for retrieval of information sources. This practice will enhance the information literacy skills of lawyers, which will ultimately result in a better legal system in Pakistan. Practical implication(s): The findings of the study will motivate the policymakers and authorities of legal forums to restructure the information literacy programs to fulfill the lawyers' information needs. Contribution to the knowledge: No significant work has been done on the lawyers' information literacy skills in Khyber Pakhtunkhwa-Pakistan. It will bring a clear picture of the information literacy skills of law practitioners and address the problems faced by them during the seeking process.

Keywords: information literacy-Pakistan, infromation literacy-lawyers, information literacy-lawyers-KP, law practitioners-Pakistan

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26758 A Generative Pretrained Transformer-Based Question-Answer Chatbot and Phantom-Less Quantitative Computed Tomography Bone Mineral Density Measurement System for Osteoporosis

Authors: Mian Huang, Chi Ma, Junyu Lin, William Lu

Abstract:

Introduction: Bone health attracts more attention recently and an intelligent question and answer (QA) chatbot for osteoporosis is helpful for science popularization. With Generative Pretrained Transformer (GPT) technology developing, we build an osteoporosis corpus dataset and then fine-tune LLaMA, a famous open-source GPT foundation large language model(LLM), on our self-constructed osteoporosis corpus. Evaluated by clinical orthopedic experts, our fine-tuned model outperforms vanilla LLaMA on osteoporosis QA task in Chinese. Three-dimensional quantitative computed tomography (QCT) measured bone mineral density (BMD) is considered as more accurate than DXA for BMD measurement in recent years. We develop an automatic Phantom-less QCT(PL-QCT) that is more efficient for BMD measurement since no need of an external phantom for calibration. Combined with LLM on osteoporosis, our PL-QCT provides efficient and accurate BMD measurement for our chatbot users. Material and Methods: We build an osteoporosis corpus containing about 30,000 Chinese literatures whose titles are related to osteoporosis. The whole process is done automatically, including crawling literatures in .pdf format, localizing text/figure/table region by layout segmentation algorithm and recognizing text by OCR algorithm. We train our model by continuous pre-training with Low-rank Adaptation (LoRA, rank=10) technology to adapt LLaMA-7B model to osteoporosis domain, whose basic principle is to mask the next word in the text and make the model predict that word. The loss function is defined as cross-entropy between the predicted and ground-truth word. Experiment is implemented on single NVIDIA A800 GPU for 15 days. Our automatic PL-QCT BMD measurement adopt AI-associated region-of-interest (ROI) generation algorithm for localizing vertebrae-parallel cylinder in cancellous bone. Due to no phantom for BMD calibration, we calculate ROI BMD by CT-BMD of personal muscle and fat. Results & Discussion: Clinical orthopaedic experts are invited to design 5 osteoporosis questions in Chinese, evaluating performance of vanilla LLaMA and our fine-tuned model. Our model outperforms LLaMA on over 80% of these questions, understanding ‘Expert Consensus on Osteoporosis’, ‘QCT for osteoporosis diagnosis’ and ‘Effect of age on osteoporosis’. Detailed results are shown in appendix. Future work may be done by training a larger LLM on the whole orthopaedics with more high-quality domain data, or a multi-modal GPT combining and understanding X-ray and medical text for orthopaedic computer-aided-diagnosis. However, GPT model gives unexpected outputs sometimes, such as repetitive text or seemingly normal but wrong answer (called ‘hallucination’). Even though GPT give correct answers, it cannot be considered as valid clinical diagnoses instead of clinical doctors. The PL-QCT BMD system provided by Bone’s QCT(Bone’s Technology(Shenzhen) Limited) achieves 0.1448mg/cm2(spine) and 0.0002 mg/cm2(hip) mean absolute error(MAE) and linear correlation coefficient R2=0.9970(spine) and R2=0.9991(hip)(compared to QCT-Pro(Mindways)) on 155 patients in three-center clinical trial in Guangzhou, China. Conclusion: This study builds a Chinese osteoporosis corpus and develops a fine-tuned and domain-adapted LLM as well as a PL-QCT BMD measurement system. Our fine-tuned GPT model shows better capability than LLaMA model on most testing questions on osteoporosis. Combined with our PL-QCT BMD system, we are looking forward to providing science popularization and early morning screening for potential osteoporotic patients.

Keywords: GPT, phantom-less QCT, large language model, osteoporosis

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26757 Impact of Serum Estrogen and Progesterone Levels in the Outcome Pregnancy Rate in Frozen Embryo Transfer Cycles. A Prospective Cohort Study

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

Abstract:

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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26756 Neonatology Clinical Routine in Cats and Dogs: Cases, Main Conditions and Mortality

Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

The neonatal care of cats and dogs represents a challenge to veterinarians due to the small size of the newborns and their physiological particularities. In addition, many Veterinary Medicine colleges around the world do not include neonatology in the curriculum, which makes it less likely for the veterinarian to have basic knowledge regarding neonatal care and worsens the clinical care these patients receive. Therefore, lack of assistance and negligence have become frequent in the field, which contributes towards the high mortality rates. This study aims at describing cases and the main conditions pertaining to the neonatology clinical routine in cats and dogs, highlighting the importance of specialized care in this field of Veterinary Medicine. The study included 808 neonates admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil, between January 2018 and November 2019. Of these, 87.3% (705/808) were dogs and 12.7% (103/808) were cats. Among the neonates admitted, 57.3% (463/808) came from emergency c-sections due to dystocia, 8.7% (71/808) cane from vaginal deliveries with obstetric maneuvers due to dystocia, and 34% (274/808) were admitted for clinical care due to neonatal conditions. Among the neonates that came from emergency c-sections and vaginal deliveries, 47.3% (253/534) was born in respiratory distress due to severe hypoxia or persistent apnea and required resuscitation procedure, such as the Jen Chung acupuncture point (VG26), oxygen therapy with mask, pulmonary expansion with resuscitator, heart massages and administration of emergency medication, such as epinephrine. On the other hand, in the neonatal clinical care, the main conditions and alterations observed in the newborns were omphalophlebitis, toxic milk syndrome, neonatal conjunctivitis, swimmer puppy syndrome, neonatal hemorrhagic syndrome, pneumonia, trauma, low weight at birth, prematurity, congenital malformations (cleft palate, cleft lip, hydrocephaly, anasarca, vascular anomalies in the heart, anal atresia, gastroschisis, omphalocele, among others), neonatal sepsis and other local and systemic bacterial infections, viral infections (feline respiratory complex, parvovirus, canine distemper, canine infectious traqueobronchitis), parasitical infections (Toxocara spp., Ancylostoma spp., Strongyloides spp., Cystoisospora spp., Babesia spp. and Giardia spp.) and fungal infections (dermatophytosis by Microsporum canis). The most common clinical presentation observed was the neonatal triad (hypothermia, hypoglycemia and dehydration), affecting 74.6% (603/808) of the patients. The mortality rate among the neonates was 10.5% (85/808). Being knowledgeable about neonatology is essential for veterinarians to provide adequate care for these patients in the clinical routine. Adding neonatology to college curriculums, improving the dissemination of information on the subject, and providing annual training in neonatology for veterinarians and employees are important to improve immediate care and reduce the mortality rates.

Keywords: neonatal care, puppies, neonatal, conditions

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26755 The Implementation of Level of Service for Development of Kuala Lumpur Transit Information System using GIS

Authors: Mokhtar Azizi

Abstract:

Due to heavy traffic and congested roads, it is crucial that the most popular main public transport services in Kuala Lumpur i.e. Putra LRT, Star LRT, KTM Commuter, KL Monorail and Rapid Bus must be continuously monitored and improved to fulfill the rider’s requirement and kept updated by the transit agencies. Evaluation on the current status of the services has been determined out by calculating the transit supportive area (TSA) and level of service (LOS) for each transit station. This research study has carried out the TSA and LOS mapping based on GIS techniques. The detailed census data of the region along the line of services has been collected from the Department of Statistics Malaysia for this purpose. The service coverage has been decided by 400 meters buffer zone for bus stations and 800 meters for rails station and railways in measurement the Quality of Service along the line of services. All the required information has been calculated by using the customized GIS software called Kuala Lumpur Transit Information System (KLTIS). The transit supportive area was calculated with the employment density at least 10 job/hectare or household density at 7.5 unit/hectare and total area covered by transit supportive area is 22516 hectare and the total area that is not supported by transit is 1718 hectare in Kuala Lumpur. The level of service is calculated with the percentage of transit supportive area served by transit for each station. In overall the percentage transit supportive areas served by transit for all the stations were less than 50% which falls in a very low level of service category. This research has proven its benefit by providing the current transit services operators with vital information for improvement of existing public transport services.

Keywords: service coverage, transit supportive area, level of service, transit system

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26754 Antifungal Susceptibility of Yeasts Isolated from Clinical Samples from a Tertiary Hospital from State of Puebla

Authors: Ricardo Munguia-Perez, Nayeli Remigio-Alvarado, M.Miriam Hernandez-Arroyo, Elsa Castañeda-Roldan

Abstract:

Fungi have emerged as important pathogens causing morbidity and mortality mainly in immunosuppressed, malnourished and elderly patients. It has detected an increase in resistance to azoles primarily to fluconazol. The fungal infections have become a problem of public health for the resistance to antifungal agents, they have developed new antifungals with broad-spectrum. The aim of this study was determine the antifungal susceptibility of yeasts isolated from clinical samples (respiratory secretions, exudates, wounds, blood cultures, urine cultures) obtained from inpatients and outpatients of a tertiary hospital from State of Puebla. The antifungal susceptibility of the yeast from several clinical samples were determined by the CLS M44-A disk diffusion methods. 149 samples of yeast were analyzed. All species were 100% susceptible to nystatin and amphotericin B. Candida albicans showed resistance of 95.5 % to fluconazole, 50.7 % to 5-flurocytosine and 55.2 % intermediate susceptibility to ketoconazole. Candida glabrata 81.3 % was susceptibility to ketoconazole and 75 % to fluconazole, for the case of 5-flurocytosine the 56.3 % was susceptible. Candida krusei 100 % was susceptible to ketoconazole, 50 % to fluconazole and 37.5 % to 5-flurocytosine. The internal medicine have greater diversity of yeast, the samples have susceptibility of 64.7% to ketoconazole, 47.1 % to fluconazole and 27.5 % to 5-flurocytosine. Hospitalized patients are more resistant to fluconazole and nystatin, but in the case of outpatients presents resistance to ketoconazole.

Keywords: antifungal, susceptibility, yeast, clinical samples

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26753 Osteoarticular Ultrasound for Diagnostic Purposes in the Practice of the Rheumatologist

Authors: A. Ibovi Mouondayi, S. Zaher, K. Nassar, S. Janani

Abstract:

Introduction: Osteoarticular ultrasound has become an essential tool for the investigation and monitoring of osteoarticular pathologies for rheumatologists. It is performed in the clinic, cheap to access than other imaging technics. Important anatomical sites of inflammation in inflammatory diseases such as synovium, tendon sheath, and enthesis are easily identifiable on ultrasound. Objective: The objective of this study was to evaluate the importance of ultrasound for rheumatologists in the development of diagnoses of inflammatory rheumatism in cases of uncertain clinical presentation. Material and Methods: This is a retrospective study conducted in our department and carried out over a period of 30 months from January 2020 to June 2022. We included all patients with inflammatory arthralgia without clinical arthritis. Patients' data were collected through a patient operating system. Results: A total of 35 patients were identified, made up of 4 men and 31 women, with a sex ratio M/F of 0.12. The average age of the patients was 48.8 years, with extremes ranging from 17 years to 83 years. All patients had inflammatory polyarthralgia for an average of 9.3 years. Only two patients had suspicious synovitis on clinical examination. 91.43% of patients had a positive inflammatory assessment with an average CRP of 22.2 mg/L. Rheumatoid factor (RF) was present in 45.7% of patients and anti-CCP in 48.57%, with respective averages of 294.43 and 314.63 international units/mL. Radiographic lesions were found in 54% of patients. Osteoarticular ultrasound was performed in all these patients. Subclinical synovitis was found in 60% of patients, including 23% Doppler positive. Tenosynovitis was found in 11% of patients. Enthesitis was objectified in 3% of patients. Rheumatoid arthritis (RA) was retained in 40% of patients; psoriatic arthritis in 6% of patients, hydroxyapatite arthritis, and osteoarthritis in 3% each. Conclusion: Osteoarticular ultrasound has been an essential tool in the practice of rheumatology in recent years. It is for diagnostic purposes in chronic inflammatory rheumatism as well as in degenerative rheumatism and crystal induced arthropathies, but also essential in the follow-up of patients in rheumatology.

Keywords: ultrasound, skeletal, rheumatoid arthritis, arthralgia

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26752 Characterization of Chest Pain in Patients Consulting to the Emergency Department of a Health Institution High Level of Complexity during 2014-2015, Medellin, Colombia

Authors: Jorge Iván Bañol-Betancur, Lina María Martínez-Sánchez, María de los Ángeles Rodríguez-Gázquez, Estefanía Bahamonde-Olaya, Ana María Gutiérrez-Tamayo, Laura Isabel Jaramillo-Jaramillo, Camilo Ruiz-Mejía, Natalia Morales-Quintero

Abstract:

Acute chest pain is a distressing sensation between the diaphragm and the base of the neck and it represents a diagnostic challenge for any physician in the emergency department. Objective: To establish the main clinical and epidemiological characteristics of patients who present with chest pain to the emergency department in a private clinic from the city of Medellin, during 2014-2015. Methods: Cross-sectional retrospective observational study. Population and sample were patients who consulted for chest pain in the emergency department who met the eligibility criteria. The information was analyzed in SPSS program vr.21; qualitative variables were described through relative frequencies, and the quantitative through mean and standard deviation ‬or medians according to their distribution in the study population. Results: A total of 231 patients were evaluated, the mean age was 49.5 ± 19.9 years, 56.7% were females. The most frequent pathological antecedents were hypertension 35.5%, diabetes 10,8%, dyslipidemia 10.4% and coronary disease 5.2%. Regarding pain features, in 40.3% of the patients the pain began abruptly, in 38.2% it had a precordial location, for 20% of the cases physical activity acted as a trigger, and 60.6% was oppressive. Costochondritis was the most common cause of chest pain among patients with an established etiologic diagnosis, representing the 18.2%. Conclusions: Although the clinical features of pain reported coincide with the clinical presentation of an acute coronary syndrome, the most common cause of chest pain in study population was costochondritis instead, indicating that it is a differential diagnostic in the approach of patients with pain acute chest.

Keywords: acute coronary syndrome, chest pain, epidemiology, osteochondritis

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26751 Criminal Laws Associated with Cyber-Medicine and Telemedicine in Current Law Systems in the World

Authors: Shahryar Eslamitabar

Abstract:

Currently, the internet plays an important role in the various scientific, commercial and service practices. Thanks to information and communication technology, the healthcare industry via the internet, generally known as cyber-medicine, can offer professional medical service in a wider geographical area. Having some appealing benefits such as convenience in offering healthcare services, improved accessibility to the services, enhanced information exchange, cost-effectiveness, time-saving, etc. Tele-health has increasingly developed innovative models of healthcare delivery. However, it presents many potential hazards to cyber-patients, inherent in the use of the system. First, there are legal issues associated with the communication and transfer of information on the internet. These include licensure, malpractice, liabilities and jurisdictions as well as privacy, confidentiality and security of personal data as the most important challenge brought about by this system. Additional items of concern are technological and ethical. Although, there are some rules to deal with pitfalls associated with cyber-medicine practices in the USA and some European countries, yet for all developments, it is being practiced in a legal vacuum in many countries. In addition to the domestic legislations to deal with potential problems arisen from the system, it is also imperative that some international or regional agreement should be developed to achieve the harmonization of laws among countries and states. This article discusses some implications posed by the practice of cyber-medicine in the healthcare system according to the experience of some developed countries using a comparative study of laws. It will also review the status of tele-health laws in Iran. Finally, it is intended to pave the way to outline a plan for countries like Iran, with newly-established judicial system for health laws, to develop appropriate regulations through providing some recommendations.

Keywords: tele-health, cyber-medicine, telemedicine, criminal laws, legislations, time-saving

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26750 Integration of Educational Data Mining Models to a Web-Based Support System for Predicting High School Student Performance

Authors: Sokkhey Phauk, Takeo Okazaki

Abstract:

The challenging task in educational institutions is to maximize the high performance of students and minimize the failure rate of poor-performing students. An effective method to leverage this task is to know student learning patterns with highly influencing factors and get an early prediction of student learning outcomes at the timely stage for setting up policies for improvement. Educational data mining (EDM) is an emerging disciplinary field of data mining, statistics, and machine learning concerned with extracting useful knowledge and information for the sake of improvement and development in the education environment. The study is of this work is to propose techniques in EDM and integrate it into a web-based system for predicting poor-performing students. A comparative study of prediction models is conducted. Subsequently, high performing models are developed to get higher performance. The hybrid random forest (Hybrid RF) produces the most successful classification. For the context of intervention and improving the learning outcomes, a feature selection method MICHI, which is the combination of mutual information (MI) and chi-square (CHI) algorithms based on the ranked feature scores, is introduced to select a dominant feature set that improves the performance of prediction and uses the obtained dominant set as information for intervention. By using the proposed techniques of EDM, an academic performance prediction system (APPS) is subsequently developed for educational stockholders to get an early prediction of student learning outcomes for timely intervention. Experimental outcomes and evaluation surveys report the effectiveness and usefulness of the developed system. The system is used to help educational stakeholders and related individuals for intervening and improving student performance.

Keywords: academic performance prediction system, educational data mining, dominant factors, feature selection method, prediction model, student performance

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26749 Information Needs and Information Usage of the Older Person Club’s Members in Bangkok

Authors: Siriporn Poolsuwan

Abstract:

This research aims to explore the information needs, information usages, and problems of information usage of the older people club’s members in Dusit District, Bangkok. There are 12 clubs and 746 club’s members in this district. The research results use for older person service in this district. Data is gathered from 252 club’s members by using questionnaires. The quantitative approach uses in research by percentage, means and standard deviation. The results are as follows (1) The older people need Information for entertainment, occupation and academic in the field of short story, computer work, and religion and morality. (2) The participants use Information from various sources. (3) The Problem of information usage is their language skills because of the older people’s literacy problem.

Keywords: information behavior, older person, information seeking, knowledge discovery and data mining

Procedia PDF Downloads 254
26748 [Keynote Talk]: Mathematical and Numerical Modelling of the Cardiovascular System: Macroscale, Mesoscale and Microscale Applications

Authors: Aymen Laadhari

Abstract:

The cardiovascular system is centered on the heart and is characterized by a very complex structure with different physical scales in space (e.g. micrometers for erythrocytes and centimeters for organs) and time (e.g. milliseconds for human brain activity and several years for development of some pathologies). The development and numerical implementation of mathematical models of the cardiovascular system is a tremendously challenging topic at the theoretical and computational levels, inducing consequently a growing interest over the past decade. The accurate computational investigations in both healthy and pathological cases of processes related to the functioning of the human cardiovascular system can be of great potential in tackling several problems of clinical relevance and in improving the diagnosis of specific diseases. In this talk, we focus on the specific task of simulating three particular phenomena related to the cardiovascular system on the macroscopic, mesoscopic and microscopic scales, respectively. Namely, we develop numerical methodologies tailored for the simulation of (i) the haemodynamics (i.e., fluid mechanics of blood) in the aorta and sinus of Valsalva interacting with highly deformable thin leaflets, (ii) the hyperelastic anisotropic behaviour of cardiomyocytes and the influence of calcium concentrations on the contraction of single cells, and (iii) the dynamics of red blood cells in microvasculature. For each problem, we present an appropriate fully Eulerian finite element methodology. We report several numerical examples to address in detail the relevance of the mathematical models in terms of physiological meaning and to illustrate the accuracy and efficiency of the numerical methods.

Keywords: finite element method, cardiovascular system, Eulerian framework, haemodynamics, heart valve, cardiomyocyte, red blood cell

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26747 Syntactic Analyzer for Tamil Language

Authors: Franklin Thambi Jose.S

Abstract:

Computational Linguistics is a branch of linguistics, which deals with the computer and linguistic levels. It is also said, as a branch of language studies which applies computer techniques to linguistics field. In Computational Linguistics, Natural Language Processing plays an important role. This came to exist because of the invention of Information Technology. In computational syntax, the syntactic analyser breaks a sentence into phrases and clauses and identifies the sentence with the syntactic information. Tamil is one of the major Dravidian languages, which has a very long written history of more than 2000 years. It is mainly spoken in Tamilnadu (in India), Srilanka, Malaysia and Singapore. It is an official language in Tamilnadu (in India), Srilanka, Malaysia and Singapore. In Malaysia Tamil speaking people are considered as an ethnic group. In Tamil syntax, the sentences in Tamil are classified into four for this research, namely: 1. Main Sentence 2. Interrogative Sentence 3. Equational Sentence 4. Elliptical Sentence. In computational syntax, the first step is to provide required information regarding the head and its constituent of each sentence. This information will be incorporated to the system using programming languages. Now the system can easily analyse a given sentence with the criteria or mechanisms given to it. Providing needful criteria or mechanisms to the computer to identify the basic types of sentences using Syntactic parser in Tamil language is the major objective of this paper.

Keywords: tamil, syntax, criteria, sentences, parser

Procedia PDF Downloads 500
26746 An Efficient and Provably Secure Three-Factor Authentication Scheme with Key Agreement

Authors: Mohan Ramasundaram, Amutha Prabakar Muniyandi

Abstract:

Remote user authentication is one of the important tasks for any kind of remote server applications. Several remote authentication schemes are proposed by the researcher for Telecare Medicine Information System (TMIS). Most of the existing techniques have limitations, vulnerable to various kind attacks, lack of functionalities, information leakage, no perfect forward security and ineffectiveness. Authentication is a process of user verification mechanism for allows him to access the resources of a server. Nowadays, most of the remote authentication protocols are using two-factor authentications. We have made a survey of several remote authentication schemes using three factors and this survey shows that the most of the schemes are inefficient and subject to several attacks. We observed from the experimental evaluation; the proposed scheme is very secure against various known attacks that include replay attack, man-in-the-middle attack. Furthermore, the analysis based on the communication cost and computational cost estimation of the proposed scheme with related schemes shows that our proposed scheme is efficient.

Keywords: Telecare Medicine Information System, elliptic curve cryptography, three-factor, biometric, random oracle

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26745 Integration of GIS with Remote Sensing and GPS for Disaster Mitigation

Authors: Sikander Nawaz Khan

Abstract:

Natural disasters like flood, earthquake, cyclone, volcanic eruption and others are causing immense losses to the property and lives every year. Current status and actual loss information of natural hazards can be determined and also prediction for next probable disasters can be made using different remote sensing and mapping technologies. Global Positioning System (GPS) calculates the exact position of damage. It can also communicate with wireless sensor nodes embedded in potentially dangerous places. GPS provide precise and accurate locations and other related information like speed, track, direction and distance of target object to emergency responders. Remote Sensing facilitates to map damages without having physical contact with target area. Now with the addition of more remote sensing satellites and other advancements, early warning system is used very efficiently. Remote sensing is being used both at local and global scale. High Resolution Satellite Imagery (HRSI), airborne remote sensing and space-borne remote sensing is playing vital role in disaster management. Early on Geographic Information System (GIS) was used to collect, arrange, and map the spatial information but now it has capability to analyze spatial data. This analytical ability of GIS is the main cause of its adaption by different emergency services providers like police and ambulance service. Full potential of these so called 3S technologies cannot be used in alone. Integration of GPS and other remote sensing techniques with GIS has pointed new horizons in modeling of earth science activities. Many remote sensing cases including Asian Ocean Tsunami in 2004, Mount Mangart landslides and Pakistan-India earthquake in 2005 are described in this paper.

Keywords: disaster mitigation, GIS, GPS, remote sensing

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26744 Integration GIS–SCADA Power Systems to Enclosure Air Dispersion Model

Authors: Ibrahim Shaker, Amr El Hossany, Moustafa Osman, Mohamed El Raey

Abstract:

This paper will explore integration model between GIS–SCADA system and enclosure quantification model to approach the impact of failure-safe event. There are real demands to identify spatial objects and improve control system performance. Nevertheless, the employed methodology is predicting electro-mechanic operations and corresponding time to environmental incident variations. Open processing, as object systems technology, is presented for integration enclosure database with minimal memory size and computation time via connectivity drivers such as ODBC:JDBC during main stages of GIS–SCADA connection. The function of Geographic Information System is manipulating power distribution in contrast to developing issues. In other ward, GIS-SCADA systems integration will require numerical objects of process to enable system model calibration and estimation demands, determine of past events for analysis and prediction of emergency situations for response training.

Keywords: air dispersion model, environmental management, SCADA systems, GIS system, integration power system

Procedia PDF Downloads 348
26743 Application of WHO's Guideline to Evaluating Apps for Smoking Cessation

Authors: Suin Seo, Sung-Il Cho

Abstract:

Background: The use of mobile apps for smoking cessation has grown exponentially in recent years. Yet, there were limited researches which evaluated the quality of smoking cessation apps to our knowledge. In most cases, a clinical practice guideline which is focused on clinical physician was used as an evaluation tool. Objective: The objective of this study was to develop a user-centered measure for quality of mobile smoking cessation apps. Methods: A literature search was conducted to identify articles containing explicit smoking cessation guideline for smoker published until January 2018. WHO’s guide for tobacco users to quit was adopted for evaluation tool which assesses smoker-oriented contents of smoking cessation apps. Compared to the clinical practice guideline, WHO guideline was designed for smokers (non-specialist). On the basis of existing criteria which was developed based on 2008 clinical practice guideline for Treating Tobacco Use and Dependence, evaluation tool was modified and developed by an expert panel. Results: There were five broad categories of criteria that were identified including five objective quality scales: enhancing motivation, assistance with a planning and making quit attempts, preparation for relapse, self-efficacy, connection to smoking. Enhancing motivation and assistance with planning and making quit attempts were similar to contents of clinical practice guideline, but preparation for relapse, self-efficacy and connection to smoking (environment or habit which reminds of smoking) only existed on WHO guideline. WHO guideline had more user-centered elements than clinical guideline. Especially, self-efficacy is the most important determinant of behavior change in accordance with many health behavior change models. With the WHO guideline, it is now possible to analyze the content of the app in the light of a health participant, not a provider. Conclusion: The WHO guideline evaluation tool is a simple, reliable and smoker-centered tool for assessing the quality of mobile smoking cessation apps. It can also be used to provide a checklist for the development of new high-quality smoking cessation apps.

Keywords: smoking cessation, evaluation, mobile application, WHO, guideline

Procedia PDF Downloads 172
26742 High-Throughput Mechanized Microfluidic Test Groundwork for Precise Microbial Genomics

Authors: Pouya Karimi, Ramin Gasemi Shayan, Parsa Sheykhzade

Abstract:

Ease shotgun DNA sequencing is changing the microbial sciences. Sequencing instruments are compelling to the point that example planning is currently the key constraining element. Here, we present a microfluidic test readiness stage that incorporates the key strides in cells to grouping library test groundwork for up to 96 examples and decreases DNA input prerequisites 100-overlay while keeping up or improving information quality. The universally useful microarchitecture we show bolsters work processes with subjective quantities of response and tidy up or catch steps. By decreasing the example amount necessities, we empowered low-input (∼10,000 cells) entire genome shotgun (WGS) sequencing of Mycobacterium tuberculosis and soil miniaturized scale settlements with prevalent outcomes. We additionally utilized the upgraded throughput to succession ∼400 clinical Pseudomonas aeruginosa libraries and exhibit magnificent single-nucleotide polymorphism discovery execution that clarified phenotypically watched anti-toxin opposition. Completely coordinated lab-on-chip test arrangement beats specialized boundaries to empower more extensive organization of genomics across numerous fundamental research and translational applications.

Keywords: clinical microbiology, DNA, microbiology, microbial genomics

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26741 Understanding the Prevalence and Expression of Virulence Factors Harbored by Enterotoxigenic Escherichia Coli

Authors: Debjyoti Bhakat, Indranil Mondal, Asish K. Mukhopadayay, Nabendu S. Chatterjee

Abstract:

Enterotoxigenic Escherichia coli is one of the leading causes of diarrhea in infants and travelers in developing countries. Colonization factors play an important role in pathogenesis and are one of the main targets for Enterotoxigenic Escherichia coli (ETEC) vaccine development. However, ETEC vaccines had poorly performed in the past, as the prevalence of colonization factors is region-dependent. There are more than 25 classical colonization factors presently known to be expressed by ETEC, although all are not expressed together. Further, there are other multiple non-classical virulence factors that are also identified. Here the presence and expression of common classical and non-classical virulence factors were studied. Further studies were done on the expression of prevalent colonization factors in different strains. For the prevalence determination, multiplex polymerase chain reaction (PCR) was employed, which was confirmed by simplex PCR. Quantitative RT-PCR was done to study the RNA expression of these virulence factors. Strains negative for colonization factors expression were confirmed by SDS-PAGE. Among the clinical isolates, the most prevalent toxin was est+elt, followed by est and elt, while the pattern was reversed in the control strains. There were 29% and 40% strains negative for any classical colonization factors (CF) or non-classical virulence factors (NCVF) among the clinical and control strains, respectively. Among CF positive ETEC strains, CS6 and CS21 were the prevalent ones in the clinical strains, whereas in control strains, CS6 was the predominant one. For NCVF genes, eatA was the most prevalent among the clinical isolates and etpA for control. CS6 was the most expressed CF, and eatA was the predominantly expressed NCVF for both clinical and controlled ETEC isolates. CS6 expression was more in strains having CS6 alone. Different strains express CS6 at different levels. Not all strains expressed their respective virulence factors. Understanding the prevalent colonization factor, CS6, and its nature of expression will contribute to designing an effective vaccine against ETEC in this region of the globe. The expression pattern of CS6 also will help in examining the relatedness between the ETEC subtypes.

Keywords: classical virulence factors, CS6, diarrhea, enterotoxigenic escherichia coli, expression, non-classical virulence factors

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26740 Revised Risk Priority Number in Failure Mode and Effects Analysis Model from the Perspective of Healthcare System

Authors: Fatemeh Rezaei, Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshnas

Abstract:

Background: Failure Modes and Effect Analysis is now having known as the main methods of risk assessment and the accreditation requirements for many organizations. The Risk Priority Number (RPN) approach is generally preferred, especially for its easiness of use. Indeed it does not require statistical data, but it is based on subjective evaluations given by the experts about the Occurrence (O i), the Severity (Si) and the Detectability (D i) of each cause of failure. Methods: This study is a quantitative – qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment was conducted to calculate RPN score. Results; We have studied patient’s journey process in surgery ward and the most important phase of the process determined Transport of the patient from the holding area to the operating room. Failures of the phase with the highest priority determined by defining inclusion criteria included severity (clinical effect, claim consequence, waste of time and financial loss), occurrence (time- unit occurrence and degree of exposure to risk) and preventability (degree of preventability and defensive barriers) and quantifying risks priority criteria in the context of RPN index. Ability of improved RPN reassess by root cause (RCA) analysis showed some variations. Conclusions: Finally, It could be concluded that understandable criteria should have been developed according to personnel specialized language and communication field. Therefore, participation of both technical and clinical groups is necessary to modify and apply these models.

Keywords: failure mode, effects analysis, risk priority number(RPN), health system, risk assessment

Procedia PDF Downloads 300
26739 Coffee Consumption and Glucose Metabolism: a Systematic Review of Clinical Trials

Authors: Caio E. G. Reis, Jose G. Dórea, Teresa H. M. da Costa

Abstract:

Objective: Epidemiological data shows an inverse association of coffee consumption with risk of type 2 diabetes mellitus. However, the clinical effects of coffee consumption on the glucose metabolism biomarkers remain controversial. Thus, this paper reviews clinical trials that evaluated the effects of coffee consumption on glucose metabolism. Research Design and Methods: We identified studies published until December 2014 by searching electronic databases and reference lists. We included randomized clinical trials which the intervention group received caffeinated and/or decaffeinated coffee and the control group received water or placebo treatments and measured biomarkers of glucose metabolism. The Jadad Score was applied to evaluate the quality of the studies whereas studies that scored ≥ 3 points were considered for the analyses. Results: Seven clinical trials (total of 237 subjects) were analyzed involving adult healthy, overweight and diabetic subjects. The studies were divided in short-term (1 to 3h) and long-term (2 to 16 weeks) duration. The results for short-term studies showed that caffeinated coffee consumption may increase the area under the curve for glucose response, while for long-term studies caffeinated coffee may improve the glycemic metabolism by reducing the glucose curve and increasing insulin response. These results seem to show that the benefits of coffee consumption occur in the long-term as has been shown in the reduction of type 2 diabetes mellitus risk in epidemiological studies. Nevertheless, until the relationship between long-term coffee consumption and type 2 diabetes mellitus is better understood and any mechanism involved identified, it is premature to make claims about coffee preventing type 2 diabetes mellitus. Conclusion: The findings suggest that caffeinated coffee may impairs glucose metabolism in short-term but in the long-term the studies indicate reduction of type 2 diabetes mellitus risk. More clinical trials with comparable methodology are needed to unravel this paradox.

Keywords: coffee, diabetes mellitus type 2, glucose, insulin

Procedia PDF Downloads 446
26738 Background Check System for Turkish IT Companies

Authors: Arzu Baloglu, Ugur Kaplancali

Abstract:

This paper focuses on Background Check Systems and Pre-Employment Screening. In our study, we attempted to make an online background checking site that will help employers when hiring employees. Our site has two types of users which are free and powered user. Free users are the employees and powered users are the employers which will hire employers. The database of the site will contain all the information about the employees and employers which are registered in the system so the employers can make a search based on their searching criteria to find the suitable employee for the job. The web site also has a comments and points system. The current employer can make comments to his/her employees and can also give them points. The comments will be shown on employee’s profile, so; when an employer searches for an employee he/she can check the points and comments of the employee to see whether he or she is capable of the job or not. The employers can also follow some employees if they desire. This paper has been designed and implemented with using ASP.NET, C# and JavaScript. The outputs have a user friendly interface. The interface also aimed to provide the useful information for Turkish Technology Companies.

Keywords: background, checking, verification, human resources, online

Procedia PDF Downloads 176
26737 Patients' Quality of Life and Caregivers' Burden of Parkinson's Disease

Authors: Kingston Rajiah, Mari Kannan Maharajan, Si Jen Yeen, Sara Lew

Abstract:

Parkinson’s disease (PD) is a progressive neurodegenerative disorder with evolving layers of complexity. Both motor and non-motor symptoms of PD may affect patients’ quality of life (QoL). Life expectancy for an individual with Parkinson’s disease depends on the level of care the individual has access to, can have a direct impact on length of life. Therefore, improvement of the QoL is a significant part of therapeutic plans. Patients with PD, especially those who are in advanced stages, are in great need of assistance, mostly from their family members or caregivers in terms of medical, emotional, and social support. The role of a caregiver becomes increasingly important with the progression of PD, the severity of motor impairment and increasing age of the patient. The nature and symptoms associated with PD can place significant stresses on the caregivers’ burden. As the prevalence of PD is estimated to more than double by 2030, it is important to recognize and alleviate the burden experienced by caregivers. This study focused on the impact of the clinical features on the QoL of PD patients, and of their caregivers. This study included PD patients along with their caregivers and was undertaken at the Malaysian Parkinson's Disease Association from June 2016 to November 2016. Clinical features of PD patients were assessed using the Movement Disorder Society revised Unified Parkinson Disease Rating Scale (MDS-UPDRS); the Hoehn and Yahr Staging of Parkinson's Disease were used to assess the severity and Parkinson's disease activities of daily living scale were used to assess the disability of Parkinson’s disease patients. QoL of PD patients was measured using the Parkinson's Disease Questionnaire-39 (PDQ-39). The revised version of the Zarit Burden Interview assessed caregiver burden. At least one of the clinical features affected PD patients’ QoL, and at least one of the QoL domains affected the caregivers’ burden. Clinical features ‘Saliva and Drooling’, and ‘Dyskinesia’ explained 29% of variance in QoL of PD patients. The QoL domains ‘stigma’, along with ‘emotional wellbeing’ explained 48.6% of variance in caregivers’ burden. Clinical features such as saliva, drooling and dyskinesia affected the QoL of PD patients. The PD patients’ QoL domains such as ‘stigma’ and ‘emotional well-being’ influenced their caregivers’ burden.

Keywords: carers, quality of life, clinical features, Malaysia

Procedia PDF Downloads 229