Search results for: initiate diagnosis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2184

Search results for: initiate diagnosis

1404 The Role of Critical Thinking in Disease Diagnosis: A Comprehensive Review

Authors: Mohammad Al-Mousawi

Abstract:

This academic article explores the indispensable role of critical thinking in the process of diagnosing diseases. Employing a multidisciplinary approach, we delve into the cognitive skills and analytical mindset that clinicians, researchers, and healthcare professionals must employ to navigate the complexities of disease identification. By examining the integration of critical thinking within the realms of medical education, diagnostic decision-making, and technological advancements, this article aims to underscore the significance of cultivating and applying critical thinking skills in the ever-evolving landscape of healthcare.

Keywords: critical thinking, medical education, diagnostic decision-making, fostering critical thinking

Procedia PDF Downloads 48
1403 Play-Based Intervention Training Program for Daycare Workers Attending to Children with Autism

Authors: Raymond E. Raguindin

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Objective: This research studied the teaching improvement of daycare workers in imitation, joint attention, and language activities using the play-based early intervention training program in Cabanatuan City, Nueva Ecija. Methods: Focus group discussions were developed to explore the attitude, beliefs, and practices of daycare workers. Results: Findings of the study revealed that daycare workers have existing knowledge and experience in teaching children with autism. Their workshops on managing inappropriate behaviors of children with autism resulting in a general positive perception of accepting and teaching children with autism in daycare centers. Play based activities were modelled and participated in by daycare workers. These include demonstration, modelling, prompting and providing social reinforcers as reward. Five lectures and five training days were done to implement the training program. Daycare workers’ levels of skill in teaching imitation, joint attention and language were gathered before and after the participation in the training program. Findings suggest significant differences between pre-test and post test scores. They have shown significant improvement in facilitating imitation, joint attention, and language children with autism after the play-based early intervention training. They were able to initiate and sustain imitation, joint attention, and language activities with adequate knowledge and confidence. Conclusions: 1. Existing attitudes and beliefs greatly influenced the positive delivery mode of instruction. 2. Teacher-directed approach to improve attention, imitation, joint attention, and language of children with autism can be acquired by daycare workers. 3. Teaching skills and experience can be used as reference and basis for identifying future training needs.

Keywords: early intervention, imitation, joint attention, language

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1402 Being Reticent for Healing – Singularity and Non-Verbalization in Indigenous Medical Practices in Sri Lanka

Authors: Ayami Umemura

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The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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1401 The Implementation of Strengthening Institutional Model of Women Farmers Group in Developing Household Food Security

Authors: Rahmadanih, Sitti Bulkis, A. Amrullah, R. M. Rukka, N. M. Viantika

Abstract:

Food security is still a global issue, including in Indonesia. In South Sulawesi, this issue also occurs in members of farmer groups/women farmer groups. This study aims to (1) describe the implementation of strengthening institutional model of Women Farmer Groups (WFG) and (2) analyzing the capacity building of WFG members in order to develop food security after the implementations on institutional model. The research was conducted in Bulukumba and Luwu Utara District, South Sulawesi, Indonesia. The research was designed with qualitative and quantitative (mixed) method. Qualitative data were collected through in-depth interview and Focus Group Discussion (FGD); while quantitative data collected through a household survey of WGF members. Two WGF were selected they are WFG in Bulukumba and WGF in Luwu Utara District. Both WGF has been selected as the case unit, which consisting of 60 households. Institutional strengthening model that been implemented is a combination model of (1) institutional support and (2) capacity development of WGF members. The model of institutional support aim is to develop food security could be achieved through facilitation on produce banana chips (initiate a business group formation) and preparation of institution rule (AD/ART). (2) The developing Model of WFG members capacity building are (a) technical training of banana chips producing process, also food and nutrition counseling as well as the utilization of the yard, (b) processing of food products from their yards. Food and nutrition knowledge of WFG members was increased about 30% - 60% and accompanied by the development of households’ food security by 6.7% - 10.0%.; when compared to last year percentage.

Keywords: food security, institutional strengthening, model implementation, women farmer group

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1400 Shoulder Range of Motion Measurements using Computer Vision Compared to Hand-Held Goniometric Measurements

Authors: Lakshmi Sujeesh, Aaron Ramzeen, Ricky Ziming Guo, Abhishek Agrawal

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Introduction: Range of motion (ROM) is often measured by physiotherapists using hand-held goniometer as part of mobility assessment for diagnosis. Due to the nature of hand-held goniometer measurement procedure, readings often tend to have some variations depending on the physical therapist taking the measurements (Riddle et al.). This study aims to validate computer vision software readings against goniometric measurements for quick and consistent ROM measurements to be taken by clinicians. The use of this computer vision software hopes to improve the future of musculoskeletal space with more efficient diagnosis from recording of patient’s ROM with minimal human error across different physical therapists. Methods: Using the hand-held long arm goniometer measurements as the “gold-standard”, healthy study participants (n = 20) were made to perform 4 exercises: Front elevation, Abduction, Internal Rotation, and External Rotation, using both arms. Assessment of active ROM using computer vision software at different angles set by goniometer for each exercise was done. Interclass Correlation Coefficient (ICC) using 2-way random effects model, Box-Whisker plots, and Root Mean Square error (RMSE) were used to find the degree of correlation and absolute error measured between set and recorded angles across the repeated trials by the same rater. Results: ICC (2,1) values for all 4 exercises are above 0.9, indicating excellent reliability. Lowest overall RMSE was for external rotation (5.67°) and highest for front elevation (8.00°). Box-whisker plots showed have showed that there is a potential zero error in the measurements done by the computer vision software for abduction, where absolute error for measurements taken at 0 degree are shifted away from the ideal 0 line, with its lowest recorded error being 8°. Conclusion: Our results indicate that the use of computer vision software is valid and reliable to use in clinical settings by physiotherapists for measuring shoulder ROM. Overall, computer vision helps improve accessibility to quality care provided for individual patients, with the ability to assess ROM for their condition at home throughout a full cycle of musculoskeletal care (American Academy of Orthopaedic Surgeons) without the need for a trained therapist.

Keywords: physiotherapy, frozen shoulder, joint range of motion, computer vision

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1399 Empirical Study of Correlation between the Cost Performance Index Stability and the Project Cost Forecast Accuracy in Construction Projects

Authors: Amin AminiKhafri, James M. Dawson-Edwards, Ryan M. Simpson, Simaan M. AbouRizk

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Earned value management (EVM) has been introduced as an integrated method to combine schedule, budget, and work breakdown structure (WBS). EVM provides various indices to demonstrate project performance including the cost performance index (CPI). CPI is also used to forecast final project cost at completion based on the cost performance during the project execution. Knowing the final project cost during execution can initiate corrective actions, which can enhance project outputs. CPI, however, is not constant during the project, and calculating the final project cost using a variable index is an inaccurate and challenging task for practitioners. Since CPI is based on the cumulative progress values and because of the learning curve effect, CPI variation dampens and stabilizes as project progress. Although various definitions for the CPI stability have been proposed in literature, many scholars have agreed upon the definition that considers a project as stable if the CPI at 20% completion varies less than 0.1 from the final CPI. While 20% completion point is recognized as the stability point for military development projects, construction projects stability have not been studied. In the current study, an empirical study was first conducted using construction project data to determine the stability point for construction projects. Early findings have demonstrated that a majority of construction projects stabilize towards completion (i.e., after 70% completion point). To investigate the effect of CPI stability on cost forecast accuracy, the correlation between CPI stability and project cost at completion forecast accuracy was also investigated. It was determined that as projects progress closer towards completion, variation of the CPI decreases and final project cost forecast accuracy increases. Most projects were found to have 90% accuracy in the final cost forecast at 70% completion point, which is inlined with findings from the CPI stability findings. It can be concluded that early stabilization of the project CPI results in more accurate cost at completion forecasts.

Keywords: cost performance index, earned value management, empirical study, final project cost

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1398 The Evaluation for Interfacial Adhesion between SOFC and Metal Adhesive in the High Temperature Environment

Authors: Sang Koo Jeon, Seung Hoon Nahm, Oh Heon Kwon

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The unit cell of solid oxide fuel cell (SOFC) must be stacked as several layers type to obtain the high power. The most of researcher have concerned about the performance of stacked SOFC rather than the structural stability of stacked SOFC and especially interested how to design for reducing the electrical loss and improving the high efficiency. Consequently, the stacked SOFC able to produce the electrical high power and related parts like as manifold, gas seal, bipolar plate were developed to optimize the stack design. However, the unit cell of SOFC was just layered on the interconnector without the adhesion and the hydrogen and oxygen were injected to the interfacial layer in the high temperature. On the operating condition, the interfacial layer can be the one of the weak point in the stacked SOFC. Therefore the evaluation of the structural safety for the failure is essentially needed. In this study, interfacial adhesion between SOFC and metal adhesive was estimated in the high temperature environment. The metal adhesive was used to strongly connect the unit cell of SOFC with interconnector and provide the electrical conductivity between them. The four point bending test was performed to measure the interfacial adhesion. The unit cell of SOFC and SiO2 wafer were diced and then attached by metal adhesive. The SiO2 wafer had the center notch to initiate a crack from the tip of the notch. The modified stereomicroscope combined with the CCD camera and system for measuring the length was used to observe the fracture behavior. Additionally, the interfacial adhesion was evaluated in the high temperature condition because the metal adhesive was affected by high temperature. Also the specimen was exposed in the furnace during several hours and then the interfacial adhesion was evaluated. Finally, the interfacial adhesion energy was quantitatively determined and compared in the each condition.

Keywords: solid oxide fuel cell (SOFC), metal adhesive, adhesion, high temperature

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1397 Understanding the Nature of Blood Pressure as Metabolic Syndrome Component in Children

Authors: Mustafa M. Donma, Orkide Donma

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Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.

Keywords: blood pressure, children, index, metabolic syndrome, obesity

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1396 Accurate Mass Segmentation Using U-Net Deep Learning Architecture for Improved Cancer Detection

Authors: Ali Hamza

Abstract:

Accurate segmentation of breast ultrasound images is of paramount importance in enhancing the diagnostic capabilities of breast cancer detection. This study presents an approach utilizing the U-Net architecture for segmenting breast ultrasound images aimed at improving the accuracy and reliability of mass identification within the breast tissue. The proposed method encompasses a multi-stage process. Initially, preprocessing techniques are employed to refine image quality and diminish noise interference. Subsequently, the U-Net architecture, a deep learning convolutional neural network (CNN), is employed for pixel-wise segmentation of regions of interest corresponding to potential breast masses. The U-Net's distinctive architecture, characterized by a contracting and expansive pathway, enables accurate boundary delineation and detailed feature extraction. To evaluate the effectiveness of the proposed approach, an extensive dataset of breast ultrasound images is employed, encompassing diverse cases. Quantitative performance metrics such as the Dice coefficient, Jaccard index, sensitivity, specificity, and Hausdorff distance are employed to comprehensively assess the segmentation accuracy. Comparative analyses against traditional segmentation methods showcase the superiority of the U-Net architecture in capturing intricate details and accurately segmenting breast masses. The outcomes of this study emphasize the potential of the U-Net-based segmentation approach in bolstering breast ultrasound image analysis. The method's ability to reliably pinpoint mass boundaries holds promise for aiding radiologists in precise diagnosis and treatment planning. However, further validation and integration within clinical workflows are necessary to ascertain their practical clinical utility and facilitate seamless adoption by healthcare professionals. In conclusion, leveraging the U-Net architecture for breast ultrasound image segmentation showcases a robust framework that can significantly enhance diagnostic accuracy and advance the field of breast cancer detection. This approach represents a pivotal step towards empowering medical professionals with a more potent tool for early and accurate breast cancer diagnosis.

Keywords: mage segmentation, U-Net, deep learning, breast cancer detection, diagnostic accuracy, mass identification, convolutional neural network

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1395 Brain Age Prediction Based on Brain Magnetic Resonance Imaging by 3D Convolutional Neural Network

Authors: Leila Keshavarz Afshar, Hedieh Sajedi

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Estimation of biological brain age from MR images is a topic that has been much addressed in recent years due to the importance it attaches to early diagnosis of diseases such as Alzheimer's. In this paper, we use a 3D Convolutional Neural Network (CNN) to provide a method for estimating the biological age of the brain. The 3D-CNN model is trained by MRI data that has been normalized. In addition, to reduce computation while saving overall performance, some effectual slices are selected for age estimation. By this method, the biological age of individuals using selected normalized data was estimated with Mean Absolute Error (MAE) of 4.82 years.

Keywords: brain age estimation, biological age, 3D-CNN, deep learning, T1-weighted image, SPM, preprocessing, MRI, canny, gray matter

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1394 DenseNet and Autoencoder Architecture for COVID-19 Chest X-Ray Image Classification and Improved U-Net Lung X-Ray Segmentation

Authors: Jonathan Gong

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

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

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1393 Pres Syndrome in Pregnancy: A Case Series of Five Cases

Authors: Vaibhavi Birle

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Posterior reversible encephalopathy syndrome is a rare clinic-radiological syndrome associated with acute changes in blood pressure during pregnancy. It is characterized symptomatically by headache, seizures, altered mental status, and visual blurring with radiological changes of white matter (vasogenic oedema) affecting the posterior occipital and parietal lobes of the brain. It is being increasingly recognized due to increased institutional deliveries and advances in imaging particularly magnetic resonance imaging (MRI). In spite of the increasing diagnosis the prediction of PRES and patient factors affecting susceptibility is still not clear. Hence, we conducted the retrospective study to analyse the factors associated with PRES at our tertiary centre.

Keywords: pres syndrome, eclampsia, maternal outcome, fetal outcome

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1392 EGF Serum Level in Diagnosis and Prediction of Mood Disorder in Adolescents and Young Adults

Authors: Monika Dmitrzak-Weglarz, Aleksandra Rajewska-Rager, Maria Skibinska, Natalia Lepczynska, Piotr Sibilski, Joanna Pawlak, Pawel Kapelski, Joanna Hauser

Abstract:

Epidermal growth factor (EGF) is a well-known neurotrophic factor that involves in neuronal growth and synaptic plasticity. The proteomic research provided in order to identify novel candidate biological markers for mood disorders focused on elevated EGF serum level in patients during depression episode. However, the EGF association with mood disorder spectrum among adolescents and young adults has not been studied extensively. In this study, we aim to investigate the serum levels of EGF in adolescents and young adults during hypo/manic, depressive episodes and in remission compared to healthy control group. In our study, we involved 80 patients aged 12-24 years in 2-year follow-up study with a primary diagnosis of mood disorder spectrum, and 35 healthy volunteers matched by age and gender. Diagnoses were established according to DSM-IV-TR criteria using structured clinical interviews: K-SADS for child and adolescents, and SCID for young adults. Clinical and biological evaluations were made at baseline and euthymic mood (at 3th or 6th month of treatment and after 1 and 2 years). The Young Mania Rating Scale and Hamilton Rating Scale for Depression were used for assessment. The study protocols were approved by the relevant ethics committee. Serum protein concentration was determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Human EGF (cat. no DY 236) DuoSet ELISA kit was used (R&D Systems). Serum EGF levels were analysed with following variables: age, age under 18 and above 18 years old, sex, family history of affective disorders, drug-free vs. medicated. Shapiro-Wilk test was used to test the normality of the data. The homogeneity of variance was calculated with Levene’s test. EGF levels showed non-normal distribution and the homogeneity of variance was violated. Non-parametric tests: Mann-Whitney U test, Kruskall-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient was applied in the analyses The statistical significance level was set at p<0.05. Elevated EGF level at baseline (p=0.001) and at month 24 (p=0.02) was detected in study subjects compared with controls. Increased EGF level in women at month 12 (p=0.02) compared to men in study group have been observed. Using Wilcoxon signed rank test differences in EGF levels were detected: decrease from baseline to month 3 (p=0.014) and increase comparing: month 3 vs. 24 (p=0.013); month 6 vs. 12 (p=0.021) and vs. 24 (p=0.008). EGF level at baseline was negatively correlated with depression and mania occurrence at 24 months. EGF level at 24 months was positively correlated with depression and mania occurrence at 12 months. No other correlations of EGF levels with clinical and demographical variables have been detected. The findings of the present study indicate that EGF serum level is significantly elevated in the study group of patients compared to the controls. We also observed fluctuations in EGF levels during two years of disease observation. EGF seems to be useful as an early marker for prediction of diagnosis, course of illness and treatment response in young patients during first episode od mood disorders, which requires further investigation. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: biological marker, epidermal growth factor, mood disorders, prediction

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1391 Controlling Drone Flight Missions through Natural Language Processors Using Artificial Intelligence

Authors: Sylvester Akpah, Selasi Vondee

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Unmanned Aerial Vehicles (UAV) as they are also known, drones have attracted increasing attention in recent years due to their ubiquitous nature and boundless applications in the areas of communication, surveying, aerial photography, weather forecasting, medical delivery, surveillance amongst others. Operated remotely in real-time or pre-programmed, drones can fly autonomously or on pre-defined routes. The application of these aerial vehicles has successfully penetrated the world due to technological evolution, thus a lot more businesses are utilizing their capabilities. Unfortunately, while drones are replete with the benefits stated supra, they are riddled with some problems, mainly attributed to the complexities in learning how to master drone flights, collision avoidance and enterprise security. Additional challenges, such as the analysis of flight data recorded by sensors attached to the drone may take time and require expert help to analyse and understand. This paper presents an autonomous drone control system using a chatbot. The system allows for easy control of drones using conversations with the aid of Natural Language Processing, thus to reduce the workload needed to set up, deploy, control, and monitor drone flight missions. The results obtained at the end of the study revealed that the drone connected to the chatbot was able to initiate flight missions with just text and voice commands, enable conversation and give real-time feedback from data and requests made to the chatbot. The results further revealed that the system was able to process natural language and produced human-like conversational abilities using Artificial Intelligence (Natural Language Understanding). It is recommended that radio signal adapters be used instead of wireless connections thus to increase the range of communication with the aerial vehicle.

Keywords: artificial ntelligence, chatbot, natural language processing, unmanned aerial vehicle

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1390 The Introduction of Modern Diagnostic Techniques and It Impact on Local Garages

Authors: Mustapha Majid

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Gone were the days when technicians/mechanics will have to spend too much time trying to identify a mechanical fault and rectify the problem. Now the emphasis is on the use of Automobile diagnosing Equipment through the use of computers and special software. An investigation conducted at Tamale Metropolis and Accra in the Northern and Greater Accra regions of Ghana, respectively. Methodology for data gathering were; questionnaires, physical observation, interviews, and newspaper. The study revealed that majority of mechanics lack computer skills which can enable them use diagnosis tools such as Exhaust Gas Analyzer, Scan Tools, Electronic Wheel Balancing machine, etc.

Keywords: diagnosing, local garages and modern garages, lack of knowledge of diagnosing posing an existential threat, training of local mechanics

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1389 Maximum Entropy Based Image Segmentation of Human Skin Lesion

Authors: Sheema Shuja Khattak, Gule Saman, Imran Khan, Abdus Salam

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Image segmentation plays an important role in medical imaging applications. Therefore, accurate methods are needed for the successful segmentation of medical images for diagnosis and detection of various diseases. In this paper, we have used maximum entropy to achieve image segmentation. Maximum entropy has been calculated using Shannon, Renyi, and Tsallis entropies. This work has novelty based on the detection of skin lesion caused by the bite of a parasite called Sand Fly causing the disease is called Cutaneous Leishmaniasis.

Keywords: shannon, maximum entropy, Renyi, Tsallis entropy

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1388 Wear Diagnosis of Diesel Engine Helical Gear

Authors: Surjit Angra, Gajanan Rane, Vinod Kumar, Sushma Rani

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This paper presents metallurgical investigation of failed helical gear of diesel engine gear box used in a car. The failure had occurred near the bottomland of the tooth spacing. The failed surface was studied under Scanning Electron Microscope (SEM) and also visually investigated. The images produced through SEM at various magnifications were studied. Detailed metallurgical study indicates that failure was due to foreign material inclusion which is a casting defect. Further study also revealed pitting, spalling and inter-granular fracture as the causes of gear failure.

Keywords: helical gear, scanning electron microscope, casting defect, pitting

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1387 Similarity Based Retrieval in Case Based Reasoning for Analysis of Medical Images

Authors: M. Dasgupta, S. Banerjee

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Content Based Image Retrieval (CBIR) coupled with Case Based Reasoning (CBR) is a paradigm that is becoming increasingly popular in the diagnosis and therapy planning of medical ailments utilizing the digital content of medical images. This paper presents a survey of some of the promising approaches used in the detection of abnormalities in retina images as well in mammographic screening and detection of regions of interest in MRI scans of the brain. We also describe our proposed algorithm to detect hard exudates in fundus images of the retina of Diabetic Retinopathy patients.

Keywords: case based reasoning, exudates, retina image, similarity based retrieval

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1386 Bearing Condition Monitoring with Acoustic Emission Techniques

Authors: Faisal AlShammari, Abdulmajid Addali

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Monitoring the conditions of rotating machinery as bearing is important in order to improve its stability of works. Acoustic emission (AE) and vibration analysis are some of the most accomplished techniques used for this purpose. Acoustic emission has the ability to detect the initial phase of component degradation. Moreover, it has been observed that the success of vibration analysis does not take place below 100 rpm rotational speed. This because the energy generated below 100 rpm rotational speed is not detectable using conventional vibration. From this pint, this paper has presented a focused review of using acoustic emission techniques for monitoring bearings condition.

Keywords: condition monitoring, stress wave analysis, low-speed bearings, bearing defect diagnosis

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1385 A Study of Industrial Symbiosis and Implementation of Indigenous Circular Economy Technique on an Indian Industrial Area

Authors: A. Gokulram

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Industrial waste is often categorized as commercial and non-commercial waste by market value. In many Indian industries and other industrialized countries, the commercial value waste is capitalized and non-commercial waste is dumped to landfill. A lack of adequate research on industrial waste leads to the failure of effective resource management and the non-commercial waste are being considered as commercially non-viable residues. The term Industrial symbiosis refers to the direct inter-firm reuse or exchange of material and energy resource. The resource efficiency of commercial waste is mainly followed by an informal symbiosis in our research area. Some Industrial residues are reused within the facility where they are generated, others are reused directly nearby industrial facilities and some are recycled via the formal and informal market. The act of using industrial waste as a resource for another product faces challenges in India. This research study has observed a major negligence of trust and communication among several bodies to implement effective circular economy in India. This study applies interviewing process across researchers, government bodies, industrialist and designers to understand the challenges of circular economy in India. The study area encompasses an industrial estate in Ahmedabad in the state of Gujarat which comprises of 1200 industries. The research study primarily focuses on making industrial waste as commercial ready resource and implementing Indigenous sustainable practice in modern context to improve resource efficiency. This study attempted to initiate waste exchange platform among several industrialist and used varied methodologies from mail questionnaire to telephone survey. This study makes key suggestions to policy change and sustainable finance to improve circular economy in India.

Keywords: effective resource management, environmental policy, indigenous technique, industrial symbiosis, sustainable finance

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1384 Management of Urinary Tract Infections by Nurse Practitioners in a Canadian Pediatric Emergency Department: A Rretrospective Cohort Study

Authors: T. Mcgraw, F. N. Morin, N. Desai

Abstract:

Background: Antimicrobial resistance is a critical issue in global health care and a significant contributor to increased patient morbidity and mortality. Suspected urinary tract infection (UTI) is a key area of inappropriate antibiotic prescription in pediatrics. Management patterns of infectious diseases have been shown to vary by provider type within a single setting. The aim of this study was to assess compliance with national UTI management guidelines by nurse practitioners in a pediatric emergency department (ED). Methods: This was a post-hoc analysis of a retrospective cohort study to review and evaluate visits to a tertiary care freestanding pediatric emergency department. Patients were included if they were 60 days to 36 months old and discharged with a diagnosis of UTI or ‘rule-out UTI’ between July 2015 and July 2020. Primary outcome measure was proportion of visits seen by Nurse Practitioners (NP) which were associated with national guideline compliance in the diagnosis and treatment of suspected UTI. We performed descriptive statistics and comparative analyses to determine differences in practice patterns between NPs, and physicians. Results: A total of 636 charts were reviewed, of which 402 patients met inclusion criteria. 17 patients were treated by NPs, 385 were treated by either Pediatric Emergency Medicine physicians (PEM) or non-PEM physicians. Overall, the proportion of infants receiving guideline-compliant care was 25.9% (21.8-30.4%). Of those who were prescribed antibiotics, 79.6% (74.7-83.8%) received first line guideline recommended therapy and 58.9% (53.8-63.8%) received fully compliant therapy with respect to age, dose, duration, and frequency. In patients treated by NPs, 16/17 (94%(95% CI:73.0-99.0)) required antibiotics, 15/16 (93%(95% CI: 71.7-98.9)) were treated with first line agent (cephalexin), 8/16 (50%(95% CI:28-72)) were guideline compliant of dose and duration. 5/8 (63%(95% CI:30.6-86.3)) were noncompliant for dose being too high. There was no difference in receiving guideline compliant empiric antibiotic therapy between physicians and nurse practitioners (OR: 0.837 CI: 0.302-2.69). Conclusion: In this post-hoc analysis, guideline noncompliance by nurse practitioners is common in children tested and treated for UTIs in a pediatric emergency department. Care by a Nurse Practitioner was not associated with greater rate of noncompliance than care by a Pediatric Emergency Medicine physician. Future appropriately powered studies may focus on confirming these results.

Keywords: antibiotic stewardship, infectious disease, nurse practitioner, urinary tract infection

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1383 Local Identities to Global in the Centre of Isan, Thailand: Promoting Local Development and Community Participation

Authors: Thammanoon Raveepong, Craig Wheway

Abstract:

Originating from a multifaceted research project beginning with the opening of the Green Market at Ban Laow sub-district, Kosum Phisai, Mahasarakham with the support of Kosum Phisai Governor. The project involves key stakeholders related to villagers who have become involved with linking local identity to a more global identity to help ameliorate falling agricultural incomes and casualised work. There have been fifteen formal meetings involving local government stakeholders that took place at the local university, local schools, a public meeting at Ban-Don-Toom and Village meeting shelters. These events hosted 176 local stakeholders consisting of the District Governor, 7 Chairpersons/Heads of the District Development Council, a Health Promotion group, District retired government staff, 4 sub-district local government members, the City Development Council, 2 representatives from Mahasarakham Provincial Culture Council, 4 principles of all local schools, 11 village heads, 15 scholars form local and national universities, 132 villagers and 4 staff from public relation units. The goal of the project was to initiate a variety of local projects including promotion of Local healthy food, farm/homestay accommodation, local uniqueness, Travel guides (in book form and guide youths) and the proposed development of community tourism with the aim to utilise local people and activities to tap into the growing alternative tourism market. This paper aims to document the progress thus far, and the challenges presented working with local communities that have lacked expertise in linking to the global economy to derive economic benefits for their communities.

Keywords: Community-based tourism, community participation, local identity, mahasarakham province

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1382 Diapause Incidence in Zygogramma bicolorata Pallister Coleoptera: Chrysomelidae

Authors: Fazil Hasan, M. Shafiq Ansari, Mohammad Muslim

Abstract:

Zygogramma bicolorata Pallister (Coleoptera: Chrysomelidae) is an exotic insect and effective biocontrol agent of Parthenium hysterophorus L. (Asteraceae). Our study aimed to determine the induction and termination of diapause, in response to abiotic (temperature and moisture) and biotic factors (age and reproductive status) and the effect of diapause on adult longevity and female fecundity. The adults burrowed into the soil about 1–6 cm below the surface for diapause at any time from July to December with a peak of 70% in the 2nd week of December at Aligarh region, India. The termination of diapause took place in May and June with the commencement of monsoon rains. Non-diapausing adults were also capable of breeding during winter under laboratory conditions. There was a significantly increased in the percentage of diapaused adults in subsequent generation i.e. 4% in F1 generation and 90% in F7 generation. The percentage of diapause was also significantly increased with age of adults. It has a positive effect on female fecundity as compared to the fecundity in pre-diapaused duration. Experiments proved that soil moisture played an important role in providing the conditions for initiation and termination of diapause. The adults which undergone diapause in January and February were continuously exposed to 35º, 40º and 45º C for one week and a daily dose of 10 and 8 hours for 6 and 5 days, respectively resulting in termination of diapause. This method may be used to initiate mass multiplication for carrying out releases early in the season. Exposure of adults to extremely low temperatures i.e. 5º and 10º C induced 94.3% and 92.5% diapause, respectively with no adult mortality. Therefore, low temperatures can also be used as a medium for the storage of mass reared beetles for a long time without having negative effect on their longevity and fecundity. Thus, our findings are of great utility in the biological suppression of P. hysterophorus as it will enhance the effectiveness of this beetle through manipulation of diapause.

Keywords: Zygogramma bicolorata, environmental factors, age, sex, diapause, Parthenium hysterophorus, biocontrol

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1381 Transforming Maternity and Neonatal Services in a Middle Eastern Country

Authors: M. A. Brown, K. Hugill, D. Meredith

Abstract:

Since the establishment of midwifery, as a professional identity in its own right, in the early years of the 20th century, midwifery-led models of childbirth have prevailed in many parts of the world. However, in many locations midwives’ scope of practice remains underdeveloped or absent. In Qatar, all births take place in hospital and are under the professional jurisdiction of obstetricians, predominately supported by internationally trained nurse-midwives and obstetric nurses. The strategic vision for health services in Qatar endorsed a desire to provide women with the ‘Best Care Always’ and the introduction of midwifery was seen as a way to achieve this. In 2015 the process of recruiting postgraduate educated Clinical Midwife Specialists from international sources began. The midwives were brought together to initiate an in hospital and community service transformation plan. This plan set out a series of wide-ranging actions to transform maternity and neonatal services to make care safer and give women more health choices. Change in any organization is a complex and dynamic process. This is made even more complex when multifaceted professional and cross cultural factors are involved. This presentation reports upon the motivations and challenges that exist and the progress around introducing a multicultural midwifery model of childbirth care in the state of Qatar. The paper examines and reflects upon the drivers and unique features of childbirth in the country. Despite accomplishments, progress still needs to be made in order to fully implement sustainable changes to further improve care and ensure women and neonates get the ‘Best Care Always’. The progress within the transformation plan highlights how midwifery may coexist with competing models of maternity care to create an innovative, eclectic and culturally sensitive paradigm that can best serve women and neonatal health needs.

Keywords: culture, managing change, midwifery, neonatal, service transformation plan

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1380 On Improving Breast Cancer Prediction Using GRNN-CP

Authors: Kefaya Qaddoum

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The aim of this study is to predict breast cancer and to construct a supportive model that will stimulate a more reliable prediction as a factor that is fundamental for public health. In this study, we utilize general regression neural networks (GRNN) to replace the normal predictions with prediction periods to achieve a reasonable percentage of confidence. The mechanism employed here utilises a machine learning system called conformal prediction (CP), in order to assign consistent confidence measures to predictions, which are combined with GRNN. We apply the resulting algorithm to the problem of breast cancer diagnosis. The results show that the prediction constructed by this method is reasonable and could be useful in practice.

Keywords: neural network, conformal prediction, cancer classification, regression

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1379 Fault Diagnosis in Confined Systems

Authors: Nesrine Berber, Hafid Haffaf, Abdel Madjid Meghabar

Abstract:

In the last decade, technology has continued to grow and has changed the structure of our society. Today, new technologies including the information and communication (ICT) play a main role which importance continues to grow, now it's become indispensable to the economic, social and cultural. Thus, ICT technology has proven to be as a promising intervention in the area of road transport. The supervision model of class of train of intelligent and autonomous vehicles leads us to give some defintions about IAV and the different technologies used for communication between them. Our aim in this work is to present an hypergraph modeling a class of train of Intelligent and Autonomous Vehicles (IAV).

Keywords: intelligent transportation system, intelligent autonomous vehicles, Ad Hoc network, wireless technologies, hypergraph modeling, supervision

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1378 Incidental Findings in the Maxillofacial Region Detected on Cone Beam Computed Tomography

Authors: Zeena Dcosta, Junaid Ahmed, Ceena Denny, Nandita Shenoy

Abstract:

In the field of dentistry, there are many conditions which warrant the requirement of three-dimensional imaging that can aid in diagnosis and therapeutic management. Cone beam computed tomography (CBCT) is considered highly accurate in producing a three-dimensional image of an object and provides a complete insight of various findings in the captured volume. But, most of the clinicians focus primarily on the teeth and jaws and numerous unanticipated clinically significant incidental findings may be missed out. Rapid integration of CBCT into the practice of dentistry has led to the detection of various incidental findings. However, the prevalence of these incidental findings is still unknown. Thus, the study aimed to discern the reason for referral and to identify incidental findings on the referred CBCT scans. Patient’s demographic data such as age and gender was noted. CBCT scans of multiple fields of views (FOV) were considered. The referral for CBCT scans was broadly classified into two major categories: diagnostic scan and treatment planning scan. Any finding on the CBCT volumes, other than the area of concern was recorded as incidental finding which was noted under airway, developmental, pathological, endodontics, TMJ, bone, soft tissue calcifications and others. Few of the incidental findings noted under airway were deviated nasal septum, nasal turbinate hypertrophy, mucosal thickening and pneumatization of sinus. Developmental incidental findings included dilaceration, impaction, pulp stone and gubernacular canal. Resorption of teeth and periapical pathologies were noted under pathological incidental findings. Root fracture along with over and under obturation was noted under endodontics. Incidental findings under TMJ were flattening, erosion and bifid condyle. Enostosis and exostosis were noted under bone lesions. Tonsillolth, sialolith and calcified styloid ligament were noted under soft tissue calcifications. Incidental findings under others included foreign body, fused C1- C2 vertebrae, nutrient canals, and pneumatocyst. Maxillofacial radiologists should be aware of possible incidental findings and should be vigilant about comprehensively evaluating the entire captured volume, which can help in early diagnosis of any potential pathologies that may go undetected. Interpretation of CBCT is truly an art and with the experience, we can unravel the secrets hidden in the grey shades of the radiographic image.

Keywords: cone beam computed tomography, incidental findings, maxillofacial region, radiologist

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1377 A Rare Case of Myometrial Ectopic

Authors: Madeleine Cox

Abstract:

Objective: Discussion of diagnosis and management options for myometrial ectopic pregnancy Case: A 30 yo G1P0 presented to the emergency department with vaginal bleeding for the last 4 days. She had a positive home urine pregnancy test, confirmed with a serum HCG. When she presented for an ultrasound, there was no intrauterine pregnancy, no evidence of adnexal pregnancy, however, the anterior myometrium of the uterus was noted to be markedly abnormal. When she presented to the emergency department of a busy tertiary hospital in Queensland, she had a small amount of vaginal bleeding, was anxious but well, observations normal. Repeat blood testes demonstrated a serum HCG of 9246 IU/L, haemoglobin of 143g/L. The patient had an interesting history of a right oophorectomy and open myomectomy in another country. A repeat ultrasound again showed an abnormality within the myometrium of the uterus, which was initially reported as concerning for an AVM, or potentially invasive gestational trophoblastic disease. An MRI was organised 2 days later, which demonstrated a intramural/subserosal irregularity in the right lateral body measuring 35x38x42mm with peripheral enhancement and central cystic components, favouring a myometrial ectopic most likely at the site of previous myomectomy. Alternative diagnosis of AVM, GTD were considered less likely. After discussion with the patient, IV methotrexate was administered as an in patient 4 days after her initial presentation to emergency. After this, her HCG fell to 1236 IU/L on day 6 post treatment. Weekly reviews showed stable ultrasound appearances with a steadily dropping HCG level. A repeat MRI was performed 3 weeks after methotrexate administration which confirmed involution of the myometrial ectopic, however, showed ongoing progression of vascularity surrounding the site. Despite resolution of HCG, the patient persisted to have ongoing bleeding associated with this and went to have uterine artery embolisation. Follow up ultrasound showed resolution of abnormal vascularity and negative HCG levels. Conclusion: Myometrial ectopic pregnancies are a rare occurrence and require a multidisciplinary approach to achieve timely management for these patients. This patient was in a very well resourced setting with excellent access to Interventional Radiology and specialist Radiologists who could work together with the Obstetrics, Gynaecology, and Maternal Fetal Medicine team to provide multiple options of management which preserved her fertility. This case has a very good outcome, with the patient being referred back to our service 12 months later with an early intrauterine pregnancy.

Keywords: ectopic, pregnancy, miscarriage, gynaecology

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1376 Diagnosis of Static Eccentricity in 400 kW Induction Machine Based on the Analysis of Stator Currents

Authors: Saleh Elawgali

Abstract:

Current spectrums of a four pole-pair, 400 kW induction machine were calculated for the cases of full symmetry and static eccentricity. The calculations involve integration of 93 electrical plus four mechanical ordinary differential equations. Electrical equations account for variable inductances affected by slotting and eccentricities. The calculations were followed by Fourier analysis of the stator currents in steady state operation. Zooms of the current spectrums, around the 50 Hz fundamental harmonic as well as of the main slot harmonic zone, were included. The spectrums included refer to both calculated and measured currents.

Keywords: diagnostic, harmonic, induction machine, spectrum

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1375 School and Family Impairment Associated with Childhood Anxiety Disorders: Examining Differences in Parent and Child Report

Authors: Melissa K. Hord, Stephen P. Whiteside

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Impairment in functioning is a requirement for diagnosing psychopathology, identifying individuals in need of treatment, and documenting improvement with treatment. Further, identifying different types of functional impairment can guide educators and treatment providers. However, most assessment tools focus on symptom severity and few measures assess impairment associated with childhood anxiety disorders. The child- and parent-report versions of the Child Sheehan Disability Scale (CSDS) are measures that may provide useful information regarding impairment. The purpose of the present study is to examine whether children diagnosed with different anxiety disorders have greater impairment in school or home functioning based on self or parent report. The sample consisted of 844 children ages 5 to 19 years of age (mean 13.43, 61% female, 90.9% Caucasian), including 281 children diagnosed with obsessive compulsive disorder (OCD), 200 with generalized anxiety disorder (GAD), 176 with social phobia, 83 with separation anxiety, 61 with anxiety not otherwise specified (NOS), 30 with panic disorder, and 13 with panic with agoraphobia. To assess whether children and parents reported greater impairment in school or home functioning, a multivariate analysis of variance was conducted. (The assumptions of independence and homogeneity of variance were checked and met). A significant difference was found, Pillai's trace = .143, F (4, 28) = 4.19, p < .001, partial eta squared = .04. Post hoc comparisons using the Tukey HSD test indicated that children report significantly greater impairment in school with panic disorder (M=5.18, SD=3.28), social phobia (M=4.95, SD=3.20), and OCD (M=4.62, SD=3.32) compared to other diagnoses; whereas parents endorse significantly greater school impairment when their child has a social phobia (M=5.70, SD=3.39) diagnosis. Interestingly, both children and parents reported greater impairment in family functioning for an OCD (child report M=5.37, SD=3.20; parent report M=5.59, SD=3.38) diagnosis compared to other anxiety diagnoses. (Additional findings for the anxiety disorders associated with less impairment will also be presented). The results of the current study have important implications for educators and treatment providers who are working with anxious children. First, understanding that differences exist in how children and parents view impairment related to childhood anxiety can help those working with these families to be more sensitive during interactions. Second, evidence suggests that difficulties in one environment do not necessarily translate to another environment, thus caregivers may benefit from careful explanation of observations obtained by educators. Third, results support the use of the CSDS measure by treatment providers to identify impairment across environments in order to more effectively target interventions.

Keywords: anxiety, childhood, impairment, school functioning

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