Search results for: wireless patient monitoring

Authors: Amreth Chandrasehar

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Machine Learning (ML) Models are developed and run in production to solve various use cases that help organizations to be more efficient and help drive the business. But this comes at a massive development cost and lost business opportunities. According to the Gartner report, 85% of data science projects fail, and one of the factors impacting this is not paying attention to Model Observability. Model Observability helps the developers and operators to pinpoint the model performance issues data drift and help identify root cause of issues. This paper focuses on providing insights into incorporating model observability in model development and operationalizing it in production.

Keywords: model observability, monitoring, drift detection, ML observability platform

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Authors: Faruk Emir, Simel Ayyıldız, Cem Şahin

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Behçet’s disease or Behçet’s syndrome is a chronic and multi-systemic inflammatory disease of unknown cause. This syndrome often presents with mucous membrane ulceration and ocular problems. As a systemic disease Behcet includes triple-symptom complex of recurrent oral aphthous ulcers, genital ulcers, and uveitis. Nearly all patients present with some form of painful oral mucocutaneous ulcerations in the form of aphthous ulcers. The aim of the treatment plan for Behçet’s Disease patients is to eliminate oral problems and increase the patient comfort.This clinical report represents the prosthodontic rehabilitation of Behcet’s disease patients mandibular total edentulism with the use of implant supported prosthesis that planned on custom abutments and bar retainers via CAD/CAM technology and patient satisfaction has been achieved in function and aesthetics.

Keywords: Behçet’s disease, CAD/CAM, custom-made manufacturing, titanium milled bar retainer

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Authors: Blake Milton, Georgette Goode, Elias Sachawars, Virgil Chan, Jason Dizon, Christopher Oldmeadow, Garbor Major

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Fragility fractures of the pelvis (FFP) are a common and increasing fracture type in our ageing population. A novel grading classification system developed for FFP by Rommens and Hofmann attributes a severity score related to degree of pelvic ring involvement, which is assessed on CT imaging. The purpose of this study is to assess the relationship between radiologist-assigned FFP grading and patient mortality in conservatively managed patients. This retrospective review identified consecutive 100 patients aged ≥ 65 years at time of FFP. The Rommens-Hofmann severity grading was allocated to these injuries by 2 radiology trainees and a consultant radiologist. Five-year survival was determined from review of patient medical records. Patient medical records were also analysed to account for possible confounding factors including age, gender, comorbidities (Charlson score) and relative socio-economic disadvantage (SEIFA decile). Suitable FFP’s (n = 99) were classified by increasing severity by increasing severity grades: Type I (43% (n = 43)), Type II (33% (n = 33)), Type III (13% (n = 13)), Type IV (10% (n = 10)). No significant differences in survival were found between fracture groups, which persisted when also adjusting for age, gender, Charslon score or SEIFA decile. There was a lack of evidence to suggest a relationship between CT-based fracture grading and patient survival, even when accounting for the listed possible confounding factors. This may be due to small sample size or possible study biases, or possible heterogeneity within the population not adequately captured with available metrics. Given that no difference in mortality has been identified between FFP grades in conservatively managed patients, further research is important to assess mortality benefit in an operative patient population.

Keywords: fragility fractures, fracture classification, pelvic CT, pelvic fracture, pelvic ring fracture

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Authors: Maryam Kiani

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The self-sensing capability opens up new possibilities for structural health monitoring, offering real-time information on the condition and performance of constructions. The synthesis and characterization of these functional 2D material geopolymers will be explored in this study. Various fabrication techniques, including mixing, dispersion, and coating methods, will be employed to ensure uniform distribution and integration of the 2D materials within the geopolymers. The resulting composite materials will be evaluated for their mechanical strength, electrical conductivity, and sensing capabilities through rigorous testing and analysis. The potential applications of these self-sensing geopolymers are vast. They can be used in infrastructure projects, such as bridges, tunnels, and buildings, to provide continuous monitoring and early detection of structural damage or degradation. This proactive approach to maintenance and safety can significantly improve the lifespan and efficiency of constructions, ultimately reducing maintenance costs and enhancing overall sustainability. In conclusion, the development of functional 2D material geopolymers as self-sensing materials presents an exciting advancement in the construction industry. By integrating these innovative materials into structures, we can create a new generation of intelligent, self-monitoring constructions that can adapt and respond to their environment.

Keywords: 2D materials, geopolymers, electrical properties, self-sensing

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Authors: Munachiso A. Muoneke

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The global healthcare system faces unprecedented challenges of fragmented information systems, inefficient data management, and limited service accessibility. With the rapid evolution of digital technologies, there is a dire need to develop integrated technological infrastructures that can reinvent healthcare delivery from its core. This research addresses the significant gap between existing healthcare technologies and the growing demand for more responsive, secure, and patient-centered medical services. The study uses a mixed-method research approach, combining quantitative system performance analysis and qualitative healthcare provider interviews to comprehensively evaluate the limitations of the current digital health infrastructure. Across multiple healthcare settings, technological barriers are mapped to help develop a robust framework for assessing and redesigning digital health platforms. The research reveals significant potential for technology to transform healthcare delivery. It reveals that strategic technological interventions can reduce administrative inefficiencies by up to 40%, improving patient data security and creating more responsive healthcare ecosystems. The research shows how integrated digital infrastructure can bridge existing gaps in healthcare service delivery, improving patient access and healthcare provider coordination. By providing a practical framework for the transformation of digital health infrastructure, this research offers actionable insights for healthcare providers, technology developers and policy makers seeking to modernize healthcare service delivery in an increasingly digital world.

Keywords: decentralized healthcare, digital health, healthcare systems transformation, patient-centric technology

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Authors: Nicolae Constantin, Ştefan Sorohan

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The small and medium wind turbines are running in quite different conditions as compared to the big ones. Consequently, they need also a different approach concerning the structural health monitoring (SHM) issues. There are four main differences between the above mentioned categories: (i) significantly smaller dimensions, (ii) considerably higher rotation speed, (iii) generally small distance between the turbine and the energy consumer and (iv) monitoring assumed in many situations by the owner. In such conditions, nondestructive inspections (NDI) have to be made as much as possible with affordable, yet effective techniques, requiring portable and accessible equipment. Additionally, the turbines and accessories should be easy to mount, dispose and repair. As the materials used for such unit can be metals, composites and combined, the technologies should be adapted accordingly. An example in which the two materials co-exist is the situation in which the damaged metallic skin of a blade is repaired with a composite patch. The paper presents the inspection of the bonding state of the patch, using portable ultrasonic equipment, able to put in place the Lamb wave method, which proves efficient in global and local inspections as well. The equipment is relatively easy to handle and can be borrowed from specialized laboratories or used by a community of small wind turbine users, upon the case. This evaluation is the first in a row, aimed to evaluate efficiency of NDI performed with rather accessible, less sophisticated equipment and related inspection techniques, having field inspection capabilities. The main goal is to extend such inspection procedures to other components of the wind power unit, such as the support tower, water storage tanks, etc.

Keywords: structural health monitoring, small wind turbines, non-destructive inspection, field inspection capabilities

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Authors: Anupuma Raina, Ajay Parkash

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In forensic investigation, DNA analysis helps in the identification of a particular individual under investigation. A set of Short Tandem Repeats loci are widely used for individualization at a molecular level in forensic testing. STRs with tetrameric repeats of DNA are highly polymorphic and widely used for forensic DNA analysis. Identification of an individual became challenging for forensic examiners after Hematopoietic Stem Cell Transplantation. HSCT is a well-accepted and life-saving treatment to treat malignant and nonmalignant diseases. It involves the administration of healthy donor stem cells to replace the patient’s own unhealthy stem cells. A successful HSCT results in complete donor-derived cells in a patient’s hematopoiesis and hence have the capability to change the genetic makeup of the patient. Although an individual who has undergone HSCT and then committed a crime is a very rare situation, but not impossible. Keeping such a situation in mind, various biological samples like blood, buccal swab, and hair follicle were collected and studied after a certain interval of time after HSCT. Blood was collected from both the patient and the donor before the transplant. The DNA profile of both was analyzed using a short tandem repeat kit for autosomal chromosomes. Among all exhibits studied, only hair follicles were found to be the most suitable biological exhibit, as no donor DNA profile was observed for up to 90 days of study.

Keywords: chimerism, HSCT, STRs analysis, forensic identification

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Authors: Olga Maksakova

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A work with unconscious patients after acute brain damages besides special knowledge and practical skills of all the participants requires a very specific organization. A lot of said about team approach in neurorehabilitation, usually as for outpatient mode. Rehabilitologists deal with fixed patient problems or deficits (motion, speech, cognitive or emotional disorder). Team-building means superficial paradigm of management psychology. Linear mode of teamwork fits casual relationships there. Cases with deep altered states of consciousness (vegetative states, coma, and confusion) require non-linear mode of teamwork: recovery of consciousness might not be the goal due to phenomenon uncertainty. Rehabilitation team as Semi-open Complex System includes the patient as a part. Patient's response pattern becomes formed not only with brain deficits but questions-stimuli, context, and inquiring person. Teamwork is sourcing of phenomenology knowledge of patient's processes as Third-person approach is replaced with Second- and after First-person approaches. Here is a chance for real-time change. Patient’s contacts with his own body and outward things create a basement for restoration of consciousness. The most important condition is systematic feedbacks to any minimal movement or vegetative signal of the patient. Up to now, recovery work with the most severe contingent is carried out in the mode of passive physical interventions, while an effective rehabilitation team should include specially trained psychologists and psychotherapists. It is they who are able to create a network of feedbacks with the patient and inter-professional ones building up the team. Characteristics of ‘Team-Patient’ system (TPS) are energy, entropy, and complexity. Impairment of consciousness as the absence of linear contact appears together with a loss of essential functions (low energy), vegetative-visceral fits (excessive energy and low order), motor agitation (excessive energy and excessive order), etc. Techniques of teamwork are different in these cases for resulting optimization of the system condition. Directed regulation of the system complexity is one of the recovery tools. Different signs of awareness appear as a result of system self-organization. Joint meetings are an important part of teamwork. Regular or event-related discussions form the language of inter-professional communication, as well as the patient's shared mental model. Analysis of complex communication process in TPS may be useful for creation of the general theory of consciousness.

Keywords: rehabilitation team, urgent rehabilitation, severe brain damage, consciousness disorders, complex system theory

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Authors: Yiannis Vacanas, Kyriacos Themistocleous, Athos Agapiou, Diofantos Hadjimitsis

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Building Information Modelling (BIM) technology is considered by construction professionals as a very valuable process in modern design, procurement and project management. Construction professionals of all disciplines can use a single 3D model which BIM technology provides, to design a project accurately and furthermore monitor the progress of construction works effectively and efficiently. Unmanned Aerial Vehicles (UAVs), a technology initially developed for military applications, is now without any difficulty accessible and has already been used by commercial industries, including the construction industry. UAV technology has mainly been used for collection of images that allow visual monitoring of building and civil engineering projects conditions in various circumstances. UAVs, nevertheless, have undergone significant advances in equipment capabilities and now have the capacity to acquire high-resolution imagery from many angles in a cost effective manner, and by using photogrammetry methods, someone can determine characteristics such as distances, angles, areas, volumes and elevations of an area within overlapping images. In order to examine the potential of using a combination of BIM and UAV technologies in construction project management, this paper presents the results of a case study of a typical road construction project where the combined use of the two technologies was used in order to achieve efficient and accurate as-built data collection of the works progress, with outcomes such as volumes, and production of sections and 3D models, information necessary in project progress monitoring and efficient project management.

Keywords: BIM, project management, project monitoring, UAV

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Authors: Karthikeyan M., Paul M. J.

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This case report discusses a 54-year-old woman from Salem, Tamilnadu, who presented with a rare case of papillary thyroid carcinoma (PTC), manifesting as a hypervascular mass in the left carotid sheath. The patient had a two-and-a-half-month history of non-progressive neck swelling, with symptoms including dysphagia and a choking sensation. Clinical examination and investigations such as FNAC and CECT revealed a large vascular mass in the left neck region, initially perplexing the diagnosis. The patient underwent total thyroidectomy and excision of the left carotid sheath mass. Histopathology confirmed PTC. Postoperatively, the patient received Iodine-131 ablation and showed good recovery with no recurrence. This case highlights the diagnostic challenge and atypical presentation of PTC as a vascular neck mass, emphasizing the importance of a comprehensive approach in evaluating thyroid and neck lesions.

Keywords: lateral neck vascular mass, lateral aberrant thyroid, thyroid vascular swelling, smooth post op recovery

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Authors: M. Brockes, S. Beck, A. Sigaroudi, C. Brockes

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Over the last few years, telemedicine and telemonitoring have become popular ways of treatment, especially in other chronic diseases. Therefore, this type of treatment methodology was also implemented in patients with interstitial lung disease (ILD). In January 2024, a new service for patients with interstitial lung disease (ILD) treated with Nintedanib was established, which contains daily telemonitoring (home spirometry, pulse oximetry, and daily level of activity), daily evaluation of parameters as well as a telemedical availability answered by doctors and telemedical specialists throughout 365 days per year. The main motivational points of this service are the early detection of first signs of exacerbations and/or other symptoms/complications, as well as easier access to healthcare professionals. The evaluation of the patient’s quality of life and the subjective feeling of safetyness was measured through patient-reported experience measurements (PREMs) and patient-reported outcome measurements (PROMs). Patients were introduced to the telemedical and telemonitoring service six months ago. Within this period, every sixty days, the questionnaires were conducted by the scientific employees. Due to the unlimited time frame of the long-term service, the evaluation has not been completed. The first analysis of patient-reported experience measurements (PREMs) and patient reported outcome measurements (PROMs) had shown an increased positive effect on the patients' quality of life as well as an increased positive effect on the subjective feeling of safety at home, plus a reduction and avoidance of secondary damages (e.g., exacerbations, deterioration of typical interstitial lung disease ILD symptoms and pharmaceutical side effects). The first results have shown a tendency that the telemedical treatment combined with telemonitoring at home and the encouragement of patients to actively participate in their healthcare has a positive effect on the patient’s overall well-being and could be implemented as a complementation of the traditional standard of care.

Keywords: avoidance of secondary damages, interstitial lung disease, telemedicine and telemonitoring, subjective feeling of safety

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Authors: Reeta Devi, Hitender Kumar Tyagi, Dinesh Kumar

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In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.

Keywords: early stage prediction, heart rate variability, linear and non-linear analysis, sudden cardiac death

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Authors: Ashagrie Getnet Flattie

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Line-of-sight (LOS) information, data rates, good quality, and flexible network service are limited by the fact that, for the duration of any given connection, they experience severe variation in signal strength due to fading and path loss. Wireless system faces major challenges in achieving wide coverage and capacity without affecting the system performance and to access data everywhere, all the time. In this paper, the cell coverage and edge rate of different Multiple-input multiple-output (MIMO) schemes in 20 MHz Long Term Evolution (LTE) system under Unmanned Air Vehicles (UAV) platform are investigated. After some background on the enormous potential of UAV, MIMO, and LTE in wireless links, the paper highlights the presented system model which attempts to realize the various benefits of MIMO being incorporated into UAV platform. The performances of the three MIMO LTE schemes are compared with the performance of 4x4 MIMO LTE in UAV scheme carried out to evaluate the improvement in cell radius, BER, and data throughput of the system in different morphology. The results show that significant performance gains such as bit error rate (BER), data rate, and coverage can be achieved by using the presented scenario.

Keywords: LTE, MIMO, path loss, UAV

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Authors: Danika Tynes

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Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory (Rogers, 1962). System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of telehealth (teleradiology, teledermatology, telepathology, telepsychology, and remote monitoring) using multiple logistic regression. The analyses supported relative advantage and compatibility as the strongest influencers of telehealth adoption, remote monitoring in particular. These findings help to quantitatively clarify the factors influencing the adoption of innovation and advance the ability to make recommendations on the viability of state telehealth adoption. In addition, results indicate when DoI theory is most applicable to the understanding of telehealth diffusion. Ultimately, this research may contribute to more focused allocation of scarce health care resources through consideration of existing state conditions available foster innovation.

Keywords: adoption, diffusion of innovation theory, remote monitoring, system-level indicators

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Authors: Ting Gao, Mingyue He

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Reconfigurable intelligent surfaces (RISs) are expected to be an important part of next-generation wireless communication networks due to their potential to reduce the hardware cost and energy consumption of millimeter Wave (mmWave) massive multiple-input multiple-output (MIMO) technology. However, owing to the lack of signal processing abilities of the RIS, the perfect channel state information (CSI) in RIS-assisted communication systems is difficult to acquire. In this paper, the uplink channel estimation for mmWave systems with a hybrid active/passive RIS architecture is studied. Specifically, a deep learning-based estimation scheme is proposed to estimate the channel between the RIS and the user. In particular, the sparse structure of the mmWave channel is exploited to formulate the channel estimation as a sparse reconstruction problem. To this end, the proposed approach is derived to obtain the distribution of non-zero entries in a sparse channel. After that, the channel is reconstructed by utilizing the least-squares (LS) algorithm and compressed sensing (CS) theory. The simulation results demonstrate that the proposed channel estimation scheme is superior to existing solutions even in low signal-to-noise ratio (SNR) environments.

Keywords: channel estimation, reconfigurable intelligent surface, wireless communication, deep learning

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Authors: Eirini Konstanta, Cedric Gouedard, Aggeliki Delimitsou, Stefania Patera, Samuel Murray

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Introduction: Quality reference DNA standards (QRS) for molecular testing by next-generation sequencing (NGS) are essential for accurate quantitation of copy number variations (CNV) for germline and variant allelic frequencies (VAF) for somatic analyses. Objectives: Presently, several molecular analytics for oncology patients are reliant upon quantitative metrics. Test validation and standardisation are also reliant upon the availability of surrogate control materials allowing for understanding test LOD (limit of detection), sensitivity, specificity. We have developed a dual calibration platform allowing for QRS pairs to be included in analysed DNA samples, allowing for accurate quantitation of CNV and VAF metrics within and between patient samples. Methods: QRS™ blocks up to 500nt were designed for common NGS panel targets incorporating ≥ 2 identification tags (IDTDNA.com). These were analysed upon spiking into gDNA, somatic, and ctDNA using a proprietary CalSuite™ platform adaptable to common LIMS. Results: We demonstrate QRS™ calibration reproducibility spiked to 5–25% at ± 2.5% in gDNA and ctDNA. Furthermore, we demonstrate CNV and VAF within and between samples (gDNA and ctDNA) with the same reproducibility (± 2.5%) in a clinical sample of lung cancer and HBOC (EGFR and BRCA1, respectively). CNV analytics was performed with similar accuracy using a single pair of QRS calibrators when using multiple single targeted sequencing controls. Conclusion: Dual paired QRS™ calibrators allow for accurate and reproducible quantitative analyses of CNV, VAF, intrinsic sample allele measurement, inter and intra-sample measure not only simplifying NGS analytics but allowing for monitoring clinically relevant biomarker VAF across patient ctDNA samples with improved accuracy.

Keywords: calibrator, CNV, gene copy number, VAF

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Authors: Dylan Shiting Lu, Samson Okello, Anita Chunyan Wei, Daniel Xiao Li

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Mammotome vacuum-assisted breast biopsy (MVB) introduced in 1995 can be used for the removal of benign breast lesions. Whether or not MVB is a better option compared to conventional open surgery is inconclusive. We aim to compare the clinical and patient-related outcomes between MVB and open surgery to remove benign breast tumors less than 5 cm in women. We searched English and Chinese electronic databases with the keywords of Mammotome, clinical trial (CT), vacuum-assisted breast biopsy for studies comparing MVB and open surgery until May 2021. We performed a systematic review and random-effects meta-analysis to compare incision size, operation time, intraoperative blood loss, healing time, scar length, patient satisfaction, postoperative hematoma rate, wound infection rate, postoperative ecchymosis, and postoperative sunken skin among those who have Mammotome and those who have surgery. Our analysis included nine randomized CTs with 1155 total patients (575 Mammotome, 580 surgery) and mean age 40.32 years (standard deviation 3.69). We found statistically significant favorable outcomes for Mammotome including blood loss (ml) [standardized mean difference SMD -5.03, 95%CI (-7.30, -2.76)], incision size (cm) [SMD -12.22, 95%CI (-17.40, -7.04)], operation time (min) [SMD -6.66, 95%CI (-9.01, -4.31)], scar length (cm) [SMD -7.06, 95%CI (-10.76, -3.36)], healing time (days) [SMD -6.57, 95%CI (-10.18, -2.95)], and patient satisfaction [relative risk RR 0.38, 95%CI (0.13, 1.08)]. In conclusion, Mammotome vacuum-assisted breast biopsy compared to open surgery shows better clinical and patient-related outcomes. Further studies should be done on whether or not MVB is a better option for benign breast tumors excision.

Keywords: clinical and patient outcomes, open surgery, Mammotome vacuum-assisted breast biopsy, meta-analysis

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Authors: Bashir Abdu Muzakkari, Mohamad Afendee Mohamad, Mohd Fadzil Abdul Kadir

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Wireless Sensor Networks (WSNs) is an aggregation of several tiny, low-cost sensor nodes, spatially distributed to monitor physical or environmental status. WSN is constantly changing because of the rapid technological advancements in sensor elements such as radio, battery and operating systems. The Medium Access Control (MAC) protocols remain very vital in the WSN because of its role in coordinating communication amongst the sensors. Other than battery consumption, packet collision, network lifetime and latency are factors that largely depend on WSN MAC protocol and these factors have been widely treated in recent days. In this paper, we survey some latest proposed WSN Contention-based, Scheduling-based and Hybrid MAC protocols while presenting an examination, correlation of advantages and limitations of each protocol. Concentration is directed towards investigating the treatment of Quality of Service (QoS) performance metrics within these particular protocols. The result shows that majority of the protocols leaned towards energy conservation. We, therefore, believe that other performance metrics of guaranteed QoS such as latency, throughput, packet loss, network and bandwidth availability may play a critical role in the design of future MAC protocols for WSNs.

Keywords: WSN, QoS, energy consumption, MAC protocol

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Authors: A. Bruce Janati, Muhammad Umair Khan, Naif Alghassab, Ibrahim Alzeir, Assem Mahmoud, M. Sammour

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Rationale: Lennox-Gastaut syndrome(LGS) is an electro-clinical syndrome composed of the triad of mental retardation, multiple seizure types, and the characteristic generalized slow spike-wave complexes in the EEG. In this article, we report on two patients with LGS whose brain MRI showed dysgenesis of corpus callosum(CC). We review the literature and stress the role of CC in the genesis of secondary bilateral synchrony(SBS). Method: This was a clinical study conducted at King Khalid Hospital. Results: The EEG was consistent with LGS in patient 1 and unilateral slow spike-wave complexes in patient 2. The MRI showed hypoplasia of the splenium of CC in patient 1, and global hypoplasia of CC combined with Joubert syndrome in patient 2. Conclusion: Based on the data, we proffer the following hypotheses: 1-Hypoplasia of CC interferes with functional integrity of this structure. 2-The genu of CC plays a pivotal role in the genesis of secondary bilateral synchrony. 3-Electrodecremental seizures in LGS emanate from pacemakers generated in the brain stem, in particular the mesencephalon projecting abnormal signals to the cortex via thalamic nuclei. 4-Unilateral slow spike-wave complexes in the context of mental retardation and multiple seizure types may represent a variant of LGS, justifying neuroimaging studies.

Keywords: EEG, Lennox-Gastaut syndrome, corpus callosum , MRI

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Authors: B. Petrović, M. Petrović, L. Rutonjski, I. Djan, V. Ivanović

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Objective: Cardiac pacemakers are very sensitive to radiotherapy treatment from two sources: electromagnetic influence from the medical linear accelerator producing ionizing radiation- influencing electronics within the pacemaker, and the absorption of dose to the device. On the other hand, patients with cardiac pacemakers at the place of a tumor are rather rare, and single clinic hardly has experience with the management of such patients. The widely accepted international guidelines for management of radiation oncology patients recommend that these patients should be closely monitored and examined before, during and after radiotherapy treatment by cardiologist, and their device and condition followed up. The number of patients having both cancer and pacemaker, is growing every year, as both cancer incidence, as well as cardiac diseases incidence, are inevitably growing figures. Materials and methods: Female patient, age 69, was diagnozed with valvular cardiomyopathy and got implanted a pacemaker in 2005 and prosthetic mitral valve in 1993 (cancer was diagnosed in 2012). She was stable cardiologically and came to radiation therapy department with the diagnosis of right breast cancer, with the tumor in upper lateral quadrant of the right breast. Since she had all lymph nodes positive (28 in total), she had to have irradiated the supraclavicular region, as well as the breast with the tumor bed. She previously received chemotherapy, approved by the cardiologist. The patient was estimated to be with the high risk as device was within the field of irradiation, and the patient had high dependence on her pacemaker. The radiation therapy plan was conducted as 3D conformal therapy. The delineated target was breast with supraclavicular region, where the pacemaker was actually placed, with the addition of a pacemaker as organ at risk, to estimate the dose to the device and its components as recommended, and the breast. The targets received both 50 Gy in 25 fractions (where 20% of a pacemaker received 50 Gy, and 60% of a device received 40 Gy). The electrode to the heart received between 1 Gy and 50 Gy. Verification of dose planned and delivered was performed. Results: Evaluation of the patient status according to the guidelines and especially evaluation of all associated risks to the patient during treatment was done. Patient was irradiated by prescribed dose and followed up for the whole year, with no symptoms of failure of the pacemaker device during, or after treatment in follow up period. The functionality of a device was estimated to be unchanged, according to the parameters (electrode impedance and battery energy). Conclusion: Patient was closely monitored according to published guidelines during irradiation and afterwards. Pacemaker irradiated with the full dose did not show any signs of failure despite recommendations data, but in correlation with other published data.

Keywords: cardiac pacemaker, breast cancer, radiotherapy treatment planning, complications of treatment

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Authors: Parya Salimitari, Farhad Tabatabai Ghomsheh, Siyamak Khorramymehr, Hossein Taghadosi, Mohammad Hossein Dashti

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The aim of this study was to evaluate the effect of heel height on the knee joint direction in Genu recurvatum patients compared to normal state. The test was performed on a patient with Genu recurvatum and a healthy person with similar and match biomechanical conditions. Subjects were tested under six different positions of shoes with heels 0, 1, 2, 3, 4 and 5 cm after marking during the gate. The results of the spatial temporal geometry obtained from Vicon Motion System (six-camera T10 model, Oxford Metrics Ltd., Oxford, UK), and were used to compute and analyze the kinematic results. In this study, we tried to determine the effect of shoe heel intervention on knee joint direction correction. The results indicate that the 1 cm heel has been optimized and significantly improved in knee joint flexion and flexion-extension angle so that the difference in knee flexion-extension angle between the patient and the healthy person at some stages of walking has reached zero (good posture). The 3 cm heel compared with the 0 cm heel has reduced the knee recurvatum index (KRI) by up to 21.74% in the patient (from 219.233 mm to 47.6714 mm). According to the findings of this study, it can be concluded that heel increase is effective in correcting knee joints in Genu recurvatum and the optimum heel height is 1 cm.

Keywords: joint alignment of knee, gait analysis, genu recurvatum, heel lift, kinematics, motion-analysis

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Authors: Tabassum Yasmin, Hamid Pahlevan

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HIV/Hepatitis C co-infection treatments have evolved substantially and they have similar sustained virologic response rates as those of Hepatitis C monoinfected population. There are a few studies on therapy of patients with dual genotypes, especially in HIV/Hepatic C coinfected group. Most studies portrayed case reports of dual genotype chronic Hepatitis C coinfection treatment with Sofosbuvir/Ledipasvir and Ribavirin. A 79-year-old male with a history of HIV on Truvada and Isentress had chronic Hepatitis C with 1a and 2 genotypes. The patient has a history of alcohol intake for 40 years but recently stopped drinking alcohol. He has a history of intravenous drug use in the past and currently is not using any recreational drugs. Patient has Fibro score of 0.7 with Metavir score F2 to F4. AFP is 3.2. The HCV RNA is 493,034 IU/ML. The HBV viral DNA is < 1.30 (not detected). The CD4 is 687CU/MM. The FIB 4 is 3.34 with APRI index 0.717. The HIV viral load is 101 copies/ML. MRI abdomen did not show any liver abnormality. Fixed dose Sofosbuvir/Ledipasvir was used for therapy without Ribavirin. He tolerated medication except for some minor gastrointestinal side effects like abdominal bloating. He demonstrated 100% adherence rate. Patient completed 12 weeks of therapy. HCV RNA was undetectable at 4 and 12 weeks. He achieved SVR at week 12 and subsequently had undetectable RNA for 2 years. Dual genotype prevalence in chronic hepatitis C population is rare, especially in HIV/hepatic coinfection. Our case demonstrates that dual genotypic cases can still be successfully treated with Direct Acting Antiviral agents. The newer agents for therapy for pan genotypes were not available at the time the patient was being treated. We demonstrated that dual agent therapy was still able to maintain SVR in our patient.

Keywords: HIV/Hepatitis C, SVR (sustained virologic response), DAA (direct active antiviral agents, dual genotype

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Authors: Siddhartha Chauhan, Nitin Kumar Kotania

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

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

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Authors: Mohammed Khamis Albalushi

Abstract:

Background: Somatic symptoms disorders are usually comorbid with depressive disorders despite the fact that there is little evidence for effective treatment for it. Repetitive transcranial magnetic stimulation (rTMS) has been approved by the FDA for mildly resistant depression. From this point, we hypothesized that rTMS delivered over the prefrontal cortex (PFC) may be useful in somatic symptoms disorder. Therefore, in our case report, we want to shed light on the potential effectiveness of rTMS in somatic symptoms disorder. Case Report: A 65-year-old Omani female with multiple medical comorbidities on multiple medications. She presented complaining of multiple somatic complaints in the last 2 years after visiting multiple clinics and underwent several specialists’ examinations, investigations and procedures for somatic treatments; all of them were normal. Then patient was seen by a different psychiatric clinic; multiple anti-depressant and adjuvant anti-psychotic medications were tried, patient still did not improve. The patient was admitted to the hospital for observation and management. Initially, she was preoccupied with her somatic complaint and kept on Fluoxetine and Olanzapine along with that, topiramate was added, but still with minimal improvement. Then rTMS was added to her management plan following Intermittent theta burst (iTBS) rTMS protocol. After completing all sessions of rTMS, the patient was recovering from all her symptoms, and no complaints were reported from her. Conclusion: Our case highlights the importance of investigating more thoroughly in rTMS as a treatment option for Persistent Somatic symptoms Disorder.

Keywords: rTMS, somatic symptoms disorder, resistive cases, TMS

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Authors: Veruska C. Dutra, Afonso R. Aquino

Abstract:

Since the 1980s, global tourism activity has consolidated worldwide to become an important economic contributor, and consequently, the sociocultural and environmental impacts are starting to become evidenced. This raises the need of discussing about actions for sustainable tourism that should be linked not only to the economy, but also to the environment and social aspects. The work that is going to be presented is part of a doctoral research project in Sciences undertaken at the Sao Paulo University, Brazil. It aims to analyze whether the monitoring of the tourism sector with a focus on sustainability is applicable or not, through those indicators, put in a case study in the Jalapão State Park (JSP) conservation unit, in the state of Tocantins, Brazil. This is a study of an interdisciplinary nature that had the deductive method as its guide. We concluded that the key points of the sustainable tourism, when analyzed with the focal point in environmental indicators, are an important evaluation and quantification tool of that activity in the study locus. It displayed itself as an adequate tool for monitoring, thus decoding, the main environmental impacts that occur in tourism regions and their intensity, which is made possible through analysis, and has the objective to trace ways to prevent and correct the presented impacts.

Keywords: indicators, tourism, sustainability, Jalapão

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Authors: Mina Dabirinezhad, Mohsen Bayat Pour, Amin Dabirinejad

Abstract:

This paper is intended to introduce the technology to solve some of the deficiencies of the direct digital radiology. Nowadays, digital radiology is the latest progression in dental imaging, which has become an essential part of dentistry. There are two main parts of the direct digital radiology comprised of an intraoral X-ray machine and a sensor (digital image receptor). The dentists and the dental nurses experience afflictions during the taking image process by the direct digital X-ray machine. For instance, sometimes they need to readjust the sensor in the mouth of the patient to take the X-ray image again due to the low quality of that. Another problem is, the position of the sensor may move in the mouth of the patient and it triggers off an inappropriate image for the dentists. It means that it is a time-consuming process for dentists or dental nurses. On the other hand, taking several the X-ray images brings some problems for the patient such as being harmful to their health and feeling pain in their mouth due to the pressure of the sensor to the jaw. The author provides a technology to solve the above-mentioned issues that is called “Self-Recognition Direct Digital Radiology” (SDDR). This technology is based on the principle that the intraoral X-ray machine is capable to diagnose the location of the sensor in the mouth of the patient automatically. In addition, to solve the aforementioned problems, SDDR technology brings out fewer environmental impacts in comparison to the previous version.

Keywords: Dental direct digital imaging, digital image receptor, digital x-ray machine, and environmental impacts

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Authors: Andrey V. Timofeev

Abstract:

An adaptive nonparametric method is proposed for stable real-time detection of seismoacoustic sources in multichannel C-OTDR systems with a significant number of channels. This method guarantees given upper boundaries for probabilities of Type I and Type II errors. Properties of the proposed method are rigorously proved. The results of practical applications of the proposed method in a real C-OTDR-system are presented in this report.

Keywords: guaranteed detection, multichannel monitoring systems, change point, interval estimation, adaptive detection

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Authors: Guru Prakash, Revanth Dugalam

Abstract:

A road’s condition often deteriorates due to harsh loading such as overload due to trucks, and severe environmental conditions such as heavy rain, snow load, and cyclic loading. In absence of proper maintenance planning, this results in potholes, wide cracks, bumps, and increased roughness of roads. In this paper, a data-driven model will be developed to detect these damages using vibration and image signals. The key idea of the proposed methodology is that the road anomaly manifests in these signals, which can be detected by training a machine learning algorithm. The use of various machine learning techniques such as the support vector machine and Radom Forest method will be investigated. The proposed model will first be trained and tested with artificially simulated data, and the model architecture will be finalized by comparing the accuracies of various models. Once a model is fixed, the field study will be performed, and data will be collected. The field data will be used to validate the proposed model and to predict the future road’s health condition. The proposed will help to automate the road condition monitoring process, repair cost estimation, and maintenance planning process.

Keywords: SVM, data-driven, road health monitoring, pot-hole

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Authors: Ivan Gunass Govender, Andrea Giampiccoli

Abstract:

A developmental state should use community engagement to facilitate socio-economic development for disadvantaged groups and individual members of society through empowerment, social justice, sustainability, and self-reliance. In this regard, community-based tourism (CBT) as a growing market should be an indigenous effort aided by external facilitation. Since this form of tourism presents its own preconditions, characteristics, and challenges, it could be guided by higher education institutions engagement. In particular, the facilitation should not only serve to assist the community members to reach their own goals; but rather also focus on learning through knowledge creation and sharing with the engagement of higher education institutions. While the increased relevance of CBT has produced various CBT manuals (or handbooks/guidelines) documents aimed to ‘teach’ and assist various entities in CBT development, this research aims to analyse the current monitoring & evaluation (M&E) manuals and thereafter, propose an M&E model for CBT. It is important to mention that all too often effective monitoring is seldom carried out thus risking the long-term sustainability and improvement of the CBT ventures. Therefore, the proposed model will also consider some inputs external to the tourism field, but in relation to local economic development (LED) matters from the previously proposed development monitoring and evaluation system framework. M&E should be seen as fundamental components of any CBT initiative, and the whole CBT intervention should be evaluated. In this context, M&E in CBT should go beyond strict ‘numerical’ economic matters and should be understood in a holistic development. In addition, M&E in CBT should not consider issues in various ‘compartments’ such as tourists, tourism attractions, CBT owners/participants, and stakeholder engagement but as interdependent components of a macro-ecosystem. Finally, the external facilitation process should be structured in a way to promote community self-reliance in both the intervention and the M&E process. The research will attempt to propose an M&E model for CBT so as to enhance the CBT possibilities of long-term growth and success through effective collaborations with key stakeholders.

Keywords: community-based tourism, community-engagement, monitoring and evaluation, stakeholders

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Authors: Anna Ghosh, Dominic Shields, Ceri McIntosh, Stephen Crank

Abstract:

A 29-year-old male was a referral to the maxillofacial unit following a referral from his general dental practitioner via a routine pathway regarding a large periapical lesion on the LR4 with root resorption. The patient was asymptomatic, the LR4 vital and unrestored, and this was an incidental finding at a routine check-up. The patient's past medical history was unremarkable. Examination revealed no extra or intra-oral pathology and non-mobile teeth. No focal neurology was detected. An orthopantogram demonstrated a well-defined unilocular corticated radiolucency associated with the LR4. The root appeared shortened with the radiolucency between the root and a radio-opacity, possibly representing the displacement of the apical tip of the tooth. It was recommended that the referring general practitioner should proceed with orthograde root canal therapy, after which time exploration, enucleation, and retrograde root filling of the LR4 would be carried out by a maxillofacial unit. The patient was reviewed six months later where, due to the COVID-19 pandemic, the patient had been unable to access general dental services for the root canal treatment. He was still entirely asymptomatic. A one-year review was planned in the hope this would allow time for the orthograde root canal therapy to be completed. At this review, the orthograde root canal therapy had still not been completed. Interestingly, a repeat orthopantogram revealed a significant reduction in size with good bony infill and a significant reduction in the size of the lesion. Due to the ongoing delays with primary care dental therapy, the patient was subsequently internally referred to the restorative dentistry department for care. The patient was seen again by oral and maxillo-facial surgery in mid-2022 where he still reports this tooth as asymptomatic with no focal neurology. The patient's history was fully reviewed, and noted that 15 years previously, the patient underwent open reduction and internal fixation of a left angle of mandible fracture. Temporary IMF involving IMF screws and fixation wires were employed to maintain occlusion during plating and subsequently removed post-operatively. It is proposed that the radiolucency was, as a result of the IMF screw placement, penetrating the LR4 root resulting in resorption of the tooth root and development of a radiolucency. This case highlights the importance of careful screw size and physical site location, and placement of IMF screws, as there can be permeant damage to a patient’s dentition.

Keywords: facial trauma, inter-maxillary fixation, mandibular radiolucency, oral and maxillo-facial surgery

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