Search results for: outbreak prediction
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2440

Search results for: outbreak prediction

1630 Hybrid Learning and Testing at times of Corona: A Case Study at an English Department

Authors: Mimoun Melliti

Abstract:

In the wake of the global pandemic, educational systems worldwide faced unprecedented challenges and had to swiftly adapt to new conditions. This necessitated a fundamental shift in assessment processes, as traditional in-person exams became impractical. The present paper aims to investigate how educational systems have adapted to the new conditions imposed by the outbreak of the pandemic. This paper serves as a case study documenting the various decisions, conditions, experiments, and outcomes associated with transitioning the assessment processes of a higher education institution to a fully online format. The participants of this study consisted of 4666 students from health, engineering, science, and humanities disciplines, who were enrolled in general English (Eng101/104) and English for specific purposes (Eng102/113) courses at a preparatory year institution in Saudi Arabia. The findings of this study indicate that online assessment can be effectively implemented given the fulfillment of specific requirements. These prerequisites encompass the presence of competent staff, administrative flexibility, and the availability of necessary infrastructure and technological support. The significance of this case study lies in its comprehensive description of the various steps and measures undertaken to adapt to the "new normal" situation. Furthermore, it evaluates the impact of these measures and offers detailed recommendations for potential similar future scenarios.

Keywords: hybrid learning, testing, adaptive teaching, EFL

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1629 A Framework on Data and Remote Sensing for Humanitarian Logistics

Authors: Vishnu Nagendra, Marten Van Der Veen, Stefania Giodini

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Effective humanitarian logistics operations are a cornerstone in the success of disaster relief operations. However, for effectiveness, they need to be demand driven and supported by adequate data for prioritization. Without this data operations are carried out in an ad hoc manner and eventually become chaotic. The current availability of geospatial data helps in creating models for predictive damage and vulnerability assessment, which can be of great advantage to logisticians to gain an understanding on the nature and extent of the disaster damage. This translates into actionable information on the demand for relief goods, the state of the transport infrastructure and subsequently the priority areas for relief delivery. However, due to the unpredictable nature of disasters, the accuracy in the models need improvement which can be done using remote sensing data from UAVs (Unmanned Aerial Vehicles) or satellite imagery, which again come with certain limitations. This research addresses the need for a framework to combine data from different sources to support humanitarian logistic operations and prediction models. The focus is on developing a workflow to combine data from satellites and UAVs post a disaster strike. A three-step approach is followed: first, the data requirements for logistics activities are made explicit, which is done by carrying out semi-structured interviews with on field logistics workers. Second, the limitations in current data collection tools are analyzed to develop workaround solutions by following a systems design approach. Third, the data requirements and the developed workaround solutions are fit together towards a coherent workflow. The outcome of this research will provide a new method for logisticians to have immediately accurate and reliable data to support data-driven decision making.

Keywords: unmanned aerial vehicles, damage prediction models, remote sensing, data driven decision making

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1628 Financial Fraud Prediction for Russian Non-Public Firms Using Relational Data

Authors: Natalia Feruleva

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The goal of this paper is to develop the fraud risk assessment model basing on both relational and financial data and test the impact of the relationships between Russian non-public companies on the likelihood of financial fraud commitment. Relationships mean various linkages between companies such as parent-subsidiary relationship and person-related relationships. These linkages may provide additional opportunities for committing fraud. Person-related relationships appear when firms share a director, or the director owns another firm. The number of companies belongs to CEO and managed by CEO, the number of subsidiaries was calculated to measure the relationships. Moreover, the dummy variable describing the existence of parent company was also included in model. Control variables such as financial leverage and return on assets were also implemented because they describe the motivating factors of fraud. To check the hypotheses about the influence of the chosen parameters on the likelihood of financial fraud, information about person-related relationships between companies, existence of parent company and subsidiaries, profitability and the level of debt was collected. The resulting sample consists of 160 Russian non-public firms. The sample includes 80 fraudsters and 80 non-fraudsters operating in 2006-2017. The dependent variable is dichotomous, and it takes the value 1 if the firm is engaged in financial crime, otherwise 0. Employing probit model, it was revealed that the number of companies which belong to CEO of the firm or managed by CEO has significant impact on the likelihood of financial fraud. The results obtained indicate that the more companies are affiliated with the CEO, the higher the likelihood that the company will be involved in financial crime. The forecast accuracy of the model is about is 80%. Thus, the model basing on both relational and financial data gives high level of forecast accuracy.

Keywords: financial fraud, fraud prediction, non-public companies, regression analysis, relational data

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1627 Post-Yugoslav Identity Negotiations in Diaspora Settings: Biographical Narration among Academics of Serbian Origin in Baden-Württemberg

Authors: Dragana Bubulj

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The Former Republic of Yugoslavia was a sort of protective umbrella, a unique concept of gathering different ethnical, cultural, and religious identities, as well as diverse intersections of those. After 43-months long civil war and states disintegration in 1995, which resulted in 5 post-Yugoslav countries, Yugoslav Diaspora experienced radical changes. In Germany, one of the countries with the highest percentage of Yugoslav emigration, segregation on ethno-national grounds was empowered by the outbreak of the conflict: firstly on a socio-cultural level, and followed by changes on the level of institutional organizing. Psycho-emotional and financial involvement of Diaspora into the war is also not to be neglected. People of Serbian origin have been additionally overstrained with the designation of Serbs as war criminals in German media and the public sphere. In this way, the path from 'being a Yugoslav' toward 'becoming a Serb', outside nowadays Serbia, has been qualitatively different in comparison to potential identity shiftings experienced by other members of Former Yugoslav population. This paper is part of an ongoing PhD research and tackles biographical narratives of academics of Serbian origin in one German region. Paper addresses processes of post-Yugoslav identity negotiations in Diaspora settings, nationalistic tendentious among second generation youth, and discusses - based on NS-references founded in collected data - question of historicity of biographies.

Keywords: biography, diaspora, ethnography, former republic of Yugoslavia, identity

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1626 Predictability of Kiremt Rainfall Variability over the Northern Highlands of Ethiopia on Dekadal and Monthly Time Scales Using Global Sea Surface Temperature

Authors: Kibrom Hadush

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Countries like Ethiopia, whose economy is mainly rain-fed dependent agriculture, are highly vulnerable to climate variability and weather extremes. Sub-seasonal (monthly) and dekadal forecasts are hence critical for crop production and water resource management. Therefore, this paper was conducted to study the predictability and variability of Kiremt rainfall over the northern half of Ethiopia on monthly and dekadal time scales in association with global Sea Surface Temperature (SST) at different lag time. Trends in rainfall have been analyzed on annual, seasonal (Kiremt), monthly, and dekadal (June–September) time scales based on rainfall records of 36 meteorological stations distributed across four homogenous zones of the northern half of Ethiopia for the period 1992–2017. The results from the progressive Mann–Kendall trend test and the Sen’s slope method shows that there is no significant trend in the annual, Kiremt, monthly and dekadal rainfall total at most of the station's studies. Moreover, the rainfall in the study area varies spatially and temporally, and the distribution of the rainfall pattern increases from the northeast rift valley to northwest highlands. Methods of analysis include graphical correlation and multiple linear regression model are employed to investigate the association between the global SSTs and Kiremt rainfall over the homogeneous rainfall zones and to predict monthly and dekadal (June-September) rainfall using SST predictors. The results of this study show that in general, SST in the equatorial Pacific Ocean is the main source of the predictive skill of the Kiremt rainfall variability over the northern half of Ethiopia. The regional SSTs in the Atlantic and the Indian Ocean as well contribute to the Kiremt rainfall variability over the study area. Moreover, the result of the correlation analysis showed that the decline of monthly and dekadal Kiremt rainfall over most of the homogeneous zones of the study area are caused by the corresponding persistent warming of the SST in the eastern and central equatorial Pacific Ocean during the period 1992 - 2017. It is also found that the monthly and dekadal Kiremt rainfall over the northern, northwestern highlands and northeastern lowlands of Ethiopia are positively correlated with the SST in the western equatorial Pacific, eastern and tropical northern the Atlantic Ocean. Furthermore, the SSTs in the western equatorial Pacific and Indian Oceans are positively correlated to the Kiremt season rainfall in the northeastern highlands. Overall, the results showed that the prediction models using combined SSTs at various ocean regions (equatorial and tropical) performed reasonably well in the prediction (With R2 ranging from 30% to 65%) of monthly and dekadal rainfall and recommends it can be used for efficient prediction of Kiremt rainfall over the study area to aid with systematic and informed decision making within the agricultural sector.

Keywords: dekadal, Kiremt rainfall, monthly, Northern Ethiopia, sea surface temperature

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1625 Design of Sustainable Concrete Pavement by Incorporating RAP Aggregates

Authors: Selvam M., Vadthya Poornachandar, Surender Singh

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These Reclaimed Asphalt Pavement (RAP) aggregates are generally dumped in the open area after the demolition of Asphalt Pavements. The utilization of RAP aggregates in cement concrete pavements may provide several socio-economic-environmental benefits and could embrace the circular economy. The cross recycling of RAP aggregates in the concrete pavement could reduce the consumption of virgin aggregates and saves the fertile land. However, the structural, as well as functional properties of RAP-concrete could be significantly lower than the conventional Pavement Quality Control (PQC) pavements. This warrants judicious selection of RAP fraction (coarse and fine aggregates) along with the accurate proportion of the same for PQC highways. Also, the selection of the RAP fraction and its proportion shall not be solely based on the mechanical properties of RAP-concrete specimens but also governed by the structural and functional behavior of the pavement system. In this study, an effort has been made to predict the optimum RAP fraction and its corresponding proportion for cement concrete pavements by considering the low-volume and high-volume roads. Initially, the effect of inclusions of RAP on the fresh and mechanical properties of concrete pavement mixes is mapped through an extensive literature survey. Almost all the studies available to date are considered for this study. Generally, Indian Roads Congress (IRC) methods are the most widely used design method in India for the analysis of concrete pavements, and the same has been considered for this study. Subsequently, fatigue damage analysis is performed to evaluate the required safe thickness of pavement slab for different fractions of RAP (coarse RAP). Consequently, the performance of RAP-concrete is predicted by employing the AASHTO-1993 model for the following distresses conditions: faulting, cracking, and smoothness. The performance prediction and total cost analysis of RAP aggregates depict that the optimum proportions of coarse RAP aggregates in the PQC mix are 35% and 50% for high volume and low volume roads, respectively.

Keywords: concrete pavement, RAP aggregate, performance prediction, pavement design

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1624 Machine Learning Techniques in Seismic Risk Assessment of Structures

Authors: Farid Khosravikia, Patricia Clayton

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The main objective of this work is to evaluate the advantages and disadvantages of various machine learning techniques in two key steps of seismic hazard and risk assessment of different types of structures. The first step is the development of ground-motion models, which are used for forecasting ground-motion intensity measures (IM) given source characteristics, source-to-site distance, and local site condition for future events. IMs such as peak ground acceleration and velocity (PGA and PGV, respectively) as well as 5% damped elastic pseudospectral accelerations at different periods (PSA), are indicators of the strength of shaking at the ground surface. Typically, linear regression-based models, with pre-defined equations and coefficients, are used in ground motion prediction. However, due to the restrictions of the linear regression methods, such models may not capture more complex nonlinear behaviors that exist in the data. Thus, this study comparatively investigates potential benefits from employing other machine learning techniques as statistical method in ground motion prediction such as Artificial Neural Network, Random Forest, and Support Vector Machine. The results indicate the algorithms satisfy some physically sound characteristics such as magnitude scaling distance dependency without requiring pre-defined equations or coefficients. Moreover, it is shown that, when sufficient data is available, all the alternative algorithms tend to provide more accurate estimates compared to the conventional linear regression-based method, and particularly, Random Forest outperforms the other algorithms. However, the conventional method is a better tool when limited data is available. Second, it is investigated how machine learning techniques could be beneficial for developing probabilistic seismic demand models (PSDMs), which provide the relationship between the structural demand responses (e.g., component deformations, accelerations, internal forces, etc.) and the ground motion IMs. In the risk framework, such models are used to develop fragility curves estimating exceeding probability of damage for pre-defined limit states, and therefore, control the reliability of the predictions in the risk assessment. In this study, machine learning algorithms like artificial neural network, random forest, and support vector machine are adopted and trained on the demand parameters to derive PSDMs for them. It is observed that such models can provide more accurate estimates of prediction in relatively shorter about of time compared to conventional methods. Moreover, they can be used for sensitivity analysis of fragility curves with respect to many modeling parameters without necessarily requiring more intense numerical response-history analysis.

Keywords: artificial neural network, machine learning, random forest, seismic risk analysis, seismic hazard analysis, support vector machine

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1623 A Computational Approach for the Prediction of Relevant Olfactory Receptors in Insects

Authors: Zaide Montes Ortiz, Jorge Alberto Molina, Alejandro Reyes

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Insects are extremely successful organisms. A sophisticated olfactory system is in part responsible for their survival and reproduction. The detection of volatile organic compounds can positively or negatively affect many behaviors in insects. Compounds such as carbon dioxide (CO2), ammonium, indol, and lactic acid are essential for many species of mosquitoes like Anopheles gambiae in order to locate vertebrate hosts. For instance, in A. gambiae, the olfactory receptor AgOR2 is strongly activated by indol, which accounts for almost 30% of human sweat. On the other hand, in some insects of agricultural importance, the detection and identification of pheromone receptors (PRs) in lepidopteran species has become a promising field for integrated pest management. For example, with the disruption of the pheromone receptor, BmOR1, mediated by transcription activator-like effector nucleases (TALENs), the sensitivity to bombykol was completely removed affecting the pheromone-source searching behavior in male moths. Then, the detection and identification of olfactory receptors in the genomes of insects is fundamental to improve our understanding of the ecological interactions, and to provide alternatives in the integrated pests and vectors management. Hence, the objective of this study is to propose a bioinformatic workflow to enhance the detection and identification of potential olfactory receptors in genomes of relevant insects. Applying Hidden Markov models (Hmms) and different computational tools, potential candidates for pheromone receptors in Tuta absoluta were obtained, as well as potential carbon dioxide receptors in Rhodnius prolixus, the main vector of Chagas disease. This study showed the validity of a bioinformatic workflow with a potential to improve the identification of certain olfactory receptors in different orders of insects.

Keywords: bioinformatic workflow, insects, olfactory receptors, protein prediction

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1622 Descriptive Analysis of Community-Based Needs among Asylum Seekers in New England before and after COVID-19

Authors: Viknesh Kasthuri, Victoria Angenent-Mari, Jade Wexler

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The COVID-19 pandemic dramatically altered the landscape of asylum medicine. Brown Human Rights Asylum Clinic (BHRAC) is a medical-student-run asylum clinic that provides pro-bono medical evaluations and forensic affidavits for individuals seeking asylum in New England. After the outbreak of COVID-19 in March 2020, BHRAC experienced numerous changes both in the number of clients requesting services as well as in the resource needs of these clients. Uniquely, BHRAC assesses the needs of clients during their affidavit interview and seeks to address these needs by connecting clients to local community organizations and resources. Data regarding the specific needs of clients range from 2019-present day. Analysis of internal BHRAC’s internal data suggested a small increase in requests for assistance with light and gas (from 5% of total resource requests pre-COVID to 11%), as well as a decrease in requests for mental health services (from 20% of resources pre-COVID to 13% post-COVID). Furthermore, BHRAC witnessed a decline in clinic volume during the second half of 2020. In short, our data suggest that the pandemic affected asylum seekers' access to medico-legal services and the resources they need. Future research with larger sample sizes and in other geographic locations is required to determine the holistic impact of the COVID-19 pandemic on asylum seekers.

Keywords: asylum clinic, asylum medicine, COVID, social determinants of health

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1621 Modified Weibull Approach for Bridge Deterioration Modelling

Authors: Niroshan K. Walgama Wellalage, Tieling Zhang, Richard Dwight

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State-based Markov deterioration models (SMDM) sometimes fail to find accurate transition probability matrix (TPM) values, and hence lead to invalid future condition prediction or incorrect average deterioration rates mainly due to drawbacks of existing nonlinear optimization-based algorithms and/or subjective function types used for regression analysis. Furthermore, a set of separate functions for each condition state with age cannot be directly derived by using Markov model for a given bridge element group, which however is of interest to industrial partners. This paper presents a new approach for generating Homogeneous SMDM model output, namely, the Modified Weibull approach, which consists of a set of appropriate functions to describe the percentage condition prediction of bridge elements in each state. These functions are combined with Bayesian approach and Metropolis Hasting Algorithm (MHA) based Markov Chain Monte Carlo (MCMC) simulation technique for quantifying the uncertainty in model parameter estimates. In this study, factors contributing to rail bridge deterioration were identified. The inspection data for 1,000 Australian railway bridges over 15 years were reviewed and filtered accordingly based on the real operational experience. Network level deterioration model for a typical bridge element group was developed using the proposed Modified Weibull approach. The condition state predictions obtained from this method were validated using statistical hypothesis tests with a test data set. Results show that the proposed model is able to not only predict the conditions in network-level accurately but also capture the model uncertainties with given confidence interval.

Keywords: bridge deterioration modelling, modified weibull approach, MCMC, metropolis-hasting algorithm, bayesian approach, Markov deterioration models

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1620 Design of a Standard Weather Data Acquisition Device for the Federal University of Technology, Akure Nigeria

Authors: Isaac Kayode Ogunlade

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Data acquisition (DAQ) is the process by which physical phenomena from the real world are transformed into an electrical signal(s) that are measured and converted into a digital format for processing, analysis, and storage by a computer. The DAQ is designed using PIC18F4550 microcontroller, communicating with Personal Computer (PC) through USB (Universal Serial Bus). The research deployed initial knowledge of data acquisition system and embedded system to develop a weather data acquisition device using LM35 sensor to measure weather parameters and the use of Artificial Intelligence(Artificial Neural Network - ANN)and statistical approach(Autoregressive Integrated Moving Average – ARIMA) to predict precipitation (rainfall). The device is placed by a standard device in the Department of Meteorology, Federal University of Technology, Akure (FUTA) to know the performance evaluation of the device. Both devices (standard and designed) were subjected to 180 days with the same atmospheric condition for data mining (temperature, relative humidity, and pressure). The acquired data is trained in MATLAB R2012b environment using ANN, and ARIMAto predict precipitation (rainfall). Root Mean Square Error (RMSE), Mean Absolute Error (MAE), Correction Square (R2), and Mean Percentage Error (MPE) was deplored as standardize evaluation to know the performance of the models in the prediction of precipitation. The results from the working of the developed device show that the device has an efficiency of 96% and is also compatible with Personal Computer (PC) and laptops. The simulation result for acquired data shows that ANN models precipitation (rainfall) prediction for two months (May and June 2017) revealed a disparity error of 1.59%; while ARIMA is 2.63%, respectively. The device will be useful in research, practical laboratories, and industrial environments.

Keywords: data acquisition system, design device, weather development, predict precipitation and (FUTA) standard device

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1619 A Novel Epitope Prediction for Vaccine Designing against Ebola Viral Envelope Proteins

Authors: Manju Kanu, Subrata Sinha, Surabhi Johari

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Viral proteins of Ebola viruses belong to one of the best studied viruses; however no effective prevention against EBOV has been developed. Epitope-based vaccines provide a new strategy for prophylactic and therapeutic application of pathogen-specific immunity. A critical requirement of this strategy is the identification and selection of T-cell epitopes that act as vaccine targets. This study describes current methodologies for the selection process, with Ebola virus as a model system. Hence great challenge in the field of ebola virus research is to design universal vaccine. A combination of publicly available bioinformatics algorithms and computational tools are used to screen and select antigen sequences as potential T-cell epitopes of supertypes Human Leukocyte Antigen (HLA) alleles. MUSCLE and MOTIF tools were used to find out most conserved peptide sequences of viral proteins. Immunoinformatics tools were used for prediction of immunogenic peptides of viral proteins in zaire strains of Ebola virus. Putative epitopes for viral proteins (VP) were predicted from conserved peptide sequences of VP. Three tools NetCTL 1.2, BIMAS and Syfpeithi were used to predict the Class I putative epitopes while three tools, ProPred, IEDB-SMM-align and NetMHCII 2.2 were used to predict the Class II putative epitopes. B cell epitopes were predicted by BCPREDS 1.0. Immunogenic peptides were identified and selected manually by putative epitopes predicted from online tools individually for both MHC classes. Finally sequences of predicted peptides for both MHC classes were looked for common region which was selected as common immunogenic peptide. The immunogenic peptides were found for viral proteins of Ebola virus: epitopes FLESGAVKY, SSLAKHGEY. These predicted peptides could be promising candidates to be used as target for vaccine design.

Keywords: epitope, b cell, immunogenicity, ebola

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1618 Thermo-Mechanical Analysis of Composite Structures Utilizing a Beam Finite Element Based on Global-Local Superposition

Authors: Andre S. de Lima, Alfredo R. de Faria, Jose J. R. Faria

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Accurate prediction of thermal stresses is particularly important for laminated composite structures, as large temperature changes may occur during fabrication and field application. The normal transverse deformation plays an important role in the prediction of such stresses, especially for problems involving thick laminated plates subjected to uniform temperature loads. Bearing this in mind, the present study aims to investigate the thermo-mechanical behavior of laminated composite structures using a new beam element based on global-local superposition, accounting for through-the-thickness effects. The element formulation is based on a global-local superposition in the thickness direction, utilizing a cubic global displacement field in combination with a linear layerwise local displacement distribution, which assures zig-zag behavior of the stresses and displacements. By enforcing interlaminar stress (normal and shear) and displacement continuity, as well as free conditions at the upper and lower surfaces, the number of degrees of freedom in the model is maintained independently of the number of layers. Moreover, the proposed formulation allows for the determination of transverse shear and normal stresses directly from the constitutive equations, without the need of post-processing. Numerical results obtained with the beam element were compared to analytical solutions, as well as results obtained with commercial finite elements, rendering satisfactory results for a range of length-to-thickness ratios. The results confirm the need for an element with through-the-thickness capabilities and indicate that the present formulation is a promising alternative to such analysis.

Keywords: composite beam element, global-local superposition, laminated composite structures, thermal stresses

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1617 Physiochemical Parameters Assessment and Evaluation of the Quality of Drinking Water in Some Parts of Lagos State

Authors: G. T. Mudashiru, Mayowa P. Ibitola

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Investigation was carried out at Ikorodu North local council development area of Lagos state using physiochemical parameters to study the quality drinking water. It was ascertained that the human functions and activities were dependent on the continuous and availability of good drinking water. Six water samples were collected at six different boreholes from various outlets and homes in Ikorodu North local council development area. Lagos state Nigeria. Analysis was carried out to determine the purity of water for domestic use. Physicochemical properties evaluation was adapted using standard chemical methods. A number of parameters such as PH, turbidity, conductivity, total dissolved solids, color, chloride, sulphate, nitrate, hardness were determined. Heavy metals such as Zn, Mg, Fe, Pb, Hg, and Mn as well as total coliform counts were observed. The resulted values of each parameter were justified with World Health Organization (WHO) and Lagos state water regulatory commission LSWRC standard values for quantitative comparison. The result reveals that all the water had pH value well below the WHO maximum permissible level for potable water. Other physicochemical parameters were within the safe limit of WHO standard showing the portability nature of the water. It can be concluded that though the water is potable, there should be a kind of treatment of the water before consumption to prevent outbreak of diseases.

Keywords: drinking water, physiology, boreholes, heavy metals, domestic

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1616 Practical Modelling of RC Structural Walls under Monotonic and Cyclic Loading

Authors: Reza E. Sedgh, Rajesh P. Dhakal

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Shear walls have been used extensively as the main lateral force resisting systems in multi-storey buildings. The recent development in performance based design urges practicing engineers to conduct nonlinear static or dynamic analysis to evaluate seismic performance of multi-storey shear wall buildings by employing distinct analytical models suggested in the literature. For practical purpose, application of macroscopic models to simulate the global and local nonlinear behavior of structural walls outweighs the microscopic models. The skill level, computational time and limited access to RC specialized finite element packages prevents the general application of this method in performance based design or assessment of multi-storey shear wall buildings in design offices. Hence, this paper organized to verify capability of nonlinear shell element in commercially available package (Sap2000) in simulating results of some specimens under monotonic and cyclic loads with very oversimplified available cyclic material laws in the analytical tool. The selection of constitutive models, the determination of related parameters of the constituent material and appropriate nonlinear shear model are presented in detail. Adoption of proposed simple model demonstrated that the predicted results follow the overall trend of experimental force-displacement curve. Although, prediction of ultimate strength and the overall shape of hysteresis model agreed to some extent with experiment, the ultimate displacement(significant strength degradation point) prediction remains challenging in some cases.

Keywords: analytical model, nonlinear shell element, structural wall, shear behavior

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1615 Trauma Scores and Outcome Prediction After Chest Trauma

Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

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Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

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1614 Assessment of Biosecurity Strategies of Selected Fishponds in Bataan

Authors: Rudy C. Flores, Felicisima E. Tungol, Armando A. Villafuerte, Abraham S. Antonio, Roy N. Oroyo, Henry A. Cruz

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An assessment of the biosecurity strategies of selected fishponds in Bataan was conducted by the researchers from Bataan Peninsula State University Orani Campus to determine the present status of Biosecurity strategies being practice by selected freshwater and brackish water fishpond operators in the province to have an initial data of their system of safeguarding cultured fishes against possible diseases. Likewise, it aims to evaluate the extent of implementation of the following areas of Biosecurity namely; fishpond location, perimeter, entrance, building/ pond structure, shipping, new stocks, feeds, dead stocks, soil and water treatment, disinfection and vaccination program. The results of the assessment revealed that the present average status of the surveyed fish ponds in Bataan based on the data gathered from selected fishpond operators is poor for 44.64% and fair for 12.61%, which means that more than one- half of the surveyed fishpond do not have the first and second line of defense against diseases and there is always a higher risk of infection, contamination and possibility of disease outbreak. This indicates that fishpond operators in Bataan need technological interventions to improve their harvest and prevent heavy losses from fish diseases, although biosecurity is satisfactory for 12.92% and very good for 9.16%, which indicate that 22.08% of the surveyed fishponds have their own strategies to keep their stocks from diseases.

Keywords: biosecurity, fishpond operators, soil and water treatment, filtration system, bird scaring devices

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1613 Forecast Financial Bubbles: Multidimensional Phenomenon

Authors: Zouari Ezzeddine, Ghraieb Ikram

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From the results of the academic literature which evokes the limitations of previous studies, this article shows the reasons for multidimensionality Prediction of financial bubbles. A new framework for modeling study predicting financial bubbles by linking a set of variable presented on several dimensions dictating its multidimensional character. It takes into account the preferences of financial actors. A multicriteria anticipation of the appearance of bubbles in international financial markets helps to fight against a possible crisis.

Keywords: classical measures, predictions, financial bubbles, multidimensional, artificial neural networks

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1612 An Internet of Things Smart Washroom Framework

Authors: Robin Ratnasingham, Maher Elshakankiri

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This research report will look at how to make a smart washroom to increase public hygiene and cleanliness. The system would use IoT devices to pick up various activities in the washroom and notify the appropriate stakeholders or devices to regulate the condition of the washroom. As more people are required to physically go back to the office or school, ensuring a clean and sanitized washroom is even more important now than before. It would help prevent virus outbreaks and safeguard the organization from shutdowns or slowdowns in their business. A framework of the suggested smart washroom was introduced to help reduce the chances of a virus outbreak. Most organizations outsource renovation or implementation to an external party. Using the smart washroom framework, we looked at vendors that provide smart washroom solutions. There are IoT vendors that cannot match the framework, and there are vendors that can support the framework design. This segment is a niche market, and most of the devices are similar in their basic functions. However, all the vendors have unique characteristics to give them a competitive advantage over the rest of the IoT washroom companies. Ultimately, the organization would need to decide if they want to add IoT devices to enable smart capability or renovate the washroom to create a fluid IoT smart washroom design. The report would introduce an IoT smart washroom framework to help organizations design a cohesive preventive measure network for the daily maintenance routine. The framework is designed to help understand how to manage washroom cleanliness more efficiently and to provide guidance in achieving this goal. The leading result is eliminating potential viral outbreaks that could jeopardize the organization.

Keywords: IoT, smart washroom, public hygiene, cleanliness, virus outbreaks, safeguard

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1611 Comparison between Two Software Packages GSTARS4 and HEC-6 about Prediction of the Sedimentation Amount in Dam Reservoirs and to Estimate Its Efficient Life Time in the South of Iran

Authors: Fatemeh Faramarzi, Hosein Mahjoob

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Building dams on rivers for utilization of water resources causes problems in hydrodynamic equilibrium and results in leaving all or part of the sediments carried by water in dam reservoir. This phenomenon has also significant impacts on water and sediment flow regime and in the long term can cause morphological changes in the environment surrounding the river, reducing the useful life of the reservoir which threatens sustainable development through inefficient management of water resources. In the past, empirical methods were used to predict the sedimentation amount in dam reservoirs and to estimate its efficient lifetime. But recently the mathematical and computational models are widely used in sedimentation studies in dam reservoirs as a suitable tool. These models usually solve the equations using finite element method. This study compares the results from tow software packages, GSTARS4 & HEC-6, in the prediction of the sedimentation amount in Dez dam, southern Iran. The model provides a one-dimensional, steady-state simulation of sediment deposition and erosion by solving the equations of momentum, flow and sediment continuity and sediment transport. GSTARS4 (Generalized Sediment Transport Model for Alluvial River Simulation) which is based on a one-dimensional mathematical model that simulates bed changes in both longitudinal and transverse directions by using flow tubes in a quasi-two-dimensional scheme to calibrate a period of 47 years and forecast the next 47 years of sedimentation in Dez Dam, Southern Iran. This dam is among the highest dams all over the world (with its 203 m height), and irrigates more than 125000 square hectares of downstream lands and plays a major role in flood control in the region. The input data including geometry, hydraulic and sedimentary data, starts from 1955 to 2003 on a daily basis. To predict future river discharge, in this research, the time series data were assumed to be repeated after 47 years. Finally, the obtained result was very satisfactory in the delta region so that the output from GSTARS4 was almost identical to the hydrographic profile in 2003. In the Dez dam due to the long (65 km) and a large tank, the vertical currents are dominant causing the calculations by the above-mentioned method to be inaccurate. To solve this problem, we used the empirical reduction method to calculate the sedimentation in the downstream area which led to very good answers. Thus, we demonstrated that by combining these two methods a very suitable model for sedimentation in Dez dam for the study period can be obtained. The present study demonstrated successfully that the outputs of both methods are the same.

Keywords: Dez Dam, prediction, sedimentation, water resources, computational models, finite element method, GSTARS4, HEC-6

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1610 Biomechanical Prediction of Veins and Soft Tissues beneath Compression Stockings Using Fluid-Solid Interaction Model

Authors: Chongyang Ye, Rong Liu

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

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

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1609 Application of a Model-Free Artificial Neural Networks Approach for Structural Health Monitoring of the Old Lidingö Bridge

Authors: Ana Neves, John Leander, Ignacio Gonzalez, Raid Karoumi

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Systematic monitoring and inspection are needed to assess the present state of a structure and predict its future condition. If an irregularity is noticed, repair actions may take place and the adequate intervention will most probably reduce the future costs with maintenance, minimize downtime and increase safety by avoiding the failure of the structure as a whole or of one of its structural parts. For this to be possible decisions must be made at the right time, which implies using systems that can detect abnormalities in their early stage. In this sense, Structural Health Monitoring (SHM) is seen as an effective tool for improving the safety and reliability of infrastructures. This paper explores the decision-making problem in SHM regarding the maintenance of civil engineering structures. The aim is to assess the present condition of a bridge based exclusively on measurements using the suggested method in this paper, such that action is taken coherently with the information made available by the monitoring system. Artificial Neural Networks are trained and their ability to predict structural behavior is evaluated in the light of a case study where acceleration measurements are acquired from a bridge located in Stockholm, Sweden. This relatively old bridge is presently still in operation despite experiencing obvious problems already reported in previous inspections. The prediction errors provide a measure of the accuracy of the algorithm and are subjected to further investigation, which comprises concepts like clustering analysis and statistical hypothesis testing. These enable to interpret the obtained prediction errors, draw conclusions about the state of the structure and thus support decision making regarding its maintenance.

Keywords: artificial neural networks, clustering analysis, model-free damage detection, statistical hypothesis testing, structural health monitoring

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1608 Pulmonary Disease Identification Using Machine Learning and Deep Learning Techniques

Authors: Chandu Rathnayake, Isuri Anuradha

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Early detection and accurate diagnosis of lung diseases play a crucial role in improving patient prognosis. However, conventional diagnostic methods heavily rely on subjective symptom assessments and medical imaging, often causing delays in diagnosis and treatment. To overcome this challenge, we propose a novel lung disease prediction system that integrates patient symptoms and X-ray images to provide a comprehensive and reliable diagnosis.In this project, develop a mobile application specifically designed for detecting lung diseases. Our application leverages both patient symptoms and X-ray images to facilitate diagnosis. By combining these two sources of information, our application delivers a more accurate and comprehensive assessment of the patient's condition, minimizing the risk of misdiagnosis. Our primary aim is to create a user-friendly and accessible tool, particularly important given the current circumstances where many patients face limitations in visiting healthcare facilities. To achieve this, we employ several state-of-the-art algorithms. Firstly, the Decision Tree algorithm is utilized for efficient symptom-based classification. It analyzes patient symptoms and creates a tree-like model to predict the presence of specific lung diseases. Secondly, we employ the Random Forest algorithm, which enhances predictive power by aggregating multiple decision trees. This ensemble technique improves the accuracy and robustness of the diagnosis. Furthermore, we incorporate a deep learning model using Convolutional Neural Network (CNN) with the RestNet50 pre-trained model. CNNs are well-suited for image analysis and feature extraction. By training CNN on a large dataset of X-ray images, it learns to identify patterns and features indicative of lung diseases. The RestNet50 architecture, known for its excellent performance in image recognition tasks, enhances the efficiency and accuracy of our deep learning model. By combining the outputs of the decision tree-based algorithms and the deep learning model, our mobile application generates a comprehensive lung disease prediction. The application provides users with an intuitive interface to input their symptoms and upload X-ray images for analysis. The prediction generated by the system offers valuable insights into the likelihood of various lung diseases, enabling individuals to take appropriate actions and seek timely medical attention. Our proposed mobile application has significant potential to address the rising prevalence of lung diseases, particularly among young individuals with smoking addictions. By providing a quick and user-friendly approach to assessing lung health, our application empowers individuals to monitor their well-being conveniently. This solution also offers immense value in the context of limited access to healthcare facilities, enabling timely detection and intervention. In conclusion, our research presents a comprehensive lung disease prediction system that combines patient symptoms and X-ray images using advanced algorithms. By developing a mobile application, we provide an accessible tool for individuals to assess their lung health conveniently. This solution has the potential to make a significant impact on the early detection and management of lung diseases, benefiting both patients and healthcare providers.

Keywords: CNN, random forest, decision tree, machine learning, deep learning

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1607 The Difference of Menstrual Cycle Profile and Urinary Luteinizing Hormone Changes In Polycystic Ovary Syndrome And Healthy Women

Authors: Ning Li, Jiacheng Zhang, Zheng Yang, Sylvia Kang

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Introduction: Polycystic ovary syndrome (PCOS) is a common physiological symptom in women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods and excess male hormone (androgen) levels. Mira analyzes the cycle profiles and the luteinizing hormone (LH) changes in urine, closely related to the fertility level of healthy women and PCOS women. From the difference between the two groups, Mira helps to understand the physiological state of PCOS women and their hormonal changes in the menstrual cycle. Methods: In this study, data from 1496 cycles and information from 342 women belonging to two groups (181 PCOS and 161 Healthy) were collected and analyzed. Women test their luteinizing hormone (LH) in urine daily with Mira fertility test wand and Mira analyzer, from the day after the menstruation to the starting day of the next menstruation. All the collected data meets Mira’s user agreement and users’ identification was removed. The cycle length, LH peak, and other cycle information of the PCOS group were compared with the Healthy group. Results: The average cycle length of PCOS women is 41 days and of the Healthy women is 33 days. 91.4% of cycle length is within 40 days for the Healthy group, while it decreases to 71.9% for the PCOS group. This means PCOS women have a longer menstrual cycle and more variation during the cycle. With more variation, the ovulation prediction becomes more difficult for the PCOS group. The deviation between the LH surge day and the predicted ovulation day, calculated by the starting day of the next menstruation minus 14 days, is greater in the PCOS group compared with the Healthy group. Also, 46.96% of PCOS women have an irregular cycle, and only 19.25% of healthy women show an irregular cycle. Conclusion: PCOS women have longer menstrual cycles and more variation during the menstrual cycles. The traditional ovulation prediction is not suitable for PCOS women.

Keywords: menstrual cycle, PCOS, urinary luteinizing hormone, Mira

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1606 Energy System Analysis Using Data-Driven Modelling and Bayesian Methods

Authors: Paul Rowley, Adam Thirkill, Nick Doylend, Philip Leicester, Becky Gough

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The dynamic performance of all energy generation technologies is impacted to varying degrees by the stochastic properties of the wider system within which the generation technology is located. This stochasticity can include the varying nature of ambient renewable energy resources such as wind or solar radiation, or unpredicted changes in energy demand which impact upon the operational behaviour of thermal generation technologies. An understanding of these stochastic impacts are especially important in contexts such as highly distributed (or embedded) generation, where an understanding of issues affecting the individual or aggregated performance of high numbers of relatively small generators is especially important, such as in ESCO projects. Probabilistic evaluation of monitored or simulated performance data is one technique which can provide an insight into the dynamic performance characteristics of generating systems, both in a prognostic sense (such as the prediction of future performance at the project’s design stage) as well as in a diagnostic sense (such as in the real-time analysis of underperforming systems). In this work, we describe the development, application and outcomes of a new approach to the acquisition of datasets suitable for use in the subsequent performance and impact analysis (including the use of Bayesian approaches) for a number of distributed generation technologies. The application of the approach is illustrated using a number of case studies involving domestic and small commercial scale photovoltaic, solar thermal and natural gas boiler installations, and the results as presented show that the methodology offers significant advantages in terms of plant efficiency prediction or diagnosis, along with allied environmental and social impacts such as greenhouse gas emission reduction or fuel affordability.

Keywords: renewable energy, dynamic performance simulation, Bayesian analysis, distributed generation

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1605 Count Data Regression Modeling: An Application to Spontaneous Abortion in India

Authors: Prashant Verma, Prafulla K. Swain, K. K. Singh, Mukti Khetan

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Objective: In India, around 20,000 women die every year due to abortion-related complications. In the modelling of count variables, there is sometimes a preponderance of zero counts. This article concerns the estimation of various count regression models to predict the average number of spontaneous abortion among women in the Punjab state of India. It also assesses the factors associated with the number of spontaneous abortions. Materials and methods: The study included 27,173 married women of Punjab obtained from the DLHS-4 survey (2012-13). Poisson regression (PR), Negative binomial (NB) regression, zero hurdle negative binomial (ZHNB), and zero-inflated negative binomial (ZINB) models were employed to predict the average number of spontaneous abortions and to identify the determinants affecting the number of spontaneous abortions. Results: Statistical comparisons among four estimation methods revealed that the ZINB model provides the best prediction for the number of spontaneous abortions. Antenatal care (ANC) place, place of residence, total children born to a woman, woman's education and economic status were found to be the most significant factors affecting the occurrence of spontaneous abortion. Conclusions: The study offers a practical demonstration of techniques designed to handle count variables. Statistical comparisons among four estimation models revealed that the ZINB model provided the best prediction for the number of spontaneous abortions and is recommended to be used to predict the number of spontaneous abortions. The study suggests that women receive institutional Antenatal care to attain limited parity. It also advocates promoting higher education among women in Punjab, India.

Keywords: count data, spontaneous abortion, Poisson model, negative binomial model, zero hurdle negative binomial, zero-inflated negative binomial, regression

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1604 Comparison of Feedforward Back Propagation and Self-Organizing Map for Prediction of Crop Water Stress Index of Rice

Authors: Aschalew Cherie Workneh, K. S. Hari Prasad, Chandra Shekhar Prasad Ojha

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Due to the increase in water scarcity, the crop water stress index (CWSI) is receiving significant attention these days, especially in arid and semiarid regions, for quantifying water stress and effective irrigation scheduling. Nowadays, machine learning techniques such as neural networks are being widely used to determine CWSI. In the present study, the performance of two artificial neural networks, namely, Self-Organizing Maps (SOM) and Feed Forward-Back Propagation Artificial Neural Networks (FF-BP-ANN), are compared while determining the CWSI of rice crop. Irrigation field experiments with varying degrees of irrigation were conducted at the irrigation field laboratory of the Indian Institute of Technology, Roorkee, during the growing season of the rice crop. The CWSI of rice was computed empirically by measuring key meteorological variables (relative humidity, air temperature, wind speed, and canopy temperature) and crop parameters (crop height and root depth). The empirically computed CWSI was compared with SOM and FF-BP-ANN predicted CWSI. The upper and lower CWSI baselines are computed using multiple regression analysis. The regression analysis showed that the lower CWSI baseline for rice is a function of crop height (h), air vapor pressure deficit (AVPD), and wind speed (u), whereas the upper CWSI baseline is a function of crop height (h) and wind speed (u). The performance of SOM and FF-BP-ANN were compared by computing Nash-Sutcliffe efficiency (NSE), index of agreement (d), root mean squared error (RMSE), and coefficient of correlation (R²). It is found that FF-BP-ANN performs better than SOM while predicting the CWSI of rice crops.

Keywords: artificial neural networks; crop water stress index; canopy temperature, prediction capability

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1603 Effect of Wettability Alteration on Production Performance in Unconventional Tight Oil Reservoirs

Authors: Rashid S. Mohammad, Shicheng Zhang, Xinzhe Zhao

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In tight oil reservoirs, wettability alteration has generally been considered as an effective way to remove fracturing fluid retention on the surface of the fracture and consequently improved oil production. However, there is a lack of a reliable productivity prediction model to show the relationship between the wettability and oil production in tight oil well. In this paper, a new oil productivity prediction model of immiscible oil-water flow and miscible CO₂-oil flow accounting for wettability is developed. This mathematical model is established by considering two different length scales: nonporous network and propped fractures. CO₂ flow diffuses in the nonporous network and high velocity non-Darcy flow in propped fractures are considered by taking into account the effect of wettability alteration on capillary pressure and relative permeability. A laboratory experiment is also conducted here to validate this model. Laboratory experiments have been designed to compare the water saturation profiles for different contact angle, revealing the fluid retention in rock pores that affects capillary force and relative permeability. Four kinds of brines with different concentrations are selected here to create different contact angles. In water-wet porous media, as the system becomes more oil-wet, water saturation decreases. As a result, oil relative permeability increases. On the other hand, capillary pressure which is the resistance for the oil flow increases as well. The oil production change due to wettability alteration is the result of the comprehensive changes of oil relative permeability and capillary pressure. The results indicate that wettability is a key factor for fracturing fluid retention removal and oil enhancement in tight reservoirs. By incorporating laboratory test into a mathematical model, this work shows the relationship between wettability and oil production is not a simple linear pattern but a parabolic one. Additionally, it can be used for a better understanding of optimization design of fracturing fluids.

Keywords: wettability, relative permeability, fluid retention, oil production, unconventional and tight reservoirs

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1602 A Neural Network for the Prediction of Contraction after Burn Injuries

Authors: Ginger Egberts, Marianne Schaaphok, Fred Vermolen, Paul van Zuijlen

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A few years ago, a promising morphoelastic model was developed for the simulation of contraction formation after burn injuries. Contraction can lead to a serious reduction in physical mobility, like a reduction in the range-of-motion of joints. If this is the case in a healing burn wound, then this is referred to as a contracture that needs medical intervention. The morphoelastic model consists of a set of partial differential equations describing both a chemical part and a mechanical part in dermal wound healing. These equations are solved with the numerical finite element method (FEM). In this method, many calculations are required on each of the chosen elements. In general, the more elements, the more accurate the solution. However, the number of elements increases rapidly if simulations are performed in 2D and 3D. In that case, it not only takes longer before a prediction is available, the computation also becomes more expensive. It is therefore important to investigate alternative possibilities to generate the same results, based on the input parameters only. In this study, a surrogate neural network has been designed to mimic the results of the one-dimensional morphoelastic model. The neural network generates predictions quickly, is easy to implement, and there is freedom in the choice of input and output. Because a neural network requires extensive training and a data set, it is ideal that the one-dimensional FEM code generates output quickly. These feed-forward-type neural network results are very promising. Not only can the network give faster predictions, but it also has a performance of over 99%. It reports on the relative surface area of the wound/scar, the total strain energy density, and the evolutions of the densities of the chemicals and mechanics. It is, therefore, interesting to investigate the applicability of a neural network for the two- and three-dimensional morphoelastic model for contraction after burn injuries.

Keywords: biomechanics, burns, feasibility, feed-forward NN, morphoelasticity, neural network, relative surface area wound

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1601 Prediction of Endotracheal Tube Size in Children by Predicting Subglottic Diameter Using Ultrasonographic Measurement versus Traditional Formulas

Authors: Parul Jindal, Shubhi Singh, Priya Ramakrishnan, Shailender Raghuvanshi

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Background: Knowledge of the influence of the age of the child on laryngeal dimensions is essential for all practitioners who are dealing with paediatric airway. Choosing the correct endotracheal tube (ETT) size is a crucial step in pediatric patients because a large-sized tube may cause complications like post-extubation stridor and subglottic stenosis. On the other hand with a smaller tube, there will be increased gas flow resistance, aspiration risk, poor ventilation, inaccurate monitoring of end-tidal gases and reintubation may also be required with a different size of the tracheal tube. Recent advancement in ultrasonography (USG) techniques should now allow for accurate and descriptive evaluation of pediatric airway. Aims and objectives: This study was planned to determine the accuracy of Ultrasonography (USG) to assess the appropriate ETT size and compare it with physical indices based formulae. Methods: After obtaining approval from Institute’s Ethical and Research committee, and parental written and informed consent, the study was conducted on 100 subjects of either sex between 12-60 months of age, undergoing various elective surgeries under general anesthesia requiring endotracheal intubation. The same experienced radiologist performed ultrasonography. The transverse diameter was measured at the level of cricoids cartilage by USG. After USG, general anesthesia was administered using standard techniques followed by the institute. An experienced anesthesiologist performed the endotracheal intubations with uncuffed endotracheal tube (Portex Tracheal Tube Smiths Medical India Pvt. Ltd.) with Murphy’s eye. He was unaware of the finding of the ultrasonography. The tracheal tube was considered best fit if air leak was satisfactory at 15-20 cm H₂O of airway pressure. The obtained values were compared with the values of endotracheal tube size calculated by ultrasonography, various age, height, weight-based formulas and diameter of right and left little finger. The correlation of the size of the endotracheal tube by different modalities was done and Pearson's correlation coefficient was obtained. The comparison of the mean size of the endotracheal tube by ultrasonography and by traditional formula was done by the Friedman’s test and Wilcoxon sign-rank test. Results: The predicted tube size was equal to best fit and best determined by ultrasonography (100%) followed by comparison to left little finger (98%) and right little finger (97%) and age-based formula (95%) followed by multivariate formula (83%) and body length (81%) formula. According to Pearson`s correlation, there was a moderate correlation of best fit endotracheal tube with endotracheal tube size by age-based formula (r=0.743), body length based formula (r=0.683), right little finger based formula (r=0.587), left little finger based formula (r=0.587) and multivariate formula (r=0.741). There was a strong correlation with ultrasonography (r=0.943). Ultrasonography was the most sensitive (100%) method of prediction followed by comparison to left (98%) and right (97%) little finger and age-based formula (95%), the multivariate formula had an even lesser sensitivity (83%) whereas body length based formula was least sensitive with a sensitivity of 78%. Conclusion: USG is a reliable method of estimation of subglottic diameter and for prediction of ETT size in children.

Keywords: endotracheal intubation, pediatric airway, subglottic diameter, traditional formulas, ultrasonography

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