Search results for: medical imaging
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4467

Search results for: medical imaging

3297 Arterial Line Use for Acute Type 2 Respiratory Failure

Authors: C. Scurr, J. Jeans, S. Srivastava

Abstract:

Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.

Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line

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3296 The Relationships between Autonomy-Based Insula Activity and Learning: A Functional Magnetic Resonance Imaging Study

Authors: Woogul Lee, Johnmarshall Reeve

Abstract:

Learners’ perceived autonomy predicts learners’ interest, engagement, and learning. To understand these processes, we conducted an fMRI experiment. In this experiment, participants saw the national flag and were asked to rate how much they freely wanted to learn about that particular national flag. The participants then learned the characteristics of the national flag. Results showed that (1) the degree of participants’ perceived autonomy was positively correlated with the degree of insula activity, (2) participants’ early-trial insula activity predicted corresponding late-trial dorsolateral prefrontal cortex activity, and (3) the degree of dorsolateral prefrontal cortex activity was positively correlated with the degree of participants’ learning about the characteristics of the national flag. Results suggest that learners’ perceived autonomy predicts learning through the mediation of insula activity associated with intrinsic satisfaction and 'pure self' processes.

Keywords: insular cortex, autonomy, self-determination, dorsolateral prefrontal cortex

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3295 Therapeutic Potential of Cannabis in Cancer: Advances in Clinical Research and Pharmacogenomic Aspects

Authors: Bouchaïb Gazzaz, Hamid El Amri, Hind Dehbi, Abderraouf Hilali

Abstract:

Medical cannabis has been cultivated and used in many countries around the world. The story of the use of cannabis as a therapeutic agent is difficult to trace, in particular, because the laws regulating its production, distribution, possession, and consumption are relatively recent. Nowadays, in countries where it is authorized, medical cannabis is used in a very wide variety of illnesses and pathologies, particularly in cancer cures. Presently, cannabinoid receptor agonists (like nabilone and dronabinol) are used for reducing chemotherapy induced vomiting. This review aims to discuss a recent finding on the use of therapeutic cannabis in patients with cancer. First, this work addresses the progress made in the use of cannabinoids as therapeutic agent and their application in the treatment of different types of cancer. Secondly, a detailed analysis of the pharmacogenetic aspect of cannabis will be discussed.

Keywords: cannabinoids, endocannabinoids system, cancer treatment, cannabinoid receptors, genetic polymorphism, pharmacogenomics

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3294 The Various Forms of a Soft Set and Its Extension in Medical Diagnosis

Authors: Biplab Singha, Mausumi Sen, Nidul Sinha

Abstract:

In order to deal with the impreciseness and uncertainty of a system, D. Molodtsov has introduced the concept of ‘Soft Set’ in the year 1999. Since then, a number of related definitions have been conceptualized. This paper includes a study on various forms of Soft Sets with examples. The paper contains the concepts of domain and co-domain of a soft set, conversion to one-one and onto function, matrix representation of a soft set and its relation with one-one function, upper and lower triangular matrix, transpose and Kernel of a soft set. This paper also gives the idea of the extension of soft sets in medical diagnosis. Here, two soft sets related to disease and symptoms are considered and using AND operation and OR operation, diagnosis of the disease is calculated through appropriate examples.

Keywords: kernel of a soft set, soft set, transpose of a soft set, upper and lower triangular matrix of a soft set

Procedia PDF Downloads 344
3293 Experimental Investigation of Flow Structure around a Rectangular Cylinder in Different Configurations

Authors: Cemre Polat, Dogan B. Saydam, Mustafa Soyler, Coskun Ozalp

Abstract:

In this study, the flow structure was investigated by particle imaging velocimetry (PIV) method at Re = 26000 for two different rectangular cylinders placed perpendicular and parallel to the flow direction. After obtaining streamwise and spanwise velocity data, average vorticity, streamlines, velocity magnitude, turbulence kinetic energy, root mean square of streamwise and spanwise velocity fluctuations are calculated, and critical points of flow structure are explained. As a result of the study, it was seen that the vertical configuration has less effect on the flow structure in the back region of the body compared to the horizontal configuration. When the streamwise velocity component is examined in both configurations, it is seen that the negative velocity component is stronger on the long sides compared to the short sides. It has been observed that the vertically positioned cylinder expands the flow separation point compared to the horizontally positioned cylinder; also the vertical cylinder creates an increase in turbulence kinetic energy compared to the horizontal cylinder.

Keywords: bluff body, flow characteristics, PIV, rectangular cylinder

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3292 Cluster Analysis of Students’ Learning Satisfaction

Authors: Purevdolgor Luvsantseren, Ajnai Luvsan-Ish, Oyuntsetseg Sandag, Javzmaa Tsend, Akhit Tileubai, Baasandorj Chilhaasuren, Jargalbat Puntsagdash, Galbadrakh Chuluunbaatar

Abstract:

One of the indicators of the quality of university services is student satisfaction. Aim: We aimed to study the level of satisfaction of students in the first year of premedical courses in the course of Medical Physics using the cluster method. Materials and Methods: In the framework of this goal, a questionnaire was collected from a total of 324 students who studied the medical physics course of the 1st course of the premedical course at the Mongolian National University of Medical Sciences. When determining the level of satisfaction, the answers were obtained on five levels of satisfaction: "excellent", "good", "medium", "bad" and "very bad". A total of 39 questionnaires were collected from students: 8 for course evaluation, 19 for teacher evaluation, and 12 for student evaluation. From the research, a database with 39 fields and 324 records was created. Results: In this database, cluster analysis was performed in MATLAB and R programs using the k-means method of data mining. Calculated the Hopkins statistic in the created database, the values are 0.88, 0.87, and 0.97. This shows that cluster analysis methods can be used. The course evaluation sub-fund is divided into three clusters. Among them, cluster I has 150 objects with a "good" rating of 46.2%, cluster II has 119 objects with a "medium" rating of 36.7%, and Cluster III has 54 objects with a "good" rating of 16.6%. The teacher evaluation sub-base into three clusters, there are 179 objects with a "good" rating of 55.2% in cluster II, 108 objects with an "average" rating of 33.3% in cluster III, and 36 objects with an "excellent" rating in cluster I of 11.1%. The sub-base of student evaluations is divided into two clusters: cluster II has 215 objects with an "excellent" rating of 66.3%, and cluster I has 108 objects with an "excellent" rating of 33.3%. Evaluating the resulting clusters with the Silhouette coefficient, 0.32 for the course evaluation cluster, 0.31 for the teacher evaluation cluster, and 0.30 for student evaluation show statistical significance. Conclusion: Finally, to conclude, cluster analysis in the model of the medical physics lesson “good” - 46.2%, “middle” - 36.7%, “bad” - 16.6%; 55.2% - “good”, 33.3% - “middle”, 11.1% - “bad” in the teacher evaluation model; 66.3% - “good” and 33.3% of “bad” in the student evaluation model.

Keywords: questionnaire, data mining, k-means method, silhouette coefficient

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3291 Determination of Critical Organ Doses for Liver Scintigraphy Using Cr-51

Authors: O. Maranci, A. B. Tugrul

Abstract:

Scintigraphy is an imaging method of nuclear events provoked by collisions or charged current interactions with radiation. It is used for diagnostic test used in nuclear medicine via radiopharmaceuticals emitting radiation which is captured by gamma cameras to form two-dimensional images. Liver scintigraphy is widely used in nuclear medicine.Tc-99m and Cr-51 gamma radioisotopes can be used for this purpose. Cr-51 usage is more important for patients’ organ dose that has higher energy and longer half-life as compared to Tc-99m. In this study, it is aimed to determine the required dose for critical organs of patient through liver scintigraphy via Cr-51 gamma radioisotope. Experimental studies were conducted on patients even though conducting experimental studies on patients is extremely difficult for determination of critical organ doses. Torso phantom was utilized to simulate the liver scintigraphy by using 20 mini packages of Cr-51 that were placed on the organ. The radioisotope was produced by irradiation in central thimble of TRIGA MARK II Reactor at 250 KW power. As the results of the study, critical organ doses were determined and evaluated with different critic organs.

Keywords: critical organ doses, liver, scintigraphy, TRIGA Mark-II

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3290 Alumni Experiences of How Their Undergraduate Medical Education Instilled and Fostered a Commitment to Community-Based Work in Later Life: A Sequential Exploratory Mixed-Methods Study

Authors: Harini Aiyer, Kalyani Premkumar

Abstract:

Health professionals are the key players who can help achieve the goals of population health equity. Social accountability (SA) of health professionals emphasizes their role in addressing issues of equity in the population they serve. Therefore, health professional education must focus on instilling SA in health professionals. There is limited literature offering a longitudinal perspective of how students sustain the practice of SA in later life. This project aims to identify the drivers of social accountability among physicians. This study employed an exploratory mixed methods design (QUAL-> Quant) to explore alumni perceptions and experiences. The qualitative data, collected via 20 in-depth, semi-structured interviews, provided an understanding of the perceptions of the alumni regarding the influence of their undergraduate learning environment on their SA. This was followed by a quantitative portion -a questionnaire designed from the themes identified from the qualitative data. Emerging themes from the study highlighted community-centered education and a focus on social and preventative medicine in both curricular and non-curricular facilitators of SA among physicians. Curricular components included opportunities to engage with the community, such as roadside clinics, community-orientation programs, and postings at a secondary hospital. Other facilitators that emerged were the faculty leading by example, a subsidized fee structure, and a system that prepared students for practice in rural and remote areas. The study offers a fresh perspective and dimension on how SA is addressed by medical schools. The findings may be adapted by medical schools to understand how their own SA initiatives have been sustained among physicians over the long run.

Keywords: community-based work, global health, health education, medical education, providing health in remote areas, social accountability

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3289 An Audit of Climate Change and Sustainability Teaching in Medical School

Authors: Karolina Wieczorek, Zofia Przypaśniak

Abstract:

Climate change is a rapidly growing threat to global health, and part of the responsibility to combat it lies within the healthcare sector itself, including adequate education of future medical professionals. To mitigate the consequences, the General Medical Council (GMC) has equipped medical schools with a list of outcomes regarding sustainability teaching. Students are expected to analyze the impact of the healthcare sector’s emissions on climate change. The delivery of the related teaching content is, however, often inadequate and insufficient time is devoted for exploration of the topics. Teaching curricula lack in-depth exploration of the learning objectives. This study aims to assess the extent and characteristics of climate change and sustainability subjects teaching in the curriculum of a chosen UK medical school (Barts and The London School of Medicine and Dentistry). It compares the data to the national average scores from the Climate Change and Sustainability Teaching (C.A.S.T.) in Medical Education Audit to draw conclusions about teaching on a regional level. This is a single-center audit of the timetabled sessions of teaching in the medical course. The study looked at the academic year 2020/2021 which included a review of all non-elective, core curriculum teaching materials including tutorials, lectures, written resources, and assignments in all five years of the undergraduate and graduate degrees, focusing only on mandatory teaching attended by all students (excluding elective modules). The topics covered were crosschecked with GMC Outcomes for graduates: “Educating for Sustainable Healthcare – Priority Learning Outcomes” as gold standard to look for coverage of the outcomes and gaps in teaching. Quantitative data was collected in form of time allocated for teaching as proxy of time spent per individual outcomes. The data was collected independently by two students (KW and ZP) who have received prior training and assessed two separate data sets to increase interrater reliability. In terms of coverage of learning outcomes, 12 out of 13 were taught (with the national average being 9.7). The school ranked sixth in the UK for time spent per topic and second in terms of overall coverage, meaning the school has a broad range of topics taught with some being explored in more detail than others. For the first outcome 4 out of 4 objectives covered (average 3.5) with 47 minutes spent per outcome (average 84 min), for the second objective 5 out of 5 covered (average 3.5) with 46 minutes spent (average 20), for the third 3 out of 4 (average 2.5) with 10 mins pent (average 19 min). A disproportionately large amount of time is spent delivering teaching regarding air pollution (respiratory illnesses), which resulted in the topic of sustainability in other specialties being excluded from teaching (musculoskeletal, ophthalmology, pediatrics, renal). Conclusions: Currently, there is no coherent strategy on national teaching of climate change topics and as a result an unstandardized amount of time spent on teaching and coverage of objectives can be observed.

Keywords: audit, climate change, sustainability, education

Procedia PDF Downloads 87
3288 Study of Side Effects of Myopia Contact Correction by Soft Lenses and Orthokeratology Lenses among Medical Students

Authors: K. Iu. Hrizhymalska, O. Ol. Andrushkova, I. Iu. Pshenychna

Abstract:

Aim. To study and copare the side effects of myopia contact correction by soft lenses and orthokeratology lenses among medical students. Patients and methods: 34 students (68 eyes) with moderate and severe myopia, who used contact correction of myopia for 2-4 years, were examined. Some of them used soft lenses, while others - orthokeratology lenses. Methods were used: biomicroscopy of the eye surface, Schirmer's test, Norn's test, survey regarding satisfaction with use. Results. Corneal vascularization along the limbus was noted in 4 (5%) eyes of the examined students. In 8 (11%) eyes, symptoms of mild dry eye disease were detected. 2 (3%) eyes showed signs of meibomitis. Allergic conjunctivitis was observed in 4 (5%) eyes, and a purulent corneal ulcer was present in 1 eye. Surveys have shown that orthokeratology lenses unlike soft lenses don't limit everyday activity (in sports, tourism, swimming etc.), they also don't cause discomfort during temperature changes and reduce existing symptoms of dry eye disease. Conclusion. Thus, myopia contact correction is one of the optimal options among students, which allows to expand physical and mental activity. However, taking into account the frequency of side effects in users of soft contact lenses, it is necessary to carry out prevention and treatment of myopia in medical students, follow the recommendations for use, instill preservative-free tear substitutes with trehalose when symptoms of dry eye appear. Also when side reactions occur, contact correction with soft lenses should be changed to orthokeratology lenses.

Keywords: correction, myopia, soft lenses, orthokeratology, specracles, cornea, dry eye, side effects, refractive errors

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3287 Asynchronous Low Duty Cycle Media Access Control Protocol for Body Area Wireless Sensor Networks

Authors: Yasin Ghasemi-Zadeh, Yousef Kavian

Abstract:

Wireless body area networks (WBANs) technology has achieved lots of popularity over the last decade with a wide range of medical applications. This paper presents an asynchronous media access control (MAC) protocol based on B-MAC protocol by giving an application for medical issues. In WBAN applications, there are some serious problems such as energy, latency, link reliability (quality of wireless link) and throughput which are mainly due to size of sensor networks and human body specifications. To overcome these problems and improving link reliability, we concentrated on MAC layer that supports mobility models for medical applications. In the presented protocol, preamble frames are divided into some sub-frames considering the threshold level. Actually, the main reason for creating shorter preambles is the link reliability where due to some reasons such as water, the body signals are affected on some frequency bands and causes fading and shadowing on signals, therefore by increasing the link reliability, these effects are reduced. In case of mobility model, we use MoBAN model and modify that for some more areas. The presented asynchronous MAC protocol is modeled by OMNeT++ simulator. The results demonstrate increasing the link reliability comparing to B-MAC protocol where the packet reception ratio (PRR) is 92% also covers more mobility areas than MoBAN protocol.

Keywords: wireless body area networks (WBANs), MAC protocol, link reliability, mobility, biomedical

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3286 Effect of Nanoscale Bismuth Oxide on Radiation Shielding and Interaction Characteristics of Polyvinyl Alcohol-Based Polymer for Medical Apron Design

Authors: E. O. Echeweozo

Abstract:

This study evaluated radiation shielding and interaction characteristics of polyvinyl alcohol (PVA) polymer separately doped with 10% and 20% nanoscale Bi₂O₃, respectively, for medical apron design and shielding special electronic installations. Prepared samples were characterized by scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS). The EDS results showed that Carbon (C), Oxygen (O), and bismuth (Bi) elements were the predominant elements present in the prepared samples. The SEM result displaced surface irregularities due to a special bonding matrix between PVA and Bi₂O₃. Mass attenuation coefficient (MAC), effective atomic number (Zeff), Half value layer (HVL), Mean free path (MFP), Fast neutron removal cross-section (R), Total Mass Stopping Power (TSP), and photon Range (R) of the prepared polymer composites (PV-1Bi and PV-2Bi) were evaluated with XCOM and PHITS computer programs. Results showed that the MAC of the prepared polymer samples was significantly higher than some recently developed composites at 0.662MeV and 1.25MeV gamma energy. Therefore, polyvinyl alcohol (PVA) polymer doped with Bi₂O₃ should be deployed in medical apron design and shielding special electronic installations where flexibility and high adhesion ability are crucial.

Keywords: polyvinyl alcohol (PVA);, polymer composite, gamma-rays, charged particles

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3285 Impact of a Structured Antimicrobial Stewardship Program in a North-East Italian Hospital

Authors: Antonio Marco Miotti, Antonella Ruffatto, Giampaola Basso, Antonio Madia, Giulia Zavatta, Emanuela Salvatico, Emanuela Zilli

Abstract:

A National Action Plan to fight antimicrobial resistance was launched in Italy in 2017. In order to reduce inappropriate exposure to antibiotics and infections from multi-drug resistant bacteria, it is essential to set up a structured system of surveillance and monitoring of the implementation of National Action Plan standards, including antimicrobial consumption, with a special focus on quinolones, third generation cephalosporins and carbapenems. A quantitative estimate of antibiotic consumption (defined daily dose - DDD - consumption per 100 days of hospitalization) has been provided by the Pharmaceutical Service to the Hospital of Cittadella, ULSS 6 Euganea – Health Trust (District of Padua) for the years 2019 (before the pandemic), 2020 and 2021 for all classes of antibiotics. Multidisciplinary meetings have been organized monthly by the local Antimicrobial Stewardship Group. Between 2019 and 2021, an increase in the consumption of carbapenems in the Intensive Care Unit (from 12.2 to 18.2 DDD, + 49.2%) and a decrease in Medical wards (from 5.3 to 2.6 DDD, - 50.9%) was reported; a decrease in the consumption of quinolones in Intensive Care Unit (from 17.2 to 10.8 DDD, - 37.2%), Medical wards (from 10.5 to 6.6 DDD, - 37.1%) and Surgical wards (from 10.2 to 9.3 DDD, - 8.8%) was highlighted; an increase in the consumption of third generation cephalosporins in Medical wards (from 18.1 to 22.6 DDD, + 24,1%) was reported. Finally, after an increase in the consumption of macrolides between 2020 and 2019, in 2021, a decrease was reported in the Intensive Care Unit (DDD: 8.0 in 2019, 18.0 in 2020, 6.4 in 2021) and Medical wards (DDD: 9.0 in 2019, 13.7 in 2020, 10.9 in 2021). Constant monitoring of antimicrobial consumption and timely identifying of warning situations that may need a specific intervention are the cornerstone of Antimicrobial Stewardship programs, together with analysing data on bacterial resistance rates and infections from multi-drug resistant bacteria.

Keywords: carbapenems, quinolones, antimicrobial, stewardship

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3284 The Ethics of Organ Donation and Transplantation: Philosophical Perspectives

Authors: Elijah Ojochonu Okpanachi

Abstract:

This paper explores the ethical dimensions of organ donation and transplantation through various philosophical lenses, including utilitarianism, deontology, and virtue ethics. As advancements in medical technology increase the possibilities for life-saving transplants, ethical dilemmas surrounding consent, allocation, and the commodification of human organs have become increasingly pertinent. Utilitarian perspectives emphasize maximizing overall well-being, raising questions about how to equitably allocate limited resources. Deontological approaches focus on the moral obligations of individuals and institutions, particularly regarding informed consent and the sanctity of the human body. Virtue ethics encourages a consideration of the character and intentions of donors and medical professionals, fostering a holistic understanding of the ethical landscape. By analyzing real-world case studies and ethical frameworks, this study highlights the complexities in decision-making processes related to organ donation. It addresses issues such as presumed consent, living donations, and the societal implications of organ markets. Ultimately, this paper aims to contribute to the ongoing discourse on organ donation ethics, advocating for policies that respect individual rights while promoting altruism and social responsibility. Through a philosophical lens, we seek to propose a balanced approach that honors both the dignity of individuals and the urgent need for organ transplants in modern medicine.

Keywords: organ donation, medical technology, virtue ethics, Altruism

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3283 Photoplethysmography-Based Device Designing for Cardiovascular System Diagnostics

Authors: S. Botman, D. Borchevkin, V. Petrov, E. Bogdanov, M. Patrushev, N. Shusharina

Abstract:

In this paper, we report the development of the device for diagnostics of cardiovascular system state and associated automated workstation for large-scale medical measurement data collection and analysis. It was shown that optimal design for the monitoring device is wristband as it represents engineering trade-off between accuracy and usability. The monitoring device is based on the infrared reflective photoplethysmographic sensor, which allows collecting multiple physiological parameters, such as heart rate and pulsing wave characteristics. Developed device use BLE interface for medical and supplementary data transmission to the coupled mobile phone, which process it and send it to the doctor's automated workstation. Results of this experimental model approbation confirmed the applicability of the proposed approach.

Keywords: cardiovascular diseases, health monitoring systems, photoplethysmography, pulse wave, remote diagnostics

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3282 The Importance of Introducing New Academic Programs in ‎Egyptian National Cancer ‎Institute

Authors: Mohammed S. Mohammed, Asmaa M. S. Mohammed

Abstract:

Background: To achieve the quality of cancer care, the oncologic academic programs should be continuously developed with establishing new ones. We highlighted three disciplines, Clinical nutrition, medical biophysics and radiobiology and Psycho-oncology programs; without a doubt, the Egyptian National Cancer Institute, in ‎the accreditation era, will be establishing them ‎ due to their importance in improving the skills of cancer practitioners. Methods: The first suggested program in Clinical Nutrition that is dealing with the assessment of the patient's well-being before, during and after treatment to avoid the defects in the metabolism resulting from the cancer disease and its treatment by giving the supplements in the patient's diet. The second program is Medical Biophysics and Radiobiology, which there's no denying that it ‎is ‎provided ‎in Cairo University as a good program in the faculty of science but lacks the clinical ‎practice. Hence, it is probably better to establish this program in our institute to ‎improve the ‎practitioner skills and introduce a tailored radiation therapy regimen for every patient according to ‎their characteristic profile.‎ While patients are receiving their treatment, the risk of post-traumatic stress disorder arises, so the importance of the third program, Psycho-Oncology, is clearly obtained. This program is concerned with the psychological, social, behavioral, and ethical aspects of cancer. The area of multi-disciplinary interest has boundaries with the major specialties in oncology: the clinical disciplines (surgery, medicine, pediatrics, and radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. Results: It is a prospective academic plan which is compatible with the institutional vision and its strategic plan. Conclusion: In this context, evaluating and understanding the suggested academic programs has become a mandatory part of cancer care. And it is essential to be provided by the NCI.

Keywords: clinical nutrition, psycho-oncology, medical biophysics and radiobiology, medical education

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3281 An Image Segmentation Algorithm for Gradient Target Based on Mean-Shift and Dictionary Learning

Authors: Yanwen Li, Shuguo Xie

Abstract:

In electromagnetic imaging, because of the diffraction limited system, the pixel values could change slowly near the edge of the image targets and they also change with the location in the same target. Using traditional digital image segmentation methods to segment electromagnetic gradient images could result in lots of errors because of this change in pixel values. To address this issue, this paper proposes a novel image segmentation and extraction algorithm based on Mean-Shift and dictionary learning. Firstly, the preliminary segmentation results from adaptive bandwidth Mean-Shift algorithm are expanded, merged and extracted. Then the overlap rate of the extracted image block is detected before determining a segmentation region with a single complete target. Last, the gradient edge of the extracted targets is recovered and reconstructed by using a dictionary-learning algorithm, while the final segmentation results are obtained which are very close to the gradient target in the original image. Both the experimental results and the simulated results show that the segmentation results are very accurate. The Dice coefficients are improved by 70% to 80% compared with the Mean-Shift only method.

Keywords: gradient image, segmentation and extract, mean-shift algorithm, dictionary iearning

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3280 High-Speed LIF-OH Imaging of H2-Air Turbulent Premixed Flames

Authors: Ahmed A. Al-Harbi

Abstract:

This paper presents a comparative study of effects of the repeated solid obstacles on the propagation of H2-Air premixed flames. Pressure, speed of the flame front as well as structure of reaction zones are studied for hydrogen. Two equivalence ratios are examined for different configurations of three baffle plates and two obstacles with a square cross-section having blockage ratios of either 0.24 or 0.5. Hydrogen fuel mixtures with two equivalence ratios of 0.7 and 0.8 are studied and this is limited by the excessive overpressures. The results show that the peak pressure and its rate of change can be increased by increasing the blockage ratio or by decreasing the space between successive baffles. As illustrated by the high speed images of LIF-OH, the degree of wrinkling and contortion in the flame front increase as the blockages increase. The images also show how the flame front relaminarises with increasing distances between obstacles, which accounts for the pressure decrease with increasing separation. It is also found that more than one obstacle is needed to achieve a turbulent flame structure with intense corrugations.

Keywords: premixed propagating flames, flame-obstacle interaction, turbulent premixed flames, overpressure, transient flames

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3279 Characterization of the Worn Surfaces of Brake Discs and Friction Materials after Dynobench Tests

Authors: Ana Paula Gomes Nogueira, Pietro Tonolini, Andrea Bonfanti

Abstract:

Automotive braking systems must convert kinetic into thermal energy by friction. Nowadays, the disc brake system is the most widespread configuration on the automotive market, which its specific configuration provides a very efficient heat dissipation. At the same time, both discs and pads wear out. Different wear mechanisms can act during the braking, which makes the understanding of the phenomenon essential for the strategies to be applied when an increased lifetime of the components is required. In this study, a specific characterization approach was conducted to analyze the worn surfaces of commercial pad friction materials and its conterface cast iron disc after dynobench tests. Scanning electronic microscope (SEM), confocal microscope, and focus ion beam microscope (FIB) were used as the main tools of the analysis, and they allowed imaging of the footprint of the different wear mechanisms presenting on the worn surfaces. Aspects such as the temperature and specific ingredients of the pad friction materials are discussed since they play an important role in the wear mechanisms.

Keywords: wear mechanism, surface characterization, brake tests, friction materials, disc brake

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3278 Neural Correlates of Decision-Making Under Ambiguity and Conflict

Authors: Helen Pushkarskaya, Michael Smithson, Jane E. Joseph, Christine Corbly, Ifat Levy

Abstract:

Studies of decision making under uncertainty generally focus on imprecise information about outcome probabilities (“ambiguity”). It is not clear, however, whether conflicting information about outcome probabilities affects decision making in the same manner as ambiguity does. Here we combine functional Magnetic Resonance Imaging (fMRI) and a simple gamble design to study this question. In this design, the levels of ambiguity and conflict are parametrically varied, and ambiguity and conflict gambles are matched on both expected value and variance. Behaviorally, participants avoided conflict more than ambiguity, and attitudes toward ambiguity and conflict did not correlate across subjects. Neurally, regional brain activation was differentially modulated by ambiguity level and aversion to ambiguity and by conflict level and aversion to conflict. Activation in the medial prefrontal cortex was correlated with the level of ambiguity and with ambiguity aversion, whereas activation in the ventral striatum was correlated with the level of conflict and with conflict aversion. This novel double dissociation indicates that decision makers process imprecise and conflicting information differently, a finding that has important implications for basic and clinical research.

Keywords: decision making, uncertainty, ambiguity, conflict, fMRI

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3277 Optimization of Surface Coating on Magnetic Nanoparticles for Biomedical Applications

Authors: Xiao-Li Liu, Ling-Yun Zhao, Xing-Jie Liang, Hai-Ming Fan

Abstract:

Owing to their unique properties, magnetic nanoparticles have been used as diagnostic and therapeutic agents for biomedical applications. Highly monodispersed magnetic nanoparticles with controlled particle size and surface coating have been successfully synthesized as a model system to investigate the effect of surface coating on the T2 relaxivity and specific absorption rate (SAR) under an alternating magnetic field, respectively. Amongst, by using mPEG-g-PEI to solubilize oleic-acid capped 6 nm magnetic nanoparticles, the T2 relaxivity could be significantly increased by up to 4-fold as compared to PEG coated nanoparticles. Moreover, it largely enhances the cell uptake with a T2 relaxivity of 92.6 mM-1s-1 for in vitro cell MRI. As for hyperthermia agent, SAR value increase with the decreased thickness of PEG surface coating. By elaborate optimization of surface coating and particle size, a significant increase of SAR (up to 74%) could be achieved with a minimal variation on the saturation magnetization (<5%). The 19 nm magnetic nanoparticles with 2000 Da PEG exhibited the highest SAR of 930 W•g-1 among the samples, which can be maintained in various simulated physiological conditions. This systematic work provides a general strategy for the optimization of surface coating of magnetic core for high performance MRI contrast agent and hyperthermia agent.

Keywords: magnetic nanoparticles, magnetic hyperthermia, magnetic resonance imaging, surface modification

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3276 Outcome of Patients Undergoing Hemicraniectomy for Malignant Middle Cerebral Artery Infarction: A 5 Year Retrospective Study at Perpetual Succour Hospital, Cebu City, Philippines

Authors: Adelson G. Guillarte, M. D., Noel J. Belonguel, Jarungchai Anton S. Vatanagul

Abstract:

Patients with malignant middle cerebral infarction (MCA) (with massive brain swelling and herniation) were reported to have a mortality rate of 80% even with the appropriate conservative medical therapy. European Trials (DECIMAL, DESTINY I, and II, HAMLET) showed significant improvement in mortality and functional outcome with hemicraniectomy. No known published local studies in the region, thus a local study is vital. This is a single center, retrospective, descriptive, cross-sectional, chart review study which includes ≥18 year-old patients with malignant MCA infarction, who underwent hemicraniectomy, and those who were given conservative medical therapy alone, from January 2008 to December 2012 at Perpetual Succour Hospital. Excluded were patients whose charts are with insufficient data, prior MCA stroke, with concomitant intracerebral hemorrhage and with other serious medical conditions or terminal illnesses. Minimum of 32 populations were needed. Data were presented in mean, standard deviation, frequency and percentage distribution. Man n Whitney U test and Chi Square test were used. P-values lesser than 0.05 alpha were considered statistically significant. A total of 672 stroke patients were admitted. 34 patients pass the inclusion criteria. 9 underwent hemicraniectomy and 25 were treated by conservative medical therapy alone. Although not statistically significant (64% vs 33%, p=0.112) there were more patients noted improved in the conservative treatment group. Meanwhile, the Hemicraniectomy group have increased percentage of mortality (67%) (p=0.112). There was a decreasing trend in the average NIHSS score in both groups from admission to post-op 7 days (p=0.198, p=0.78). A bigger multicenter prospective study is recommended to control inherent biases and limitations of a retrospective and smaller study.

Keywords: cerebral infarct, hemicraniectomy, ischemic stroke, malignant middle cerebral artery (MCA) infarct

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3275 Text Mining Past Medical History in Electrophysiological Studies

Authors: Roni Ramon-Gonen, Amir Dori, Shahar Shelly

Abstract:

Background and objectives: Healthcare professionals produce abundant textual information in their daily clinical practice. The extraction of insights from all the gathered information, mainly unstructured and lacking in normalization, is one of the major challenges in computational medicine. In this respect, text mining assembles different techniques to derive valuable insights from unstructured textual data, so it has led to being especially relevant in Medicine. Neurological patient’s history allows the clinician to define the patient’s symptoms and along with the result of the nerve conduction study (NCS) and electromyography (EMG) test, assists in formulating a differential diagnosis. Past medical history (PMH) helps to direct the latter. In this study, we aimed to identify relevant PMH, understand which PMHs are common among patients in the referral cohort and documented by the medical staff, and examine the differences by sex and age in a large cohort based on textual format notes. Methods: We retrospectively identified all patients with abnormal NCS between May 2016 to February 2022. Age, gender, and all NCS attributes reports were recorded, including the summary text. All patients’ histories were extracted from the text report by a query. Basic text cleansing and data preparation were performed, as well as lemmatization. Very popular words (like ‘left’ and ‘right’) were deleted. Several words were replaced with their abbreviations. A bag of words approach was used to perform the analyses. Different visualizations which are common in text analysis, were created to easily grasp the results. Results: We identified 5282 unique patients. Three thousand and five (57%) patients had documented PMH. Of which 60.4% (n=1817) were males. The total median age was 62 years (range 0.12 – 97.2 years), and the majority of patients (83%) presented after the age of forty years. The top two documented medical histories were diabetes mellitus (DM) and surgery. DM was observed in 16.3% of the patients, and surgery at 15.4%. Other frequent patient histories (among the top 20) were fracture, cancer (ca), motor vehicle accident (MVA), leg, lumbar, discopathy, back and carpal tunnel release (CTR). When separating the data by sex, we can see that DM and MVA are more frequent among males, while cancer and CTR are less frequent. On the other hand, the top medical history in females was surgery and, after that, DM. Other frequent histories among females are breast cancer, fractures, and CTR. In the younger population (ages 18 to 26), the frequent PMH were surgery, fractures, trauma, and MVA. Discussion: By applying text mining approaches to unstructured data, we were able to better understand which medical histories are more relevant in these circumstances and, in addition, gain additional insights regarding sex and age differences. These insights might help to collect epidemiological demographical data as well as raise new hypotheses. One limitation of this work is that each clinician might use different words or abbreviations to describe the same condition, and therefore using a coding system can be beneficial.

Keywords: abnormal studies, healthcare analytics, medical history, nerve conduction studies, text mining, textual analysis

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3274 Deep Feature Augmentation with Generative Adversarial Networks for Class Imbalance Learning in Medical Images

Authors: Rongbo Shen, Jianhua Yao, Kezhou Yan, Kuan Tian, Cheng Jiang, Ke Zhou

Abstract:

This study proposes a generative adversarial networks (GAN) framework to perform synthetic sampling in feature space, i.e., feature augmentation, to address the class imbalance problem in medical image analysis. A feature extraction network is first trained to convert images into feature space. Then the GAN framework incorporates adversarial learning to train a feature generator for the minority class through playing a minimax game with a discriminator. The feature generator then generates features for minority class from arbitrary latent distributions to balance the data between the majority class and the minority class. Additionally, a data cleaning technique, i.e., Tomek link, is employed to clean up undesirable conflicting features introduced from the feature augmentation and thus establish well-defined class clusters for the training. The experiment section evaluates the proposed method on two medical image analysis tasks, i.e., mass classification on mammogram and cancer metastasis classification on histopathological images. Experimental results suggest that the proposed method obtains superior or comparable performance over the state-of-the-art counterparts. Compared to all counterparts, our proposed method improves more than 1.5 percentage of accuracy.

Keywords: class imbalance, synthetic sampling, feature augmentation, generative adversarial networks, data cleaning

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3273 Assessing Image Quality in Mobile Radiography: A Phantom-Based Evaluation of a New Lightweight Mobile X-Ray Equipment

Authors: May Bazzi, Shafik Tokmaj, Younes Saberi, Mats Geijer, Tony Jurkiewicz, Patrik Sund, Anna Bjällmark

Abstract:

Mobile radiography, employing portable X-ray equipment, has become a routine procedure within hospital settings, with chest X-rays in intensive care units standing out as the most prevalent mobile X-ray examinations. This approach is not limited to hospitals alone, as it extends its benefits to imaging patients in various settings, particularly those too frail to be transported, such as elderly care residents in nursing homes. Moreover, the utility of mobile X-ray isn't confined solely to traditional healthcare recipients; it has proven to be a valuable resource for vulnerable populations, including the homeless, drug users, asylum seekers, and patients with multiple co-morbidities. Mobile X-rays reduce patient stress, minimize costly hospitalizations, and offer cost-effective imaging. While studies confirm its reliability, further research is needed, especially regarding image quality. Recent advancements in lightweight equipment with enhanced battery and detector technology provide the potential for nearly handheld radiography. The main aim of this study was to evaluate a new lightweight mobile X-ray system with two different detectors and compare the image quality with a modern stationary system. Methods: A total of 74 images of the chest (chest anterior-posterior (AP) views and chest lateral views) and pelvic/hip region (AP pelvis views, hip AP views, and hip cross-table lateral views) were acquired on a whole-body phantom (Kyotokagaku, Japan), utilizing varying image parameters. These images were obtained using a stationary system - 18 images (Mediel, Sweden), a mobile X-ray system with a second-generation detector - 28 images (FDR D-EVO II; Fujifilm, Japan) and a mobile X-ray system with a third-generation detector - 28 images (FDR D-EVO III; Fujifilm, Japan). Image quality was assessed by visual grading analysis (VGA), which is a method to measure image quality by assessing the visibility and accurate reproduction of anatomical structures within the images. A total of 33 image criteria were used in the analysis. A panel of two experienced radiologists, two experienced radiographers, and two final-term radiographer students evaluated the image quality on a 5-grade ordinal scale using the software Viewdex 3.0 (Viewer for Digital Evaluation of X-ray images, Sweden). Data were analyzed using visual grading characteristics analysis. The dose was measured by the dose-area product (DAP) reported by the respective systems. Results: The mobile X-ray equipment (both detectors) showed significantly better image quality than the stationary equipment for the pelvis, hip AP and hip cross-table lateral images with AUCVGA-values ranging from 0.64-0.92, while chest images showed mixed results. The number of images rated as having sufficient quality for diagnostic use was significantly higher for mobile X-ray generation 2 and 3 compared with the stationary X-ray system. The DAP values were higher for the stationary compared to the mobile system. Conclusions: The new lightweight radiographic equipment had an image quality at least as good as a fixed system at a lower radiation dose. Future studies should focus on clinical images and consider radiographers' viewpoints for a comprehensive assessment.

Keywords: mobile x-ray, visual grading analysis, radiographer, radiation dose

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3272 Analysis of Human Mental and Behavioral Models for Development of an Electroencephalography-Based Human Performance Management System

Authors: John Gaber, Youssef Ahmed, Hossam A. Gabbar, Jing Ren

Abstract:

Accidents at Nuclear Power Plants (NPPs) occur due to various factors, notable among them being poor safety management and poor safety culture. During abnormal situations, the likelihood of human error is many-fold higher due to the higher cognitive workload. The most common cause of human error and high cognitive workload is mental fatigue. Electroencephalography (EEG) is a method of gathering the electromagnetic waves emitted by a human brain. We propose a safety system by monitoring brainwaves for signs of mental fatigue using an EEG system. This requires an analysis of the mental model of the NPP operator, changes in brain wave power in response to certain stimuli, and the risk factors on mental fatigue and attention that NPP operators face when performing their tasks. We analyzed these factors and developed an EEG-based monitoring system, which aims to alert NPP operators when levels of mental fatigue and attention hinders their ability to maintain safety.

Keywords: brain imaging, EEG, power plant operator, psychology

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3271 Blockchain-Based Decentralized Architecture for Secure Medical Records Management

Authors: Saeed M. Alshahrani

Abstract:

This research integrated blockchain technology to reform medical records management in healthcare informatics. It was aimed at resolving the limitations of centralized systems by establishing a secure, decentralized, and user-centric platform. The system was architected with a sophisticated three-tiered structure, integrating advanced cryptographic methodologies, consensus algorithms, and the Fast Healthcare Interoperability Resources (HL7 FHIR) standard to ensure data security, transaction validity, and semantic interoperability. The research has profound implications for healthcare delivery, patient care, legal compliance, operational efficiency, and academic advancements in blockchain technology and healthcare IT sectors. The methodology adapted in this research comprises of Preliminary Feasibility Study, Literature Review, Design and Development, Cryptographic Algorithm Integration, Modeling the data and testing the system. The research employed a permissioned blockchain with a Practical Byzantine Fault Tolerance (PBFT) consensus algorithm and Ethereum-based smart contracts. It integrated advanced cryptographic algorithms, role-based access control, multi-factor authentication, and RESTful APIs to ensure security, regulate access, authenticate user identities, and facilitate seamless data exchange between the blockchain and legacy healthcare systems. The research contributed to the development of a secure, interoperable, and decentralized system for managing medical records, addressing the limitations of the centralized systems that were in place. Future work will delve into optimizing the system further, exploring additional blockchain use cases in healthcare, and expanding the adoption of the system globally, contributing to the evolution of global healthcare practices and policies.

Keywords: healthcare informatics, blockchain, medical records management, decentralized architecture, data security, cryptographic algorithms

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3270 An Ultrasonic Signal Processing System for Tomographic Imaging of Reinforced Concrete Structures

Authors: Edwin Forero-Garcia, Jaime Vitola, Brayan Cardenas, Johan Casagua

Abstract:

This research article presents the integration of electronic and computer systems, which developed an ultrasonic signal processing system that performs the capture, adaptation, and analog-digital conversion to later carry out its processing and visualization. The capture and adaptation of the signal were carried out from the design and implementation of an analog electronic system distributed in stages: 1. Coupling of impedances; 2. Analog filter; 3. Signal amplifier. After the signal conditioning was carried out, the ultrasonic information was digitized using a digital microcontroller to carry out its respective processing. The digital processing of the signals was carried out in MATLAB software for the elaboration of A-Scan, B and D-Scan types of ultrasonic images. Then, advanced processing was performed using the SAFT technique to improve the resolution of the Scan-B-type images. Thus, the information from the ultrasonic images was displayed in a user interface developed in .Net with Visual Studio. For the validation of the system, ultrasonic signals were acquired, and in this way, the non-invasive inspection of the structures was carried out and thus able to identify the existing pathologies in them.

Keywords: acquisition, signal processing, ultrasound, SAFT, HMI

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3269 Nanoscale Metal-Organic Framework Coated Carbon Nitride Nanosheet for Combination Cancer Therapy

Authors: Rui Chen, Jinfeng Zhang, Chun-Sing Lee

Abstract:

In the past couple of decades, nanoscale metal-organic frameworks (NMOFs) have been highlighted as promising delivery platforms for biomedical applications, which combine many potent features such as high loading capacity, progressive biodegradability and low cytotoxicity. While NMOF has been extensively used as carriers for drugs of different modalities, so far there is no report on exploiting the advantages of NMOF for combination therapy. Herein, we prepared core-shell nanoparticles, where each nanoparticle contains a single graphitic-phase carbon nitride (g-C3N4) nanosheet encapsulated by a zeolitic-imidazolate frameworks-8 (ZIF-8) shell. The g-C3N4 nanosheets are effective visible-light photosensitizer for photodynamic therapy (PDT). When hosting DOX (doxorubicin), the as-synthesized core-shell nanoparticles could realize combinational photo-chemo therapy and provide dual-color fluorescence imaging. Therefore, we expect NMOFs-based core-shell nanoparticles could provide a new way to achieve much-enhanced cancer therapy.

Keywords: carbon nitride, combination therapy, drug delivery, nanoscale metal-organic frameworks

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3268 Drug Therapy Problems and Associated Factors among Patients with Heart Failure in the Medical Ward of Arba Minch General Hospital, Ethiopia

Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam

Abstract:

Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.

Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia

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