Search results for: data driven diagnosis

Authors: Yun-Shan Tsai, Si-Ping Lin, En-Chieh Lin, Xin-Hong Chen, Shin-Yun Ho, Shin-Hong Huang, Ching-ju Hsieh

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Background and significance: Uncorrected refractive errors and cataracts are the main visually debilitating ophthalmological abnormalities in adult participants with intellectual disability (ID). However, not all adult participants with ID may receive a regular and timely ophthalmological assessment. Consequently, some of the ocular diseases may not be diagnosed until late, thereby causing unnecessary ocular morbidity. In addition, recent clinical practice and researches have also suggested that eye-care services for this group are neglected. Purpose: To investigate the unmet need for eye care services, clinical characteristics of cataract, visual function, surgical outcome and prognostic predictors in adult participants with ID at Taipei City Hospital in Taiwan. Methods: This is a one-year prospective clinical study. We recruited about 120 eyes of 60 adult participants with ID who were received cataract surgery. Caregivers of all participants received a questionnaire on current eye care services. Clinical demographic data, such as age, gender, and associated systemic diseases or syndromes, were collected. All complete ophthalmologic examinations were performed 1 month preoperatively and 3 months postoperatively, including ocular biometry, visual function, refractive status, morphology of cataract, associated ocular features, anesthesia methods, surgical types, and complications. Morphology of cataract, visual and surgical outcome was analyzed. Results: A total of 60 participants with mean age 43.66 ± 13.94 years, including 59.02% male and 40.98% female, took part in comprehensive eye-care services. The prevalence of unmet need for eye care services was high (about 70%). About 50% of adult participants with ID have bilateral cataracts at the time of diagnosis. White cataracts were noted in about 30% of all adult participants with ID at the time of presentation. Associated ocular disorders were included myopic maculopathy (4.54%), corneal disorders (11.36%), nystagmus (20.45%), strabismus (38.64%) and glaucoma (2.27%). About 26.7% of adult participants with ID underwent extracapsular cataract extraction whereas a phacoemulsification was performed in 100% of eyes. Intraocular lens implantation was performed in all eyes. The most common postoperative complication was posterior capsular opacification (30%). The mean best-corrected visual acuity was significantly improved from preoperatively (mean log MAR 0.48 ± 0.22) to at 3 months postoperatively (mean log MAR 0.045 ± 0.22) (p < .05). Conclusions: Regular follow up will help address the need for eye-care services in participants with ID. A high incidence of bilateral cataracts, as well as white cataracts, was observed in adult participants with ID. Because of early diagnosis and early intervention of cataract, the visual and surgical outcomes of cataract are good, but the visual outcomes are suboptimal due to associated ocular comorbidities.

Keywords: adult participants with intellectual disability, cataract, cataract surgery

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Authors: Harshadkumar Rajgor, Jeff Butterworth

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Background: Barretts oesophagus increases the risk of developing oesophageal adenocarcinoma. Over the last 40 years, there has been a 6 fold increase in the incidence of oesophageal adenocarcinoma in the western world and the incidence rates are increasing at a greater rate than cancers of the colon, breast and lung. Endoscopic mucosal resection (EMR) is a relatively new technique being used by 2 centres in the greater midlands cancer network. EMR can be used for curative or staging purposes, for high-grade dysplasia’s and T1 tumours of the oesophagus. EMR is also suitable for those who are deemed high risk for oesophagectomy. EMR has a recurrence rate of 21% according to the Wiesbaden data. Method: A retrospective study of prospectively collected data was carried out involving 24 patients who had EMR for curative or staging purposes. Complications of residual or recurrent disease following EMR that required further treatment were investigated. Results: In 54% of cases residual or recurrent disease was suspected. 96% of patients were given clear and concise information regarding their diagnosis of high-grade dysplasia or T1 tumours. All 24 patients consulted the same specialist healthcare team. Conclusion: EMR is a safe and effective treatment for patients who have high-grade dysplasia and T1NO tumours. In 54% of cases residual or recurrent disease was suspected. Initially, only single resections were undertaken. Multiple resections are now being carried out to reduce the risk of recurrence. Complications from EMR remain low in this series and consisted of a single episode of post procedural bleeding.

Keywords: endoscopic mucosal resection, oesophageal dysplasia, T1 tumours, cancer network

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Authors: Jamila Mohammed Makarfi, Yontem Sonmez

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Developing countries like Nigeria have recently been affected by conflicts characterized by violence, high levels of risk and insecurity, resulting in loss of lives, livelihoods, displacement of communities, degradation of health, educational and social infrastructure as well as economic underdevelopment. The Nigerian government’s response to most of these conflicts has mainly been reactionary in the form of military deployments, as against precautionary to prevent or address the root causes of the conflicts. Several studies have shown that at various points of a conflict, conflict regions can benefit from the resources and expertise available outside the government, mainly from the private sector through mechanisms such as corporate social responsibility (CSR) by businesses. The main aim of this study is to examine the role of businesses in peacebuilding in Northern Nigeria through CSR in the last decade. The expected contributions from this will answer research questions, such as the key business motivations to engage in peacebuilding, as well as the degree of influence exerted from various stakeholder groups on the business decision to engage. The methodology of the study adopts a multiple case study of over 120 businesses of various sizes, ranging from small, medium and large-scale. A mixed method enabled the collection of quantitative and qualitative primary data to augment the secondary data. The results indicated that the most important business motivations to engage in peacebuilding were the negative effects of the conflict on economic stability, as well as stakeholder-driven motives. On the other hand, out of the 12 identified stakeholders, micro-, small- and medium-scale enterprises (MSMEs) considered the chief executive officer’s interest to be the most important factor, while large companies rated the government and community pressure as the highest. Overall, the foreign stakeholders scored low on the influence chart for all business types.

Keywords: conflict, corporate social responsibility, peacebuilding, stakeholder

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Authors: Eileen Y. Wong, Katherine Jin, Anat Talmon

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Background: Help seeking behaviors are highly contingent on socio-cultural factors such as ethnicity. Both Latino and Asian Americans underutilize mental health services compared to their White American counterparts. This difference may be related to the composite of one’s social support system, which includes family cohesion and social networks. Previous studies have found that Latino families are characterized by higher levels of family cohesion and social support, and Asian American families with greater family cohesion exhibit lower levels of help seeking behaviors. While both are broadly considered collectivist communities, within-culture variability is also significant. Therefore, this study aims to investigate the relationship between help seeking behaviors in the two cultures with levels of family cohesion and strength of social network. We also consider such relationships in light of previous traumatic events and diagnoses, particularly post-traumatic stress disorder (PTSD), to understand whether clinically diagnosed individuals differ in their strength of network and help seeking behaviors. Method: An adult sample (N = 2,990) from the National Latino and Asian American Study (NLAAS) provided data on participants’ social network, family cohesion, likelihood of seeking professional help, and DSM-IV diagnoses. T-tests compared Latino American (n = 1,576) and Asian American respondents (n = 1,414) in strength of social network, level of family cohesion, and likelihood of seeking professional help. Linear regression models were used to identify the probability of help-seeking behavior based on ethnicity, PTSD diagnosis, and strength of social network. Results: Help-seeking behavior was significantly associated with family cohesion and strength of social network. It was found that higher frequency of expressing one’s feelings with family significantly predicted lower levels of help-seeking behaviors (β = [-.072], p = .017), while higher frequency of spending free time with family significantly predicted higher levels of help-seeking behaviors (β = [.129], p = .002) in the Asian American sample. Subjective importance of family relations compared to that of one’s peers also significantly predict higher levels of help-seeking behaviors (β = [.095], p = .011) in the Asian American sample. Frequency of sharing one’s problems with relatives significantly predicted higher levels of help-seeking behaviors (β = [.113], p < .01) in the Latino American sample. A PTSD diagnosis did not have any significant moderating effect. Conclusion: Considering the underutilization of mental health services in Latino and Asian American minority groups, it is crucial to understand ways in which help seeking behavior can be encouraged. Our findings suggest that different dimensions within family cohesion and social networks have differential impacts on help-seeking behavior. Given the multifaceted nature of family cohesion and cultural relevance, the implications of our findings for theory and practice will be discussed.

Keywords: family cohesion, social networks, Asian American, Latino American, help-seeking behavior

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Authors: Lu Zhao, Nadir Farhi, Zoi Christoforou, Nadia Haddadou

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The safety test of deploying intelligent connected vehicles (ICVs) on the road network is a critical challenge. Road traffic network simulation can be used to test the functionality of ICVs, which is not only time-saving and less energy-consuming but also can create scenarios with car collisions. However, the relationship between different human driver behaviors and the car-collision occurrences has been not understood clearly; meanwhile, the procedure of car-collisions generation in the traffic numerical simulators is not fully integrated. In this paper, we propose an approach to identify specific driver profiles from real driven data; then, we replicate them in numerical traffic simulations with the purpose of generating inter-vehicular collisions. We proposed three profiles: (i) 'aggressive': short time-headway, (ii) 'inattentive': long reaction time, and (iii) 'normal' with intermediate values of reaction time and time-headway. These three driver profiles are extracted from the NGSIM dataset and simulated using the intelligent driver model (IDM), with an extension of reaction time. At last, the generation of inter-vehicular collisions is performed by varying the percentages of different profiles.

Keywords: vehicular collisions, human driving behavior, traffic modeling, car-following models, microscopic traffic simulation

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Authors: Daniel Osorio, Janneth Gonzalez, Andres Pinzon

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In this work, proteins and metabolic pathways associated with the neuroprotective response mediated by the synthetic neurosteroid tibolone under a palmitate-induced inflammatory model were identified by flux balance analysis (FBA). Three different metabolic scenarios (‘healthy’, ‘inflamed’ and ‘medicated’) were modeled over a gene expression data-driven constructed tissue-specific metabolic reconstruction of mature astrocytes. Astrocyte reconstruction was built, validated and constrained using three open source software packages (‘minval’, ‘g2f’ and ‘exp2flux’) released through the Comprehensive R Archive Network repositories during the development of this work. From our analysis, we predict that tibolone executes their neuroprotective effects through a reduction of neurotoxicity mediated by L-glutamate in astrocytes, inducing the activation several metabolic pathways with neuroprotective actions associated such as taurine metabolism, gluconeogenesis, calcium and the Peroxisome Proliferator Activated Receptor signaling pathways. Also, we found a tibolone associated increase in growth rate probably in concordance with previously reported side effects of steroid compounds in other human cell types.

Keywords: astrocytes, flux balance analysis, genome scale metabolic reconstruction, inflammation, neuroprotection, tibolone

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Authors: Vanessa Cho, Janet Hsiao, Nigel King, Robert Anthonappa

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Background: The personal protective equipment (PPE) requirements for health care workers (HCWs) have changed significantly during the COVID-19 pandemic. Aim: To ascertain, using eye-tracking technology, what children notice the most when seeing HCWs in various PPE. Design: A Tobii nano pro-eye-tracking camera tracked 156 children's visual attention while they viewed photographs of HCWs in various PPEs. Eye Movement analysis with Hidden Markov Models (EMHMM) was employed to analyse 624 recordings using two approaches, namely (i) data-driven where children's fixation determined the regions of interest (ROIs), and (ii) fixed ROIs where the investigators predefined the ROIs. Results: Two significant eye movement patterns, namely distributed(85.2%) and selective(14.7%), were identified(P<0.05). Most children fixated primarily on the face regardless of the different PPEs. Children fixated equally on all PPE images in the distributed pattern, while a strong preference for unmasked faces was evident in the selective pattern (P<0.01). Conclusion: Children as young as 2.5 years used a top-down visual search behaviour and demonstrated their face processing ability. Most children did not show a strong visual preference for a specific PPE, while a minority preferred PPE with distinct facial features, namely without masks and loupes.

Keywords: COVID-19, PPE, dentistry, pediatric

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Authors: Oliver Bertram, Leonel Akoto Chama

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In today's civil transport aircraft, the design of flight control systems is based on the experience gained from previous aircraft configurations with a clear distinction between primary and secondary flight control functions for controlling the aircraft altitude and trajectory. Significant system improvements are now seen particularly in multifunctional moveable concepts where the flight control functions are no longer considered separate but integral. This allows new functions to be implemented in order to improve the overall aircraft performance. However, the classical design process of flight controls is sequential and insufficiently interdisciplinary. In particular, the systems discipline is involved only rudimentarily in the early phase. In many cases, the task of systems design is limited to meeting the requirements of the upstream disciplines, which may lead to integration problems later. For this reason, approaching design with an incremental development is required to reduce the risk of a complete redesign. Although the potential and the path to multifunctional moveable concepts are shown, the complete re-engineering of aircraft concepts with less classic moveable concepts is associated with a considerable risk for the design due to the lack of design methods. This represents an obstacle to major leaps in technology. This gap in state of the art is even further increased if, in the future, unconventional aircraft configurations shall be considered, where no reference data or architectures are available. This means that the use of the above-mentioned experience-based approach used for conventional configurations is limited and not applicable to the next generation of aircraft. In particular, there is a need for methods and tools for a rapid trade-off between new multifunctional flight control systems architectures. To close this gap in the state of the art, an integrated system-driven design process for multifunctional flight control systems of non-classical aircraft configurations will be presented. The overall goal of the design process is to find optimal solutions for single or combined target criteria in a fast process from the very large solution space for the flight control system. In contrast to the state of the art, all disciplines are involved for a holistic design in an integrated rather than a sequential process. To emphasize the systems discipline, this paper focuses on the methodology for designing moveable actuation systems in the context of this integrated design process of multifunctional moveables. The methodology includes different approaches for creating system architectures, component design methods as well as the necessary process outputs to evaluate the systems. An application example of a reference configuration is used to demonstrate the process and validate the results. For this, new unconventional hydraulic and electrical flight control system architectures are calculated which result from the higher requirements for multifunctional moveable concept. In addition to typical key performance indicators such as mass and required power requirements, the results regarding the feasibility and wing integration aspects of the system components are examined and discussed here. This is intended to show how the systems design can influence and drive the wing and overall aircraft design.

Keywords: actuation systems, flight control surfaces, multi-functional movables, wing design process

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Authors: Sitaram Dahal

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Sustainable Development, a universal need for the present generation and the future generation, is an accepted way to assure intra and inter-generational equity. International movements like Rio Earth Summit 1992, Stockholm Conference 1972, Kyoto Protocol, Sustainable Development Goals (SDGs) proclaim the need of sustainable globe. The socio- economic disparity prevailing in the society shows that the indigenous peoples are living life far below poverty line. These indigenous people, aboriginal social groups sharing common cultural values and with a unique identity, are away from development being merely focused on the growth. Though studies suggest that most of the indigenous practices are often environment-friendly, alert about the plunging trend of the practices. This study explores the trend of intergenerational transmission of indigenous profession of pottery making of Kumal community (Meghauli Village Development Committee of Chitwan district) and factors affecting the trend. The SD indicators - contribution of IP to well-being of pottery makers had been query in the study. The study reveals that the pottery making profession can stand sustainable in terms of environment and socio-economic capital compared to modern technologies. However, the number of practitioners has been decreasing and youths hardly show interest to continue their indigenous profession. The new generations are not in a stage of accepting pottery in complete profession, that challenges the social and cultural sustainability of the profession. Indigenous profession demand people investments over modern technology and innovations. The relative investment of human labour is dramatically high with the indigenous profession. In addition, the fashion and innovations of market rule challenge the sustainability of the pottery making profession. The practice is limited to small cluster as a show piece at present. The study illustrates the market driven unsustainability of indigenous profession of Kumal community.

Keywords: professional unsustainability, pottery making, Kumal Community, Indigenous Professoin

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Authors: Leona Ondrejikova, Martin Hill, Antonin Parizek

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The incidence of gestational diabetes mellitus (GDM) is higher in women predisposed to developing intrahepatic cholestasis of pregnancy (ICP). Both diseases are associated with altered steroidogenesis when compared with none-ICP controls. However, the effect of GDM on circulating steroids in ICP patients remains unclear. The question remains, whether the levels of circulating steroids differ between ICP patients with and without GDM. In total 10 ICP patients without GDM (ICP+GDM-), 7 ICP patients with GDM (ICP+GDM+), and 15 controls (ICP-GDM-) were monitored during late gestation, at labor, and during three periods postpartum (day 5, week 3, and week 6 postpartum) (Šimják et al., 2018). The relationships between steroid profiles and patients’ status were evaluated using the ANOVA model consisting of subject factor, between-subject factors Group (ICP+GDM+, ICP+GDM-, ICP-GDM-), gestational age at the diagnosis of ICP and gestational age at labor, and within-subject factor Stage and ICP × Stage interaction. The levels of the C21 and C19 Δ5 steroids and 5α/β-reduced C19 steroids were highest in ICP+GDM+, while those for the ICP-GDM-, and ICP+GDM- groups were lower. In the C21 Δ4 steroids and their 5α/β-reduced metabolites, the steroid levels were highest in the ICP+GDM-, intermediate in the ICP-GDM- and lowest in the ICP+GDM+ group. This higher concentration in ICP+GDM- group may be of importance as the 5α-pregnane-3α,20α-diol disulfate, is considered as the substance inducing ICP. In general, these data show that the comorbidity with GDM substantially changes the steroidome in ICP patients towards the higher activity of steroid CYP17A1 lyase step in adrenal zona reticularis reduced CYP17A1 hydroxylase step in zona fasciculata. This is consistent with our previously published hypothesis about the critical role of maternal zona reticularis in the pathophysiology of ICP. Our present data also indicate that the comorbidity with GDM might moderate the gravity of the ICP in this way.

Keywords: CYP17A1, GC-MS, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy

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Authors: Luvisa Kusuma, Panji Yudha Prakasa

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Cloud storage, as a subservice of infrastructure as a service (IaaS) in Cloud Computing, is the model of nerworked storage where data can be stored in server. In this paper, we propose a secure cloud storage system consisting of two main components; client as a user who uses the cloud storage service and server who provides the cloud storage service. In this system, we propose the protocol schemes to guarantee against security attacks in the data transmission. The protocols are login protocol, upload data protocol, download protocol, and push data protocol, which implement hybrid cryptographic mechanism based on data encryption before it is sent to the cloud, so cloud storage provider does not know the user's data and cannot analysis user’s data, because there is no correspondence between data and user.

Keywords: cloud storage, security, cryptographic protocol, artificial intelligence

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Authors: Meshari Aljohani, Stephan Olariu, Ravi Mukkamala

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Data is essential for enhancing the quality of life. Its value creates chances for users to profit from data sales and purchases. Users in data marketplaces, however, must share and trade data in a secure and trusted environment while maintaining their privacy. The first main contribution of this paper is to identify enabling technologies and challenges facing the development of decentralized data marketplaces. The second main contribution is to propose a decentralized data marketplace framework based on blockchain technology. The proposed framework enables sellers and buyers to transact with more confidence. Using a security deposit, the system implements a unique approach for enforcing honesty in data exchange among anonymous individuals. Before the transaction is considered complete, the system has a time frame. As a result, users can submit disputes to the arbitrators which will review them and respond with their decision. Use cases are presented to demonstrate how these technologies help data marketplaces handle issues and challenges.

Keywords: blockchain, data, data marketplace, smart contract, reputation system

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Authors: Keith Dominic T. Li

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The soaring prices of residential properties in Hong Kong has become a social problem that even the middle class is having dif?iculties in purchasing homes. In making policies to curb the prices, it is important to determine the factors that contribute to the property in?lation. Many researches attribute this in?lation to macroeconomic factors especially the interest rate. However, it is important to remember that Hong Kong is under a Currency Board system which makes its interest rate exogenously determined. This research aims to show the signi?icance of the money supply on Hong Kong residential property prices in post-1997 Asian Financial Crisis period. Using money supply data, macroeconomic fundamentals, and demographic variables from 2000Q1 to 2013Q2, the factors contributed to residential property price in?lation are estimated to calculate the share of each explanatory variable in disparity. It is found that the Hong Kong property market is mainly driven by investment and that the in?lation on Hong Kong residential property prices can explained by the increase in the Hang Seng Index and in the money supply M2.

Keywords: real estate, Hong Kong, property market, monetary economics, monetary policy

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Authors: Khaled Alabduljabbar

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Background: Benign, isolated, recurrent sixth nerve palsy is very rare in children. Here we report a case of recurrent abducens nerve palsy with no obvious etiology. It is a diagnosis of exclusion. A recurrent benign form of 6th nerve palsy, a rarer still palsy, has been described in the literature, and it is of most likely secondary to inflammatory causes, e.g, following viral and bacterial infections. Purpose: To present a case of 14 months old girl with recurrent attacks of isolated left sixth cranial nerve palsy following upper respiratory tract infection. Observation: The patient presented to opthalmology clinic with sudden onset of inward deviation (esotropia) of the left eye with a compensatory left face turn one week following signs of upper respiratory tract infection. Ophthalmological examination revealed large angle esotropia of the left eye in primary position, with complete limitation of abduction of the left eye, no palpebral fissure changes, and abnormal position of the head (left face turn). Visual acuity was normal, and no significant refractive error on cycloplegic refraction for her age. Fundus examination was normal with no evidence of papilledema. There was no relative afferent pupillary defect (RAPD) and no anisocoria. Past medical history and family history were unremarkable, with no history of convulsion attacks or head trauma. Additional workout include CBC. Erythrocyte sedimentation rate, Urgent magnetic resonance imaging (MRI), and angiography of the brain were performed and demonstrated the absence of intracranial and orbital lesions. Referral to pediatric neurologist was also done and concluded no significant finding. The patient showed improvement of the left sixth cranial nerve palsy and left face turn over a period of two months. Seven months since the first attack, she experienced a recurrent attack of left eye esotropia with left face turn concurrent with URTI. The rest of eye examination was again unremarkable. CT scan and MRI scan of brain and orbit were performed and showed only signs of sinusitis with no intracranial pathology. The palsy resolved spontaneously within two months. A third episode of left 6th nerve palsy occurred 6 months later, whichrecovered over one month. Examination and neuroimagingwere unremarkable. A diagnosis of benign recurrent left 6th cranial nerve palsy was made. Conclusion: Benign sixth cranial nerve palsy is always a diagnosis of exclusion given the more serious and life-threatening alternative causes. It seems to have a good prognosis with only supportive measures. The likelihood of benign 6th cranial nerve palsy to resolve completely and spontaneously is high. Observation for at least 6 months without intervention is advisable.

Keywords: 6th nerve pasy, abducens nerve pasy, recurrent nerve palsy, cranial nerve palsy

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Authors: Stehr Melanie

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The availability of apposite information is essential for the decision-making process of organizational buyers. Due to the constraints of the Covid-19 crisis, information channels that emphasize face-to-face contact (e.g. sales visits, trade shows) have been unavailable, and usage of digitally-driven information channels (e.g. videoconferencing, platforms) has skyrocketed. This paper explores the question in which areas the pandemic induced shift in the use of information channels could be sustainable and in which areas it is a temporary phenomenon. While information and buying behavior in B2C purchases has been regularly studied in the last decade, the last fundamental model of organizational buying behavior in B2B was introduced by Johnston and Lewin (1996) in times before the advent of the internet. Subsequently, research efforts in B2B marketing shifted from organizational buyers and their decision and information behavior to the business relationships between sellers and buyers. This study builds on the extensive literature on situational factors influencing organizational buying and information behavior and uses the economics of information theory as a theoretical framework. The research focuses on the German woodworking industry, which before the Covid-19 crisis was characterized by a rather low level of digitization of information channels. By focusing on an industry with traditional communication structures, a shift in information behavior induced by an exogenous shock is considered a ripe research setting. The study is exploratory in nature. The primary data source is 40 in-depth interviews based on the repertory-grid method. Thus, 120 typical buying situations in the woodworking industry and the information and channels relevant to them are identified. The results are combined into clusters, each of which shows similar information behavior in the procurement process. In the next step, the clusters are analyzed in terms of the post and pre-Covid-19 crisis’ behavior identifying stable and dynamic information behavior aspects. Initial results show that, for example, clusters representing search goods with low risk and complexity suggest a sustainable rise in the use of digitally-driven information channels. However, in clusters containing trust goods with high significance and novelty, an increased return to face-to-face information channels can be expected after the Covid-19 crisis. The results are interesting from both a scientific and a practical point of view. This study is one of the first to apply the economics of information theory to organizational buyers and their decision and information behavior in the digital information age. Especially the focus on the dynamic aspects of information behavior after an exogenous shock might contribute new impulses to theoretical debates related to the economics of information theory. For practitioners - especially suppliers’ marketing managers and intermediaries such as publishers or trade show organizers from the woodworking industry - the study shows wide-ranging starting points for a future-oriented segmentation of their marketing program by highlighting the dynamic and stable preferences of elaborated clusters in the choice of their information channels.

Keywords: B2B buying process, crisis, economics of information theory, information channel

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Authors: Bu Kyung Park

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Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.

Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis

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Authors: N. Demertzis, J. L. Bowen

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Sepsis is a complex and rapidly evolving condition, resulting from uncontrolled prolonged activation of host immune system due to pathogenic insult. The aim of this study is the development of a multiplex electrochemical sensing platform, capable of detecting both pathogen associated and host immune markers to enable the rapid and definitive diagnosis of sepsis. A combination of aptamers and molecular imprinting approaches have been employed to generate sensing systems for lipopolysaccharide (LPS), c-reactive protein (CRP) and procalcitonin (PCT). Gold working electrodes were mechanically polished and electrochemically cleaned with 0.1 M sulphuric acid using cyclic voltammetry (CV). Following activation, a self-assembled monolayer (SAM) was generated, by incubating the electrodes with a thiolated anti-LPS aptamer / dithiodibutiric acid (DTBA) mixture (1:20). 3-aminophenylboronic acid (3-APBA) in combination with the anti-LPS aptamer was used for the development of the hybrid molecularly imprinted sensor (apta-MIP). Aptasensors, targeting PCT and CRP were also fabricated, following the same approach as in the case of LPS, with mercaptohexanol (MCH) replacing DTBA. In the case of the CRP aptasensor, the SAM was formed following incubation of a 1:1 aptamer: MCH mixture. However, in the case of PCT, the SAM was formed with the aptamer itself, with subsequent backfilling with 1 μM MCH. The binding performance of all systems has been evaluated using electrochemical impedance spectroscopy. The apta-MIP’s polymer thickness is controlled by varying the number of electropolymerisation cycles. In the ideal number of polymerisation cycles, the polymer must cover the electrode surface and create a binding pocket around LPS and its aptamer binding site. Less polymerisation cycles will create a hybrid system which resembles an aptasensor, while more cycles will be able to cover the complex and demonstrate a bulk polymer-like behaviour. Both aptasensor and apta-MIP were challenged with LPS and compared to conventional imprinted (absence of aptamer from the binding site, polymer formed in presence of LPS) and non-imprinted polymers (NIPS, absence of LPS whilst hybrid polymer is formed). A stable LPS aptasensor, capable of detecting down to 5 pg/ml of LPS was generated. The apparent Kd of the system was estimated at 17 pM, with a Bmax of approximately 50 pM. The aptasensor demonstrated high specificity to LPS. The apta-MIP demonstrated superior recognition properties with a limit of detection of 1 fg/ml and a Bmax of 100 pg/ml. The CRP and PCT aptasensors were both able to detect down to 5 pg/ml. Whilst full binding performance is currently being evaluated, there is none of the sensors demonstrate cross-reactivity towards LPS, CRP or PCT. In conclusion, stable aptasensors capable of detecting LPS, PCT and CRP at low concentrations have been generated. The realisation of a multiplex panel such as described herein, will effectively contribute to the rapid, personalised diagnosis of sepsis.

Keywords: aptamer, electrochemical impedance spectroscopy, molecularly imprinted polymers, sepsis

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Authors: A.Chayaporn Kaoropthai, B. Onjaree Natakuatoong, C. Nagul Cooharojananone

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The first year is usually the most critical year for university students. Generally, a considerable number of first-year students worldwide drop out of university every year. One of the major reasons for dropping out is failing. Although they are supposed to have mastered sufficient English proficiency upon completing their high school education, most first-year students are still novices in academic reading. Due to their lack of experience in academic reading, first-year students need significant support from teachers to help develop their academic reading skills. Reading strategies training is thus a necessity and plays a crucial role in classroom instruction. However, individual differences in both students, as well as teachers, are the main factors contributing to the failure in not responding to each individual student’s needs. For this reason, reading strategies training inevitably needs a diagnosis of students’ academic reading skills levels before, during, and after learning, in order to respond to their different needs. To further support reading strategies training, scaffolding is proposed to facilitate students in understanding and practicing using reading strategies under the teachers’ guidance. The use of the Intelligent Tutoring Systems (ITSs) as a tool for diagnosing students’ reading problems will be very beneficial to both students and their teachers. The ITSs consist of four major modules: the Expert module, the Student module, the Diagnostic module, and the User Interface module. The application of Artificial Intelligence (AI) enables the systems to perform diagnosis consistently and appropriately for each individual student. Thus, it is essential to develop the Intelligent Scaffolding Diagnostic Reading Strategies Tutoring Systems to enhance first-year students’ academic reading skills. The systems proposed will contribute to resolving classroom reading strategies training problems, developing students’ academic reading skills, and facilitating teachers.

Keywords: academic reading, intelligent tutoring systems, scaffolding, university students

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Authors: Taleb L., Benarbia M., Boutira F. M., Allam H., Boukerche A.

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Introduction and purpose of the study: Meningiomas are the most common non-glial intracranial tumors in adults, accounting for approximately 30% of all central nervous system tumors. The aim of our study is to determine the epidemiological, clinical, therapeutic, and evolutionary characteristics of a cohort of patients with intracranial meningioma treated with radiotherapy at the Emir Abdelkader Cancer Center in Oran. Material and methods: This is a retrospective study of 44 patients during the period from 2014 to 2020. The overall survival and relapse-free survival curves were calculated using the Kaplan-Meier method. Results and statistical analysis: The median age of the patients was 49 years [21-76 years] with a clear female predominance (sex ratio=2.4). The average diagnostic delay was seven months [2 to 24 months], the circumstances of the discovery of which were dominated by headaches in 54.5% of cases (n=24), visual disturbances in 40.9% (n=18), and motor disorders in 15.9% (n=7). The seat of the tumor was essentially at the level of the base of the skull in 52.3% of patients (n=23), including 29.5% (n=13) at the level of the cavernous sinus, 27.3% (n=12) at the parasagittal level and 20.5% (n=9) at the convexity. The diagnosis was confirmed surgically in 36 patients (81.8%) whose anatomopathological study returned in favor of grades I, II, and III in respectively 40.9%, 29.5%, and 11.4% of the cases. Radiotherapy was indicated postoperatively in 45.5% of patients (n=20), exclusive in 27.3% (n=12) and after tumor recurrence in 27.3% of cases (n=18). The irradiation doses delivered were as follows: 50 Gy (20.5%), 54 Gy (65.9%), and 60 Gy (13.6%). With a median follow-up of 69 months, the probabilities of relapse-free survival and overall survival at three years are 93.2% and 95.4%, respectively, whereas they are 71.2% and 80.7% at five years. Conclusion: Meningiomas are common primary brain tumors. Most often benign but can also progress aggressively. Their treatment is essentially surgical, but radiotherapy retains its place in specific situations, allowing good tumor control and overall survival.

Keywords: diagnosis, meningioma, surgery, radiotherapy, survival

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Authors: Sathish Kumar Jayaraj

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The study of urban traffic dynamics, underpinned by the principles of fluid dynamics, offers a distinct perspective to comprehend and enhance the efficiency of traffic flow within bustling cityscapes. Leveraging the concept of the Traffic Flow Factor (TFF) as an analog to the Reynolds number, this research delves into the intricate interplay between traffic density, velocity, and road category, drawing compelling parallels to fluid dynamics phenomena. By introducing the notion of Vehicle Shearing Resistance (VSR) as an analogy to dynamic viscosity, the study sheds light on the multifaceted influence of traffic regulations, lane management, and road infrastructure on the smoothness and resilience of traffic flow. The TFF equation serves as a comprehensive metric for quantifying traffic dynamics, enabling the identification of congestion hotspots, the optimization of traffic signal timings, and the formulation of data-driven traffic management strategies. The study underscores the critical significance of integrating fluid dynamics principles into the domain of urban traffic management, fostering sustainable transportation practices, and paving the way for a more seamless and resilient urban mobility ecosystem.

Keywords: traffic flow factor (TFF), urban traffic dynamics, fluid dynamics principles, vehicle shearing resistance (VSR), traffic congestion management, sustainable urban mobility

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Authors: Sean Goltz, Michael Mayo

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The purpose of this research is to use Global-Regulation.com database of the world laws, focusing on tax treaties between countries, in order to create an AI-driven tax simulator that will run an AI agent through potential tax scenarios across countries. The AI agent goal is to identify the scenario that will result in minimum tax liability based on tax treaties between countries. The results will be visualized by a three dimensional matrix. This will be an online web application. Multinational corporations are running their business through multiple countries. These countries, in turn, have a tax treaty with many other countries to regulate the payment of taxes on income that is transferred between these countries. As a result, planning the best tax scenario across multiple countries and numerous tax treaties is almost impossible. This research propose to use Global-Regulation.com database of word laws in English (machine translated by Google and Microsoft API’s) in order to create a simulator that will include the information in the tax treaties. Once ready, an AI agent will be sent through the simulator to identify the scenario that will result in minimum tax liability. Identifying the best tax scenario across countries may save multinational corporations, like Google, billions of dollars annually. Given the nature of the raw data and the domain of taxes (i.e., numbers), this is a promising ground to employ artificial intelligence towards a practical and beneficial purpose.

Keywords: taxation, law, multinational, corporation

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Authors: Ali Alshahrani, Adel Almaai, Saad Garni

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Aim of the study: To explore duration and determinants of consultation time at a family medicine center. Methodology: This study was conducted at the Family Medicine Center in Ahad Rafidah City, at the southwestern part of Saudi Arabia. It was conducted on the working days of March 2013. Trained nurses helped in filling in the checklist. A total of 459 patients were included. A checklist was designed and used in this study. It included patient’s age, sex, diagnosis, type of visit, referral and its type, psychological problems and additional work-up. In addition, number of daily bookings, physician`s experience and consultation time. Results: More than half of patients (58.39%) had less than 10 minutes’ consultation (Mean+SD: 12.73+9.22 minutes). Patients treated by physicians with shortest experience (i.e., ≤5 years) had the longest consultation time while those who were treated with physicians with the longest experience (i.e., > 10 years) had the shortest consultation time (13.94±10.99 versus 10.79±7.28, p=0.011). Regarding patients’ diagnosis, those with chronic diseases had the longest consultation time (p<0.001). Patients who did not need referral had significantly shorter consultation time compared with those who had routine or urgent referral (11.91±8.42,14.60±9.03 and 22.42±14.81 minutes, respectively, p<0.001). Patients with associated psychological problems needed significantly longer consultation time than those without associated psychological problems (20.06±13.32 versus 12.45±8.93, p<0.001). Conclusions: The average length of consultation time at Ahad Rafidah Family Medicine Center is approximately 13 minutes. Less-experienced physicians tend to spend longer consultation times with patients. Referred patients, those with psychological problems, those with chronic diseases tend to have longer consultation time. Recommendations: Family physicians should be encouraged to keep their optimal consultation time. Booking an adequate number of patients per shift would allow the family physician to provide enough consultation time for each patient.

Keywords: consultation, quality, medicine, clinics

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Authors: Fulya Gokalp Yavuz, Mark Daniel Ward

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This study focuses on a contemporary and inevitable topic of Data Science and its exemplary application for early career building: Big Data and Leaving Learning Community (LLC). ‘Academia’ and ‘Industry’ have a common sense on the importance of Big Data. However, both of them are in a threat of missing the training on this interdisciplinary area. Some traditional teaching doctrines are far away being effective on Data Science. Practitioners needs some intuition and real-life examples how to apply new methods to data in size of terabytes. We simply explain the scope of Data Science training and exemplified its early stage application with LLC, which is a National Science Foundation (NSF) founded project under the supervision of Prof. Ward since 2014. Essentially, we aim to give some intuition for professors, researchers and practitioners to combine data science tools for comprehensive real-life examples with the guides of mentees’ feedback. As a result of discussing mentoring methods and computational challenges of Big Data, we intend to underline its potential with some more realization.

Keywords: Big Data, computation, mentoring, training

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Authors: Arvind Aggarwal

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We have developed a comprehensive global healthcare delivery System based on information technology. It has medical consultation system where a virtual consultant can give medical consultation to the patients and Doctors at the digital medical centre after reviewing the patient’s EMR file consisting of patient’s history, investigations in the voice, images and data format. The system has the surgical operation system too, where a remote robotic consultant can conduct surgery at the robotic surgical centre. The instant speech and text translation is incorporated in the software where the patient’s speech and text (language) can be translated into the consultant’s language and vice versa. A consultant of any specialty (surgeon or Physician) based in any country can provide instant health care consultation, to any patient in any country without loss of time. Robotic surgeons based in any country in a tertiary care hospital can perform remote robotic surgery, through patient friendly telemedicine and tele-surgical centres. The patient EMR, financial data and data of all the consultants and robotic surgeons shall be stored in cloud. It is a complete comprehensive business model with healthcare medical and surgical delivery system. The whole system is self-financing and can be implemented in any country. The entire system uses paperless, filmless techniques. This eliminates the use of all consumables thereby reduces substantial cost which is incurred by consumables. The consultants receive virtual patients, in the form of EMR, thus the consultant saves time and expense to travel to the hospital to see the patients. The consultant gets electronic file ready for reporting & diagnosis. Hence time spent on the physical examination of the patient is saved, the consultant can, therefore, spend quality time in studying the EMR/virtual patient and give his instant advice. The time consumed per patient is reduced and therefore can see more number of patients, the cost of the consultation per patients is therefore reduced. The additional productivity of the consultants can be channelized to serve rural patients devoid of doctors.

Keywords: e-health, telemedicine, telecare, IT-based healthcare

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Authors: Yousif Mohamed Y. Abdallah, Razan Manofely, Rajab M. Ben Yousef

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X-Ray images are very popular as a first tool for diagnosis. Automating the process of analysis of such images is important in order to help physician procedures. In this practice, teeth segmentation from the radiographic images and feature extraction are essential steps. The main objective of this study was to study correction preprocessing of x-rays images using local adaptive filters in order to evaluate contrast enhancement pattern in different x-rays images such as grey color and to evaluate the usage of new nonlinear approach for contrast enhancement of soft tissues in x-rays images. The data analyzed by using MatLab program to enhance the contrast within the soft tissues, the gray levels in both enhanced and unenhanced images and noise variance. The main techniques of enhancement used in this study were contrast enhancement filtering and deblurring images using the blind deconvolution algorithm. In this paper, prominent constraints are firstly preservation of image's overall look; secondly, preservation of the diagnostic content in the image and thirdly detection of small low contrast details in diagnostic content of the image.

Keywords: enhancement, x-rays, pixel intensity values, MatLab

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Authors: Mohamed Elkholy, Ahmed Elfatatry

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Cloud computing has emerged as a flexible computing paradigm that reshaped the Information Technology map. However, cloud computing brought about a number of security challenges as a result of the physical distribution of computational resources and the limited control that users have over the physical storage. This situation raises many security challenges for data integrity and confidentiality as well as authentication and access control. This work proposes a security mechanism for data integrity that allows a data owner to be aware of any modification that takes place to his data. The data integrity mechanism is integrated with an extended Kerberos authentication that ensures authorized access control. The proposed mechanism protects data confidentiality even if data are stored on an untrusted storage. The proposed mechanism has been evaluated against different types of attacks and proved its efficiency to protect cloud data storage from different malicious attacks.

Keywords: access control, data integrity, data confidentiality, Kerberos authentication, cloud security

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Authors: F. Ghazalnaz Sharifonnasabi, Iman Makhdoom

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Breast cancer is a serious health concern that affects many people around the world. According to a study published in the Breast journal, the global burden of breast cancer is expected to increase significantly over the next few decades. The number of deaths from breast cancer has been increasing over the years, but the age-standardized mortality rate has decreased in some countries. It’s important to be aware of the risk factors for breast cancer and to get regular check- ups to catch it early if it does occur. Machin learning techniques have been used to aid in the early detection and diagnosis of breast cancer. These techniques, that have been shown to be effective in predicting and diagnosing the disease, have become a research hotspot. In this study, we consider two deep learning approaches including: Multi-Layer Perceptron (MLP), and Convolutional Neural Network (CNN). We also considered the five-machine learning algorithm titled: Decision Tree (C4.5), Naïve Bayesian (NB), Support Vector Machine (SVM), K-Nearest Neighbors (KNN) Algorithm and XGBoost (eXtreme Gradient Boosting) on the Breast Cancer Wisconsin Diagnostic dataset. We have carried out the process of evaluating and comparing classifiers involving selecting appropriate metrics to evaluate classifier performance and selecting an appropriate tool to quantify this performance. The main purpose of the study is predicting and diagnosis breast cancer, applying the mentioned algorithms and also discovering of the most effective with respect to confusion matrix, accuracy and precision. It is realized that CNN outperformed all other classifiers and achieved the highest accuracy (0.982456). The work is implemented in the Anaconda environment based on Python programing language.

Keywords: breast cancer, multi-layer perceptron, Naïve Bayesian, SVM, decision tree, convolutional neural network, XGBoost, KNN

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Authors: F. Sarkinfada, Dabo N. Tukur, Abbas A. Muaz, Adamu A. Yahuza

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Appropriate Quality Assurance (QA) of parasite-based diagnosis of malaria to justify Artemisinin-based Combination Therapy (ACT) is essential for Malaria Programmes. In Low and Middle Income Countries (LMIC), resource constrain appears to be a major challenge in implementing the conventional QA system. We designed and implemented a modified LQAS model for QA of malaria parasite (MP) microscopy and RDT in a State Specialist Hospital (SSH) and a University Health Clinic (UHC) in Kano, Nigeria. The capacities of both facilities for MP microscopy and RDT were assessed before implementing a modified LQAS over a period of 3 months. Quality indicators comprising the qualities of blood film and staining, MP positivity rates, concordance rates, error rates (in terms of false positives and false negatives), sensitivity and specificity were monitored and evaluated. Seventy one percent (71%) of the basic requirements for malaria microscopy was available in both facilities, with the absence of certifies microscopists, SOPs and Quality Assurance mechanisms. A daily average of 16 to 32 blood samples were tested with a blood film staining quality of >70% recorded in both facilities. Using microscopy, the MP positivity rates were 50.46% and 19.44% in SSH and UHS respectively, while the MP positivity rates were 45.83% and 22.78% in SSH and UHS when RDT was used. Higher concordance rates of 88.90% and 93.98% were recorded in SSH and UHC respectively using microscopy, while lower rates of 74.07% and 80.58% in SSH and UHC were recorded when RDT was used. In both facilities, error rates were higher when RDT was used than with microscopy. Sensitivity and specificity were higher when microscopy was used (95% and 84% in SSH; 94% in UHC) than when RDT was used (72% and 76% in SSH; 78% and 81% in UHC). It could be feasible to implement an integrated QA model for MP microscopy and RDT using modified LQAS in Malaria Control Programmes in Low and Middle Income Countries that might have resource constrain for parasite-base diagnosis of malaria to justify ACT treatment.

Keywords: malaria, microscopy, quality assurance, RDT

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Authors: Nasir Khalid, S. Thirumalaichelvam

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In most buildings, according to US Department of Energy Data Book, the electrical consumption attributable to centralized heating and ventilation of air- condition (HVAC) component can be as high as 40-60% of the total electricity consumption for an entire building. To provide efficient energy management for the market today, researchers are finding new ways to develop a system that can save electrical consumption of buildings even more. In this concept paper, a system known as Intelligent Chiller Energy Efficiency (iCEE) System is being developed that is capable of saving up to 25% from the chiller’s existing electrical energy consumption. In variable frequency drives (VFDs), research has found significant savings up to 30% of electrical energy consumption. Together with the VFDs at specific Air Handling Unit (AHU) of HVAC component, this system will save even more electrical energy consumption. The iCEE System is compatible with any make, model or age of centrifugal, rotary or reciprocating chiller air-conditioning systems which are electrically driven. The iCEE system uses engineering principles of efficiency analysis, enthalpy analysis, heat transfer, mathematical prediction, modified genetic algorithm, psychometrics analysis, and optimization formulation to achieve true and tangible energy savings for consumers.

Keywords: variable frequency drives, adjustable speed drives, ac drives, chiller energy system

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Authors: Mahima Shrivastava, Soumya Kar, B. Swetha Malika, Lalu Saheb, M. Muthu Kumar, P. V. Ponambala Moorthi

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Natural hazards and manmade destruction causes both economic and societal losses. Generalized pre-mitigation strategies introduced and adopted for prevention of disaster all over the world are capable of augmenting the resiliency and optimizing the life-cycle cost of facilities. In countries like India where varied topographical feature exists requires location specific mitigation measures and strategies to be followed for better enhancement by event-driven and code-driven approaches. Present state of vindication measures followed and adopted, lags dominance in accomplishing the required development. In addition, serious concern and debate over climate change plays a vital role in enhancing the need and requirement for the development of time bound adaptive mitigation measures. For the development of long-term sustainable policies incorporation of future climatic variation is inevitable. This will further assist in assessing the impact brought about by the climate change on life-cycle cost of facilities. This paper develops more definite region specific and time bound pre-mitigation measures, by reviewing the present state of mitigation measures in India and all over the world for improving life-cycle cost of facilities. For the development of region specific adoptive measures, Indian regions were divided based on multiple-calamity prone regions and geo-referencing tools were used to incorporate the effect of climate changes on life-cycle cost assessment. This study puts forward significant effort in establishing sustainable policies and helps decision makers in planning for pre-mitigation measures for different regions. It will further contribute towards evaluating the life cycle cost of facilities by adopting the developed measures.

Keywords: climate change, geo-referencing tools, life-cycle cost, multiple-calamity prone regions, pre-mitigation strategies, sustainable policies

Procedia PDF Downloads 372