Search results for: clinical interpretation

Authors: Maria Bonolo Mathevula

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Background: Children are important members of communities playing major role in the future of any given country (Pera, Fails, Gelsomini, &Garzotto, 2018). Visual Perceptual Skills (VPSs) in children are important health aspect of early childhood development through the Foundation Phases in school. Subsequently, children should undergo visual screening before commencement of schooling for early diagnosis ofVPSs anomalies because the primary role of VPSs is to capacitate children with academic performance in general. Aim : The aim of this study was to determine the anomalies of visual VPSs amongst school children in Foundation Phase. The study’s objectives were to determine the prevalence of VPSs anomalies amongst school children in Foundation Phase; Determine the relationship between children’s academic and VPSs anomalies; and to investigate the relationship between VPSs anomalies and refractive error. Methodology: This study was a mixed method whereby triangulated qualitative (interviews) and quantitative (questionnaire and clinical data) was used. This was, therefore, descriptive by nature. The study’s target population was school children in Foundation Phase. The study followed purposive sampling method. School children in Foundation Phase were purposively sampled to form part of this study provided their parents have given a signed the consent. Data was collected by the use of standardized interviews; questionnaire; clinical data card, and TVPS standard data card. Results: Although the study is still ongoing, the preliminary study outcome based on data collected from one of the Foundation Phases have suggested the following:While VPSs anomalies is not prevalent, it, however, have indirect relationship with children’s academic performance in Foundation phase; Notably, VPSs anomalies and refractive error are directly related since majority of children with refractive error, specifically compound hyperopic astigmatism, failed most subtests of TVPS standard tests. Conclusion: Based on the study’s preliminary findings, it was clear that optometrists still have a lot to do in as far as researching on VPSs is concerned. Furthermore, the researcher recommends that optometrist, as the primary healthcare professionals, should also conduct the school-readiness pre-assessment on children before commencement of their grades in Foundation phase.

Keywords: foundation phase, visual perceptual skills, school children, refractive error

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Authors: Farzad Khajavi

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Studies about the interaction between active pharmaceutical ingredients (API) and excipients are so important in the pre-formulation stage of development of all dosage forms. Analytical techniques such as differential scanning calorimetry (DSC), Thermal gravimetry (TG), and Furrier transform infrared spectroscopy (FTIR) are commonly used tools for investigating regarding compatibility and incompatibility of APIs with excipients. Sometimes the interpretation of data obtained from these techniques is difficult because of severe overlapping of API spectrum with excipients in their mixtures. Principal component analysis (PCA) as a powerful factor analytical method is used in these situations to resolve data matrices acquired from these analytical techniques. Binary mixtures of API and interested excipients are considered and produced. Peaks of FTIR, DSC, or TG of pure API and excipient and their mixtures at different mole ratios will construct the rows of the data matrix. By applying PCA on the data matrix, the number of principal components (PCs) is determined so that it contains the total variance of the data matrix. By plotting PCs or factors obtained from the score of the matrix in two-dimensional spaces if the pure API and its mixture with the excipient at the high amount of API and the 1:1mixture form a separate cluster and the other cluster comprise of the pure excipient and its blend with the API at the high amount of excipient. This confirms the existence of compatibility between API and the interested excipient. Otherwise, the incompatibility will overcome a mixture of API and excipient.

Keywords: API, compatibility, DSC, TG, interactions

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Authors: Jan Schwennen, Harlad Schmid, Juergen Fleischer

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Lightweight design plays an important role in the automotive industry. Especially the combination of metal and CFRP shows great potential for future vehicle concepts. This requires joining technologies that are cost-efficient and appropriate for the materials involved. Previous investigations show that integrating load introduction elements during CFRP part manufacturing offers great advantages in mechanical performance. However, it is not yet clear how to integrate the elements in an automated process without harming the fiber structure. In this paper, a test rig is build up to investigate the effect of different parameters during insert integration experimentally. After a short description of the experimental equipment, preliminary tests are performed to determine a set of important process parameters. Based on that, the planning of design of experiments is given. The interpretation and evaluation of the test results show that with a minimization of the insert diameter and the peak angle less harm on the fiber structure can be achieved. Furthermore, a maximization of the die diameter above the insert shows a positive effect on the fiber structure. At the end of this paper, a theoretical description of alternative peak shaping is given and then the results get validated on the basis of an industrial reference part.

Keywords: CFRP, fabrics, insert, load introduction element, integration

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Authors: Nikola Tomasevic, Marko Batic, Sanja Vranes

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Emerging Semantic Web technologies can be seen as the next step in evolution of the intelligent facility management systems. Particularly, this considers increased usage of open source and/or standardized concepts for data classification and semantic interpretation. To deliver such facility management systems, providing the comprehensive integration and interoperability platform in from of the facility data model is a prerequisite. In this paper, one of the possible modelling approaches to provide such integrative facility data model which was based on the ontology modelling concept was presented. Complete ontology development process, starting from the input data acquisition, ontology concepts definition and finally ontology concepts population, was described. At the beginning, the core facility ontology was developed representing the generic facility infrastructure comprised of the common facility concepts relevant from the facility management perspective. To develop the data model of a specific facility infrastructure, first extension and then population of the core facility ontology was performed. For the development of the full-blown facility data models, Malpensa and Fiumicino airports in Italy, two major European air-traffic hubs, were chosen as a test-bed platform. Furthermore, the way how these ontology models supported the integration and interoperability of the overall airport energy management system was analyzed as well.

Keywords: airport ontology, energy management, facility data model, ontology modeling

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Authors: Rafaella Nogaroli

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It is presented hypothetical cases in the context of AI algorithms to support clinical decisions, in order to discuss the importance of doctors to respect AI ethical principles. Regarding the principle of transparency and explanation, there is an impact on the new model of patient consent and on the understanding of qualified information. Besides, the human control of technology (AI as a tool) should guide the physician's activity; otherwise, he breaks the patient's legitimate expectation in a specific result, with the consequent transformation of the medical obligation nature.

Keywords: medical law, artificial intelligence, ethical principles, patient´s informed consent, medical obligations

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Authors: Mina Salamatmanesh, Elizabeth Fitzpatrick, Tim Ramsay, Josee Lagacé, Lindsey Sikora, JoAnne Whittingham

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Introduction: Hearing loss (HL) is one of the most common disorders that presents at birth and in early childhood. Universal newborn hearing screening (UNHS) has been adopted based on the assumption that with early identification of HL, children will have access to optimal amplification and intervention at younger ages, therefore, taking advantage of the brain’s maximal plasticity. One particular challenge for parents in the early years is achieving consistent hearing aid (HA) use which is critical to the child’s development and constitutes the first step in the rehabilitation process. This study examined the consistency of hearing aid use in young children based on data logging information documented during audiology sessions in the first three years after hearing aid fitting. Methodology: The first 100 children who were diagnosed with bilateral HL before 72 months of age since 2003 to 2015 in a pediatric audiology clinic and who had at least two hearing aid follow-up sessions with available data logging information were included in the study. Data from each audiology session (age of child at the session, average hours of use per day (for each ear) in the first three years after HA fitting) were collected. Clinical characteristics (degree of hearing loss, age of HA fitting) were also documented to further understanding of factors that impact HA use. Results: Preliminary analysis of the results of the first 20 children shows that all of them (100%) have at least one data logging session recorded in the clinical audiology system (Noah). Of the 20 children, 17(85%) have three data logging events recorded in the first three years after HA fitting. Based on the statistical analysis of the first 20 cases, the median hours of use in the first follow-up session after the hearing aid fitting in the right ear is 3.9 hours with an interquartile range (IQR) of 10.2h. For the left ear the median is 4.4 and the IQR is 9.7h. In the first session 47% of the children use their hearing aids ≤5 hours, 12% use them between 5 to 10 hours and 22% use them ≥10 hours a day. However, these children showed increased use by the third follow-up session with a median (IQR) of 9.1 hours for the right ear and 2.5, and of 8.2 hours for left ear (IQR) IQR is 5.6 By the third follow-up session, 14% of children used hearing aids ≤5 hours, while 38% of children used them ≥10 hours. Based on the primary results, factors like age and level of HL significantly impact the hours of use. Conclusion: The use of data logging information to assess the actual hours of HA provides an opportunity to examine the: a) challenges of families of young children with HAs, b) factors that impact use in very young children. Data logging when used collaboratively with parents, can be a powerful tool to identify problems and to encourage and assist families in maximizing their child’s hearing potential.

Keywords: hearing loss, hearing aid, data logging, hours of use

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Authors: Awatef Chniguir, Tarek Farah, Zouhair Ben Jemaa, Safya Belguith

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Optimal routing allows minimizing energy consumption in wireless sensor networks (WSN). Clustering has proven its effectiveness in organizing WSN by reducing channel contention and packet collision and enhancing network throughput under heavy load. Therefore, nowadays, with the emergence of the Internet of Things, heterogeneity is essential. Stable election protocol (SEP) that has increased the network stability period and lifetime is the first clustering protocol for heterogeneous WSN. SEP and its descendants, namely SEP, Threshold Sensitive SEP (TSEP), Enhanced TSEP (ETSSEP) and Current Energy Allotted TSEP (CEATSEP), were studied. These algorithms’ performance was evaluated based on different metrics, especially first node death (FND), to compare their stability. Simulations were conducted on the MATLAB tool considering two scenarios: The first one demonstrates the fraction variation of advanced nodes by setting the number of total nodes. The second considers the interpretation of the number of nodes while keeping the number of advanced nodes permanent. CEATSEP outperforms its antecedents by increasing stability and, at the same time, keeping a low throughput. It also operates very well in a large-scale network. Consequently, CEATSEP has a useful lifespan and energy efficiency compared to the other routing protocol for heterogeneous WSN.

Keywords: clustering, heterogeneous, stability, scalability, IoT, WSN

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Authors: Lindani Mbatha, Suvendi Rimer, Mpho Gololo

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Image segmentation is the process of dividing an image into several sections, such as the object's background and the foreground. It is a critical technique in both image-processing tasks and computer vision. Most of the image segmentation algorithms have been developed for gray-scale images and little research and algorithms have been developed for the color images. Most image segmentation algorithms or techniques vary based on the input data and the application. Nearly all of the techniques are not suitable for noisy environments. Most of the work that has been done uses the Markov Random Field (MRF), which involves the computations and is said to be robust to noise. In the past recent years' image segmentation has been brought to tackle problems such as easy processing of an image, interpretation of the contents of an image, and easy analysing of an image. This article reviews and summarizes some of the image segmentation techniques and algorithms that have been developed in the past years. The techniques include neural networks (CNN), edge-based techniques, region growing, clustering, and thresholding techniques and so on. The advantages and disadvantages of medical ultrasound image segmentation techniques are also discussed. The article also addresses the applications and potential future developments that can be done around image segmentation. This review article concludes with the fact that no technique is perfectly suitable for the segmentation of all different types of images, but the use of hybrid techniques yields more accurate and efficient results.

Keywords: clustering-based, convolution-network, edge-based, region-growing

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Authors: A. Bandyopadhyay

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Vedic philosophy is one of the oldest existing philosophies of the world. Started around 6500 BC, in Western Indian subcontinent, the Indus valley Civilizations developed a theology which, gradually developed into a well-established philosophy of beliefs, popularly known as ‘Hindu religion’. In Vedic theology, the abstract concept of God was formulated mostly by close observation of the dynamicity and the recurrence of natural and universal phenomena. Through the ages, the philosophy of this theology went through various discursions, debates, and questionings and the abstract concept of God was, in time, formalized into more representational forms by the means of various signs and symbols. Often, these symbols were used in more subtle ways in the construction of “sacred” sculptures and structures. Apparently, two different philosophies were developed from the Vedic philosophy and these two philosophies are mostly seen in the northern part and southern part of the Indian subcontinent. This paper tries to summarize the complex philosophical treaties of Hinduism of northern and southern India and seeks to understand the meanings of the various signs and symbolisms that were incorporated in the architecture of Hindu temples, including the names given to various parts of the temples. The Hindu temples are not only places of worship or ‘houses of Gods’ like the Greek and Roman temples but are also structures that symbolize the dynamicity and also spiritual upliftment of human beings.

Keywords: Hindu, philosophy, temple, Vedic

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Authors: Woldegerima G. Medhin, Tadele Araya

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Background: Rabies is acute viral encephalitis affecting mainly carnivores and insectivorous but can affect any mammal. Case fatality rate is 100% once clinical signs appear. Rabies has a worldwide distribution in continental regions of Asia and Africa. Globally, rabies is responsible for more than 61000 human deaths annually. An estimation of human mortality rabies in Asia and Africa annually exceed 35172 and 21476 respectively. Ethiopia approximately 2900 people were estimated to die of rabies annually, Tigary region approximately 98 people were estimated to die annually. The aim of this study is to analyze trends, describe, and evaluate the ten years rabies data in Tigray, Ethiopia. Methods: We conducted descriptive epidemiological study from 15-30 February, 2023 of rabies exposure and death in humans by reviewing the health management information system report from Tigray Regional Health Bureau and vaccination coverage of dog population from 2013 to 2022. We used case definition, suspected cases are those bitten by the dogs displaying clinical signs consistent with rabies and confirmed cases were deaths from rabies at time of the exposure. Results: A total 21031 dog bites and 375 deaths report of rabies and 18222 post exposure treatments for humans in Tigray region were used. A suspected rabies patients had shown an increasing trend from 2013 to 2015 and 2018 to 2019. Overall mortality rate was 19/1000 in Tigray. Majority of suspected patients (45%) were age <15 years old. An estimated by Agriculture Bureau of Tigray Region about 12000 owned and 2500 stray dogs are available in the region, but yearly dog vaccination remains low (50%). Conclusion: Rabies is a public health problem in Tigray region. It is highly recommended to vaccinate individually owned dogs and concerned sectors should eliminate stray dogs. Surveillance system should strengthen for estimating the real magnitude, launch preventive and control measures.

Keywords: rabies, Virus, transmision, prevalence

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Authors: Adama Sow, Abdoulaye Guiss´e, Oumar Niang

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To assist medical diagnosis, we propose a federation of several existing and open medical ontologies and terminologies. The goal is to merge the strengths of all these resources to provide clinicians the access to a variety of shared knowledges that can facilitate identification and association of human diseases and all of their available characteristic signs such as symptoms and clinical signs. This work results to an integration model loaded from target known ontologies of the bioportal platform such as DOID, MESH, and SNOMED for diseases selection, SYMP, and CSSO for all existing signs.

Keywords: medical decision, medical ontologies, ontologies integration, linked data, knowledge engineering, e-health system

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Authors: G.S. Patel

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In this research paper the discussion have been made on teachers work mental stress and coping strategies. Stress Measurement scale was developed for school teachers. All the scientific steps of test construction was followed. For this test construction, different factors like teachers workplace, teachers' residential area, teachers' family life, teachers' ability and skills, economic factors and other factors to construct teachers stress measurement scale. In this research tool, situational statements have been made and teachers have to give a response in each statement on five-point rating scale what they experienced in their daily life. Special features of the test also established like validity and reliability of this test and also computed norms for its interpretation. A sample of 320 teachers of school teachers of Gujarat state was selected by Cluster sampling technique. t-test was computed for testing null hypothesis. The main findings of the present study are Urban area teachers feel more stressful situation compare to rural area teachers. Those teachers who live in the joint family feel less stress compare to teachers who live in a nuclear family. This research work is very useful to prepare list of activities to reduce teachers mental stress.

Keywords: stress measurement scale, level of stress, validity, reliability, norms

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Authors: Ezeoke Callistus Obiora, Ezeoke Nneka Angela

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The study investigated the effect of deficit financing on macroeconomic variables in Nigeria. The specific objectives included to find out the relationship between deficit financing and GDP, interest rate, inflation rate, money supply, exchange rate and private investment respectively on a time series covering a period of 44 years (1970 – 2013). The Ordinary Least Square multiple regression produced statistics for the coefficient of determination (R2), F-test, t-test used for the interpretation of the study. The findings revealed that Deficit financing has significant positive effect on GDP and exchange rate. Again, deficit financing has a positive and insignificant relationship inflation, money supply and investment. Only interest rate recorded negative yet insignificant relationship with deficit financing. The implications of the findings are that deficit financing can be a veritable tool for boosting economic development in Nigeria, but the influential positively rising exchange rate implies that deficit financing devalues the Naira exchange rate to other currencies indicating that deficit financing can affect Nigerians competitive advantage at the world market. Thus, the study concludes that deficit financing has not encouraged economic growth in Nigeria.

Keywords: deficit financing, money supply, exchange rate, inflation, GDP, investment, Nigeria

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Authors: Mahla Azimi

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Introduction: Post-bladder catheter infection is a common and significant healthcare-associated infection that affects individuals with indwelling urinary catheters. These infections can lead to various complications, including urinary tract infections (UTIs), bacteremia, sepsis, and increased morbidity and mortality rates. This article aims to provide a comprehensive review of post-bladder catheter infections, including their causes, risk factors, clinical presentation, diagnosis, treatment options, and preventive measures. Causes and Risk Factors: Post-bladder catheter infections primarily occur due to the colonization of microorganisms on the surface of the urinary catheter. The most common pathogens involved are Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus species. Several risk factors contribute to the development of these infections, such as prolonged catheterization duration, improper insertion technique, poor hygiene practices during catheter care, compromised immune system function in patients with underlying conditions or immunosuppressive therapy. Clinical Presentation: Patients with post-bladder catheter infections may present with symptoms such as fever, chills, malaise, suprapubic pain or tenderness, and cloudy or foul-smelling urine. In severe cases or when left untreated for an extended period of time, patients may develop more severe symptoms like hematuria or signs of systemic infection. Diagnosis: The diagnosis of post-bladder catheter infection involves a combination of clinical evaluation and laboratory investigations. Urinalysis is crucial in identifying pyuria (presence of white blood cells) and bacteriuria (presence of bacteria). A urine culture is performed to identify the causative organism(s) and determine its antibiotic susceptibility profile. Treatment Options: Prompt initiation of appropriate antibiotic therapy is essential in managing post-bladder catheter infections. Empirical treatment should cover common pathogens until culture results are available. The choice of antibiotics should be guided by local antibiogram data to ensure optimal therapy. In some cases, catheter removal may be necessary, especially if the infection is recurrent or associated with severe complications. Preventive Measures: Prevention plays a vital role in reducing the incidence of post-bladder catheter infections. Strategies include proper hand hygiene, aseptic technique during catheter insertion and care, regular catheter maintenance, and timely removal of unnecessary catheters. Healthcare professionals should also promote patient education regarding self-care practices and signs of infection. Conclusion: Post-bladder catheter infections are a significant healthcare concern that can lead to severe complications and increased healthcare costs. Early recognition, appropriate diagnosis, and prompt treatment are crucial in managing these infections effectively. Implementing preventive measures can significantly reduce the incidence of post-bladder catheter infections and improve patient outcomes. Further research is needed to explore novel strategies for prevention and management in this field.

Keywords: post-bladder catheter infection, urinary tract infection, bacteriuria, indwelling urinary catheters, prevention

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Authors: Branka Milicic Stanic, Romana Mijovic

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In primary hyperparathyroidism, an increased risk of developing cardiovascular disease may exist due to increased activity of the renin-angiotensin-aldosterone system (RAAS). In adenomatous altered tissue of parathyroid gland, compared to normal tissue, there are two to fourfold increase in the expression of type 1 angiotensin II receptors. As there is a clear evidence of the independent role of aldosterone on the cardiovascular system, the aim of this study was to evaluate the existence of an association between aldosterone secretion and parathyroid hormone in patients with primary hyperparathyroidism. This study included 48 patients with elevated parathyroid hormone who had come to the Departement of Nuclear Medicine, Clinical Center of Vojvodina, for Parathyroid Scintigraphy. The control group consisted of 30 healthy subjects who matched age and gender to the study group. All the results were statistically processed by statistical package STATISTICA 14 (Statsoft Inc,Tulsa, OK, USA). The survey was conducted between February 2017 and April 2018 at the Departement of Nuclear Medicine and at the Departement for Endocinology Diagnoistics, in Clinical Center of Vojvodina, Novi Sad. Compared to the control group, the study group had statistically significantly higher values of aldosterone (p=0.028), total calcium (p=0.01), ionized calcium (p=0.003) and parathyroid hormone (N-TACT PTH) (p=0.00), while statistically a significant lower levels in the study group were for phosphorus (p=0.003) and vitamin D (p=0.04). A linear correlation analysis in the study group revealed a statistically significant degree of positive correlation between renin and N-TACT PTH (r=0.688, p<0.05); renin and calcium (r=0.673, p<0.05) and renin and ionized calcium (r=0.641, p<0.05). Serum aldosterone and parathyroid hormone levels (N-TACT) were correlated positively in patients with primary hyperparathyroidism (r=0.509, p<0.05). According to the linear correlation analysis in the control group, aldosterone showed no positive correlation with N-TACT PTH (r=-0.285, p>0.05), as well as total and ionized calcium (r=-0.200, p>0.05; r=-0.313, p>0.05). In multivariate regression analysis of the study group, the strongest predictive variable of aldosterone secretion was N-TACT PTH (p=0.011). Aldosterone correlated positively to PTH levels in patients with primary hyperparathyroidism, and the fact is that in these patients aldosterone might be a key mediator of cardiovascular symptoms. All this knowledge should help to find new treatments to prevent cardiovascular disease.

Keywords: aldosterone, hyperparathyroidism, parathyroid hormone, parathyroid gland

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Authors: Taner Ersoz, Filiz Ersoz

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This study was designed enable application of multivariate technique in the interpretation of categorical data for measuring health care services satisfaction in Turkey. The data was collected from a total of 17726 respondents. The establishment of the sample group and collection of the data were carried out by a joint team from The Ministry of Health and Turkish Statistical Institute (Turk Stat) of Turkey. The multiple correspondence analysis (MCA) was used on the data of 2882 respondents who answered the questionnaire in full. The multiple correspondence analysis indicated that, in the evaluation of health services females, public employees, younger and more highly educated individuals were more concerned and complainant than males, private sector employees, older and less educated individuals. Overall 53 % of the respondents were pleased with the improvements in health care services in the past three years. This study demonstrates the public consciousness in health services and health care satisfaction in Turkey. It was found that most the respondents were pleased with the improvements in health care services over the past three years. Awareness of health service quality increases with education levels. Older individuals and males would appear to have lower expectancies in health services.

Keywords: multiple correspondence analysis, multivariate categorical data, health care services, health satisfaction survey

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Authors: S. Ibrahim, D. Salilew-Wondim, M. Hoelker, C. Looft, E. Tholen, C. Grosse-Brinkhaus, K. Schellander, C. Neuhoff, D. Tesfaye

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Bovine endometrial cells appear to have a key role in innate immune defense of the female genital tract. A better understanding of molecular changes in microRNAs (miRNAs) and their target genes expression may identify reliable prognostic indicators for cows that will resolve inflammation and resume cyclicity. In the current study, we hypothesized that let-7 miRNAs family has a primary role in the innate immune defence of the endometrium tissue against bacterial infection, which is partly achieved via regulating mRNA stability of pro-inflammatory cytokines at the post-transcriptional level. Therefore, we conducted two experiments. In the first experiment, primary bovine endometrial cells were challenged with clinical (3.0 μg/ml) and sub-clinical (0.5 μg/ml) doses of lipopolysaccharide (LPS) for 24h. In the 2nd experiment, we have investigated the potential role of let-7 miRNAs (let-7a and let-7f) using gain and loss of function approaches. Additionally, tumor necrosis factor alpha (TNFα), transforming growth factor beta 1 induced transcript 1 (TGFB1I1) and serum deprivation response (SDPR) genes were validated using reporter assay. Here we addressed for the first time that let-7 miRNAs have a precise role in bovine endometrium, where LPS dysregulated let-7 miRNAs family expression was associated with an increased pro-inflammatory cytokine level by directly/indirectly targeting the TNFα, interleukin 6 (IL6), nuclear factor kappa-light-chain enhancer of activated B cells (NFκB), TGFβ1I1 and SDPR genes. To our knowledge, this is the first study showing that TNFα, TGFβ1I1 and SDPR were identified and validated as novel let-7 miRNAs targets and could have a distinct role in inflammatory immune response of LPS challenged bovine endometrial cells. Our data represent a new finding by which uterine homeostasis is maintained through functional regulation of let-7a by down-regulation of pro-inflammatory cytokines expression (TNFα and IL6) at the mRNA and protein levels. These findings suggest that LPS serves as a negative regulator of let-7 miRNAs expression and provides a mechanism for the persistent pro-inflammatory phenotype, which is a hallmark of bovine subclinical endometritis.

Keywords: bovine endometrial cells, let-7, lipopolysaccharide, pro-inflammatory cytokines

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Authors: Meenal Badki

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We address the issue of active feature determination, where the objective is to determine the set of examples on which additional data (such as lab tests) needs to be gathered, given a large number of examples with some features (such as demographics) and some examples with all the features (such as the complete Electronic Health Record). We note that certain features may be more costly, unique, or laborious to gather. Our proposal is a general active learning approach that is independent of classifiers and similarity metrics. It allows us to identify examples that differ from the full data set and obtain all the features for the examples that match. Our comprehensive evaluation shows the efficacy of this approach, which is driven by four authentic clinical tasks.

Keywords: feature determination, classification, active learning, sample-efficiency

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Authors: Keping Zuo, Foad Kabinejadian, Gideon Praveen Kumar Vijayakumar, Fangsen Cui, Pei Ho, Hwa Liang Leo

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Carotid artery stenting (CAS) is the standard procedure for patients with severe carotid stenosis at high risk for carotid endarterectomy (CAE). A major drawback of CAS is the higher incidence of procedure-related stroke compared with traditional open surgical treatment for carotid stenosis - CEA, even with the use of the embolic protection devices (EPD). As the currently available bare metal stents cannot address this problem, our research group developed a novel preferential covered-stent for carotid artery aims to prevent friable fragments of atherosclerotic plaques from flowing into the cerebral circulation, and yet maintaining the flow of the external carotid artery. The preliminary animal studies have demonstrated the potential of this novel covered-stent design for the treatment of carotid atherosclerotic stenosis. The purpose of this study is to evaluate the effect of membrane coating on the stent flexibility in order to improve the clinical performance of our novel covered stents. A total of 21 stents were evaluated in this study: 15 self expanding bare nitinol stents and 6 PTFE-covered stents. 10 of the bare stents were coated with 11%, 16% and 22% Polyurethane(PU), 4%, 6.25% and 11% EE, as well as 22% PU plus 5 μm Parylene. Different laser cutting designs were performed on 4 of the PTFE covert stents. All the stents, with or without the covered membrane, were subjected to a three-point flexural test. The stents were placed on two supports that are 30 mm apart, and the actuator is applying a force in the exact middle of the two supports with a loading pin with radius 2.5 mm. The loading pin displacement change, the force and the variation in stent shape were recorded for analysis. The flexibility of the stents was evaluated by the lumen area preservation at three displacement bending levels: 5mm, 7mm, and 10mm. All the lumen areas in all stents decreased with the increase of the displacement from 0 to 10 mm. The bare stents were able to maintain 0.864 ± 0.015, 0.740 ± 0.025 and 0.597 ± 0.031of original lumen area at 5 mm, 7 mm and 10mm displacement respectively. For covered stents, the stents with EE coating membrane showed the best lumen area preservation (0.839 ± 0.005, 0.7334 ± 0.043 and 0.559 ± 0.014), whereas, the stents with PU and Parylene coating were only 0.662, 0.439 and 0.305. Bending stiffness was also calculated and compared. These results provided optimal material information and it was crucial for enhancing clinical performance of our novel covered stents.

Keywords: carotid artery, covered stent, nonlinear, hyperelastic, stress, strain

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Authors: Mekroud Amel

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Emergency departments are known for the workload, the variety of pathologies and the difficulties in their management with the continuous influx of patients The role of our service in the management of patients with two or three mild to moderate organ failures, involving several disciplines at the same time, as well as the effect of this management on the skills and efficiency of our team has been demonstrated Borderline cases between two or three or even more disciplines, with instability of a vital function, which have been successfully managed in the emergency room, the therapeutic procedures adopted, the consequences on the quality and level of care delivered by our team, as well as that the logistical consequences, and the pedagogical consequences are demonstrated. The consequences found are Positive on the emergency teams, in rare situations are negative Regarding clinical situations, it is the entanglement of hemodynamic distress with right, left or global participation, tamponade, low flow with acute pulmonary edema, and/or state of shock With respiratory distress with more or less profound hypoxemia, with haematosis disorder related to a bacterial or viral lung infection, pleurisy, pneumothorax, bronchoconstrictive crisis. With neurological disorders such as recent stroke, comatose state, or others With metabolic disorders such as hyperkalaemia renal insufficiency severe ionic disorders with accidents with anti vitamin K With or without septate effusion of one or more serous membranes with or without tamponade It’s a Retrospective, monocentric, descriptive study Period 05.01.2022 to 10.31.2022 the purpose of our work: Search for a statistically significant link between the type of moderate to severe pathology managed in the emergency room whose problems are multivisceral on the efficiency of the healthcare team and its level of care and optional care offered for patients Statistical Test used: Chi2 test to prove the significant link between the resolution of serious multidisciplinary cases in the emergency room and the effectiveness of the team in the management of complicated cases Search for a statistically significant link : The management of the most difficult clinical cases for organ specialties has given general practitioner emergency teams a great perspective and has been able to improve their efficiency in the face of emergencies received

Keywords: emergency care teams, management of patients with dysfunction of more than one organ, learning curve, quality of care

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Authors: Moshe Mello, Hilary Rutto, Tumisang Seodigeng

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The accelerating requirement to reach 0% sulfur content in liquid fuels demands researchers to seek efficient alternative technologies to challenge the predicament. In this current study, the adsorption capabilities of modified Cu(I)-Y zeolite were tested for removal of organosulfur compounds (OSC) present in TPO. The π-complexation-based adsorbent was obtained by ion exchanging Y-zeolite with Cu+ cation using liquid phase ion exchange (LPIE). Preparation of the adsorbent involved firstly ion-exchange between Na-Y zeolite with a Cu(NO3)2 aqueous solution of 0.5M for 48 hours followed by reduction of Cu2+ to Cu+. Batch studies for TPO in comparison with model diesel comprising of sulfur compounds such as thiophene (TH), benzothiophene (BTH), dibenzothiophene (DBT) and 4,6-dimethyldibenzothiophe (4,6-DMDBT) showed that modified Cu(I)-Y zeolite is an effective adsorbent for removal of OSC in liquid fuels. The effect of multiple operating conditions such as adsorbent dosage, reaction time and temperature were studied to optimize the process. For model diesel fuel, the selectivity for adsorption of sulfur compounds followed the order 4,6-DMDBT> DBT> BTH> TH. Interpretation of the results was justified using the molecular orbital theory and calculations. Langmuir and Freundlich isotherms were used to predict adsorption of the reaction mixture. The Cu(I)-Y zeolite is fully regeneratable and this is achieved by a simple procedure of blowing the adsorbent with air at 350 °C, followed by reactivation at 450 °C in a rich helium surrounding.

Keywords: adsorption, desulfurization, TPO, zeolite

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Authors: Aleksandra Bylinska, Samantha Slight-Webb, Kevin Thomas, Miles Smith, Susan Macwana, Nicolas Dominguez, Eliza Chakravarty, Joan T. Merrill, Judith A. James, Joel M. Guthridge

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Background: Systemic Lupus Erythematosus (SLE) is an interferon-related autoimmune disease characterized by B cell dysfunction. One of the main hallmarks is a loss of tolerance to self-antigens leading to increased levels of autoantibodies against nuclear components (ANAs). However, up to 20% of healthy ANA+ individuals will not develop clinical illness. SLE is more prevalent among women and minority populations (African, Asian American and Hispanics). Moreover, African Americans have a stronger interferon (IFN) signature and develop more severe symptoms. The exact mechanisms involved in ethnicity-dependent B cell dysregulation and the progression of autoimmune disease from ANA+ healthy individuals to clinical disease remains unclear. Methods: Peripheral blood mononuclear cells (PBMCs) from African (AA) and European American (EA) ANA- (n=12), ANA+ (n=12) and SLE (n=12) individuals were assessed by multimodal scRNA-Seq/CITE-Seq methods to examine differential gene signatures in specific B cell subsets. Library preparation was done with a 10X Genomics Chromium according to established protocols and sequenced on Illumina NextSeq. The data were further analyzed for distinct cluster identification and differential gene signatures in the Seurat package in R and pathways analysis was performed using Ingenuity Pathways Analysis (IPA). Results: Comparing all subjects, 14 distinct B cell clusters were identified using a community detection algorithm and visualized with Uniform Manifold Approximation Projection (UMAP). The proportion of each of those clusters varied by disease status and ethnicity. Transitional B cells trended higher in ANA+ healthy individuals, especially in AA. Ribonucleoprotein high population (HNRNPH1 elevated, heterogeneous nuclear ribonucleoprotein, RNP-Hi) of proliferating Naïve B cells were more prevalent in SLE patients, specifically in EA. Interferon-induced protein high population (IFIT-Hi) of Naive B cells are increased in EA ANA- individuals. The proportion of memory B cells and plasma cells clusters tend to be expanded in SLE patients. As anticipated, we observed a higher signature of cytokine-related pathways, especially interferon, in SLE individuals. Pathway analysis among AA individuals revealed an NRF2-mediated Oxidative Stress response signature in the transitional B cell cluster, not seen in EA individuals. TNFR1/2 and Sirtuin Signaling pathway genes were higher in AA IFIT-Hi Naive B cells, whereas they were not detected in EA individuals. Interferon signaling was observed in B cells in both ethnicities. Oxidative phosphorylation was found in age-related B cells (ABCs) for both ethnicities, whereas Death Receptor Signaling was found only in EA patients in these cells. Interferon-related transcription factors were elevated in ABCs and IFIT-Hi Naive B cells in SLE subjects of both ethnicities. Conclusions: ANA+ healthy individuals have altered gene expression pathways in B cells that might drive apoptosis and subsequent clinical autoimmune pathogenesis. Increases in certain regulatory pathways may delay progression to SLE. Further, AA individuals have more elevated activation pathways that may make them more susceptible to SLE.

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Authors: Thirumila Muthukamaru

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The objective of a Health Risk Assessment (HRA) is to achieve a quality evaluation of risk assessments in a timely manner where adequate controls can be in place to protect workers health, especially during turnarounds where the exposure to health hazards is expected to rise during the performance of the many activities that take place, exposing workers to health risk. HRA development requires a competent team comprising experienced subject matter experts in the field, such as Industrial hygienists, Occupational Health Doctors, Turnaround Coordinators, Operation / Maintenance personnel, etc. The conventional way of conducting HRA is not only tedious and time-consuming but also less appreciated when it is not interpreted correctly, which may contribute to inadequate operationalization of it. Simplification can be the essence of timely intervention in managing health risks. This paper is intended as a sharing of the approach taken to simplify the methodology of developing the HRA report and operationalizing it. The approach includes developing a Generic HRA for turnaround activities to be used as a reference document and the empowerment of identified personnel through upskilling sessions to take up the role of facilitating HRA sessions. This empowerment is one of the key approaches towards the successful translation of the HRA into specific turnaround Job Hazard Analysis (JHA) that embed it in the Permit to Work (PTW) process. The approach used here increases awareness and compliance on HRA for turnaround activities through better interpretation and operationalization of the HRA report, adding value to the risk assessment for turnaround activities.

Keywords: industrial hygiene, health risk assessment, HRA, risk assessment

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Authors: Mezidi Amar

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In this research work, crack propagation at the interface of a composite beam is considered. The behavior of composite beams (CB) depends upon a law based on relationship between tangential or normal efforts with inelastic propagation. Throughout this study, composite beams are classified like composite beams with partial connection or sandwich beams of three layers. These structural systems are controlled by the same nature of differential equations regarding their behavior in the plane, as well as out-of-plane. Multi-layer elements with partial connection are typically met in the field of timber construction where the elements are assembled by joining. The formalism of the behavior in the plane and out-of-plane of these composite beams is obtained and their results concerning the engineering aspect or simple of interpretation are proposed for the case of composite beams made up of rectangular section and simply supported section. An apparent analytical peculiarity or paradox in the bending behavior of elastic–composite beams with interlayer slip, sandwich beam or other similar problems subjected to boundary moments exists. For a fully composite beam subjected to end moments, the partial composite model will render a non-vanishing uniform value for the normal force in the individual subelement. Obtained results are similar to those for the case of vibrations in the plane as well for the composite beams as for the sandwich beams where eigen-frequencies increase with related rigidity.

Keywords: composite beam, behaviour, interface, deflection, propagation

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Authors: Osa D Egonwa

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In the 21^st century, the disciplinary boundaries of past centuries that we often create through mainstream art historical classification, techniques and sources may have been eroded by visual culture, which seems to provide a more inclusive umbrella for the new ways artists go about the creative process and its resultant commodities. Over the past four decades, artists in Africa have resorted to new materials, techniques and themes which have affected our ways of research on these artists and their art. Frontline artists such as El Anatsui, Yinka Shonibare, Erasmus Onyishi are demonstrating that any material is just suitable for artistic expression. Most of times, these materials come with their own techniques/effects and visual syntax: a combination of materials compounds techniques, formal aesthetic indexes, halo effects, and iconography. This tends to challenge the categories and we lean on to view, think and talk about them. This renders our main stream art historical research methods inadequate, thus suggesting new discursive concepts, terms and theories. This paper proposed the Africanist eclectic methods derived from the dual framework of Masquerade Theory and What Comes Behind Six is More Than Seven. This paper shares thoughts/research on art historical methods, terminological re-alignments on classification/source data, presentational format and interpretation arising from the emergent trends in our subject. The outcome provides useful tools to mediate new thoughts and experiences in recent African art and visual culture.

Keywords: art historical methods, classifications, concepts, re-alignment

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Authors: Sweta Pandey, Samridhi Dhyani, Susmita Chaudhuri

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Klebsiella pneumoniae causes a wide range of infections, including urinary tract infections, sepsis, bacteremia, pneumonia, and liver abscesses. The emergence of multi-drug resistance in this bacterium led to a major setback for clinical management. WHO also endorsed a need for finding alternative therapy to antibiotics for the treatment of these infections. Development of vaccines and passive antibody therapy has been proven as a potent alternative to antibiotics in the case of MDR, XDR, and PDR Klebsiella infections. Siderophore receptors have been demonstrated to be overexpressed for the internalization of iron siderophore complexes during infections in most Gram-negative bacteria. For the present study, immune response to siderophore receptors to establish this protein as a potential immunogen for the development of therapeutic leads was explored. Clinical strains of Klebsiella pneumoniae were grown in iron-deficient conditions, and the iron-regulated outer membrane proteins were extracted and characterized through mass spectrometry for specific identification. The gene for identified protein was cloned in pET- 28a vector and expressed in E. coli. The native protein and the recombinant protein were isolated and purified and used as antigens for the generation of immune response in BALB/c mice. The native protein of Klebsiella pneumoniae grown in iron-deficient conditions was identified as FepA (Ferrienterobactin receptor) and other siderophore receptors. This 80 kDa protein generated an immune response in BALB/c mice. The antiserum from mice after subsequent booster doses was collected and showed binding with FepA protein in western blot and phagocytic uptake of the K. pneumoniae in the presence antiserum from immunized mice also observed from the animal studies after bacterial challenge post immunisation in mice have shown bacterial clearance. The antiserum from mice showed binding and clearance of the Klebsiella pneumoniae bacteria in vitro and in vivo. These antigens used for generating an active immune response in mice can further be used for therapeutic monoclonal antibody development against Klebsiella pneumoniae infections.

Keywords: antiserum, FepA, Klebsiella pneumoniae, multi drug resistance, siderophore receptor

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Authors: Rahah Hasan, Faridah Sahari

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This paper describes the development of modern art in Borneo, particularly in Sarawak, Sabah, and Brunei, after the Second World War until the 1970s. This was the period when the British Colonial government dictated the education system, which consequentially inculcated visual art through art and craft subjects imposed on all vernacular schools in Borneo. British influence within the state governance, social, and education system designed with Western ideology created not only a westernized society and mindset but at the same time generated artistic opportunities for emerging local painters to be involved in the initiation of Modern Art in Borneo. Through the historical method and analysis of primary and secondary data, it was obvious that the existence of colonial government departments and institutions such as museums and teaching colleges, and other social organizations in Borneo at that time contributed significantly to the artistic movement. The similar structure and motivation of development in other areas of Borneo confirmed that artistic affirmation of modern art advanced homogenously. Their understanding of easel painting as well as a unique interpretation of culture once distanced from traditional art, resulting in a new visual image that transcended their ethnicity and identity through new mediums and tools. These meticulous interventions modestly visualized in each painting, as discussed in this paper, hopefully, will give a deeper understanding and appreciation of the history of modern art in Borneo.

Keywords: art history, Borneo art, fine art, modern art

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Authors: Joyce K. Anastasi, Bernadette Capili

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Community Engagement Strategies to Assist with the Development of an RCT Among People Living with HIV Our research team focuses on developing and testing protocols to manage chronic symptoms. For many years, our team designed and implemented symptom management studies for people living with HIV (PLWH). We identify symptoms that are not curative and are not adequately controlled by conventional therapies. As an exemplar, we describe how we successfully engaged PLWH in developing and refining our research feasibility protocol for distal sensory peripheral neuropathy (DSP) associated with HIV. With input from PLWH with DSP, our research received National Institutes of Health (NIH) research funding support. Significance: DSP is one of the most common neurologic complications in HIV. It is estimated that DSP affects 21% to 50% of PLWH. The pathogenesis of DSP in HIV is complex and unclear. Proposed mechanisms include cytokine dysregulation, viral protein-produced neurotoxicity, and mitochondrial dysfunction associated with antiretroviral medications. There are no FDA-approved treatments for DSP in HIV. Purpose: Aims: 1) to explore the impact of DSP on the lives of PLWH, 2) to identify patients’ perspectives on successful treatments for DSP, 3) to identify interventions considered feasible and sensitive to the needs of PLWH with DSP, and 4) to obtain participant input for protocol/study design. Description of Process: We conducted a needs assessment with PLWH with DSP. From our needs assessment, we learned from the patients’ perspective detailed descriptions of their symptoms; physical functioning with DSP; self-care remedies tried, and desired interventions. We also asked about protocol scheduling, instrument clarity, study compensation, study-related burdens, and willingness to participate in a randomized controlled trial (RCT) with a placebo and a waitlist group. Implications: We incorporated many of the suggestions learned from the need assessment. We developed and completed a feasibility study that provided us with invaluable information that informed subsequent NIH-funded studies. In addition to our extensive clinical and research experience working with PLWH, learning from the patient perspective helped in developing our protocol and promoting a successful plan for recruitment and retention of study participants.

Keywords: clinical trial development, peripheral neuropathy, traditional medicine, HIV, AIDS

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Authors: Mohammad Arshad Ikram

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We report three cases of challenging fractures in children treated by intramedullary fixation using the Metaizeau method and achieved anatomical reduction with excellent clinical results. Jean-Paul Metaizeau described the centromedullary fixation for the radial neck in 1980 using K-wires Radial neck fractures are uncommon in children. Treatment of severely displaced fractures is always challenging. Closed reduction techniques are more popular as compared to open reduction due to the low risk of complications. Metaizeau technique of closed reduction with centromedullary pinning is a commonly preferred method of treatment. We present two cases with a severely displaced radial neck fracture, treated by this method and achieved sound union; anatomical position of the radial head and full function were observed two months after surgery. Proximal humerus fractures are another uncommon injury in children accounting for less than 5% of all pediatric fractures. Most of these injuries occur through the growth plate because of its relative weakness. Salter-Harris type I is commonly seen in the younger age group, whereas type II & III occurs in older children and adolescents. In contrast to adults, traumatic glenohumeral dislocation is an infrequently observed condition among children. A combination of proximal humerus fracture and glenohumeral dislocation is extremely rare and occurs in less than 2% of the pediatric population. The management of this injury is always challenging. Treatment ranged from closed reduction with and without internal fixation and open reduction with internal fixation. The children who had closed reduction with centromedullary fixation by the Metaizeau method showed excellent results with the return of full movements at the shoulder in a short time without any complication. We present the case of a child with anterior dislocation of the shoulder associated with a complete displaced proximal humerus metaphyseal fracture. The fracture was managed by closed reduction and then fixation by two centromedullary K-wires using the Metaizeau method, achieving the anatomical reduction of the fracture and dislocation. This method of treatment enables us to achieve excellent radiological and clinical results in a short time.

Keywords: glenohumeral, Metaizeau method, pediatric fractures, radial neck

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Authors: Cleiton Pons Ferreira, Diana Francisca Adamatti

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Advancements in computers technology have allowed to obtain information for research in biology and neuroscience. In order to transform the data from these surveys, networks have long been used to represent important biological processes, changing the use of this tools from purely illustrative and didactic to more analytic, even including interaction analysis and hypothesis formulation. Many studies have involved this application, but not directly for interpretation of data obtained from brain functions, asking for new perspectives of development in neuroinformatics using existent models of tools already disseminated by the bioinformatics. This study includes an analysis of neurological data through electroencephalogram (EEG) signals, using the Cytoscape, an open source software tool for visualizing complex networks in biological databases. The data were obtained from a comparative case study developed in a research from the University of Rio Grande (FURG), using the EEG signals from a Brain Computer Interface (BCI) with 32 eletrodes prepared in the brain of a blind and a sighted individuals during the execution of an activity that stimulated the spatial ability. This study intends to present results that lead to better ways for use and adapt techniques that support the data treatment of brain signals for elevate the understanding and learning in neuroscience.

Keywords: neuroinformatics, bioinformatics, network tools, brain mapping

Procedia PDF Downloads 159