Search results for: clinical/non-clinical sample
7706 The Level of Stress and Coping Stress Strategies of Young People with Profound Hearing Impairment
Authors: Anna Czyż
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This article is focused on the issues of stress and coping with the stress of young people with profound hearing loss. Perceptional disorders, especially visual or hearing defects, are the reason of homeostasis dysfunction. Biopsychological development can become poor. A substitute reality is formed as a result of compensatory activities of other senses. The hearing disorder itself is a stress-inducing factor, affecting the quality of human functioning. In addition, the limitations of perceptual capabilities in the context of the functioning environment can contribute to increasing the amount of stressors, as well as the specific sensitivity to the stressors, and the use of specific strategies to overcome the difficulties. The appropriate study was conducted on a sample of 92 students, aged 16 -19 years old, 43 females, 49 males. For diagnostic purposes, the standardized psychological' research tools were used. The level of the stress and the strategies of coping with the stress were evaluated. The results of the research indicate that level of the stress is indifferent. The most frequently chosen strategies for coping with the stress in the sample are concentrated on 1) acceptation, 2) 'doing something different', 3) searching of emotional supporting, 4) searching of instrumental supporting, and the factors (grouped items) of coping with the stress are concentrated on 1) searching of support, 2) acceptance. The relationships in both male and female research groups were specified. Also the relationships between the highlighted variables were determined.Keywords: cooping stress, deaf, hearing impairment, quality of life, stress, stress
Procedia PDF Downloads 2667705 Enhancing Skills of Mothers of Asthmatic Children in Techniques of Drug Administration
Authors: Erna Judith Roach, Nalini Bhaskaranand
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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.Keywords: childhood asthma, drug administration, mothers of children, inhaler
Procedia PDF Downloads 4237704 Awareness among Medical Students and Faculty about Integration of Artifical Intelligence Literacy in Medical Curriculum
Authors: Fatima Faraz
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BACKGROUND: While Artificial intelligence (AI) provides new opportunities across a wide variety of industries, healthcare is no exception. AI can lead to advancements in how the healthcare system functions and improves the quality of patient care. Developing countries like Pakistan are lagging in the implementation of AI-based solutions in healthcare. This demands increased knowledge and AI literacy among health care professionals. OBJECTIVES: To assess the level of awareness among medical students and faculty about AI in preparation for teaching AI basics and data science applications in clinical practice in an integrated medical curriculum. METHODS: An online 15-question semi-structured questionnaire, previously tested and validated, was delivered among participants through convenience sampling. The questionnaire composed of 3 parts: participant’s background knowledge, AI awareness, and attitudes toward AI applications in medicine. RESULTS: A total of 182 students and 39 faculty members from Rawalpindi Medical University, Pakistan, participated in the study. Only 26% of students and 46.2% of faculty members responded that they were aware of AI topics in clinical medicine. The major source of AI knowledge was social media (35.7%) for students and professional talks and colleagues (43.6%) for faculty members. 23.5% of participants answered that they personally had a basic understanding of AI. Students and faculty (60.1%) were interested in AI in patient care and teaching domain. These findings parallel similar published AI survey results. CONCLUSION: This survey concludes interest among students and faculty in AI developments and technology applications in healthcare. Further studies are required in order to correctly fit AI in the integrated modular curriculum of medical education.Keywords: medical education, data science, artificial intelligence, curriculum
Procedia PDF Downloads 1017703 A Development of Online Lessons to Strengthen the Learning Process of Master's Degree Students Majoring in Curriculum and Instruction at Suan Sunandha Rajabhat University
Authors: Chaiwat Waree
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The purposes of the research were to develop online lessons to strengthen the learning process of Master's degree students majoring in Curriculum and Instruction at Suan Sunandha Rajabhat University; to achieve the efficiency criteria of 80/80; and to study the satisfaction of students who use online lessons to strengthen the learning process of Master’s degree students majoring in Curriculum and Instruction at Suan Sunandha Rajabhat University. The sample consisted of 40 University students studying in semester 1, academic year 2012. The sample was determined by Purposive Sampling. Selected students were from the class which the researcher was the homeroom tutor. The tutor was responsible for the teaching of learning process. Tools used in the study were online lessons, 60-point performance test, and evaluation test of satisfaction of students on online lessons. Data analysis yielded the following results; 83.66/88.29 efficiency of online lessons measured against the criteria; the comparison of performance before and after taking online lessons using t-test yielded 29.67. The statistical significance was at 0.05; the average satisfaction level of forty students on online lessons was 4.46 with standard deviation of 0.68.Keywords: online, lessons, curriculum, instruction
Procedia PDF Downloads 2247702 Effect of Sodium Aluminate on Compressive Strength of Geopolymer at Elevated Temperatures
Authors: Ji Hoi Heo, Jun Seong Park, Hyo Kim
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Geopolymer is an inorganic material synthesized by alkali activation of source materials rich in soluble SiO2 and Al2O3. Many researches have studied the effect of aluminum species on the synthesis of geopolymer. However, it is still unclear about the influence of Al additives on the properties of geopolymer. The current study identified the role of the Al additive on the thermal performance of fly ash based geopolymer and observing the microstructure development of the composite. NaOH pellets were dissolved in water for 14 M (14 moles/L) sodium hydroxide solution which was used as an alkali activator. The weight ratio of alkali activator to fly ash was 0.40. Sodium aluminate powder was employed as an Al additive and added in amounts of 0.5 wt.% to 2 wt.% by the weight of fly ash. The mixture of alkali activator and fly ash was cured in a 75°C dry oven for 24 hours. Then, the hardened geopolymer samples were exposed to 300°C, 600°C and 900°C for 2 hours, respectively. The initial compressive strength after oven curing increased with increasing sodium aluminate content. It was also observed in SEM results that more amounts of geopolymer composite were synthesized as sodium aluminate was added. The compressive strength increased with increasing heating temperature from 300°C to 600°C regardless of sodium aluminate addition. It was consistent with the ATR-FTIR results that the peak position related to asymmetric stretching vibrations of Si-O-T (T: Si or Al) shifted to higher wavenumber as the heating temperature increased, indicating the further geopolymer reaction. In addition, geopolymer sample with higher content of sodium aluminate showed better compressive strength. It was also reflected on the IR results by more shift of the peak position assigned to Si-O-T toward the higher wavenumber. However, the compressive strength decreased after being exposed to 900°C in all samples. The degree of reduction in compressive strength was decreased with increasing sodium aluminate content. The deterioration in compressive strength was most severe in the geopolymer sample without sodium aluminate additive, while the samples with sodium aluminate addition showed better thermal durability at 900°C. This is related to the phase transformation with the occurrence of nepheline phase at 900°C, which was most predominant in the sample without sodium aluminate. In this work, it was concluded that sodium aluminate could be a good additive in the geopolymer synthesis by showing the improved compressive strength at elevated temperatures.Keywords: compressive strength, fly ash based geopolymer, microstructure development, Na-aluminate
Procedia PDF Downloads 1227701 Flame Retardancy of Organophosphorus Compound on Cellulose - an Eco Friendly Concern
Authors: M. A. Hannan, N. Matthias Neisius
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Organophosphorus compound diethyloxymethyl-9-oxa-10-phosphaphenanthrene-10-oxide (DOPAC) was applied on cotton cellulose to impart eco-friendly flame retardant property to it. Here acetal linkage was introduced rather than conventionally used ester linkage to rescue from the undurability problem of flame retardant compound. Some acidic catalysts, sodium dihydrogen phosphate (NaH2PO4), ammonium dihydrogen phosphate (NH4H2PO4) and phosphoric acid (H3PO4) were successfully used to form acetal linkage between the base material and flame retardant compound. Inspiring limiting oxygen index (LOI) value of 22.4 was found after exclusive washing treatment. A good outcome of total heat of combustion (THC) 6.05 KJ/g was found possible during pyrolysis combustion flow calorimetry (PCFC) test of the treated sample. Low temperature dehydration with sufficient amount of char residue (14.89%) was experienced in case of treated sample. In addition, the temperature of peak heat release rate (TPHRR) 343.061°C supported the expected low temperature pyrolysis in condensed phase mechanism. With the consequence of pyrolysis effects, thermogravimetric analysis (TGA) also reported inspiring weight retention% of the treated samples.Keywords: acetal linkage, char residue, cotton cellulose, flame retardant, loi, low temperature pyrolysis, organophosphorus, THC, THRR
Procedia PDF Downloads 3037700 Modified Evaluation of the Hydro-Mechanical Dependency of the Water Coefficient of Permeability of a Clayey Sand with a Novel Permeameter for Unsaturated Soils
Authors: G. Adelian, A. Mirzaii, S. S. Yasrobi
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This paper represents data of an extensive experimental laboratory testing program for the measurement of the water coefficient of permeability of clayey sand in different hydraulic and mechanical boundary conditions. A novel permeameter was designed and constructed for the experimental testing program, suitable for the study of flow in unsaturated soils in different hydraulic and mechanical loading conditions. In this work, the effect of hydraulic hysteresis, net isotropic confining stress, water flow condition, and sample dimensions are evaluated on the water coefficient of permeability of understudying soil. The experimental results showed a hysteretic variation for the water coefficient of permeability versus matrix suction and degree of saturation, with higher values in drying portions of the SWCC. The measurement of the water permeability in different applied net isotropic stress also signified that the water coefficient of permeability increased within the increment of net isotropic consolidation stress. The water coefficient of permeability also appeared to be independent of different applied flow heads, water flow condition, and sample dimensions.Keywords: water permeability, unsaturated soils, hydraulic hysteresis, void ratio, matrix suction, degree of saturation
Procedia PDF Downloads 5277699 Role of Imaging in Predicting the Receptor Positivity Status in Lung Adenocarcinoma: A Chapter in Radiogenomics
Authors: Sonal Sethi, Mukesh Yadav, Abhimanyu Gupta
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The upcoming field of radiogenomics has the potential to upgrade the role of imaging in lung cancer management by noninvasive characterization of tumor histology and genetic microenvironment. Receptor positivity like epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) genotyping are critical in lung adenocarcinoma for treatment. As conventional identification of receptor positivity is an invasive procedure, we analyzed the features on non-invasive computed tomography (CT), which predicts the receptor positivity in lung adenocarcinoma. Retrospectively, we did a comprehensive study from 77 proven lung adenocarcinoma patients with CT images, EGFR and ALK receptor genotyping, and clinical information. Total 22/77 patients were receptor-positive (15 had only EGFR mutation, 6 had ALK mutation, and 1 had both EGFR and ALK mutation). Various morphological characteristics and metastatic distribution on CT were analyzed along with the clinical information. Univariate and multivariable logistic regression analyses were used. On multivariable logistic regression analysis, we found spiculated margin, lymphangitic spread, air bronchogram, pleural effusion, and distant metastasis had a significant predictive value for receptor mutation status. On univariate analysis, air bronchogram and pleural effusion had significant individual predictive value. Conclusions: Receptor positive lung cancer has characteristic imaging features compared with nonreceptor positive lung adenocarcinoma. Since CT is routinely used in lung cancer diagnosis, we can predict the receptor positivity by a noninvasive technique and would follow a more aggressive algorithm for evaluation of distant metastases as well as for the treatment.Keywords: lung cancer, multidisciplinary cancer care, oncologic imaging, radiobiology
Procedia PDF Downloads 1367698 Mongolian Water Quality Problem and Health of Free-Grazing Sheep
Authors: Yu Yoshihara, Chika Tada, Moe Takada, Nyam-Osor Purevdorj, Khorolmaa Chimedtseren, Yutaka Nakai
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Water pollution from animal waste and its influence on grazing animals is a current concern regarding Mongolian grazing lands. We allocated 32 free-grazing lambs to four groups and provided each with water from a different source (upper stream, lower stream, well, and pond) for 49 days. We recorded the amount of water consumed by the lambs, as well as their body weight, behavior, white blood cell count, acute phase (haptoglobin) protein level, and fecal condition. We measured the chemical and biological qualities of the four types of water, and we detected enteropathogenic and enterohemorrhagic Escherichia coli in fecal samples by using a genetic approach. Pond water contained high levels of nitrogen and minerals, and well water contained high levels of bacteria. The odor concentration index decreased in order from pond water to upper stream, lower stream, and well. On day 15 of the experiment, the following parameters were the highest in lambs drinking water from the following sources: water intake (pond or lower stream), body weight gain (pond), WBC count (lower stream), haptoglobin concentration (well), and enteropathogenic E. coli infection rate (lower stream). Lambs that drank well water spent more time lying down and less time grazing than the others, and lambs that drank pond water spent more time standing and less time lying down. Lambs given upper or lower stream water exhibited more severe diarrhea on day 15 of the experiment than before the experiment. Mongolian sheep seemed to adapt to chemically contaminated water: their productivity benefited the most from pond water, likely owing to its rich mineral content. Lambs that drank lower stream water showed increases in enteropathogenic E. coli infection, clinical diarrhea, and WBC count. Lambs that drank well water, which was bacteriologically contaminated, had increased serum acute phase protein levels and poor physical condition; they were thus at increased risk of negative health and production effects.Keywords: DNA, Escherichia coli, fecal sample, lower stream, well water
Procedia PDF Downloads 4727697 Serum 25-Dihydroxy Vitamin D3 Level Estimation and Insulin Resistance in Women of 18-40 Years Age Group with Polycystic Ovarian Syndrome
Authors: Thakur Pushpawati, Singh Vinita, Agrawal Sarita, Mohapatra Eli
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Polycystic ovary syndrome (PCOS) is a disease of endocrine and frequently encountered in women in their reproductive period, and it is characterized by clinical features of anovulation, clinical and biochemical features of hyperandrogenism, and PCOS morphology on ultrasonographic examination. In Indian scenario, only a few studies are available on the correlation of serum 25-dihydroxy vitamin D3 level and insulin level. The present study is a prospective case-control study and aims to estimate the concentration of serum 25-dihydroxy vitamin D3 and insulin resistance and determine the association of serum 25-dihydroxy vitamin D3 with insulin resistance in PCOS women of 18-40 years age group. In this study, the primary objective is to estimate the concentration of 25-dihydroxy vitamin D3, insulin, glycaemic status, calcium and phosphorus levels in 18-40 year age women with polycystic ovary syndrome and to compare these parameters with age and BMI matched healthy control of same age group women. The secondary objective is to determine the association between 25-dihydroxy vitamin D3 concentration and insulin resistance among PCOS cases in 18-40 years age group women. This study was carried on at outpatient Department of Obstetrics & Gynaecology, Aiims Raipur. It took one year from the date of approval. In case, 32 women were diagnosed (Diagnosed PCOS cases as per Rotterdoms criteria among women of 18-40 years of age), as control group 32 women of 18-40 years of age were diagnosed As a result, serum insulin level was elevated among PCOS women along with 25-dihydroxy vitamin D3 deficiency.Conclude up, PCOS is more common in the age group of 20-40 years. There is a strong correlation between vitamin D deficiency and insulin resistance among PCOS patients.Keywords: vitamin D, insulin resistance, PCOS, reproductive age group
Procedia PDF Downloads 1357696 Simultech - Innovative Country-Wide Ultrasound Training Center
Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper
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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.Keywords: medical training, simulations, ultrasound, Simultech
Procedia PDF Downloads 2807695 Fouling of Regenerated Ultrafiltration Membrane in Treatment of Oily Wastewater of Palm Oil Refinery
Authors: K. F. Md Yunos, N. S. Pajar, N. S. Azmi
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Oily wastewater in Malaysian refinery has become a big issue of water and environment pollution to be solved urgently. The results of an experimental study on separation of oily wastewaters are presented. The characteristic of filtration behavior of commercial polymer ultrafiltration (UF) membranes was evaluated in the treatment of oily wastewater from palm oil refinery. The performance of different molecular weight cut off 5kDa and 10kDa regenerated cellulose membrane were evaluated and compared and the fouling behavior were analyzed by scanning electron microscopy (SEM). The effect of pressure (0.5, 1.0, 1.5, 2.0, 2.5 bar) and sample concentration (100%, 75%, 50%, 25%) on fouling of 5kDa and 10kDa membrane were evaluated. The characteristic of the sample solutions were analyzed for turbidity, total dissolved solid (TDS), total suspended solid (TSS), BOD, and COD. The results showed that the best fit to experimental data corresponds to the cake layer formation followed by the intermediate blocking for the experimental conditions tested. A more detailed analysis of the fouling mechanisms was studied by dividing the filtration curves into different regions corresponding to the different fouling mechanisms. Intermediate blocking and cake layer formation or combinations of them were found to occur during the UF experiments depending on the operating conditions.Keywords: fouling, oily wastewater, regenerated cellulose, ultrafiltration
Procedia PDF Downloads 4197694 Causal Estimation for the Left-Truncation Adjusted Time-Varying Covariates under the Semiparametric Transformation Models of a Survival Time
Authors: Yemane Hailu Fissuh, Zhongzhan Zhang
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In biomedical researches and randomized clinical trials, the most commonly interested outcomes are time-to-event so-called survival data. The importance of robust models in this context is to compare the effect of randomly controlled experimental groups that have a sense of causality. Causal estimation is the scientific concept of comparing the pragmatic effect of treatments conditional to the given covariates rather than assessing the simple association of response and predictors. Hence, the causal effect based semiparametric transformation model was proposed to estimate the effect of treatment with the presence of possibly time-varying covariates. Due to its high flexibility and robustness, the semiparametric transformation model which shall be applied in this paper has been given much more attention for estimation of a causal effect in modeling left-truncated and right censored survival data. Despite its wide applications and popularity in estimating unknown parameters, the maximum likelihood estimation technique is quite complex and burdensome in estimating unknown parameters and unspecified transformation function in the presence of possibly time-varying covariates. Thus, to ease the complexity we proposed the modified estimating equations. After intuitive estimation procedures, the consistency and asymptotic properties of the estimators were derived and the characteristics of the estimators in the finite sample performance of the proposed model were illustrated via simulation studies and Stanford heart transplant real data example. To sum up the study, the bias of covariates was adjusted via estimating the density function for truncation variable which was also incorporated in the model as a covariate in order to relax the independence assumption of failure time and truncation time. Moreover, the expectation-maximization (EM) algorithm was described for the estimation of iterative unknown parameters and unspecified transformation function. In addition, the causal effect was derived by the ratio of the cumulative hazard function of active and passive experiments after adjusting for bias raised in the model due to the truncation variable.Keywords: causal estimation, EM algorithm, semiparametric transformation models, time-to-event outcomes, time-varying covariate
Procedia PDF Downloads 1257693 Linguistic Competencies of Students with Hearing Impairment
Authors: Khalil Ullah Khan
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Linguistic abilities in students with hearing impairment yet remain a concern for educationists. The emerging technological support and provisions in the recent era vow to have addressed the situation and claim significant contributions in terms of linguistic repertoire. Being a descriptive and quantitative paradigm of study, the purpose of this research set forth was to assess the linguistic competencies of students with hearing impairment in the English language. The goals were further broken down to identify the level of reading abilities in the subject population. The population involved students with HI studying at a higher secondary level in Lahore. A simple random sampling technique was used to choose a sample of fifty students. A purposive curriculum-based assessment was designed in line with the accelerated learning program by the Punjab Government to assess Linguistic competence among the sample. Further to it, an Informal Reading Inventory (IRI) corresponding to reading levels was also developed by researchers duly validated and piloted before the final use. Descriptive and inferential statistics were utilized to reach the findings. Spearman’s correlation was used to find out the relationship between the degree of hearing loss, grade level, gender and type of amplification device. An Independent sample t-test was used to compare means among groups. Major findings of the study revealed that students with hearing impairment exhibit significant deviation from the mean scores when compared in terms of grades, severity and amplification device. The study divulged that respective students with HI have yet failed to qualify for an independent level of reading according to their grades, as the majority fall at the frustration level of word recognition and passage comprehension. The poorer performance can be attributed to lower linguistic competence, as it is shown in the frustration levels of reading, writing and comprehension. The correlation analysis did reflect an improved performance grade. Wise. However, scores could only correspond to frustration level, and independent levels were never achieved. Reported achievements at the instructional level of the subject population may further to linguistic skills if practiced purposively.Keywords: linguistic competence, hearing impairment, reading levels, educationist
Procedia PDF Downloads 417692 Effect of Simulation on Anxiety and Knowledge among Novice Nursing Students
Authors: Suja Karkada, Jayanthi Radhakrishnan, Jansi Natarajan, Gerald, Amandu Matua, Sujatha Shanmugasundaram
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Simulation-based learning is an educational strategy designed to simulate actual clinical situations in a safe environment. Globally, simulation is recognized by several landmark studies as an effective teaching-learning method. A systematic review of the literature on simulation revealed simulation as a useful strategy in creating a learning environment which contributes to knowledge, skills, safety, and confidence. However, to the best of the author's knowledge, there are no studies on assessing the anxiety of the students undergoing simulation. Hence the researchers undertook a study with the aim to evaluate the effectiveness of simulation on anxiety and knowledge among novice nursing students. This quasi-experimental study had a total sample of 69 students (35- Intervention group with simulation and 34- Control group with case scenario) consisting of all the students enrolled in the Fundamentals of Nursing Laboratory course during Spring 2016 and Fall 2016 semesters at a college of nursing in Oman. Ethical clearance was obtained from the Institutional Review Board (IRB) of the college of nursing. Informed consent was obtained from every participant. Study received the Dean’s fund for research. The data were collected regarding the demographic information, knowledge and anxiety levels before and after the use of simulation and case scenario for the procedure nasogastric tube feeding in intervention and control group respectively. The intervention was performed by four faculties who were the core team members of the course. Results were analyzed in SPSS using descriptive and inferential statistics. Majority of the students’ in intervention (82.9%) and control (89.9%) groups were equal to or below the age of 20 years, were females (71%), 76.8% of them were from rural areas and 65.2% had a GPA of more than 2.5. The selection of the samples to either the experimental or the control group was from a homogenous population (p > 0.05). There was a significant reduction of anxiety among the students of control group (t (67) = 2.418, p = 0.018) comparing to the experimental group, indicating that simulation creates anxiety among Novice nursing students. However, there was no significant difference in the mean scores of knowledge. In conclusion, the study was useful in that it will help the investigators better understand the implications of using simulation in teaching skills to novice students. Since previous studies with students indicate better knowledge acquisition; this study revealed that simulation can increase anxiety among novice students possibly it is the first time they are introduced to this method of teaching.Keywords: anxiety, knowledge, novice students, simulation
Procedia PDF Downloads 1597691 Fashion through Senses: A Study of the Impact of Sensory Cues on the Consumption of Fashion Accessories by Female Shoppers
Authors: Vaishali Joshi
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Purpose: A literature gap exists on the concept of sensory marketing elements, such as tactile elements, auditory elements, visual elements, and olfactory elements, studied together in the context of retailing. An investigation is required to study the impact of these sensory cues together on consumer behaviour. So, this study will undertake the impact of sensory marketing in fashion accessories stores on female shoppers’ purchasing activities. The present research study highlights the role of sensory cues, such as tactile cues, visual cues, auditory cues, and olfactory cues, on the shopper’s emotional states and their purchase intention. Design/methodology/approach: The emotional states and the purchase intention of the female shoppers influenced by the visual, tactile, olfactory, and auditory cues present in the fashion accessories stores were measured. The mall intercept technique was used for the data collection. Data analysis was done through Structural Equation Modelling. Research limitations/implications: The restricted geographical range and limited sample size of the study had a substantial poor influence on the wide usage of the study’s outcome. Also, here, the sample was female respondents only.Keywords: sensory marketing, visual cues, olfactory cues, tactile cues, auditory cues
Procedia PDF Downloads 867690 Uses of Fibrinogen Concentrate in the Management of Trauma-Induced Coagulopathy in the Prehospital Environment: A Scoping Review
Authors: Nura Khattab, Fayad Al-Haimus, Teruko Kishibe, Netanel Krugliak, Melissa McGowan, Brodie Nolan
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Trauma-induced coagulopathy remains a significant contributor to mortality in severely injured patients. Fibrinogen is essential for early hemostasis and is recognized as the first coagulation factor to fall below critical levels, compromising the coagulation cascade. Early administration of fibrinogen concentrate may be feasible and effective to prevent coagulopathy. We conducted this scoping review to characterize the existing quantity of literature, and to explore the usage of prehospital fibrinogen concentrate products in improving clinical outcomes in trauma patients. Methods: A search strategy was developed in consultation with an information specialist. We searched MEDLINE, Embase, Cochrane, and Scopus from inception to May 6th 2024. English studies evaluating prehospital/military usage of fibrinogen concentrate in trauma patients were included. Studies were assessed by three independent reviewers for meeting inclusion and exclusion criteria. Reference lists of included articles were reviewed to identify additional studies meeting inclusion criteria. Clinical endpoints regarding fibrinogen concentrate were extracted and synthesized. Results: The literature search returned 1301 articles with seven studies meeting the inclusion criteria. Five studies (71%) were conducted in civilian settings and two studies (29%) were conducted in military settings. Of the included studies, three (43%) utilized a randomized control trial. We identified seven outcomes that compared varying concentrations of fibrinogen or fibrinogen concentrate to a placebo group. The outcomes included overall mortality, death from hemorrhage, thromboembolic events, clotting time, maximum clot firmness, clot stability at ER admission, and fibrinogen concentration at ER admission. Apart from thromboembolic events, all other reported outcomes showed statistically significant differences in group comparisons, determined using p values. The four (57%) non-clinical studies underscored the robustness, practicality, and degree of fibrinogen concentrate utilization in military environments and retrieval services. Conclusion: Preliminary research suggests that prehospital fibrinogen concentrate administration in traumatic bleeding patients is both feasible and effective, improving mortality and clotting parameters. While implementing a time-saving and proactive approach with fibrinogen holds potential for enhancing trauma care, the current evidence is limited. Further studies in this novel field are warranted.Keywords: fibrinogen concentrate, prehospital, military, trauma, trauma-induced coagulopathy
Procedia PDF Downloads 257689 Improving Fine Motor Skills in the Hands of Children with ASD with Applying the Fine Motor Activities in Montessori Method of Education
Authors: Yeganeh Faraji, Ned Faraji
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The aim of the present study is to search for the effects of training on improving fine hand skills in children with autistic spectrum disorder through the case study statistic method. The sample group was selected by the available sampling method and included four participants. The methodology of this research was a single-subject semi-experimental of AB design. The data were gathered by natural observation. In the next stage, the data were recorded on data record sheets and then presented on diagrams. The sample group was evaluated by an assessment which the researcher created based on Lincoln-Oseretsky’ motor development scale in two pre-test and post-test phases. In order to promote fingers’ fine movement, the Montessori method was applied. Collecting and analyzing data which were shown by the data presentation method and diagrams, proved that it had no significant effect on improving fingers’ fine movement. Therefore, based on the current research findings, it is suggested that future researchers can apply various teaching methods and different tests for improving fine hand skills or increasing the period of training.Keywords: autism spectrum disorder, Montessori method, fine motor skills, Lincoln-Oseretsky assessment
Procedia PDF Downloads 937688 Predicting Relative Performance of Sector Exchange Traded Funds Using Machine Learning
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Machine learning has been used in many areas today. It thrives at reviewing large volumes of data and identifying patterns and trends that might not be apparent to a human. Given the huge potential benefit and the amount of data available in the financial market, it is not surprising to see machine learning applied to various financial products. While future prices of financial securities are extremely difficult to forecast, we study them from a different angle. Instead of trying to forecast future prices, we apply machine learning algorithms to predict the direction of future price movement, in particular, whether a sector Exchange Traded Fund (ETF) would outperform or underperform the market in the next week or in the next month. We apply several machine learning algorithms for this prediction. The algorithms are Linear Discriminant Analysis (LDA), k-Nearest Neighbors (KNN), Decision Tree (DT), Gaussian Naive Bayes (GNB), and Neural Networks (NN). We show that these machine learning algorithms, most notably GNB and NN, have some predictive power in forecasting out-performance and under-performance out of sample. We also try to explore whether it is possible to utilize the predictions from these algorithms to outperform the buy-and-hold strategy of the S&P 500 index. The trading strategy to explore out-performance predictions does not perform very well, but the trading strategy to explore under-performance predictions can earn higher returns than simply holding the S&P 500 index out of sample.Keywords: machine learning, ETF prediction, dynamic trading, asset allocation
Procedia PDF Downloads 987687 Antimicrobial Activity of Biosynthesized Silver Nanoparticles Using Different Bacteria
Authors: Malalage Mudara Peiris
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Objectives of the study are: the biosynthesis of silver nanoparticles (AgNPs) using Escherichia coli, Acinetobacter baumannii and Staphylococcus aureus, characterization of silver nanoparticles and determination of antimicrobial activity against E. coli, P. aeruginosa, S. aureus, MRSA, and C. Albicans. Methods: E. coli (ATCC 25922), A. baumanii (clinical strain), S. aureus (clinical strain) cultured in nutrient broth medium were used for biosynthesis of AgNPs. Culture conditions (AgNO3 concentration, pH, incubation time and temperature) were optimized. Characterization of synthesized NPs was done by UV-Visible spectroscopy. The antimicrobial activity of the synthesized NPs was studied using the good diffusion assay against E. coli, S. aureus, MRSA (Methicillin-resistant Staphylococcus aureus), P. aeruginosa and C. Albicans. Results: All the selected bacteria produced silver nanoparticles at alkaline pH above 0.3 g/L AgNO3 concentration. The optimum reaction temperature was 60oC. According to the UV-Visible spectroscopy, the maximum absorbance was found to be around 420 - 430 nm indicating the presence of AgNPs. According to the good diffusion results, AgNPs produced by S. aureus resulted in the larger zone of inhibition (ZOI) against the selected pathogens, while AgNPs produced by E. coli showed comparatively smaller ZOI. In general, biosynthesized AgNPs were highly effective against gram-negative bacteria compared to gram-positive bacterial and fungal species. Conclusions: Green AgNPs produced by each bacterium show antimicrobial activity against the selected pathogens. AgNPs produced by S. aureus are the most effective NPs among tested AgNPs, while AgNPs produced by E. coli are the least effective. Further characterization of NPs is required to study the physical properties of silver NPs.Keywords: green nanotechnology, silver nanoparticles, bacteria, antimicrobial activity
Procedia PDF Downloads 2067686 Endometriosis-Associated Ovarian Cancer: Clinical and Pathological Pattern
Authors: I. Ramalho, S. Campos, M. Dias
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Introduction: Endometriosis may play a role in the pathogenesis of ovarian cancer (OC), however, the risk and prognosis have not been well established. The association between these two pathologies could have an important impact on prevention and early diagnosis of OC. Objective: To analyze the prevalence of endometriosis associated ovarian cancer and related clinical, epidemiological and histopathological issues. Design: We conducted a retrospective case series analysis of patients diagnosed with endometriosis and ovarian cancer in the Gynecology Department of Coimbra University Hospital Center since 2006 to 2015. Methods: We collected data from women diagnosed with ovarian cancer, with anatomopathology records reporting findings of endometriosis in ovarian cancer patients. Patients were retrieved from the pathological records and appropriate medical records were retrospectively reviewed. Statistical analysis was performed using SPSS 22.0. Results: Histological evidence of endometriosis was found in 17 out of 261 patients diagnosed with ovarian cancer (OC) (6.51%). The most usual symptoms were pelvic pain, abdominal distension, asthenia, ascites, weight loss and nausea. Mean age at diagnosis was 61.2 ± 15.1, 41-86 years old, 33.3% were pre-menopausal patients and cancer stage distribution was predominantly stage I (31.3%) and stage III (56.3%). OC occurred unilaterally in 14 patients and 2 patients were diagnosed with a synchronous ovarian and endometrial cancer. Regarding histological type, 10 OC were classified as clear cell carcinoma (CCC), 4 endometrioid carcinomas (EC) and 3 mixed type (clear cell and endometrioid). Four ovarian carcinomas presumably arose from endometriomas: 3 CCC and 1 EC. Conclusions: In accordance with previous studies, clear cell was the most common pathological type in endometriotic patients, followed by endometrioid carcinomas, and two rare synchronous ovarian and endometrial carcinomas were registered. Although endometriosis association to OC is uncommon, endometriosis should be managed with special care in order to early diagnosis.Keywords: endometriosis, histology, observational study, ovarian cancer
Procedia PDF Downloads 2297685 Addressing Sexual Health in Males with Spinal Cord Injury in Rural South India: Using the Knowledge to Action Framework to Evaluate an Education Manual on Improving Knowledge, Attitudes and Practices
Authors: Cassandra Maffei, Effie Pomaki, Salomé Deslauriers-Brouillard, Levana Dahan, Caroline Storr, Ramasubramanian Ponnusamy, Philippe S. Archambault
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Sexual health education following spinal cord injury (SCI) remains poorly integrated into the rehabilitation process, especially in low-income countries where the topics of disability and sexuality are stigmatized. This research aimed to evaluate a sexual health manual that was created and distributed amongst males with SCI who had received rehabilitation services at Amar Seva Sangam (ASSA), a rehabilitation center located in rural South India. A service evaluation was completed to collect data from a convenience sample of 37 males with spinal cord injuries. Data were analyzed using descriptive statistics and content analysis. The service evaluation showed that the manual was well received by the sample and had positive impacts on secondary outcome measures, including relationship dynamics and quality of life. It can thus be used as an effective adjunct tool to support the improvement of sexual health knowledge, attitudes, and practices of individuals with SCI.Keywords: spinal cord injury, sexual health, rehabilitation, India, education, service evaluation
Procedia PDF Downloads 957684 Preparation and Conductivity Measurements of LSM/YSZ Composite Solid Oxide Electrolysis Cell Anode Materials
Authors: Christian C. Vaso, Rinlee Butch M. Cervera
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One of the most promising anode materials for solid oxide electrolysis cell (SOEC) application is the Sr-doped LaMnO3 (LSM) which is known to have a high electronic conductivity but low ionic conductivity. To increase the ionic conductivity or diffusion of ions through the anode, Yttria-stabilized Zirconia (YSZ), which has good ionic conductivity, is proposed to be combined with LSM to create a composite electrode and to obtain a high mixed ionic and electronic conducting anode. In this study, composite of lanthanum strontium manganite and YSZ oxide, La0.8Sr0.2MnO3/Zr0.92Y0.08O2 (LSM/YSZ), with different wt.% compositions of LSM and YSZ were synthesized using solid-state reaction. The obtained prepared composite samples of 60, 50, and 40 wt.% LSM with remaining wt.% of 40, 50, and 60, respectively for YSZ were fully characterized for its microstructure by using powder X-ray diffraction (XRD), Thermogravimetric analysis (TGA), Fourier transform infrared (FTIR), and Scanning electron microscope/Energy dispersive spectroscopy (SEM/EDS) analyses. Surface morphology of the samples via SEM analysis revealed a well-sintered and densified pure LSM, while a more porous composite sample of LSM/YSZ was obtained. Electrochemical impedance measurements at intermediate temperature range (500-700 °C) of the synthesized samples were also performed which revealed that the 50 wt.% LSM with 50 wt.% YSZ (L50Y50) sample showed the highest total conductivity of 8.27x10-1 S/cm at 600 oC with 0.22 eV activation energy.Keywords: ceramics, microstructure, fuel cells, electrochemical impedance spectroscopy
Procedia PDF Downloads 2487683 The Effect of Applying Surgical Safety Checklist on Surgical Team’s Knowledge and Performance in Operating Room
Authors: Soheir Weheida, Amal E. Shehata, Samira E. Aboalizm
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The aim of this study was to examine the effect of surgical safety checklist on surgical team’s knowledge and performance in operating room. Subjects: A convenience sample 151 (48 head nurse, 45 nurse, 37 surgeon and 21 anesthesiologist) which available in operating room at two different hospitals was included in the study. Setting: The study was carried out at operating room in Menoufia University and Shebin Elkom Teaching Hospitals, Egypt. Tools: I: Surgical safety: Surgical team knowledge assessment structure interview schedule. II: WHO surgical safety observational Checklist. III: Post Surgery Culture Survey scale. Results: There was statistical significant improvement of knowledge mean score and performance about surgical safety especially in post and follow up than pre intervention, before patients entering the operating, before induction of anesthesia, skin incision and post skin closure and before patient leaves operating room, P values (P < 0.001). Improvement of communication post intervention than pre intervention between surgical team’s (4.74 ± 0.540). About two thirds (73.5 %) of studied sample strongly agreed on surgical safety in operating room. Conclusions: Implementation of surgical safety checklist has a positive effect on improving knowledge, performance and communication between surgical teams and these seems to have a positive effect on improve patient safety in the operating room.Keywords: knowledge, operating room, performance, surgical safety checklist
Procedia PDF Downloads 3347682 Pharmacological Activities and Potential Uses of Cyperus Rotundus: A Review
Authors: Arslan Masood Pirzada, Muhammad Naeem, Hafiz Haider Ali, Muhammad Latif, Aown Sammar Raza, Asad Hussain Bukhari, Muhammad Saqib, Muhammad Ijaz
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Cyperus rotundus (Cyperaceae), a medicinal herb, is being traditionally used as a home remedy for the treatment of various clinical conditions like diarrhea, diabetic, pyretic, inflammation, malaria, and for treating stomach and bowel disorders. Its current status is one of the most widespread, troublesome, and economically damaging agronomic weeds, growing wildly in various tropical and sub-tropical regions of the world. Tuber and rhizomes of Cyperus rotundus possess a higher concentration of active ingredients in the form of essential oils, phenolic acids, ascorbic acids and flavonoids, responsible for its remedial properties. Exploitation of any medicinal plant application depends on the crucial and comprehensive information about the therapeutic potential of a plant. Researchers have evaluated and characterized the significance of Cyperus rotundus as an anti-androgenic, anti-bacterial, anti-cancerous, anti-convulsant, anti-diabetic, anti-diarrheal, anti-genotoxic, anti-inflammatory, anti-lipidemic, anti-malarial, anti-mutagenic, anti-obesity, anti-oxidant, anti-uropathogenic, hepato-, cardio-, neuroprotective, and nootropic agent. This paper comprises a broad review to summarize the current state of knowledge about chemical constituents, potential economic uses and therapeutic aspects of Cyperus rotundus that will aid in the development of bioethanol and modern herbal medicine through latest technologies that will promote the ability of this plant in the cure of many clinical disorders.Keywords: purple nutsedge, chemical composition, economic uses, therapeutic values, future directions
Procedia PDF Downloads 5137681 Price Heterogeneity in Establishing Real Estate Composite Price Index as Underlying Asset for Property Derivatives in Russia
Authors: Andrey Matyukhin
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Russian official statistics have been showing a steady decline in residential real estate prices for several consecutive years. Price risk in real estate markets is thus affecting various groups of economic agents, namely, individuals, construction companies and financial institutions. Potential use of property derivatives might help mitigate adverse consequences of negative price dynamics. Unless a sustainable price indicator is developed, settlement of such instruments imposes constraints on counterparties involved while imposing restrictions on real estate market development. The study addresses geographical and classification heterogeneity in real estate prices by means of variance analysis in various groups of real estate properties. In conclusion, we determine optimal sample structure of representative real estate assets with sufficient level of price homogeneity. The composite price indicator based on the sample would have a higher level of robustness and reliability and hence improving liquidity in the market for property derivatives through underlying standardization. Unlike the majority of existing real estate price indices, calculated on country-wide basis, the optimal indices for Russian market shall be constructed on the city-level.Keywords: price homogeneity, property derivatives, real estate price index, real estate price risk
Procedia PDF Downloads 3077680 Physiotherapy Assessment of People with Neurological Conditions in Australia: A National Survey of Clinical Practice
Authors: Jill Garner, Belinda Lange, Sheila Lennon, Maayken van den Berg
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Currently, there are approximately one billion people worldwide affected by a neurological condition. Many of whom are assessed and treated by a physiotherapist in a variety of settings. There is a lack of consensus in the literature related to what is clinically assessed by physiotherapists in people with neurological conditions. This study aimed to explore assessment in people with neurological conditions, including how health care setting, experience, and therapeutic approach, may influence neurological assessment. A national survey targeted Australian physiotherapists who assess adults with neurological conditions as part of their clinical practice. The survey consisted of 39 questions and was distributed to physiotherapists through the Australian Physiotherapy Association, and Chief Allied Health Officers across Australia and advertised on the National Neurological Physiotherapy Facebook page. In total, 395 respondents consented to the survey from all states within Australia. Most respondents were female (85.4%) with a mean (SD) age of 35.7 years. Respondents reported working clinically in acute, community, outpatients, and community settings. Stroke was the most assessed condition (58.0%). There is variability in domains assessed by Australian physiotherapists, with common inclusions of balance, muscle strength, gait, falls and safety, function, goal setting, range of movement, pain, coordination, activity tolerance, postural alignment and symmetry and upper limb. There is little evidence to support what physiotherapists assess in practice, in different settings, and in different states within Australia and not enough information to develop a decision tree regarding what is important for assessment in different settings. Further research is needed to explore this area and develop a consensus around best practices.Keywords: physiotherapy, neurological, assessment, domains
Procedia PDF Downloads 937679 Stroke Prevention in Patients with Atrial Fibrillation and Co-Morbid Physical and Mental Health Problems
Authors: Dina Farran, Mark Ashworth, Fiona Gaughran
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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems
Procedia PDF Downloads 497678 The Prevalence of Coronary Artery Disease and Its Risk Factors in Rural and Urban Areas of Pakistan
Authors: Muhammad Kamran Hanif Khan, Fahad Mushtaq
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Background: In both developed and underdeveloped countries, coronary artery disease (CAD) is a serious cause of death and disability. Cardiovascular disease (CVD) is becoming more prevalent in emerging countries like Pakistan due to the spread and acceptance of Western lifestyles. Material and Methods: An observational cross-sectional investigation was conducted, and data collection relied on a random cluster sampling method. The sample size for this cross-sectional study was calculated using the following factors: estimated true proportion of 17.5%, desired precision of 2%, and confidence interval of 95%. The data for this study was collected from a sample of 1387 adults. Results: The average age of those living in rural areas is 55.24 years, compared to 52.60 years for those living in urban areas. The mean fasting blood glucose of the urban participants is 105.28 mg/dL, which is higher than the mean fasting blood glucose of the rural participants, which is 102.06 mg/dL. The mean total cholesterol of the urban participants is 192.20 mg/dL, which is slightly higher than the mean total cholesterol of the rural participants, which is 191.97 mg/dL. CAD prevalence is greater in urban areas than in rural areas. ECG abnormalities prevalence is 16.1% in females compared to 12.5% in men. Conclusion: The prevalence of CAD is more common in urban areas than in rural ones for all of the measures of CAD used in the study.Keywords: CVD prevalence, CVD risk factors, rural area, urban area
Procedia PDF Downloads 797677 Diffusion MRI: Clinical Application in Radiotherapy Planning of Intracranial Pathology
Authors: Pomozova Kseniia, Gorlachev Gennadiy, Chernyaev Aleksandr, Golanov Andrey
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In clinical practice, and especially in stereotactic radiosurgery planning, the significance of diffusion-weighted imaging (DWI) is growing. This makes the existence of software capable of quickly processing and reliably visualizing diffusion data, as well as equipped with tools for their analysis in terms of different tasks. We are developing the «MRDiffusionImaging» software on the standard C++ language. The subject part has been moved to separate class libraries and can be used on various platforms. The user interface is Windows WPF (Windows Presentation Foundation), which is a technology for managing Windows applications with access to all components of the .NET 5 or .NET Framework platform ecosystem. One of the important features is the use of a declarative markup language, XAML (eXtensible Application Markup Language), with which you can conveniently create, initialize and set properties of objects with hierarchical relationships. Graphics are generated using the DirectX environment. The MRDiffusionImaging software package has been implemented for processing diffusion magnetic resonance imaging (dMRI), which allows loading and viewing images sorted by series. An algorithm for "masking" dMRI series based on T2-weighted images was developed using a deformable surface model to exclude tissues that are not related to the area of interest from the analysis. An algorithm of distortion correction using deformable image registration based on autocorrelation of local structure has been developed. Maximum voxel dimension was 1,03 ± 0,12 mm. In an elementary brain's volume, the diffusion tensor is geometrically interpreted using an ellipsoid, which is an isosurface of the probability density of a molecule's diffusion. For the first time, non-parametric intensity distributions, neighborhood correlations, and inhomogeneities are combined in one segmentation of white matter (WM), grey matter (GM), and cerebrospinal fluid (CSF) algorithm. A tool for calculating the coefficient of average diffusion and fractional anisotropy has been created, on the basis of which it is possible to build quantitative maps for solving various clinical problems. Functionality has been created that allows clustering and segmenting images to individualize the clinical volume of radiation treatment and further assess the response (Median Dice Score = 0.963 ± 0,137). White matter tracts of the brain were visualized using two algorithms: deterministic (fiber assignment by continuous tracking) and probabilistic using the Hough transform. The proposed algorithms test candidate curves in the voxel, assigning to each one a score computed from the diffusion data, and then selects the curves with the highest scores as the potential anatomical connections. White matter fibers were visualized using a Hough transform tractography algorithm. In the context of functional radiosurgery, it is possible to reduce the irradiation volume of the internal capsule receiving 12 Gy from 0,402 cc to 0,254 cc. The «MRDiffusionImaging» will improve the efficiency and accuracy of diagnostics and stereotactic radiotherapy of intracranial pathology. We develop software with integrated, intuitive support for processing, analysis, and inclusion in the process of radiotherapy planning and evaluating its results.Keywords: diffusion-weighted imaging, medical imaging, stereotactic radiosurgery, tractography
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