Search results for: medical resonance (MR) images
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6184

Search results for: medical resonance (MR) images

4474 Visualization of Wave Propagation in Monocoupled System with Effective Negative Stiffness, Effective Negative Mass, and Inertial Amplifier

Authors: Abhigna Bhatt, Arnab Banerjee

Abstract:

A periodic system with only a single coupling degree of freedom is called a monocoupled system. Monocoupled systems with mechanisms like mass in the mass system generates effective negative mass, mass connected with rigid links generates inertial amplification, and spring-mass connected with a rigid link generateseffective negative stiffness. In this paper, the representative unit cell is introduced, considering all three mechanisms combined. Further, the dynamic stiffness matrix of the unit cell is constructed, and the dispersion relation is obtained by applying the Bloch theorem. The frequency response function is also calculated for the finite length of periodic unit cells. Moreover, the input displacement signal is given to the finite length of periodic structure and using inverse Fourier transform to visualize the wave propagation in the time domain. This visualization explains the sudden attenuation in metamaterial due to energy dissipation by an embedded resonator at the resonance frequency. The visualization created for wave propagation is found necessary to understand the insights of physics behind the attenuation characteristics of the system.

Keywords: mono coupled system, negative effective mass, negative effective stiffness, inertial amplifier, fourier transform

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4473 Hall Coefficient in the Presence of Strong Electromagnetic Waves Caused by Confined Electrons and Phonons in a Rectangular Quantum Wire

Authors: Nguyen Quang Bau, Nguyen Thu Huong, Dang Thi Thanh Thuy

Abstract:

The analytic expression for the Hall Coefficient (HC) caused by the confined electrons in the presence of a strong electromagnetic wave (EMW) including the effect of phonon confinement in rectangular quantum wires (RQWs) is calculated by using the quantum kinetic equation for electrons in the case of electron - optical phonon scattering. It is because the expression of the HC for the confined phonon case contains indexes m, m’ which are specific to the phonon confinement. The expression in a RQW is different from that for the case of unconfined phonons in a RQW or in 2D. The results are numerically calculated and discussed for a GaAs/GaAsAl RQW. The numerical results show that HC in a RQW can have both negative and positive values. This is different from the case of the absence of EMW and the case presence of EMW including the effect of phonon unconfinement in a RQW. These results are also compared with those in the case of unconfined phonons in a RQW and confined phonons in a quantum well. The conductivity in the case of confined phonon has more resonance peaks compared with that in case of unconfined phonons in a RQW. This new property is the same in quantum well. All results are compared with the case of unconfined phonons to see differences.

Keywords: Hall coefficient, rectangular quantum wires, electron-optical phonon interaction, quantum kinetic equation, confined phonons

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4472 Return to Work Rates of Participants in Medical Rehabilitation: The Role of Fitness and Health

Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

Abstract:

Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

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4471 Valence Effects on Episodic Memory Retrieval Following Exposure to Arousing Stimuli in Young and Old Adults

Authors: Marianna Constantinou, Hana Burianova, Ala Yankouskaya

Abstract:

Episodic memory retrieval benefits from arousal, with better performance linked to arousing to-be-remembered information. However, the enduring impact of arousal on subsequent memory processes, particularly for non-arousing stimuli, remains unclear. This functional Magnetic Resonance Imaging (fMRI) study examined the effects of arousal on episodic memory processes in young and old adults, focusing on memory of neutral information following arousal exposure. Neural activity was assessed at three distinct timepoints: during exposure to arousing and non-arousing stimuli, memory consolidation (with or without arousing stimulus exposure), and during memory retrieval (with or without arousing stimulus exposure). Behavioural results show that across both age groups, participants performed worse when retrieving episodic memories about a video preceded by a highly arousing negative image. Our fMRI findings reveal three key findings: i) the extension of the influence of negative arousal beyond encoding; ii) the presence of this influence in both young and old adults; iii) and the differential treatment of positive arousal between these age groups. Our findings emphasise valence-specific effects on memory processes and support the enduring impact of negative arousal. We further propose an age-related alteration in the old adult brain in differentiating between positive and negative arousal.

Keywords: episodic memory, ageing, fmri, arousal, valence

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4470 Small Scale Mobile Robot Auto-Parking Using Deep Learning, Image Processing, and Kinematics-Based Target Prediction

Authors: Mingxin Li, Liya Ni

Abstract:

Autonomous parking is a valuable feature applicable to many robotics applications such as tour guide robots, UV sanitizing robots, food delivery robots, and warehouse robots. With auto-parking, the robot will be able to park at the charging zone and charge itself without human intervention. As compared to self-driving vehicles, auto-parking is more challenging for a small-scale mobile robot only equipped with a front camera due to the camera view limited by the robot’s height and the narrow Field of View (FOV) of the inexpensive camera. In this research, auto-parking of a small-scale mobile robot with a front camera only was achieved in a four-step process: Firstly, transfer learning was performed on the AlexNet, a popular pre-trained convolutional neural network (CNN). It was trained with 150 pictures of empty parking slots and 150 pictures of occupied parking slots from the view angle of a small-scale robot. The dataset of images was divided into a group of 70% images for training and the remaining 30% images for validation. An average success rate of 95% was achieved. Secondly, the image of detected empty parking space was processed with edge detection followed by the computation of parametric representations of the boundary lines using the Hough Transform algorithm. Thirdly, the positions of the entrance point and center of available parking space were predicted based on the robot kinematic model as the robot was driving closer to the parking space because the boundary lines disappeared partially or completely from its camera view due to the height and FOV limitations. The robot used its wheel speeds to compute the positions of the parking space with respect to its changing local frame as it moved along, based on its kinematic model. Lastly, the predicted entrance point of the parking space was used as the reference for the motion control of the robot until it was replaced by the actual center when it became visible again by the robot. The linear and angular velocities of the robot chassis center were computed based on the error between the current chassis center and the reference point. Then the left and right wheel speeds were obtained using inverse kinematics and sent to the motor driver. The above-mentioned four subtasks were all successfully accomplished, with the transformed learning, image processing, and target prediction performed in MATLAB, while the motion control and image capture conducted on a self-built small scale differential drive mobile robot. The small-scale robot employs a Raspberry Pi board, a Pi camera, an L298N dual H-bridge motor driver, a USB power module, a power bank, four wheels, and a chassis. Future research includes three areas: the integration of all four subsystems into one hardware/software platform with the upgrade to an Nvidia Jetson Nano board that provides superior performance for deep learning and image processing; more testing and validation on the identification of available parking space and its boundary lines; improvement of performance after the hardware/software integration is completed.

Keywords: autonomous parking, convolutional neural network, image processing, kinematics-based prediction, transfer learning

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4469 Development of Bioactive Medical Textiles by Immobilizing Nanoparticles at Cotton Fabric

Authors: Munir Ashraf, Shagufta Riaz

Abstract:

Personal protective equipment (PPE) and bioactive textiles are highly important for the health care of front line hospital workers, patients, and the general population to be safe from highly infectious diseases. This was even more critical in the wake of COVID-19 outbreak. Most of the medical textiles are inactive against various viruses and bacteria, hence there is a need to wash them frequently to avoid the spread of microorganisms. According to survey conducted by the world health organization, more than 500 million people get infected from hospitals, and more than 13 million died due to these hospitals’ acquired deadly diseases. The market available PPE are though effective against the penetration of pathogens and to kill bacteria but, they are not breathable and active against different viruses. Therefore, there was a great need to develop textiles that are not only effective against bacteria, fungi, and viruses but also are comfortable to the medical personnel and patients. In the present study, waterproof breathable, and biologically active textiles were developed using antiviral and antibacterial nanomaterials. These nanomaterials like TiO₂, ZnO, Cu, and Ag were immobilized at the surface of cotton fabric by using different silane coupling agents and electroless deposition that they retained their functionality even after 30 industrial laundering cycles. Afterwards, the treated fabrics were coated with a waterproof breathable film to prevent the permeation of liquid droplets, any particle or microorganisms greater than 80 nm. The developed cotton fabric was highly active against bacteria and viruses. The good durability of nanomaterials at the cotton surface after several industrial washing cycles makes this fabric an ideal candidate for bioactive textiles used in the medical field.

Keywords: antibacterial, antiviral, cotton, durable

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4468 Suicide in Late-Life Major Depressive Disorder: A Review of Structural and Functional Neuroimaging Studies

Authors: Wenqiu Cao

Abstract:

Suicide prevention is a global problem that needs to be taken seriously. Investigating the mechanisms of suicide in major depressive disorder (MDD) separately through neuroimaging technology is essential for effective suicide prevention. And it’s particularly urgent in geriatric depressive patients since older adults are more likely to use rapidly deadly means, and suicidal behavior is more lethal for older adults. The current study reviews five studies related to suicide in geriatric MDD that uses neuroimaging methodology in order to analyze the relevant neurobiological mechanisms. The majority of the studies found significant white matter and grey matter reduction or lesion widespread in multiple brain regions, including the frontal and parietal regions, the midbrain, the external capsule, and the cerebellum. Regarding the cognitive impairment in geriatric MDD, the reward signals were found weakened in the paralimbic cortex. The functional magnetic resonance imaging (fMRI) studies also found hemodynamic changes in the right dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC), and right frontopolar cortex (FPC) regions in late-life MDD patients with suicidal ideation. Future studies should consider the age of depression onset, more accurate measurements of suicide, larger sample size, and longitudinal design.

Keywords: brain imaging, geriatric major depressive disorder, suicidality, suicide

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4467 Pre-conditioning and Hot Water Sanitization of Reverse Osmosis Membrane for Medical Water Production

Authors: Supriyo Das, Elbir Jove, Ajay Singh, Sophie Corbet, Noel Carr, Martin Deetz

Abstract:

Water is a critical commodity in the healthcare and medical field. The utility of medical-grade water spans from washing surgical equipment, drug preparation to the key element of life-saving therapy such as hydrotherapy and hemodialysis for patients. A properly treated medical water reduces the bioburden load and mitigates the risk of infection, ensuring patient safety. However, any compromised condition during the production of medical-grade water can create a favorable environment for microbial growth putting patient safety at high risk. Therefore, proper upstream treatment of the medical water is essential before its application in healthcare, pharma and medical space. Reverse Osmosis (RO) is one of the most preferred treatments within healthcare industries and is recommended by all International Pharmacopeias to achieve the quality level demanded by global regulatory bodies. The RO process can remove up to 99.5% of constituents from feed water sources, eliminating bacteria, proteins and particles sizes of 100 Dalton and above. The combination of RO with other downstream water treatment technologies such as Electrodeionization and Ultrafiltration meet the quality requirements of various pharmacopeia monographs to produce highly purified water or water for injection for medical use. In the reverse osmosis process, the water from a liquid with a high concentration of dissolved solids is forced to flow through an especially engineered semi-permeable membrane to the low concentration side, resulting in high-quality grade water. However, these specially engineered RO membranes need to be sanitized either chemically or at high temperatures at regular intervals to keep the bio-burden at the minimum required level. In this paper, we talk about Dupont´s FilmTec Heat Sanitizable Reverse Osmosis membrane (HSRO) for the production of medical-grade water. An HSRO element must be pre-conditioned prior to initial use by exposure to hot water (80°C-85°C) for its stable performance and to meet the manufacturer’s specifications. Without pre-conditioning, the membrane will show variations in feed pressure operations and salt rejection. The paper will discuss the critical variables of pre-conditioning steps that can affect the overall performance of the HSRO membrane and demonstrate the data to support the need for pre-conditioning of HSRO elements. Our preliminary data suggests that there can be up to 35 % reduction in flow due to initial heat treatment, which also positively affects the increase in salt rejection. The paper will go into detail about the fundamental understanding of the performance change of HSRO after the pre-conditioning step and its effect on the quality of medical water produced. The paper will also discuss another critical point, “regular hot water sanitization” of these HSRO membranes. Regular hot water sanitization (at 80°C-85°C) is necessary to keep the membrane bioburden free; however, it can negatively impact the performance of the membrane over time. We will demonstrate several data points on hot water sanitization using FilmTec HSRO elements and challenge its robustness to produce quality medical water. The last part of this paper will discuss the construction details of the FilmTec HSRO membrane and features that make it suitable to pre-condition and sanitize at high temperatures.

Keywords: heat sanitizable reverse osmosis, HSRO, medical water, hemodialysis water, water for Injection, pre-conditioning, heat sanitization

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4466 3D Stereoscopic Measurements from AR Drone Squadron

Authors: R. Schurig, T. Désesquelles, A. Dumont, E. Lefranc, A. Lux

Abstract:

A cost-efficient alternative is proposed to the use of a single drone carrying multiple cameras in order to take stereoscopic images and videos during its flight. Such drone has to be particularly large enough to take off with its equipment, and stable enough in order to make valid measurements. Corresponding performance for a single aircraft usually comes with a large cost. Proposed solution consists in using multiple smaller and cheaper aircrafts carrying one camera each instead of a single expensive one. To give a proof of concept, AR drones, quad-rotor UAVs from Parrot Inc., are experimentally used.

Keywords: drone squadron, flight control, rotorcraft, Unmanned Aerial Vehicle (UAV), AR drone, stereoscopic vision

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4465 Production of Hydroxy Marilone C as a Bioactive Compound from Streptomyces badius

Authors: Osama H. Elsayed, Mohsen M. S. Asker, Mahmoud A. Swelim, Ibrahim H. Abbas, Aziza I. Attwa, Mohamed E. El Awady

Abstract:

Hydroxy marilone C is a bioactive metabolite was produced from the culture broth of Streptomyces badius isolated from Egyptian soil. hydroxy marilone C was purified and fractionated by silica gel column with a gradient mobile phase dicloromethane (DCM) : Methanol then Sephadex LH-20 column using methanol as a mobile phase. It was subjected to many instruments as Infrared (IR), nuclear magnetic resonance (NMR), Mass spectroscopy (MS) and UV spectroscopy to the elucidation of its structure. It was evaluated for antioxidant, cytotoxicity against human alveolar basal epithelial cell line (A-549) and human breast adenocarcinoma cell line (MCF-7) and antiviral activities; showed that the maximum antioxidant activity was 78.8 % at 3000 µg/ml after 90 min. and the IC50 value against DPPH radical found about 1500 µg/ml after 60 min. By Using MTT assay the effect of the pure compound on the proliferation of A-549 cells and MCF-7 cells were 443 µg/ml and 147.9 µg/ml, respectively. While for detection of antiviral activity using Madin-Darby canine kidney (MDCK) cells the maximum cytotoxicity was at 27.9% and IC50 was 128.1µg/ml. The maximum concentration required for protecting 50% of the virus-infected cells against H1N1 viral cytopathogenicity (EC50) was 33.25% for 80 µg/ml. This results indicated that the hydroxy marilone C has a potential antitumor and antiviral activities.

Keywords: hydroxy marilone C, production, bioactive compound, Streptomyces badius

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4464 A Multilevel Approach for Stroke Prediction Combining Risk Factors and Retinal Images

Authors: Jeena R. S., Sukesh Kumar A.

Abstract:

Stroke is one of the major reasons of adult disability and morbidity in many of the developing countries like India. Early diagnosis of stroke is essential for timely prevention and cure. Various conventional statistical methods and computational intelligent models have been developed for predicting the risk and outcome of stroke. This research work focuses on a multilevel approach for predicting the occurrence of stroke based on various risk factors and invasive techniques like retinal imaging. This risk prediction model can aid in clinical decision making and help patients to have an improved and reliable risk prediction.

Keywords: prediction, retinal imaging, risk factors, stroke

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4463 Challenges Faced by Physician Leaders in Teaching Hospitals of Private Medical Schools in the National Capital Region, Philippines

Authors: Policarpio Jr. Joves

Abstract:

Physicians in most teaching hospitals are commonly promoted into managerial roles, yet their training is mostly in clinical and scientific skills but not in leadership competencies. When they shift into roles of physician leadership, the majority hold on to their primary identity of physicians. These conflicting roles affect their identity and eventually their work. The physician leaders also face additional challenges related to academics which include incorporation of new knowledge into the existing curriculum, use of technology in the delivery of teaching, the need to train medical students outside of hospital wards, etc. The study aims to explore how physician leaders in teaching hospitals of private medical schools enact their leadership roles and how they face the challenges as physician leaders. The study setting shall be teaching hospitals of three private medical schools situated in the National Capital Region, Philippines. A multiple case study design shall be adopted in this research. Physicians shall be eligible to participate in the study if they are practicing clinicians limited to the five major clinical specialty: Internal Medicine, Pediatrics, Family Medicine, Surgery, Obstetrics and Gynecology. They must be teaching in the College of Medicine prior to their appointments as physician leaders in both medical school and teaching hospital. Semi-structured face-to-face interviews shall be utilized as a means of data collection, with open-ended questions, enabling physician leaders to present narratives about their identity, role enactment, conflicts, reaction of colleagues, and the challenges encountered in their day-to-day work as physician leaders. Interviews shall be combined with observations and review of records to gain more insights into how the physician leaders are 'doing' management. Within-case analysis shall be done initially followed by a thematic analysis across the cases, referred to as cross–case analysis or cross-case synthesis.

Keywords: academic leaders, academic managers, physician leaders, physician managers

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4462 GSM Based Smart Patient Monitoring System

Authors: Ayman M. Mansour

Abstract:

In this paper, we propose an intelligent system that is used for monitoring the health conditions of Patients. Monitoring the health condition of Patients is a complex problem that involves different medical units and requires continuous monitoring especially in rural areas because of inadequate number of available specialized physicians. The proposed system will Improve patient care and drive costs down comparing to the existing system in Jordan. The proposed system will be the start point to Faster and improve the communication between different units in the health system in Jordan. Connecting patients and their physicians beyond hospital doors regarding their geographical area is an important issue in developing the health system in Jordan. The propose system will provide an intelligent system that will generate initial diagnosing to the patient case. This will assist and advice clinicians at the point of care. The decision is based on demographic data and laboratory test results of patient data. Using such system with the ability of making medical decisions, the quality of medical care in Jordan and specifically in Tafial is expected to be improved. This will provide more accurate, effective, and reliable diagnoses and treatments especially if the physicians have insufficient knowledge.

Keywords: GSM, SMS, patient, monitoring system, fuzzy logic, multi-agent system

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4461 Ill-Posed Inverse Problems in Molecular Imaging

Authors: Ranadhir Roy

Abstract:

Inverse problems arise in medical (molecular) imaging. These problems are characterized by large in three dimensions, and by the diffusion equation which models the physical phenomena within the media. The inverse problems are posed as a nonlinear optimization where the unknown parameters are found by minimizing the difference between the predicted data and the measured data. To obtain a unique and stable solution to an ill-posed inverse problem, a priori information must be used. Mathematical conditions to obtain stable solutions are established in Tikhonov’s regularization method, where the a priori information is introduced via a stabilizing functional, which may be designed to incorporate some relevant information of an inverse problem. Effective determination of the Tikhonov regularization parameter requires knowledge of the true solution, or in the case of optical imaging, the true image. Yet, in, clinically-based imaging, true image is not known. To alleviate these difficulties we have applied the penalty/modified barrier function (PMBF) method instead of Tikhonov regularization technique to make the inverse problems well-posed. Unlike the Tikhonov regularization method, the constrained optimization technique, which is based on simple bounds of the optical parameter properties of the tissue, can easily be implemented in the PMBF method. Imposing the constraints on the optical properties of the tissue explicitly restricts solution sets and can restore uniqueness. Like the Tikhonov regularization method, the PMBF method limits the size of the condition number of the Hessian matrix of the given objective function. The accuracy and the rapid convergence of the PMBF method require a good initial guess of the Lagrange multipliers. To obtain the initial guess of the multipliers, we use a least square unconstrained minimization problem. Three-dimensional images of fluorescence absorption coefficients and lifetimes were reconstructed from contact and noncontact experimentally measured data.

Keywords: constrained minimization, ill-conditioned inverse problems, Tikhonov regularization method, penalty modified barrier function method

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4460 Quality Assurances for an On-Board Imaging System of a Linear Accelerator: Five Months Data Analysis

Authors: Liyun Chang, Cheng-Hsiang Tsai

Abstract:

To ensure the radiation precisely delivering to the target of cancer patients, the linear accelerator equipped with the pretreatment on-board imaging system is introduced and through it the patient setup is verified before the daily treatment. New generation radiotherapy using beam-intensity modulation, usually associated the treatment with steep dose gradients, claimed to have achieved both a higher degree of dose conformation in the targets and a further reduction of toxicity in normal tissues. However, this benefit is counterproductive if the beam is delivered imprecisely. To avoid shooting critical organs or normal tissues rather than the target, it is very important to carry out the quality assurance (QA) of this on-board imaging system. The QA of the On-Board Imager® (OBI) system of one Varian Clinac-iX linear accelerator was performed through our procedures modified from a relevant report and AAPM TG142. Two image modalities, 2D radiography and 3D cone-beam computed tomography (CBCT), of the OBI system were examined. The daily and monthly QA was executed for five months in the categories of safety, geometrical accuracy and image quality. A marker phantom and a blade calibration plate were used for the QA of geometrical accuracy, while the Leeds phantom and Catphan 504 phantom were used in the QA of radiographic and CBCT image quality, respectively. The reference images were generated through a GE LightSpeed CT simulator with an ADAC Pinnacle treatment planning system. Finally, the image quality was analyzed via an OsiriX medical imaging system. For the geometrical accuracy test, the average deviations of the OBI isocenter in each direction are less than 0.6 mm with uncertainties less than 0.2 mm, while all the other items have the displacements less than 1 mm. For radiographic image quality, the spatial resolution is 1.6 lp/cm with contrasts less than 2.2%. The spatial resolution, low contrast, and HU homogenous of CBCT are larger than 6 lp/cm, less than 1% and within 20 HU, respectively. All tests are within the criteria, except the HU value of Teflon measured with the full fan mode exceeding the suggested value that could be due to itself high HU value and needed to be rechecked. The OBI system in our facility was then demonstrated to be reliable with stable image quality. The QA of OBI system is really necessary to achieve the best treatment for a patient.

Keywords: CBCT, image quality, quality assurance, OBI

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4459 Artemisia Species from Iran as Valuable Resources for Medicinal Uses

Authors: Mohammad Reza Naghavi, Farzad Alaeimoghadam, Hossein Ghafoori

Abstract:

Artemisia species, which are medically beneficial, are widespread in temperate regions of both Northern and Southern hemispheres among which Iran is located. About 35 species of Artemisia are indigenous in Iran among them some are widespread in all or most provinces, yet some are restricted to some specific regions. In this review paper, initially, GC-Mass results of some experiments done in different provinces of Iran are mentioned among them some compounds are common among species, some others are mostly restricted to other species; after that, medical advantages based on some researches on species of this genus are reviewed; different qualities such as anti-leishmania, anti-bacteria, antiviral as well as anti-proliferative could be mentioned.

Keywords: artemisia, GC-Mass analysis, medical advantage, antiviral

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4458 A Study on the Personality Traits of Students Who Have Chosen Medicine as Their Career

Authors: Khairani Omar, Shalinawati Ramli, Nurul Azmawati Mohamed, Zarini Ismail, Nur Syahrina Rahim, Nurul Hayati Chamhuri

Abstract:

Choosing a career which matches a student’s personality traits is one of the key factors for future work satisfaction. This is because career satisfaction is at the highest when it is in line with one’s personality strength, values and attitudes. Personality traits play a major role in determining the success of a student in the medical course. In the pre-clinical years, medical theories are being emphasized, thus, conscientious students would perform better than those with lower level of this trait. As the emphasis changes in the clinical years during which patient interaction is important, personality traits which involved interpersonal values become more essential for success. The aim of this study was to determine the personality traits of students who had chosen medicine as their career. It was a cross-sectional study conducted at the Islamic Science University of Malaysia. The respondents consisted of 81 students whose age ranged between 20-21 years old. A set of personality assessment inventory index which has been validated for the local context was used to determine the students’ personality traits. The instrument assessed 15 personality traits namely: aggressive, analytical, autonomy, creativity, extrovert, intellectual, motivation, diversity, resiliency, self-criticism, control, helpful, support, structured and achievement. The scores ranged between 1-100%, and they were categorized into low (1-30%), moderate (40-60%) and high scores (70-100%). The respondents were Year 3 pre-clinical medical students and there were more female students (69%) compared to male students (31%). Majority of them were from middle-income families. Approximately 70% of both parents of the respondents had tertiary education. Majority of the students had high scores in autonomy, creativity, diversity, helpful, structured and achievement. In other words, more than 50% of them scored high (70-100%) in these traits. Scoring high in these traits was beneficial for the medical course. For aggressive trait, 54% of them had moderate scores which is compatible for medicine as this indicated an inclination to being assertive. In the analytical and intellectual components, only 40% and 25% had high scores respectively. These results contradicted the usual expectation of medical students whereby they are expected to be highly analytical and intellectual. It would be an added value if the students had high scores in being extrovert as this reflects on good interpersonal values, however, the students had approximately similar scores in all categories of this trait. Being resilient in the medical school is important as the course is difficult and demanding. The students had good scores in this component in which 46% had high scores while 39% had moderate scores. In conclusion, by understanding their personality traits, strengths and weaknesses, the students will have an opportunity to improve themselves in the areas they lack. This will help them to become better doctors in future.

Keywords: career, medical students, medicine, personality traits

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4457 Automated Facial Symmetry Assessment for Orthognathic Surgery: Utilizing 3D Contour Mapping and Hyperdimensional Computing-Based Machine Learning

Authors: Wen-Chung Chiang, Lun-Jou Lo, Hsiu-Hsia Lin

Abstract:

This study aimed to improve the evaluation of facial symmetry, which is crucial for planning and assessing outcomes in orthognathic surgery (OGS). Facial symmetry plays a key role in both aesthetic and functional aspects of OGS, making its accurate evaluation essential for optimal surgical results. To address the limitations of traditional methods, a different approach was developed, combining three-dimensional (3D) facial contour mapping with hyperdimensional (HD) computing to enhance precision and efficiency in symmetry assessments. The study was conducted at Chang Gung Memorial Hospital, where data were collected from 2018 to 2023 using 3D cone beam computed tomography (CBCT), a highly detailed imaging technique. A large and comprehensive dataset was compiled, consisting of 150 normal individuals and 2,800 patients, totaling 5,750 preoperative and postoperative facial images. These data were critical for training a machine learning model designed to analyze and quantify facial symmetry. The machine learning model was trained to process 3D contour data from the CBCT images, with HD computing employed to power the facial symmetry quantification system. This combination of technologies allowed for an objective and detailed analysis of facial features, surpassing the accuracy and reliability of traditional symmetry assessments, which often rely on subjective visual evaluations by clinicians. In addition to developing the system, the researchers conducted a retrospective review of 3D CBCT data from 300 patients who had undergone OGS. The patients’ facial images were analyzed both before and after surgery to assess the clinical utility of the proposed system. The results showed that the facial symmetry algorithm achieved an overall accuracy of 82.5%, indicating its robustness in real-world clinical applications. Postoperative analysis revealed a significant improvement in facial symmetry, with an average score increase of 51%. The mean symmetry score rose from 2.53 preoperatively to 3.89 postoperatively, demonstrating the system's effectiveness in quantifying improvements after OGS. These results underscore the system's potential for providing valuable feedback to surgeons and aiding in the refinement of surgical techniques. The study also led to the development of a web-based system that automates facial symmetry assessment. This system integrates HD computing and 3D contour mapping into a user-friendly platform that allows for rapid and accurate evaluations. Clinicians can easily access this system to perform detailed symmetry assessments, making it a practical tool for clinical settings. Additionally, the system facilitates better communication between clinicians and patients by providing objective, easy-to-understand symmetry scores, which can help patients visualize the expected outcomes of their surgery. In conclusion, this study introduced a valuable and highly effective approach to facial symmetry evaluation in OGS, combining 3D contour mapping, HD computing, and machine learning. The resulting system achieved high accuracy and offers a streamlined, automated solution for clinical use. The development of the web-based platform further enhances its practicality, making it a valuable tool for improving surgical outcomes and patient satisfaction in orthognathic surgery.

Keywords: facial symmetry, orthognathic surgery, facial contour mapping, hyperdimensional computing

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4456 Landsat Data from Pre Crop Season to Estimate the Area to Be Planted with Summer Crops

Authors: Valdir Moura, Raniele dos Anjos de Souza, Fernando Gomes de Souza, Jose Vagner da Silva, Jerry Adriani Johann

Abstract:

The estimate of the Area of Land to be planted with annual crops and its stratification by the municipality are important variables in crop forecast. Nowadays in Brazil, these information’s are obtained by the Brazilian Institute of Geography and Statistics (IBGE) and published under the report Assessment of the Agricultural Production. Due to the high cloud cover in the main crop growing season (October to March) it is difficult to acquire good orbital images. Thus, one alternative is to work with remote sensing data from dates before the crop growing season. This work presents the use of multitemporal Landsat data gathered on July and September (before the summer growing season) in order to estimate the area of land to be planted with summer crops in an area of São Paulo State, Brazil. Geographic Information Systems (GIS) and digital image processing techniques were applied for the treatment of the available data. Supervised and non-supervised classifications were used for data in digital number and reflectance formats and the multitemporal Normalized Difference Vegetation Index (NDVI) images. The objective was to discriminate the tracts with higher probability to become planted with summer crops. Classification accuracies were evaluated using a sampling system developed basically for this study region. The estimated areas were corrected using the error matrix derived from these evaluations. The classification techniques presented an excellent level according to the kappa index. The proportion of crops stratified by municipalities was derived by a field work during the crop growing season. These proportion coefficients were applied onto the area of land to be planted with summer crops (derived from Landsat data). Thus, it was possible to derive the area of each summer crop by the municipality. The discrepancies between official statistics and our results were attributed to the sampling and the stratification procedures. Nevertheless, this methodology can be improved in order to provide good crop area estimates using remote sensing data, despite the cloud cover during the growing season.

Keywords: area intended for summer culture, estimated area planted, agriculture, Landsat, planting schedule

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4455 The Use of Modern Technologies and Computers in the Archaeological Surveys of Sistan in Eastern Iran

Authors: Mahyar MehrAfarin

Abstract:

The Sistan region in eastern Iran is a significant archaeological area in Iran and the Middle East, encompassing 10,000 square kilometers. Previous archeological field surveys have identified 1662 ancient sites dating from prehistoric periods to the Islamic period. Research Aim: This article aims to explore the utilization of modern technologies and computers in archaeological field surveys in Sistan, Iran, and the benefits derived from their implementation. Methodology: The research employs a descriptive-analytical approach combined with field methods. New technologies and software, such as GPS, drones, magnetometers, equipped cameras, satellite images, and software programs like GIS, Map source, and Excel, were utilized to collect information and analyze data. Findings: The use of modern technologies and computers in archaeological field surveys proved to be essential. Traditional archaeological activities, such as excavation and field surveys, are time-consuming and costly. Employing modern technologies helps in preserving ancient sites, accurately recording archaeological data, reducing errors and mistakes, and facilitating correct and accurate analysis. Creating a comprehensive and accessible database, generating statistics, and producing graphic designs and diagrams are additional advantages derived from the use of efficient technologies in archaeology. Theoretical Importance: The integration of computers and modern technologies in archaeology contributes to interdisciplinary collaborations and facilitates the involvement of specialists from various fields, such as geography, history, art history, anthropology, laboratory sciences, and computer engineering. The utilization of computers in archaeology spanned across diverse areas, including database creation, statistical analysis, graphics implementation, laboratory and engineering applications, and even artificial intelligence, which remains an unexplored area in Iranian archaeology. Data Collection and Analysis Procedures: Information was collected using modern technologies and software, capturing geographic coordinates, aerial images, archeogeophysical data, and satellite images. This data was then inputted into various software programs for analysis, including GIS, Map source, and Excel. The research employed both descriptive and analytical methods to present findings effectively. Question Addressed: The primary question addressed in this research is how the use of modern technologies and computers in archeological field surveys in Sistan, Iran, can enhance archaeological data collection, preservation, analysis, and accessibility. Conclusion: The utilization of modern technologies and computers in archaeological field surveys in Sistan, Iran, has proven to be necessary and beneficial. These technologies aid in preserving ancient sites, accurately recording archaeological data, reducing errors, and facilitating comprehensive analysis. The creation of accessible databases, statistics generation, graphic designs, and interdisciplinary collaborations are further advantages observed. It is recommended to explore the potential of artificial intelligence in Iranian archaeology as an unexplored area. The research has implications for cultural heritage organizations, archaeology students, and universities involved in archaeological field surveys in Sistan and Baluchistan province. Additionally, it contributes to enhancing the understanding and preservation of Iran's archaeological heritage.

Keywords: Iran, sistan, archaeological surveys, computer use, modern technologies

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4454 Improvements in OpenCV's Viola Jones Algorithm in Face Detection–Skin Detection

Authors: Jyoti Bharti, M. K. Gupta, Astha Jain

Abstract:

This paper proposes a new improved approach for false positives filtering of detected face images on OpenCV’s Viola Jones Algorithm In this approach, for Filtering of False Positives, Skin Detection in two colour spaces i.e. HSV (Hue, Saturation and Value) and YCrCb (Y is luma component and Cr- red difference, Cb- Blue difference) is used. As a result, it is found that false detection has been reduced. Our proposed method reaches the accuracy of about 98.7%. Thus, a better recognition rate is achieved.

Keywords: face detection, Viola Jones, false positives, OpenCV

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4453 Bulk Amounts of Linear and Cyclic Polypeptides on Our Hand within a Short Time

Authors: Yu Zhang, Il Kim

Abstract:

Polypeptides with defined peptide sequences illustrate the power of remarkable applications in drug delivery, tissue engineering, sensing and catalysis. Especially the cyclic polypeptides, the distinctive topological architecture imparts many characteristic properties comparing to linear polypeptides. Here, a facile and highly efficient strategy for the synthesis of linear and cyclic polypeptides is reported using N-heterocyclic carbenes (NHCs)-mediated ring-opening polymerization (ROP) of α-amino acid N-carboxyanhydrides (NCA) in the presence or absence of primary amine initiator. The polymerization proceeds rapidly in a quasi-living manner, allowing access to linear and cyclic polypeptides of well-defined chain length and narrow polydispersity, as evidenced by nuclear magnetic resonance spectrum (1H NMR and 13C NMR spectra) and size exclusion chromatography (SEC) analysis. The cyclic architecture of the polypeptides was further verified by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectra (MALDI-TOF MS) and electrospray ionization (ESI) mass spectra, as well as viscosity studies. This approach can also simplify workup procedures and make bulk scale synthesis possible, which thereby opens avenues for practical uses in diverse areas, opening up the new generation of polypeptide synthesis.

Keywords: α-amino acid N-carboxyanhydrides, living polymerization, polypeptides, N-heterocyclic carbenes, ring-opening polymerization

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4452 Analyses of Defects in Flexible Silicon Photovoltaic Modules via Thermal Imaging and Electroluminescence

Authors: S. Maleczek, K. Drabczyk, L. Bogdan, A. Iwan

Abstract:

It is known that for industrial applications using solar panel constructed from silicon solar cells require high-efficiency performance. One of the main problems in solar panels is different mechanical and structural defects, causing the decrease of generated power. To analyse defects in solar cells, various techniques are used. However, the thermal imaging is fast and simple method for locating defects. The main goal of this work was to analyze defects in constructed flexible silicon photovoltaic modules via thermal imaging and electroluminescence method. This work is realized for the GEKON project (No. GEKON2/O4/268473/23/2016) sponsored by The National Centre for Research and Development and The National Fund for Environmental Protection and Water Management. Thermal behavior was observed using thermographic camera (VIGOcam v50, VIGO System S.A, Poland) using a DC conventional source. Electroluminescence was observed by Steinbeis Center Photovoltaics (Stuttgart, Germany) equipped with a camera, in which there is a Si-CCD, 16 Mpix detector Kodak KAF-16803type. The camera has a typical spectral response in the range 350 - 1100 nm with a maximum QE of 60 % at 550 nm. In our work commercial silicon solar cells with the size 156 × 156 mm were cut for nine parts (called single solar cells) and used to create photovoltaic modules with the size of 160 × 70 cm (containing about 80 single solar cells). Flexible silicon photovoltaic modules on polyamides or polyester fabric were constructed and investigated taking into consideration anomalies on the surface of modules. Thermal imaging provided evidence of visible voltage-activated conduction. In electro-luminescence images, two regions are noticeable: darker, where solar cell is inactive and brighter corresponding with correctly working photovoltaic cells. The electroluminescence method is non-destructive and gives greater resolution of images thereby allowing a more precise evaluation of microcracks of solar cell after lamination process. Our study showed good correlations between defects observed by thermal imaging and electroluminescence. Finally, we can conclude that the thermographic examination of large scale photovoltaic modules allows us the fast, simple and inexpensive localization of defects at the single solar cells and modules. Moreover, thermographic camera was also useful to detection electrical interconnection between single solar cells.

Keywords: electro-luminescence, flexible devices, silicon solar cells, thermal imaging

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4451 The Effect of Gamma rays on Physicochemical Properties of Carboxymethyl Starch

Authors: N. Rajeswara Rao, T. Venkatappa Rao, K. Sowri Babu, N. Srinivas Rao, P. S. V. Shanmukhi

Abstract:

Carboxymethyl Starch (CMS) is a biopolymer derived from starch by the substitution method. CMS is proclaimed to have improved physicochemical properties than native starch. The present work deals with the effect of gamma radiation on the physicochemical properties of CMS. The samples were exposed to gamma irradiation of doses 30, 60 and 90 kGy. The resultant properties were studied with electron spin resonance (ESR), fourier transform infrared spectrometer (FTIR), differential scanning calorimeter (DSC), X-ray diffractometer (XRD) and scanning electron microscopy. Irradiation of CMS by gamma rays initiates cleavage of glucosidic bonds producing different types of radicals. Some of these radicals convert to peroxy radicals by abstracting oxygen. The ESR spectrum of CMS is anisotropic and is thought to be due to the superposition of various component spectra. In order to analyze the ESR spectrum, computer simulations were also employed. ESR spectra are also recorded under different conditions like post-irradiation times, variable temperatures and saturation behavior in order to evaluate the stability of free radicals produced on irradiation. Thermal studies from DSC depict that for CMS the gelatization process was absconded at higher doses. Relative crystallinity was reduced significantly after irradiation from XRD Studies. FTIR studies also confirm the same aspect. From ESR studies, it was concluded that irradiated CMS could be a potential reference material in ESR dosimetry.

Keywords: gamma rays, free radicals, ESR simulations, gelatization

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4450 An Overview of the Porosity Classification in Carbonate Reservoirs and Their Challenges: An Example of Macro-Microporosity Classification from Offshore Miocene Carbonate in Central Luconia, Malaysia

Authors: Hammad T. Janjuhah, Josep Sanjuan, Mohamed K. Salah

Abstract:

Biological and chemical activities in carbonates are responsible for the complexity of the pore system. Primary porosity is generally of natural origin while secondary porosity is subject to chemical reactivity through diagenetic processes. To understand the integrated part of hydrocarbon exploration, it is necessary to understand the carbonate pore system. However, the current porosity classification scheme is limited to adequately predict the petrophysical properties of different reservoirs having various origins and depositional environments. Rock classification provides a descriptive method for explaining the lithofacies but makes no significant contribution to the application of porosity and permeability (poro-perm) correlation. The Central Luconia carbonate system (Malaysia) represents a good example of pore complexity (in terms of nature and origin) mainly related to diagenetic processes which have altered the original reservoir. For quantitative analysis, 32 high-resolution images of each thin section were taken using transmitted light microscopy. The quantification of grains, matrix, cement, and macroporosity (pore types) was achieved using a petrographic analysis of thin sections and FESEM images. The point counting technique was used to estimate the amount of macroporosity from thin section, which was then subtracted from the total porosity to derive the microporosity. The quantitative observation of thin sections revealed that the mouldic porosity (macroporosity) is the dominant porosity type present, whereas the microporosity seems to correspond to a sum of 40 to 50% of the total porosity. It has been proven that these Miocene carbonates contain a significant amount of microporosity, which significantly complicates the estimation and production of hydrocarbons. Neglecting its impact can increase uncertainty about estimating hydrocarbon reserves. Due to the diversity of geological parameters, the application of existing porosity classifications does not allow a better understanding of the poro-perm relationship. However, the classification can be improved by including the pore types and pore structures where they can be divided into macro- and microporosity. Such studies of microporosity identification/classification represent now a major concern in limestone reservoirs around the world.

Keywords: overview of porosity classification, reservoir characterization, microporosity, carbonate reservoir

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4449 The Trend of Epidemics in Population and Body Regulation in Iran (1850-1920)

Authors: Seyedfateh Moradi

Abstract:

Medical issues mark the beginning of a new form of epistemology in nineteenth-century Iran. The emergence of epidemic diseases led to the formation of a medical discourse and conflict over the body which displayed itself in the concept of health progress and development. The discourse attributed to this development in the health system defines the general structure of the given period. This discourse manifested itself in the conflict between the traditional and new medicine. The regulation and classification of body and population reveal the nature of this period. The government attempted to adapt itself to the modern and progressive discourse. This paper seeks to reveal part of this rupture and adaptation around epidemics and modern medical discourse. Also, accepting part of the traditional discourse in the new era, or adapting and integrating parts of it indicate a delegation of part of the power of traditional authorities. The delegation of power arose in the context of the discursive hegemony of Western modernism from which there was no escape. This provided the ground for the acceptance of government and emergence of other discourses. Finally, during the reign of Reza Shah (1922-1942), body and population planning changed into the key issues of government, which created serious tensions in society.

Keywords: epidemic, population, body, cholera, plague

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4448 Adversarial Attacks and Defenses on Deep Neural Networks

Authors: Jonathan Sohn

Abstract:

Deep neural networks (DNNs) have shown state-of-the-art performance for many applications, including computer vision, natural language processing, and speech recognition. Recently, adversarial attacks have been studied in the context of deep neural networks, which aim to alter the results of deep neural networks by modifying the inputs slightly. For example, an adversarial attack on a DNN used for object detection can cause the DNN to miss certain objects. As a result, the reliability of DNNs is undermined by their lack of robustness against adversarial attacks, raising concerns about their use in safety-critical applications such as autonomous driving. In this paper, we focus on studying the adversarial attacks and defenses on DNNs for image classification. There are two types of adversarial attacks studied which are fast gradient sign method (FGSM) attack and projected gradient descent (PGD) attack. A DNN forms decision boundaries that separate the input images into different categories. The adversarial attack slightly alters the image to move over the decision boundary, causing the DNN to misclassify the image. FGSM attack obtains the gradient with respect to the image and updates the image once based on the gradients to cross the decision boundary. PGD attack, instead of taking one big step, repeatedly modifies the input image with multiple small steps. There is also another type of attack called the target attack. This adversarial attack is designed to make the machine classify an image to a class chosen by the attacker. We can defend against adversarial attacks by incorporating adversarial examples in training. Specifically, instead of training the neural network with clean examples, we can explicitly let the neural network learn from the adversarial examples. In our experiments, the digit recognition accuracy on the MNIST dataset drops from 97.81% to 39.50% and 34.01% when the DNN is attacked by FGSM and PGD attacks, respectively. If we utilize FGSM training as a defense method, the classification accuracy greatly improves from 39.50% to 92.31% for FGSM attacks and from 34.01% to 75.63% for PGD attacks. To further improve the classification accuracy under adversarial attacks, we can also use a stronger PGD training method. PGD training improves the accuracy by 2.7% under FGSM attacks and 18.4% under PGD attacks over FGSM training. It is worth mentioning that both FGSM and PGD training do not affect the accuracy of clean images. In summary, we find that PGD attacks can greatly degrade the performance of DNNs, and PGD training is a very effective way to defend against such attacks. PGD attacks and defence are overall significantly more effective than FGSM methods.

Keywords: deep neural network, adversarial attack, adversarial defense, adversarial machine learning

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4447 Knowledge, Attitude and Practices Regarding Advance Directives among Resident Physicians in Vicente Sotto Memorial Medical Center

Authors: Marica Pidor-Quingco, Francis Cabatingan

Abstract:

Background: One of the essential roles of a physician is to assess a patient’s worth and support them in making decisions regarding their future preferences when it comes to medical care. Advance Directives is a patient-centered approach which is liked to a better-quality treatment at the end of life. General Objective: To assess and describe the knowledge, attitudes and practices of resident physicians regarding advance directive among the resident physicians in Vicente Sotto Memorial Medical Study. Methods: An analytical cross-sectional study was conducted at Vicente Sotto Memorial Medical Center. There was a total of 129 respondents who gave their consent and was given survey questionnaire containing the demographic profile, knowledge, attitude and practices. Categorical variables were presented as frequency and percentage. Chi Square Test was used to determine the association of demographic profile with knowledge and attitude. Man-Whitney U test was utilized for the association of age with knowledge and attitude. Results: Out of 129 respondents, 36.59% were in favor towards self-determination and autonomy. Majority of the revealed an adequate knowledge and positive attitude regarding advance directives. Based on the results, there were no significant correlations between sociodemographic of the residents towards to knowledge and attitude. Over 66.7% of the respondents had used Advance Directives to their patients but 25% were not comfortable about it. Though most of the respondents was able to discuss AD with their patients, 7.0% of them are not willing to open the topic to the family. Conclusion: VSMMC is a tertiary hospital which also caters Hospice, Palliative and Supportive care to the patients. One of the services offered is initiating Advance Directives which may be a factor for a positive knowledge, attitude and practices towards this topic.

Keywords: advance directives, philippines, physicians, palliative

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4446 Cartography through Picasso’s Eyes

Authors: Desiree Di Marco

Abstract:

The aim of this work is to show through the lens of art first which kind of reality was the one represented through fascist maps, and second to study the impact of the fascist regime’s cartography (FRC) on observers eye’s. In this study, it is assumed that the FRC’s representation of reality was simplified, timeless, and even a-spatial because it underrates the concept of territoriality. Cubism and Picasso’s paintings will be used as counter-examples to mystify fascist cartography’s ideological assumptions. The difference between the gaze of an observer looking at the surface of a fascist map and the gaze of someone observing a Picasso painting is impressive. Because there is always something dark, hidden, behind and inside a map, the world of fascist maps was a world built starting from the observation of a “window” that distorted reality and trapped the eyes of the observers. Moving across the map, they seem as if they were hypnotized. Cartohypnosis is the state in which the observer finds himself enslaved by the attractive force of the map, which uses a sort of “magic” geography, a geography that, by means of symbolic language, never has as its primary objective the attempt to show us reality in its complexity, but that of performing for its audience. Magical geography and hypnotic cartography in fascism blended together, creating an almost mystical, magical relationship that demystified reality to reduce the world to a conquerable space. This reduction offered the observer the possibility of conceiving new dimensions: of the limit, of the boundary, elements with which the subject felt fully involved and in which the aesthetic force of the images demonstrated all its strength. But in the early 20th century, the combination of art and cartography gave rise to new possibilities. Cubism which, more than all the other artistic currents showed us how much the observation of reality from a single point of view falls within dangerous logic, is an example. Cubism was an artistic movement that brought about a profound transformation in pictorial culture. It was not only a revolution of pictorial space, but it was a revolution of our conception of pictorial space. Up until that time, men and women were more inclined to believe in the power of images and their representations. Cubist painters rebelled against this blindness by claiming that art must always offer an alternative. Indeed the contribution of this work is precisely to show how art can be able to provide alternatives to even the most horrible regimes and the most atrocious human misfortunes. It also enriches the field of cartography because it "reassures" it by showing how much good it can be for cartography if also for other disciplines come close. Only in this way researcher can increase the chances for the cartography of a greater diffusion at the academic level.

Keywords: cartography, Picasso, fascism, culture

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4445 Restless Leg Syndrome as the Presenting Symptom of Neuroendocrine Tumor

Authors: Mustafa Cam, Nedim Ongun, Ufuk Kutluana

Abstract:

Introduction: Restless LegsSyndrome (RLS) is a common, under-recognized disorder disrupts sleep and diminishes quality of life (1). The most common conditions highly associated with RLS include renalfailure, iron and folic acid deficiency, peripheral neuropathy, pregnancy, celiacdisease, Crohn’sdiseaseandrarelymalignancy (2).Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficientanemic populations is unknown (2). We report here a case of RLS due to iron deficiency in the setting of neuroendocrinetumor. Report of Case: A 35 year-old man was referred to our clinic with general weakness, weight loss (10 kg in 2 months)and 2-month history of uncomfortable sensations in his legs with urge to move, partially relieved by movement. The symptoms were presented very day, worsening in the evening; the discomfort forced the patient to getup and walk around at night. RLS was severe, with a score of 22 at the International RLS ratingscale. The patient had no past medical history. The patient underwent a complete set of blood analyses and the following ab normal values were found (normal limitswithinbrackets): hemoglobin 9.9 g/dl (14-18), MCV 70 fL (80-94), ferritin 3,5 ng/mL (13-150). Brain and spinemagnetic resonance imaging was normal. The patient consultated with gastroenterology clinic and gastointestinal systemendoscopy was performed for theetiology of the iron deficiency anemia. After the gastricbiopsy, results allowed us to reach the diagnosis of neuroen docrine tumor and the patient referred to oncology clinic. Discussion: The first important consideration from this case report is that the patient was referred to our clinic because of his severe RLS symptoms dramatically reducing his quality of life. However, our clinical study clearly demonstrated that RLS was not the primary disease. Considering the information available for this patient, we believe that the most likely possibility is that RLS was secondary to iron deficiency, a very well-known and established cause of RLS in theliterature (3,4). Neuroendocrine tumors (NETs) are rare epithelial neoplasms with neuroendocrine differentiation that most commonly originate in the lungs and gastrointestinal tract (5). NETs vary widely in their clinical presentation; symptoms are often nonspecific and can be mistaken for those of other more common conditions (6). 50% of patients with reported disease stage have either regional or distant metastases at diagnosis (7). Accurate and earlier NET diagnosis is the first step in shortening the time to optimal care and improved outcomes for patients (8). The most important message from this case report is that RLS symptoms can sometimes be thesign of a life-threatening condition. Conclusion: Careful and complete collection of clinical and laboratory data should be carried out in RLS patients. Inparticular, if RLS onset coincides with weight loss and iron deficieny anemia, gastricendos copy should be performed. It is known about that malignancy is a rare etiology in RLS patients and to our knowledge; it is the first case with neuro endocrine tumor presenting with RLS.

Keywords: neurology, neuroendocrine tumor, restless legs syndrome, sleep

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