Search results for: clinical characteristic
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5035

Search results for: clinical characteristic

3025 The Role of Personality Characteristics and Psychological Harassment Behaviors Which Employees Are Exposed on Work Alienation

Authors: Hasan Serdar Öge, Esra Çiftçi, Kazım Karaboğa

Abstract:

The main purpose of the research is to address the role of psychological harassment behaviors (mobbing) to which employees are exposed and personality characteristics over work alienation. Research population was composed of the employees of Provincial Special Administration. A survey with four sections was created to measure variables and reach out the basic goals of the research. Correlation and step-wise regression analyses were performed to investigate the separate and overall effects of sub-dimensions of psychological harassment behaviors and personality characteristic on work alienation of employees. Correlation analysis revealed significant but weak relationships between work alienation and psychological harassment and personality characteristics. Step-wise regression analysis revealed also significant relationships between work alienation variable and assault to personality, direct negative behaviors (sub dimensions of mobbing) and openness (sub-dimension of personality characteristics). Each variable was introduced into the model step by step to investigate the effects of significant variables in explaining the variations in work alienation. While the explanation ratio of the first model was 13%, the last model including three variables had an explanation ratio of 24%.

Keywords: alienation, five-factor personality characteristics, mobbing, psychological harassment, work alienation

Procedia PDF Downloads 409
3024 The Comparison of pH Saliva before and after Brushing Teeth Using Tooth Paste Containing Betel Leaf Extracts

Authors: Ika Anisyah, Nety Trisnawaty

Abstract:

Mechanical brushing can help control plaque and is the first step to control dental caries. The type of toothpaste used is one of the contributing factors in it since the benefits of toothpaste are to reduce plaque formation and strengthen the teeth against dental caries, clean and polish tooth surfaces, eliminate or reduce bad breath, give a fresh taste to the mouth and maintain gingival health. Betel leaf toothpaste has the ability to inhibit the Streptococcus mutans bacteria that can cause the increase of pH saliva. Betel leaf extracts can increase the pH saliva because betel leaf has an anti bacterial characteristic against Streptococcus mutans so that pH saliva increases. This study aims to see the difference between pH saliva before and after brushing teeth with toothpaste containing betel leaf extracts. This type of research is pre-experimental using One Group Pretest-Posttest Design. This study was conducted on 32 subjects taken randomly from the representatives of students aged 11-12 years old in SD Pesanggrahan 03. The result of statistic test using non parametric test showed a value of 0.000. The resulted value being smaller than 0.05 (p < 0.05) means there is a significant salivary pH difference before and after teeth brushing using toothpaste containing betel leaf. The conclusion of this study showed an increase in salivary pH after teeth brushing with toothpaste containing betel leaves extracts in children aged 11-12 years old.

Keywords: pH saliva, brushing teeth, tooth paste, betel leaves extracts

Procedia PDF Downloads 128
3023 Computational Prediction of the Effect of S477N Mutation on the RBD Binding Affinity and Structural Characteristic, A Molecular Dynamics Study

Authors: Mohammad Hossein Modarressi, Mozhgan Mondeali, Khabat Barkhordari, Ali Etemadi

Abstract:

The COVID-19 pandemic, caused by SARS-CoV-2, has led to significant concerns worldwide due to its catastrophic effects on public health. The SARS-CoV-2 infection is initiated with the binding of the receptor-binding domain (RBD) in its spike protein to the ACE2 receptor in the host cell membrane. Due to the error-prone entity of the viral RNA-dependent polymerase complex, the virus genome, including the coding region for the RBD, acquires new mutations, leading to the appearance of multiple variants. These variants can potentially impact transmission, virulence, antigenicity and evasive immune properties. S477N mutation located in the RBD has been observed in the SARS-CoV-2 omicron (B.1.1. 529) variant. In this study, we investigated the consequences of S477N mutation at the molecular level using computational approaches such as molecular dynamics simulation, protein-protein interaction analysis, immunoinformatics and free energy computation. We showed that displacement of Ser with Asn increases the stability of the spike protein and its affinity to ACE2 and thus increases the transmission potential of the virus. This mutation changes the folding and secondary structure of the spike protein. Also, it reduces antibody neutralization, raising concern about re-infection, vaccine breakthrough and therapeutic values.

Keywords: S477N, COVID-19, molecular dynamic, SARS-COV2 mutations

Procedia PDF Downloads 179
3022 Evaluation of the Cities Specific Characteristics in the Formation of the Safavid Period Mints

Authors: Mahmood Seyyed, Akram Salehi Heykoei, Hamidreza Safakish Kashani

Abstract:

Among the remaining resource of the past, coins considered as an authentic documents among the most important documentary sources. The coins were minted in a place that called mint. The number and position of the mints in each period reflects the amount of economic power, political security and business growth, which was always fluctuated its position with changing the political and economic condition. Considering that, trade has more growth during the Safavid period than previous ones, the mint also has been in greater importance. It seems the one hand, the growth of economic in Safavid period has a direct link with the number and places of the mints at that time and in the other hand, the mints have been formed in some places because of the specific characteristic of cities and regions. Increasing the number of mints in the north of the country due to the growth of silk trade and in the west and northwest due to the political and commercial relation with Ottoman Empire, also the characteristics such as existence of mines, located in the Silk Road and communication ways, all are the results of this investigation. Accordingly, in this article researcher tries to examine the characteristics that give priority to a city for having mint. With considering that in the various historical periods, the mints were based in the most important cities in terms of political and social, at that time, this article examines the cities specific characteristics in the formation of the mints in Safavid period.

Keywords: documentary sources, coins, mint, city, Safavid

Procedia PDF Downloads 269
3021 Extraction of Compound Words in Malay Sentences Using Linguistic and Statistical Approaches

Authors: Zamri Abu Bakar Zamri, Normaly Kamal Ismail Normaly, Mohd Izani Mohamed Rawi Izani

Abstract:

Malay noun compound are phrases that consist of two or more nouns. The key characteristic behind noun compounds lies on its frequent occurrences within the text. Therefore, extracting these noun compounds is essential for several domains of research such as Information Retrieval, Sentiment Analysis and Question Answering. Many research efforts have been proposed in terms of extracting Malay noun compounds using linguistic and statistical approaches. Most of the existing methods have concentrated on the extraction of bi-gram noun+noun compound. However, extracting noun+verb, noun+adjective and noun+prepositional is challenging due to the difficulty of selecting an appropriate method with effective results. Thus, there is still room for improvement in terms of enhancing the effectiveness of compound word extraction. Therefore, this study proposed a combination of linguistic approach and statistical measures in order to enhance the extraction of compound words. Several preprocessing steps are involved including normalization, tokenization, and stemming. The linguistic approach that has been used in this study is Part-of-Speech (POS) tagging. In addition, a new linguistic pattern for named entities has been utilized using a list of Malays named entities in order to enhance the linguistic approach in terms of noun compound recognition. The proposed statistical measures consists of NC-value, NTC-value and NLC value.

Keywords: Compound Word, Noun Compound, Linguistic Approach, Statistical Approach

Procedia PDF Downloads 351
3020 Links between Inflammation and Insulin Resistance in Children with Morbid Obesity and Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is a clinical state associated with low-grade inflammation. It is also a major risk factor for insulin resistance (IR). In its advanced stages, metabolic syndrome (MetS), a much more complicated disease which may lead to life-threatening problems, may develop. Obesity-mediated IR seems to correlate with the inflammation. Human studies performed particularly on pediatric population are scarce. The aim of this study is to detect possible associations between inflammation and IR in terms of some related ratios. 549 children were grouped according to their age- and sex-based body mass index (BMI) percentile tables of WHO. MetS components were determined. Informed consent and approval from the Ethics Committee for Clinical Investigations were obtained. The principles of the Declaration of Helsinki were followed. The exclusion criteria were infection, inflammation, chronic diseases and those under drug treatment. Anthropometric measurements were obtained. Complete blood cell, fasting blood glucose, insulin, and C-reactive protein (CRP) analyses were performed. Homeostasis model assessment of insulin resistance (HOMA-IR), systemic immune inflammation (SII) index, tense index, alanine aminotransferase to aspartate aminotransferase ratio (ALT/AST), neutrophils to lymphocyte (NLR), platelet to lymphocyte, and lymphocyte to monocyte ratios were calculated. Data were evaluated by statistical analyses. The degree for statistical significance was 0.05. Statistically significant differences were found among the BMI values of the groups (p < 0.001). Strong correlations were detected between the BMI and waist circumference (WC) values in all groups. Tense index values were also correlated with both BMI and WC values in all groups except overweight (OW) children. SII index values of children with normal BMI were significantly different from the values obtained in OW, obese, morbid obese and MetS groups. Among all the other lymphocyte ratios, NLR exhibited a similar profile. Both HOMA-IR and ALT/AST values displayed an increasing profile from N towards MetS3 group. BMI and WC values were correlated with HOMA-IR and ALT/AST. Both in morbid obese and MetS groups, significant correlations between CRP versus SII index as well as HOMA-IR versus ALT/AST were found. ALT/AST and HOMA-IR values were correlated with NLR in morbid obese group and with SII index in MetS group, (p < 0.05), respectively. In conclusion, these findings showed that some parameters may exhibit informative differences between the early and late stages of obesity. Important associations among HOMA-IR, ALT/AST, NLR and SII index have come to light in the morbid obese and MetS groups. This study introduced the SII index and NLR as important inflammatory markers for the discrimination of normal and obese children. Interesting links were observed between inflammation and IR in morbid obese children and those with MetS, both being late stages of obesity.

Keywords: children, inflammation, insulin resistance, metabolic syndrome, obesity

Procedia PDF Downloads 138
3019 Genetic Divergence and Morphogenic Analysis of Sugarcane Red Rot Pathogen Colletotrichum falcatum under South Gujarat Condition

Authors: Prittesh Patel, Ramar Krishnamurthy

Abstract:

In the present study, nine strains of C. falcatum obtained from different places and cultivars were characterized for sporulation, growth rate, and 18S rRNA gene sequence. All isolates had characteristic fast-growing sparse and fleecy aerial mycelia on potato dextrose agar with sickle shape conidia (length x width: varied from 20.0 X 3.89 to 25.52 X 5.34 μm) and blackish to orange acervuli with setae (length x width: varied from 112.37X 2.78 to 167.66 X 6.73 μm). They could be divided into two groups on the base of morphology; P1, dense mycelia with concentric growth and P2, sparse mycelia with uneven growth. Genomic DNA isolation followed by PCR amplification with ITS1 and ITS4 primer produced ~550bp amplicons for all isolates. Phylogeny generated by 18S rRNA gene sequence confirmed the variation in isolates and mainly grouped into two clusters; cluster 1 contained CoC671 isolates (cfNAV and cfPAR) and Co86002 isolate (cfTIM). Other isolates cfMAD, cfKAM, and cfMAR were grouped into cluster 2. Remaining isolates did not fall into any cluster. Isolate cfGAN, collected from Co86032 was found highly diverse of all the nine isolates. In a nutshell, we found considerable genetic divergence and morphological variation within C. falcatum accessions collected from different areas of south Gujarat, India and these can be used for the breeding program.

Keywords: Colletotrichum falcatum, ITS, morphology, red rot, sugarcane

Procedia PDF Downloads 130
3018 Correlation between Speech Emotion Recognition Deep Learning Models and Noises

Authors: Leah Lee

Abstract:

This paper examines the correlation between deep learning models and emotions with noises to see whether or not noises mask emotions. The deep learning models used are plain convolutional neural networks (CNN), auto-encoder, long short-term memory (LSTM), and Visual Geometry Group-16 (VGG-16). Emotion datasets used are Ryerson Audio-Visual Database of Emotional Speech and Song (RAVDESS), Crowd-sourced Emotional Multimodal Actors Dataset (CREMA-D), Toronto Emotional Speech Set (TESS), and Surrey Audio-Visual Expressed Emotion (SAVEE). To make it four times bigger, audio set files, stretch, and pitch augmentations are utilized. From the augmented datasets, five different features are extracted for inputs of the models. There are eight different emotions to be classified. Noise variations are white noise, dog barking, and cough sounds. The variation in the signal-to-noise ratio (SNR) is 0, 20, and 40. In summation, per a deep learning model, nine different sets with noise and SNR variations and just augmented audio files without any noises will be used in the experiment. To compare the results of the deep learning models, the accuracy and receiver operating characteristic (ROC) are checked.

Keywords: auto-encoder, convolutional neural networks, long short-term memory, speech emotion recognition, visual geometry group-16

Procedia PDF Downloads 80
3017 Covid Medical Imaging Trial: Utilising Artificial Intelligence to Identify Changes on Chest X-Ray of COVID

Authors: Leonard Tiong, Sonit Singh, Kevin Ho Shon, Sarah Lewis

Abstract:

Investigation into the use of artificial intelligence in radiology continues to develop at a rapid rate. During the coronavirus pandemic, the combination of an exponential increase in chest x-rays and unpredictable staff shortages resulted in a huge strain on the department's workload. There is a World Health Organisation estimate that two-thirds of the global population does not have access to diagnostic radiology. Therefore, there could be demand for a program that could detect acute changes in imaging compatible with infection to assist with screening. We generated a conventional neural network and tested its efficacy in recognizing changes compatible with coronavirus infection. Following ethics approval, a deidentified set of 77 normal and 77 abnormal chest x-rays in patients with confirmed coronavirus infection were used to generate an algorithm that could train, validate and then test itself. DICOM and PNG image formats were selected due to their lossless file format. The model was trained with 100 images (50 positive, 50 negative), validated against 28 samples (14 positive, 14 negative), and tested against 26 samples (13 positive, 13 negative). The initial training of the model involved training a conventional neural network in what constituted a normal study and changes on the x-rays compatible with coronavirus infection. The weightings were then modified, and the model was executed again. The training samples were in batch sizes of 8 and underwent 25 epochs of training. The results trended towards an 85.71% true positive/true negative detection rate and an area under the curve trending towards 0.95, indicating approximately 95% accuracy in detecting changes on chest X-rays compatible with coronavirus infection. Study limitations include access to only a small dataset and no specificity in the diagnosis. Following a discussion with our programmer, there are areas where modifications in the weighting of the algorithm can be made in order to improve the detection rates. Given the high detection rate of the program, and the potential ease of implementation, this would be effective in assisting staff that is not trained in radiology in detecting otherwise subtle changes that might not be appreciated on imaging. Limitations include the lack of a differential diagnosis and application of the appropriate clinical history, although this may be less of a problem in day-to-day clinical practice. It is nonetheless our belief that implementing this program and widening its scope to detecting multiple pathologies such as lung masses will greatly assist both the radiology department and our colleagues in increasing workflow and detection rate.

Keywords: artificial intelligence, COVID, neural network, machine learning

Procedia PDF Downloads 97
3016 The Use of Video Conferencing to Aid the Decision in Whether Vulnerable Patients Should Attend In-Person Appointments during a COVID Pandemic

Authors: Nadia Arikat, Katharine Blain

Abstract:

During the worst of the COVID pandemic, only essential treatment was provided for patients needing urgent care. With the prolonged extent of the pandemic, there has been a return to more routine referrals for paediatric dentistry advice and treatment for specialist conditions. However, some of these patients and/or their carers may have significant medical issues meaning that attending in-person appointments carries additional risks. This poses an ethical dilemma for clinicians. This project looks at how a secure video conferencing platform (“Near Me”) has been used to assess the need and urgency for in-person new patient visits, particularly for patients and families with additional risks. “Near Me” is a secure online video consulting service used by NHS Scotland. In deciding whether to bring a new patient to the hospital for an appointment, the clinical condition of the teeth together with the urgency for treatment need to be assessed. This is not always apparent from the referral letter. In addition, it is important to judge the risks to the patients and carers of such visits, particularly if they have medical issues. The use and effectiveness of “Near Me” consultations to help decide whether vulnerable paediatric patients should have in-person appointments will be illustrated and discussed using two families: one where the child is medically compromised (Alagille syndrome with previous liver transplant), and the other where there is a medically compromised parent (undergoing chemotherapy and a bone marrow transplant). In both cases, it was necessary to take into consideration the risks and moral implications of requesting that they attend the dental hospital during a pandemic. The option of remote consultation allowed further clinical information to be evaluated and the families take part in the decision-making process about whether and when such visits should be scheduled. These cases will demonstrate how medically compromised patients (or patients with vulnerable carers), could have their dental needs assessed in a socially distanced manner by video consultation. Together, the clinician and the patient’s family can weigh up the risks, with regards to COVID-19, of attending for in-person appointments against the benefit of having treatment. This is particularly important for new paediatric patients who have not yet had a formal assessment. The limitations of this technology will also be discussed. It is limited by internet availability, the strength of the connection, the video quality and families owning a device which allows video calls. For those from a lower socio-economic background or living in some rural areas, this may not be possible or limit its usefulness. For the two patients discussed in this project, where the urgency of their dental condition was unclear, video consultation proved beneficial in deciding an appropriate outcome and preventing unnecessary exposure of vulnerable people to a hospital environment during a pandemic, demonstrating the usefulness of such technology when it is used appropriately.

Keywords: COVID-19, paediatrics, triage, video consultations

Procedia PDF Downloads 102
3015 Effects of Small Amount of Poly(D-Lactic Acid) on the Properties of Poly(L-Lactic Acid)/Microcrystalline Cellulose/Poly(D-Lactic Acid) Blends

Authors: Md. Hafezur Rahaman, Md. Sagor Hosen, Md. Abdul Gafur, Rasel Habib

Abstract:

This research is a systematic study of effects of poly(D-lactic acid) (PDLA) on the properties of poly(L-lactic acid)(PLLA)/microcrystalline cellulose (MCC)/PDLA blends by stereo complex crystallization. Blends were prepared with constant percentage of (3 percent) MCC and different percentage of PDLA by solution casting methods. These blends were characterized by Fourier Transform Infrared Spectroscopy (FTIR) for the confirmation of blends compatibility, Wide-Angle X-ray Scattering (WAXS) and scanning electron microscope (SEM) for the analysis of morphology, thermo-gravimetric analysis (TGA) and differential thermal analysis (DTA) for thermal properties measurement. FTIR Analysis results confirm no new characteristic absorption peaks appeared in the spectrum instead shifting of peaks due to hydrogen bonding help to have compatibility of blends component. Development of three new peaks from XRD analysis indicates strongly the formation of stereo complex crystallinity in the PLLA structure with the addition of PDLA. TGA and DTG results indicate that PDLA can improve the heat resistivity of the PLLA/MCC blends by increasing its degradation temperature. Comparison of DTA peaks also ensure developed thermal properties. Image of SEM shows the improvement of surface morphology.

Keywords: microcrystalline cellulose, poly(l-lactic acid), stereocomplex crystallization, thermal stability

Procedia PDF Downloads 139
3014 Effect of Air Temperatures (°C) and Slice Thickness (mm) on Drying Characteristics and Some Quality Properties of Omani Banana

Authors: Atheer Al-Maqbali, Mohammed Al-Rizeiqi, Pankaj Pathare

Abstract:

There is an ever-increased demand for the consumption of banana products in Oman and elsewhere in the region due to the nutritional value and the decent taste of the product. There are approximately 3,751 acres of land designated for banana cultivation in the Sultanate of Oman, which produces approximately 18,447 tons of banana product. The fresh banana product is extremely perishable, resulting in a significant post-harvest economic loss. Since the product has high sensory acceptability, the drying method is a common method for processing fresh banana products. This study aims to use the drying technology in the production of dried bananas to preserve the largest amount of natural color and delicious taste for the consumer. The study also aimed to assess the shelf stability of both water activity (aw) and color (L*, a*, b*) for fresh and finished dried bananas by using a Conventional Air Drying System. Water activity aw, color characteristic L a b, and product’s hardness were analyzed for 3mm, 5mm, and7 mm thickness at different temperaturesoC. All data were analyzed statistically using STATA 13.0, and α ≤ 0.05 was considered for the significance level. The study is useful to banana farmers to improve cultivation, food processors to optimize producer’s output and policy makers in the optimization of banana processing and post-harvest management of the products.

Keywords: banana, drying, oman, quality, thickness, hardness, color

Procedia PDF Downloads 95
3013 Nano-Coating for Corrosion Prevention

Authors: M. J. Suriani, F. Mansor, W. Siti Maizurah, I. Nurizwani

Abstract:

Silicon Carbide (SiC) is one of the Silicon-based materials, which get interested by the researcher. SiC is an emerging semiconductor material, which has received a great deal of attention due to their application in high frequency and high power systems. Although its superior characteristic for a semiconductor material, its outstanding mechanical properties, chemical inertness and thermal stability has gained important aspect for a surface coating for deployment in extreme environments. Very high frequency (VHF)-PECVD technique utilized to deposit nano ns-SiC film in which variation in chamber pressure, substrate temperature, RF power and precursor gases flow rate will be investigated in order to get a good quality of thin film coating. Characterization of the coating performed in order to study the surface morphology, structural information. This performance of coating evaluated through corrosion test to determine the effectiveness of the coating for corrosion prevention. Ns-SiC film expected to possess better corrosion resistance and optical properties, as well as preserving the metal from the marine environment. Through this research project, corrosion protection performance by applying coating will be explored to obtain a great corrosion prevention method to the shipping and oil and gas industry in Malaysia. Besides, the cost of repair and maintenance spending by the government of Malaysia can be reduced through practicing this method.

Keywords: composite materials, marine corrosion, nano-composite, nano structure–coating

Procedia PDF Downloads 472
3012 Factors Influencing Family Resilience and Quality of Life in Pediatric Cancer Patients and Their Caregivers: A Cluster Analysis

Authors: Li Wang, Dan Shu, Shiguang Pang, Lixiu Wang, Bing Xiang Yang, Qian Liu

Abstract:

Background: Cancer is one of the most severe diseases in childhood; long-term treatment and its side effects significantly impact the patient's physical, psychological, social functioning and quality of life while also placing substantial physical and psychological burdens on caregivers and families. Family resilience is crucial for children with cancer, helping them cope better with the disease and supporting the family in facing challenges together. As a family-level variable, family resilience requires information from multiple family members. However, to our best knowledge, there is currently no research investigating family resilience from both the perspectives of pediatric cancer patients and their caregivers. Therefore, this study aims to investigate the family resilience and quality of life of pediatric cancer patients from a patient–caregiver dyadic perspective. Methods: A total of 149 dyads of patients diagnosed with pediatric cancer patients and their principal caregivers were recruited from oncology departments of 4 tertiary hospitals in Wuhan and Taiyuan, China. All participants completed questionnaires that identified their demographic and clinical characteristics as well as assessed their family resilience and quality of life for both the patients and their caregivers. K-means cluster analysis was used to identify different clusters of family resilience based on the reports from patients and caregivers. Multivariate logistic regression and linear regression are used to analyze the factors influencing family resilience and quality of life, as well as the relationship between the two. Results: Three clusters of family resilience were identified: a cluster of high family resilience (HR), a cluster of low family resilience (LR), and a cluster of discrepant family resilience (DR). Most (67.1%) families fell into the cluster with low resilience. Characteristics such as the types of caregivers perceived social support of the patient were different among the three clusters. Compared to the LR group, families where the mother is the caregiver and where the patient has high social support are more likely to be assigned to the HR. The quality of life for caregivers was consistently highest in the HR cluster and lowest in the LR cluster. The patient's quality of life is not related to family resilience. In the linear regression analysis of the patient's quality of life, patients who are the first-born have higher quality of life, while those living with their parents have lower quality of life. The participants' characteristics were not associated with the quality of life for caregivers. Conclusions: In most families, family resilience was low. Families with maternal caregivers and patients receiving high levels of social support are more inclined to be higher levels of family resilience. Family resilience was linked to the quality of life of caregivers of pediatric cancer patients. The clinical implications of this findings suggest that healthcare and social support organizations should prioritize and support the participation of mothers in caregiving responsibilities. Furthermore, they should assist families in accessing social support to enhance family resilience. This study also emphasizes the importance of promoting family resilience for enhancing family health and happiness, as well as improving the quality of life for caregivers.

Keywords: pediatric cancer, cluster analysis, family resilience, quality of life

Procedia PDF Downloads 41
3011 EWMA and MEWMA Control Charts for Monitoring Mean and Variance in Industrial Processes

Authors: L. A. Toro, N. Prieto, J. J. Vargas

Abstract:

There are many control charts for monitoring mean and variance. Among these, the X y R, X y S, S2 Hotteling and Shewhart control charts, for mentioning some, are widely used for monitoring mean a variance in industrial processes. In particular, the Shewhart charts are based on the information about the process contained in the current observation only and ignore any information given by the entire sequence of points. Moreover, that the Shewhart chart is a control chart without memory. Consequently, Shewhart control charts are found to be less sensitive in detecting smaller shifts, particularly smaller than 1.5 times of the standard deviation. These kind of small shifts are important in many industrial applications. In this study and effective alternative to Shewhart control chart was implemented. In case of univariate process an Exponentially Moving Average (EWMA) control chart was developed and Multivariate Exponentially Moving Average (MEWMA) control chart in case of multivariate process. Both of these charts were based on memory and perform better that Shewhart chart while detecting smaller shifts. In these charts, information the past sample is cumulated up the current sample and then the decision about the process control is taken. The mentioned characteristic of EWMA and MEWMA charts, are of the paramount importance when it is necessary to control industrial process, because it is possible to correct or predict problems in the processes before they come to a dangerous limit.

Keywords: control charts, multivariate exponentially moving average (MEWMA), exponentially moving average (EWMA), industrial control process

Procedia PDF Downloads 357
3010 A Congenital Case of Dandy-Walker Malformation

Authors: Neerja Meena, Paresh Sukhani

Abstract:

Dandy walker malformation is a generalised disorder of mesenchymal development that affect both the cerebellum and overlying meninges. Classically dandy-walker malformation consists of a triad of- 1:vermian and hemispheric cerebellar hypoplasia 2:cystic dilatation of 4th ventricle 3: enlarged posterior fossa with the upward migration of tentorium(lambdoid- torcular inversion). Clinical presentation: four months old female child with hydrocephalus and neurological symptoms. Generally- early death is common in classic dandy walker malformation. However, if it is relatively mild and uncomplicated by other CNS anomalies, intelligence can be normal and neurologic deficits minimal. Usually, VP shunting is the treatment of choice for this hydrocephalus. Conclusion: MRI is the modality of choice to diagnose posterior fossa malformation. However, it can be ruled out through using during the antenatal check as the prognosis of this malformation is not good; it's better to diagnose it inutero.

Keywords: Dandy Walker, Mri, Earlydaignosis, Treatment

Procedia PDF Downloads 79
3009 The Validation of RadCalc for Clinical Use: An Independent Monitor Unit Verification Software

Authors: Junior Akunzi

Abstract:

In the matter of patient treatment planning quality assurance in 3D conformational therapy (3D-CRT) and volumetric arc therapy (VMAT or RapidArc), the independent monitor unit verification calculation (MUVC) is an indispensable part of the process. Concerning 3D-CRT treatment planning, the MUVC can be performed manually applying the standard ESTRO formalism. However, due to the complex shape and the amount of beams in advanced treatment planning technic such as RapidArc, the manual independent MUVC is inadequate. Therefore, commercially available software such as RadCalc can be used to perform the MUVC in complex treatment planning been. Indeed, RadCalc (version 6.3 LifeLine Inc.) uses a simplified Clarkson algorithm to compute the dose contribution for individual RapidArc fields to the isocenter. The purpose of this project is the validation of RadCalc in 3D-CRT and RapidArc for treatment planning dosimetry quality assurance at Antoine Lacassagne center (Nice, France). Firstly, the interfaces between RadCalc and our treatment planning systems (TPS) Isogray (version 4.2) and Eclipse (version13.6) were checked for data transfer accuracy. Secondly, we created test plans in both Isogray and Eclipse featuring open fields, wedges fields, and irregular MLC fields. These test plans were transferred from TPSs according to the radiotherapy protocol of DICOM RT to RadCalc and the linac via Mosaiq (version 2.5). Measurements were performed in water phantom using a PTW cylindrical semiflex ionisation chamber (0.3 cm³, 31010) and compared with the TPSs and RadCalc calculation. Finally, 30 3D-CRT plans and 40 RapidArc plans created with patients CT scan were recalculated using the CT scan of a solid PMMA water equivalent phantom for 3D-CRT and the Octavius II phantom (PTW) CT scan for RapidArc. Next, we measure the doses delivered into these phantoms for each plan with a 0.3 cm³ PTW 31010 cylindrical semiflex ionisation chamber (3D-CRT) and 0.015 cm³ PTW PinPoint ionisation chamber (Rapidarc). For our test plans, good agreements were found between calculation (RadCalc and TPSs) and measurement (mean: 1.3%; standard deviation: ± 0.8%). Regarding the patient plans, the measured doses were compared to the calculation in RadCalc and in our TPSs. Moreover, RadCalc calculations were compared to Isogray and Eclispse ones. Agreements better than (2.8%; ± 1.2%) were found between RadCalc and TPSs. As for the comparison between calculation and measurement the agreement for all of our plans was better than (2.3%; ± 1.1%). The independent MU verification calculation software RadCal has been validated for clinical use and for both 3D-CRT and RapidArc techniques. The perspective of this project includes the validation of RadCal for the Tomotherapy machine installed at centre Antoine Lacassagne.

Keywords: 3D conformational radiotherapy, intensity modulated radiotherapy, monitor unit calculation, dosimetry quality assurance

Procedia PDF Downloads 217
3008 Instrumentation for Engine Start Cycle Characterization at Cold Weather High Altitude Condition

Authors: Amit Kumar Gupta, Rohit Vashistha, G. P. Ravishankar, Mahesh P. Padwale

Abstract:

A cold soaked gas turbine engine have known starting problems in high altitude and low temperature conditions. The high altitude results in lower ambient temperature, pressure, and density. Soaking at low temperature leads to higher oil viscosity, increasing the engine starter system torque requirement. Also, low temperature soaks results in a cold compressor rotor and casing. Since the thermal mass of rotor is higher than casing, casing expands faster, thereby, increasing the blade-casing tip clearance. The low pressure flow over the compressor blade coupled with the secondary flow through the compressor tip clearance during start result in stall inception. The present study discusses engine instrumentation required for capturing the stall inception event. The engine fan exit and combustion chamber were instrumented with dynamic pressure probes to capture the pressure characteristic and clamp-on current meter on primary igniter cable to capture ignition event during start cycle. The experiment was carried out at 10500 Ft. pressure altitude and -15°C ambient temperature. The high pressure compressor stall events were recorded during the starts.

Keywords: compressor inlet, dynamic pressure probe, engine start cycle, flight test instrumentation

Procedia PDF Downloads 321
3007 Creativity and Intelligence: Psychoeducational Connections

Authors: Cristina Costa-Lobo, Carla B. Vestena, Filomena E. Ponte

Abstract:

Creativity and intelligence are concepts that have aroused very expressive interest in the field of educational sciences and the field of psychological science since the middle of the last century since they have a great impact on the potential and well-being of individuals. However, due to progress in cognitive and positive psychology, there has been a growing interest in the psychoeducational domain of intelligence and creativity in the last decade. In this theoretical work, are analyzed comparatively the theoretical models that relate the intelligence and the creativity, are analyzed several psychoeducational intervention programs that have been implemented with a view to the promotion of creativity and signal possibilities, realities and ironies around the psychological evaluation of intelligence and creativity. In order to reach a broad perspective on creativity, the evidence is presented that points the need to evaluate different psychological domains. The psychoeducational intervention programs addressed have, with a common characteristic, the full stimulation of the creative potential of the participants, assumed as a highly valued capacity at the present time. The results point to the systematize that all interventions in the ambit of creativity have two guiding principles: all individuals can be creative, and creativity is a capacity that can be stimulated. This work refers to the importance of stimulus creativity in educational contexts, to the usefulness and pertinence of the creation, the implementation, and monitoring of flexible curricula, adapted to the educational needs of students, promoting a collaborative work among teachers, parents, students, psychologists, managers and educational administrators.

Keywords: creativity, intelligence, psychoeducational intervention programs, psychological evaluation, educational contexts

Procedia PDF Downloads 408
3006 Wetting Treatement: Comparative Overview: Case of Polypropylene Top Sheet Layer on Disposable Baby Diaper

Authors: Tilouche Rahma, Sayeb Soumaya, Ben Hassen Mohamed

Abstract:

The wettability of materials is a very important aspect of surface science, it presents a key factor providing the best characteristic of product, especially in hygienic field. Hydrophobic polypropylene is used as nonwoven topsheet in disposable diaper, for its interesting properties (toughness, lightness...) by comparing with traditional product previously used. SURFACTANTs are widely used to reduce contact angle (water contact angles larger than 90° on smooth surfaces) and to change wetting properties. In the present work, we study ways to obtain hydrophilic polypropylene surface, by the deposition of a variety of surfactant on surfaces of varying morphology. We used two different methods for surface wetting: Spraying method and the coating method. The concentration of the wetting agent, the type of non-woven fabric and the parameters in the method for controlling, hugely affect the quality of treatment. Therefore need that the treatment is effective in terms of contact angle without affecting the mechanical properties of the nonwoven. For the assessment of the quality of treatment, two methods are used: The measurement of the contact angle and the strike trough time. Also, with subjective evaluation by Hedonic test (which involves the consumer preference (naive panel: group of moms). Finally, we selected the better treated topsheet referring to the assessment results.

Keywords: SURFACTANT, topsheet polypropylene, hydrophilic, hydrophobic

Procedia PDF Downloads 548
3005 Dynamics Characterizations of Dielectric Electro- Active Polymer Pull Actuator for Vibration Control


Authors: Abdul Malek Abdul Wahab, Emiliano Rustighi

Abstract:

The elastomeric dielectric material has become a new alternative for actuator technology recently. The characteristic of dielectric elastomer that induces significant strain by applying voltage attracts the attention of many researchers to study this material in actuator technology. Thus, for a couple of years, Danfoss Ventures A/S has established their dielectric electro-active polymer (DEAP), which called Polypower. The main objective of this work was to investigate the characterization of PolyPower folded actuator as a ‘pull’ actuator for vibration control. A range of experiment was carried out on folded actuator including passive (without electrical stimulate) and active (with electrical stimulate) testing. For both categories static and dynamic testing have been done to determine the behavior of folded DEAP actuator. Voltage-Strain experiment determines that DEAP folded actuator is the non-linear system. The voltage supplied has no effect on the natural frequency which shows by ongoing dynamic testing. Finally, varies AC voltage with different amplitude and frequency has been provided to DEAP folded actuator. This experiment shows the parameter that influences the performance of DEAP folded actuator. As a result, the actuator performance dominated by the frequency dependence of the elastic response and was less influenced by dielectric properties.

Keywords: elastomeric dielectric, dielectric electro-active polymer, folded actuator, voltage-strain

Procedia PDF Downloads 324
3004 Advanced Palliative Aquatics Care Multi-Device AuBento for Symptom and Pain Management by Sensorial Integration and Electromagnetic Fields: A Preliminary Design Study

Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

Abstract:

Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: advanced palliative aquatics care, magnetic field therapy, medical device, research design

Procedia PDF Downloads 129
3003 Role of Artificial Intelligence in Nano Proteomics

Authors: Mehrnaz Mostafavi

Abstract:

Recent advances in single-molecule protein identification (ID) and quantification techniques are poised to revolutionize proteomics, enabling researchers to delve into single-cell proteomics and identify low-abundance proteins crucial for biomedical and clinical research. This paper introduces a different approach to single-molecule protein ID and quantification using tri-color amino acid tags and a plasmonic nanopore device. A comprehensive simulator incorporating various physical phenomena was designed to predict and model the device's behavior under diverse experimental conditions, providing insights into its feasibility and limitations. The study employs a whole-proteome single-molecule identification algorithm based on convolutional neural networks, achieving high accuracies (>90%), particularly in challenging conditions (95–97%). To address potential challenges in clinical samples, where post-translational modifications affecting labeling efficiency, the paper evaluates protein identification accuracy under partial labeling conditions. Solid-state nanopores, capable of processing tens of individual proteins per second, are explored as a platform for this method. Unlike techniques relying solely on ion-current measurements, this approach enables parallel readout using high-density nanopore arrays and multi-pixel single-photon sensors. Convolutional neural networks contribute to the method's versatility and robustness, simplifying calibration procedures and potentially allowing protein ID based on partial reads. The study also discusses the efficacy of the approach in real experimental conditions, resolving functionally similar proteins. The theoretical analysis, protein labeler program, finite difference time domain calculation of plasmonic fields, and simulation of nanopore-based optical sensing are detailed in the methods section. The study anticipates further exploration of temporal distributions of protein translocation dwell-times and the impact on convolutional neural network identification accuracy. Overall, the research presents a promising avenue for advancing single-molecule protein identification and quantification with broad applications in proteomics research. The contributions made in methodology, accuracy, robustness, and technological exploration collectively position this work at the forefront of transformative developments in the field.

Keywords: nano proteomics, nanopore-based optical sensing, deep learning, artificial intelligence

Procedia PDF Downloads 106
3002 Malnutrition Among Adult Hospitalized Orthopedic Patients: Nursing Role And Nutrition Screening

Authors: Ehsan Ahmed Yahia

Abstract:

Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

Procedia PDF Downloads 102
3001 Effect of Provitamin a Biofortified Maize Inclusion Diet on Consumers' Acceptability of Ovambo Chicken Meat

Authors: Feyisayo Odunitan-Wayas, Unathi Kolanisi, Micheal Chimonyo, Muthulisi Siwela

Abstract:

Consumers’ surveys have indicated low acceptability of provitamin A biofortified maize (PABM), a high vitamin A (HVA) maize in Southern Africa to curb vitamin A deficiency (VAD). Indigenous chickens are reared and consumed by almost all rural households which are the major VAD prone areas in southern Africa. The objective of this study was to determine if HVA diet fed to the Ovambo indigenous chicken breed will influence consumers’ acceptability of the meat. The leg (thigh and drumstick) of the male birds (21 weeks old) were used for the sensory characteristics. 52 consumer panellists evaluated the sensory characteristics on based on a 5-point hedonic scale and preference test. There was no significant difference (P<0.05) in the preference test between the two diets. There were no significant differences (P<0.05) between the diets based on all sensory characteristics. Age and gender of the consumers and their interactions had no effect (P<0.05) on the acceptability and sensory characteristic ratings. It was concluded that indigenous chickens fed provitamin A biofortified maize can be a possible tool for curbing VAD in southern Africa regions where there is low acceptability of the human consumption of provitamin A biofortified maize. It was concluded that PABM diet fed to indigenous chickens will not influence the acceptability of the chicken meat by VAD vulnerable consumers.

Keywords: biofortified pro-vitamin a maize, ovambo, chicken meat, sensory characteristics, gender, age

Procedia PDF Downloads 352
3000 Stability Analysis of Two-delay Differential Equation for Parkinson's Disease Models with Positive Feedback

Authors: M. A. Sohaly, M. A. Elfouly

Abstract:

Parkinson's disease (PD) is a heterogeneous movement disorder that often appears in the elderly. PD is induced by a loss of dopamine secretion. Some drugs increase the secretion of dopamine. In this paper, we will simply study the stability of PD models as a nonlinear delay differential equation. After a period of taking drugs, these act as positive feedback and increase the tremors of patients, and then, the differential equation has positive coefficients and the system is unstable under these conditions. We will present a set of suggested modifications to make the system more compatible with the biodynamic system. When giving a set of numerical examples, this research paper is concerned with the mathematical analysis, and no clinical data have been used.

Keywords: Parkinson's disease, stability, simulation, two delay differential equation

Procedia PDF Downloads 135
2999 Electrical Properties of Polarization-Induced Aluminum Nitride/Gallium Nitride Heterostructures Homoepitaxially Grown on Aluminum Nitride Sapphire Template by Molecular Beam Epitaxy

Authors: Guanlin Wu, Jiajia Yao, Fang Liu, Junshuai Xue, Jincheng Zhang, Yue Hao

Abstract:

Owing to the excellent thermal conductivity and ultra-wide bandgap, Aluminum nitride (AlN)/Gallium nitride (GaN) is a highly promising material to achieve high breakdown voltage and output power devices among III-nitrides. In this study, we explore the growth and characterization of polarization-induced AlN/GaN heterostructures using plasma-assisted molecular beam epitaxy (PA-MBE) on AlN-on-sapphire templates. To improve the crystal quality and demonstrate the effectiveness of the PA-MBE approach, a thick AlN buffer of 180 nm was first grown on the AlN-on sapphire template. This buffer acts as a back-barrier to enhance the breakdown characteristic and isolate leakage paths that exist in the interface between the AlN epilayer and the AlN template. A root-mean-square roughness of 0.2 nm over a scanned area of 2×2 µm2 was measured by atomic force microscopy (AFM), and the full-width at half-maximum of (002) and (102) planes on the X-ray rocking curve was 101 and 206 arcsec, respectively, using by high-resolution X-ray diffraction (HR-XRD). The electron mobility of 443 cm2/Vs with a carrier concentration of 2.50×1013 cm-2 at room temperature was achieved in the AlN/GaN heterostructures by using a polarization-induced GaN channel. The low depletion capacitance of 15 pF is resolved by the capacitance-voltage. These results indicate that the polarization-induced AlN/GaN heterostructures have great potential for next-generation high-temperature, high-frequency, and high-power electronics.

Keywords: AlN, GaN, MBE, heterostructures

Procedia PDF Downloads 88
2998 Effect of the Drawbar Force on the Dynamic Characteristics of a Spindle-Tool Holder System

Authors: Jui-Pui Hung, Yu-Sheng Lai, Tzuo-Liang Luo, Kung-Da Wu, Yun-Ji Zhan

Abstract:

This study presented the investigation of the influence of the tool holder interface stiffness on the dynamic characteristics of a spindle tool system. The interface stiffness was produced by drawbar force on the tool holder, which tends to affect the spindle dynamics. In order to assess the influence of interface stiffness on the vibration characteristic of spindle unit, we first created a three dimensional finite element model of a high speed spindle system integrated with tool holder. The key point for the creation of FEM model is the modeling of the rolling interface within the angular contact bearings and the tool holder interface. The former can be simulated by a introducing a series of spring elements between inner and outer rings. The contact stiffness was calculated according to Hertz contact theory and the preload applied on the bearings. The interface stiffness of the tool holder was identified through the experimental measurement and finite element modal analysis. Current results show that the dynamic stiffness was greatly influenced by the tool holder system. In addition, variations of modal damping, static stiffness and dynamic stiffness of the spindle tool system were greatly determined by the interface stiffness of the tool holder which was in turn dependent on the draw bar force applied on the tool holder. Overall, this study demonstrates that identification of the interface characteristics of spindle tool holder is of very importance for the refinement of the spindle tooling system to achieve the optimum machining performance.

Keywords: dynamic stiffness, spindle-tool holder, interface stiffness, drawbar force

Procedia PDF Downloads 401
2997 A Comparison of Three Protocols Weight-Loss Interventions for Obese Females

Authors: Nayera E. Hassan, Sahar A. El-Masry, Rokia El-Banna, Mohamed S. El Hussieny

Abstract:

There are several different modalities for treatment of obesity. Common intervention methods for obesity include low-calorie diet, exercise. Also acupuncture has shown good therapeutic results in the treatment of obesity. A recent clinical observation showed that laser acupuncture could reduce body weight and body mass index in obese persons. So, the aim of this research is focused on body composition changes as related to type of intervention, before and after intentional weight loss in overweight and obesity. 76 subjects were included in the study analysis. The present study recommended that every obese female must do lipid profile and fasting blood sugar analysis before weight-loss intervention to take the decision of which method should be used.

Keywords: obesity, weight-loss, body composition, modalities

Procedia PDF Downloads 491
2996 Multimodal Integration of EEG, fMRI and Positron Emission Tomography Data Using Principal Component Analysis for Prognosis in Coma Patients

Authors: Denis Jordan, Daniel Golkowski, Mathias Lukas, Katharina Merz, Caroline Mlynarcik, Max Maurer, Valentin Riedl, Stefan Foerster, Eberhard F. Kochs, Andreas Bender, Ruediger Ilg

Abstract:

Introduction: So far, clinical assessments that rely on behavioral responses to differentiate coma states or even predict outcome in coma patients are unreliable, e.g. because of some patients’ motor disabilities. The present study was aimed to provide prognosis in coma patients using markers from electroencephalogram (EEG), blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) and [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET). Unsuperwised principal component analysis (PCA) was used for multimodal integration of markers. Methods: Approved by the local ethics committee of the Technical University of Munich (Germany) 20 patients (aged 18-89) with severe brain damage were acquired through intensive care units at the Klinikum rechts der Isar in Munich and at the Therapiezentrum Burgau (Germany). At the day of EEG/fMRI/PET measurement (date I) patients (<3.5 month in coma) were grouped in the minimal conscious state (MCS) or vegetative state (VS) on the basis of their clinical presentation (coma recovery scale-revised, CRS-R). Follow-up assessment (date II) was also based on CRS-R in a period of 8 to 24 month after date I. At date I, 63 channel EEG (Brain Products, Gilching, Germany) was recorded outside the scanner, and subsequently simultaneous FDG-PET/fMRI was acquired on an integrated Siemens Biograph mMR 3T scanner (Siemens Healthineers, Erlangen Germany). Power spectral densities, permutation entropy (PE) and symbolic transfer entropy (STE) were calculated in/between frontal, temporal, parietal and occipital EEG channels. PE and STE are based on symbolic time series analysis and were already introduced as robust markers separating wakefulness from unconsciousness in EEG during general anesthesia. While PE quantifies the regularity structure of the neighboring order of signal values (a surrogate of cortical information processing), STE reflects information transfer between two signals (a surrogate of directed connectivity in cortical networks). fMRI was carried out using SPM12 (Wellcome Trust Center for Neuroimaging, University of London, UK). Functional images were realigned, segmented, normalized and smoothed. PET was acquired for 45 minutes in list-mode. For absolute quantification of brain’s glucose consumption rate in FDG-PET, kinetic modelling was performed with Patlak’s plot method. BOLD signal intensity in fMRI and glucose uptake in PET was calculated in 8 distinct cortical areas. PCA was performed over all markers from EEG/fMRI/PET. Prognosis (persistent VS and deceased patients vs. recovery to MCS/awake from date I to date II) was evaluated using the area under the curve (AUC) including bootstrap confidence intervals (CI, *: p<0.05). Results: Prognosis was reliably indicated by the first component of PCA (AUC=0.99*, CI=0.92-1.00) showing a higher AUC when compared to the best single markers (EEG: AUC<0.96*, fMRI: AUC<0.86*, PET: AUC<0.60). CRS-R did not show prediction (AUC=0.51, CI=0.29-0.78). Conclusion: In a multimodal analysis of EEG/fMRI/PET in coma patients, PCA lead to a reliable prognosis. The impact of this result is evident, as clinical estimates of prognosis are inapt at time and could be supported by quantitative biomarkers from EEG, fMRI and PET. Due to the small sample size, further investigations are required, in particular allowing superwised learning instead of the basic approach of unsuperwised PCA.

Keywords: coma states and prognosis, electroencephalogram, entropy, functional magnetic resonance imaging, machine learning, positron emission tomography, principal component analysis

Procedia PDF Downloads 342