Search results for: diagnostic tests

Authors: Mohamed Khalifa Zayet, Salma Belal Eiid, Mushira Mohamed Dahaba

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Introduction: Malignant tumors may not be easily detected by traditional radiographic techniques especially in an anatomically complex area like maxillofacial region. At the same time, the advent of biological functional MRI was a significant footstep in the diagnostic imaging field. Objective: The purpose of this study was to define the malignant metabolic profile of maxillofacial lesions using diffusion MRI and magnetic resonance spectroscopy, as adjunctive aids for diagnosing of such lesions. Subjects and Methods: Twenty-one patients with twenty-two lesions were enrolled in this study. Both morphological and functional MRI scans were performed, where T1, T2 weighted images, diffusion-weighted MRI with four apparent diffusion coefficient (ADC) maps were constructed for analysis, and magnetic resonance spectroscopy with qualitative and semi-quantitative analyses of choline and lactate peaks were applied. Then, all patients underwent incisional or excisional biopsies within two weeks from MR scans. Results: Statistical analysis revealed that not all the parameters had the same diagnostic performance, where lactate had the highest areas under the curve (AUC) of 0.9 and choline was the lowest with insignificant diagnostic value. The best cut-off value suggested for lactate was 0.125, where any lesion above this value is supposed to be malignant with 90 % sensitivity and 83.3 % specificity. Despite that ADC maps had comparable AUCs still, the statistical measure that had the final say was the interpretation of likelihood ratio. As expected, lactate again showed the best combination of positive and negative likelihood ratios, whereas for the maps, ADC map with 500 and 1000 b-values showed the best realistic combination of likelihood ratios, however, with lower sensitivity and specificity than lactate. Conclusion: Diffusion weighted imaging and magnetic resonance spectroscopy are state-of-art in the diagnostic arena and they manifested themselves as key players in the differentiation process of orofacial tumors. The complete biological profile of malignancy can be decoded as low ADC values, high choline and/or high lactate, whereas that of benign entities can be translated as high ADC values, low choline and no lactate.

Keywords: diffusion magnetic resonance imaging, magnetic resonance spectroscopy, malignant tumors, maxillofacial

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Authors: Kieren Wilson, Gulnaz Majeed

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NHS constitution gives rights to the patient with suspected cancer to be seen by a cancer specialist within 2 weeks of referral. Guys and St Thomas Hospital (GSTT) is one of the largest cancer centres in London. NICE guidelines have provided guidance for health professionals to refer patients appropriately to RAC. In GSTT suspected gynae cancer referrals are mostly by NHS e-Referral Service with some fax, emails as well as paper referrals. The objective of this study was to evaluate compliance with 2-week referral pathway with emphasis on one stop diagnostic service with supporting efficient pathways. A prospective evaluation over 3 months (1 Jan 2017 to 31 Mar 2017) was undertaken. There were 26 clinics, 761 patients were booked in the clinics with a DNA rate of 13% (n=101) hence 606 patients were seen. Majority of referrals were for post menopausal bleeding (PMB) 25% (n=194) followed by cervical, vaginal, vulval reasons 23% (n=179) (abnormal cytology excluded as patients directly referred to colposcopy unit in GSTT), ovarian 7% (n=54) and endometrial 5% (n=41). Women with new or previous established diagnosis of cancer were 24, cervical (n=17), vulva (n=6) and vagina (n=1). Multifocal preinvasive disease vulva (VIN), vagina (VAIN) and cervix (CIN) was confirmed in twenty-six patients 4% (high prevalence in HIV patients). Majority of cervical referrals: PCB (n=14), cervical erosion (n=7), polyps (n=9) and cervical cyst were benign. However, two women with PMB had cervical cancer. Only 2 out of 13 referrals with vaginal concerns had VAIN. One case with non-cervical glandular cytology was confirmed to have endometrial cancer. One stop service based on the diagnostic support of ultrasound, colposcopy and hysteroscopy was achieved in 54% (n=359). Patients were discharged to GP, benign gynaecology, endometriosis, combined vulval/dermatology clinic or gynae oncology. 33% (n=202) required a second visit, 12% (n=70) third visit, 3% (n=19) fourth visit, 1% (n=4) fifth visit and 1% (n=6) sixth visit. Main reasons for follow ups were the unavailability of diagnostic slots, patient choice, need for interpreters, the discussion following gynae MDM review for triage to benign gynae, delay in availability of diagnostic results like histology/MRI/CT. Recommendations following this study are multi disciplinary review of pathways with the availability of additional diagnostic procedure slots to aim for one stop service. Furthermore, establishment of virtual and telephone consultations to reduce follow ups.

Keywords: multifocal disease, post menopausal bleeding, preinvasive disease, rapid access clinic

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Authors: Di Luo, Maria Buchberger, Anja Pickhard

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Objectives: The purpose of this study was to assess and compare the diagnostic accuracy of four common morphological approaches, including sonography, computed tomography (CT), positron emission tomography/computed tomography (PET/CT), and magnetic resonance imaging (MRI) for the evaluation of cervical lymph node metastases in head and neck squamous cell carcinoma (HNSCC) patients. Material and Methods: Included in this retrospective study were 26 patients diagnosed with HNSCC between 2010 and 2011 who all underwent sonography, CT, PET/CT, and MRI imaging before neck dissection. Morphological data were compared to the corresponding histopathological results. Statistical analysis was performed with SPSS statistic software (version 26.0), calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detection of cervical lymph node metastases. Results: The 5-year survival rate of the patient collective was 55.5%.Risk factors for survival included initial primary tumor stage, initial lymph node stage, initial metastasis status, and therapeutic approaches. Cox regression showed initial metastasis status(HR 8.671, 95%CI 1.316-57.123, p=0.025) and therapeutic approaches(HR 6.699, 95%CI 1.746-25.700, p=0.006)to be independent predictive risk factors for survival. Sensitivity was highest for MRI (96% compared to 85% for sonography and 89% for CT and PET/CT). Specificity was comparable with 95 % for CT and 98 % for sonography and PET/CT, but only 68% for MRI. While the MRI showed the least PPV (34%) compared to all other methods (85% for sonography,75% for CT, and 86% for PET/CT), the NPV was comparable in all methods(98-99%). The overall accuracy of cervical lymph node metastases detection was comparable for sonography, CT, and PET/CT with 96%,97%,94%, respectively, while MRI had only 72% accuracy. Conclusion: Since the initial status of metastasis is an independent predictive risk factor for patients’ survival, efficient detection is crucial to plan adequate therapeutic approaches. Sonography, CT, and PET/CT have better diagnostic accuracy than MRI for the evaluation of cervical lymph node metastases in HNSCC patients.

Keywords: cervical lymph node metastases, diagnostic accuracy, head and neck squamous carcinoma, risk factors, survival

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Authors: Ahmad Saadiq, Neeraj Sahu

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The partial or full replacement of natural coarse aggregate by recycled concrete aggregate (RCA) is of great benefit to the environment, as the demand of natural coarse aggregate reduces. In the modern construction and practice, the use of RCA is limited to backfilling and road construction. The establishment of RCA for its wide application can only be done after having an understanding of the use of RCA in conventional concrete. To have an insight to this, various tests to determine the compressive strength, elastic strength, workability, durability and drying shrinkage tests can be done and the test results may be different from that obtained from natural coarse aggregates, by using natural coarse aggregate in concrete. This paper gives a comprehensive review of the said tests done on RCA concrete. The results obtained from the tests indicate that RCA concrete gives comparable compressive strength, stiffness, and workability relative to the corresponding results obtained from the natural coarse aggregates. However, the durability and drying shrinkage had more variance but well within recommended limits.

Keywords: aggregate, compressive strength, durability, modulus of elasticity, recycled concrete, shrinkage, workability

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Authors: Mustafa M. Donma, Orkide Donma

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Metabolic syndrome (MetS) is a disease associated with obesity. It is a complicated clinical problem possibly affecting body composition as well as macrominerals. These parameters gain further attention, particularly in the pediatric population. The aim of this study is to investigate the amount of discrete body composition fractions in groups that differ in the severity of obesity. Also, the possible associations with calcium (Ca), phosphorus (P), magnesium (Mg) will be examined. The study population was divided into four groups. Twenty-eight, 29, 34, and 34 children were involved in Group 1 (healthy), 2 (obese), 3 (morbid obese), and 4 (MetS), respectively. Institutional Ethical Committee approved the study protocol. Informed consent forms were obtained from the participants. The classification of obese groups was performed based upon the recommendations of the World Health Organization. Metabolic syndrome components were defined. Serum Ca, P, Mg concentrations were measured. Within the scope of body composition, fat mass, fat-free mass, protein mass, mineral mass were determined by a body composition monitor using bioelectrical impedance analysis technology. Weight, height, waist circumference, hip circumference, head circumference, and neck circumference values were recorded. Body mass index, diagnostic obesity notation model assessment index, fat mass index, and fat-free mass index values were calculated. Data were statistically evaluated and interpreted. There was no statistically significant difference among the groups in terms of Ca and P concentrations. Magnesium concentrations differed between Group 1 and Group 4. Strong negative correlations were detected between P as well as Mg and fat mass index as well as diagnostic obesity notation model assessment index in Group 4, the group, which comprised morbid obese children with MetS. This study emphasized unique associations of P and Mg minerals with diagnostic obesity notation model assessment index and fat mass index during the evaluation of morbid obese children with MetS. It was also concluded that diagnostic obesity notation model assessment index and fat mass index were more proper indices in comparison with body mass index and fat-free mass index for the purpose of defining body composition in children.

Keywords: children, fat mass, fat-free mass, macrominerals, obesity

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Authors: Christine Li, Amanda Robertson

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Epidermal inclusion cysts occur when epidermal cells are implanted in the dermis following trauma, or surgery. They are a rare cause of an umbilical mass, with very few cases previously reported following abdominal surgery. These lesions can present with a range of symptoms, including palpable mass, pain, redness, or discharge. This paper reports a case of an umbilical epidermal inclusion cyst in a 52-year-old female presenting with a six-week history of a painful, red umbilical lump on a background of two previous diagnostic laparoscopies. Abdominal computed tomography (CT) scans revealed non-specific soft tissue thickening in the umbilical region. This was successfully treated with complete excision of the lesion. Umbilical lumps are a common presentation but can represent a diagnostic challenge. The differential diagnosis should include an epidermal inclusion cyst, particularly in a patient who has had previous abdominal surgery, including laparoscopic surgery.

Keywords: epidermal inclusion cyst, laparoscopy, umbilical mass, umbilicus

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Authors: Shanza Akram, Sameen Toor, Heba Harb Abu Alkass, Zainab Abdulsalam Altaha, Sara Taha Abdulla, Saleem Imran

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Acute pulmonary embolism (PE) is a common disease and can be fatal. The clinical presentation is variable and nonspecific, making accurate diagnosis difficult. Testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly CT and D-dimer measurement, may not improve care while potentially leading to patient harm and unnecessary expense. CTPA is the investigation of choice for PE. Its easy availability, accuracy and ability to provide alternative diagnosis has lowered the threshold for performing it, resulting in its overuse. Guidelines have recommended the use of clinical pretest probability tools such as ‘Wells score’ to assess risk of suspected PE. Unfortunately, implementation of guidelines in clinical practice is inconsistent. This has led to low risk patients being subjected to unnecessary imaging, exposure to radiation and possible contrast related complications. Aim: To study the diagnostic yield of CT PA, clinical pretest probability of patients according to wells score and to determine whether or not there was an overuse of CTPA in our service. Methods: CT scans done on patients with suspected P.E in our hospital from 1st January 2014 to 31st December 2014 were retrospectively reviewed. Medical records were reviewed to study demographics, clinical presentation, final diagnosis, and to establish if Wells score and D-Dimer were used correctly in predicting the probability of PE and the need for subsequent CTPA. Results: 100 patients (51male) underwent CT PA in the time period. Mean age was 57 years (24-91 years). Majority of patients presented with shortness of breath (52%). Other presenting symptoms included chest pain 34%, palpitations 6%, collapse 5% and haemoptysis 5%. D Dimer test was done in 69%. Overall Wells score was low (<2) in 28 %, moderate (>2 - < 6) in 47% and high (> 6) in 15% of patients. Wells score was documented in medical notes of only 20% patients. PE was confirmed in 12% (8 male) patients. 4 had bilateral PE’s. In high-risk group (Wells > 6) (n=15), there were 5 diagnosed PEs. In moderate risk group (Wells >2 - < 6) (n=47), there were 6 and in low risk group (Wells <2) (n=28), one case of PE was confirmed. CT scans negative for PE showed pleural effusion in 30, Consolidation in 20, atelactasis in 15 and pulmonary nodule in 4 patients. 31 scans were completely normal. Conclusion: Yield of CT for pulmonary embolism was low in our cohort at 12%. A significant number of our patients who underwent CT PA had low Wells score. This suggests that CT PA is over utilized in our institution. Wells score was poorly documented in medical notes. CT-PA was able to detect alternative pulmonary abnormalities explaining the patient's clinical presentation. CT-PA requires concomitant pretest clinical probability assessment to be an effective diagnostic tool for confirming or excluding PE. . Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Combining Wells scores with clinical and laboratory assessment may reduce the need for CTPA.

Keywords: CT PA, D dimer, pulmonary embolism, wells score

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Authors: Kambiz Hassanzadeh, Seyedeh Shohreh Ebrahimi, Shahrbanoo Oryan, Arman Rahimmi, Esmael Izadpanah

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Parkinson’s disease is one of the most prevalent neurodegenerative diseases which occurs in elderly. There are convincing evidences that oxidative stress has an important role in both the initiation and progression of Parkinson’s disease. Thymoquinone (TQ) is shown to have antioxidant and anti-inflammatory properties in invitro and invivo studies. It is well documented that TQ acts as a free radical scavenger and prevents the cell damage. Therefore this study aimed to evaluate the effect of TQ on motor and non-motor symptoms in animal model of Parkinson’s disease. Male Wistar rats (10-12 months) received rotenone (1mg/kg/day, sc) to induce Parkinson’s disease model. Pretreatment with TQ (7.5 and 15 mg/kg/day, po) was administered one hour before the rotenone injection. Three motor tests (rotarod, rearing and bar tests) and two non-motor tests (forced swimming and elevated plus maze) were performed for behavioral assessment. Our results indicated that TQ significantly ameliorated the rotenone-induced motor dysfunction in rotarod and rearing tests also it could prevent the non-motor dysfunctions in forced swimming and elevated plus maze tests. In conclusion we found that TQ delayed the Parkinson's disease induction by rotenone and this effect might be related to its proved antioxidant effect.

Keywords: Parkinson's disease, thymoquinone, motor and non-motor symptoms, neurodegenerative disease

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Authors: Laurent Debailleux

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Although past research has focused on parameters influencing the vulnerability of brick and its decay, in practice ancient fired clay bricks are usually replaced without any particular assessment of their characteristics. This paper presents results of non-destructive Schmidt hammer tests performed on ancient fired clay bricks sampled from historic masonry. Samples under study were manufactured between the 18th and 20th century and came from facades and interior walls. Tests were performed on three distinct brick surfaces, depending on their position within the masonry unit. Schmidt hammer tests were carried out in order to measure the mean rebound value (Rn), which refers to the resistance of the surface to successive impacts of the hammer plunger tip. Results indicate that rebound values increased with successive impacts at the same point. Therefore, mean Schmidt hammer rebound values (Rn), limited to the first impact on a surface minimises the estimation of compressive strength. In addition, the results illustrate that this technique is sensitive enough to measure weathering differences, even for different surfaces of a particular sample. Finally, the paper also highlights the relevance of considering the position of the brick within the masonry when conducting particular assessments of the material’s strength.

Keywords: brick, non-destructive tests, rebound number, Schmidt hammer, weathering grade

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Authors: Rabia Chaudhry, Andrew Dawson

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Identification of steady/critical state of coarse granular soil is challenging at conventional pressures. This study examines the drained and undrained triaxial tests for large strains on loose to dense, uniformly graded, Leighton Buzzard Fraction A sand. The triaxial tests are conducted under controlled test conditions. The comparison of soil behavior on shear strength characteristics at different effective stresses has been studied at the medium to large strains levels and the uniqueness of the critical state was discussed. The test results showed that there were two steady/critical state lines for drained and undrained conditions at confining pressures less than 1000 kPa. A critical state friction angle is not constant and the overall scatter in the steady/critical state line for the tested sand is ±0.01 in terms of void ratio at stress levels less than 1000 kPa.

Keywords: critical state, stress strain behavior, fabric/structure, triaxial tests

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Authors: Ramya Rathan, Miral N. F. Salama

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The variations in the arteries have been drawing attention of anatomists for a long time because of their clinical significance. The brachial artery is the principal artery of the arm which is the continuation of the axillary artery from the lower border of the Teres Major. It terminates into the radial and ulnar arteries below the elbow joint at the neck radius. The present study aims at exploring the clinical significance of the high termination of the brachial artery. During the routine cadaveric dissection of the arm, for the undergraduate students of medicine at our university, we observed a high bifurcation of the radial and the ulnar artery at the midshaft of the humerus. The median nerve was seen passing between these two junctions. Further, the course and the relations of this artery were studied. The accurate knowledge regarding these kinds of variation in the blood vessels is mandatory for planning of designing. General physicians, surgeons and radiologists should keep in mind the variations in the branching pattern of the arteries in their daily medical, diagnostic and therapeutic procedures to avoid complications in diagnostic and surgical procedures.

Keywords: brachial artery, high termination, radial artery, ulnar artery

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Authors: Surapol Raadnui

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This particular work describes an experimental investigation on gear wear in which wear and pitting were intentionally allowed to occur, namely, moisture corrosion pitting, acid-induced corrosion pitting, hard contaminant-related pitting and mechanical induced wear. A back to back spur gear test rig and a grease lubricated worm gear rig were used. The tests samples of wear debris were collected and assessed through the utilization of an optical microscope in order to correlate and compare the debris morphology to pitting and wear degradation of the worn gears. In addition, weight loss from all test gear pairs were assessed with utilization of statistical design of experiment. It can be deduced that wear debris characteristics from both cases exhibited a direct relationship with different pitting and wear modes. Thus, it should be possible to detect and diagnose gear pitting and wear utilization of worn surfaces, generated wear debris and quantitative measurement such as weight loss.

Keywords: predictive maintenance, worm gear, spur gear, wear debris analysis, problem diagnostic

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Authors: Ossama Abdelmotaal, Olfat Shaker, Tarek Salman, Lamiaa Nabeel, Mostafa Shabayek

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Colorectal Cancer (CRC) is an important worldwide health problem. Colonoscopy is used in detecting CRC suffer from drawbacks where colonoscopy is an invasive method. This study validates easier and less time-consuming techniques to evaluate the usefulness of detecting miRNA-21, miRNA-215 and miRNA-378 in the sera of colorectal cancer patients as new diagnostic tools. This study includes malignant (Colo Rectal Cancer patients, n= 64)) and healthy (n=27) groups. The studied groups were subjected to colonoscopic examination and estimation of miRNA-21, miRNA-215 and miRNA-378 in sera by RT-PCR. miRNA-21 showed the statistically significantly highest median fold change. miRNA-378 showed statistically significantly lower value (Both showed over-expression). miRNA-215 showed the statistically significantly lowest median fold change (It showed down-regulation). Overall the miRNA (21-215 and 378) appear to be promising method of detecting CRC and evaluating its stages.

Keywords: colorectal cancer, miRNA-21, miRNA-215, miRNA-378

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Authors: Ayad Salih Sabbar, Amin Chegenizadeh, Hamid Nikraz

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Utilizing waste materials in civil engineering applications has a positive influence on the environment by reducing carbon dioxide emissions and issues associated with waste disposal. Granulated blast furnace slag (GBFS) is a by-product of the iron and steel industry, with millions of tons of slag being annually produced worldwide. Slag has been widely used in structural engineering and for stabilizing clay soils; however, studies on the effect of slag on sandy soils are scarce. This article investigates the effect of slag content on shear strength parameters through direct shear tests and unconsolidated undrained triaxial tests on mixtures of Perth sand and slag. For this purpose, sand-slag mixtures, with slag contents of 2%, 4%, and 6% by weight of samples, were tested with direct shear tests under three normal stress values, namely 100 kPa, 150 kPa, and 200 kPa. Unconsolidated undrained triaxial tests were performed under a single confining pressure of 100 kPa and relative density of 80%. The internal friction angles and shear stresses of the mixtures were determined via the direct shear tests, demonstrating that shear stresses increased with increasing normal stress and the internal friction angles and cohesion increased with increasing slag. There were no significant differences in shear stresses parameters when slag content rose from 4% to 6%. The unconsolidated undrained triaxial tests demonstrated that shear strength increased with increasing slag content.

Keywords: direct shear, shear strength, slag, UU test

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Authors: H. I. Beloufa, M. Tarfaoui

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For many applications, adhesively bonded assemblies have gained an increasing interest in the industry due to several advantages over welding, riveting and bolting, such as reduction of stress concentrations, lightness, low cost and easy manufacturing. This work is largely concerned to show the effects of the loading rate of the adhesively bonded joints under different speed rates. The tensile tests were conducted at four different rates; static (5mm/min, 50mm/min) and dynamic tests (1m/s, and 10m/s). An attempt was made to determine the damage kinetic and a comparison between the use of aluminium and composite laminate substrates is introduced. Aluminum T6082 and glass/vinylester laminated composite Substrates were used to construct aluminum/aluminum and laminate/laminate specimens. The adhesive used in this study was Araldite 2015. The results showed the effects of the loading rate évolution on the double joint strength. The comparison of the results of static and dynamic tests showed a raise of the strength of the specimens while the load velocity is elevated. In the case of composite substrates double joint lap, the stiffness increased by more than 60% between static and dynamic tests. However, in the case of aluminum substrates, the rigidity improved about 28% from static to moderately high velocity loading. For both aluminum and composite double joint lap, the strength increased by approximately 25% when the tensile velocity is increased from 5 mm/min to 50 mm/min (static tests). Nevertheless, the tensile velocity is extended to 1m/s the strength increased by 13% and 25% respectively for composite and aluminum substrates.

Keywords: adhesive, double lap joints, static and dynamic behavior, tensile tests

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Authors: Priyal Chikhaliwala, Sudeshna Chandra

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Liver cancer is one of the most common malignant tumors with poor prognosis. This is because liver cancer does not exhibit any symptoms in early stage of disease. Increased serum level of AFP is clinically considered as a diagnostic marker for liver malignancy. The present diagnostic modalities include various types of immunoassays, radiological studies, and biopsy. However, these tests undergo slow response times, require significant sample volumes, achieve limited sensitivity and ultimately become expensive and burdensome to patients. Considering all these aspects, electrochemical biosensors based on dendrimer-magnetic nanoparticles (MNPs) was designed. Dendrimers are novel nano-sized, three-dimensional molecules with monodispersed structures. Poly-amidoamine (PAMAM) dendrimers with eight –NH₂ groups using ethylenediamine as a core molecule were synthesized using Michael addition reaction. Dendrimers provide added the advantage of not only stabilizing Fe₃O₄ NPs but also displays capability of performing multiple electron redox events and binding multiple biological ligands to its dendritic end-surface. Fe₃O₄ NPs due to its superparamagnetic behavior can be exploited for magneto-separation process. Fe₃O₄ NPs were stabilized with PAMAM dendrimer by in situ co-precipitation method. The surface coating was examined by FT-IR, XRD, VSM, and TGA analysis. Electrochemical behavior and kinetic studies were evaluated using CV which revealed that the dendrimer-Fe₃O₄ NPs can be looked upon as electrochemically active materials. Electrochemical immunosensor was designed by immobilizing anti-AFP onto dendrimer-MNPs by gluteraldehyde conjugation reaction. The bioconjugates were then incubated with AFP antigen. The immunosensor was characterized electrochemically indicating successful immuno-binding events. The binding events were also further studied using magnetic particle imaging (MPI) which is a novel imaging modality in which Fe₃O₄ NPs are used as tracer molecules with positive contrast. Multicolor MPI was able to clearly localize AFP antigen and antibody and its binding successfully. Results demonstrate immense potential in terms of biosensing and enabling MPI of AFP in clinical diagnosis.

Keywords: alpha-fetoprotein, dendrimers, electrochemical biosensors, magnetic nanoparticles

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Authors: Francis Zerd, Brian E. Moore, Atuganile E. Malango, Patrick W. Hosokawa, Kevin O. Lillehei, Laurence Lemery Mchome, D. Ryan Ormond

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Introduction: Since neuropathologic diagnosis in the developing world is hampered by limitations in technical infrastructure, trained laboratory personnel, and subspecialty-trained pathologists, the use of telepathology for diagnostic support, second-opinion consultations, and ongoing training holds promise as a means of addressing these challenges. This research aims to assess the utility of static teleneuropathology in improving neuropathologic diagnoses in low- and middle-income countries. Methods: Consecutive neurosurgical biopsy and resection specimens obtained at Muhimbili National Hospital in Tanzania between July 1, 2018, and June 30, 2019, were selected for retrospective, blinded static-image neuropathologic review followed by on-site review by an expert neuropathologist. Results: A total of 75 neuropathologic cases were reviewed. The agreement of static images and on-site glass diagnosis was 71% with strict criteria and 88% with less stringent criteria. This represents an overall improvement in diagnostic accuracy from 36% by general pathologists to 71% by a neuropathologist using static telepathology (or 76% to 88% with less stringent criteria). Conclusions: Telepathology offers a suitable means of providing diagnostic support, second-opinion consultations, and ongoing training to pathologists practicing in resource-limited countries. Moreover, static digital teleneuropathology is an uncomplicated, cost-effective, and reliable way to achieve these goals.

Keywords: neuropathology, resource-limited settings, static image, Tanzania, teleneuropathology

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Authors: Alireza Pesarakloo, Masoumeh Najibzadeh

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We studied the development and morphology of different larval stages of Pelophylax bedriagae at two rearing temperatures (20 and 24°C). Eggs collected from a breeding site in south-western Iran. Diagnostic morphological characters are provided for Gosner (1960) larval stages 1-46. The larvae hatched about seven days after egg deposition. Principal diagnostic feature including the formation of the funnel-shaped oral disc became discernible about ten days after hatch at Gosner stage 21 and degenerated at Gosner stage 42. Larvae developed faster at higher temperatures. The largest body length of larval P. bedriagae measured about 54mm in 70 days after egg deposition. Based on our results, the longest metamorphosis time was observed on temperature (20°C) whilst the shortest metamorphosis time occurred on temperature (24°C). Compared with the majority of other Palearctic Anurans, it appears that embryonic and larval development is usually slow rapid in P. bedriagae.

Keywords: development, larval stages, Pelophylax bedriagae, temperatures

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Authors: Seyed Abolhassan Naeini, Ali Namaei

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This investigation presents the behavior of the unsaturated silty sand by calculating the shear resistance of the specimens by numerical method. In order to investigate this behavior, a series of triaxial tests have been simulated in constant water condition. The finite difference software FLAC3D has been carried out for analyzing the shear resistance and the results are compared with findings from a previous laboratory tests. Constant water tests correspond to a field condition where the rate of the loading is much quicker than the rate at which the pore water is able to drain out of the soil. Tests were simulated on two groups of the silty sands. The obtained results show that the FLAC software may be able to simulate the behavior of specimens with the low suction value magnitude. As the initial suction increased, the differences between numerical and experimental results increased, especially in loose sand. Since some assumptions were used for input parameters, a conclusive result needs more investigations.

Keywords: finite difference, shear resistance, unsaturated silty sand, constant water test

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Authors: Chung-Hao Wu, Tung-Dju Lin, Ming-Chin Ho, Minehiro Nishiyama

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This paper discusses reported fire tests of concrete beams and columns, future fire tests of beam/column frames, and an innovative concept for designing a beam/column furnace. The proposed furnace could be designed to maximize the efficiency of fire test procedures and minimize the cost of furnace construction and fuel consumption. ASTM E119 and ISO 834 standards were drafted based on prescriptive codes and have several weaknesses. The first involves a provision allowing the support regions of a test element to be protected from fire exposure. The second deals with the L/30 deflection end point instead of the structural end point (collapse) in order to protect the hydraulic rams from fire damage. Furthermore, designers commonly use the measured fire endurances of interior columns to assess fire ratings of edge and corner columns of the same building. The validity of such an engineering practice is theoretically unsound. Performance-Based Codes (PBC) require verification tests of structural frames including the beam/column joints to overcome these weaknesses but allow the use of element test data as reference only. In the last 30 years, PBC have gained global popularity because the innovative design and flexibility in achieving an ultimate performance goal.

Keywords: fire resistance, concrete structure, beam/column frame, fire tests

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Authors: Angelis P. Barlampas

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Purpose or Learning Objective It is well known that previous examinations play a major role in futural diagnosis, thus avoiding unnecessary new exams that cost in time and money both for the patient and the health system. A case is presented in which past patient’s results, in combination with the least needed new tests, give an easy final diagnosis. Methods or Background A middle aged man visited the emergency department complaining of hard controlled, persisting fever for the last few days. Laboratory tests showed an elevated number of white blood cells with neutrophil shift and abnormal CRP. The patient was admitted to hospital a month ago for continuing lungs symptomatology after a recent covid-19 infection. Results or Findings Computed tomography scanning showed a solid mass with spiculating margins in right lower lobe. After intravenous iodine contrast administration, there was mildly peripheral enhancement and eccentric non enhancing area. A pneumonic cancer was suspected. Comparison with the patient’s latest computed tomography revealed no mass in the area of interest but only signs of recent post covid-19 lung parenchyma abnormalities. Any new mass that appears in a month’s time span can not be a cancer but a benign lesion. It was obvious that an abscess was the most suitable explanation. The patient was admitted to hospital, and antibiotic therapy was given, with very good results. After a few days, the patient was afebrile and in good condition. Conclusion In this case , a PET scan or a biopsy was avoided, thanks to the patient’s medical history and the availability of previous examinations. It is worthy encouraging the patients to keep their medical records and organizing more efficiently the health system with the current technology of archiving the medical examinations, too.

Keywords: covid-19, chest ct, cancer, abscess, fever

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Authors: Jian Zheng, Li Li, Maxime Daviault

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In several cases, one needs apply lubrication materials in laboratory tests to reduce the friction (shear strength) along the interfaces between a tested soil and the side walls of container. Several types of lubricants are available. Their effectiveness had been tested mostly through direct shear tests. These testing conditions are quite different than those when the tested soil is placed in the container. Thus, the shear strengths measured from direct shear tests may not be totally representative of those of interfaces between the tested soil and the sidewalls of container. In this paper, the effectiveness of different lubricants used to reduce the friction (shear strength) of soil-structure interfaces has been studied. Results show that the selected lubricants do not significantly reduce the sidewall friction (shear strength). Rather, the application of wax, graphite, grease or lubricant oil has effect to increase the sidewall shear strength due probably to the high viscosity of such materials. Subsequently, the application of lubricants between tested soil and sidewall and neglecting the friction (shear strength) along the sidewalls may lead to inaccurate test results.

Keywords: arching, friction, laboratory tests, lubricants

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Authors: Abdullah Al Mamoon, Ataur Rahman

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Due to climate change, future rainfall will change at many locations on earth; however, the spatial and temporal patterns of this change are not easy to predict. One approach of predicting such future changes is to examine the trends in the historical rainfall data at a given region and use the identified trends to make future prediction. For this, a statistical trend test is commonly applied to the historical data. This paper examines the trends of daily extreme rainfall events from 30 rain gauges located in the State of Qatar. Rainfall data covering from 1962 to 2011 were used in the analysis. A combination of four non-parametric and parametric tests was applied to identify trends at 10%, 5%, and 1% significance levels. These tests are Mann-Kendall (MK), Spearman’s Rho (SR), Linear Regression (LR) and CUSUM tests. These tests showed both positive and negative trends throughout the country. Only eight stations showed positive (upward) trend, which were however not statistically significant. In contrast, significant negative (downward) trends were found at the 5% and 10% levels of significance in six stations. The MK, SR and LR tests exhibited very similar results. This finding has important implications in the derivation/upgrade of design rainfall for Qatar, which will affect design and operation of future urban drainage infrastructure in Qatar.

Keywords: trends, extreme rainfall, daily rainfall, Mann-Kendall test, climate change, Qatar

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Authors: Melissa C. Monney

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Psychological testing has been of interest to researchers for many years as useful tools in assessing and diagnosing various disorders as well as to assist in understanding human behavior. However, for over 20 years now, researchers and laypersons alike have been interested in using them for other purposes, such as determining factors in employee selection, promotion, and even termination. In recent years, psychological assessments have been useful in facilitating workplace decision processing, regarding employee circulation within organizations. This literature review explores four of the most commonly used psychological tests in workplace environments, namely cognitive ability, emotional intelligence, integrity, and personality tests, as organizations have used these tests to assess different factors of human behavior as predictive measures of future employee behaviors. The findings suggest that while there is much controversy and debate regarding the validity and reliability of these tests in workplace settings as they were not originally designed for these purposes, the use of such assessments in the workplace has been useful in decreasing costs and employee turnover as well as increase job satisfaction by ensuring the right employees are selected for their roles.

Keywords: cognitive ability, personality testing, predictive validity, workplace behavior

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Authors: Youn-Sung Kim, Hye-Mi Kim, Sang-Hoon Seo, Jaden Cha

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This International standard IEC 61508 sets out a generic approach for all safety lifecycle activities for systems comprised of electrical/electronic/programmable electronic (E/E/PE) elements that are used to perform safety functions. The control unit in stage control system is safety related facilities to control state and speed for stage system running, and it performs safety-critical function by stage control system. The controller unit is part of safety loops corresponding to the IEC 61508 and classified as logic part in the safety loop. In this paper, we analyze using FMEDA (Failure Mode Effect and Diagnostic Analysis) to verification for fault tolerance methods and functional safety of control unit. Moreover, we determined SIL (Safety Integrity Level) for control unit according to the safety requirements defined in IEC 61508-2 based on an analyzed functional safety.

Keywords: safety function, failure mode effect, IEC 61508-2, diagnostic analysis, stage control system

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Authors: Rithika Sriram, Kiran M. Bhojwani

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Introduction : Tuberculosis of the head and neck has proved to be a diagnostic challenge for otorhinolarynologists around the world. These lesions are often misdiagnosed as cancer. So in order to contribute to a better understanding of these lesions, we have conducted our study among patients affected by TB in the head and neck region with the objective of assessing the various manifestations, presentations, diagnostic techniques, risk factors such as smoking and alcohol consumption, coexisting illnesses and treatment modalities. Materials and Methods: This was a retrospective study conducted over a three year period (2012-2014) in 2 hospitals affliated to Kasturba Medical College in Mangalore, South India. A semi structured proforma was used to capture information from the medical records pertaining to the various objectives of the study such as clinical features and history of smoking. Data was analysed using SPSS version 16.0 and results obtained were depicted as percentages. Chi square test was used to find association between the variables and p<0.05 was considered statistically significant. Results: 104 patients were found to have TB of the head and neck and among them,the most common manifestation was found to be Tubercular Lymphadenitis (86.53%), followed by laryngeal TB (4.8%), submandibular gland TB (3.8%), deep neck space abscess(3.8%) and adenotonsillar TB. FNAC was found to be the gold standard for the diagnosis of TB disease of the lymph node.26% of the patients had coexisting HIV infection and 16.3% of the patients had associated pulmonary TB. More than 20% of the patients were smokers. Most patients were treated using ATT. Conclusion: Tuberculosis affecting regions of head and neck is no longer uncommon. Sufficient knowledge and appropriate diagnostic means is required while dealing with these lesions and must be included in the differential diagnosis of pathological lesions of head and neck.

Keywords: FNAC, Mangalore, smoking, tuberculosis

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Authors: Leonardo Juan Ramírez López, Javier Oswaldo Rodriguez Velasquez

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We have designed a Holter that measures the heart´s activity for over 24 hours, implemented a prediction methodology, and generate alarms as well as indicators to patients and treating physicians. Various diagnostic advances have been developed in clinical cardiology thanks to Holter implementation; however, their interpretation has largely been conditioned to clinical analysis and measurements adjusted to diverse population characteristics, thus turning it into a subjective examination. This, however, requires vast population studies to be validated that, in turn, have not achieved the ultimate goal: mortality prediction. Given this context, our Insight Research Group developed a mathematical methodology that assesses cardiac dynamics through entropy and probability, creating a numerical and geometrical attractor which allows quantifying the normalcy of chronic and acute disease as well as the evolution between such states, and our Tigum Research Group developed a holter device with 12 channels and advanced computer software. This has been shown in different contexts with 100% sensitivity and specificity results.

Keywords: attractor , cardiac, entropy, holter, mathematical , prediction

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Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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Authors: Ethan James

Abstract:

Over one billion people worldwide suffer from some level of vision loss or blindness as a result of progressive retinal diseases. Many patients, particularly in developing areas, are incorrectly diagnosed or undiagnosed whatsoever due to unconventional diagnostic tools and screening methods. Artificial intelligence (AI) based on deep learning (DL) convolutional neural networks (CNN) have recently gained a high interest in ophthalmology for its computer-imaging diagnosis, disease prognosis, and risk assessment. Optical coherence tomography (OCT) is a popular imaging technique used to capture high-resolution cross-sections of retinas. In ophthalmology, DL has been applied to fundus photographs, optical coherence tomography, and visual fields, achieving robust classification performance in the detection of various retinal diseases including macular degeneration, diabetic retinopathy, and retinitis pigmentosa. However, there is no complete diagnostic model to analyze these retinal images that provide a diagnostic accuracy above 90%. Thus, the purpose of this project was to develop an AI model that utilizes machine learning techniques to automatically diagnose specific retinal diseases from OCT scans. The algorithm consists of neural network architecture that was trained from a dataset of over 20,000 real-world OCT images to train the robust model to utilize residual neural networks with cyclic pooling. This DL model can ultimately aid ophthalmologists in diagnosing patients with these retinal diseases more quickly and more accurately, therefore facilitating earlier treatment, which results in improved post-treatment outcomes.

Keywords: artificial intelligence, deep learning, imaging, medical devices, ophthalmic devices, ophthalmology, retina

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Authors: Marcin Michalak

Abstract:

Due to the increasing efforts on saving our natural environment a change in the structure of energy resources can be observed - an increasing fraction of a renewable energy sources. In many countries traditional underground coal mining loses its significance but there are still countries, like Poland or Germany, in which the coal based technologies have the greatest fraction in a total energy production. This necessitates to make an effort to limit the costs and negative effects of underground coal mining. The longwall complex is as essential part of the underground coal mining. The safety and the effectiveness of the work is strongly dependent of the diagnostic state of powered roof supports. The building of a useful and reliable diagnostic system requires a lot of data. As the acquisition of a data of any possible operating conditions it is important to have a possibility to generate a demanded artificial working characteristics. In this paper a new approach of modelling a leg pressure in the single unit of powered roof support. The model is a result of the analysis of a typical working cycles.

Keywords: machine modelling, underground mining, coal mining, structure

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