Search results for: diagnostic error
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2915

Search results for: diagnostic error

845 Development and Verification of the Idom Shielding Optimization Tool

Authors: Omar Bouhassoun, Cristian Garrido, César Hueso

Abstract:

The radiation shielding design is an optimization problem with multiple -constrained- objective functions (radiation dose, weight, price, etc.) that depend on several parameters (material, thickness, position, etc.). The classical approach for shielding design consists of a brute force trial-and-error process subject to previous designer experience. Therefore, the result is an empirical solution but not optimal, which can degrade the overall performance of the shielding. In order to automate the shielding design procedure, the IDOM Shielding Optimization Tool (ISOT) has been developed. This software combines optimization algorithms with the capabilities to read/write input files, run calculations, as well as parse output files for different radiation transport codes. In the first stage, the software was established to adjust the input files for two well-known Monte Carlo codes (MCNP and Serpent) and optimize the result (weight, volume, price, dose rate) using multi-objective genetic algorithms. Nevertheless, its modular implementation easily allows the inclusion of more radiation transport codes and optimization algorithms. The work related to the development of ISOT and its verification on a simple 3D multi-layer shielding problem using both MCNP and Serpent will be presented. ISOT looks very promising for achieving an optimal solution to complex shielding problems.

Keywords: optimization, shielding, nuclear, genetic algorithm

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844 Molecular Detection of Acute Virus Infection in Children Hospitalized with Diarrhea in North India during 2014-2016

Authors: Ali Ilter Akdag, Pratima Ray

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Background:This acute gastroenteritis viruses such as rotavirus, astrovirus, and adenovirus are mainly responsible for diarrhea in children below < 5 years old. Molecular detection of these viruses is crucially important to the understand development of the effective cure. This study aimed to determine the prevalence of common these viruses in children < 5 years old presented with diarrhea from Lala Lajpat Rai Memorial Medical College (LLRM) centre (Meerut) North India, India Methods: Total 312 fecal samples were collected from diarrheal children duration 3 years: in year 2014 (n = 118), 2015 (n = 128) and 2016 (n = 66) ,< 5 years of age who presented with acute diarrhea at the Lala Lajpat Rai Memorial Medical College (LLRM) centre(Meerut) North India, India. All samples were the first detection by EIA/RT-PCR for rotaviruses, adenovirus and astrovirus. Results: In 312 samples from children with acute diarrhea in sample viral agent was found, rotavirus A was the most frequent virus identified (57 cases; 18.2%), followed by Astrovirus in 28 cases (8.9%), adenovirus in 21 cases (6.7%). Mixed infections were found in 14 cases, all of which presented with acute diarrhea (14/312; 4.48%). Conclusions: These viruses are a major cause of diarrhea in children <5 years old in North India. Rotavirus A is the most common etiological agent, follow by astrovirus. This surveillance is important to vaccine development of the entire population. There is variation detection of virus year wise due to differences in the season of sampling, method of sampling, hygiene condition, socioeconomic level of the entire people, enrolment criteria, and virus detection methods. It was found Astrovirus higher then Rotavirus in 2015, but overall three years study Rotavirus A is mainly responsible for causing severe diarrhea in children <5 years old in North India. It emphasizes the required for cost-effective diagnostic assays for Rotaviruses which would help to determine the disease burden.

Keywords: adenovirus, Astrovirus, hospitalized children, Rotavirus

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843 Distributional and Dynamic impact of Energy Subsidy Reform

Authors: Ali Hojati Najafabadi, Mohamad Hosein Rahmati, Seyed Ali Madanizadeh

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Governments execute energy subsidy reforms by either increasing energy prices or reducing energy price dispersion. These policies make less use of energy per plant (intensive margin), vary the total number of firms (extensive margin), promote technological progress (technology channel), and make additional resources to redistribute (resource channel). We estimate a structural dynamic firm model with endogenous technology adaptation using data from the manufacturing firms in Iran and a country ranked the second-largest energy subsidy plan by the IMF. The findings show significant dynamics and distributional effects due to an energy reform plan. The price elasticity of energy consumption in the industrial sector is about -2.34, while it is -3.98 for large firms. The dispersion elasticity, defined as the amounts of changes in energy consumption by a one-percent reduction in the standard error of energy price distribution, is about 1.43, suggesting significant room for a distributional policy. We show that the intensive margin is the main driver of energy price elasticity, whereas the other channels mostly offset it. In contrast, the labor response is mainly through the extensive margin. Total factor productivity slightly improves in light of the reduction in energy consumption if, at the same time, the redistribution policy boosts the aggregate demands.

Keywords: energy reform, firm dynamics, structural estimation, subsidy policy

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842 Understanding the Heterogeneity of Polycystic Ovarian Syndrome: The Influence of Ethnicity and Body Mass

Authors: Hamza Ikhlaq, Stephen Franks

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Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. The aetiology behind PCOS is poorly understood but influencing ethnic, environmental, and genetic factors have been recognised. However, literature examining the impact of ethnicity is scarce. We hypothesised Body Mass Index (BMI) and ethnicity influence the clinical, metabolic, and biochemical presentations of PCOS, with an interaction between these factors. Methods: A database of 1081 women with PCOS and a control group of 72 women were analysed. BMIs were grouped using the World Health Organisation classification into normal weight, overweight and obese groups. Ethnicities were classified into European, South Asian, and Afro-Caribbean groups. Biochemical and clinical presentations were compared amongst these groups, and statistical analyses were performed to assess significance. Results: This study revealed ethnicity significantly influences biochemical and clinical presentations of PCOS. A greater proportion of South Asian women are impacted by menstrual cycle disturbances and hirsutism than European and Afro-Caribbean women. South Asian and Afro-Caribbean women show greater measures of insulin resistance and weight gain when compared to their European peers. Women with increased BMI are shown to have an increased prevalence of PCOS phenotypes alongside increased levels of insulin resistance and testosterone. Furthermore, significantly different relationships between the waist-hip ratio and measures of insulin and glucose control for Afro-Caribbean women were identified compared to other ethnic groups. Conclusions: The findings of this study show ethnicity significantly influence the phenotypic and biochemical presentations of PCOS, with an interaction between body habitus and ethnicity found. Furthermore, we provide further data on the influences of BMI on the manifestations of PCOS. Therefore, we highlight the need to consider these factors when reviewing diagnostic criteria and delivering clinical care for these groups.

Keywords: PCOS, ethnicity, BMI, clinical

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841 Surface Pressure Distributions for a Forebody Using Pressure Sensitive Paint

Authors: Yi-Xuan Huang, Kung-Ming Chung, Ping-Han Chung

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Pressure sensitive paint (PSP), which relies on the oxygen quenching of a luminescent molecule, is an optical technique used in wind-tunnel models. A full-field pressure pattern with low aerodynamic interference can be obtained, and it is becoming an alternative to pressure measurements using pressure taps. In this study, a polymer-ceramic PSP was used, using toluene as a solvent. The porous particle and polymer were silica gel (SiO₂) and RTV-118 (3g:7g), respectively. The compound was sprayed onto the model surface using a spray gun. The absorption and emission spectra for Ru(dpp) as a luminophore were respectively 441-467 nm and 597 nm. A Revox SLG-55 light source with a short-pass filter (550 nm) and a 14-bit CCD camera with a long-pass (600 nm) filter were used to illuminate PSP and to capture images. This study determines surface pressure patterns for a forebody of an AGARD B model in a compressible flow. Since there is no experimental data for surface pressure distributions available, numerical simulation is conducted using ANSYS Fluent. The lift and drag coefficients are calculated and in comparison with the data in the open literature. The experiments were conducted using a transonic wind tunnel at the Aerospace Science and Research Center, National Cheng Kung University. The freestream Mach numbers were 0.83, and the angle of attack ranged from -4 to 8 degree. Deviation between PSP and numerical simulation is within 5%. However, the effect of the setup of the light source should be taken into account to address the relative error.

Keywords: pressure sensitive paint, forebody, surface pressure, compressible flow

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840 Deep Learning Application for Object Image Recognition and Robot Automatic Grasping

Authors: Shiuh-Jer Huang, Chen-Zon Yan, C. K. Huang, Chun-Chien Ting

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Since the vision system application in industrial environment for autonomous purposes is required intensely, the image recognition technique becomes an important research topic. Here, deep learning algorithm is employed in image system to recognize the industrial object and integrate with a 7A6 Series Manipulator for object automatic gripping task. PC and Graphic Processing Unit (GPU) are chosen to construct the 3D Vision Recognition System. Depth Camera (Intel RealSense SR300) is employed to extract the image for object recognition and coordinate derivation. The YOLOv2 scheme is adopted in Convolution neural network (CNN) structure for object classification and center point prediction. Additionally, image processing strategy is used to find the object contour for calculating the object orientation angle. Then, the specified object location and orientation information are sent to robotic controller. Finally, a six-axis manipulator can grasp the specific object in a random environment based on the user command and the extracted image information. The experimental results show that YOLOv2 has been successfully employed to detect the object location and category with confidence near 0.9 and 3D position error less than 0.4 mm. It is useful for future intelligent robotic application in industrial 4.0 environment.

Keywords: deep learning, image processing, convolution neural network, YOLOv2, 7A6 series manipulator

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839 Applying Computer Simulation Methods to a Molecular Understanding of Flaviviruses Proteins towards Differential Serological Diagnostics and Therapeutic Intervention

Authors: Sergio Alejandro Cuevas, Catherine Etchebest, Fernando Luis Barroso Da Silva

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The flavivirus genus has several organisms responsible for generating various diseases in humans. Special in Brazil, Zika (ZIKV), Dengue (DENV) and Yellow Fever (YFV) viruses have raised great health concerns due to the high number of cases affecting the area during the last years. Diagnostic is still a difficult issue since the clinical symptoms are highly similar. The understanding of their common structural/dynamical and biomolecular interactions features and differences might suggest alternative strategies towards differential serological diagnostics and therapeutic intervention. Due to their immunogenicity, the primary focus of this study was on the ZIKV, DENV and YFV non-structural proteins 1 (NS1) protein. By means of computational studies, we calculated the main physical chemical properties of this protein from different strains that are directly responsible for the biomolecular interactions and, therefore, can be related to the differential infectivity of the strains. We also mapped the electrostatic differences at both the sequence and structural levels for the strains from Uganda to Brazil that could suggest possible molecular mechanisms for the increase of the virulence of ZIKV. It is interesting to note that despite the small changes in the protein sequence due to the high sequence identity among the studied strains, the electrostatic properties are strongly impacted by the pH which also impact on their biomolecular interactions with partners and, consequently, the molecular viral biology. African and Asian strains are distinguishable. Exploring the interfaces used by NS1 to self-associate in different oligomeric states, and to interact with membranes and the antibody, we could map the strategy used by the ZIKV during its evolutionary process. This indicates possible molecular mechanisms that can explain the different immunological response. By the comparison with the known antibody structure available for the West Nile virus, we demonstrated that the antibody would have difficulties to neutralize the NS1 from the Brazilian strain. The present study also opens up perspectives to computationally design high specificity antibodies.

Keywords: zika, biomolecular interactions, electrostatic interactions, molecular mechanisms

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838 Poly (Diphenylamine-4-Sulfonic Acid) Modified Glassy Carbon Electrode for Voltammetric Determination of Gallic Acid in Honey and Peanut Samples

Authors: Zelalem Bitew, Adane Kassa, Beyene Misgan

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In this study, a sensitive and selective voltammetric method based on poly(diphenylamine-4-sulfonic acid) modified glassy carbon electrode (poly(DPASA)/GCE) was developed for determination of gallic acid. Appearance of an irreversible oxidative peak at both bare GCE and poly(DPASA)/GCE for gallic acid with about three folds current enhancement and much reduced potential at poly(DPASA)/GCE showed catalytic property of the modifier towards oxidation of gallic acid. Under optimized conditions, Adsorptive stripping square wave voltammetric peak current response of the poly(DPASA)/GCE showed linear dependence with gallic acid concentration in the range 5.00 × 10-7 − 3.00 × 10-4 mol L-1 with limit of detection of 4.35 × 10-9. Spike recovery results between 94.62-99.63, 95.00-99.80 and 97.25-103.20% of gallic acid in honey, raw peanut, and commercial peanut butter samples respectively, interference recovery results with less than 4.11% error in the presence of uric acid and ascorbic acid, lower LOD and relatively wider dynamic range than most of the previously reported methods validated the potential applicability of the method based on poly(DPASA)/GCE for determination of gallic acid real samples including in honey and peanut samples.

Keywords: gallic acid, diphenyl amine sulfonic acid, adsorptive anodic striping square wave voltammetry, honey, peanut

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837 From Electroencephalogram to Epileptic Seizures Detection by Using Artificial Neural Networks

Authors: Gaetano Zazzaro, Angelo Martone, Roberto V. Montaquila, Luigi Pavone

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Seizure is the main factor that affects the quality of life of epileptic patients. The diagnosis of epilepsy, and hence the identification of epileptogenic zone, is commonly made by using continuous Electroencephalogram (EEG) signal monitoring. Seizure identification on EEG signals is made manually by epileptologists and this process is usually very long and error prone. The aim of this paper is to describe an automated method able to detect seizures in EEG signals, using knowledge discovery in database process and data mining methods and algorithms, which can support physicians during the seizure detection process. Our detection method is based on Artificial Neural Network classifier, trained by applying the multilayer perceptron algorithm, and by using a software application, called Training Builder that has been developed for the massive extraction of features from EEG signals. This tool is able to cover all the data preparation steps ranging from signal processing to data analysis techniques, including the sliding window paradigm, the dimensionality reduction algorithms, information theory, and feature selection measures. The final model shows excellent performances, reaching an accuracy of over 99% during tests on data of a single patient retrieved from a publicly available EEG dataset.

Keywords: artificial neural network, data mining, electroencephalogram, epilepsy, feature extraction, seizure detection, signal processing

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836 Early Warning System of Financial Distress Based On Credit Cycle Index

Authors: Bi-Huei Tsai

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Previous studies on financial distress prediction choose the conventional failing and non-failing dichotomy; however, the distressed extent differs substantially among different financial distress events. To solve the problem, “non-distressed”, “slightly-distressed” and “reorganization and bankruptcy” are used in our article to approximate the continuum of corporate financial health. This paper explains different financial distress events using the two-stage method. First, this investigation adopts firm-specific financial ratios, corporate governance and market factors to measure the probability of various financial distress events based on multinomial logit models. Specifically, the bootstrapping simulation is performed to examine the difference of estimated misclassifying cost (EMC). Second, this work further applies macroeconomic factors to establish the credit cycle index and determines the distressed cut-off indicator of the two-stage models using such index. Two different models, one-stage and two-stage prediction models, are developed to forecast financial distress, and the results acquired from different models are compared with each other, and with the collected data. The findings show that the two-stage model incorporating financial ratios, corporate governance and market factors has the lowest misclassification error rate. The two-stage model is more accurate than the one-stage model as its distressed cut-off indicators are adjusted according to the macroeconomic-based credit cycle index.

Keywords: Multinomial logit model, corporate governance, company failure, reorganization, bankruptcy

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835 Evaluating the Nexus between Energy Demand and Economic Growth Using the VECM Approach: Case Study of Nigeria, China, and the United States

Authors: Rita U. Onolemhemhen, Saheed L. Bello, Akin P. Iwayemi

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The effectiveness of energy demand policy depends on identifying the key drivers of energy demand both in the short-run and the long-run. This paper examines the influence of regional differences on the link between energy demand and other explanatory variables for Nigeria, China and USA using the Vector Error Correction Model (VECM) approach. This study employed annual time series data on energy consumption (ED), real gross domestic product (GDP) per capita (RGDP), real energy prices (P) and urbanization (N) for a thirty-six-year sample period. The utilized time-series data are sourced from World Bank’s World Development Indicators (WDI, 2016) and US Energy Information Administration (EIA). Results from the study, shows that all the independent variables (income, urbanization, and price) substantially affect the long-run energy consumption in Nigeria, USA and China, whereas, income has no significant effect on short-run energy demand in USA and Nigeria. In addition, the long-run effect of urbanization is relatively stronger in China. Urbanization is a key factor in energy demand, it therefore recommended that more attention should be given to the development of rural communities to reduce the inflow of migrants into urban communities which causes the increase in energy demand and energy excesses should be penalized while energy management should be incentivized.

Keywords: economic growth, energy demand, income, real GDP, urbanization, VECM

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834 Importance of Prostate Volume, Prostate Specific Antigen Density and Free/Total Prostate Specific Antigen Ratio for Prediction of Prostate Cancer

Authors: Aliseydi Bozkurt

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Objectives: Benign prostatic hyperplasia (BPH) is the most common benign disease, and prostate cancer (PC) is malign disease of the prostate gland. Transrectal ultrasound-guided biopsy (TRUS-bx) is one of the most important diagnostic tools in PC diagnosis. Identifying men at increased risk for having a biopsy detectable prostate cancer should consider prostate specific antigen density (PSAD), f/t PSA Ratio, an estimate of prostate volume. Method: We retrospectively studied 269 patients who had a prostate specific antigen (PSA) score of 4 or who had suspected rectal examination at any PSA level and received TRUS-bx between January 2015 and June 2018 in our clinic. TRUS-bx was received by 12 experienced urologists with 12 quadrants. Prostate volume was calculated prior to biopsy together with TRUS. Patients were classified as malignant and benign at the end of pathology. Age, PSA value, prostate volume in transrectal ultrasonography, corpuscle biopsy, biopsy pathology result, the number of cancer core and Gleason score were evaluated in the study. The success rates of PV, PSAD, and f/tPSA were compared in all patients and those with PSA 2.5-10 ng/mL and 10.1-30 ng/mL tp foresee prostate cancer. Result: In the present study, in patients with PSA 2.5-10 ng/ml, PV cut-off value was 43,5 mL (n=42 < 43,5 mL and n=102 > 43,5 mL) while in those with PSA 10.1-30 ng/mL prostate volüme (PV) cut-off value was found 61,5 mL (n=31 < 61,5 mL and n=36 > 61,5 mL). Total PSA values in the group with PSA 2.5-10 ng/ml were found lower (6.0 ± 1.3 vs 6.7 ± 1.7) than that with PV < 43,5 mL, this value was nearly significant (p=0,043). In the group with PSA value 10.1-30 ng/mL, no significant difference was found (p=0,117) in terms of total PSA values between the group with PV < 61,5 mL and that with PV > 61,5 mL. In the group with PSA 2.5-10 ng/ml, in patients with PV < 43,5 mL, f/t PSA value was found significantly lower compared to the group with PV > 43,5 mL (0.21 ± 0.09 vs 0.26 ± 0.09 p < 0.001 ). Similarly, in the group with PSA value of 10.1-30 ng/mL, f/t PSA value was found significantly lower in patients with PV < 61,5 mL (0.16 ± 0.08 vs 0.23 ± 0.10 p=0,003). In the group with PSA 2.5-10 ng/ml, PSAD value in patients with PV < 43,5 mL was found significantly higher compared to those with PV > 43,5 mL (0.17 ± 0.06 vs 0.10 ± 0.03 p < 0.001). Similarly, in the group with PSA value 10.1-30 ng/mL PSAD value was found significantly higher in patients with PV < 61,5 mL (0.47 ± 0.23 vs 0.17 ± 0.08 p < 0.001 ). The biopsy results suggest that in the group with PSA 2.5-10 ng/ml, in 29 of the patients with PV < 43,5 mL (69%) cancer was detected while in 13 patients (31%) no cancer was detected. While in 19 patients with PV > 43,5 mL (18,6%) cancer was found, in 83 patients (81,4%) no cancer was detected (p < 0.001). In the group with PSA value 10.1-30 ng/mL, in 21 patients with PV < 61,5 mL (67.7%) cancer was observed while only in10 patients (32.3%) no cancer was seen. In 5 patients with PV > 61,5 mL (13.9%) cancer was found while in 31 patients (86.1%) no cancer was observed (p < 0.001). Conclusions: Identifying men at increased risk for having a biopsy detectable prostate cancer should consider PSA, f/t PSA Ratio, an estimate of prostate volume. Prostate volume in PC was found lower.

Keywords: prostate cancer, prostate volume, prostate specific antigen, free/total PSA ratio

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833 A Transformer-Based Approach for Multi-Human 3D Pose Estimation Using Color and Depth Images

Authors: Qiang Wang, Hongyang Yu

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Multi-human 3D pose estimation is a challenging task in computer vision, which aims to recover the 3D joint locations of multiple people from multi-view images. In contrast to traditional methods, which typically only use color (RGB) images as input, our approach utilizes both color and depth (D) information contained in RGB-D images. We also employ a transformer-based model as the backbone of our approach, which is able to capture long-range dependencies and has been shown to perform well on various sequence modeling tasks. Our method is trained and tested on the Carnegie Mellon University (CMU) Panoptic dataset, which contains a diverse set of indoor and outdoor scenes with multiple people in varying poses and clothing. We evaluate the performance of our model on the standard 3D pose estimation metrics of mean per-joint position error (MPJPE). Our results show that the transformer-based approach outperforms traditional methods and achieves competitive results on the CMU Panoptic dataset. We also perform an ablation study to understand the impact of different design choices on the overall performance of the model. In summary, our work demonstrates the effectiveness of using a transformer-based approach with RGB-D images for multi-human 3D pose estimation and has potential applications in real-world scenarios such as human-computer interaction, robotics, and augmented reality.

Keywords: multi-human 3D pose estimation, RGB-D images, transformer, 3D joint locations

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832 NOx Prediction by Quasi-Dimensional Combustion Model of Hydrogen Enriched Compressed Natural Gas Engine

Authors: Anas Rao, Hao Duan, Fanhua Ma

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The dependency on the fossil fuels can be minimized by using the hydrogen enriched compressed natural gas (HCNG) in the transportation vehicles. However, the NOx emissions of HCNG engines are significantly higher, and this turned to be its major drawback. Therefore, the study of NOx emission of HCNG engines is a very important area of research. In this context, the experiments have been performed at the different hydrogen percentage, ignition timing, air-fuel ratio, manifold-absolute pressure, load and engine speed. Afterwards, the simulation has been accomplished by the quasi-dimensional combustion model of HCNG engine. In order to investigate the NOx emission, the NO mechanism has been coupled to the quasi-dimensional combustion model of HCNG engine. The three NOx mechanism: the thermal NOx, prompt NOx and N2O mechanism have been used to predict NOx emission. For the validation purpose, NO curve has been transformed into NO packets based on the temperature difference of 100 K for the lean-burn and 60 K for stoichiometric condition. While, the width of the packet has been taken as the ratio of crank duration of the packet to the total burnt duration. The combustion chamber of the engine has been divided into three zones, with the zone equal to the product of summation of NO packets and space. In order to check the accuracy of the model, the percentage error of NOx emission has been evaluated, and it lies in the range of ±6% and ±10% for the lean-burn and stoichiometric conditions respectively. Finally, the percentage contribution of each NO formation has been evaluated.

Keywords: quasi-dimensional combustion , thermal NO, prompt NO, NO packet

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831 A Brief Trauma Treatment Program for Survivors of Trauma: A Single-Case Design

Authors: Duane Booysen, Ashraf Kagee

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There is a high prevalence of violent crime and trauma exposure in South African society. Considering the prevalence of continuous violent crimes and traumatization in South Africa, the public mental health sector is required to combat the burgeoning effect of traumatic stress in South Africa. Trauma counselors, especially, provide important mental health services at primary health care to persons affected by traumatic events. Therefore, the evaluation and implementation of evidence-based trauma therapies is essential at a primary health care level in treating traumatic stress. A single-case design was used to evaluate the treatment effect of a Brief Trauma Treatment Programme treating persons who present with symptoms of posttraumatic stress disorder at a primary care trauma centre in Cape Town, South Africa. The sample consisted of six adult participants who presented with symptoms of posttraumatic stress and were assessed at baseline, during treatment, post-intervention and at 3-month follow. All participants received six sessions of trauma therapy. Assessment measures included the posttraumatic stress disorder symptom scale interviews for Diagnostic and Statistical Manual fifth edition (DSM5), the posttraumatic disorder checklist for DSM5, Beck Depression Inventory and Beck Anxiety Inventory. Results demonstrate that participants had noticeable reduced symptoms for traumatic stress, anxiety and depression despite living in contexts of violent crime and trauma. In conclusion, the article critically reflects on the need to evaluate and implement evidence-based treatments for the South African context, and how evidence-based treatments are used in developing socio-economic and cultural diverse contexts with continuous levels of violence and traumatization.

Keywords: psychological interventions, public mental health, traumatic stress, single-case design

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830 Segmenting 3D Optical Coherence Tomography Images Using a Kalman Filter

Authors: Deniz Guven, Wil Ward, Jinming Duan, Li Bai

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Over the past two decades or so, Optical Coherence Tomography (OCT) has been used to diagnose retina and optic nerve diseases. The retinal nerve fibre layer, for example, is a powerful diagnostic marker for detecting and staging glaucoma. With the advances in optical imaging hardware, the adoption of OCT is now commonplace in clinics. More and more OCT images are being generated, and for these OCT images to have clinical applicability, accurate automated OCT image segmentation software is needed. Oct image segmentation is still an active research area, as OCT images are inherently noisy, with the multiplicative speckling noise. Simple edge detection algorithms are unsuitable for detecting retinal layer boundaries in OCT images. Intensity fluctuation, motion artefact, and the presence of blood vessels also decrease further OCT image quality. In this paper, we introduce a new method for segmenting three-dimensional (3D) OCT images. This involves the use of a Kalman filter, which is commonly used in computer vision for object tracking. The Kalman filter is applied to the 3D OCT image volume to track the retinal layer boundaries through the slices within the volume and thus segmenting the 3D image. Specifically, after some pre-processing of the OCT images, points on the retinal layer boundaries in the first image are identified, and curve fitting is applied to them such that the layer boundaries can be represented by the coefficients of the curve equations. These coefficients then form the state space for the Kalman Filter. The filter then produces an optimal estimate of the current state of the system by updating its previous state using the measurements available in the form of a feedback control loop. The results show that the algorithm can be used to segment the retinal layers in OCT images. One of the limitations of the current algorithm is that the curve representation of the retinal layer boundary does not work well when the layer boundary is split into two, e.g., at the optic nerve, the layer boundary split into two. This maybe resolved by using a different approach to representing the boundaries, such as b-splines or level sets. The use of a Kalman filter shows promise to developing accurate and effective 3D OCT segmentation methods.

Keywords: optical coherence tomography, image segmentation, Kalman filter, object tracking

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829 Effect of Psychological Stress to the Mucosal IL-6 and Helicobacter pylori Activity in Functional Dyspepsia and Myocytes

Authors: Eryati Darwin, Arina Widya Murni, Adnil Edwin Nurdin

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Background: Functional dyspepsia (FD) is a highly prevalent and heterogeneous disorder. Most patients with FD complain of symptoms related to the intake of meals. Psychological stress may promote peptic ulcer and had an effect on ulcers associated Hp, and may also trigger worsen symptoms in inflammatory disorders of the gastrointestinal. Cells in mucosal gastric stimulate the production of several cytokines, which might associated with Helicobacter pylori infection. The cascade of biological events leading to stress-induced FD remains poorly understood. Aim of Study: To determine the prion-flammatory cytokine IL-6, and Helicobacter pylori activity on mucosal gastric of FD and their association with psychological stress. Methods: The subjects of this study were dyspeptic patients who visited M. Djamil General Hospital and in two Community Health Centers in Padang. On the basis of the stress index scale to identify psychological stress by using Depression Anxiety and Stress Scale (DASS 42), subjects were divided into two groups of 20 each, stress groups and non-stress groups. All diagnoses were confirmed by review of cortisol and esophagogastroduodenoscopy reports. Gastric biopsy samples and peripheral blood were taken during diagnostic procedures. Immunohistochemistry methods were used to determine the expression of IL-6 and Hp in gastric mucosal. The data were statistically analyzed by univariate and bivariate analysis. All procedures of this study were approved by Research Ethics Committee of Medical Faculty Andalas University. Results: In this study, we enrolled 40 FD patients (26 woman and 14 men) in range between 35-56 years old. Cortisol level of blood FD patients as parameter of stress hormone which taken in the morning was significantly higher in stress group than non-stress group. The expression of IL-6 in gastric mucosa was significantly higher in stress group in compared to non-stress group (p<0,05). Helicobacter pylori activity in gastric mucosal in stress group were significantly higher than non-stress group. Conclusion: The present study showed that psychological stress can induce gastric mucosal inflammation and increase of Helicobacter pylori activity.

Keywords: functional dyspepsia, Helicobacter pylori, interleukin-6, psychological stress

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828 Validation of the Female Sexual Function Index and the Female Sexual Distress Scale-Desire/Arousal/Orgasm in Chinese Women

Authors: Lan Luo, Jingjing Huang, Huafang Li

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Introduction: Distressing low sexual desire is common in China, while the lack of reliable and valid instruments to evaluate symptoms of hypoactive sexual desire disorder (HSDD) impedes related research and clinical services. Aim: This study aimed to validate the reliability and validity of the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) in Chinese female HSDD patients. Methods: We administered FSFI and FSDS-DAO in a convenient sample of Chinese adult women. Participants were diagnosed by a psychiatrist according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). Results: We had a valid analysis sample of 279 Chinese women, of which 107 were HSDD patients. The Cronbach's α of FSFI and FSDS-DAO were 0.947 and 0.956, respectively, and the intraclass correlation coefficients of which were 0.86 and 0.89, respectively (the interval was 13-15 days). The correlation coefficient between the Revised Adult Attachment Scale (RAAS) and FSFI (or FSDS-DAO) did not exceed 0.4; the area under the receiver operating characteristic (ROC) curve was 0. 83 when combined FSFI-d (the desire domain of FSFI) and FSDS-DAO to diagnose HSDD, which was significantly different from that of using these scales individually. FSFI-d of less than 2.7 (1.2-6) and FSDS-DAO of no less than 15 (0-60) (Sensitivity 65%, Specificity 83%), or FSFI-d of no more than 3.0 (1.2-6) and FSDS-DAO of no less than 14 (0-60) (Sensitivity 74%, Specificity 77%) can be used as cutoff scores in clinical research or outpatient screening. Clinical implications: FSFI (including FSFI-d) and FSDS-DAO are suitable for the screening and evaluation of Chinese female HSDD patients of childbearing age. Strengths and limitations: Strengths include a thorough validation of FSFI and FSDS-DAO and the exploration of the cutoff score combing FSFI-d and FSDS-DAO. Limitations include a small convenience sample and the requirement of being sexually active for HSDD patients. Conclusion: FSFI (including FSFI-d) and FSDS-DAO have good internal consistency, test-retest reliability, construct validity, and criterion validity in Chinese female HSDD patients of childbearing age.

Keywords: sexual desire, sexual distress, hypoactive sexual desire disorder, scale

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827 Bayesian Borrowing Methods for Count Data: Analysis of Incontinence Episodes in Patients with Overactive Bladder

Authors: Akalu Banbeta, Emmanuel Lesaffre, Reynaldo Martina, Joost Van Rosmalen

Abstract:

Including data from previous studies (historical data) in the analysis of the current study may reduce the sample size requirement and/or increase the power of analysis. The most common example is incorporating historical control data in the analysis of a current clinical trial. However, this only applies when the historical control dataare similar enough to the current control data. Recently, several Bayesian approaches for incorporating historical data have been proposed, such as the meta-analytic-predictive (MAP) prior and the modified power prior (MPP) both for single control as well as for multiple historical control arms. Here, we examine the performance of the MAP and the MPP approaches for the analysis of (over-dispersed) count data. To this end, we propose a computational method for the MPP approach for the Poisson and the negative binomial models. We conducted an extensive simulation study to assess the performance of Bayesian approaches. Additionally, we illustrate our approaches on an overactive bladder data set. For similar data across the control arms, the MPP approach outperformed the MAP approach with respect to thestatistical power. When the means across the control arms are different, the MPP yielded a slightly inflated type I error (TIE) rate, whereas the MAP did not. In contrast, when the dispersion parameters are different, the MAP gave an inflated TIE rate, whereas the MPP did not.We conclude that the MPP approach is more promising than the MAP approach for incorporating historical count data.

Keywords: count data, meta-analytic prior, negative binomial, poisson

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826 Global Navigation Satellite System and Precise Point Positioning as Remote Sensing Tools for Monitoring Tropospheric Water Vapor

Authors: Panupong Makvichian

Abstract:

Global Navigation Satellite System (GNSS) is nowadays a common technology that improves navigation functions in our life. Additionally, GNSS is also being employed on behalf of an accurate atmospheric sensor these times. Meteorology is a practical application of GNSS, which is unnoticeable in the background of people’s life. GNSS Precise Point Positioning (PPP) is a positioning method that requires data from a single dual-frequency receiver and precise information about satellite positions and satellite clocks. In addition, careful attention to mitigate various error sources is required. All the above data are combined in a sophisticated mathematical algorithm. At this point, the research is going to demonstrate how GNSS and PPP method is capable to provide high-precision estimates, such as 3D positions or Zenith tropospheric delays (ZTDs). ZTDs combined with pressure and temperature information allows us to estimate the water vapor in the atmosphere as precipitable water vapor (PWV). If the process is replicated for a network of GNSS sensors, we can create thematic maps that allow extract water content information in any location within the network area. All of the above are possible thanks to the advances in GNSS data processing. Therefore, we are able to use GNSS data for climatic trend analysis and acquisition of the further knowledge about the atmospheric water content.

Keywords: GNSS, precise point positioning, Zenith tropospheric delays, precipitable water vapor

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825 Wrong Site Surgery Should Not Occur In This Day And Age!

Authors: C. Kuoh, C. Lucas, T. Lopes, I. Mechie, J. Yoong, W. Yoong

Abstract:

For all surgeons, there is one preventable but still highly occurring complication – wrong site surgeries. They can have potentially catastrophic, irreversible, or even fatal consequences on patients. With the exponential development of microsurgery and the use of advanced technological tools, the consequences of operating on the wrong side, anatomical part, or even person is seen as the most visible and destructive of all surgical errors and perhaps the error that is dreaded by most clinicians as it threatens their licenses and arouses feelings of guilt. Despite the implementation of the WHO surgical safety checklist more than a decade ago, the incidence of wrong-site surgeries remains relatively high, leading to tremendous physical and psychological repercussions for the clinicians involved, as well as a financial burden for the healthcare institution. In this presentation, the authors explore various factors which can lead to wrong site surgery – a combination of environmental and human factors and evaluate their impact amongst patients, practitioners, their families, and the medical industry. Major contributing factors to these “never events” include deviations from checklists, excessive workload, and poor communication. Two real-life cases are discussed, and systems that can be implemented to prevent these errors are highlighted alongside lessons learnt from other industries. The authors suggest that reinforcing speaking-up, implementing medical professional trainings, and higher patient’s involvements can potentially improve safety in surgeries and electrosurgeries.

Keywords: wrong side surgery, never events, checklist, workload, communication

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824 A Case Study for User Rating Prediction on Automobile Recommendation System Using Mapreduce

Authors: Jiao Sun, Li Pan, Shijun Liu

Abstract:

Recommender systems have been widely used in contemporary industry, and plenty of work has been done in this field to help users to identify items of interest. Collaborative Filtering (CF, for short) algorithm is an important technology in recommender systems. However, less work has been done in automobile recommendation system with the sharp increase of the amount of automobiles. What’s more, the computational speed is a major weakness for collaborative filtering technology. Therefore, using MapReduce framework to optimize the CF algorithm is a vital solution to this performance problem. In this paper, we present a recommendation of the users’ comment on industrial automobiles with various properties based on real world industrial datasets of user-automobile comment data collection, and provide recommendation for automobile providers and help them predict users’ comment on automobiles with new-coming property. Firstly, we solve the sparseness of matrix using previous construction of score matrix. Secondly, we solve the data normalization problem by removing dimensional effects from the raw data of automobiles, where different dimensions of automobile properties bring great error to the calculation of CF. Finally, we use the MapReduce framework to optimize the CF algorithm, and the computational speed has been improved times. UV decomposition used in this paper is an often used matrix factorization technology in CF algorithm, without calculating the interpolation weight of neighbors, which will be more convenient in industry.

Keywords: collaborative filtering, recommendation, data normalization, mapreduce

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823 Estimation of the Road Traffic Emissions and Dispersion in the Developing Countries Conditions

Authors: Hicham Gourgue, Ahmed Aharoune, Ahmed Ihlal

Abstract:

We present in this work our model of road traffic emissions (line sources) and dispersion of these emissions, named DISPOLSPEM (Dispersion of Poly Sources and Pollutants Emission Model). In its emission part, this model was designed to keep the consistent bottom-up and top-down approaches. It also allows to generate emission inventories from reduced input parameters being adapted to existing conditions in Morocco and in the other developing countries. While several simplifications are made, all the performance of the model results are kept. A further important advantage of the model is that it allows the uncertainty calculation and emission rate uncertainty according to each of the input parameters. In the dispersion part of the model, an improved line source model has been developed, implemented and tested against a reference solution. It provides improvement in accuracy over previous formulas of line source Gaussian plume model, without being too demanding in terms of computational resources. In the case study presented here, the biggest errors were associated with the ends of line source sections; these errors will be canceled by adjacent sections of line sources during the simulation of a road network. In cases where the wind is parallel to the source line, the use of the combination discretized source and analytical line source formulas minimizes remarkably the error. Because this combination is applied only for a small number of wind directions, it should not excessively increase the calculation time.

Keywords: air pollution, dispersion, emissions, line sources, road traffic, urban transport

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822 Impact of 99mTc-MDP Bone SPECT/CT Imaging in Failed Back Surgery Syndrome

Authors: Ching-Yuan Chen, Lung-Kwang Pan

Abstract:

Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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821 Prediction of Boundary Shear Stress with Gradually Tapering Flood Plains

Authors: Spandan Sahu, Amiya Kumar Pati, Kishanjit Kumar Khatua

Abstract:

River is the main source of water. It is a form of natural open channel which gives rise to many complex phenomenon of sciences that needs to be tackled such as the critical flow conditions, boundary shear stress and depth averaged velocity. The development of society more or less solely depends upon the flow of rivers. The rivers are major sources of many sediments and specific ingredients which are much essential for human beings. During floods, part of a river is carried by the simple main channel and rest is carried by flood plains. For such compound asymmetric channels, the flow structure becomes complicated due to momentum exchange between main channel and adjoining flood plains. Distribution of boundary shear in subsections provides us with the concept of momentum transfer between the interface of main channel and the flood plains. Experimentally, to get better data with accurate results are very complex because of the complexity of the problem. Hence, Conveyance Estimation System (CES) software has been used to tackle the complex processes to determine the shear stresses at different sections of an open channel having asymmetric flood plains on both sides of the main channel and the results are compared with the symmetric flood plains for various geometrical shapes and flow conditions. Error analysis is also performed to know the degree of accuracy of the model implemented.

Keywords: depth average velocity, non prismatic compound channel, relative flow depth , velocity distribution

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820 A Non-Destructive Estimation Method for Internal Time in Perilla Leaf Using Hyperspectral Data

Authors: Shogo Nagano, Yusuke Tanigaki, Hirokazu Fukuda

Abstract:

Vegetables harvested early in the morning or late in the afternoon are valued in plant production, and so the time of harvest is important. The biological functions known as circadian clocks have a significant effect on this harvest timing. The purpose of this study was to non-destructively estimate the circadian clock and so construct a method for determining a suitable harvest time. We took eight samples of green busil (Perilla frutescens var. crispa) every 4 hours, six times for 1 day and analyzed all samples at the same time. A hyperspectral camera was used to collect spectrum intensities at 141 different wavelengths (350–1050 nm). Calculation of correlations between spectrum intensity of each wavelength and harvest time suggested the suitability of the hyperspectral camera for non-destructive estimation. However, even the highest correlated wavelength had a weak correlation, so we used machine learning to raise the accuracy of estimation and constructed a machine learning model to estimate the internal time of the circadian clock. Artificial neural networks (ANN) were used for machine learning because this is an effective analysis method for large amounts of data. Using the estimation model resulted in an error between estimated and real times of 3 min. The estimations were made in less than 2 hours. Thus, we successfully demonstrated this method of non-destructively estimating internal time.

Keywords: artificial neural network (ANN), circadian clock, green busil, hyperspectral camera, non-destructive evaluation

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819 Flame Volume Prediction and Validation for Lean Blowout of Gas Turbine Combustor

Authors: Ejaz Ahmed, Huang Yong

Abstract:

The operation of aero engines has a critical importance in the vicinity of lean blowout (LBO) limits. Lefebvre’s model of LBO based on empirical correlation has been extended to flame volume concept by the authors. The flame volume takes into account the effects of geometric configuration, the complex spatial interaction of mixing, turbulence, heat transfer and combustion processes inside the gas turbine combustion chamber. For these reasons, flame volume based LBO predictions are more accurate. Although LBO prediction accuracy has improved, it poses a challenge associated with Vf estimation in real gas turbine combustors. This work extends the approach of flame volume prediction previously based on fuel iterative approximation with cold flow simulations to reactive flow simulations. Flame volume for 11 combustor configurations has been simulated and validated against experimental data. To make prediction methodology robust as required in the preliminary design stage, reactive flow simulations were carried out with the combination of probability density function (PDF) and discrete phase model (DPM) in FLUENT 15.0. The criterion for flame identification was defined. Two important parameters i.e. critical injection diameter (Dp,crit) and critical temperature (Tcrit) were identified, and their influence on reactive flow simulation was studied for Vf estimation. Obtained results exhibit ±15% error in Vf estimation with experimental data.

Keywords: CFD, combustion, gas turbine combustor, lean blowout

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818 Sequence Analysis and Structural Implications of Rotavirus Capsid Proteins

Authors: Nishal Parbhoo, John B. Dewar, Samantha Gildenhuys

Abstract:

Rotavirus is the major cause of severe gastroenteritis worldwide in children aged 5 and younger. Death rates are high particularly in developing countries. The mature rotavirus is a non-enveloped triple-layered nucleocapsid containing 11 double-stranded RNA segments. Here a global view on the sequence and structure of the three main capsid proteins, VP7, VP6, and VP2 is taken by generating a consensus sequence for each of these rotavirus proteins, for each species obtained from published data of representative rotavirus genotypes from across the world and across species. The degree of conservation between species was represented on homology models for each of the proteins. VP7 shows the highest level of variation with 14 - 45 amino acids showing conservation of less than 60%. These changes are localized to the outer surface which is exposed to antibodies alluding to a possible mechanism in evading the immune system. The middle layer, VP6 shows lower variability with only 14-32 sites having lower than 70% conservation. The inner structural layer made up of VP2 showed the lowest variability with only 1-16 sites having less than 70% conservation across species. The results correlate with proteins’ multiple structural roles. Although the nucleotide sequences vary due to an error-prone replication and lack of proofreading, the corresponding amino acid sequence of VP2, 6 and 7 remains conserved. Sequence conservation maintained for the virus results in stable protein structures, fit for function. This can be exploited in drug design, molecular studies and biotechnological applications.

Keywords: amino acid sequence conservation, capsid protein, protein structure, vaccine candidate

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817 Urinary Volatile Organic Compound Testing in Fast-Track Patients with Suspected Colorectal Cancer

Authors: Godwin Dennison, C. E. Boulind, O. Gould, B. de Lacy Costello, J. Allison, P. White, P. Ewings, A. Wicaksono, N. J. Curtis, A. Pullyblank, D. Jayne, J. A. Covington, N. Ratcliffe, N. K. Francis

Abstract:

Background: Colorectal symptoms are common but only infrequently represent serious pathology, including colorectal cancer (CRC). A large number of invasive tests are presently performed for reassurance. We investigated the feasibility of urinary volatile organic compound (VOC) testing as a potential triage tool in patients fast-tracked for assessment for possible CRC. Methods: A prospective, multi-centre, observational feasibility study was performed across three sites. Patients referred on NHS fast-track pathways for potential CRC provided a urine sample which underwent Gas Chromatography Mass Spectrometry (GC-MS), Field Asymmetric Ion Mobility Spectrometry (FAIMS) and Selected Ion Flow Tube Mass Spectrometry (SIFT-MS) analysis. Patients underwent colonoscopy and/or CT colonography and were grouped as either CRC, adenomatous polyp(s), or controls to explore the diagnostic accuracy of VOC output data supported by an artificial neural network (ANN) model. Results: 558 patients participated with 23 (4.1%) CRC diagnosed. 59% of colonoscopies and 86% of CT colonographies showed no abnormalities. Urinary VOC testing was feasible, acceptable to patients, and applicable within the clinical fast track pathway. GC-MS showed the highest clinical utility for CRC and polyp detection vs. controls (sensitivity=0.878, specificity=0.882, AUROC=0.884). Conclusion: Urinary VOC testing and analysis are feasible within NHS fast-track CRC pathways. Clinically meaningful differences between patients with cancer, polyps, or no pathology were identified therefore suggesting VOC analysis may have future utility as a triage tool. Acknowledgment: Funding: NIHR Research for Patient Benefit grant (ref: PB-PG-0416-20022).

Keywords: colorectal cancer, volatile organic compound, gas chromatography mass spectrometry, field asymmetric ion mobility spectrometry, selected ion flow tube mass spectrometry

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816 Central Vascular Function and Relaxibility in Beta-thalassemia Major Patients vs. Sickle Cell Anemia Patients by Abdominal Aorta and Aortic Root Speckle Tracking Echocardiography

Authors: Gehan Hussein, Hala Agha, Rasha Abdelraof, Marina George, Antoine Fakhri

Abstract:

Background: β-Thalassemia major (TM) and sickle cell disease (SCD) are inherited hemoglobin disorders resulting in chronic hemolytic anemia. Cardiovascular involvement is an important cause of morbidity and mortality in these groups of patients. The narrow border is between overt myocardial dysfunction and clinically silent left ventricular (LV) and / or right ventricular (RV) dysfunction in those patients. 3 D Speckle tracking echocardiography (3D STE) is a novel method for the detection of subclinical myocardial involvement. We aimed to study myocardial affection in SCD and TM using 3D STE, comparing it with conventional echocardiography, correlate it with serum ferritin level and lactate dehydrogenase (LDH). Methodology: Thirty SCD and thirty β TM patients, age range 4-18 years, were compared to 30 healthy age and sex matched control group. Cases were subjected to clinical examination, laboratory measurement of hemoglobin level, serum ferritin, and LDH. Transthoracic color Doppler echocardiography, 3D STE, tissue Doppler echocardiography, and aortic speckle tracking were performed. Results: significant reduction in global longitudinal strain (GLS), global circumferential strain (GCS), and global area strain (GAS) in SCD and TM than control (P value <0.001) there was significantly lower aortic speckle tracking in patients with TM and SCD than control (P value< 0.001). LDH was significantly higher in SCD than both TM and control and it correlated significantly positive mitral inflow E, (p value:0.022 and 0.072. r: 0.416 and -0.333 respectively) lateral E/E’ (p value.<0.001and 0.818. r. 0.618 and -0. 044.respectively) and septal E/E’ (p value 0.007 and 0.753& r value 0.485 and -0.060 respectively) in SCD but not TM and significant negative correlation between LDH and aortic root speckle tracking (value 0.681& r. -0.078.). The potential diagnostic accuracy of LDH in predicting vascular dysfunction as represented by aortic root GCS with a sensitivity 74% and aortic root GCS was predictive of LV dysfunction in SCD patients with sensitivity 100% Conclusion: 3D STE LV and RV systolic dysfunction in spite of their normal values by conventional echocardiography. SCD showed significantly lower right ventricular dysfunction and aortic root GCS than TM and control. LDH can be used to screen patients for cardiac dysfunction in SCD, not in TM

Keywords: thalassemia major, sickle cell disease, 3d speckle tracking echocardiography, LDH

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