Search results for: clinical error

Authors: Debabrata Das

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This paper explains how to design a regulation loop for a power supply circuit. It also discusses the need of a regulation loop and the improvement of a circuit with regulation loop. A sample design is used to demonstrate how to use PSpice to design feedback loop to control output voltage of a power supply and how to check if the power supply is stable or oscillatory. A sample design is made using a specific Integrated Circuit (IC) available in the PSpice library. A designer can experiment feedback loop design using Cadence Pspice tool. PSpice is easy to use, reliable, and convenient. To test a feedback loop, generally, engineers use trial and error method with the hardware which takes a lot of time and manpower. Moreover, it is expensive because component and Printed Circuit Board (PCB) may go bad. PSpice can be used by designers to test their loop designs without using hardware circuits. A designer can save time, cost, manpower and simulate his/her power supply circuit accurately before making a real hardware using this software package.

Keywords: power electronics, feedback loop, regulation, stability, pole, zero, oscillation

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Authors: S. Mousavian, A. Abedianpour, A. Khanmohammadi, S. Hematian, Gh. Eidi Veisi

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Distillation is one of the most important and utilized separation methods in the industrial practice. There are different ways to design of distillation column. One of these ways is short cut method. In short cut method, material balance and equilibrium are employed to calculate number of tray in distillation column. There are different methods that are classified in short cut method. One of these methods is Fenske-Underwood-Gilliland method. In this method, minimum reflux ratio should be calculated by underwood equation. Underwood proposed an equation that is useful for simple distillation column with one feed and one top and bottom product. In this study, underwood method is developed to predict minimum reflux ratio for column with one side stream upper than feed. The result of this model compared with McCabe-Thiele method. The result shows that proposed method able to calculate minimum reflux ratio with very small error.

Keywords: minimum reflux ratio, side stream, distillation, Underwood’s method

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Authors: Ghada Mahmoud El Kassas, Maged Atta El Wakeel

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Background: Environmental enteric dysfunction (EED) is impending trouble that flared up in the last decades to be pervasive in infants and children. EED is asymptomatic villous atrophy of the small bowel that is prevalent in the developing world and is associated with altered intestinal function and integrity. Evidence has suggested that supplementary zinc might ameliorate this damage by reducing gastrointestinal inflammation and may also benefit cognitive development. Objective: We tested whether zinc supplementation improves intestinal integrity, growth, and cognitive function in stunted children predicted to have EED. Methodology: This case–control prospective interventional study was conducted on 120 Egyptian Stunted children aged 1-10 years who recruited from the Nutrition clinic, the National research center, and 100 age and gender-matched healthy children as controls. At the primary phase of the study, Full history taking, clinical examination, and anthropometric measurements were done. Standard deviation score (SDS) for all measurements were calculated. Serum markers as Zonulin, Endotoxin core antibody (EndoCab), highly sensitive C-reactive protein (hsCRP), alpha1-acid glycoprotein (AGP), Tumor necrosis factor (TNF), and fecal markers such as myeloperoxidase (MPO), neopterin (NEO), and alpha-1-anti-trypsin (AAT) (as predictors of EED) were measured. Cognitive development was assessed (Bayley or Wechsler scores). Oral zinc at a dosage of 20 mg/d was supplemented to all cases and followed up for 6 months, after which the 2ry phase of the study included the previous clinical, laboratory, and cognitive assessment. Results: Serum and fecal inflammatory markers were significantly higher in cases compared to controls. Zonulin (P < 0.01), (EndoCab) (P < 0.001) and (AGP) (P < 0.03) markedly decreased in cases at the end of 2ry phase. Also (MPO), (NEO), and (AAT) showed a significant decline in cases at the end of the study (P < 0.001 for all). A significant increase in mid-upper arm circumference (MUAC) (P < 0.01), weight for age z-score, and skinfold thicknesses (P< 0.05 for both) was detected at end of the study, while height was not significantly affected. Cases also showed significant improvement of cognitive function at phase 2 of the study. Conclusion: Intestinal inflammatory state related to EED showed marked recovery after zinc supplementation. As a result, anthropometric and cognitive parameters showed obvious improvement with zinc supplementation.

Keywords: stunting, cognitive function, environmental enteric dysfunction, zinc

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Authors: Khaled M. EL-Naggar

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Synchronizing and damping torque coefficients of a synchronous machine can give a quite clear picture for machine behavior during transients. These coefficients are used as a power system transient stability measurement. In this paper, a crow search optimization algorithm is presented and implemented to study the power system stability during transients. The algorithm makes use of the machine responses to perform the stability study in time domain. The problem is formulated as a dynamic estimation problem. An objective function that minimizes the error square in the estimated coefficients is designed. The method is tested using practical system with different study cases. Results are reported and a thorough discussion is presented. The study illustrates that the proposed method can estimate the stability coefficients for the critical stable cases where other methods may fail. The tests proved that the proposed tool is an accurate and reliable tool for estimating the machine coefficients for assessment of power system stability.

Keywords: optimization, estimation, synchronous, machine, crow search

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Authors: Khenenou Tarek, Benzaoui Hassina, Melizi Mohamed

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The diagnosis requires a background of current knowledge in the field and also complementary means in which the laboratory occupies the central place for a better investigation. A correct diagnosis allows to establish the most appropriate treatment as soon as possible and avoids both the economic losses associated with mortality and growth retardation often observed in poultry furthermore it may reduce the high cost of treatment. Epedemiologic survey, hematologic and histopathologic study’s are three aspects of diagnosis heavily used in both human and veterinary pathology and the advanced researches in human medicine would be exploited to be applied in veterinary medicine with given modification .Whereas, the diagnostic methods in the east of Algeria are limited to the clinical signs and necropsy finding. Therefore, the diagnosis is based simply on the success or the failure of the therapeutic methods (therapeutic diagnosis).

Keywords: chicken, diagnosis, hematology, histopathology

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Authors: Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee

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Objective: To compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. The three positions were: semi-recumbent, squatting, and squatting with the aid of ergonomically designed ankle supports. Methods: A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women in their 38th to 42nd gestational week. None of the participants received epidural analgesia during labor and all were free of pregnancy and labor-related complications. Intervention: During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while wearing the ergonomically designed ankle supports; comparison group A was asked to push in the squatting position without the use of these supports; and comparison group B was asked to push in a standard semi-recumbent position. Measures: The participants completed a demographic and obstetrics datasheet, the Short Form McGill Pain Questionnaire (MPQ-SF), and the Labor Pushing Experience scale within 4-hours postpartum. Conclusion: In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.52 minutes less (F =6.02, p< .05) than the time for comparison group B (semi-recumbent). Furthermore, the duration between the start of pushing to infant birth averaged 25.21 minutes less for the experimental group than for comparison group B (F =6.14, p< .05). Moreover, the experimental group had a lower average VAS pain score (5.05±3.22) than comparison group B and the average McGill pain score for the experimental group was lower than both comparison groups (F=18.12, p< .001). In summary, the participants in the group that delivered from a squatting position with ankle supports had better labor pushing experiences than their peers in the comparison groups. Results: In comparison to both unsupported squatting and semi-recumbent pushing, squatting with the aid of ergonomically designed ankle supports reduced pushing times, ameliorated labor pain, and improved the pushing experience. Clinical application and suggestion: The squatting with ankle-support intervention introduced in the present study may significantly reduce tiredness and difficulties in maintaining balance as well as increase pushing efficiency. Thus, this intervention may reduce the caring needs of women during the second stage of labor. This intervention may be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

Keywords: second stage of labor, pushing, squatting with ankle supports, squatting

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Authors: Osama A. Omer, Amal Hamed

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Successful blind image Super-Resolution algorithms require the exact estimation of the Point Spread Function (PSF). In the absence of any prior information about the imagery system and the true image; this estimation is normally done by trial and error experimentation until an acceptable restored image quality is obtained. Multi-frame blind Super-Resolution algorithms often have disadvantages of slow convergence and sensitiveness to complex noises. This paper presents a Super-Resolution image reconstruction algorithm based on estimation of the PSF that yields the optimum restored image quality. The estimation of PSF is performed by the knife-edge method and it is implemented by measuring spreading of the edges in the reproduced HR image itself during the reconstruction process. The proposed image reconstruction approach is using L1 norm minimization and robust regularization based on a bilateral prior to deal with different data and noise models. A series of experiment results show that the proposed method can outperform other previous work robustly and efficiently.

Keywords: blind, PSF, super-resolution, knife-edge, blurring, bilateral, L1 norm

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Authors: Steven Vusmuzi Mashego, Opeyeolu Timothy Laseinde

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This paper presents a case study on applying maintenance strategies observed in a turbo-generator at a coal power plant. Turbo generators are one of the primary and critical components in energy generation. It is essential to apply correct maintenance strategies and apply operational procedures accordingly. The maintenance strategies are implemented to ensure the high reliability of the equipment. The study was carried out at a coal power station which will transit to a cleaner energy source in the nearest future. The study is relevant as lessons learned in this system will support plans and operational models implemented when cleaner energy sources replace coal-powered turbines. This paper first outlines different maintenance strategies executed on the turbo-generator modules. Secondly, the impacts of human factors on a coal power station are discussed, and the findings prompted recommendations for future actions.

Keywords: maintenance strategies, turbo generator, operational error, human factor, electricity generation

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Authors: Margarita Grushanina

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After several prominent central banks including European Central Bank (ECB), Federal Reserve System (Fed), Bank of Japan and Bank of England employed unconventional monetary policies in the aftermath of the financial crisis of 2008-2009 the problem of identification of the effects from such policies became of great interest. One of the main difficulties in identification of shocks from unconventional monetary policy measures in structural VAR analysis is that they often are anticipated, which leads to a non-fundamental MA representation of the VAR model. Moreover, the unconventional monetary policy actions may indirectly transmit to markets information about the future stance of the interest rate, which raises a question of the plausibility of the assumption of orthogonality between shocks from unconventional and conventional policy measures. This paper offers a method of identification that takes into account the abovementioned issues. The author uses factor-augmented VARs to increase the information set and identification through heteroskedasticity of error terms and rank restrictions on the errors’ second moments’ matrix to deal with the cross-correlation of the structural shocks.

Keywords: factor-augmented VARs, identification through heteroskedasticity, monetary policy, structural VARs

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Authors: I. Alhajri, G. Zahedi, R. Alazmi, A. Akbari

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In this paper, an Artificial Neural Network (ANN) was developed to predict Asphaltene Precipitation (AP) during the injection of carbon dioxide into crude oil reservoirs. In this study, the experimental data from six different oil fields were collected. Seventy percent of the data was used to develop the ANN model, and different ANN architectures were examined. A network with the Trainlm training algorithm was found to be the best network to estimate the AP. To check the validity of the proposed model, the model was used to predict the AP for the thirty percent of the data that was unevaluated. The Mean Square Error (MSE) of the prediction was 0.0018, which confirms the excellent prediction capability of the proposed model. In the second part of this study, the ANN model predictions were compared with modified Hirschberg model predictions. The ANN was found to provide more accurate estimates compared to the modified Hirschberg model. Finally, the proposed model was employed to examine the effect of different operating parameters during gas injection on the AP. It was found that the AP is mostly sensitive to the reservoir temperature. Furthermore, the carbon dioxide concentration in liquid phase increases the AP.

Keywords: artificial neural network, asphaltene, CO2 injection, Hirschberg model, oil reservoirs

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Authors: Maziar Ramezani, Thomas Neitzert, Timotius Pasang

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This paper aims at experimental and numerical investigation of springback behavior of sheet metals during L-bending process with emphasis on Stribeck-type friction modeling. The coefficient of friction in Stribeck curve depends on sliding velocity and contact pressure. The springback behavior of mild steel and aluminum alloy 6022-T4 sheets was studied experimentally and using numerical simulations with ABAQUS software with two types of friction model: Coulomb friction and Stribeck friction. The influence of forming speed on springback behavior was studied experimentally and numerically. The results showed that Stribeck-type friction model has better results in predicting springback in sheet metal forming. The FE prediction error for mild steel and 6022-T4 AA is 23.8%, 25.5% respectively, using Coulomb friction model and 11%, 13% respectively, using Stribeck friction model. These results show that Stribeck model is suitable for simulation of sheet metal forming especially at higher forming speed.

Keywords: friction, L-bending, springback, Stribeck curves

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Authors: Maria Sciammarella, Uttam M. Shrestha, Youngho Seo, Grant T. Gullberg, Elias H. Botvinick

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Background: Myocardial perfusion imaging (MPI) is typically performed with static imaging protocols and visually assessed for perfusion defects based on the relative intensity distribution. Dynamic cardiac SPECT, on the other hand, is a new imaging technique that is based on time varying information of radiotracer distribution, which permits quantification of myocardial blood flow (MBF). In this abstract, we report a progress and current status of dynamic cardiac SPECT using conventional gamma camera (Infinia Hawkeye 4, GE Healthcare) for estimation of myocardial blood flow and coronary flow reserve. Methods: A group of patients who had high risk of coronary artery disease was enrolled to evaluate our methodology. A low-dose/high-dose rest/pharmacologic-induced-stress protocol was implemented. A standard rest and a standard stress radionuclide dose of ⁹⁹ᵐTc-tetrofosmin (140 keV) was administered. The dynamic SPECT data for each patient were reconstructed using the standard 4-dimensional maximum likelihood expectation maximization (ML-EM) algorithm. Acquired data were used to estimate the myocardial blood flow (MBF). The correspondence between flow values in the main coronary vasculature with myocardial segments defined by the standardized myocardial segmentation and nomenclature were derived. The coronary flow reserve, CFR, was defined as the ratio of stress to rest MBF values. CFR values estimated with SPECT were also validated with dynamic PET. Results: The range of territorial MBF in LAD, RCA, and LCX was 0.44 ml/min/g to 3.81 ml/min/g. The MBF between estimated with PET and SPECT in the group of independent cohort of 7 patients showed statistically significant correlation, r = 0.71 (p < 0.001). But the corresponding CFR correlation was moderate r = 0.39 yet statistically significant (p = 0.037). The mean stress MBF value was significantly lower for angiographically abnormal than that for the normal (Normal Mean MBF = 2.49 ± 0.61, Abnormal Mean MBF = 1.43 ± 0. 0.62, P < .001). Conclusions: The visually assessed image findings in clinical SPECT are subjective, and may not reflect direct physiologic measures of coronary lesion. The MBF and CFR measured with dynamic SPECT are fully objective and available only with the data generated from the dynamic SPECT method. A quantitative approach such as measuring CFR using dynamic SPECT imaging is a better mode of diagnosing CAD than visual assessment of stress and rest images from static SPECT images Coronary Flow Reserve.

Keywords: dynamic SPECT, clinical SPECT/CT, selective coronary angiograph, ⁹⁹ᵐTc-Tetrofosmin

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Authors: Sara Tusian, Zahra Salehi Motaahed, Narges Sajjadie, Nikoo Dialame

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One of the methods which have frequently been used in Quran is the “question”. In the Quran, in addition to the content, methods are also important. Using analysis-interpretation method, the present study has investigated Quranic questions, and extracted its functions from educational perspective. In so doing, it has first investigated all the questions in Quran and then taking the three-stage classification of education into account, it has offered question functions. The results obtained from this study suggest that question functions in Quran are presented in three categories: the preparation stage (including preparation of the audience, revising the insights, and internal Evolution); main body (including the granting the insight, and elimination of intellectual negligence and the question of innate and logical axioms, the introducting of the realm of thinking, creating emotional arousal and alleged in the claim) and the third stage as modification and revision (including invitation to move in the framework of tasks using the individual beliefs to reveal the contradictions and, Error detection and contribution to change the function) that each of which has a special role in the education process.

Keywords: education, question, Quranic questions, Quran

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Authors: Raed H. Allawi

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Formation pressure is the most critical parameter in hydrocarbon exploration and exploitation. Specifically, predicting abnormal pressures (high formation pressures) and subnormal pressure zones can provide valuable information to minimize uncertainty for anticipated drilling challenges and risks. This study aims to interpret and delineate the pore and fracture pressure of the Mishrif reservoir in the southern Iraq Oilfield. The data required to implement this study included acoustic compression wave, gamma-ray, bulk density, and drilling events. Furthermore, supporting these models needs the pore pressure measurement from the Modular Formation Dynamics Tester (MDT). Many measured values of pore pressure were used to validate the accurate model. Using sonic velocity approaches, the mean absolute percentage error (MAPE) was about 4%. The fracture pressure results were consistent with the measurement data, actual drilling report, and events. The model's results will be a guide for successful drilling in future wells in the same oilfield.

Keywords: pore pressure, fracture pressure, overburden pressure, effective stress, drilling events

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Authors: Muhammad Tariq, Jafar Khan Kasi, Samiullah, Ajab Khan Kasi

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Biosensors are playing vital role in industrial, clinical, and chemical analysis applications. Among other techniques, ZnO based biosensor is an easy approach due to its exceptional chemical and electrical properties. ZnO nanorods have positively charged isoelectric point which helps immobilize the negative charge glucose oxides (GOx). Here, we report ZnO nanorods based biosensors for the immobilization of GOx. The ZnO nanorods were grown by hydrothermal method on indium tin oxide substrate (ITO). The fabrication of biosensors was carried through batch processing using conventional photolithography. The buffer solutions of GOx were prepared in phosphate with a pH value of around 7.3. The biosensors effectively immobilized the GOx and result was analyzed by calculation of voltage and current on nanostructures.

Keywords: hydrothermal growth, sol-gel, zinc dioxide, biosensors

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Authors: Benjamin Bobbia, Matthias Picard

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In recent years active learning methodologies based on the representativity of the data seems more promising to limit overfitting. The presented query methodology for regression using the Wasserstein distance measuring the representativity of our labelled dataset compared to the global distribution. In this work a crucial use of GroupSort Neural Networks is made therewith to draw a double advantage. The Wasserstein distance can be exactly expressed in terms of such neural networks. Moreover, one can provide explicit bounds for their size and depth together with rates of convergence. However, heterogeneity of the dataset is also considered by weighting the Wasserstein distance with the error of approximation at the previous step of active learning. Such an approach leads to a reduction of overfitting and high prediction performance after few steps of query. After having detailed the methodology and algorithm, an empirical study is presented in order to investigate the range of our hyperparameters. The performances of this method are compared, in terms of numbers of query needed, with other classical and recent query methods on several UCI datasets.

Keywords: active learning, Lipschitz regularization, neural networks, optimal transport, regression

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Authors: Ella Tyuryumina, Alexey Neznanov

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This study is an attempt to obtain reliable data on the natural history of breast cancer growth. We analyze the opportunities for using classical mathematical models (exponential and logistic tumor growth models, Gompertz and von Bertalanffy tumor growth models) to try to describe growth of the primary tumor and the secondary distant metastases of human breast cancer. The research aim is to improve predicting accuracy of breast cancer progression using an original mathematical model referred to CoMPaS and corresponding software. We are interested in: 1) modelling the whole natural history of the primary tumor and the secondary distant metastases; 2) developing adequate and precise CoMPaS which reflects relations between the primary tumor and the secondary distant metastases; 3) analyzing the CoMPaS scope of application; 4) implementing the model as a software tool. The foundation of the CoMPaS is the exponential tumor growth model, which is described by determinate nonlinear and linear equations. The CoMPaS corresponds to TNM classification. It allows to calculate different growth periods of the primary tumor and the secondary distant metastases: 1) ‘non-visible period’ for the primary tumor; 2) ‘non-visible period’ for the secondary distant metastases; 3) ‘visible period’ for the secondary distant metastases. The CoMPaS is validated on clinical data of 10-years and 15-years survival depending on the tumor stage and diameter of the primary tumor. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer growth models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. The CoMPaS model and predictive software: a) fit to clinical trials data; b) detect different growth periods of the primary tumor and the secondary distant metastases; c) make forecast of the period of the secondary distant metastases appearance; d) have higher average prediction accuracy than the other tools; e) can improve forecasts on survival of breast cancer and facilitate optimization of diagnostic tests. The following are calculated by CoMPaS: the number of doublings for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases; tumor volume doubling time (days) for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases. The CoMPaS enables, for the first time, to predict ‘whole natural history’ of the primary tumor and the secondary distant metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on the primary tumor sizes. Summarizing: a) CoMPaS describes correctly the primary tumor growth of IA, IIA, IIB, IIIB (T1-4N0M0) stages without metastases in lymph nodes (N0); b) facilitates the understanding of the appearance period and inception of the secondary distant metastases.

Keywords: breast cancer, exponential growth model, mathematical model, metastases in lymph nodes, primary tumor, survival

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Authors: C. G. Jinimole, A. Harsha

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One of the key problems facing in the analysis of Computed Tomography (CT) images is the poor contrast of the images. Image enhancement can be used to improve the visual clarity and quality of the images or to provide a better transformation representation for further processing. Contrast enhancement of images is one of the acceptable methods used for image enhancement in various applications in the medical field. This will be helpful to visualize and extract details of brain infarctions, tumors, and cancers from the CT image. This paper presents a comparison study of five contrast enhancement techniques suitable for the contrast enhancement of CT images. The types of techniques include Power Law Transformation, Logarithmic Transformation, Histogram Equalization, Contrast Stretching, and Laplacian Transformation. All these techniques are compared with each other to find out which enhancement provides better contrast of CT image. For the comparison of the techniques, the parameters Peak Signal to Noise Ratio (PSNR) and Mean Square Error (MSE) are used. Logarithmic Transformation provided the clearer and best quality image compared to all other techniques studied and has got the highest value of PSNR. Comparison concludes with better approach for its future research especially for mapping abnormalities from CT images resulting from Brain Injuries.

Keywords: computed tomography, enhancement techniques, increasing contrast, PSNR and MSE

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Authors: Maria Ahmad, Michael Page, Danë Goodsman

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‘Educational’ debriefing – a construct distinct from clinical debriefing – is used following simulated scenarios and is central to learning and development in fields ranging from aviation to emergency medicine. However, little research into educational debriefing in prehospital medicine exists. This qualitative study explored the facilitation and effects of prehospital educational debriefing and identified obstacles to debriefing, using the London’s Air Ambulance Pre-Hospital Care Course (PHCC) as a model. Method: Ethnographic observations of moulages and debriefs were conducted over two consecutive days of the PHCC in October 2019. Detailed contemporaneous field notes were made and analysed thematically. Subsequently, seven one-to-one, semi-structured interviews were conducted with four PHCC debrief facilitators and three course participants to explore their experiences of prehospital educational debriefing. Interview data were manually transcribed and analysed thematically. Results: Four overarching themes were identified: the approach to the facilitation of debriefs, effects of debriefing, facilitator development, and obstacles to debriefing. The unpredictable debriefing environment was seen as both hindering and paradoxically benefitting educational debriefing. Despite using varied debriefing structures, facilitators emphasised similar key debriefing components, including exploring participants’ reasoning and sharing experiences to improve learning and prevent future errors. Debriefing was associated with three principal effects: releasing emotion; learning and improving, particularly participant compound learning as they progressed through scenarios; and the application of learning to clinical practice. Facilitator training and feedback were central to facilitator learning and development. Several obstacles to debriefing were identified, including mismatch of participant and facilitator agendas, performance pressure, and time. Interestingly, when used appropriately in the educational environment, these obstacles may paradoxically enhance learning. Conclusions: Educational debriefing in prehospital medicine is complex. It requires the establishment of a safe learning environment, an understanding of participant agendas, and facilitator experience to maximise participant learning. Aspects unique to prehospital educational debriefing were identified, notably the unpredictable debriefing environment, interdisciplinary working, and the paradoxical benefit of educational obstacles for learning. This research also highlights aspects of educational debriefing not extensively detailed in the literature, such as compound participant learning, display of ‘professional honesty’ by facilitators, and facilitator learning, which require further exploration. Future research should also explore educational debriefing in other prehospital services.

Keywords: debriefing, prehospital medicine, prehospital medical education, pre-hospital care course

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Authors: Ibrahim Watad, Ibrahim Abdulhalim

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Conventional spectroscopic surface plasmon resonance (SPR) sensors are widely used, both in fundamental research and environmental monitoring as well as healthcare diagnostics. However, they still lack the low limit of detection (LOD) and there still a place for improvement. SPR conventional sensors are based on the detection of a dip in the reflectivity spectrum which is relatively wide. To improve the performance of these sensors, many techniques and methods proposed either to reduce the width of the dip or to increase the sensitivity. Together with that, profiting from the sharp jump in the phase spectrum under SPR, several works suggested the extraction of the phase of the reflected wave. However, existing phase measurement setups are in general more complicated compared to the conventional setups, require more stability and are very sensitive to external vibrations and noises. In this study, a simple polarimetric technique for phase extraction under SPR is presented, followed by a theoretical error analysis and an experimental verification. The advantages of the proposed technique upon existing techniques will be elaborated, together with conclusions regarding the best polarimetric function, and its corresponding optimal metal layer range of thicknesses to use under the conventional Kretschmann-Raether configuration.

Keywords: plasmonics, polarimetry, thin films, optical sensors

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Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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Authors: Zenah Gheblawi, Susan Armijo-Olivo, Elisa B. Pelai, Vaishali Sharma, Musa Tashfeen, Angela Fung, Francisca Claveria

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Due to physiological differences between men and women, pain is experienced differently between the two sexes. Chronic pain disorders, notably temporomandibular disorders (TMDs), disproportionately affect women in diagnosis, and pain severity in opposition of their male counterparts. TMDs are a type of musculoskeletal disorder that target the masticatory muscles, temporalis muscle, and temporomandibular joints, causing considerable orofacial pain which can usually be referred to the neck and back. Therapeutic methods are scarce, and are not TMD-centered, with the latest research suggesting that subjects with chronic musculoskeletal pain disorders have abnormal alterations in the grey matter of their brains which can be remedied with exercise, and thus, decreasing the pain experienced. The aim of the study is to investigate the effects of exercise therapy in TMD female patients experiencing chronic jaw pain and to assess the consequential effects on brain activity. In a randomized controlled trial, the effectiveness of an exercise program to improve brain alterations and clinical outcomes in women with TMD pain will be tested. Women with chronic TMD pain will be randomized to either an intervention arm or a placebo control group. Women in the intervention arm will receive 8 weeks of progressive exercise of motor control training using visual feedback (MCTF) of the cervical muscles, twice per week. Women in the placebo arm will receive innocuous transcutaneous electrical nerve stimulation during 8 weeks as well. The primary outcomes will be changes in 1) pain, measured with the Visual Analogue Scale, 2) brain structure and networks, measured by fractional anisotropy (brain structure) and the blood-oxygen level dependent signal (brain networks). Outcomes will be measured at baseline, after 8 weeks of treatment, and 4 months after treatment ends and will determine effectiveness of MCTF in managing TMD, through improved clinical outcomes. Results will directly inform and guide clinicians in prescribing more effective interventions for women with TMD. This study is underway, and no results are available at this point. The results of this study will have substantial implications on the advancement in understanding the scope of plasticity the brain has in regards with pain, and how it can be used to improve the treatment and pain of women with TMD, and more generally, other musculoskeletal disorders.

Keywords: exercise therapy, musculoskeletal disorders, physical therapy, rehabilitation, tempomandibular disorders

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Authors: Hong Lu, Wei Fan, Yongquan Zhang, Junbo Zhang

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A cross coupling sliding synchronization control strategy is proposed for the dual-driving feed system. This technology will minimize the position error oscillation and achieve the precise synchronization performance in the high speed and high precision drive system, especially some high speed and high precision machine. Moreover, a cross coupling compensation matrix is provided to offset the mismatched disturbance and the disturbance observer is established to eliminate the chattering phenomenon. Performance comparisons of proposed dual-driving cross coupling sliding mode control (CCSMC), normal cross coupling control （CCC） strategy with PID control, and electronic virtual main shaft control (EVMSC) strategy with SMC control are investigated by simulation and a dual-driving control system; the results show the effectiveness of the proposed control scheme.

Keywords: cross coupling matrix, dual motors, synchronization control, sliding mode control

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Authors: Jongwoo Lee, Dae-Eun Kang, Sang-Young Park

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This study presents a precise relative navigational method for satellites flying in formation using laser-based intermittent measurement data. The measurement data for the relative navigation between two satellites consist of a relative distance measured by a laser instrument and relative attitude angles measured by attitude determination. The relative navigation solutions are estimated by both the Extended Kalman filter (EKF) and unscented Kalman filter (UKF). The solutions estimated by the EKF may become inaccurate or even diverge as measurement outage time gets longer because the EKF utilizes a linearization approach. However, this study shows that the UKF with the appropriate scaling parameters provides a stable and accurate relative navigation solutions despite the long measurement outage time and large initial error as compared to the relative navigation solutions of the EKF. Various navigation results have been analyzed by adjusting the scaling parameters of the UKF.

Keywords: satellite relative navigation, laser-based measurement, intermittent measurement, unscented Kalman filter

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Authors: Ashkan Zakaryazad, Ekrem Duman

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A typical classification technique ranks the instances in a data set according to the likelihood of belonging to one (positive) class. A credit card (CC) fraud detection model ranks the transactions in terms of probability of being fraud. In fact, this approach is often criticized, because firms do not care about fraud probability but about the profitability or costliness of detecting a fraudulent transaction. The key contribution in this study is to focus on the profit maximization in the model building step. The artificial neural network proposed in this study works based on profit maximization instead of minimizing the error of prediction. Moreover, some studies have shown that the back propagation algorithm, similar to other gradient–based algorithms, usually gets trapped in local optima and swarm-based algorithms are more successful in this respect. In this study, we train our profit maximization ANN using the Migrating Birds optimization (MBO) which is introduced to literature recently.

Keywords: neural network, profit-based neural network, sum of squared errors (SSE), MBO, gradient descent

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Authors: Y. H. Wu, Ji-Yuan Lin, Yu-Ming Liou

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This study aims to set up the landslide susceptibility map of County Route 89 at Ren-Ai Township in Nantou County using the Instability Index Method and Logistic regression. Seven susceptibility factors including Slope Angle, Aspect, Elevation, Distance to fold, Distance to River, Distance to Road and Accumulated Rainfall were obtained by GIS based on the Typhoon Toraji landslide area identified by Industrial Technology Research Institute in 2001. To calculate the landslide percentage of each factor and acquire the weight and grade the grid by means of Instability Index Method. In this study, landslide susceptibility can be classified into four grades: high, medium high, medium low and low, in order to determine the advantages and disadvantages of the two models. The precision of this model is verified by classification error matrix and SRC curve. These results suggest that the logistic regression model is a preferred method than instability index in the assessment of landslide susceptibility. It is suitable for the landslide prediction and precaution in this area in the future.

Keywords: instability index method, logistic regression, landslide susceptibility, SRC curve

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Authors: Rubens P. Costa, Marcelo A. Leigui de Oliveira

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The comprehension of features on the energy spectra, the chemical compositions, and the origins of Ultra-High Energy Cosmic Rays (UHECRs) - mainly atomic nuclei with energies above ~1.0 EeV (exa-electron volts) - are intrinsically linked to the problem of determining the magnitude of their deflections in cosmic magnetic fields on cosmological scales. In addition, as they propagate from the source to the observer, modifications are expected in their original energy spectra, anisotropy, and the chemical compositions due to interactions with low energy photons and matter. This means that any consistent interpretation of the nature and origin of UHECRs has to include the detailed knowledge of their propagation in a three-dimensional environment, taking into account the magnetic deflections and energy losses. The parameter space range for the magnetic fields in the universe is very large because the field strength and especially their orientation have big uncertainties. Particularly, the strength and morphology of the Extragalactic Magnetic Fields (EGMFs) remain largely unknown, because of the intrinsic difficulty of observing them. Monte Carlo simulations of charged particles traveling through a simulated magnetized universe is the straightforward way to study the influence of extragalactic magnetic fields on UHECRs propagation. However, this brings two major difficulties: an accurate numerical modeling of charged particles diffusion in magnetic fields, and an accurate numerical modeling of the magnetized Universe. Since magnetic fields do not cause energy losses, it is important to impose that the particle tracking method conserve the particle’s total energy and that the energy changes are results of the interactions with background photons only. Hence, special attention should be paid to computational effects. Additionally, because of the number of particles necessary to obtain a relevant statistical sample, the particle tracking method must be computationally efficient. In this work, we present an analysis of the propagation of ultra-high energy charged particles in the intergalactic medium. The EGMFs are considered to be coherent within cells of 1 Mpc (mega parsec) diameter, wherein they have uniform intensities of 1 nG (nano Gauss). Moreover, each cell has its field orientation randomly chosen, and a border region is defined such that at distances beyond 95% of the cell radius from the cell center smooth transitions have been applied in order to avoid discontinuities. The smooth transitions are simulated by weighting the magnetic field orientation by the particle's distance to the two nearby cells. The energy losses have been treated in the continuous approximation parameterizing the mean energy loss per unit path length by the energy loss length. We have shown, for a particle with the typical energy of interest the integration method performance in the relative error of Larmor radius, without energy losses and the relative error of energy. Additionally, we plotted the distance amplification from rectilinear propagation as a function of the traveled distance, particle's magnetic rigidity, without energy losses, and particle's energy, with energy losses, to study the influence of particle's species on these calculations. The results clearly show when it is necessary to use a full three-dimensional simulation.

Keywords: cosmic rays propagation, extragalactic magnetic fields, magnetic deflections, ultra-high energy

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Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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Authors: Kassoul Ilyes

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The field of error correcting codes has been revolutionized by the introduction of iteratively decoded codes. Among these, LDPC codes are now a preferred solution thanks to their remarkable performance and low complexity. The binary version of LDPC codes showed even better performance, although it’s decoding introduced greater complexity. This thesis studies the performance of binary LDPC codes using simplified weighted decisions. Information is transported between a transmitter and a receiver by digital transmission systems, either by propagating over a radio channel or also by using a transmission medium such as the transmission line. The purpose of the transmission system is then to carry the information from the transmitter to the receiver as reliably as possible. These codes have not generated enough interest within the coding theory community. This forgetfulness will last until the introduction of Turbo-codes and the iterative principle. Then it was proposed to adopt Pearl's Belief Propagation (BP) algorithm for decoding these codes. Subsequently, Luby introduced irregular LDPC codes characterized by a parity check matrix. And finally, we study simplifications on binary LDPC codes. Thus, we propose a method to make the exact calculation of the APP simpler. This method leads to simplifying the implementation of the system.

Keywords: LDPC, parity check matrix, 5G, BER, SNR

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Authors: Zorica Tomičić, Ružica Tomičić, Peter Raspor

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Growing resistance of pathogenic yeast Candida glabrata to many classes of antifungal drugs has stimulated efforts to discover new agents to combat a rising number of invasive C. glabrata infections, which deserves a great deal of concern due to the high mortality rate in immunocompromised populations. One promising strategy is the use of probiotic microorganisms, which, when administered in adequate amounts, confers a health benefit. A selected number of probiotic organisms, Saccharomyces boulardii among them, have been tested as potential biotherapeutic agents. The aim of this study was to investigate the effect of the probiotic yeast S. boulardii on the adhesion of clinical isolates of C. glabrata at different temperatures, pH values, and in the presence of three clinically important antifungal drugs, such as fluconazole, itraconazole and amphotericin B. The method used to assess adhesion was crystal violet staining. The selection of antimycotics concentrations used in the adhesion assay was based on minimum inhibitory concentrations (MICs) obtained by the preliminarily performed microdilution modification of the Reference method for broth dilution antifungal susceptibility testing of yeast (Clinical and Laboratory Standards Institute (CLSI), standard M27-A2). the results showed that despite the nonadhesiveness of S. boulardii cells, probiotic yeast significantly suppressed the adhesion of C. glabrata strains. Besides, at specific strain ratios, a slight stimulatory effect was observed in some C. glabrata strains, which highlights the importance of strain specificity and opens up further research interests. When environmental conditions are considered, temperature and pH significantly influenced co-culture adhesion of C. glabrata and S. boulardii. The adhesion of C. glabrata strains was relatively equally reduced over all tested temperature range (28°C, 37°C, 39°C and 42°C) in the presence of S. boulardii cells, while the adhesion of a few C. glabrata strains were significantly stimulated at 28°C and suppressed at 42°C. Further, the adhesion was highly dependent on pH, with the highest adherence at pH 4 and lowest at pH 8.5. It was observed that S. boulardii did not manage to suppress the adhesion of C. glabrata strains at high pH. Antimycotics on the other hand showed a greater impact, since S. boulardii failed to affect co-culture adhesion at higher antimycotics concentrations. As expected, exposure to various concentrations of amphotericin B significantly reduced the adherence ability of C.glabrata strains both in a single culture and co-culture with S. boulardii. Therefore, it can be speculated that S. boulardii could substitute the effect of antimycotics in a range concentrations and with specific type of strains. This would certainly change the view on the treatment of yeast infections in the future.

Keywords: adhesion, antimycotics, candida glabrata, saccharomyces boulardii

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