Search results for: pediatric computed tomography imaging

Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

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Background: Validation of communication activities of daily living-second edition (CADL-2) and assessment of language-related functional activities (ALFA) tests is a critical investment decision, and activities related to language impairments often are underestimated. Literature indicates that age factors, and gender differences may affect the performance of the aphasics. Thus, understanding these influential factors is highly important to neuropsycholinguists and speech language pathologists (SLPs). Purpose: The goal of this study is twofold: (1) to in/validate CADL-2 and ALFA tests, and (2) to investigate whether or not the two assessment tests are reliable. Design: A comparative study is made between the results obtained from the analyses of the Arabic versions of CADL-2 and ALFA tests. Participants: The communication activities of daily-living and language-related functional activities were assessed from the obtained results of 100 adult aphasics (50 males, 50 females; ages 16 to 65). Procedures: Firstly, the two translated and standardized Arabic versions of CADL-2 and ALFA tests were introduced to the Arab aphasics under investigation. Armed with the new two versions of the tests, one of the researchers assessed the language-related functional communication and activities. Outcomes drawn from the obtained analysis of the comparative studies were then qualitatively and statistically analyzed. Main outcomes and Results: Regarding the validity of CADL-2 and ALFA, it is found that …. Is more valid in both pre-and posttests. Concerning the reliability of the two tests, it is found that ….is more reliable in both pre-and-posttests which undoubtedly means that …..is more trustable. Nor must we forget to indicate here that the relationship between age and gender was very weak due to that no remarkable gender differences between the two in both CADL-2 and ALFA pre-and-posttests. Conclusions & Implications: CADL-2 and ALFA tests were found to be valid and reliable tests. In contrast to previous studies, age and gender were not significantly associated with the results of validity and reliability of the two assessment tests. In clearer terms, age and gender patterns do not affect the validation of these two tests. Future studies might focus on complex questions including the use of CADL-2 and ALFA functionally; how gender and puberty influence the results in case the sample is large; the effects of each type of aphasia on the final outcomes, and measurements’ results of imaging techniques.

Keywords: CADL-2, ALFA, comparison, language test, arab aphasics, validity, reliability, neuropsycholinguistics, comparison

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Authors: Priyanka Patil, Logan Manikam

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Background: The first 1000 days of life are a critical window and can result in adverse health consequences due to inadequate nutrition. South-Asian (SA) communities face significant health disparities, particularly in maternal and child health. Community-based interventions, often employing Participatory-Learning and Action (PLA) approaches, have effectively addressed health inequalities in lower-income nations. The aim of this study was to assess the feasibility of implementing a PLA intervention to improve infant feeding and care practices in SA communities living in London. Methods: Comprehensive analyses were conducted to assess the feasibility/fidelity of this pilot randomized controlled trial. Summary statistics were computed to compare key metrics, including participant consent rates, attendance, retention, intervention support, and perceived effectiveness, against predefined progression rules guiding toward a definitive trial. Secondary outcomes were analyzed, drawing insights from multiple sources, such as The Children’s-Eating-Behaviour Questionnaire (CEBQ), Parental-Feeding-Style Questionnaires (PFSQ), Food-diary, and the Equality-Impact-Assessment (EIA) tool. A video analysis of children's mealtime behavior trends was conducted. Feedback interviews were collected from study participants. Results: Process-outcome measures met predefined progression rules for a definitive trial, which deemed the intervention as feasible and acceptable. The secondary outcomes analysis revealed no significant changes in children's BMI z-scores. This could be attributed to the abbreviated follow-up period of 6 months, reduced from 12 months, due to COVID-19-related delays. CEBQ analysis showed increased food responsiveness, along with decreased emotional over/undereating. A similar trend was observed in PFSQ. The EIA tool found no potential discrimination areas, and video analysis revealed a decrease in force-feeding practices. Participant feedback revealed improved awareness and knowledge sharing. Conclusion: This study demonstrates that a co-adapted PLA intervention is feasible and well-received in optimizing infant-care practices among South-Asian community members in a high-income country. These findings highlight the potential of community-based interventions to enhance health outcomes, promoting health equity.

Keywords: child health, childhood obesity, community-based, infant nutrition

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Authors: Mehrnaz Mostafavi

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Nanoliposomes, minute lipid-based vesicles at the nano-scale, show promise in the realm of photothermal therapy (PTT). This study presents an extensive overview of nanoliposomes in PTT, exploring their distinct attributes and the significant progress in this therapeutic methodology. The research delves into the fundamental traits of nanoliposomes, emphasizing their adaptability, compatibility with biological systems, and their capacity to encapsulate diverse therapeutic substances. Specifically, it examines the integration of light-absorbing materials, like gold nanoparticles or organic dyes, into nanoliposomal formulations, enabling their efficacy as proficient agents for photothermal treatment Additionally, this paper elucidates the mechanisms involved in nanoliposome-mediated PTT, highlighting their capability to convert light energy into localized heat, facilitating the precise targeting of diseased cells or tissues. This precise regulation of light absorption and heat generation by nanoliposomes presents a non-invasive and precisely focused therapeutic approach, particularly in conditions like cancer. The study explores advancements in nanoliposomal formulations aimed at optimizing PTT outcomes. These advancements include strategies for improved stability, enhanced drug loading, and the targeted delivery of therapeutic agents to specific cells or tissues. Furthermore, the paper discusses multifunctional nanoliposomal systems, integrating imaging components or targeting elements for real-time monitoring and improved accuracy in PTT. Moreover, the review highlights recent preclinical and clinical trials showcasing the effectiveness and safety of nanoliposome-based PTT across various disease models. It also addresses challenges in clinical implementation, such as scalability, regulatory considerations, and long-term safety assessments. In conclusion, this paper underscores the substantial potential of nanoliposomes in advancing PTT as a promising therapeutic approach. Their distinctive characteristics, combined with their precise ability to convert light into heat, offer a tailored and efficient method for treating targeted diseases. The encouraging outcomes from preclinical studies pave the way for further exploration and potential clinical applications of nanoliposome-based PTT.

Keywords: nanoliposomes, photothermal therapy, light absorption, heat conversion, therapeutic agents, targeted delivery, cancer therapy

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Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

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Authors: Pangkaj Kumar Mahanta, Md. Rafizul Islam

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The rapid growth of the population causes a substantial amount of increase in household waste all over the world. Waste management is becoming one of the most challenging phenomena in the present day. The most environmentally friendly final disposal process of waste is sanitary landfilling, which is practiced in most developing countries. However, in Southeast Asia, most of the final disposal point is an open dump site. Due to the ignominy of proper management of waste and monitoring, the surrounding environment gets polluted more by the open dump site in comparison with a sanitary landfill. Khulna is 3rd largest metropolitan city in Bangladesh, having a population of around 1.5 million and producing approximately 450 tons per day of Municipal Solid Waste. The Municipal solid waste of Khulna city is disposed of in Rajbandh open dump site. The surrounding air is being polluted by the gas produced in the open dump site. Also, the open dump site produces leachate, which contains various heavy metals like Cadmium (Cd), Chromium (Cr), Lead (Pb), Manganese (Mn), Mercury (Hg), Strontium (Sr), etc. Leachate pollutes the soil as well as the groundwater of the open dump site and also the surrounding area through seepage. Moreover, during the rainy season, the surface water is polluted by leachate runoff. Also, the plastic waste flowing out from the open dump site through various drivers pollutes the nearby environment. The health risk assessment associated with heavy metals was carried out by computing the chronic daily intake (CDI), hazard quotient (HQ), and hazard index (HI) via different exposure pathways following the USEPA guidelines. For ecological risk, potential contamination index (Cp), Contamination factor (CF), contamination load index (PLI), numerical integrated contamination factor (NICF), enrichment factor (EF), ecological risk index (ER), and potential ecological risk index (PERI) were computed. The health risk and ecological risk assessment results reveal that some heavy metals possess strong health and ecological risk. In addition, the child faces higher harmful health risks from several heavy metals than the adult for all the exposure pathways and media. The conversion of an open dump site into a sanitary landfill and a proper management system can reduce the problems associated with an open dump site. In the sanitary landfill, the produced gas will be managed properly to save the surrounding atmosphere from being polluted. The seepage of leachate can be minimized by installing a compacted clay layer (CCL) as a baseline and leachate collection in a sanitary landfill to save the underlying soil layer and surrounding water bodies from leachate. Another important component of a sanitary landfill is the conversion of plastic waste to energy will minimize the plastic pollution in the landfill area and also the surrounding soil and water bodies. Also, in the sanitary landfill, the bio-waste can be used to make compost to reduce the volume of bio-waste and proper utilization of the landfill area.

Keywords: ecological risk, health risk, open dump site, sanitary landfill

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Authors: Pawan Kumar, Dhananjoy Shaw, Manoj Kumar Rathi

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Purpose of the study were to compare between (a) frequencies among the four quartiles of percentile norms of autonomic variables from power events and (b) frequencies among the four quartiles percentile norms of autonomic variables from aerobic events of Indian sportspersons withdrawn from competitive games and sports in regard to number of samples falling in each quartile. The study was conducted on 430 males of 30 to 35 years of age. Based on the nature of game/sports the retired sportspersons were classified into power events (throwers, judo players, wrestlers, short distance swimmers, cricket fast bowlers and power lifters) and aerobic events (long distance runners, long distance swimmers, water polo players). Date was collected using ECG polygraphs. Data were processed and extracted using frequency domain analysis and time domain analysis. Collected data were computed with frequency, percentage of each quartile and finally the frequencies were compared with the chi square analysis. The finding pertaining to norm reference comparison of frequencies among the four quartiles of Indian sportspersons withdrawn from competitive games and sports from (a) power events suggests that frequency distribution in four quartile namely Q1, Q2, Q3, and Q4 are significantly different at .05 level in regard to variables namely, SDNN, Total Power (Absolute Power), HF (Absolute Power), LF (Normalized Power), HF (Normalized Power), LF/HF ratio, deep breathing test, expiratory respiratory ratio, valsalva manoeuvre, hand grip test, cold pressor test and lying to standing test, whereas, insignificantly different at .05 level in regard to variables namely, SDSD, RMSSD, SDANN, NN50 Count, pNN50 Count, LF (Absolute Power) and 30: 15 Ratio (b) aerobic events suggests that frequency distribution in four quartile are significantly different at .05 level in regard to variables namely, SDNN, LF (Normalized Power), HF (Normalized Power), LF/HF ratio, deep breathing test, expiratory respiratory ratio, hand grip test, cold pressor test, lying to standing test and 30: 15 ratio, whereas, insignificantly different at .05 level in regard to variables namely, SDSD, RMSSD. SDANN, NN50 count, pNN50 count, Total Power (Absolute Power), LF(Absolute Power) HF(Absolute Power), and valsalva manoeuvre. The study concluded that comparison of frequencies among the four quartiles of Indian retired sportspersons from power events and aerobic events are different in four quartiles in regard to selected autonomic functions, hence the developed percentile norms are not homogenously distributed across the percentile scale; hence strengthen the percentage distribution towards normal distribution.

Keywords: power, aerobic, absolute power, normalized power

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Authors: Mohammad Moezzibadi, Isabelle Charpentier, Adrien Wanko, Robert Mosé

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The calibration of hydrodynamic parameters for subsurface constructed wetlands (CWs) is a sensitive process since highly non-linear equations are involved in unsaturated flow modeling. CW systems are engineered systems designed to favour natural treatment processes involving wetland vegetation, soil, and their microbial flora. Their significant efficiency at reducing the ecological impact of urban runoff has been recently proved in the field. Numerical flow modeling in a vertical variably saturated CW is here carried out by implementing the Richards model by means of a mixed hybrid finite element method (MHFEM), particularly well adapted to the simulation of heterogeneous media, and the van Genuchten-Mualem parametrization. For validation purposes, MHFEM results were compared to those of HYDRUS (a software based on a finite element discretization). As van Genuchten-Mualem soil hydrodynamic parameters depend on water content, their estimation is subject to considerable experimental and numerical studies. In particular, the sensitivity analysis performed with respect to the van Genuchten-Mualem parameters reveals a predominant influence of the shape parameters α, n and the saturated conductivity of the filter on the piezometric heads, during saturation and desaturation. Modeling issues arise when the soil reaches oven-dry conditions. A particular attention should also be brought to boundary condition modeling (surface ponding or evaporation) to be able to tackle different sequences of rainfall-runoff events. For proper parameter identification, large field datasets would be needed. As these are usually not available, notably due to the randomness of the storm events, we thus propose a simple, robust and low-cost numerical method for the inverse modeling of the soil hydrodynamic properties. Among the methods, the variational data assimilation technique introduced by Le Dimet and Talagrand is applied. To that end, a variational data assimilation technique is implemented by applying automatic differentiation (AD) to augment computer codes with derivative computations. Note that very little effort is needed to obtain the differentiated code using the on-line Tapenade AD engine. Field data are collected for a three-layered CW located in Strasbourg (Alsace, France) at the water edge of the urban water stream Ostwaldergraben, during several months. Identification experiments are conducted by comparing measured and computed piezometric head by means of the least square objective function. The temporal variability of hydrodynamic parameter is then assessed and analyzed.

Keywords: automatic differentiation, constructed wetland, inverse method, mixed hybrid FEM, sensitivity analysis

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Authors: Mahboobe Daneshvar

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Introduction: Clinical studies on the effect of systemic conditions on periodontal diseases have shown that some systemic deficiencies may provide grounds for the onset of periodontal diseases. One of these systemic problems is osteoporosis, which may be a risk factor for the onset and exacerbation of periodontitis. This study tends to evaluate periodontal indices in osteoporotic menopausal women and compare them with healthy controls. Materials and Methods: In this case-control study, participants included 45-75-year-old menopausal women referred to rheumatology wards of the Khatamolanbia Clinic and Shahid Sadoughi Hospital in Yazd; Their bone density was determined by DEXA-scan and by imaging the femoral-lumbar bone. Thirty patients with osteoporosis and 30 subjects with normal BMD were selected. Then, informed consent was obtained for participation in the study. During the clinical examinations, tooth loss (TL), plaque index (PI), gingival recession, pocket probing depth (PPD), clinical attachment loss (CAL), and tooth mobility (TM) were measured to evaluate the periodontal status. These clinical examinations were performed to determine the periodontal status by catheter, mirror and probe. Results: During the evaluation, there was no significant difference in PPD, PI, TM, gingival recession, and CAL between case and control groups (P-value>0.05); that is, osteoporosis has no effect on the above factors. These periodontal factors are almost the same in both healthy and patient groups. In the case of missing teeth, the following results were obtained: the mean of missing teeth was 22.173% of the total teeth in the case group and 18.583% of the total teeth in the control group. In the study of the missing teeth in the case and control groups, there was a significant relationship between case and control groups (P-value = 0.025). Conclusion: In fact, since periodontal disease is multifactorial and microbial plaque is the main cause, osteoporosis is considered a predisposing factor in exacerbation or persistence of periodontal disease. In patients with osteoporosis, usually pathological fractures, hormonal changes, and aging lead to reduced physical activity and affect oral health, which leads to the manifestation of periodontal disease. But this disease increases tooth loss by changing the shape and structure of bone trabeculae and weakening them. Osteoporosis does not seem to be a deterministic factor in the incidence of periodontal disease, since it affects bone quality rather than bone quantity.

Keywords: plaque index, Osteoporosis, tooth mobility, periodontal packet

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Authors: Regina A. Tayong, Reza Barati

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A stable, fast and robust three-phase, 2D IMPES simulator has been developed for assessing the influence of; breaker concentration on yield stress of filter cake and broken gel viscosity, varying polymer concentration/yield stress along the fracture face, fracture conductivity, fracture length, capillary pressure changes and formation damage on fracturing fluid cleanup in tight gas reservoirs. This model has been validated as against field data reported in the literature for the same reservoir. A 2-D, two-phase (gas/water) fracture propagation model is used to model our invasion zone and create the initial conditions for our clean-up model by distributing 200 bbls of water around the fracture. A 2-D, three-phase IMPES simulator, incorporating a yield-power-law-rheology has been developed in MATLAB to characterize fluid flow through a hydraulically fractured grid. The variation in polymer concentration along the fracture is computed from a material balance equation relating the initial polymer concentration to total volume of injected fluid and fracture volume. All governing equations and the methods employed have been adequately reported to permit easy replication of results. The effect of increasing capillary pressure in the formation simulated in this study resulted in a 10.4% decrease in cumulative production after 100 days of fluid recovery. Increasing the breaker concentration from 5-15 gal/Mgal on the yield stress and fluid viscosity of a 200 lb/Mgal guar fluid resulted in a 10.83% increase in cumulative gas production. For tight gas formations (k=0.05 md), fluid recovery increases with increasing shut-in time, increasing fracture conductivity and fracture length, irrespective of the yield stress of the fracturing fluid. Mechanical induced formation damage combined with hydraulic damage tends to be the most significant. Several correlations have been developed relating pressure distribution and polymer concentration to distance along the fracture face and average polymer concentration variation with injection time. The gradient in yield stress distribution along the fracture face becomes steeper with increasing polymer concentration. The rate at which the yield stress (τ_o) is increasing is found to be proportional to the square of the volume of fluid lost to the formation. Finally, an improvement on previous results was achieved through simulating yield stress variation along the fracture face rather than assuming constant values because fluid loss to the formation and the polymer concentration distribution along the fracture face decreases as we move away from the injection well. The novelty of this three-phase flow model lies in its ability to (i) Simulate yield stress variation with fluid loss volume along the fracture face for different initial guar concentrations. (ii) Simulate increasing breaker activity on yield stress and broken gel viscosity and the effect of (i) and (ii) on cumulative gas production within reasonable computational time.

Keywords: formation damage, hydraulic fracturing, polymer cleanup, multiphase flow numerical simulation

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Authors: Premalatha B. S., Shenoy A. M.

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Background: Rehabilitation of swallowing is as vital as speech in surgically treated head and neck cancer patients to maintain nutritional support, enhance wound healing and improve quality of life. Aspiration following supraglottic laryngectomy is very common, and rehabilitation of the same is crucial which requires involvement of speech therapist in close contact with head and neck surgeon. Objectives: To examine the functions of swallowing outcomes after intensive therapy in supraglottic laryngectomy. Materials: Thirty-nine supra glottic laryngectomees were participated in the study. Of them, 36 subjects were males and 3 were females, in the age range of 32-68 years. Eighteen subjects had undergone standard supra glottis laryngectomy (Group1) for supraglottic lesions where as 21 of them for extended supraglottic laryngectomy (Group 2) for base tongue and lateral pharyngeal wall lesion. Prior to surgery visit by speech pathologist was mandatory to assess the sutability for surgery and rehabilitation. Dysphagia rehabilitation started after decannulation of tracheostoma by focusing on orientation about anatomy, physiological variation before and after surgery, which was tailor made for each individual based on their type and extent of surgery. Supraglottic diet - Soft solid with supraglottic swallow method was advocated to prevent aspiration. The success of intervention was documented as number of sessions taken to swallow different food consistency and also percentage of subjects who achieved satisfactory swallow in terms of number of weeks in both the groups. Results: Statistical data was computed in two ways in both the groups 1) to calculate percentage (%) of subjects who swallowed satisfactorily in the time frame of less than 3 weeks to more than 6 weeks, 2) number of sessions taken to swallow without aspiration as far as food consistency was concerned. The study indicated that in group 1 subjects of standard supraglottic laryngectomy, 61% (n=11) of them were successfully rehabilitated but their swallowing normalcy was delayed by an average 29th post operative day (3-6 weeks). Thirty three percentages (33%) (n=6) of the subjects could swallow satisfactorily without aspiration even before 3 weeks and only 5 % (n=1) of the needed more than 6 weeks to achieve normal swallowing ability. Group 2 subjects of extended SGL only 47 %( n=10) of them could achieved satisfactory swallow by 3-6 weeks and 24% (n=5) of them of them achieved normal swallowing ability before 3 weeks. Around 4% (n=1) needed more than 6 weeks and as high as 24 % (n=5) of them continued to be supplemented with naso gastric feeding even after 8-10 months post operative as they exhibited severe aspiration. As far as type of food consistencies were concerned group 1 subject could able to swallow all types without aspiration much earlier than group 2 subjects. Group 1 needed only 8 swallowing therapy sessions for thickened soft solid and 15 sessions for liquids whereas group 2 required 14 sessions for soft solid and 17 sessions for liquids to achieve swallowing normalcy without aspiration. Conclusion: The study highlights the importance of dysphagia intervention in supraglottic laryngectomees by speech pathologist.

Keywords: dysphagia management, supraglotic diet, supraglottic laryngectomy, supraglottic swallow

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Authors: Astrid Tannert, Anuradha Ramoji, Christina Ebert, Frederike Gladigau, Lorena Tuchscherr, Jürgen Popp, Ute Neugebauer

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Staphylococcus aureus is a facultative intracellular pathogen, which by entering host cells may evade immunologic host response as well as antimicrobial treatment. In that way, S. aureus can cause persistent intracellular infections which are difficult to treat. Depending on the strain, S. aureus may persist at different intracellular locations like the phagolysosome. The first barrier invading pathogens from the blood stream that they have to cross are the endothelial cells lining the inner surface of blood and lymphatic vessels. Upon proceeding from an acute to a chronic infection, intracellular pathogens undergo certain biochemical and structural changes including a deceleration of metabolic processes to adopt for long-term intracellular survival and the development of a special phenotype designated as small colony variant. In this study, the endothelial cell line Ea.hy 926 was used as a model for acute and chronic S. aureus infection. To this end, Ea.hy 926 cells were cultured on QIAscout™ Microraft Arrays, a special graded cell culture substrate that contains around 12,000 microrafts of 200 µm edge length. After attachment to the substrate, the endothelial cells were infected with GFP-expressing S. aureus for 3 weeks. The acute infection and the development of persistent bacteria was followed by confocal laser scanning microscopy, scanning the whole Microraft Array for the presence and for detailed determination of the intracellular location of fluorescent intracellular bacteria every second day. After three weeks of infection representative microrafts containing infected cells, cells with protruded infections and cells that did never show any infection were isolated and fixed for Raman micro-spectroscopic investigation. For comparison, also microrafts with acute infection were isolated. The acquired Raman spectra are correlated with the fluorescence microscopic images to give hints about a) the molecular alterations in endothelial cells during acute and chronic infection compared to non-infected cells, and b) metabolic and structural changes within the pathogen when entering a mode of persistence within host cells. We thank Dr. Ruth Kläver from QIAGEN GmbH for her support regarding QIAscout technology. Financial support by the BMBF via the CSCC (FKZ 01EO1502) and from the DFG via the Jena Biophotonic and Imaging Laboratory (JBIL, FKZ PO 633/29-1, BA 1601/10-1) is highly acknowledged.

Keywords: correlative image analysis, intracellular infection, pathogen-host adaption, Raman micro-spectroscopy

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Authors: Aleksandra Zieminska-Stolarska, Ireneusz Zbicinski

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Introduction: The objective of the present work was to develop and validate a 3D CFD numerical model for simulating flow through 17 kilometers long dam reservoir of a complex bathymetry. In contrast to flowing waters, dam reservoirs were not emphasized in the early years of water quality modeling, as this issue has never been the major focus of urban development. Starting in the 1970s, however, it was recognized that natural and man-made lakes are equal, if not more important than estuaries and rivers from a recreational standpoint. The Sulejow Reservoir (Central Poland) was selected as the study area as representative of many lowland dam reservoirs and due availability of a large database of the ecological, hydrological and morphological parameters of the lake. Method: 3D, 2-phase and 1-phase CFD models were analysed to determine hydrodynamics in the Sulejow Reservoir. Development of 3D, 2-phase CFD model of flow requires a construction of mesh with millions of elements and overcome serious convergence problems. As 1-phase CFD model of flow in relation to 2-phase CFD model excludes from the simulations the dynamics of waves only, which should not change significantly water flow pattern for the case of lowland, dam reservoirs. In 1-phase CFD model, the phases (water-air) are separated by a plate which allows calculations of one phase (water) flow only. As the wind affects velocity of flow, to take into account the effect of the wind on hydrodynamics in 1-phase CFD model, the plate must move with speed and direction equal to the speed and direction of the upper water layer. To determine the velocity at which the plate will move on the water surface and interacts with the underlying layers of water and apply this value in 1-phase CFD model, the 2D, 2-phase model was elaborated. Result: Model was verified on the basis of the extensive flow measurements (StreamPro ADCP, USA). Excellent agreement (an average error less than 10%) between computed and measured velocity profiles was found. As a result of work, the following main conclusions can be presented: •The results indicate that the flow field in the Sulejow Reservoir is transient in nature, with swirl flows in the lower part of the lake. Recirculating zones, with the size of even half kilometer, may increase water retention time in this region •The results of simulations confirm the pronounced effect of the wind on the development of the water circulation zones in the reservoir which might affect the accumulation of nutrients in the epilimnion layer and result e.g. in the algae bloom. Conclusion: The resulting model is accurate and the methodology develop in the frame of this work can be applied to all types of storage reservoir configurations, characteristics, and hydrodynamics conditions. Large recirculating zones in the lake which increase water retention time and might affect the accumulation of nutrients were detected. Accurate CFD model of hydrodynamics in large water body could help in the development of forecast of water quality, especially in terms of eutrophication and water management of the big water bodies.

Keywords: CFD, mathematical modelling, dam reservoirs, hydrodynamics

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Authors: Emmanuel A. David, Rebecca O. Soremekun, Roseline I. Aderemi-Williams

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Background: The complexities involved in the management of diabetes mellitus require a multi-dimensional, multi-professional collaborative and continuous care by health care providers and a substantial self-care by the patients in order to achieve desired treatment outcomes. The effect of pharmacists’ care in the management of diabetes in resource-endowed nations is well documented in literature, but randomised-controlled assessment of the impact of pharmacist-led care among patients with diabetes in resource-limited settings like Nigeria and sub-Saharan Africa countries is scarce. Objective: To evaluate the impact of Pharmacist-led care on glycaemic control in patients with uncontrolled type 2 diabetes, using a randomised-controlled study design Methods: This study employed a prospective randomised controlled design, to assess the impact of pharmacist-led care on glycaemic control of 108 poorly controlled type 2 diabetic patients. A total of 200 clinically diagnosed type 2 diabetes patients were purposively selected using fasting blood glucose ≥ 7mmol/L and tested for long term glucose control using Glycated haemoglobin measure. One hundred and eight (108) patients with ≥ 7% Glycated haemoglobin were recruited for the study and assigned unique identification numbers. They were further randomly allocated to intervention and usual care groups using computer generated random numbers, with each group containing 54 subjects. Patients in the intervention group received pharmacist-structured intervention, including education, periodic phone calls, adherence counselling, referral and 6 months follow-up, while patients in usual care group only kept clinic appointments with their physicians. Data collected at baseline and six months included socio-demographic characteristics, fasting blood glucose, Glycated haemoglobin, blood pressure, lipid profile. With an intention to treat analysis, Mann-Whitney U test was used to compared median change from baseline in the primary outcome (Glycated haemoglobin) and secondary outcomes measure, effect size was computed and proportion of patients that reached target laboratory parameter were compared in both arms. Results: All enrolled participants (108) completed the study, 54 in each study. Mean age was 51±11.75 and majority were female (68.5%). Intervention patients had significant reduction in Glycated haemoglobin (-0.75%; P<0.001; η2 = 0.144), with greater proportion attaining target laboratory parameter after 6 months of care compared to usual care group (Glycated haemoglobin: 42.6% vs 20.8%; P=0.02). Furthermore, patients who received pharmacist-led care were about 3 times more likely to have better glucose control (AOR 2.718, 95%CI: 1.143-6.461) compared to usual care group. Conclusion: Pharmacist-led care significantly improved glucose control in patients with uncontrolled type 2 diabetes mellitus and should be integrated in the routine management of diabetes patients, especially in resource-limited settings.

Keywords: glycaemic control , pharmacist-led care, randomised-controlled trial , type 2 diabetes mellitus

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Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini

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Background: There is growing evidence that Cerebral Vascular Accident (CVA) can be a consequence of Covid-19 infection. Understanding novel treatment approaches are important in optimizing patient outcomes. Case: This case explores the use of Virtual Reality (VR) in the treatment of a 23-year-old COVID-positive female presenting with left hemiparesis in August 2020. Imaging showed right globus pallidus, thalamus, and internal capsule ischemic stroke. Conventional rehabilitation was started two weeks later, with virtual reality (VR) included. This game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and functions for stroke. Physical examination showed left hemiparesis with muscle strength 3/5 in the upper extremity and 4/5 in the lower extremity. The range of motion of the shoulder was 90-100 degrees. The speech exam showed a mild decrease in fluency. Mild lower lip dynamic asymmetry was seen. Babinski was positive on the left. Gait speed was decreased (75 steps per minute). Intervention: Our game-based VR system was developed based on upper extremity physiotherapy exercises for post-stroke patients to increase the active, voluntary movement of the upper extremity joints and improve the function. The conventional program was initiated with active exercises, shoulder sanding for joint ROMs, walking shoulder, shoulder wheel, and combination movements of the shoulder, elbow, and wrist joints, alternative flexion-extension, pronation-supination movements, Pegboard and Purdo pegboard exercises. Also, fine movements included smart gloves, biofeedback, finger ladder, and writing. The difficulty of the game increased at each stage of the practice with progress in patient performances. Outcome: After 6 weeks of treatment, gait and speech were normal and upper extremity strength was improved to near normal status. No adverse effects were noted. Conclusion: This case suggests that VR is a useful tool in the treatment of a patient with covid-19 related CVA. The safety of newly developed instruments for such cases provides new approaches to improve the therapeutic outcomes and prognosis as well as increased satisfaction rate among patients.

Keywords: covid-19, stroke, virtual reality, rehabilitation

Procedia PDF Downloads 140

Authors: Nishanth Venugopal Menon, Chuah Yon Jin, Samantha Phey, Wu Yingnan, Zhang Ying, Vincent Chan, Kang Yuejun

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Cell Migration is a vital phenomenon that the cells undergo in various physiological processes like wound healing, disease progression, embryogenesis, etc. Cell migration depends primarily on the chemical and physical cues available in the cellular environment. The chemical cue involves the chemokines secreted and gradients generated in the environment while physical cues indicate the impact of matrix properties like nanotopography and stiffness on the cells. Mesenchymal Stem Cells (MSCs) have been shown to have a role wound healing in vivo and its migration to the site of the wound has been shown to have a therapeutic effect. In the field of stem cell based tissue regeneration of bones and cartilage, one approach has been to introduce scaffold laden with MSCs into the site of injury to enable tissue regeneration. In this work, we have studied the combinatorial impact of the substrate physical properties on MSC migration. A microfluidic in vitro model was created to perform the migration studies. The microfluidic model used is a three compartment device consisting of two cell seeding compartments and one migration compartment. Four different PDMS substrates with varying substrate roughness, stiffness and hydrophobicity were created. Its surface roughness and stiffness was measured using Atomic Force Microscopy (AFM) while its hydrphobicity was measured from the water contact angle using an optical tensiometer. These PDMS substrates are sealed to the microfluidic chip following which the MSCs are seeded and the cell migration is studied over the period of a week. Cell migration was quantified using fluorescence imaging of the cytoskeleton (F-actin) to find out the area covered by the cells inside the migration compartment. The impact of adhesion proteins on cell migration was also quantified using a real-time polymerase chain reaction (qRT PCR). These results suggested that the optimal substrate for cell migration would be one with an intermediate level of roughness, stiffness and hydrophobicity. A higher or lower value of these properties affected cell migration negatively. These observations have helped us in understanding that different substrate properties need to be considered in tandem, especially while designing scaffolds for tissue regeneration as cell migration is normally impacted by the combinatorial impact of the matrix. These observations may lead us to scaffold optimization in future tissue regeneration applications.

Keywords: cell migration, microfluidics, in vitro model, stem cell migration, scaffold, substrate properties

Procedia PDF Downloads 555

Authors: Ali Kadir, O. Anwar Beg

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Thermal barrier coatings are among the most popular methods for providing corrosion protection in high temperature applications including aircraft engine systems, external spacecraft structures, rocket chambers etc. Many different materials are available for such coatings, of which ceramics generally perform the best. Motivated by these applications, the current investigation presents detailed finite element simulations of coating stress analysis for a 3- dimensional, 3-layered model of a test sample representing a typical gas turbine component scenario. Structural steel is selected for the main inner layer, Titanium (Ti) alloy for the middle layer and Silicon Carbide (SiC) for the outermost layer. The model dimensions are 20 mm (width), 10 mm (height) and three 1mm deep layers. ANSYS software is employed to conduct three types of analysis- static structural, thermal stress analysis and also computational fluid dynamic erosion/corrosion analysis (via ANSYS FLUENT). The specified geometry which corresponds to corrosion test samples exactly is discretized using a body-sizing meshing approach, comprising mainly of tetrahedron cells. Refinements were concentrated at the connection points between the layers to shift the focus towards the static effects dissipated between them. A detailed grid independence study is conducted to confirm the accuracy of the selected mesh densities. To recreate gas turbine scenarios; in the stress analysis simulations, static loading and thermal environment conditions of up to 1000 N and 1000 degrees Kelvin are imposed. The default solver was used to set the controls for the simulation with the fixed support being set as one side of the model while subjecting the opposite side to a tabular force of 500 and 1000 Newtons. Equivalent elastic strain, total deformation, equivalent stress and strain energy were computed for all cases. Each analysis was duplicated twice to remove one of the layers each time, to allow testing of the static and thermal effects with each of the coatings. ANSYS FLUENT simulation was conducted to study the effect of corrosion on the model under similar thermal conditions. The momentum and energy equations were solved and the viscous heating option was applied to represent improved thermal physics of heat transfer between the layers of the structures. A Discrete Phase Model (DPM) in ANSYS FLUENT was employed which allows for the injection of continuous uniform air particles onto the model, thereby enabling an option for calculating the corrosion factor caused by hot air injection (particles prescribed 5 m/s velocity and 1273.15 K). Extensive visualization of results is provided. The simulations reveal interesting features associated with coating response to realistic gas turbine loading conditions including significantly different stress concentrations with different coatings.

Keywords: thermal coating, corrosion, ANSYS FEA, CFD

Procedia PDF Downloads 134

Authors: Lydia Ouma Radoli

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The paradox of documenting history through visuals that objectify gruesome images to depict the prominence of stories intrigues media researchers. In East Africa, the topic has been captured in a variety of media frames, but scantly in scholarly work. This paper adopts Visual Rhetoric and Framing Theories to tease out the drivers behind the criteria for the selection of violent visuals. The paper projects that quantitative and qualitative literature regarding journalists’ personal and work-related exposure to PSTD will give insights into the concept of trauma journalism - reporting of horrific events, e.g., violent crime and terror. The data will be collected through methods such as document analysis (photographs and videos) and in-depth interviews to summarize the informational contents with respect to the research objectives and questions. The study is hinged on the background that the criterion for news production is constructed from the idea that ‘if there’s violence, conflict, and death involved, the story gets top priority.’ The anticipated outcome is to establish trauma experiences of visual rhetors, suggest mitigations, and address gaps in academic research. The findings of the study will sustain the critical role of visual rhetors. Further, media practitioners may find the study useful in assessing the effects and values of visual witnessing. Historically, the criterion for visual news production has been that if there’s violence, conflict, and death involved, the story gets top priority. To capture the goriness of the images, media theorists and sociologists have used the expression: “If it bleeds, it leads.” The statement assumes that audiences are attracted to pictures that show violent images. Further, research on visual aspects of Television news has shown its ability to hold viewers’ attention and cause aggression. This paper samples images and narratives from Journalists who have covered trauma-related events. The samples are indicative of the problem under study, which depicts journalists exposed to traumatic events as not receiving any Psycho-social support within newsrooms. It is hoped that the study could inform policy and practice within developing countries through the interpretations of theoretical and empirical explanations of existing trauma phenomena among journalists.

Keywords: visual-witnessing, media culture, visual rhetoric, imaging violence in East Africa

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Authors: Jessica Scher Lisa, Eric Shyman

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Autism spectrum disorder (ASD) is a neuro-developmental disorder that is characterized by persistent deficits in social communication and social interaction (i.e. deficits in social-emotional reciprocity, nonverbal communicative behaviors, and establishing/maintaining social relationships), as well as by the presence of repetitive behaviors and perseverative areas of interest (i.e. stereotyped or receptive motor movements, use of objects, or speech, rigidity, restricted interests, and hypo or hyperactivity to sensory input or unusual interest in sensory aspects of the environment). Additionally, diagnoses of ASD require the presentation of symptoms in the early developmental period, marked impairments in adaptive functioning, and a lack of explanation by general intellectual impairment or global developmental delay (although these conditions may be co-occurring). Over the past several decades, many theories have been developed in an effort to explain the root cause of ASD in terms of atypical central cognitive processes. The field of neuroscience is increasingly finding structural and functional differences between autistic and neurotypical individuals using neuro-imaging technology. One main area this research has focused upon is in visuospatial processing, with specific attention to the notion of ‘weak central coherence’ (WCC). This paper offers an analysis of findings from selected studies in order to explore research that challenges the ‘deficit’ characterization of a weak central coherence theory as opposed to a ‘superiority’ characterization of strong local coherence. The weak central coherence theory has long been both supported and refuted in the ASD literature and has most recently been increasingly challenged by advances in neuroscience. The selected studies lend evidence to the notion of amplified localized perception rather than deficient global perception. In other words, WCC may represent superiority in ‘local processing’ rather than a deficit in global processing. Additionally, the right hemisphere and the specific area of the extrastriate appear to be key in both the visual and lexicosemantic process. Overactivity in the striate region seems to suggest inaccuracy in semantic language, which lends itself to support for the link between the striate region and the atypical organization of the lexicosemantic system in ASD.

Keywords: autism spectrum disorder, neurology, visual processing, weak coherence

Procedia PDF Downloads 126

Authors: Baguma Daniel Kajura

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The study explores socio-economic factors, health related and individual factors that influence the breastfeeding habits of mothers and their effect on the nutritional status of their infants in the Rwenzori region of Western Uganda. A cross-sectional research design was adopted, and it involved the use of self-administered questionnaires, interview guides, and focused group discussion guides to assess the extent to which socio-demographic factors associated with breastfeeding practices influence child malnutrition. Using this design, data was collected from 276 mother-paired infants out of the selected 318 mother-paired infants over a period of ten days. Using a sample size formula by Kish Leslie for cross-sectional studies N= Zα2 P (1- P) / δ2, where N= sample size estimate of paired mother paired infants. P= assumed true population prevalence of mother–paired infants with malnutrition cases, P = 29.3%. 1-P = the probability of mother-paired infants not having malnutrition, so 1-P = 70.7% Zα = Standard normal deviation at 95% confidence interval corresponding to 1.96.δ = Absolute error between the estimated and true population prevalence of malnutrition of 5%. The calculated sample size N = 1.96 × 1.96 (0.293 × 0.707) /0,052= 318 mother paired infants. Demographic and socio-economic data for all mothers were entered into Microsoft Excel software and then exported to STATA 14 (StataCorp, 2015). Anthropometric measurements were taken for all children by the researcher and the trained assistants who physically weighed the children. The use of immunization card was used to attain the age of the child. The bivariate logistic regression analysis was used to assess the relationship between socio-demographic factors associated with breastfeeding practices and child malnutrition. The multivariable regression analysis was used to draw a conclusion on whether or not there are any true relationships between the socio-demographic factors associated with breastfeeding practices as independent variables and child stunting and underweight as dependent variables in relation to breastfeeding practices. Descriptive statistics on background characteristics of the mothers were generated and presented in frequency distribution tables. Frequencies and means were computed, and the results were presented using tables, then, we determined the distribution of stunting and underweight among infants by the socioeconomic and demographic factors. Findings reveal that children of mothers who used milk substitutes besides breastfeeding are over two times more likely to be stunted compared to those whose mothers exclusively breastfed them. Feeding children with milk substitutes instead of breastmilk predisposes them to both stunting and underweight. Children of mothers between 18 and 34 years of age are less likely to be underweight, as were those who were breastfed over ten times a day. The study further reveals that 55% of the children were underweight, and 49% were stunted. Of the underweight children, an equal number (58/151) were either mildly or moderately underweight (38%), and 23% (35/151) were severely underweight. Empowering community outreach programs by increasing knowledge and increased access to services on integrated management of child malnutrition is crucial to curbing child malnutrition in rural areas.

Keywords: infant and young child feeding, breastfeeding, child malnutrition, maternal health

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Authors: A. K. M. Badrul Alam, Yoshiaki Fujii, Nahid Hasan Dipu, Shakil Ahmed Razo

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Shale rockmasses often include silt layers, impacting slope stability in construction and mining. Analyzing their interaction is crucial for long-term stability. A study used an elastoplastic model, incorporating the stress transfer method and Coulomb's criterion, to assess a shale rock mass with silt layers. It computed stress distribution, assessed failure potential, and identified vulnerable regions where nodal forces were calculated for a comprehensive analysis. A shale rock mass ranging from 14.75 to 16.75 meters thick, with silt layers varying from 0.36 to 0.5 meters, was considered in the model. It examined four silt layer conditions: horizontal (SiHL), vertical (SiVL), inclined against slope (SiIincAGS), and along slope (SilincALO). Mechanical parameters like uniaxial compressive strength (UCS), tensile strength (TS), Young’s modulus (E), Poisson’s ratio, and density were adjusted for varied scenarios: UCS (0.5 to 5 MPa), TS (0.1 to 1 MPa), and E (6 to 60 MPa). In elastic analysis of shale rock masses, stress distributions vary based on layer properties. When shale and silt layers have the same elasticity modulus (E), stress concentrates at corners. If the silt layer has a lower E than shale, marginal changes in maximum stress (σmax) occur for SilHL. A decrease in σmax is evident at SilVL. Slight variations in σmax are observed for SilincAGS and SilincALO. In the elastoplastic analysis, the overall decrease of 20%, 40%, 60%, 80%, and 90% was considered. For SilHL:(i) Same E, UCS, and TS for silt layer and shale, UCS/TS ratio 5: strength decrease led to shear (S), tension then shear (T then S) failure; noticeable failure at 60% decrease, significant at 80%, collapse at 90%. (ii) Lower E for silt layer, same strength as shale: No significant differences. (iii) Lower E and UCS, silt layer strength 1/10: No significant differences. For SilVL: (i) Same E, UCS, and TS for silt layer and shale, UCS/TS ratio 5: Similar effects as SilHL. (ii) Lower E for silt layer, same strength as shale: Slip occurred. (iii) Lower E and UCS, silt layer strength 1/10: Bitension failure also observed with larger slip. For SilincAGS: (i) Same E, UCS, and TS for silt layer and shale, UCS/TS ratio 5: Effects similar to SilHL. (ii) Lower E for silt layer, same strength as shale: Slip occurred. (iii) Lower E and UCS, silt layer strength 1/10: Tension failure also observed with larger slip. For SilincALO: (i) Same E, UCS, and TS for silt layer and shale, UCS/TS ratio 5: Similar to SilHL with tension failure. (ii) Lower E for silt layer, same strength as shale: No significant differences; failure diverged. (iii) Lower E and UCS, silt layer strength 1/10: Bitension failure also observed with larger slip; failure diverged. Toppling failure was observed for lower E cases of SilVL and SilincAGS. The presence of silt interlayers in shale greatly impacts slope stability. Designing slopes requires careful consideration of both the silt and shale's mechanical properties. The temporal degradation of strength in these layers is a major concern. Thus, slope design must comprehensively analyze the immediate and long-term mechanical behavior of interlayer silt and shale to effectively mitigate instability.

Keywords: shale rock masses, silt layers, slope stability, elasto-plastic model, temporal degradation

Procedia PDF Downloads 52

Authors: Noppadol Poomvises, Prateep Pakdeerod, Anchalee Kongsuk

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In the middle of September 2017, a tropical storm named ‘DOKSURI’ swept through Udon Thani, Northeastern Thailand. The storm dumped heavy rain for many hours and caused large amount of water flowing into Huai Phueng reservoir. Level of impounding water increased rapidly, and the extra water flowed over a service spillway, morning-glory type constructed by concrete material for about 50 years ago. Subsequently, a sinkhole was formed on the dam crest and five points of water piping were found on downstream slope closely to spillway. Three techniques of geophysical investigation were carried out to inspect cause of failures; Electrical Resistivity Imaging (ERI), Multichannel Analysis of Surface Wave (MASW), and Ground Penetrating Radar (GPR), respectively. Result of ERI clearly shows evidence of overtop event and heterogeneity around spillway that implied possibility of previous shape of sinkhole around the pipe. The shear wave velocity of subsurface soil measured by MASW can numerically convert to undrained shear strength of impervious clay core. Result of GPR clearly reveals partial settlements of freeboard zone at top part of the dam and also shaping new refilled material to plug the sinkhole back to the condition it should be. In addition, the GPR image is a main answer to confirm that there are not any sinkholes in the survey lines, only that found on top of the spillway. Integrity interpretation of the three results together with several evidences observed during a field walk-through and data from drilled holes can be interpreted that there are four main causes in this account. The first cause is too much water flowing over the spillway. Second, the water attacking morning glory spillway creates cracks upon concrete contact where the spillway is cross-cut to the center of the dam. Third, high velocity of water inside the concrete pipe sucking fine particle of embankment material down via those cracks and flushing out to the river channel. Lastly, loss of clay material of the dam into the concrete pipe creates the sinkhole at the crest. However, in case of failure by piping, it is possible that they can be formed both by backward erosion (internal erosion along or into embedded structure of spillway walls) and also by excess saturated water of downstream material.

Keywords: dam inspection, GPR, MASW, resistivity

Procedia PDF Downloads 241

Authors: N. D'Amico, E. Grossi, B. Colombo, F. Rigiroli, M. Buscema, D. Fazzini, G. Cornalba, S. Papa

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Purpose: To characterize, through a radiomic approach, the nature of nodules considered non-specific by expert radiologists, recognized in magnetic resonance mammography (MRm) with T1-weighted (T1w) sequences with paramagnetic contrast. Material and Methods: 47 cases out of 1200 undergoing MRm, in which the MRm assessment gave uncertain classification (non-specific nodules), were admitted to the study. The clinical outcome of the non-specific nodules was later found through follow-up or further exams (biopsy), finding 35 benign and 12 malignant. All MR Images were acquired at 1.5T, a first basal T1w sequence and then four T1w acquisitions after the paramagnetic contrast injection. After a manual segmentation of the lesions, done by a radiologist, and the extraction of 150 radiomic features (30 features per 5 subsequent times) a machine learning (ML) approach was used. An evolutionary algorithm (TWIST system based on KNN algorithm) was used to subdivide the dataset into training and validation test and to select features yielding the maximal amount of information. After this pre-processing, different machine learning systems were applied to develop a predictive model based on a training-testing crossover procedure. 10 cases with a benign nodule (follow-up older than 5 years) and 18 with an evident malignant tumor (clear malignant histological exam) were added to the dataset in order to allow the ML system to better learn from data. Results: NaiveBayes algorithm working on 79 features selected by a TWIST system, resulted to be the best performing ML system with a sensitivity of 96% and a specificity of 78% and a global accuracy of 87% (average values of two training-testing procedures ab-ba). The results showed that in the subset of 47 non-specific nodules, the algorithm predicted the outcome of 45 nodules which an expert radiologist could not identify. Conclusion: In this pilot study we identified a radiomic approach allowing ML systems to perform well in the diagnosis of a non-specific nodule at MR mammography. This algorithm could be a great support for the early diagnosis of malignant breast tumor, in the event the radiologist is not able to identify the kind of lesion and reduces the necessity for long follow-up. Clinical Relevance: This machine learning algorithm could be essential to support the radiologist in early diagnosis of non-specific nodules, in order to avoid strenuous follow-up and painful biopsy for the patient.

Keywords: breast, machine learning, MRI, radiomics

Procedia PDF Downloads 266

Authors: Nicole Harley, Mahmoud Eid, Abdurahman Tarmal, Vishal Dey

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Histological sampling plays an integral role in the diagnostic process of renal diseases. Percutaneous native renal biopsy is typically performed under ultrasound guidance, with this service usually being provided by nephrologists. In some centers, there is a role for radiologists in performing renal biopsies. Previous comparative studies have demonstrated non-inferiority between outcomes of percutaneous native renal biopsies performed by nephrologists compared with radiologists. We sought to compare biopsy adequacy between nephrologists and radiologists in University Hospital Crosshouse. The online system SERPR (Scottish Electronic Renal Patient Record) contains information pertaining to patients who have undergone renal biopsies. An online search was performed to acquire a list of all patients who underwent renal biopsy between 2013 and 2020 in University Hospital Crosshouse. 355 native renal biopsies were performed in total across this 7-year period. A retrospective analysis was performed on these cases, with records and reports being assessed for: the total number of glomeruli obtained per biopsy, whether the number of glomeruli obtained was adequate for diagnosis, as per an internationally agreed standard, and whether a histological diagnosis was achieved. Nephrologists performed 43.9% of native renal biopsies (n=156) and radiologists performed 56.1% (n=199). The mean number of glomeruli obtained by nephrologists was 17.16+/-10.31. The mean number of glomeruli obtained by radiologists was 18.38+/-10.55. T-test demonstrated no statistically significant difference between specialties comparatively (p-value 0.277). Native renal biopsies are required to obtain at least 8 glomeruli to be diagnostic as per internationally agreed criteria. Nephrologists met these criteria in 88.5% of native renal biopsies (n=138) and radiologists met this criteria in 89.5% (n=178). T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.663 and 0.922, respectively). Biopsies performed by nephrologists yielded tissue that was diagnostic in 91.0% (n=142) of sampling. Biopsies performed by radiologists yielded tissue that was diagnostic in 92.4% (n=184) of sampling. T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.625 and 0.889, respectively). This project demonstrates that at University Hospital Crosshouse, there is no statistical difference between radiologists and nephrologists in terms of glomeruli acquisition or samples achieving a histological diagnosis. Given the non-inferiority between specialties demonstrated by previous studies and this project, this evidence could support the restructuring of services to allow more renal biopsies to be performed by renal services and allow reallocation of radiology department resources.

Keywords: biopsy, medical imaging, nephrology, radiology

Procedia PDF Downloads 80

Authors: Racheli Magnezi, Inbal Gazit, Michal Rassin, Joseph Barr, Orna Tal

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An effective process for transmitting patient critical information is essential for patient safety and for improving communication among healthcare staff. Previous studies have discussed handover tools such as SBAR (Situation, Background, Assessment, Recommendation) or SOFI (Short Observational Framework for Inspection). Yet, these formats lack flexibility, and require special training. In addition, nurses and physicians have different procedures for handing over information. The objectives of this study were to establish a universal, structured tool for handover, for both physicians and nurses, based on parameters that were defined as ‘important’ and ‘appropriate’ by the medical team, and to implement this tool in various hospital departments, with flexibility for each ward. A questionnaire, based on established procedures and on the literature, was developed to assess attitudes towards the most important information for effective handover between shifts (Cronbach's alpha 0.78). It was distributed to 150 senior physicians and nurses in 62 departments. Among senior medical staff, 12 physicians and 66 nurses responded to the questionnaire (52% response rate). Based on the responses, a handover form suitable for all hospital departments was designed and implemented. Important information for all staff included: Patient demographics (full name and age); Health information (diagnosis or patient complaint, changes in hemodynamic status, new medical treatment or equipment required); and Social Information (suspicion of violence, mental or behavioral changes, and guardianship). Additional information relevant to each unit included treatment provided, laboratory or imaging required, and change in scheduled surgery in surgical departments. ICU required information on background illnesses, Pediatrics required information on diet and food provided and Obstetrics required the number of days after cesarean section. Based on the model described, a flexible tool was developed that enables handover of both common and unique information. In addition, it includes general logistic information that must be transmitted to the next shift, such as planned disruptions in service or operations, staff training, etc. Development of a simple, clear, comprehensive, universal, yet flexible tool designed for all medical staff for transmitting critical information between shifts was challenging. Physicians and nurses found it useful and it was widely implemented. Ongoing research is needed to examine the efficiency of this tool, and whether the enthusiasm that accompanied its initial use is maintained.

Keywords: handover, nurses, hospital, critical information

Procedia PDF Downloads 247

Authors: A. Chatel, I. S. Torreguitart, T. Verstraete

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The paper deals with a single point optimization of the LS89 turbine using an adjoint optimization and defining the design variables within a CAD system. The advantage of including the CAD model in the design system is that higher level constraints can be imposed on the shape, allowing the optimized model or component to be manufactured. However, CAD-based approaches restrict the design space compared to node-based approaches where every node is free to move. In order to preserve a rich design space, we develop a methodology to refine the CAD model during the optimization and to create the best parameterization to use at each time. This study presents a methodology to progressively refine the design space, which combines parametric effectiveness with a differential evolutionary algorithm in order to create an optimal parameterization. In this manuscript, we show that by doing the parameterization at the CAD level, we can impose higher level constraints on the shape, such as the axial chord length, the trailing edge radius and G2 geometric continuity between the suction side and pressure side at the leading edge. Additionally, the adjoint sensitivities are filtered out and only smooth shapes are produced during the optimization process. The use of algorithmic differentiation for the CAD kernel and grid generator allows computing the grid sensitivities to machine accuracy and avoid the limited arithmetic precision and the truncation error of finite differences. Then, the parametric effectiveness is computed to rate the ability of a set of CAD design parameters to produce the design shape change dictated by the adjoint sensitivities. During the optimization process, the design space is progressively enlarged using the knot insertion algorithm which allows introducing new control points whilst preserving the initial shape. The position of the inserted knots is generally assumed. However, this assumption can hinder the creation of better parameterizations that would allow producing more localized shape changes where the adjoint sensitivities dictate. To address this, we propose using a differential evolutionary algorithm to maximize the parametric effectiveness by optimizing the location of the inserted knots. This allows the optimizer to gradually explore larger design spaces and to use an optimal CAD-based parameterization during the course of the optimization. The method is tested on the LS89 turbine cascade and large aerodynamic improvements in the entropy generation are achieved whilst keeping the exit flow angle fixed. The trailing edge and axial chord length, which are kept fixed as manufacturing constraints. The optimization results show that the multilevel optimizations were more efficient than the single level optimization, even though they used the same number of design variables at the end of the multilevel optimizations. Furthermore, the multilevel optimization where the parameterization is created using the optimal knot positions results in a more efficient strategy to reach a better optimum than the multilevel optimization where the position of the knots is arbitrarily assumed.

Keywords: adjoint, CAD, knots, multilevel, optimization, parametric effectiveness

Procedia PDF Downloads 109

Authors: Selvaprakash Ramalingam, Rabi N. Sahoo, Dharmendra Saraswat, A. Kumar, Rajeev Ranjan, Joydeep Mukerjee, Viswanathan Chinnasamy, K. K. Chaturvedi, Sanjeev Kumar

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Rice is one of the most important staple food crops in the world. Among the various diseases that affect rice crops, rice blast is particularly significant, causing crop yield and economic losses. While the plant has defense mechanisms in place, such as chemical indicators (proteins, salicylic acid, jasmonic acid, ethylene, and azelaic acid) and resistance genes in certain varieties that can protect against diseases, susceptible varieties remain vulnerable to these fungal diseases. Early prediction of rice blast (RB) disease is crucial, but conventional techniques for early prediction are time-consuming and labor-intensive. Hyperspectral remote sensing techniques hold the potential to predict RB disease at its asymptomatic stage. In this study, we aimed to demonstrate the prediction of RB disease at the asymptomatic stage using non-imaging hyperspectral ASD spectroradiometer under controlled laboratory conditions. We applied statistical spectral discrimination theory to identify unknown spectra of M. Oryzae, the fungus responsible for rice blast disease. The infrared (IR) region was found to be significantly affected by RB disease. These changes may result in alterations in the absorption, reflection, or emission of infrared radiation by the affected plant tissues. Our research revealed that the protein spectrum in the IR region is impacted by RB disease. In our study, we identified strong correlations in the region (Amide group - I) around X 1064 nm and Y 1300 nm with the Lambda / Lambda derived spectra methods for protein detection. During the stages when the disease is developing, typically from day 3 to day 5, the plant's defense mechanisms are not as effective. This is especially true for the PB-1 variety of rice, which is highly susceptible to rice blast disease. Consequently, the proteins in the plant are adversely affected during this critical time. The spectral contour plot reveals the highly correlated spectral regions 1064 nm and Y 1300 nm associated with RB disease infection. Based on these spectral sensitivities, we developed new spectral disease indices for predicting different stages of disease emergence. The goal of this research is to lay the foundation for future UAV and satellite-based studies aimed at long-term monitoring of RB disease.

Keywords: rice blast, asymptomatic stage, spectral sensitivity, IR

Procedia PDF Downloads 85

Authors: Francesca Marsili

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The reliability assessment of existing structures with probabilistic methods is becoming an increasingly important and frequent engineering task. However probabilistic reliability methods are based on an exhaustive knowledge of the stochastic modeling of the variables involved in the assessment; at the moment standards for the modeling of variables are absent, representing an obstacle to the dissemination of probabilistic methods. The framework according to probability distribution functions (PDFs) are established is represented by the Bayesian statistics, which uses Bayes Theorem: a prior PDF for the considered parameter is established based on information derived from the design stage and qualitative judgments based on the engineer past experience; then, the prior model is updated with the results of investigation carried out on the considered structure, such as material testing, determination of action and structural properties. The application of Bayesian statistics arises two different kind of problems: 1. The results of the updating depend on the engineer previous experience; 2. The updating of the prior PDF can be performed only if the structure has been tested, and quantitative data that can be statistically manipulated have been collected; performing tests is always an expensive and time consuming operation; furthermore, if the considered structure is an ancient building, destructive tests could compromise its cultural value and therefore should be avoided. In order to solve those problems, an interesting research path is represented by investigating Artificial Intelligence (AI) techniques that can be useful for the automation of the modeling of variables and for the updating of material parameters without performing destructive tests. Among the others, one that raises particular attention in relation to the object of this study is constituted by Case-Based Reasoning (CBR). In this application, cases will be represented by existing buildings where material tests have already been carried out and an updated PDFs for the material mechanical parameters has been computed through a Bayesian analysis. Then each case will be composed by a qualitative description of the material under assessment and the posterior PDFs that describe its material properties. The problem that will be solved is the definition of PDFs for material parameters involved in the reliability assessment of the considered structure. A CBR system represent a good candi¬date in automating the modelling of variables because: 1. Engineers already draw an estimation of the material properties based on the experience collected during the assessment of similar structures, or based on similar cases collected in literature or in data-bases; 2. Material tests carried out on structure can be easily collected from laboratory database or from literature; 3. The system will provide the user of a reliable probabilistic description of the variables involved in the assessment that will also serve as a tool in support of the engineer’s qualitative judgments. Automated modeling of variables can help in spreading probabilistic reliability assessment of existing buildings in the common engineering practice, and target at the best intervention and further tests on the structure; CBR represents a technique which may help to achieve this.

Keywords: reliability assessment of existing buildings, Bayesian analysis, case-based reasoning, historical structures

Procedia PDF Downloads 336

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

Procedia PDF Downloads 121

Authors: Inês N. Peça , A. Bicho, Rui Gardner, M. Margarida Cardoso

Abstract:

Inorganic/organic nanocomplexes offer tremendous scope for future biomedical applications, including imaging, disease diagnosis and drug delivery. The combination of Fe3O4 with biocompatible polymers to produce smart drug delivery systems for use in pharmaceutical formulation present a powerful tool to target anti-cancer drugs to specific tumor sites through the application of an external magnetic field. In the present study, we focused on the evaluation of the effect of the magnetic field application time on the rate of drug release from iron oxide polymeric nanoparticles. Doxorubicin, an anticancer drug, was selected as the model drug loaded into the nanoparticles. Nanoparticles composed of poly(d-lactide-co-glycolide (PLGA), a biocompatible polymer already approved by FDA, containing iron oxide nanoparticles (MNP) for magnetic targeting and doxorubicin (DOX) were synthesized by the o/w solvent extraction/evaporation method and characterized by scanning electron microscopy (SEM), by dynamic light scattering (DLS), by inductively coupled plasma-atomic emission spectrometry and by Fourier transformed infrared spectroscopy. The produced particles yielded smooth surfaces and spherical shapes exhibiting a size between 400 and 600 nm. The effect of the magnetic doxorubicin loaded PLGA nanoparticles produced on cell viability was investigated in mammalian CHO cell cultures. The results showed that unloaded magnetic PLGA nanoparticles were nontoxic while the magnetic particles without polymeric coating show a high level of toxicity. Concerning the therapeutic activity doxorubicin loaded magnetic particles cause a remarkable enhancement of the cell inhibition rates compared to their non-magnetic counterpart. In vitro drug release studies performed under a non-permanent magnetic field show that the application time and the on/off cycle duration have a great influence with respect to the final amount and to the rate of drug release. In order to determine the mechanism of drug release, the data obtained from the release curves were fitted to the semi-empirical equation of the the Korsmeyer-Peppas model that may be used to describe the Fickian and non-Fickian release behaviour. Doxorubicin release mechanism has shown to be governed mainly by Fickian diffusion. The results obtained show that the rate of drug release from the produced magnetic nanoparticles can be modulated through the magnetic field time application.

Keywords: drug delivery, magnetic nanoparticles, PLGA nanoparticles, controlled release rate

Procedia PDF Downloads 258

Authors: Ahmed Gonnah, Omar Masoud, Mohamed Abdel-Wahab, Ahmed ElMosalamy, Abdulrahman Al-Naseem

Abstract:

Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with the highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30-75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging and mammography, as well as core needle biopsies. Current management includes observation for 6-12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple-areolar distortion, scarring and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases EMBASE. MEDLINE/PubMed, Google scholar and Ovid, for English language papers published between 1st of January 2000 and 17th of March 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were ‘HIFU’, ‘High-Intensity Focused Ultrasound’, ‘Fibroadenoma’, ‘Breast’, ‘Lesion’. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, High Intensity Focused Ultrasound (HIFU), was found to be a safe, non-invasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated with a low risk of complications that can potentially include erythema, skin discoloration and bruising, with the majority of this self-resolving shortly after the procedure.

Keywords: ultrasound, HIFU, breast, efficacy, side effects, fibroadenoma

Procedia PDF Downloads 222