Search results for: differential diagnosis

Authors: Ayda Youssef, Mohammed Ali Khalaf, Tarek Rafaat

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Background: Langerhans cell histiocytosis (LCH) is a rare multi-systemic disease that shows an abnormal proliferation of these kinds of cells associated with a granular infiltration that affects different structures of the human body, including the lung, liver, spleen, lymph nodes, brain, mucocutaneous, soft tissue (head and neck), and salivary glands. Evaluation of the extent of disease is one of the major predictors of patient outcome. Objectives: To recognize the pathogenesis of Langerhans cell histiocytosis (LCH), describe the radiologic criteria that are suggestive of LCH in different organs rather than the bones and to illustrate the appropriate differential diagnoses for LCH in each of the common extra-osseous sites. Material and methods: A retrospective study was done on 150 biopsy-proven LCH patients from 2007 to 2012. All patients underwent imaging studies, mostly US, CT, and MRI. These patients were reviewed to assess the extra-skeletal manifestations of LCH. Results: In 150 patients with biopsy-proven LCH, There were 33 patients with liver affection, 5 patients with splenic lesions, 55 patients with enlarged lymph nodes, 9 patient with CNS disease and 11 patients with lung involvement. Conclusions: Because of the frequent LCH children and evaluation of the extent of disease is one of the major predictors of patient outcome. Radiologist need to be familiar with its presentation in different organs and regions of body outside the commonest site of affection (bones). A high-index suspicion should be raised a biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality.

Keywords: langerhans cell histiocytosis, extra-skeletal, pediatrics, radiology

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Authors: Jalila Jbilou, Salaheddine El Adlouni, Pierre Gosselin

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Background: West Nile virus is increasingly an important public health issue in North America. In Canada, WVN was officially reported in Toronto and Montréal for the first time in 2001. During the last decade, several WNV events have been reported in several Canadian provinces. The main objective of the present study is to update the frequency of the climate conditions favorable to WNV outbreaks in Canada. Method: Statistical frequency analysis has been used to estimate the return period for climate conditions associated with WNV outbreaks for the 1961–2050 period. The best fit is selected through the Akaike Information Criterion, and the parameters are estimated using the maximum likelihood approach. Results: Results show that the climate conditions related to the 2002 event, for Montreal and Toronto, are becoming more frequent. For Saskatoon, the highest DD20 events recorded for the last few decades were observed in 2003 and 2007. The estimated return periods are 30 years and 70 years, respectively. Conclusion: The emergence of WNV was related to extremely high DD values in the summer. However, some exceptions may be related to several factors such as virus persistence, vector migration, and also improved diagnosis and reporting levels. It is clear that such climate conditions have become much more common in the last decade and will likely continue to do so over future decades.

Keywords: West Nile virus, climate, North America, statistical frequency analysis, risk estimation, public health, modeling, scenario, temperature, precipitation

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Authors: Eva Tolmeijer, Emmanuelle Peters, Veena Kumari, Liam Mason

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Cognitive behavioral therapy for psychosis (CBTp) is effective in many but not all patients, making it important to better understand the factors that determine treatment outcomes. To date, no studies have examined whether neuroimaging can make clinically useful predictions about who will respond to CBTp. To this end, we used machine learning methods that make predictions about symptom improvement at the individual patient level. Prior to receiving CBTp, 22 patients with a diagnosis of schizophrenia completed a social-affective processing task during functional MRI. Multivariate pattern analysis assessed whether treatment response could be predicted by brain activation responses to facial affect that was either socially threatening or prosocial. The resulting models did significantly predict symptom improvement, with distinct multivariate signatures predicting psychotic (r=0.54, p=0.01) and affective (r=0.32, p=0.05) symptoms. Psychotic symptom improvement was accurately predicted from relatively focal threat-related activation across hippocampal, occipital, and temporal regions; affective symptom improvement was predicted by a more dispersed profile of responses to prosocial affect. These findings enrich our understanding of the neurobiological underpinning of treatment response. This study provides a foundation that will hopefully lead to greater precision and tailoring of the interventions offered to patients.

Keywords: cognitive behavioral therapy, machine learning, psychosis, schizophrenia

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Authors: Askar Kilmametov, Julia Ivanisenko, Boris Straumal, Horst Hahn

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The high-pressure α- to ω-phase transition was discovered in elemental Ti and Zr fifty years ago using static high pressure and then observed to appear between 2 and 12 GPa at room temperature, depending on the experimental technique, the pressure environment, and the sample purity. The fact that ω-phase is retained in a metastable state in ambient condition after the removal of the pressure has been used to check the changes in magnetic and superconductive behavior, electron band structure and mechanical properties. However, the fundamental knowledge on a combination of both mechanical treatment and high applied pressure treatments for ω-phase formation in Ti alloys is currently lacking and has to be studied in relation to improved mechanical properties of bulk nanostructured states. In the present study, nanostructured (α+β) Ti alloys containing β-stabilizing elements such as Co, Fe, Cr, Nb were performed by severe plastic deformation, namely high pressure torsion (HPT) technique. HPT-induced α- to ω-phase transformation was revealed in dependence on applied pressure and shear strains by means of X-ray diffraction, transmission electron microscopy, and differential scanning calorimetry. The transformation kinetics was compared with the kinetics of pressure-induced transition. Orientation relationship between α-, β- and ω-phases was taken into consideration and analyzed according to theoretical calculation proposed earlier. The influence of initial state before HPT appeared to be considerable for subsequent α- to ω-phase transition. Thermal stability of the HPT-induced ω-phase was discussed as well in the frame of mechanical behavior of Ti and Ti-based alloys produced by shear deformation under high applied pressure.

Keywords: bulk nanostructured materials, high pressure phase transitions, severe plastic deformation, titanium alloys

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Authors: Sule Yucelbas, Gulay Tezel, Cuneyt Yucelbas, Seral Ozsen

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In this study, it was tried to identify some heart rhythm disorders by electrocardiography (ECG) data that is taken from MIT-BIH arrhythmia database by subtracting the required features, presenting to artificial neural networks (ANN), artificial immune systems (AIS), artificial neural network based on artificial immune system (AIS-ANN) and particle swarm optimization based artificial neural network (PSO-NN) classifier systems. The main purpose of this study is to evaluate the performance of hybrid AIS-ANN and PSO-ANN classifiers with regard to the ANN and AIS. For this purpose, the normal sinus rhythm (NSR), atrial premature contraction (APC), sinus arrhythmia (SA), ventricular trigeminy (VTI), ventricular tachycardia (VTK) and atrial fibrillation (AF) data for each of the RR intervals were found. Then these data in the form of pairs (NSR-APC, NSR-SA, NSR-VTI, NSR-VTK and NSR-AF) is created by combining discrete wavelet transform which is applied to each of these two groups of data and two different data sets with 9 and 27 features were obtained from each of them after data reduction. Afterwards, the data randomly was firstly mixed within themselves, and then 4-fold cross validation method was applied to create the training and testing data. The training and testing accuracy rates and training time are compared with each other. As a result, performances of the hybrid classification systems, AIS-ANN and PSO-ANN were seen to be close to the performance of the ANN system. Also, the results of the hybrid systems were much better than AIS, too. However, ANN had much shorter period of training time than other systems. In terms of training times, ANN was followed by PSO-ANN, AIS-ANN and AIS systems respectively. Also, the features that extracted from the data affected the classification results significantly.

Keywords: AIS, ANN, ECG, hybrid classifiers, PSO

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Authors: Mateen A. Khan, Elizabeth J. Theil, Dixie J. Goss

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Cellular iron homeostasis is accomplished by the coordinated regulated expression of iron uptake, storage, and export. Iron regulate the translation of ferritin and mitochondrial aconitase iron responsive element (IRE)-mRNA by interaction with an iron regulatory protein (IRPs). Iron increases protein biosynthesis encoded in iron responsive element. The noncoding structure IRE-mRNA, approximately 30-nt, folds into a stem loop to control synthesis of proteins in iron trafficking, cell cycling, and nervous system function. Fluorescence anisotropy measurements showed the presence of one binding site on IRP1 for ferritin and mitochondrial aconitase IRE-mRNA. Scatchard analysis revealed the binding affinity (Kₐ) and average binding sites (n) for ferritin and mitochondrial aconitase IRE-mRNA were 68.7 x 10⁶ M⁻¹ and 9.2 x 10⁶ M⁻¹, respectively. In order to understand the relative importance of equilibrium and stability, we further report the contribution of electrostatic interactions in the overall binding of two IRE-mRNA with IRP1. The fluorescence quenching of IRP1 protein was measured at different ionic strengths. The binding affinity of IRE-mRNA to IRP1 decreases with increasing ionic strength, but the number of binding sites was independent of ionic strength. Such results indicate a differential contribution of electrostatics to the interaction of IRE-mRNA with IRP1, possibly related to helix bending or stem interactions and an overall conformational change. Selective destabilization of ferritin and mitochondrial aconitase RNA/protein complexes as reported here explain in part the quantitative differences in signal response to iron in vivo and indicate possible new regulatory interactions.

Keywords: IRE-mRNA, IRP1, binding, ionic strength

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Authors: Mohamed Khaled Ahmed Azzam

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Complete dentures, a non biological appliance, were and are still used to replace missing teeth and surrounding structures. Its main objectives are esthetics, speech, function and psychological state improvement. Dentists must realize that, just as dentate patients vary in their dental treatment complexity; edentulous patients also vary in the difficulty of their treatment plan. There are two main problems facing the removable Prosthodontist which harden his/her task how to please his patient with their new dentures being: Denture construction which however its fabrication is at the highest standards still is an unpleasant experience to all patients in the beginning and improves by time. This varies from one to several years according to the patient’s attitude, age, gender, socio-economical level and culture. The second problem of edentulous patients is both physical and psychological. Good interview, communication and note how patients present themselves for the concerns of their appearance, overall attitude and expectations concerning treatment is very important physically. On the psychological aspect patients have great difficulty to cope with new dentures to the extent of not using them at all. Hence their mind preparation should be commenced from day one by more than one method. This had a great impact on the acceptance which led to habituation to their dentures and patients were appreciative and pleased. In conclusion to successfully treat edentulous patients a great deal of information is required to complete a proper diagnosis, including patient mental attitude, past and present medical and dental conditions, and extra and intra-oral examinations. In addition to the clinical experience and skill of the whole dental team.

Keywords: complete dentures, edentulous patients, management of denture, psychological mind preparation

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Authors: Milena Trevisan Pelegrino, Bruna De Araujo Lima, Mônica H. M. Do Nascimento, Christiane B. Lombello, Marcelo Brocchi, Amedea B. Seabra

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Nitric oxide (NO) is a small molecule involved in a wide range of physiological and pathophysiological processes, including vasodilatation, control of inflammatory pain, wound healing, and antibacterial activities. As NO is a free radical, the design of drugs that generates therapeutic amounts of NO in controlled spatial and time manners is still a challenge. In this study, the NO donor S-nitrosoglutathione (GSNO) was incorporated into the thermoresponsive Pluronic F-127 (PL) - chitosan (CS) hydrogel, in an easy and economically feasible methodology. CS is a polysaccharide with known antimicrobial and biocompatibility properties. Scanning electron microscopy, rheology and differential scanning calorimetry techniques were used for hydrogel characterization. The results demonstrated that the hydrogel has a smooth surface, thermoresponsive behavior, and good mechanical stability. The kinetics of NO release and GSNO diffusion from GSNO-containing PL/CS hydrogel demonstrated a sustained NO/GSNO release, in concentrations suitable for biomedical applications, at physiological and skin temperatures. The GSNO-PL/CS hydrogel demonstrated a concentration-dependent toxicity to Vero cells, and antimicrobial activity to Pseudomonas aeruginosa (minimum inhibitory concentration and minimum bactericidal concentration values of 0.5 µg·mL-1 of hydrogel, which correspondents to 1 mmol·L-1 of GSNO). Interesting, the concentration range in which the NO-releasing hydrogel demonstrated antibacterial effect was not found toxic to Vero mammalian cell. Thus, GSNO-PL/CS hydrogel is suitable biomaterial for topical NO delivery applications.

Keywords: antimicrobial, chitosan, biocompatibility, S-nitrosothiols

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Authors: Nirmal Kumar Verma, Pallavi Jha

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Generation of the electromagnetic radiation oscillating at the frequencies in the terahertz range by propagation of two-color laser pulses in plasma is an active area of research due to its potential applications in various areas, including security screening, material characterization, and spectroscopic techniques. Due to nonionizing nature and the ability to penetrate several millimeters, THz radiation is suitable for diagnosis of cancerous cells. Traditional THz emitters like optically active crystals, when irradiated with high power laser radiation, are subject to material breakdown and hence low conversion efficiencies. This problem is not encountered in laser-plasma based THz radiation sources. The present paper is devoted to the study of the enhanced electromagnetic radiation generation by propagation of two-color, linearly polarized laser pulses through the magnetized plasma. The two lasers pulse orthogonally polarized are co-propagating along the same direction. The direction of the external magnetic field is such that one of the two laser pulses propagates in the ordinary mode, while the other pulse propagates in the extraordinary mode through the homogeneous plasma. A transverse electromagnetic wave with frequency in the THz range is generated due to the presence of the static magnetic field. It is observed that larger amplitude terahertz can be generated by mixing of ordinary and extraordinary modes of two-color laser pulses as compared with a single laser pulse propagating in the extraordinary mode.

Keywords: two-color laser pulses, electromagnetic radiation, magnetized plasma, ordinary and extraordinary modes

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

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Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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Authors: Waleed Jarjoura

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In various cases of visual impairments, the individuals are referred to expert Ophthalmologists in order to establish a correct diagnosis. Children with visual-impairments confront various challenging experiences in life since early childhood throughout lifespan. In some cases, blind infants, especially due to congenital hydrocephalus, suffer from high intra-cranial pressure and, consequently, go through a ventriculo-peritoneal shunt surgery in order to limit the neurological symptoms or decrease the cognitive impairments. In this article, a detailed description of numerous crucial implications of the V/P shunt surgery, through the right posterior-inferior parieto-temporal cortex, on the observed preliminary capabilities that are pre-requisites for the acquisition of literacy skills in braille, basic Math competencies, braille printing which suggest Gerstmann syndrome in the blind. In addition, significant difficultiesorientation and mobility skills using the Cane, in general, organizational skills, and social interactions were observed. The primary conclusion of this report focuses on raising awareness among neuro-surgeons towards the need for alternative intracranial routes for V/P shunt implantation in blind infants that preserve the right posterior-inferior parieto-temporal cortex that is hypothesized to modulate the tactual-spatial cues in braille discrimination. A second conclusion targets educators and therapists that address the acquired dysfunctionsin blind individuals due to V/P shunt surgeries.

Keywords: congenital blindness, hydrocephalus, shunt surgery, spatial orientation

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Authors: Rana Praween Kumar

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Preterm-low birth weight delivery is a major cause of infant morbidity and mortality in developing countries and has been linked to poor periodontal health during pregnancy. Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory oral diseases. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. This study is intended to investigate predisposing and enabling factors as determinants of oral health indicators in pregnancy as well as the association between periodontal problems during pregnancy with age and socio economic status of the individual. A community –based prospective cohort study will be conducted in Jamshedpur, Jharkhand, India among pregnant women using completed interviews and a full mouth oral clinical examination using the CPITN (Community Periodontal Index of Treatment Need) and OHI-S (Simplified Oral Hygiene) indices with adequate sample size and informed consent to the patient following proper inclusion and exclusion criteria. Multiple logistic regression analyses will be used to identify independent determinants of periodontal problems and use of dental services during pregnancy. Analysis of covariance (ANCOVA) will be used to investigate the relationship between periodontal problems with the age and socioeconomic status. The result will help in proper monitoring of periodontal health during pregnancy encouraging the delivery of healthy child and the maintenance of proper health of the mother.

Keywords: infant, periodontal problems, pregnancy, pre-term-low birth weight delivery

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Authors: Laura Dembovska, Diana Bajare, Ina Pundiene, Daira Erdmane

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The aim of this research is to estimate effect of pozzolanic substitutes and their combination on the hydration heat and final strength of high performance concrete. Ternary cementitious systems with different ratios of ordinary Portland cement, silica fume and calcined clay were investigated. Local illite clay was calcined at temperature 700oC in rotary furnace for 20 min. It has been well recognized that the use of pozzolanic materials such as silica fume or calcined clay are recommended for high performance concrete for reduction of porosity, increasing density and as a consequence raising the chemical durability of the concrete. It has been found, that silica fume has a superior influence on the strength development of concrete, but calcined clay increase density and decrease size of dominating pores. Additionally it was found that the rates of pozzolanic reaction and calcium hydroxide consumption in the silica fume-blended cement pastes are higher than in the illite clay-blended cement pastes, it strongly depends from the amount of pozzolanic substitutes which are used. If the pozzolanic reaction is dominating then amount of Ca(OH)2 is decreasing. The identity and the amount of the phases present were determined from the thermal analysis (DTA) data. The hydration temperature of blended cement pastes was measured during the first 24 hours. Fresh and hardened concrete properties were tested. Compressive strength was determined and differential thermal analysis (DTA) was conducted of specimens at the age of 3, 14, 28 and 56 days.

Keywords: high performance concrete, pozzolanic additives, silica fume, ternary systems

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Authors: Annisa Siu, Ping Zou

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Background: Existent literature addressing Asian American children and adolescents reveals that this population is experiencing rates of depression comparable to those of European American and other ethnic minority youths. Within the last decade, increased attention has been given to Asian American adolescent mental health. Methods: 44 articles were extracted from Pubmed, PsycINFO, EMBASE, and Proquest CINAHL. Data were subject to thematic analyses and categorized into factors under individual, familial, and community levels. Results: Of all the individual factors, age and gender were the most supported in their relationship with depressive symptoms. Likewise, living situations, parent-child relations, peer relations, and broader environmental factors were strongly evidenced. The remaining psychosocial factors faced contrary evidence or were insubstantially addressed in the empirical literature. Discussion: The identified psychosocial factors within this study offer a starting point for future research to examine what factors should be included in formal or informal methods of screening/consultations. Clinicians should aim to understand the cultural influences specific to Asian American adolescents, particularly the central role that family relations may have on their depressive symptoms. Conclusion: Low awareness of culturally linked expressions of psychological distress can lead to misdiagnosis or under-diagnosis of depression in Asian American youth. Further evidence is needed to clarify the relationship of psychosocial factors linked to Asian American adolescent depressive symptoms.

Keywords: adolescent, Asian American, depression, psychosocial factors

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Authors: Omar Farshad Jeelani, Makaire Njie, Viktoriia M. Korzhuk

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Recently, the application of AI-powered algorithms in healthcare continues to flourish. Particularly, access to healthcare information, including patient health history, diagnostic data, and PII (Personally Identifiable Information) is paramount in the delivery of efficient patient outcomes. However, as the exchange of healthcare information between patients and healthcare providers through AI-powered solutions increases, protecting a person’s information and their privacy has become even more important. Arguably, the increased adoption of healthcare AI has resulted in a significant concentration on the security risks and protection measures to the security and privacy of healthcare data, leading to escalated analyses and enforcement. Since these challenges are brought by the use of AI-based healthcare solutions to manage healthcare data, AI-based data protection measures are used to resolve the underlying problems. Consequently, this project proposes AI-powered safeguards and policies/laws to protect the privacy of healthcare data. The project presents the best-in-school techniques used to preserve the data privacy of AI-powered healthcare applications. Popular privacy-protecting methods like Federated learning, cryptographic techniques, differential privacy methods, and hybrid methods are discussed together with potential cyber threats, data security concerns, and prospects. Also, the project discusses some of the relevant data security acts/laws that govern the collection, storage, and processing of healthcare data to guarantee owners’ privacy is preserved. This inquiry discusses various gaps and uncertainties associated with healthcare AI data collection procedures and identifies potential correction/mitigation measures.

Keywords: data privacy, artificial intelligence (AI), healthcare AI, data sharing, healthcare organizations (HCOs)

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Authors: Zegrar Ahmed, Ghabi Mohamed

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The degradation of arid and semi-arid ecosystems in Algeria has become a palpable fact that only hinders progress and rural development. In these exceptionally fragile environments, the decline of vegetation is done according to an alarming increase and wind erosion dominates. The ecosystem is subjected to a long hot dry season and low annual average rainfall. The urgency of the fight against desertification is imposed by the very nature of the process that tends to self-accelerate, resulting when human intervention is not forthcoming the irreversibility situations, preventing any possibility of restoration state of these zones. These phenomena have led to different degradation processes, such as the destruction of vegetation, soil erosion, and deterioration of the physical environment. In this study, the work is mainly based on the criteria for classification and identification of physical parameters for spatial analysis and multi-sources to determine the vulnerability of major steppe formations and their impact on desertification. we used Landsat data with two different dates March 2010 and November 2014 in order to determine the changes in land cover, sand moving and land degradation for the diagnosis of the desertification Phenomenon. The application, through specific processes, including the supervised classification was used to characterize the main steppe formations. An analysis of the vulnerability of plant communities was conducted to assign weights and identify areas most susceptible to desertification. Vegetation indices are used to characterize the steppe formations to determine changes in land use.

Keywords: remote sensing, SIG, ecosystem, degradation, desertification

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Authors: M. Elder, L. Beech, A. Mackie

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Heterotopic pregnancy is an uncommon and potentially life-threatening condition in which there is simultaneous occurrence of intrauterine and ectopic pregnancies. It has an incidence of approximately 1:3900 pregnancies, occurring in only 1:30000 spontaneous pregnancies. This study presents a rare case of spontaneous heterotopic pregnancy in a 34-year-old primiparous woman who was brought in by ambulance to the emergency department following collapse at 20+1 weeks gestation after normal first trimester screening and morphology scan. She was hemodynamically unstable and fetal heart rate was 60bpm. Initial resuscitation included transfusion of 2 units packed red blood cells and 1g intravenous tranexamic acid. Bedside ultrasound revealed evidence of approximately 1000ml clot in the right upper quadrant. She underwent a diagnostic laparoscopy and washout, which proceeded to a midline exploratory laparotomy. This revealed a 2.6L hemoperitoneum and query right ectopic pregnancy with calcified areas and clot, with no other cause of bleeding identified. Right salpingectomy was performed, and pathology later confirmed ectopic pregnancy. The intrauterine pregnancy had no complications, and she delivered a healthy full-term baby. This case demonstrates that ultrasound confirmation of intrauterine pregnancy does not exclude coexisting ectopic pregnancy. Heterotopic pregnancy should be considered in any pregnant woman presenting with abdominal pain or signs of hemorrhagic shock, as prompt diagnosis and treatment is essential to minimize foetal and maternal morbidity and mortality.

Keywords: ectopic pregnancy, hemorrhagic shock, salpingectomy, spontaneous heterotopic pregnancy

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Authors: P. Bharathiraja

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Computer Aided decision making system is used to enhance diagnosis and prognosis of diseases and also to assist clinicians and junior doctors in clinical decision making. Medical Data used for decision making should be definite and consistent. Data Mining and soft computing techniques are used for cleaning the data and for incorporating human reasoning in decision making systems. Fuzzy rule based inference technique can be used for classification in order to incorporate human reasoning in the decision making process. In this work, missing values are imputed using the mean or mode of the attribute. The data are normalized using min-ma normalization to improve the design and efficiency of the fuzzy inference system. The fuzzy inference system is used to handle the uncertainties that exist in the medical data. Equal-width-partitioning is used to partition the attribute values into appropriate fuzzy intervals. Fuzzy rules are generated using Class Based Associative rule mining algorithm. The system is trained and tested using heart disease data set from the University of California at Irvine (UCI) Machine Learning Repository. The data was split using a hold out approach into training and testing data. From the experimental results it can be inferred that classification using fuzzy inference system performs better than trivial IF-THEN rule based classification approaches. Furthermore it is observed that the use of fuzzy logic and fuzzy inference mechanism handles uncertainty and also resembles human decision making. The system can be used in the absence of a clinical expert to assist junior doctors and clinicians in clinical decision making.

Keywords: decision making, data mining, normalization, fuzzy rule, classification

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Authors: Awais Naeem, Osama Shakeel, Faizan Ullah, Abdul Wahid Anwer

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Introduction: To study the clinic-pathological factors, diagnostic factors and survival of extra-pulmonary small cell carcinoma. Methodology: From 1995 to 2017 all patients with a diagnosis of extra-pulmonary small cell carcinoma were included in the study. Demographic variables and clinic-pathological factors were collected. Management of disease was recorded. Short and long term oncological outcomes were recorded. All data was entered and analyzed in SPSS version 21. Results: A total of 14 patients were included in the study. Median age was 53.42 +/- 16.1 years. There were 5 male and 9 female patients. Most common presentation was dysphagia in 16 patient among esophageal small cell carcinoma and while other patient had pain in abdomen. Mean duration of symptoms was 4.23+/-2.91 months .Most common site is esophagus (n=6) followed by gall bladder(n=3). Almost all of the patients received chemo-radiotherapy. Majority of the patient presented with extensive disease. Five patients (35.7%) died during the follow up period, two (14.3%) were alive and rest of the patients were lost to follow up. Mean follow up period was 22.92 months and median follow up was 15 months. Conclusion: Extra-pulmonary small cell carcinoma is rare and needs to be managed aggressively. All patients should be treated with both systemic and local therapies.

Keywords: small cell carcinoma of esophagus, extrapulmonary small cell carcinoma, small cell carcinoma of gall bladder, small cell carcinoma of rectum, small cell carcinoma of stomach

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Authors: Jayanti Gyawali, Deepak Adhikari, Mukesh Mallik, Sanjay Sah

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Radiation is defined as an emission or transmission of energy in form of waves or particles through space or material medium. The major imaging tools used in diagnostic radiology is based on the use of ionizing radiation. A cross-sectional study was carried out during July- August, 2015 among technicians in 15 different hospitals of Bharatpur, Chitwan, Nepal to assess awareness regarding radiation protection and their current practice. The researcher was directly engaged for data collection using self-administered semi-structured questionnaire. The findings of the study are presented in socio-demographic characteristics of respondents, current practice of respondents and knowledge regarding radiation protection. The result of this study demonstrated that despite the importance of radiation and its consequent hazards, the level of knowledge among technicians is only 60.23% and their current practice is 76.84%. The difference in the mean score of knowledge and practice might have resulted due to technicians’s regular work and lack of updates. The study also revealed that there is no significant (p>0.05) difference in knowledge level of technicians practicing in different hospitals. But the mean difference in practice scores of different hospital is significant (p<0.05) i.e. i.e. the cancer hospital with large volumes of regular radiological cases and radiation therapies for cancer treatment has better practice in comparison to other hospitals. The deficiency in knowledge of technicians might alter the expected benefits, compared to the risk involved, and can cause erroneous medical diagnosis and radiation hazard. Therefore, this study emphasizes the need for all technicians to update themselves with the appropriate knowledge and current practice about ionizing and non-ionizing radiation.

Keywords: technicians, knowledge, Nepal, radiation

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Authors: Raoul Ouambo Tobou, Alexis Kuitche, Marcel Edoun

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The FWM (Finite Window Method) is a new numerical meshfree technique for solving problems defined either in terms of PDEs (Partial Differential Equation) or by a set of conservation/equilibrium laws. The principle behind the FWM is that in such problem each element of the concerned domain is interacting with its neighbors and will always try to adapt to keep in equilibrium with respect to those neighbors. This leads to a very simple and robust problem solving scheme, well suited for transfer problems. In this work, we have applied the FWM to an unsteady scalar convection-diffusion equation. Despite its simplicity, it is well known that convection-diffusion problems can be challenging to be solved numerically, especially when convection is highly dominant. This has led researchers to set the scalar convection-diffusion equation as a benchmark one used to analyze and derive the required conditions or artifacts needed to numerically solve problems where convection and diffusion occur simultaneously. We have shown here that the standard FWM can be used to solve convection-diffusion equations in a robust manner as no adjustments (Upwinding or Artificial Diffusion addition) were required to obtain good results even for high Peclet numbers and coarse space and time steps. A comparison was performed between the FWM scheme and both a first order implicit Finite Volume Scheme (Upwind scheme) and a third order implicit Finite Volume Scheme (QUICK Scheme). The results of the comparison was that for equal space and time grid spacing, the FWM yields a much better precision than the used Finite Volume schemes, all having similar computational cost and conditioning number.

Keywords: Finite Window Method, Convection-Diffusion, Numerical Technique, Convergence

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Authors: A. Driouiche, S. Mohareb, A. Hadfi

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In Morocco’s Agadir region, the reuse of treated wastewater for irrigation of green spaces has faced the problem of scaling of the pipes of these waters. This research paper aims at studying the phenomenon of scaling caused by the treated wastewater from the Mzar sewage treatment plant. These waters are used in the irrigation of golf turf for the Ocean Golf Resort. Ocean Golf, located about 10 km from the center of the city of Agadir, is one of the most important recreation centers in Morocco. The course is a Belt Collins design with 27 holes, and is quite open with deep challenging bunkers. The formation of solid deposits in the irrigation systems has led to a decrease in their lifetime and, consequently, a loss of load and performance. Thus, the sprinklers used in golf turf irrigation are plugged in the first weeks of operation. To study this phenomenon, the wastewater used for the irrigation of the golf turf was taken and analyzed at various points, and also samples of scale formed in the circuits of the passage of these waters were characterized. This characterization of the scale was performed by X-ray fluorescence spectrometry, X-ray diffraction (XRD), thermogravimetric analysis (TGA), differential thermal analysis (DTA), and scanning electron microscopy (SEM). The results of the physicochemical analysis of the waters show that they are full of bicarbonates (653 mg/L), chloride (478 mg/L), nitrate (412 mg/L), sodium (425 mg/L) and calcium (199mg/L). Their pH is slightly alkaline. The analysis of the scale reveals that it is rich in calcium and phosphorus. It is formed of calcium carbonate (CaCO₃), silica (SiO₂), calcium silicate (Ca₂SiO₄), hydroxylapatite (Ca₁₀P₆O₂₆), calcium carbonate and phosphate (Ca₁₀(PO₄) 6CO₃) and silicate calcium and magnesium (Ca₅MgSi₃O₁₂).

Keywords: Agadir, irrigation, scaling water, wastewater

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Authors: Ann Vibert, Heather Hemming

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This paper presentation summarizes the findings and implications of research on the plight and practices of women educational leaders in public school systems and in one university. The authors, both women university administrators, are also scholars and researchers of education. The research project on which this paper presentation is based proposed to examine how women educational leaders imagined, experienced, and carried out their leadership roles in the context of a growing local and global accountability-based performativity discourse which is reshaping educational work especially for women, we argue, in both public school and post-secondary sites. The research employed critical ethnographic interviews with 20 women educational leaders in P-12 school systems and three women university level educational leaders. Data were collected on women educational leaders’ perceptions of the effects of accountability and performativity discourses on the nature of their work. Specifically, leaders were asked to speak to whether they experienced a growth in managerial work as a consequence of increased accountability demands; how they experienced their work changing as a consequence of accountability and performativity demands; how these changes impacted the central values they enacted in their work as women educational leaders changes; and how they responded to/negotiated/accommodated changes in the nature of their work developing as a consequence of accountability and performativity frameworks. Findings from the research data and analyses confirm and extend recent scholarly work on the gendered nature of performativity and accountability discourses and frameworks, and their differential effects across differing genders. The oral presentation we propose here focusses on those findings in terms of similarities for women educational leaders across different educational contexts.

Keywords: women in educational leadership, gender and educational performativity, accountability and women leaders, gender and educational leadership

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Authors: Nicolò Vaiana, Giorgio Serino

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In this paper, a one-dimensional (1d) Parallel Elasto- Plastic Model (PEPM), able to simulate the uniaxial dynamic behavior of seismic isolators having a continuously decreasing tangent stiffness with increasing displacement, is presented. The parallel modeling concept is applied to discretize the continuously decreasing tangent stiffness function, thus allowing to simulate the dynamic behavior of seismic isolation bearings by putting linear elastic and nonlinear elastic-perfectly plastic elements in parallel. The mathematical model has been validated by comparing the experimental force-displacement hysteresis loops, obtained testing a helical wire rope isolator and a recycled rubber-fiber reinforced bearing, with those predicted numerically. Good agreement between the simulated and experimental results shows that the proposed model can be an effective numerical tool to predict the forcedisplacement relationship of seismic isolators within relatively large displacements. Compared to the widely used Bouc-Wen model, the proposed one allows to avoid the numerical solution of a first order ordinary nonlinear differential equation for each time step of a nonlinear time history analysis, thus reducing the computation effort, and requires the evaluation of only three model parameters from experimental tests, namely the initial tangent stiffness, the asymptotic tangent stiffness, and a parameter defining the transition from the initial to the asymptotic tangent stiffness.

Keywords: base isolation, earthquake engineering, parallel elasto-plastic model, seismic isolators, softening hysteresis loops

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Authors: Hamed Khani Arani, Mohammad Shariyat, Armaghan Mohammadian

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In the present study, the free vibration of magnetostrictive nano-plate (MsNP) resting on the Pasternak foundation is investigated. Firstly, the modified couple stress (MCS) and nonlocal elasticity theories are compared together and taken into account to consider the small scale effects; in this paper not only two theories are analyzed but also it improves the MCS theory is more accurate than nonlocal elasticity theory in such problems. A feedback control system is utilized to investigate the effects of a magnetic field. First-order shear deformation theory (FSDT), Hamilton’s principle and energy method are utilized in order to drive the equations of motion and these equations are solved by differential quadrature method (DQM) for simply supported boundary conditions. The MsNP undergoes in-plane forces in x and y directions. In this regard, the dimensionless frequency is plotted to study the effects of small scale parameter, magnetic field, aspect ratio, thickness ratio and compression and tension loads. Results indicate that these parameters play a key role on the natural frequency. According to the above results, MsNP can be used in the communications equipment, smart control vibration of nanostructure especially in sensor and actuators such as wireless linear micro motor and smart nano valves in injectors.

Keywords: feedback control system, magnetostrictive nano-plate, modified couple stress theory, nonlocal elasticity theory, vibration analysis

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Authors: Saja M. Nabat Al-Ajrash, Charles Browning, Rose Eckerle, Li Cao

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Three preceramic polymer formulations for potential use in 3D printing technologies were investigated. The polymeric precursors include an allyl hydrido polycarbosilane (SMP-10), SMP-10/1,6-dexanediol diacrylate (HDDA) mixture, and polydimethylsiloxane (PDMS). The rheological property of the polymeric precursors, including the viscosity within a wide shear rate range was compared to determine the applicability in additive manufacturing technology. The structural properties of the polymeric solutions and their photocureability were investigated using Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC). Moreover, thermogravimetric analysis (TGA) and X-ray diffraction (XRD) were utilized to study polymeric to ceramic conversion for versatile precursors. The prepared precursor resin proved to have outstanding photo-curing properties and the ability to transform to the silicon carbide phase at temperatures as low as 850 °C. The obtained ceramic was fully dense with nearly linear shrinkage and a shiny, smooth surface after pyrolysis. Furthermore, after pyrolysis to 1350 °C and TGA analysis, PDMS polymer showed the highest onset decomposition temperature and the lowest retained weight (52 wt%), while SMP.10/HDDA showed the lowest onset temperature and ceramic yield (71.7 wt%). In terms of crystallography, the ceramic matrix composite appeared to have three coexisting phases, including silicon carbide, and silicon oxycarbide. The results are very promising to fabricate ceramic materials working at high temperatures with complex geometries.

Keywords: preceramic polymer, silicon carbide, photocuring, allyl hydrido polycarbosilane, SMP-10

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Authors: Michael Anton Kraus, Miriam Schuster, Geralt Siebert, Jens Schneider

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Polymers increasingly gained interest in construction materials over the last years in civil engineering applications. As polymeric materials typically show time- and temperature dependent material behavior, which is accounted for in the context of the theory of linear viscoelasticity. Within the context of this paper, the authors show, that some polymeric interlayers for laminated glass can not be considered as thermorheologically simple as they do not follow a simple TTSP, thus a methodology of identifying the thermorheologically complex constitutive bahavioir is needed. ‘Dynamical-Mechanical-Thermal-Analysis’ (DMTA) in tensile and shear mode as well as ‘Differential Scanning Caliometry’ (DSC) tests are carried out on the interlayer material ‘Ethylene-vinyl acetate’ (EVA). A navoel Bayesian framework for the Master Curving Process as well as the detection and parameter identification of the TTSPs along with their associated Prony-series is derived and applied to the EVA material data. To our best knowledge, this is the first time, an uncertainty quantification of the Prony-series in a Bayesian context is shown. Within this paper, we could successfully apply the derived Bayesian methodology to the EVA material data to gather meaningful Master Curves and TTSPs. Uncertainties occurring in this process can be well quantified. We found, that EVA needs two TTSPs with two associated Generalized Maxwell Models. As the methodology is kept general, the derived framework could be also applied to other thermorheologically complex polymers for parameter identification purposes.

Keywords: bayesian parameter identification, generalized Maxwell model, linear viscoelasticity, thermorheological complex

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Authors: Ying-Chang Yu, Yuan-Lung Lo

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Building ventilation performance is an important indicator of indoor comfort. However, in addition to the geometry of the building or the proportion of the opening, the ventilation performance is also very much related to the actual wind pressure of the building. There are more and more contemporary building designs built with multi-layer exterior envelope. Due to ventilation and view observatory requirement, the porous outer layer of the building is commonly adopted and has a significant wind damping effect, causing the phenomenon of actual wind pressure loss. However, the relationship between the wind damping effect and the actual wind pressure is not linear. This effect can make the indoor ventilation of the building rationalized to reasonable range under the condition of high wind pressure, and also maintain a good amount of ventilation performance under the condition of low wind pressure. In this study, wind tunnel experiments were carried out to simulate the different wind pressures flow through the porous outer layer, and observe the actual wind pressure strength engage with the window layer to find the decreasing relationship between the damping effect of the porous shell and the wind pressure. Experiment specimen scale was designed to be 1:50 for testing real-world building conditions; the study found that the porous enclosure has protective shielding without affecting low-pressure ventilation. Current study observed the porous skin may damp more wind energy to ease the wind pressure under high-speed wind. Differential wind speed may drop the pressure into similar pressure level by using porous skin. The actual mechanism and value of this phenomenon will need further study in the future.

Keywords: multi-layer facade, porous media, wind damping, wind tunnel test, building ventilation

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Authors: H. Boukhatem, L. Djouadi, H. Khalaf, R. M. Navarro, F. V. Ganzalez

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Synthetic organic dyes are used in various industries, such as textile industry, leather tanning industry, paper production, hair dye production, etc. Wastewaters containing these dyes may be harmful to the environment and living organisms. Therefore, it is very important to remove or degrade these dyes before discharging them into the environment. In addition to standard technologies for the degradation and/or removal of dyes, several new specific technologies, the so-called advanced oxidation processes (AOPs), have been developed to eliminate dangerous compounds from polluted waters. AOPs are all characterized by the same chemical feature: production of radicals (•OH) through a multistep process, although different reaction systems are used. These radicals show little selectivity of attack and are able to oxidize various organic pollutants due to their high oxidative capacity (reduction potential of HO• Eo = 2.8 V). Heterogeneous photocatalysis, as one of the AOPs, could be effective in the oxidation/degradation of organic dyes. A major advantage of using heterogeneous photocatalysis for this purpose is the total mineralization of organic dyes, which results in CO2, H2O and corresponding mineral acids. In this study, nanomaterials based on montmorillonite and CuxCd1-xS with different Cu concentration (0.3 < x < 0.7) were utilized for the degradation of the commercial cationic textile dye Methylene blue (MB), used as a model pollutant. The synthesized nanomaterials were characterized by fourier transform infrared (FTIR) and thermogravimetric-differential thermal analysis (TG–DTA). Test results of photocatalysis of methylene blue under UV-Visible irradiation show that the photoactivity of nanomaterials montmorillonite/ CuxCd1-xS increases with the increasing of Cu concentration. The kinetics of the degradation of the MB dye was described with the Langmuir–Hinshelwood (L–H) kinetic model.

Keywords: heterogeneous photocatalysis, methylene blue, montmorillonite, nanomaterial

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Authors: Ziyun Li, Jiudi Zhong, June Zhang

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Background: The diagnosis and treatment of lung cancer lead to varying degrees of psychological and social maladjustment among patients with lung cancer. Understanding psychosocial adjustment (PA) and its influencing factors in young and middle-aged lung cancer patients is essential to help them return to society and lead a normal life. Objectives: This study aims to examine the mediating role of resilience in the association between stigma and psychosocial adjustment among young and middle-aged patients with lung cancer. Methods: A total of 235 patients with lung cancer were recruited from a tertiary grade A cancer center in southern China and investigated using a self-designed general information questionnaire, Psychosocial Adjustment to Illness Scale Self-Report, Social Impact Scale, and Conner-Davidson Resilience Scale. Results: The mean score of PA was (32.61±14.75), and its influencing factors included treatment modalities, stigma, and resilience. The total effect of stigma on PA was significant (total effect=0.418, SE=0.045, 95%CI [0.310-0.497]), and a positive indirect effect was identified for stigma on PA via resilience (indirect effect=0.143, SE=0.041, 95% CI [0.075-0.236]). Conclusion: Stigma and resilience are significantly associated with PA, and resilience is also a mediating variable between stigma and PA. This study suggests that individualized interventions can be made to improve the PA by alleviating their stigma, or by enhancing their resilience in young and middle-aged lung cancer patients.

Keywords: psychosocial adjustment, lung cancer, cancer caring, nursing, young and middle-aged

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