Search results for: clinical error

Authors: Kuan-Wei Chen, Chien-Wei Chen, Tai-Ling Chang, Nan-Cheng Chen, Ching-Lin Hsieh, Gong-Hong Lin

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Background and Purposes: Deficits in sustained attention are common in patients with schizophrenia. Such impairment can limit patients to effectively execute daily activities and affect the efficacy of rehabilitation. The aims of this study were to examine the test-retest agreement, random measurement error, and practice effect of the Continuous Performance Test-Identical Pairs (CPT-IP) (a commonly used sustained attention test) in patients with schizophrenia. The results can provide empirical evidence for clinicians and researchers to apply a sustained attention test with sound psychometric properties in schizophrenia patients. Methods: We recruited patients with chronic schizophrenia to be assessed twice with 1 week interval using CPT-IP. The intra-class correlation coefficient (ICC) was used to examine the test-retest agreement. The percentage of minimal detectable change (MDC%) was used to examine the random measurement error. Moreover, the standardized response mean (SRM) was used to examine the practice effect. Results: A total of 56 patients participated in this study. Our results showed that the ICC was 0.82, MDC% was 47.4%, and SRMs were 0.36 for the CPT-IP. Conclusion: Our results indicate that CPT-IP has acceptable test-retests agreement, substantial random measurement error, and small practice effect in patients with schizophrenia. Therefore, to avoid overestimating patients’ changes in sustained attention, we suggest that clinicians interpret the change scores of CPT-IP conservatively in their routine repeated assessments.

Keywords: schizophrenia, sustained attention, CPT-IP, reliability

Procedia PDF Downloads 278

Authors: R. Tariq, R. Lee

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Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.

Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation

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Authors: Mohd Noah A. Rahman, Armandurni Abd Rahman, Afzaal H. Seyal, Md Rizal Md Hendry

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The article reports an automated student attendance system modeled and developed for use at a Vocational school. This project focuses on developing an application using a QR code utilizing the Reed-Solomon error correction code using a smartphone scanned through a webcam. This system enables us to speed up the process of taking attendance and would save us valuable teaching time. This is planned to help students avoid consequences that may result from poor attendances which will eventually penalize them from sitting their final examination as required.

Keywords: QR code, Reed-Solomon, error correction, system design.

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Authors: Mohammad Haghighi, Amineh Akhondi, Leila Jahangard, Mohammad Ahmadpanah, Masoud Ansari

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Background: According to the recent estimation, approximately 4%-12% percent of Iranians have difficulty in learning to read and spell possibly as a result of developmental dyslexia. The study was planned to investigate spelling error patterns among Persian children with developmental dyslexia and compare that with the errors exhibited by control groups Participants: 90 students participated in this study. 30 students from Grade level five, diagnosed as dyslexics by professionals, 30 normal 5th Grade readers and 30 younger normal readers. There were 15 boys and 15 girls in each of the groups. Qualitative and quantitative methods for analysis of errors were used. Results and conclusion: results of this study indicate similar spelling error profiles among dyslexics and the reading level matched groups, and these profiles were different from age-matched group. However, performances of dyslexic group and reading level matched group were different and inconsistent in some cases.

Keywords: spelling, error types, developmental dyslexia, Persian, writing system, learning disabilities, processing

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Authors: Daniel Fundi Murithi

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Data from economic, social, clinical, and industrial studies are in some way incomplete or incorrect due to censoring. Such data may have adverse effects if used in the estimation problem. We propose the use of Maximum Likelihood Estimation (MLE) under a progressive type-II censoring scheme to remedy this problem. In particular, maximum likelihood estimates (MLEs) for the location (µ) and scale (λ) parameters of two Parameter Rayleigh distribution are realized under a progressive type-II censoring scheme using the Expectation-Maximization (EM) and the Newton-Raphson (NR) algorithms. These algorithms are used comparatively because they iteratively produce satisfactory results in the estimation problem. The progressively type-II censoring scheme is used because it allows the removal of test units before the termination of the experiment. Approximate asymptotic variances and confidence intervals for the location and scale parameters are derived/constructed. The efficiency of EM and the NR algorithms is compared given root mean squared error (RMSE), bias, and the coverage rate. The simulation study showed that in most sets of simulation cases, the estimates obtained using the Expectation-maximization algorithm had small biases, small variances, narrower/small confidence intervals width, and small root of mean squared error compared to those generated via the Newton-Raphson (NR) algorithm. Further, the analysis of a real-life data set (data from simple experimental trials) showed that the Expectation-Maximization (EM) algorithm performs better compared to Newton-Raphson (NR) algorithm in all simulation cases under the progressive type-II censoring scheme.

Keywords: expectation-maximization algorithm, maximum likelihood estimation, Newton-Raphson method, two-parameter Rayleigh distribution, progressive type-II censoring

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Authors: Moon Jung Kim, Guil Rhim

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The clinical sensitivity of the “VEUPLEXTM TBI assay”, a clinical trial medical device, in mild traumatic brain injury was 28.6% (95% CI, 19.7%-37.5%), and the clinical specificity was 94.0% (95% CI, 89.3%). -98.7%). In addition, when the results analyzed by marker were put together, the sensitivity was higher when interpreting the two tests together than the two tests, UCHL1 and GFAP alone. Additionally, when sensitivity and specificity were analyzed based on CT results for the mild traumatic brain injury patient group, the clinical sensitivity for 2 CT-positive cases was 50.0% (95% CI: 1.3%-98.7%), and 19 CT-negative cases. The clinical specificity for cases was 68.4% (95% CI: 43.5% - 87.4%). Since the low clinical sensitivity for the two CT-positive cases was not statistically significant due to the small number of samples analyzed, it was judged necessary to secure and analyze more samples in the future. Regarding the clinical specificity analysis results for 19 CT-negative cases, there were a large number of patients who were actually clinically diagnosed with mild traumatic brain injury but actually received a CT-negative result, and about 31.6% of them showed abnormal results on VEUPLEXTM TBI assay. Although traumatic brain injury could not be detected in 31.6% of the CT scans, the possibility of actually suffering a mild brain injury could not be ruled out, so it was judged that this could be confirmed through follow-up observation of the patient. In addition, among patients with mild traumatic brain injury, CT examinations were not performed in many cases because the symptoms were very mild, but among these patients, about 25% or more showed abnormal results in the VEUPLEXTM TBI assay. In fact, no damage is observed with the naked eye immediately after traumatic brain injury, and traumatic brain injury is not observed even on CT. But in some cases, brain hemorrhage may occur (delayed cerebral hemorrhage) after a certain period of time, so the patients who did show abnormal results on VEUPLEXTM TBI assay should be followed up for the delayed cerebral hemorrhage. In conclusion, it was judged that it was difficult to judge mild traumatic brain injury with the VEUPLEXTM TBI assay only through clinical findings without CT results, that is, based on the GCS value. Even in the case of CT, it does not detect all mild traumatic brain injury, so it is difficult to necessarily judge that there is no traumatic brain injury, even if there is no evidence of traumatic brain injury in CT. And in the long term, more patients should be included to evaluate the usefulness of the VEUPLEXTM TBI assay in the detection of microscopic traumatic brain injuries without using CT.

Keywords: brain injury, traumatic brain injury, GFAP, UCHL1

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Authors: Dorota Witkowska, Paweł Gosek, Lukasz Swiecicki, Wojciech Jernajczyk, Bruce J. West, Miroslaw Latka

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In clinical practice, the selection of an antidepressant often degrades to lengthy trial-and-error. In this work we employ a normalized wavelet power of alpha waves as a biomarker of antidepressant treatment response. This novel EEG metric takes into account both non-stationarity and intersubject variability of alpha waves. We recorded resting, 19-channel EEG (closed eyes) in 22 inpatients suffering from unipolar (UD, n=10) or bipolar (BD, n=12) depression. The EEG measurement was done at the end of the short washout period which followed previously unsuccessful pharmacotherapy. The normalized alpha wavelet power of 11 responders was markedly different than that of 11 nonresponders at several, mostly temporoparietal sites. Using the prediction of treatment response based on the normalized alpha wavelet power, we achieved 81.8% sensitivity and 81.8% specificity for channel T4.

Keywords: alpha waves, antidepressant, treatment outcome, wavelet

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Authors: Hossein Javidnia, Salehe Taheri

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The Electrocardiogram (ECG) is the recording of the heart’s electrical potential versus time. ECG signals are often contaminated with noise such as baseline wander and muscle noise. As these signals have been widely used in clinical studies to detect heart diseases, it is essential to filter these noises. In this paper we compare performance of Wiener Filtering and Median Filtering methods to filter Additive White Gaussian (AWG) noise with the determined signal to noise ratio (SNR) ranging from 3 to 5 dB applied to long-term ECG recordings samples. Root mean square error (RMSE) and coefficient of determination (R2) between the filtered ECG and original ECG was used as the filter performance indicator. Experimental results show that Wiener filter has better noise filtering performance than Median filter.

Keywords: ECG noise filtering, Wiener filtering, median filtering, Gaussian noise, filtering performance

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Authors: Hamid Fallah

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Creating surveying stations is the first thing that a surveyor learns; they can use it for control and implementation in projects such as buildings, roads, tunnels, monitoring, etc., whatever is related to the preparation of maps. In this article, the method of calculation through the traverse table and by checking several examples of errors of several publishers of surveying books in the calculations of this table, we also control the results of several software in a simple way. Surveyors measure angles and lengths in creating surveying stations, so the most important task of a surveyor is to be able to correctly remove the error of angles and lengths from the calculations and to determine whether the amount of error is within the permissible limit for delete it or not.

Keywords: UTM, localization, scale factor, cartesian, traverse

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Authors: Aarati Susan Mathew, Radhika Narendra Patel, Jiji Mathew

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A retrospective study conducted at Christian Medical College (CMC) Teaching Hospital, Vellore, India on 14th August 2014 to assess the accuracy of clinically estimated foetal weight upon labour admission. Estimating foetal weight is a crucial factor in assessing maternal and foetal complications during and after labour. Medical notes of ninety-eight postnatal women who fulfilled the inclusion criteria were studied to evaluate the correlation between their recorded Estimated Foetal Weight (EFW) on admission and actual birth weight (ABW) of the newborn after delivery. Data concerning maternal and foetal demographics was also noted. Accuracy was determined by absolute percentage error and proportion of estimates within 10% of ABW. Actual birth weights ranged from 950-4080g. A strong positive correlation between EFW and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the normal weight range (2500-4000g) had a 59.5% estimation accuracy (n=74) compared to pre-term (<40 weeks) with an estimation accuracy of 0% (n=2). Out of the term deliveries, macrosomic babies (>4000g) were underestimated by 25% (n=3) and low birthweight (LBW) babies were overestimated by 12.7% (n=9). Registrars who estimated foetal weight were accurate in babies within normal weight ranges. However, there needs to be an improvement in predicting weight of macrosomic and LBW foetuses. We have suggested the use of an amended version of the Johnson’s formula for the Indian population for improvement and a need to re-audit once implemented.

Keywords: clinical palpation, estimated foetal weight, pregnancy, India, Johnson’s formula

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Authors: Gloria Toledo, Andrea Lizasoain, Leonardo Mena

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Immigration has largely increased in Chile in the last 20 years. About 6.6% of our population is foreign, from which 14.3% is Haitian. Haitians are between 15 and 29 years old and have come to Chile escaping from a social crisis. They believe that education and work will help them do better in life. Therefore, rates of Haitian students in the Chilean school system have also increased: there were 3,121 Haitian students enrolled in 2017. This is a challenge for the public school, which takes in young people who must face schooling, social immersion and learning of a second language simultaneously. The linguistic barrier affects both students’ and teachers’ adaptation process, which has an impact on the students’ academic performance and consequent acquisition of Spanish. In order to explore students’ academic performance and interlanguage development, we examined how L1 teachers assess Haitian high school students’ written production in Spanish. With this purpose, teachers were asked to use a specially designed grid to assess correction, accommodation, lexical and analytical complexity, organization and fluency of both Haitian and Chilean students. Parallelly, texts were approached from an error analysis perspective. Results from grids and error analysis were then compared. On the one hand, it has been found that teachers give very little feedback to students apart from scores and grades, which does not contribute to the development of the second language. On the other hand, error analysis has yielded that Haitian students are in a dynamic process of the acquisition of Spanish, which could be enhanced if L1 teacher were aware of the process of interlanguage developmen.

Keywords: assessment, error analysis, grid, immigration, Spanish aquisition, writing

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Authors: Pornthip Seangsanga

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Sepsis or septic shock needs urgent care because it is a cause of the high mortality rate if patients do not receive timely treatment. Songkhla Hospital does not have a clear system or clinical practice guidelines for treatment of patients with severe sepsis or septic shock, which contributes to the said problem.To compare clinical outcomes based on the protocol after using the clinical guidelines between the Emergency Room, Intensive Care Unit, and the Ward. This quasi-experimental study was conducted on the population and 50 subjects who were diagnosed with severe sepsis or septic shock from December 2013 to May 2014. The data were collected using a nursing care and referring record form for patients with severe sepsis or septic shock at Songkhla Hospital. The record form had been tested for its validity by three experts, and the IOC was 1.The mortality rate in patients with severe sepsis or septic shock who were moved from the ER to the ICU was significantly lower than that of those patients moved from the Ward to the ICU within 48 hours. This was because patients with severe sepsis or septic shock who were moved from the ER to the ICU received more fluid within the first six hours according to the protocol which helped patients to have adequate tissue perfusion within the first six hours, and that helped improve blood flow to the kidneys, and the patients’ urine was found to be with a higher quantity of 0.5 cc/kg/hr, than those patients who were moved from the Ward to the ICU. This study shows that patients with severe sepsis or septic shock need to be treated immediately. Using the clinical practice guidelines along with timely diagnosis and treatment based on the sepsis bundle in giving sufficient and suitable amount of fluid to help improve blood circulation and blood pressure can clearly prevent or reduce severity of complications.

Keywords: clinical practice guidelines, caring, septic shock, sepsis bundle protocol

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Authors: Qianhua He, Weili Zhou, Aiwu Chen

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A sparse representation speech denoising method based on adapted stopping residue error was presented in this paper. Firstly, the cross-correlation between the clean speech spectrum and the noise spectrum was analyzed, and an estimation method was proposed. In the denoising method, an over-complete dictionary of the clean speech power spectrum was learned with the K-singular value decomposition (K-SVD) algorithm. In the sparse representation stage, the stopping residue error was adaptively achieved according to the estimated cross-correlation and the adjusted noise spectrum, and the orthogonal matching pursuit (OMP) approach was applied to reconstruct the clean speech spectrum from the noisy speech. Finally, the clean speech was re-synthesised via the inverse Fourier transform with the reconstructed speech spectrum and the noisy speech phase. The experiment results show that the proposed method outperforms the conventional methods in terms of subjective and objective measure.

Keywords: speech denoising, sparse representation, k-singular value decomposition, orthogonal matching pursuit

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Authors: Sanaa Mekdad, Leenah Alsayed

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Pharmacists play an important role in the CDTM in the care of patients with heart failure (HF). CDTM allows specialized, dedicated clinical pharmacists in a formal agreement in collaborative practice with physicians. Thus, the aim of this study is to investigate the role of cardiology clinical pharmacists in CDTM in decreasing hospitalization and cost. We studied patients with left ventricular systolic dysfunction in a cluster-randomized selection in a tertiary care center. We allocated 296 patients to pharmacist intervention from 1480 patients. Results: With an acceptance rate of 86%, we documented 696 interventions carried out by clinical pharmacists in cardiology. The average intervention was 2.4 patients, and the admission after interventions decreased from 0.79 to. 0.24 (p value = 0.001). Conclusions: In HF CDTM, clinical pharmacists play a crucial role in enhancing medication management, patient education, and lifestyle modification of patients with chronic heart failure. These efforts improve patients' outcomes and lower costs by reducing hospitalization and other associated expenses.

Keywords: cardiology, medication management, heart failure, outpatient therapy, pharmacist-based services, chronic heart failure, heart failure recommendations, CDTM, Middle East, pharmacist-based services, quality of life, pharmacist

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Authors: Nasar Aldian Ambark Shashoa

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Classification with a dimension reduction based on Bayesian approach is proposed in this paper . The first step is to generate a sample (parameter) of fault-free mode class and faulty mode class. The second, in order to obtain good classification performance, a selection of important features is done with the discrete karhunen-loeve expansion. Next, the Bayes test for minimum error is used to classify the classes. Finally, the results for simulated data demonstrate the capabilities of the proposed procedure.

Keywords: analytical redundancy, fault detection, feature extraction, Bayesian approach

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Authors: Mina Jafari, Kobra Hamraee, Saied Hossein Hosseini

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The prediction of breast cancer disease is one of the challenges in medicine. In this paper we collected 528 records of women’s information who live in Kabul including demographic, life style, diet and pregnancy data. There are many classification algorithm in breast cancer prediction and tried to find the best model with most accurate result and lowest error rate. We evaluated some other common supervised algorithms in data mining to find the best model in prediction of breast cancer disease among afghan women living in Kabul regarding to momography result as target variable. For evaluating these algorithms we used Cross Validation which is an assured method for measuring the performance of models. After comparing error rate and accuracy of three models: Decision Tree, Naive Bays and Rule Induction, Decision Tree with accuracy of 94.06% and error rate of %15 is found the best model to predicting breast cancer disease based on the health care records.

Keywords: decision tree, breast cancer, probability, data mining

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Authors: Tahir Nawaz Cheema, Dumitru Baleanu, Ali Raza

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In this research work, we design intelligent computing through Bayesian Regularization artificial neural networks (BRANNs) introduced to solve the mathematical modeling of infectious diseases (Covid-19). The dynamical transmission is due to the interaction of people and its mathematical representation based on the system's nonlinear differential equations. The generation of the dataset of the Covid-19 model is exploited by the power of the explicit Runge Kutta method for different countries of the world like India, Pakistan, Italy, and many more. The generated dataset is approximately used for training, testing, and validation processes for every frequent update in Bayesian Regularization backpropagation for numerical behavior of the dynamics of the Covid-19 model. The performance and effectiveness of designed methodology BRANNs are checked through mean squared error, error histograms, numerical solutions, absolute error, and regression analysis.

Keywords: mathematical models, beysian regularization, bayesian-regularization backpropagation networks, regression analysis, numerical computing

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Authors: Cheng-Hao Jiang, Mu-Xuan Tao

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The rigid diaphragm model may cause errors in the calculation of internal forces due to neglecting the in-plane deformation of the diaphragm. This paper thus studies the effects of different diaphragm in-plane models (including in-plane rigid model and in-plane flexible model) on the seismic performance of structures. Taking an actual industrial plant as an example, the seismic performance of the structure is predicted using different floor diaphragm models, and the analysis errors caused by different diaphragm in-plane models including deformation error and internal force error are calculated. Furthermore, the influence of the aspect ratio on the analysis errors is investigated. Finally, the code rationality is evaluated by assessing the analysis errors of the structure models whose floors were determined as rigid according to the code’s criterion. It is found that different floor models may cause great differences in the distribution of structural internal forces, and the current code may underestimate the influence of the floor in-plane effect.

Keywords: industrial plant, diaphragm, calculating error, code rationality

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Authors: Ren Moses

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The process of classifying vehicles on a highway is hereby viewed as a pattern recognition problem in which connectionist techniques such as artificial neural networks (ANN) can be used to assign vehicles to their correct classes and hence to establish optimum axle spacing thresholds. In the United States, vehicles are typically classified into 13 classes using a methodology commonly referred to as “Scheme F”. In this research, the ANN model was developed, trained, and applied to field data of vehicles. The data comprised of three vehicular features—axle spacing, number of axles per vehicle, and overall vehicle weight. The ANN reduced the classification error rate from 9.5 percent to 6.2 percent when compared to an existing classification algorithm that is not ANN-based and which uses two vehicular features for classification, that is, axle spacing and number of axles. The inclusion of overall vehicle weight as a third classification variable further reduced the error rate from 6.2 percent to only 3.0 percent. The promising results from the neural networks were used to set up new thresholds that reduce classification error rate.

Keywords: artificial neural networks, vehicle classification, traffic flow, traffic analysis, and highway opera-tions

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Authors: Yawen Wang, Hongchang Chen, Shaomei Li, Chao Gao, Jiangpeng Zhang

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As the main challenge for target tracking is accounting for target scale change and real-time, we combine Mean-Shift and PCA-SIFT algorithm together to solve the problem. We introduce similarity comparison method to determine how the target scale changes, and taking different strategies according to different situation. For target scale getting larger will cause location error, we employ backward tracking to reduce the error. Mean-Shift algorithm has poor performance when tracking scale-changing target due to the fixed bandwidth of its kernel function. In order to overcome this problem, we introduce PCA-SIFT matching. Through key point matching between target and template, that adjusting the scale of tracking window adaptively can be achieved. Because this algorithm is sensitive to wrong match, we introduce RANSAC to reduce mismatch as far as possible. Furthermore target relocating will trigger when number of match is too small. In addition we take comprehensive consideration about target deformation and error accumulation to put forward a new template update method. Experiments on five image sequences and comparison with 6 kinds of other algorithm demonstrate favorable performance of the proposed tracking algorithm.

Keywords: target tracking, PCA-SIFT, mean-shift, scale-adaptive

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Authors: Jaouadi Ikram, Machhout Mohsen

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The development of a quantum key distribution (QKD) system on a field-programmable gate array (FPGA) platform is the subject of this paper. A quantum cryptographic protocol is designed based on the properties of quantum information and the characteristics of FPGAs. The proposed protocol performs key extraction, reconciliation, error correction, and privacy amplification tasks to generate a perfectly secret final key. We modeled the presence of the spy in our system with a strategy to reveal some of the exchanged information without being noticed. Using an FPGA card with a 100 MHz clock frequency, we have demonstrated the evolution of the error rate as well as the amounts of mutual information (between the two interlocutors and that of the spy) passing from one step to another in the key generation process.

Keywords: QKD, BB84, protocol, cryptography, FPGA, key, security, communication

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Authors: Maryum Nawaz

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Purpose: To determine the frequency of refractive errors in squinting eyes of children from 4 to 16 years presenting at tertiary care hospital. Study Design: A descriptive cross-sectional study was done. Place and Duration: The study was conducted in Pediatric Ophthalmology, Hayatabad Medical Complex, Peshawar. Materials and Methods: The sample size was 146 keeping 41.45%5 proportion of refractive errors in children with squinting eyes, 95% confidence interval and 8% margin of error under WHO sample size calculations. Non-probability consecutive sampling was done. Result: Mean age was 8.57±2.66 years. Male were 89 (61.0%) and female were 57 (39.0%). Refractive error was present in 56 (38.4%) and was not present in 90 (61.6%) of patients. There was no association of gender, age, parent refractive errors, or early usage of electric equipment with the refractive errors. Conclusion: There is a high prevalence of refractive errors in a patient with strabismus. There is no association of age, gender, parent refractive errors, or early usage of electric equipment in the occurrence of refractive errors. Further studies are recommended for confirmation of these.

Keywords: strabismus, refractive error, myopia, hypermetropia, astigmatism

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Authors: Walid Abouzeid, Mohamed Shadad, Mostafa Farid, Magdy El Hawary

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The most frequent treatable vascular abnormality of the spinal canal is spinal dural arteriovenous fistulae (SDAVFs), which cause progressive para- or quadriplegia mostly affecting elderly males. SDAVFs are present in the thoracolumbar region. The main goal of treatment must be to obliterate the shunting zone via superselective embolization with the usage of a liquid embolic agent. This study aims to evaluate endovascular technique as a safe and efficient approach for the treatment SDAVFs, especially with long-term follow-up clinical outcomes. Study Design: A retrospective clinical case study. From May 2010 to May 2017, 15 patients who had symptoms attributed to SDAVFs underwent the operation in the Departments of Neurosurgery in Suhag, Tanta, and Al-Azhar Universities and Interventional Radiology, Ain Shams University. All the patients had varying degrees of progressive spastic paraparesis with and without sphincteric disturbances. Endovascular embolization was used in all cases. Fourteen were males, with ages ranging from 45 to 74 years old. After the treatment, good outcome was found in five patients (33.3%), a moderate outcome was delineated in six patients (40 %), and four patients revealed a poor outcome (26.7%). Spinal AVF could be treated safely and effectively by the endovascular approach. Generally, there is no correlation between the disappearance of MRI abnormalities and significant clinical improvement. The preclinical state of the patient is directly proportional to the clinical outcome. Due to unexpected responses, embolization should be attempted even the patient is in a bad clinical condition.

Keywords: spine, arteriovenous, fistula, endovascular, embolization

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Authors: Jularat Chumnaul

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In forensic science, corpses from various homicides are different; there are both complete and incomplete, depending on causes of death or forms of homicide. For example, some corpses are cut into pieces, some are camouflaged by dumping into the river, some are buried, some are burned to destroy the evidence, and others. If the corpses are incomplete, it can lead to the difficulty of personally identifying because some tissues and bones are destroyed. To specify gender of the corpses from skeletal remains, the most precise method is DNA identification. However, this method is costly and takes longer so that other identification techniques are used instead. The first technique that is widely used is considering the features of bones. In general, an evidence from the corpses such as some pieces of bones, especially the skull and pelvis can be used to identify their gender. To use this technique, forensic scientists are required observation skills in order to classify the difference between male and female bones. Although this technique is uncomplicated, saving time and cost, and the forensic scientists can fairly accurately determine gender by using this technique (apparently an accuracy rate of 90% or more), the crucial disadvantage is there are only some positions of skeleton that can be used to specify gender such as supraorbital ridge, nuchal crest, temporal lobe, mandible, and chin. Therefore, the skeletal remains that will be used have to be complete. The other technique that is widely used for gender specifying in forensic science and archeology is skeletal measurements. The advantage of this method is it can be used in several positions in one piece of bones, and it can be used even if the bones are not complete. In this study, the classification and cluster analysis are applied to this technique, including the Kth Nearest Neighbor Classification, Classification Tree, Ward Linkage Cluster, K-mean Cluster, and Two Step Cluster. The data contains 507 particular individuals and 9 skeletal measurements (diameter measurements), and the performance of five methods are investigated by considering the apparent error rate (APER). The results from this study indicate that the Two Step Cluster and Kth Nearest Neighbor method seem to be suitable to specify gender from human skeletal remains because both yield small apparent error rate of 0.20% and 4.14%, respectively. On the other hand, the Classification Tree, Ward Linkage Cluster, and K-mean Cluster method are not appropriate since they yield large apparent error rate of 10.65%, 10.65%, and 16.37%, respectively. However, there are other ways to evaluate the performance of classification such as an estimate of the error rate using the holdout procedure or misclassification costs, and the difference methods can make the different conclusions.

Keywords: skeletal measurements, classification, cluster, apparent error rate

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Authors: Derjew Ayele Ejigu, Houde Song, Xiaojing Liu

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This work presents the particle swarm optimization trained neural network (PSO-NN) supervisory proportional integral derivative (PID) control method to monitor the pressurized water reactor (PWR) core power for safe operation. The proposed control approach is implemented on the transfer function of the PWR core, which is computed from the state-space model. The PWR core state-space model is designed from the neutronics, thermal-hydraulics, and reactivity models using perturbation around the equilibrium value. The proposed control approach computes the control rod speed to maneuver the core power to track the reference in a closed-loop scheme. The particle swarm optimization (PSO) algorithm is used to train the neural network (NN) and to tune the PID simultaneously. The controller performance is examined using integral absolute error, integral time absolute error, integral square error, and integral time square error functions, and the stability of the system is analyzed by using the Bode diagram. The simulation results indicated that the controller shows satisfactory performance to control and track the load power effectively and smoothly as compared to the PSO-PID control technique. This study will give benefit to design a supervisory controller for nuclear engineering research fields for control application.

Keywords: machine learning, neural network, pressurized water reactor, supervisory controller

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Authors: Peyman Rezaei Hachesu, Vahideh Zareh Gavgani, Zahra Salahzadeh

Abstract:

To survey the attitudes, awareness, and practice of Evidence Based Medicine (EBM), and to determine the barriers that influence apply’ EBM in therapeutic process among clinical residents in Iran.We conducted a cross sectional survey during September to December 2012 at the teaching hospitals of Tehran University of Medical Sciences among 79 clinical residents from different medical specialties. A valid and reliable questionnaire consisted of five sections and 27 statements were used in this research. We applied Spearman and Mann Whitney test for correlation between variables. Findings showed that the knowledge of residents about EBM is low. Their attitude towards EBM was positive but their knowledge and skills in regard with the evidence based medical information resources were mostly limited to PubMed and Google scholar. The main barrier was the lack of enough time to practicing EBM. There was no significant correlation between residency grade and familiarity and use of electronic EBM resources (Spearman, P = 0.138). Integration of training approaches like journal clubs or workshops with clinical practice is suggested.

Keywords: evidence-based medicine, clinical residents, decision-making, attitude, questionnaire

Procedia PDF Downloads 354

Authors: Ignatio Madanhire, Charles Mbohwa

Abstract:

This study looks at the best model of aggregate planning activity in an industrial entity and uses the trial and error method on spreadsheets to solve aggregate production planning problems. Also linear programming model is introduced to optimize the aggregate production planning problem. Application of the models in a furniture production firm is evaluated to demonstrate that practical and beneficial solutions can be obtained from the models. Finally some benchmarking of other furniture manufacturing industries was undertaken to assess relevance and level of use in other furniture firms

Keywords: aggregate production planning, trial and error, linear programming, furniture industry

Procedia PDF Downloads 528

Authors: Inkyong Yi

Abstract:

Acute kidney injury (AKI) in trauma patients is known to be associated with multiple factors, especially shock and consequent inadequate renal perfusion, yet its clinical presentation is little known in severe trauma patients. Our aim was to investigate the clinical presentation of acute kidney injury and its outcome in severe trauma patients at a level I trauma center. A total of 93 consecutive adult trauma patients with an injury severity score (ISS) of more than 15 were analyzed retrospectively from our Level I trauma center data base. Patients with direct renal injury were excluded. Patients were dichotomized into two groups, according to the presence of AKI. Various clinical parameters were compared between two groups, with Student’s T test and Mann-Whitney’s U test. The AKI group was further dichotomized into patients who recovered within seven days, and those who required more than 7days for recovery or those who did not recover at all. Various clinical parameters associated with outcome were further analyzed. Patients with AKI (n=33, 35%) presented with significantly higher age (61.4±17.3 vs. 45.4±17.3, p < 0.0001), incidence of comorbidities (hypertension; 51.5% vs. 13.3%, OR 6.906 95%CI 2.515-18.967, diabetes; 27.3% vs. 6.7%, OR 5.250, 95%CI 1.472-18.722), odds of head and neck trauma (69.7% vs. 41.7%, OR 3.220, 95%CI 1.306-7.942) and presence of shock during emergency room care (66.7% vs 21.7% OR 7.231, 95%CI, 2.798-18.687). Among AKI patients, patients who recovered within 1 week showed lower peak lactate (4.7mmol/L, 95%CI 2.9-6.5 vs 7.3mmol/L, 95%CI 5.0-9.6, p < 0.0287), lesser units of transfusion during first 24 hours (pRBC; 20.4unit, 95%CI 12.5-28.3 vs. 58.9unit, 95%CI 39.4-78.5, p=0.0003, FFP; 16.6unit, 95%CI 6.8-26.4 vs. 56.1unit, 95%CI 26.9-85.2, p=0.0027). In severe trauma patients, patients with AKI showed different clinical presentations and worse outcomes. Initial presence of shock and higher DIC profiles may be important risk factors for AKI in severe trauma patients. In patients with AKI, peak lactate level and amounts of transfusion are related to recovery.

Keywords: acute kidney injury, lactate, transfusion, trauma

Procedia PDF Downloads 178

Authors: Geeta Kasana, Kulbir Singh, Satvinder Singh

Abstract:

In this paper, a steganographic scheme for digital images using Integer Wavelet Transform (IWT) is proposed. The cover image is decomposed into wavelet sub bands using IWT. Each of the subband is divided into blocks of equal size and secret data is embedded into the largest and smallest pixel values of each block of the subband. Visual quality of stego images is acceptable as PSNR between cover image and stego is above 40 dB, imperceptibility is maintained. Experimental results show better tradeoff between capacity and visual perceptivity compared to the existing algorithms. Maximum possible error analysis is evaluated for each of the wavelet subbands of an image.

Keywords: DWT, IWT, MSE, PSNR

Procedia PDF Downloads 478

Authors: Maja Pandža, Sanjin Lovrić, Iva Čolak, Josipa Mandarić, Miro Klarić

Abstract:

This study explores the role of symptoms related to mood disorders salience on different types of defense mechanisms (mature, neurotic, immature) predominance. Total of 177 both clinical and non-clinical participants in Mostar, Bosnia & Herzegovina, completed a battery of questionnaires associated with defense mechanisms and self-reported depression and anxiety symptoms. The sample was additionally divided into four groups, given the level of symptoms experienced: 1. minimal, 2. mild, 3. moderate, 4. severe depression/anxiety. Participants with minimal anxiety and depression symptoms use mature defense mechanisms more often than other three groups. Immature mechanisms are most commonly used by the group with severe depression/anxiety levels in comparison with other groups. These differences are discussed on the dynamic level of analysis to have a better understanding of the relationship between defense mechanisms' maturity and degree of mood disorders' symptom severity. Also, results given could serve as an implication for the psychotherapeutic treatment plans.

Keywords: anxiety/depression symptoms, clinical/non-clinical sample, defense mechanism maturity, dynamic approach

Procedia PDF Downloads 437