Search results for: diagnostic challenges

Authors: Yanhua Zhao, Yu Gou, Shu Feng, Dongdong Li, Chuanmin Tao

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The natural history of HBV infection could experience immune tolerant (IT), immune clearance (IC), HBeAg-negative inactive/quienscent carrier (ENQ), and HBeAg-negative hepatitis (ENH). As current biomarkers for discriminating these four phases have some weaknesses, additional serological indicators are needed. Hepatits B core-related antigen (HBcrAg) encoded with precore/core gene contains denatured HBeAg, HBV core antigen (HBcAg) and a 22KDa precore protein (p22cr), which was demonstrated to have a close association with natural history of hepatitis B infection, but no specific cutoff values and diagnostic parameters to evaluate the diagnostic efficacy. This study aimed to clarify the distribution of HBcrAg levels and evaluate its diagnostic performance during the natural history of infection from a Western Chinese perspective. 294 samples collected from treatment-naïve chronic hepatitis B (CHB) patients in different phases (IT=64; IC=72; ENQ=100, and ENH=58). We detected the HBcrAg values and analyzed the relationship between HBcrAg and HBV DNA. HBsAg and other clinical parameters were quantitatively tested. HBcrAg levels of four phases were 9.30 log U/mL, 8.80 log U/mL, 3.00 log U/mL, and 5.10 logU/mL, respectively (p < 0.0001). Receiver operating characteristic curve analysis demonstrated that the area under curves (AUCs) of HBcrAg and quantitative HBsAg at cutoff values of 9.25 log U/mL and 4.355 log IU/mL for distinguishing IT from IC phases were 0.704 and 0.694, with sensitivity 76.39% and 59.72%, specificity 53.13% and 79.69%, respectively. AUCs of HBcrAg and quantitative HBsAg at cutoff values of 4.15 log U/mlmL and 2.395 log IU/mlmL for discriminating between ENQ and ENH phases were 0.931 and 0.653, with sensitivity 87.93% and 84%, specificity 91.38% and 39%, respectively. Therefore, HBcrAg levels varied significantly among four natural phases of HBV infection. It had higher predictive performance than quantitative HBsAg for distinguishing between ENQ-patients and ENH-patients and similar performance with HBsAg for the discrimination between IT and IC phases, which indicated that HBcrAg could be a potential serological marker for CHB.

Keywords: chronic hepatitis B, hepatitis B core-related antigen, hepatitis B surface antigens, hepatitis B virus

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Authors: Arup Dutta, Badrul Alam, Sayed M. Wazed, Taslima Newaz, Srobonti Dutta

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Background: In today's world, with modern science and contemporary technology, a lot of diseases may be quickly identified and ruled out, but children's fever of unknown origin (FUO) still presents diagnostic difficulties in clinical settings. Any fever that reaches 38 °C and lasts for more than seven days without a known cause is now classified as a fever of unknown origin (FUO). Despite tremendous progress in the medical sector, fever of unknown origin, or FOU, persists as a major health issue and a major contributor to morbidity and mortality, particularly in children, and its spectrum is sometimes unpredictable. The etiology is influenced by geographic location, age, socioeconomic level, frequency of antibiotic resistance, and genetic vulnerability. Since there are currently no known diagnostic algorithms, doctors are forced to evaluate each patient one at a time with extreme caution. A persistent fever poses difficulties for both the patient and the doctor. This prospective, observational study was carried out in a Bangladeshi tertiary care hospital from June 2018 to May 2019 with the goal of identifying the epidemiological patterns of fever of unknown origin in pediatric patients. Methods: It was a hospital-based prospective observational study carried out on 106 children (between 2 months and 12 years) with prolonged fever of >38.0 °C lasting for more than 7 days without a clear source. Children with additional chronic diseases or known immunodeficiency problems were not allowed. Clinical practices that helped determine the definitive etiology were assessed. Initial testing included a complete blood count, a routine urine examination, PBF, a chest X-ray, CRP measurement, blood cultures, serology and additional pertinent investigations. The analysis focused mostly on the etiological results. The standard program SPSS 21 was used to analyze all of the study data. Findings: A total of 106 patients identified as having FUO were assessed, with over half (57.5%) being female and the majority (40.6%) falling within the 1 to 3-year age range. The study categorized the etiological outcomes into five groups: infections, malignancies, connective tissue conditions, miscellaneous, and undiagnosed. In the group that was being studied, infections were found to be the main cause in 44.3% of cases. Undiagnosed cases came in at 31.1%, cancers at 10.4%, other causes at 8.5%, and connective tissue disorders at 4.7%. Hepato-splenomegaly was seen in people with enteric fever, malaria, acute lymphoid leukemia, lymphoma, and hepatic abscesses, either by itself or in combination with other conditions. About 53% of people who were not diagnosed also had hepato-splenomegaly at the same time. Conclusion: Infections are the primary cause of PUO (pyrexia of unknown origin) in children, with undiagnosed cases being the second most common cause. An incremental approach is beneficial in the process of diagnosing a condition. Non-invasive examinations are used to diagnose infections and connective tissue disorders, while invasive investigations are used to diagnose cancer and other ailments. According to this study, the prevalence of undiagnosed diseases is still remarkable, so extensive historical analysis and physical examinations are necessary in order to provide a precise diagnosis.

Keywords: children, diagnostic challenges, fever of unknown origin, pediatric fever, undiagnosed diseases

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Authors: Diobein Flores, Venus Buagas, Virgie Darunday

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The study inventoried the species composition of terrestrial ferns and lycopods in Center for Ecological Development and Recreation (CEDAR) Impalutao, Impasug-ong, Bukidnon. Specifically, it aimed to determine and describe the species composition, and diagnostic characters of the ferns and lycopods in the study site. Transect walk method was employed in the inventory of the species. Each species were classified, identified and described according to its diagnostic characters. Results of the study revealed a total of 20 species of ferns and lycopods. Of these, 18 species were ferns and 2 species were lycopods. Eleven (11) families and fifteen (15) genera for ferns and one (1) family and one (1) genera for lycopods. Psomiocarpa apifolia is Philippine endemic and said to be vulnerable or threatened. Taxonomic characters based on habit, rhizome, leaf arrangement and orientation, stem structure and circinate vernation were used to identify the terrestrial pteridophtyes into families, genera and species. The species collected and assessment in CEDAR should be further investigated and monitor their conservation status.

Keywords: alpha taxonomy, conservation, habit, taxonomic characters

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Authors: Tlotlollo Sidwell Hlalele, Shengzhi Du

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High voltage transmission is the most pivotal process in the electrical power industry. It requires a robust infrastructure that can last for decades without causing impairment in human life. Due to the so-called global warming, power transmission system has started to experience some challenges which could presumably escalate more in future. These challenges are earthquake resistance, transmission power losses, and high electromagnetic field. In this paper, research efforts aim to address these challenges are discussed. We focus in particular on the research in regenerative electric energy such as: wind, hydropower, biomass and sea-waves based on the energy storage and transmission possibility. We conclude by drawing attention to specific areas that we believe need more research.

Keywords: power transmission, regenerative energy, power quality, energy storage

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Authors: Matthias Grunke

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In this qualitative study, we interviewed a young man with learning disabilities who played professional baseball for two years. Individuals with severe academic challenges constitute one of the most vulnerable groups of our society. Science has to find ways on how to arm them against life’s challenges and help them to cope with the many risk factors that they are usually confronted with. Team sports like baseball seem to be a suitable means for that purpose. In the interview, our participant talked about his life as a student with severe learning difficulties and related how his career in baseball made his academic challenges appear much less significant. He gave some meaningful insights into what helped him to build a happy and fulfilling life for himself, not only in spite of his challenges but also because of what he's learning disabilities taught him. Support from significant others, a sense of purpose, his fighting spirit ignited by sports, and the success that he experienced on the baseball field were among the most relevant factors. Overall, this study highlights the importance of finding an outlet for young people with learning disabilities where their academic difficulties retreat into the background and their talents are validated.

Keywords: baseball, inclusion, learning disabilities, resilience

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Authors: Paul Nadasdy

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In 2020, oral communication classes at many universities in Japan switched to online and hybrid lessons because of the coronavirus pandemic. Teachers had to adapt their practices immediately and deal with the challenges of the online environment. Even for experienced teachers, this still presented a problem as many had not conducted online classes before. Simultaneously, for many students, this type of learning was completely alien to them, and they had to adapt to the challenges faced by communicating in English online. This study collected data from 418 first grade students in the first semester of English communication classes at a technical university in Tokyo, Japan. Zoom software was used throughout the learning period. Though there were many challenges in the setting up and implementation of Zoom classes at the university, the results indicated that the students enjoyed the format and made the most of the circumstances. This proved the robustness of the course that was taught in regular lessons and the adaptability of teachers and students to challenges in a very short timeframe.

Keywords: zoom, hybrid lessons, communicative english, online teaching

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Authors: Sandani Muthukumarana, Pavithra Rathnasiri

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Climate change is one of the greatest challenges our generation faces, but by embracing biotechnology, we can turn this challenge into an opportunity to grow the economy. Biotechnology provides the sector with a range of solutions that help mitigate the effects of global warming. However, research efforts on investigating the potential and challenges for further utilization of biotechnology to mitigate climate change impacts are still lacking. To address this issue, existing context over the use of biotechnology for climate change mitigation, potential applications, practices being used, and challenges that exist need to be investigated to provide a broader understanding for future researchers and practitioners. This paper, therefore, reviews the existing literature addressing these perspectives to facilitate the application of biotechnology in mitigating hazards arising from climate change.

Keywords: climate change, impacts, biotechnology, solutions

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Authors: Mehrnaz Mostafavi, Mahtab Shabani, Alireza Azani, Fatemeh Ghafari

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Artificial intelligence (AI) can transform breast cancer diagnosis and therapy by providing sophisticated solutions for screening, imaging interpretation, histopathological analysis, and treatment planning. This literature review digs into the many uses of AI in breast cancer treatment, highlighting the need for collaboration between AI scientists and healthcare practitioners. It emphasizes advances in AI-driven breast imaging interpretation, such as computer-aided detection and diagnosis (CADe/CADx) systems and deep learning algorithms. These have shown significant potential for improving diagnostic accuracy and lowering radiologists' workloads. Furthermore, AI approaches such as deep learning have been used in histopathological research to accurately predict hormone receptor status and categorize tumor-associated stroma from regular H&E stains. These AI-powered approaches simplify diagnostic procedures while providing insights into tumor biology and prognosis. As AI becomes more embedded in breast cancer care, it is crucial to ensure its ethical, efficient, and patient-focused implementation to improve outcomes for breast cancer patients ultimately.

Keywords: breast cancer, artificial intelligence, cancer diagnosis, clinical practice

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Authors: Jerry Gyimah, Ernest Kissi, Safowaa Osei-Tutu, Charles Dela Adobor, Theophilus Adjei-Kumi, Ernest Osei-Tutu

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Price fluctuation contract is imperative and of paramount essence, in the construction industry as it provides adequate relief and cushioning for changes in the prices of input resources during construction. As a result, several methods have been devised to better help in arriving at fair recompense in the event of price changes. However, stakeholders often appear not to be satisfied with the existing methods of fluctuation evaluation, ostensibly because of the challenges associated with them. The aim of this study was to identify the challenges to the usage of building construction cost indices in Ghana. Data was gathered from contractors and quantity surveying firms. The study utilized a survey questionnaire approach to elicit responses from the contractors and the consultants. Data gathered was analyzed scientifically, using the relative importance index (RII) to rank the problems associated with the existing methods. The findings revealed the following, among others, late release of data, inadequate recovery of costs, and work items of interest not included in the published indices as the main challenges of the existing methods. Findings provide useful lessons for policymakers and practitioners in decision making towards the usage and improvement of available indices.

Keywords: building construction cost indices, challenges, usage, Ghana

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Authors: Eki Farlen, Akas

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Condition assessment of oil-paper-insulated power transformers, particularly of water content, is becoming increasingly important for aged transformers. As insulation ages, it can produce water, which reduces its dielectric strength, accelerates the cellulose ageing process, and causes gas bubbles to form at high temperatures. This paper mainly assesses the life condition of oil-paper insulation system of Inter Bus Transformer (IBT) 30 MVA, 150/30 kV in PT PLN-Substation Jelok that has been operating for 41 years, since 1974. Valuable information about the condition of high voltage insulation may be obtained by measuring its dielectric response. This paper describes in detail the interpretation of Dielectric Response Analysis (DIRANA) measurements and the test result compared to other insulation tests to get deep information for diagnostic, such as Tan delta test, oil characteristic test and Dissolve Gas Analysis (DGA) test. This paper mainly discusses the parameter relationship between moisture content, water content, acidity, oil conductivity and dissipation factor. The result and analysis show that IBT 30 MVA Jelok phase U and W had just been ageing due to high acidity level (>0.2 mgKOH/g) which cause high moisture in cellulose/paper (%) are in wet category about 4.7% and 5% and water content in oil (ppm) about 3.13 ppm and 3.33 ppm at temperature 20°C. High acidity level can make oxidation process and produce water in paper and particle which can decrease the value of Interfacial Tension (IFT) below 22 mN/m (poor category) for both phase U and W. Even if paper insulation of transformer are in wet condition, dissipation factor and capacitance at the same frequency (50 Hz) from both measurement DIRANA test and Tangent delta test give the same result (almost), the results are 0.69% and 0.71% (<1%), it may be acceptable and should not be investigated. The DGA results show that TDCG are in level one (1) condition and there are no found a Key Gases, it means that transformers had no failure during operation like arching, partial discharge and thermal in oil or cellulose.

Keywords: diagnostic, inter-bus transformer, oil-paper insulation, moisture, dissipation factor

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

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

Keywords: biopsy, medical imaging, nephrology, radiology

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Authors: ELdessouky Sheta, Sayed Elzomor, Haithem Farghali, Kawkab A. Ahmed, Naglaa A. Abd Elkader

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The present investigation has been dealt with Spirocerca (S.) lupi infested mongrel dogs. This parasitic disease is highly infective to human beings and carnivores. The diagnosis march has been comprised the lateral contrast thoracic radiographs, fecal examination, blood profile, endoscopic examination and histopathological sections of deep seated pinch biopsies. These infested dogs have been put under an adopted treatment with Ivermectin injection combined with oral prednisolone. The obtained results reveal an absence of the pessimistic recognitions particularly after 3 weeks from the onset of treatment. Endoscopically the presented esophageal nodules are marked out in the distal third of infested dogs' esophagus as masses assigned into the esophageal lumen and fundus of stomach. The endoscopic outlook of Spirocerca lupi lesions has been considered an integral procedure of the diagnostic march and for evaluation of treatment follow up. The diagnostic procedures and the recommended treatment are the vet's guidance to care for Spirocerca lupi in dogs, hoping in future to prevent this disease from being spread among human beings and other carnivores.

Keywords: endoscopy, esophagus, stomach spirocercosis, dogs

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Authors: Kefayatullah Wahidi

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This article examines the challenges and opportunities of intercultural communication in Afghanistan. Afghanistan, with its ancient history and location on the Silk Road, connects the great civilizations of the world. This country holds a sensitive strategic and geopolitical position in the Middle East. In Afghanistan, various ethnic groups live, each with distinct linguistic, religious, and racial cultures. In today's world, elements such as identity, religion, and culture form the main components of international political relations. In some cases, these factors can even overshadow the materialistic and self-interest-driven aspects of international relations. Therefore, we used a qualitative case study method (using interviews) for this research. In this context, we attempted to discuss the issues and problems related to the challenges and opportunities of intercultural communication, with the participation of a sample of 12 Afghan people. The findings of this research show that Afghanistan is facing many challenges in the field of intercultural communication. Cultural dissatisfaction, linguistic and religious differences, and cultural sanctions are among the major challenges that can cause tensions and a lack of mutual understanding. At the same time, intercultural communication is an opportunity to increase mutual understanding, cultural exchange, and constructive interactions. Please note that I have made some minor edits for clarity and grammar, but the overall content remains the same.

Keywords: cultural dissatisfactions, language differences, intercultural communication, Afghanistan

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Authors: Salah Algabli

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As online learning takes center stage; Arabic language instructors face the imperative to adapt their practices for the digital realm. This study investigates the experiences of online Arabic instructors to unveil the pedagogical opportunities and challenges this format presents. Utilizing a transcendental phenomenological approach with 15 diverse participants, the research shines a light on the unique realities of online language teaching at the university level, specifically in the United States. The study proposes theoretical and practical solutions to maximize the benefits of online language learning while mitigating its challenges. Recommendations cater to instructors, researchers, and program coordinators, paving the way for enhancing the quality of online Arabic language education. The findings highlight the need for pedagogical approaches tailored to the online environment, ultimately shaping a future where both instructors and learners thrive in this digital landscape.

Keywords: online Arabic language learning, pedagogical opportunities and challenges, online Arabic teachers, online language instruction, digital pedagogy

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Authors: Alex Eldo Simon, Abhishek Yadav

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This study aimed to evaluate the utility of postmortem computed tomography (CT) and heart weight measurements in the assessment of cardiomegaly in cases of sudden death due to cardiac origin by comparing the results of these two diagnostic methods. The study retrospectively analyzed postmortem computed tomography (PMCT) data from 54 cases of sudden natural death and compared the findings with those of the autopsy. The study involved measuring the cardiothoracic ratio (CTR) from coronal computed tomography (CT) images and determining the actual cardiac weight by weighing the heart during the autopsy. The inclusion criteria for the study were cases of sudden death suspected to be caused by cardiac pathology, while exclusion criteria included death due to unnatural causes such as trauma or poisoning, diagnosed natural causes of death related to organs other than the heart, and cases of decomposition. Sensitivity, specificity, and diagnostic accuracy were calculated, and to evaluate the accuracy of using the cardiothoracic ratio (CTR) to detect an enlarged heart, the study generated receiver operating characteristic (ROC) curves. The cardiothoracic ratio (CTR) is a radiological tool used to assess cardiomegaly by measuring the maximum cardiac diameter in relation to the maximum transverse diameter of the chest wall. The clinically used criteria for CTR have been modified from 0.50 to 0.57 for use in postmortem settings, where abnormalities can be detected by comparing CTR values to this threshold. A CTR value of 0.57 or higher is suggestive of hypertrophy but not conclusive. Similarly, heart weight is measured during the traditional autopsy, and a cardiac weight greater than 450 grams is defined as hypertrophy. Of the 54 cases evaluated, 22 (40.7%) had a cardiothoracic ratio (CTR) ranging from > 0.50 to equal 0.57, and 12 cases (22.2%) had a CTR greater than 0.57, which was defined as hypertrophy. The mean CTR was calculated as 0.52 ± 0.06. Among the 54 cases evaluated, the weight of the heart was measured, and the mean was calculated as 369.4 ± 99.9 grams. Out of the 54 cases evaluated, 12 were found to have hypertrophy as defined by PMCT, while only 9 cases were identified with hypertrophy in traditional autopsy. The sensitivity and specificity of the test were calculated as 55.56% and 84.44%, respectively. The sensitivity of the hypertrophy test was found to be 55.56% (95% CI: 26.66, 81.12¹), the specificity was 84.44% (95% CI: 71.22, 92.25¹), and the diagnostic accuracy was 79.63% (95% CI: 67.1, 88.23¹). The limitation of the study was a low sample size of only 54 cases, which may limit the generalizability of the findings. The comparison of the cardiothoracic ratio with heart weight in this study suggests that PMCT may serve as a screening tool for medico-legal autopsies when performed by forensic pathologists. However, it should be noted that the low sensitivity of the test (55.5%) may limit its diagnostic accuracy, and therefore, further studies with larger sample sizes and more diverse populations are needed to validate these findings.

Keywords: PMCT, virtopsy, CTR, cardiothoracic ratio

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Authors: Elham Shirvani–Ghadikolaei, Seyed Mahdi Sajjadi

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State of the art technology has the tremendous impact on our life, in this situation education system have been influenced as well as. In this paper, tried to compare two space of learning text and hypertext with each other, and some challenges of using hypertext in religious education. Regarding the fact that, hypertext is an undeniable part of learning in this world and it has highly beneficial for the education process from class to office and home. In this paper tried to solve this question: the consequences and challenges of applying hypertext in religious education. Also, the consequences of this survey demonstrate the role of curriculum designer and planner of education to solve this problem.

Keywords: Hyper-textual, learning, religious education, learning text

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Authors: Mini P. Singh, Manasi Majumdar, Kapil Goyal, Pvm Lakshmi, Deepak Bhatia, Radha Kanta Ratho

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India is endemic for Hepatitis E virus and frequent water borne outbreaks are reported. The conventional diagnosis rests on the detection of serum anti-HEV IgM antibodies which may take 7-10 days to develop. Early diagnosis in such a situation is desirable for the initiation of prompt control measures. The present study compared three diagnostic methods in 60 samples collected during two suspected HEV outbreaks in the vicinity of Chandigarh, India. The anti-HEV IgM, HEV antigen and HEV-RNA could be detected in serum samples of 52 (86.66%), 16 (26.66%) and 18 (30%) patients respectively. The suitability of saliva samples for antibody detection was also evaluated in 21 paired serum- saliva samples. A total of 15 serum samples showed the presence of anti HEV IgM antibodies, out of which 10 (10/15; 66.6%) were also positive for these antibodies in saliva samples (χ2 = 7.636, p < 0.0057), thus showing a concordance of 76.91%. The positivity of reverse transcriptase PCR and HEV antigen detection was 100% within one week of illness which declined to 5-10% thereafter. The outbreak was attributed to HEV Genotype 1, Subtype 1a and the clinical and environmental strains clustered together. HEV antigen and RNA were found to be an early diagnostic marker with 96.66% concordance. The results indicate that the saliva samples can be used as an alternative to serum samples in an outbreak situation.

Keywords: HEV-antigen, outbreak, phylogenetic analysis, saliva

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Authors: Peri Harish Kumar, Rafique Umer Harvitkar

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Background: The emergency department mandates maximum efficacy in the utilization of the available resources. Non-urgent patient visits pose a serious concern to the treatment, patient triage, and resources available. Aims and Objectives: We conducted a retrospective case-control study of the emergency department patient list from October 2019 to November 2022. A total of 839 patients formed part of the study. Somatic complaints, vital signs, diagnostic test results, admission to the hospital, etc., were some of the criteria used for the categorization of patients. Results: The proportion of non-urgent visits varied from 7.2% to 43%, with a median of 21%. Somatic complaints were the least associated with further hospital admissions (n=28%), while diagnostic test results were the most significant indicator of further hospital admissions (n=74%). Effective triage helped minimize emergency department admissions by 36%. Conclusion: Our study shows that effective triaging, patient counselling, and round-the-clock consumable monitoring helped in the effective management of patients admitted and also significantly helped provide treatment to the patients most in need.

Keywords: urgent visits, non-urgent visits, traiging, emergency department admissions

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Authors: Aysun Sezer

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Magnetic Resonance Imaging (MRI) is one of the advanced diagnostic tools for evaluating shoulder pathologies. Proton Density (PD)-weighted MRI sequences prove highly effective in detecting edema. However, they are deficient in the anatomical identification of bones due to a trauma-induced decrease in signal-to-noise ratio and blur in the traumatized cortices. Computer-based diagnostic systems require precise segmentation, identification, and localization of anatomical regions in medical imagery. Deep learning-based object detection algorithms exhibit remarkable proficiency in real-time object identification and localization. In this study, the YOLOv8 model was employed to detect humeral head and scapular regions in 665 axial PD-weighted MR images. The YOLOv8 configuration achieved an overall success rate of 99.60% and 89.90% for detecting the humeral head and scapula, respectively, with an intersection over union (IoU) of 0.5. Our findings indicate a significant promise of employing YOLOv8-based detection for the humerus and scapula regions, particularly in the context of PD-weighted images affected by both noise and intensity inhomogeneity.

Keywords: YOLOv8, object detection, humerus, scapula, IRM

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Authors: Rajeshkumar Mahendrabhai Patel, Narendrakumar D. Vasava

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It is seen that higher education in India requires a high degree of attention for the quality. The Government of India has been putting its efforts to improvise the quality of higher education through different means such as need based changes in the policy of higher education, accreditation of the institutions of higher education and many others. The Social Work education in India started way back in Tata School of Social Sciences in the year 1936. Gradually the need for social work education was felt, and different institution started imparting social work education in different regions. Due to the poor educational policy of Gujarat state (The Concept of Self-Financed Education) different Universities initiated the MSW program on a self-financed basis. The present scenario of the Social work Education in Gujarat faces ample challenges and problems which need to be addressed consciously. The present paper will try to examine and analyze the challenges and problems such as curriculum, staffing, quality of teaching, the pattern of education etc. The probable responses to this scenario are also discussed in this paper.

Keywords: social work education, challenges, problems, responses, self-financed education in Gujarat

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Authors: Lilian Noronha Nassif

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Cybercrime investigation demands an appropriated evidence collection mechanism. If the investigator does not acquire digital proofs in a forensic sound, some important information can be lost, and judges can discard case evidence because the acquisition was inadequate. The correct digital forensic seizing involves preparation of professionals from fields of law, police, and computer science. This paper presents important challenges faced during evidence collection in different perspectives of places. The crime scene can be virtual or real, and technical obstacles and privacy concerns must be considered. All pointed challenges here highlight the precautions to be taken in the digital evidence collection and the suggested procedures contribute to the best practices in the digital forensics field.

Keywords: digital evidence, digital forensics process and procedures, mobile forensics, cloud forensics

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Authors: Surafel Demissie, Frank Keenan, Fergal McCaffery

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Emerging medical devices are highly relying on embedded software that runs on the specific platform in real time. The development of embedded software is different from ordinary software development due to the hardware-software dependency. MDevSPICE^® has been developed to provide guidance to support such development. To increase the flexibility of this framework agile practices have been introduced. This paper outlines the challenges for embedded medical device software development and the structure of MDevSPICE^® and suggests a suitable combination of agile practices that will help to add flexibility and address corresponding challenges of embedded medical device software development.

Keywords: agile practices, challenges, embedded software, MDevSPICE®, medical device

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Authors: Marta Skwarecka, Patrycja Bloch, Rafal Walkusz, Oliwia Urbanowicz, Grzegorz Zielinski, Sabina Zoledowska, Dawid Nidzworski

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Upper respiratory tract infections are one of the most common reasons for visiting a general doctor. Streptococci are the most common bacterial etiological factors in these infections. There are many different types of Streptococci and infections vary in severity from mild throat infections to pneumonia. For example, S. pyogenes mainly contributes to acute pharyngitis, palatine tonsils and scarlet fever, whereas S. Streptococcus pneumoniae is responsible for several invasive diseases like sepsis, meningitis or pneumonia with high mortality and dangerous complications. There are only a few diagnostic tests designed for detection Streptococci from the infected throat of patients. However, they are mostly based on lateral flow techniques, and they are not used as a standard due to their low sensitivity. The diagnostic standard is to culture patients throat swab on semi selective media in order to multiply pure etiological agent of infection and subsequently to perform antibiogram, which takes several days from the patients visit in the clinic. Therefore, the aim of our studies is to develop and implement to the market a Point of Care device for the rapid identification of Streptococcus pyogenes and Streptococcus pneumoniae with simultaneous identification of antibiotic resistance genes. In the course of our research, we successfully selected genes for to-species identification of Streptococci and genes encoding antibiotic resistance proteins. We have developed a reaction to amplify these genes, which allows detecting the presence of S. pyogenes or S. pneumoniae followed by testing their resistance to erythromycin, chloramphenicol and tetracycline. What is more, the detection of β-lactamase-encoding genes that could protect Streptococci against antibiotics from the ampicillin group, which are widely used in the treatment of this type of infection is also developed. The test is carried out directly from the patients' swab, and the results are available after 20 to 30 minutes after sample subjection, which could be performed during the medical visit.

Keywords: antibiotic resistance, Streptococci, respiratory infections, diagnostic test

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Authors: Usiobaifo Agharese Rosemary, Osaseri Roseline Oghogho

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Diabetes is a complex group of disease with a variety of causes; it is a disorder of the body metabolism in the digestion of carbohydrates food. The application of machine learning in the field of medical diagnosis has been the focus of many researchers and the use of recognition and classification model as a decision support tools has help the medical expert in diagnosis of diseases. Considering the large volume of medical data which require special techniques, experience, and high diagnostic skill in the diagnosis of diseases, the application of an artificial intelligent system to assist medical personnel in order to enhance their efficiency and accuracy in diagnosis will be an invaluable tool. In this study will propose a diabetes diagnosis model using rough set and K-nearest Neighbor classifier algorithm. The system consists of two modules: the feature extraction module and predictor module, rough data set is used to preprocess the attributes while K-nearest neighbor classifier is used to classify the given data. The dataset used for this model was taken for University of Benin Teaching Hospital (UBTH) database. Half of the data was used in the training while the other half was used in testing the system. The proposed model was able to achieve over 80% accuracy.

Keywords: classifier algorithm, diabetes, diagnostic model, machine learning

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Authors: Iga Maliga

Abstract:

As developing country, Indonesia, retreatment for greywater is an important factor that guaranteeing water sustainability? But, its still not familiar in Indonesian society. Because they still use their old habit for wasting the water without retreatment. Differently, with industry wastewater, effect of domestic wastewater is not directly looked with naked eyes. Domestic wastewater that not gets treatment directly can affect pollution in water body or river. Its affected by accumulation many pollutants that include on water. This paper is trying to analyze the challenges and advantages on greywater treatment system based on Constructed Wetlands (CWs) system in Bandung, one of the biggest cities in Indonesia. Aside that, this paper also is trying to analyze sustainability aspects. There is economic, social and of course environment with two methods. The first, study literature is used to see the advantages and challenges that faced by Indonesia when CWs are applied. Secondly, quantitative method is used to get the society perception about retreatment of greywater. Then, it will get a conclusion that this technique not only good in theoretically but also practically.

Keywords: greywater, constructed wetlands, advantages, challenges, Bandung, sustainability analysis

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Authors: Clifford Kwakwa Amoah, De-Graft Owusu-Manu, Prince Antwi-Afari

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Infrastructure is the lifeline for economic development of any country. Hence, obtaining infrastructure quality cannot be overemphasized. Nevertheless, challenges of infrastructure quality persist, and it is worse in developing countries despite the diverse study on the subject matter. Therefore, this study was formulated to identify the prevalent determinants of infrastructure quality using synthesis of extant literature (to identify key variables), and analysis of survey questionnaire of data collected by means of the inductive methodology approach, mean score ranking and descriptive statistics. The variables “partner with the private sector, growth stimulation and poverty reduction, and adherence to procurement core principles” were the most significant challenges that the government faces. Moreover, it would be of utmost concern to adopt some stringent measures to help improve and accelerate on the growth and development of the nation, thereby achieving the best quality required. This study is novel conducted to provide insight into some of the punitive measures, considered in ensuring that quality infrastructure is obtained in both developing (specifically) and developed economies. The research findings therefore provide some guidance for overcoming the accumulative challenges. Application of the stated findings will help bridge the gap of infrastructure challenges; this is because the study found strong empirical evidence that infrastructure plays a pivotal role in the productivity enhancement.

Keywords: challenges, development, economic growth, government, infrastructure quality

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Authors: Maikudi Umar

Abstract:

This paper conceived Vocational and Technical Education as those aspects of educational process, in addition to general education leading to acquisition of practical skills, attitudes as well as basic scientific knowledge as it relates to occupations in various sectors of the economic and social life. The paper therefore viewed Vocational and Technical education as those aspects of educational training designed to provide the recipient with the skills abilities and understanding needed for efficient performance in chosen occupational carrier for self reliance. The paper also examined some major inhibitions to the attainment of self reliance through VTE. The paper also recommended a change of attitudes by governments in Nigeria by providing adequate equipment so as to meet up with the challenges.

Keywords: vocational education, technical education, skills and self reliance, issues and challenges

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Authors: Amira Ben Rabeh, Faouzi Benzarti, Hamid Amiri, Mouna Bouaziz

Abstract:

Alzheimer is a disease that affects the brain. It causes degeneration of nerve cells (neurons) and in particular cells involved in memory and intellectual functions. Early diagnosis of Alzheimer Diseases (AD) raises ethical questions, since there is, at present, no cure to offer to patients and medicines from therapeutic trials appear to slow the progression of the disease as moderate, accompanying side effects sometimes severe. In this context, analysis of medical images became, for clinical applications, an essential tool because it provides effective assistance both at diagnosis therapeutic follow-up. Computer Assisted Diagnostic systems (CAD) is one of the possible solutions to efficiently manage these images. In our work; we proposed an application to detect Alzheimer’s diseases. For detecting the disease in early stage we used the three sections: frontal to extract the Hippocampus (H), Sagittal to analysis the Corpus Callosum (CC) and axial to work with the variation features of the Cortex(C). Our method of classification is based on Support Vector Machine (SVM). The proposed system yields a 90.66% accuracy in the early diagnosis of the AD.

Keywords: Alzheimer Diseases (AD), Computer Assisted Diagnostic(CAD), hippocampus, Corpus Callosum (CC), cortex, Support Vector Machine (SVM)

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Authors: D. Sigirli

Abstract:

The Receiver Operating Characteristic (ROC) curve is a commonly used statistical tool for evaluating the diagnostic performance of screening and diagnostic test with continuous or ordinal scale results which aims to predict the presence or absence probability of a condition, usually a disease. When the test results were measured as numeric values, sensitivity and specificity can be computed across all possible threshold values which discriminate the subjects as diseased and non-diseased. There are infinite numbers of possible decision thresholds along the continuum of the test results. The ROC curve presents the trade-off between sensitivity and the 1-specificity as the threshold changes. The empirical ROC curve which is a non-parametric estimator of the ROC curve is robust and it represents data accurately. However, especially for small sample sizes, it has a problem of variability and as it is a step function there can be different false positive rates for a true positive rate value and vice versa. Besides, the estimated ROC curve being in a jagged form, since the true ROC curve is a smooth curve, it underestimates the true ROC curve. Since the true ROC curve is assumed to be smooth, several smoothing methods have been explored to smooth a ROC curve. These include using kernel estimates, using log-concave densities, to fit parameters for the specified density function to the data with the maximum-likelihood fitting of univariate distributions or to create a probability distribution by fitting the specified distribution to the data nd using smooth versions of the empirical distribution functions. In the present paper, we aimed to propose a smooth ROC curve estimation based on the boundary corrected kernel function and to compare the performances of ROC curve smoothing methods for the diagnostic test results coming from different distributions in different sample sizes. We performed simulation study to compare the performances of different methods for different scenarios with 1000 repetitions. It is seen that the performance of the proposed method was typically better than that of the empirical ROC curve and only slightly worse compared to the binormal model when in fact the underlying samples were generated from the normal distribution.

Keywords: empirical estimator, kernel function, smoothing, receiver operating characteristic curve

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Authors: Eltayeb Hamad Elneel Yousif

Abstract:

This paper describes occupational radiation doses of workers in non-destructive testing (NDT) and some medical practices during the year 2007. The annual doses received by the workers of a public hospital are presented in this report. The Department is facilitated with HARSHAW Reader model 6600 and assigned the rule of personal monitoring to contribute in controlling and reducing the doses received by radiation workers. TLD cards with two TLD chips type LiF: Mg, Ti (TLD-100) were calibrated to measure the personal dose equivalent Hp(10). Around 150 medical radiation workers were monitored throughout the year. Each worker received a single TLD card worn on the chest above lead apron and returned for laboratory reading every two months. The average annual doses received by the workers of radiotherapy, nuclear medicine and diagnostic radiology were evaluated. The annual doses for individual radiation workers ranged between 0.55-4.42 mSv, 0.48-1.86 mSv, and 0.48-0.91 mSv for the workers of radiotherapy, nuclear medicine and diagnostic radiology, respectively. The mean dose per worker was 1.29±1, 1.03±0.4, and 0.69±0.2 mSv, respectively. The results showed compliance with international dose limits. Our results reconfirm the importance of personal dosimetry service in assuring the radiation protection of medical staff in developing countries.

Keywords: radiation medicine, non-destructive testing, TLD, public hospital

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