Search results for: clinical records

Authors: Godfrey Nsereko, Daniel Kadobera, Denis Okethwangu, Joyce Nguna, Alex Riolexus Ario

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Background: Malaria is a leading cause of morbidity and mortality in Uganda. In April 2018, malaria cases surged in Nwoya District, northern Uganda, exceeding the action thresholds. We investigated to assess the outbreak’s magnitude, identify transmission risk factors, and recommend evidence-based control measures. Methods: We defined a malaria case as onset of fever in a resident of Nwoya District with a positive Rapid Diagnostic Test or microscopy for malaria P. falciparum from 1 February to 22 May 2018. We reviewed medical records in all health facilities of affected sub-counties to find cases. In a case-control study, we compared exposure risk factors between 107 case-persons and 107 asymptomatic controls matched by age and village. We conducted entomological assessment on vector-density and behavior. Results: We identified 3,879 case-persons (attack rate [AR]=6.5%) and 2 deaths (case-fatality rate=5.2/10,000). Females (AR=8.1%) were more affected than males (AR=4.7%). Of all age groups, the 5-18 year age group (AR=8.4%) was most affected. Heavy rain started on 4 March; a propagated outbreak began during the week of 2 April. In the case-control study, 55% (59/107) of case-patients and 18% (19/107) of controls had stagnant water around households for several days following rainfall (ORM-H=5.6, 95%CI=3.0-11); 25% (27/107) of case-patients and 51% (55/107) of controls wore long-sleeve cloths during evening hours (ORM-H=0.30, 95%CI=0.20-0.60); 29% (31/107) of case-patients and 15% (16/107) of controls did not sleep under a long-lasting insecticide-treated net (LLIN) (ORM-H=2.3, 95%CI=1.1-4.9); 37% (40/107) of case-patients and 52% (56/107) of controls had ≥1 LLIN per 2 household members (ORM-H=0.54, 95%CI=0.30-0.97). Entomological assessment indicated active breeding sites; Anopheles gambiae sensu lato species were the predominant vector. Conclusion: Increased vector breeding sites after heavy rainfall, together with inadequate malaria preventive measures caused this outbreak. We recommended increasing coverage for LLINs and larviciding breeding sites.

Keywords: malaria outbreak, Plasmodium falciparum, global health security, Uganda

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Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

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Introduction: Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease of unknown cause. Concomitant autoimmune disorders have been described in 30–50% of patients with AIH. The aim of our study is to determine the prevalence and the type of autoimmune disorders associated with AIH. Material and Methods: It is a retrospective study over a period of 16 years (2000-2015) including all patients followed for AIH. The diagnosis of AHI was based on the criteria of the revised International AIH group scoring system (IAIHG). Results: Twenty-for patients (21 women and 3 men) followed for AIH were collected. The mean age was 39 years (17-65 years). Among these patients, 11 patients(45.8%) had at least one autoimmune disease associated to AIH. These diseases were Hashimoto's thyroiditis (n = 5), Gougerot Sjogren syndrome (n=5), Primary biliary cirrhosis (n=2), Primitive sclerosant Cholangitis (n=1), Addison disease (n = 1) and systemic sclerosis (n=1). Patients were treated with corticosteroids alone or with azathioprine associated to the specific treatment of associated diseases with complete remission of AIH in 90% of cases and clinical improvement of other diseases. Conclusion: In our study, the prevalence of autoimmune diseases in AIH patients was 45.8%. These diseases were dominated by autoimmune thyroiditis and Gougerot Sjogren syndrome. The investigation of autoimmune diseases in autoimmune hepatitis must be systematic because of their frequency and the importance of adequate management.

Keywords: autoimmune diseases, autoimmune hepatitis, autoimmune thyroiditis, gougerot sjogren syndrome

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Authors: Tahmeena Ali, Andrew Francis, Keong Yap, Sharynn Schuster

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Social anxiety is a chronic and debilitating condition characterized by fear and avoidance of social situations. Several risk factors have emerged, which emphasize the role of early childhood experiences in the development of this condition. As such, the current study tested the hypothesis that early maladaptive schemas (EMSs) mediate the relationship between retrospectively reported parental criticism and social anxiety whilst controlling the effects of depression. Three hundred and thirty-four non-clinical participants completed an online questionnaire consisting of self-report measures of parental criticism, EMSs of disconnection and rejection, and symptoms of social anxiety and depression. The mediation analysis confirmed the hypothesized model, indicating that EMSs mediated the relationship between parental criticism and social anxiety symptoms when controlling for depression. Whilst the current study is limited due to its cross-sectional design, the findings lend support to the developmental formulations of social anxiety and have important therapeutic implications for treatment.

Keywords: early maladaptive schema, parental criticism, schema, social anxiety

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Authors: H. Namazi, H. T. N. Kuan

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Brain activity can be measured by acquiring and analyzing EEG signals from an individual. In fact, the human brain response to external and internal stimuli is mapped in his EEG signals. During years some methods such as Fourier transform, wavelet transform, empirical mode decomposition, etc. have been used to analyze the EEG signals in order to find the effect of stimuli, especially external stimuli. But each of these methods has some weak points in analysis of EEG signals. For instance, Fourier transform and wavelet transform methods are linear signal analysis methods which are not good to be used for analysis of EEG signals as nonlinear signals. In this research we analyze the brain response to visual stimuli by extracting information in the form of various measures from EEG signals using a software developed by our research group. The used measures are Jeffrey’s measure, Fractal dimension and Hurst exponent. The results of these analyses are useful not only for fundamental understanding of brain response to visual stimuli but provide us with very good recommendations for clinical purposes.

Keywords: visual stimuli, brain response, EEG signal, fractal dimension, hurst exponent, Jeffrey’s measure

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Authors: Portia Murphy, Danica Vasic, Anoja W. Gunaratne, Encarnita Sitchon, Teresita Tugonon, Marou Ison, Antoinette Le Busque, Christelle Pagonis, Thomas J. Borody

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Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that affects an estimated 11% of the population globally with the most predominant symptoms being abdominal pain, bloating and altered bowel movements. All age groups suffer from IBS although the prevalence of IBS decreases for age groups over 50 years. Women are more likely to suffer from IBS than men. IBS can be categorized into 3 groups based on the type of altered bowel movement: diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-C) and IBS with mixed bowel habit (IBS-M). The contribution of the gut microbiome to the etiology of IBS is becoming increasingly recognized with rising use of anti-microbial agents. Previous studies on vancomycin and rifaximin used as monotherapy or in combination have been conducted mainly on IBS-C and showed marked improvements in the symptoms. According to our knowledge, no studies reported using these two combinations of antibiotics for IBS-D. Here, we report a consecutive cohort of 18 patients treated with both vancomycin and rifaximin for IBS-D. These patients’ records were reviewed retrospectively. In this cohort, patients ages were between 24-74 years (mean 44 years) and 9 were female. Baseline all patients had diarrhea, 4 with mucus and one with blood. Patients reported other symptoms were abdominal pain (n=11) bloating (n=9), flatulence (n=7), fatigue (n=4) and nausea (n=3). Patients treatments were personalized according to their symptom severity and tolerability and were treated with combination of rifaximin (500 - 3000mg/d) and vancomycin (500mg - 1500mg/d) for an ongoing period. Follow-ups were conducted between 2-32 weeks’ time. Of all patients, 89% patients reported improvement of the symptoms, 1 reported no change and 1 patient’s symptoms got worse. The mechanism of action for both vancomycin and rifaximin involves the inhibition of bacterial cell wall and protein synthesis respectively. The role of these medications in improving the symptoms of this cohort suggests that IBS-D may be microbiome infection driven. In this cohort, similar patient presentations to Clostridium difficile, as well as symptom improvement with the use of rifaximin and particularly vancomycin, suggest that the infectious agent may be an unidentified Clostridium. These preliminary results offer an alternative etiology for IBS-D not previously considered and open the avenue for new research.

Keywords: clostridium deficile, diarrhea predominant Irritable Bowel Syndrome, microbiome, vancomycin/rifaximin combination

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Authors: Ufuk Tosun, Reza Aghazadeh, Mehmet Bülent Özer

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This study puts forward a method to analyze the sloshing characteristics of liquid in a tuned sloshing absorber system by using image processing tools. Tuned sloshing vibration absorbers have recently attracted researchers’ attention as a seismic load damper in constructions due to its practical and logistical convenience. The absorber is liquid which sloshes and applies a force in opposite phase to the motion of structure. Experimentally characterization of the sloshing behavior can be utilized as means of verifying the results of numerical analysis. It can also be used to identify the accuracy of assumptions related to the motion of the liquid. There are extensive theoretical and experimental studies in the literature related to the dynamical and structural behavior of tuned sloshing dampers. In most of these works there are efforts to estimate the sloshing behavior of the liquid such as free surface motion and total force applied by liquid to the wall of container. For these purposes the use of sensors such as load cells and ultrasonic sensors are prevalent in experimental works. Load cells are only capable of measuring the force and requires conducting tests both with and without liquid to obtain pure sloshing force. Ultrasonic level sensors give point-wise measurements and hence they are not applicable to measure the whole free surface motion. Furthermore, in the case of liquid splashing it may give incorrect data. In this work a method for evaluating the sloshing wave height by using camera records and image processing techniques is presented. In this method the motion of the liquid and its container, made of a transparent material, is recorded by a high speed camera which is aligned to the free surface of the liquid. The video captured by the camera is processed frame by frame by using MATLAB Image Processing toolbox. The process starts with cropping the desired region. By recognizing the regions containing liquid and eliminating noise and liquid splashing, the final picture depicting the free surface of liquid is achieved. This picture then is used to obtain the height of the liquid through the length of container. This process is verified by ultrasonic sensors that measured fluid height on the surface of liquid.

Keywords: fluid structure interaction, image processing, sloshing, tuned liquid damper

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Authors: Mo Zhou, Samantha Ashby, Lyn Ebert

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In China, the changes that men experience in the perinatal period are not well researched. Men are also at risk of maladaptation to parenthood. The aim of this research is to review current studies regarding changes that Chinese men experience during transitioning to parenthood. 5 databases were employed to search relevant papers. The search found 128 articles. Based on the inclusion and exclusion criteria, 35 articles were included in this integrative review. Results showed the changes that Chinese fathers experienced during the transition to parenthood can be divided into two aspects: family relationships and mental problems. During transition to parenthood, fathers usually experienced an increase in their disappointment with marital conflict resolution and decreased sexual intimacy with their partner. Mental health declined, with fathers often feeling depressed and/or anxious during this time. Some men were diagnosed with clinical depression. The predictors of these changes included three domains: personal background (age and income), family background (gender of infant, relationship status and unplanned child) and cultural background (‘doing the month’, Confucianism, policy, social support).

Keywords: China, men, fatherhood, life change, postpartum

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Authors: Brendan Mooney

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We often do not consider the quality of the way we express ourselves as being fundamental to well-being. Society focuses predominantly on what we do, not the way we do it, to our great detriment. For example, those who have experienced domestic violence often comment that it was not what was said that hurt the most but the way it was said. In other words, the quality in the way the words were used communicated far more than the actual words themselves. This is an important area of focus for practitioners who may be inclined to emphasize who said what but not bring equal, if not more, focus to the quality of one’s expression. The aim of this study is to highlight how and why the way we express ourselves is more important than what we express, which includes words and all behaviors. Given we are a sensitive species it matters to pay attention to the communication that is not said. For example, we have the ability to recognize that a person is upset or angry by the way they walk into a room, even if they do not say anything or look at anyone. Our sensitivity allows us to detect even the slightest change in another’s emotional state, irrespective of what their exterior behaviors may be exhibiting. This study will focus on the importance of recognizing the quality in the way we express as being fundamental to wellbeing, as it allows us to easily and simply navigate life and relationships without needing to experience the usual pitfalls that otherwise prevail. This research utilizes clinical experience, client observations and client feedback, and several case studies were utilized to illustrate real-life examples of the above. This study is not so much a model of life but a way of life that confirms our deepest nature, that we are incredibly sensitive and far more so than we appreciate or utilize in everyday practical human life.

Keywords: communication, integrity, quality, sensitivity, wellbeing

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Authors: Adriana Haulica

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Powered by Machine Learning, Precise medicine is tailored by now to use genetic and molecular profiling, with the aim of optimizing the therapeutic benefits for cohorts of patients. As the majority of Machine Language algorithms come from heuristics, the outputs have contextual validity. This is not very restrictive in the sense that medicine itself is not an exact science. Meanwhile, the progress made in Molecular Biology, Bioinformatics, Computational Biology, and Precise Medicine, correlated with the huge amount of human biology data and the increase in computational power, opens new healthcare challenges. A more accurate diagnosis is needed along with real-time treatments by processing as much as possible from the available information. The purpose of this paper is to present a deeper vision for the future of Artificial Intelligence in Precise medicine. In fact, actual Machine Learning algorithms use standard mathematical knowledge, mostly Euclidian metrics and standard computation rules. The loss of information arising from the classical methods prevents obtaining 100% evidence on the diagnosis process. To overcome these problems, we introduce MEDICOMPILLS, a new architectural concept tool of information processing in Precise medicine that delivers diagnosis and therapy advice. This tool processes poly-field digital resources: global knowledge related to biomedicine in a direct or indirect manner but also technical databases, Natural Language Processing algorithms, and strong class optimization functions. As the name suggests, the heart of this tool is a compiler. The approach is completely new, tailored for omics and clinical data. Firstly, the intrinsic biological intuition is different from the well-known “a needle in a haystack” approach usually used when Machine Learning algorithms have to process differential genomic or molecular data to find biomarkers. Also, even if the input is seized from various types of data, the working engine inside the MEDICOMPILLS does not search for patterns as an integrative tool. This approach deciphers the biological meaning of input data up to the metabolic and physiologic mechanisms, based on a compiler with grammars issued from bio-algebra-inspired mathematics. It translates input data into bio-semantic units with the help of contextual information iteratively until Bio-Logical operations can be performed on the base of the “common denominator “rule. The rigorousness of MEDICOMPILLS comes from the structure of the contextual information on functions, built to be analogous to mathematical “proofs”. The major impact of this architecture is expressed by the high accuracy of the diagnosis. Detected as a multiple conditions diagnostic, constituted by some main diseases along with unhealthy biological states, this format is highly suitable for therapy proposal and disease prevention. The use of MEDICOMPILLS architecture is highly beneficial for the healthcare industry. The expectation is to generate a strategic trend in Precise medicine, making medicine more like an exact science and reducing the considerable risk of errors in diagnostics and therapies. The tool can be used by pharmaceutical laboratories for the discovery of new cures. It will also contribute to better design of clinical trials and speed them up.

Keywords: bio-semantic units, multiple conditions diagnosis, NLP, omics

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Authors: Dilesh Mogre, Jitendra Toravi, Saurabh Joshi, Prutha Deshpande, Aishwarya Kura

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In earlier days of technology, it was not possible to understand the nature of complex biomedical problems and were only left to clinical postulations. With advancement in science today, we have tools like Finite Element Modelling and simulation to solve complex biomedical problems. This paper presents how ANSYS WORKBENCH can be used to study deformation of pneumatized sphenoid bone caused by increased intracranial pressure. Intracranial pressure refers to the pressure inside the skull. The increase in the pressure above the normal range of 15mmhg can lead to serious conditions due to developed stresses and deformation. One of the areas where the deformation is suspected to occur is Sphenoid Bone. Moreover, the varying degree of pneumatization increases the complexity of the conditions. It is necessary to study deformation patterns on pneumatized sphenoid bone model at elevated intracranial pressure. Finite Element Analysis plays a major role in developing and analyzing model and give quantitative results.

Keywords: intracranial pressure, pneumatized sphenoid bone, deformation, finite element analysis

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Authors: Nicolas Bae, Theodore L. Karavasilis

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Increasingly, a large number of new and existing tall buildings are required to improve their resilient performance against strong winds and earthquakes to minimize direct, as well as indirect damages to society. Those advent stationary functions of tall building structures in metropolitan regions can be severely hazardous, in socio-economic terms, which also increase the requirement of advanced seismic performance. To achieve these progressive requirements, the seismic reinforcement for some old, conventional buildings have become enormously costly. The methods of increasing the buildings’ resilience against wind or earthquake loads have also become more advanced. Up to now, vibration control devices, such as the passive damper system, is still regarded as an effective and an easy-to-install option, in improving the seismic resilience of buildings at affordable prices. The main purpose of this paper is to examine 1) the optimization of the shape of visco plastic brace damper (VPBD) system which is one of hybrid damper system so that it can maximize its energy dissipation capacity in tall buildings against wind and earthquake. 2) the verification of the seismic performance of the visco plastic brace damper system in tall buildings; up to forty-storey high steel frame buildings, by comparing the results of Non-Linear Response History Analysis (NLRHA), with and without a damper system. The most significant contribution of this research is to introduce the optimized hybrid damper system that is adequate for high rise buildings. The efficiency of this visco plastic brace damper system and the advantages of its use in tall buildings can be verified since tall buildings tend to be affected by wind load at its normal state and also by earthquake load after yielding of steel plates. The modeling of the prototype tall building will be conducted using the Opensees software. Three types of modeling were used to verify the performance of the damper (MRF, MRF with visco-elastic, MRF with visco-plastic model) 22-set seismic records used and the scaling procedure was followed according to the FEMA code. It is shown that MRF with viscous, visco-elastic damper, it is superior effective to reduce inelastic deformation such as roof displacement, maximum story drift, roof velocity compared to the MRF only.

Keywords: tall steel building, seismic retrofit, viscous, viscoelastic damper, performance based design, resilience based design

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Authors: Bheki R. Mngomezulu

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The present paper cogently and systematically traces the history of Umkhonto Wesizwe (MK) and identifies its important role in shaping South Africa’s post-apartheid foreign policy and international relations under black leadership. It provides the political and historical contexts within which we can interpret and better understand South Africa’s controversial ‘Quiet Diplomacy’ approach to Zimbabwe’s endemic political and economic crises, which have dragged for too long. On 16 December 1961, the African National Congress (ANC) officially launched the MK as its military wing. The main aim was to train liberation fighters outside South Africa who would return into the country to topple the apartheid regime. Subsequently, the ANC established links with various countries across Africa and the globe in order to solicit arms, financial resources and military training for its recruits into the MK. Drawing from archival research and empirical data obtained through oral interviews that were conducted with some of the former MK cadres, this paper demonstrates how the ANC forged relations with a number of countries that were like-minded in order to ensure that its dream of removing the apartheid government became a reality. The findings reveal that South Africa’s foreign policy posture and international relations after the demise of apartheid in 1994 built on these relations. As such, even former and current socialist countries that were frowned upon by the Western world became post-apartheid South Africa’s international partners. These include countries such as Cuba and China, among others. Even countries that were not recognized by the Western world as independent states received good reception in post-apartheid South Africa’s foreign policy agenda. One of these countries is Palestine. Within Africa, countries with questionable human rights records such as Nigeria and Zimbabwe were accommodated in South Africa’s foreign policy agenda after 1994. Drawing from this history, the paper concludes that it would be difficult to fully understand and appreciate South Africa’s foreign policy direction and international relations after 1994 without bringing the history and the politics of the MK into the equation. Therefore, the paper proposes that the utilitarian role of history should never be undermined in the analysis of a country’s foreign policy direction and international relations. Umkhonto Wesizwe and South Africa are used as examples to demonstrate how such a link could be drawn through archival and empirical evidence.

Keywords: African National Congress, apartheid, foreign policy, international relations

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Authors: Lily Beaumont-Griffin, Philip Reynolds, Helen Pote, Pinder Kaur

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Siblings are a key part of the family unit, which Multisystemic Therapy (MST) intervenes, with the aim of reducing antisocial behavior and keeping families together. However, despite operating in multiple countries, including the United States of America, Europe, parts of South America, and the Western Hemisphere, there are only few previous studies on siblings within MST. According to best of authors knowledge neither of these seeks to understand the siblings' experience of the intervention nor their perception of the outcomes. This study utilized semi-structured interviews to understand the experience of seven siblings of children and adolescents who were closed to MST within the last year (2023-2024). Using reflexive thematic analysis, three themes were identified: sibling inclusion by the therapist, sharing responsibility for change, and fostering a safe and supportive environment at home. These themes express that siblings need to have a basic understanding of an intervention to be able to perceive benefits, siblings need help understanding responsibility across the whole family, and that safety is both physical and emotional. Clinical implications, including encouragement of therapists to integrate the siblings in the intervention more, and future research directions around integrating these findings into the development of iterations of MST standard are discussed.

Keywords: siblings, multisystemic therapy, family therapy, experience

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Authors: Ines Zemni, Maher Slimane, Jamel Ben Hassouna, Khaled Rahal

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Background: Neurofibromatosis type 1 (NF1) is a genetic disease, which is associated with an increased risk of developing different malignancies including breast cancer. The association between NF1 band breast sarcoma is a rare entity. Herein we present a 25-year-old woman with NF1 who had fibrosarcoma of the left breast. Case presentation: The patient has multiple thoraco-abdominal 'café au lait' spots. Clinical examination showed a lump of the left breast measuring 9 cm of diameter, which was noticed for 6 months. There was a left inguinal mass of 6 cm of diameter. The patient underwent first a left lumpectomy. Histopathological exam revealed a high-grade fibrosarcoma of the left breast measuring 7.5 cm. Three months later, the patient underwent a left mastectomy and excision of the inguinal mass, which was a neurofibroma. An adjuvant chemotherapy and radiation therapy were indicated, but not applied because of the timeout. The patient is now alive after a follow up of 6 years, with no loco-regional recurrence or metastasis. Conclusion: The relationship between NF1 and breast cancer need to be more clarified by further studies. Establishing a specific screening program of these patients may help to make an earlier diagnosis of breast cancer.

Keywords: neurofibromatosis, breast, sarcoma, cancer

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Authors: Abder-Rahman Ali, Antoine Vacavant, Manuel Grand-Brochier, Adélaïde Albouy-Kissi, Jean-Yves Boire

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In this paper, we present a new segmentation approach for liver lesions in regions of interest within MRI (Magnetic Resonance Imaging). This approach, based on a two-cluster Fuzzy C-Means methodology, considers the parameter variable compactness to handle uncertainty. Fine boundaries are detected by a local recursive merging of ambiguous pixels with a sequential forward floating selection with Zernike moments. The method has been tested on both synthetic and real images. When applied on synthetic images, the proposed approach provides good performance, segmentations obtained are accurate, their shape is consistent with the ground truth, and the extracted information is reliable. The results obtained on MR images confirm such observations. Our approach allows, even for difficult cases of MR images, to extract a segmentation with good performance in terms of accuracy and shape, which implies that the geometry of the tumor is preserved for further clinical activities (such as automatic extraction of pharmaco-kinetics properties, lesion characterization, etc).

Keywords: defuzzification, floating search, fuzzy clustering, Zernike moments

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Authors: Sara Pereira-Nogueira, Tim Worbs, Marc Permanyer-Bosser, Reinhold Förster

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While the entry mechanism of lymphocytes into the lymph node via the blood are well described, it is still largely unknown how cells enter lymph nodes that arrive via afferent lymphatics. In order to address this, our group has established a micro-injection technique in mice through which cells are delivered directly into the lymphatic vessel immediately afferent to the popliteal lymph node. Injected cells can then be tracked via multi-colour fluorescence or 2-photon microscopy, and their localization can be analysed within the popliteal or downstream lymph nodes by immunohistology. Since naïve B cells express the chemokine receptor CXCR5 we intra-lymphatically co-injected B cells derived from wildtype and Cxcr5-deficient mice. While CXCR5 does not play a role in guiding B cells out of the subcapsular sinus, it affects their positioning within the lymph node parenchyma, since CXCR5-deficient B cells are impaired in migrating into the B cell follicle. The knowledge obtained by studying B-cell migration may prove beneficial in clinical settings regarding tumor metastasis or autoimmune diseases.

Keywords: afferent lymphatics, B cell migration, chemokine, intra-lymphatic injection

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Authors: Chang Soo Chon, Cheol Woong Ko, Han Sung Kim

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The aim of this study is to develop an anterior lumbar interbody fusion (ALIF) PEEK cage suitable for Korean people. In this study, CT images were obtained from Korean male (173cm, 71kg) and 3D Korean lumbar models were reconstructed based on the CT images to investigate anatomical characteristics. Major design parameters of anterior lumbar interbody fusion (ALIF) PEEK Cage were selected using the morphological measurement information of the Korean Lumbar models. Through finite element analysis and mechanical tests, the developed ALIF PEEK Cage prototype was compared with the Fidji Cage (Zimmer.Inc, USA) and it was found that the ALIF prototype showed similar and/or superior mechanical performance compared to the FidJi Cage. Also, clinical validation for the ALIF PEEK Cage prototype was carried out to check predictable troubles in surgical operations. Finally, it is considered that the convenience and stability of the prototype was clinically verified.

Keywords: inter-body anterior fusion, ALIF cage, PEEK, Korean lumbar, CT image, animal test

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Authors: Mariola Głowacka

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Aim: The aim of this study was to present the assessment of dyspnea and anxiety in seniors staying in the hospice in the context of the nurse's tasks. Materials and methods: The presented research was carried out at the "Hospicjum Płockie" Association of St. Urszula Ledóchowska in Płock, in a stationary ward, for adults. The research group consisted of 100 people, women, and men. In the study described in this paper, the method of diagnostic survey, the method of estimation and analysis of patient records were used, and the research tools were the numerical scale of the NRS assessment, the modified Borg scale to assess dyspnea, the Trait Anxiety scale to test the intensity of anxiety and the sociodemographic assessment of the respondent. Results: Among the patients, the greatest number were people without dyspnoea (38 people) and with average levels of dyspnoea (26 people). People with lung cancer had a higher level of breathlessness than people with other cancers. Half of the patients included in the study felt anxiety at a low level. On average, men had a higher level of anxiety than women. Conclusion: 1) Patients staying in the hospice require comprehensive nursing care due to the underlying disease, comorbidities, and a wide range of medications taken, which aggravate the feeling of dyspnea and anxiety. 2) The study showed that in patients staying in the hospice, the level of dyspnea was of varying severity. The greatest number of people were without dyspnea (38) and patients with a low level of dyspnea (34). There were 12 people experiencing an average level of dyspnea and a high level of dyspnea 15. 3) The main factor influencing the severity of dyspnea in patients was the location of cancer. There was no significant relationship between the intensity of dyspnea and the age, gender of the patient, and time from diagnosis. 4) The study showed that in patients staying in the hospice, the level of anxiety was of varying severity. Most people experience a low level of anxiety (51). There were 16 people with a high level of anxiety, while there were 33 people experiencing anxiety at an average level. 5) The patient's gender was the main factor influencing the increase in anxiety intensity. Men had higher levels of anxiety than women. There was no significant correlation between the intensity of anxiety and the age of the respondents, as well as the type of cancer and time since diagnosis. 6) The intensity of dyspnea depended on the type of cancer the subjects had. People with lung cancer had a higher level of breathlessness than those with breast cancer and bowel cancer. It was not found that the anxiety increased depending on the type of cancer and comorbidities of the examined person.

Keywords: cancer, shortness of breath, anxiety, senior, hospice

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Authors: Mrinal Kanti Bhowmik, Shawli Bardhan Jr., Debotosh Bhattacharjee

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Human skin containing temperature value more than absolute zero, discharges infrared radiation related to the frequency of the body temperature. The difference in infrared radiation from the skin surface reflects the abnormality present in human body. Considering the difference, detection and forecasting the temperature variation of the skin surface is the main objective of using Medical Infrared Thermography(MIT) as a diagnostic tool for pain detection. Medical Infrared Thermography(MIT) is a non-invasive imaging technique that records and monitors the temperature flow in the body by receiving the infrared radiated from the skin and represent it through thermogram. The intensity of the thermogram measures the inflammation from the skin surface related to pain in human body. Analysis of thermograms provides automated anomaly detection associated with suspicious pain regions by following several image processing steps. The paper represents a rigorous study based survey related to the processing and analysis of thermograms based on the previous works published in the area of infrared thermal imaging for detecting inflammatory pain diseases like arthritis, spondylosis, shoulder impingement, etc. The study also explores the performance analysis of thermogram processing accompanied by thermogram acquisition protocols, thermography camera specification and the types of pain detected by thermography in summarized tabular format. The tabular format provides a clear structural vision of the past works. The major contribution of the paper introduces a new thermogram acquisition standard associated with inflammatory pain detection in human body to enhance the performance rate. The FLIR T650sc infrared camera with high sensitivity and resolution is adopted to increase the accuracy of thermogram acquisition and analysis. The survey of previous research work highlights that intensity distribution based comparison of comparable and symmetric region of interest and their statistical analysis assigns adequate result in case of identifying and detecting physiological disorder related to inflammatory diseases.

Keywords: acquisition protocol, inflammatory pain detection, medical infrared thermography (MIT), statistical analysis

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Authors: Eman Tadros, Natasha Finney

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The following case study involving a high-conflict, Children’s Services Bureau (CSB) referred couple is analyzed and reviewed through an integrated lens of structural family therapy and dialectical behavior therapy. In structural family therapy, normal family development is not characterized by a lack of problems, but instead by families’ having developed a functional structure for dealing with their problems. Whereas, in dialectical behavioral therapy normal family development can be characterized by having a supportive and validating environment, where all family members feel a sense of acceptance and validation for who they are and where they are in life. The clinical case conceptualization highlights the importance of conceptualizing how change occurs within a therapeutic setting. In the current case study, the couple did not only experience high-conflict, but there were also issues of substance use, health issues, and other complicating factors. Clinicians should view their clients holistically and tailor their treatment to fit their unique needs. In this framework, change occurs within the family unit, by accepting each member as they are, while at the same time working together to change maladaptive familial structures.

Keywords: couples, dialectical behavior therapy, high-conflict, structural family therapy

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Authors: Olga Smilevska Spasova, Katerina Boshkovska, Gorica Popova, Mirjana Popovska

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Introduction: Pneumonia is an infection of the pulmonary parenchyma. HPIV 3 is one of four viruses that is a member of the Paramyxoviridae family designated types 1-4 that have a nonsegmented, single-stranded RNA genome with a lipid-containing envelope. They are spread from the respiratory tract by aerosolized secretions or by direct contact with secretions. Type 3 is endemic and can cause serious illness in immunocompromised patients. Illness caused by parainfluenza occurs shortly after inoculation with the virus. The level of immunoglobulin A antibody in serum is the best predictor of susceptibility to infection. Streptococcus pneumonia or pneumococcus is a Gram-positive, spherical bacteria, usually found in pairs and it is a member of the genus Streptococcus. Streptococcus pneumonia resides asymptomatically in healthy carriers typically colonizing the respiratory tract, sinuses, and nasal cavity. In individuals with weaker immune systems like young infants, pneumococcal bacterium is the most common cause of community-acquired pneumonia in the world. Case Report: The aim is to present a case of lower respiratory tract infection in an infant caused by parainfluenza virus 3, S. pneumonia and undifferentiated gram-negative bacteria that was successfully treated. The infant is with a history of recurrent episodes of wheezing in the past 3mounts.Infant of 10months presents 2weeks before admittance with high fever, runny nose, and cough. The primary pediatrician prescribed oral cefpodoxime for 10days and inhaled salbutamol. Two days before admittance in hospital the infant with high fever, cough, and difficulty breathing. At admittance, infant is pale, anxious with rapid respirations, cough, wheezing and tachycardia. On auscultation: vesicular breathing sounds with high pitched wheezing and on the right coarse crackles. Investigations: Blood analysis: RBC: 4, 7 x1012L, WBC: 8,3x109L: Neut: 42.73% Lym: 41.57%, Hgb: 9.38 g/dl MCV: 62.7fl, MCH: 20.0pg MCHC: 31.8 g/dl RDW: 18.7% Plt-307.9 x109LCRP: 2,5mg/l, serum iron-7.92umol/l, O2sat-97% on blood gas analysis, puls-125/min.X-ray of chest with hyperinflationand right pericardial consolidation. Microbiological analysis of sputum sample is positive for undifferentiated gram-negative bacteria (colonizer)–resistant to cefotaxime, ampicillin, cefoxitin, sulfamet.+trimetoprim and sensitive to amikacin, gentamicin, and ciprofloxacin. Molecular multiplex RT-PCR for 19 viruses and multiplex PCR for 7 bacteria test for respiratory pathogens positive for Parainfluenza virus 3(Ct=22.73), Streptococcus pneumonia (Ct=26.75).IED: IgG-9.31g/l, IgA-0.351g/l, IgM-0.86g/l. Therapy: Treatment was started with inhaled salbutamol, intravenous antibiotic cefotaxime as well as systemic corticosteroids. On day 7 because of slow clinical resolution of chest auscultation findings and an etiologic clue with a positive sputum sample for resistant undifferentiated gram negative bacteria, a second intravenous antibiotic was administered amikacin. The infant is discharged on day 14 with resolution of clinical findings. Conclusion: Mixed co-infections with respiratory viruses and bacteria in immunocompromised infants are likely to lead to a more severe form of community acquired pneumonia that will need hospitalization.

Keywords: HPIV- 3, infant, pneumonia, S. pneumonia, x-ray chest

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Authors: Slawomir Pilip, Michal Wasilewski, Daniel Celinski, Leszek Szpakowski, Grzegorz Michalak

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The aim of the study was to evaluate the effectiveness of cardiopulmonary resuscitation taken by Medical Emergency Teams (MET) at the place of an accident including the usage of mechanical chest compression systems. In the period of January-May 2017, there were 137 cases of a sudden cardiac arrest in a chosen region of Eastern Poland with 360.000 inhabitants. Medical records and questionnaires filled by METs were analysed to prove the effectiveness of cardiopulmonary resuscitations that were considered to be effective when an early indication of spontaneous circulation was provided and the patient was taken to hospital. A chest compression system used by METs was applied in 60 cases (Lucas3 - 34 patients; Auto Pulse - 24 patients). The effectiveness of cardiopulmonary resuscitation among patients who were employed a chest compression system was much higher (43,3%) than the manual cardiac massage (36,4%). Thus, the usage of Lucas3 chest compression system resulted in 47% while Auto Pulse was 33,3%. The average ambulance arrival time could have had a significant impact on the subsequent effectiveness of cardiopulmonary resuscitation in these cases. Ambulances equipped with Lucas3 reached the destination within 8 minutes, and those with Auto Pulse needed 12,1 minutes. Moreover, taking effective basic life support (BLS) by bystanders before the ambulance arrival was much more frequent for ambulances with Lucas3 than Auto Pulse. Therefore, the percentage of BLS among the group of patients who were employed Lucas3 by METs was 26,5%, and 20,8% for Auto Pulse. The total percentage of taking BLS by bystanders before the ambulance arrival resulted in 25% of patients who were later applied a chest compression system by METs. Not only was shockable cardiac rhythm obtained in 47% of these cases, but an early indication of spontaneous circulation was also provided in all these patients. Both Lucas3 and Auto Pulse were evaluated to be significantly useful in improving the effectiveness of cardiopulmonary resuscitation by 97% of Medical Emergency Teams. Therefore, implementation of chest compression systems essentially makes the cardiopulmonary resuscitation even more effective. The ambulance arrival time, taking successful BLS by bystanders before the ambulance arrival and the presence of shockable cardiac rhythm determine an early indication of spontaneous circulation among patients after a sudden cardiac arrest.

Keywords: cardiac arrest, effectiveness, mechanical chest compression systems, resuscitation

Procedia PDF Downloads 247

Authors: Ashlesha Khanapure, Harsh Kashyap, Abhinav Anand, Sanjana Habib, Anupama Bidargaddi

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Technologies that are developing quickly are being developed daily in a variety of disciplines, particularly the medical field. For the purpose of detecting bone fractures in X-ray pictures of different body segments, our work compares the ResNet-50 and MobileNetV3 architectures. It evaluates accuracy and computing efficiency with X-rays of the elbow, hand, and shoulder from the MURA dataset. Through training and validation, the models are evaluated on normal and fractured images. While ResNet-50 showcases superior accuracy in fracture identification, MobileNetV3 showcases superior speed and resource optimization. Despite ResNet-50’s accuracy, MobileNetV3’s swifter inference makes it a viable choice for real-time clinical applications, emphasizing the importance of balancing computational efficiency and accuracy in medical imaging. We created a graphical user interface (GUI) for MobileNet V3 model bone fracture detection. This research underscores MobileNetV3’s potential to streamline bone fracture diagnoses, potentially revolutionizing orthopedic medical procedures and enhancing patient care.

Keywords: CNN, MobileNet V3, ResNet-50, healthcare, MURA, X-ray, fracture detection

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Authors: H. Namazi, H. T. N. Kuan

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Brain activity can be measured by acquiring and analyzing EEG signals from an individual. In fact, the human brain response to external and internal stimuli is mapped in his EEG signals. During years some methods such as Fourier transform, wavelet transform, empirical mode decomposition, etc. have been used to analyze the EEG signals in order to find the effect of stimuli, especially external stimuli. But each of these methods has some weak points in analysis of EEG signals. For instance, Fourier transform and wavelet transform methods are linear signal analysis methods which are not good to be used for analysis of EEG signals as nonlinear signals. In this research we analyze the brain response to auditory stimuli by extracting information in the form of various measures from EEG signals using a software developed by our research group. The used measures are Jeffrey’s measure, Fractal dimension and Hurst exponent. The results of these analyses are useful not only for fundamental understanding of brain response to auditory stimuli but provide us with very good recommendations for clinical purposes.

Keywords: auditory stimuli, brain response, EEG signal, fractal dimension, hurst exponent, Jeffrey’s measure

Procedia PDF Downloads 533

Authors: Pankaj Kumar Jha, Mahendra Singh Hada, Brijendra Singh, Sandeep Yadav

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Protective relays are commonly connected to the secondary windings of instrument transformers, i.e., current transformers (CTs) and/or capacitive voltage transformers (CVTs). The purpose of CT and CVT is to provide galvanic isolation from high voltages and reduce primary currents and voltages to a nominal quantity recognized by the protective relays. Selecting the correct instrument transformers for an application is imperative: failing to do so may compromise the relay’s performance, as the output of the instrument transformer may no longer be an accurately scaled representation of the primary quantity. Having an accurately rated instrument transformer is of no use if these devices are not properly connected. The performance of the protective relay is reliant on its programmed settings and on the current and voltage inputs from the instrument transformers secondary. This paper will help in understanding the fundamental concepts of the connections of Instrument Transformers to the protection relays and the effect of incorrect connection on the performance of protective relays. Multiple case studies of protection system mal-operations due to incorrect connections of instrument transformers will be discussed in detail in this paper. Apart from the connection issue of instrument transformers to protective relays, this paper will also discuss the effect of multiple earthing of CTs and CVTs secondary on the performance of the protection system. Case studies presented in this paper will help the readers to analyse the problem through real-world challenges in complex power system networks. This paper will also help the protection engineer in better analysis of disturbance records. CT and CVT connection errors can lead to undesired operations of protection systems. However, many of these operations can be avoided by adhering to industry standards and implementing tried-and-true field testing and commissioning practices. Understanding the effect of missing neutral of CVT, multiple earthing of CVT secondary, and multiple grounding of CT star points on the performance of the protection system through real-world case studies will help the protection engineer in better commissioning the protection system and maintenance of the protection system.

Keywords: bus reactor, current transformer, capacitive voltage transformer, distance protection, differential protection, directional earth fault, disturbance report, instrument transformer, ICT, REF protection, shunt reactor, voltage selection relay, VT fuse failure

Procedia PDF Downloads 81

Authors: Kambiz Teimour Najad

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The basic methodology of GPR involves the use of a transmitting antenna to send electromagnetic waves into the subsurface, which then bounce back to the surface and are detected by a receiving antenna. The transmitter and receiver antennas are typically placed on the ground surface and moved across the area of interest to create a profile of the subsurface. The GPR system consists of a control unit that powers the antennas and records the data, as well as a display unit that shows the results of the survey. The control unit sends a pulse of electromagnetic energy into the ground, which propagates through the soil or rock until it encounters a change in material or structure. When the electromagnetic wave encounters a buried object or structure, some of the energy is reflected back to the surface and detected by the receiving antenna. The GPR data is then processed using specialized software that analyzes the amplitude and travel time of the reflected waves. By interpreting the data, GPR can provide information on the depth, location, and nature of subsurface features and structures. GPR has several advantages over other geophysical survey methods, including its ability to provide high-resolution images of the subsurface and its non-invasive nature, which minimizes disruption to the site. However, the effectiveness of GPR depends on several factors, including the type of soil or rock, the depth of the features being investigated, and the frequency of the electromagnetic waves used. In environmental hazard assessments, GPR can be used to detect buried structures, such as underground storage tanks, pipelines, or utilities, which may pose a risk of contamination to the surrounding soil or groundwater. GPR can also be used to assess soil stability by identifying areas of subsurface voids or sinkholes, which can lead to the collapse of the surface. Additionally, GPR can be used to map the extent and movement of groundwater contamination, which is critical in designing effective remediation strategies. the methodology of GPR in environmental hazard assessments involves the use of electromagnetic waves to create high of the subsurface, which are then analyzed to provide information on the depth, location, and nature of subsurface features and structures. This information is critical in identifying and mitigating environmental hazards, and the non-invasive nature of GPR makes it a valuable tool in this field.

Keywords: GPR, hazard, landslide, rock fall, contamination

Procedia PDF Downloads 80

Authors: I-Han Hsiao, Chun-Ping Huang, Ching-Liang Hsieh, Yi-Wen Lin

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Epilepsy is chronic brain disorder that results in the sporadic occurrence of spontaneous seizures in the temporal lobe, cerebral cortex, and hippocampus. Clinical antiepileptic medicines are often ineffective or little benefits in the small amount of patients and usually initiate severe side effects. This inflammation contributes to enhanced neuronal excitability and the onset of epilepsy. Auricular electric-stimulation (AES) can increase parasympathetic activity and stimulate the solitary tract nucleus to induce the cholinergic anti-inflammatory pathway. Furthermore, it may be a therapeutic strategy for the treatment of epilepsy. In the present study, we want to investigate the effects of AES on inflammatory mediators in kainic acid (KA)-induced epileptic seizure rats. Experimental KA injection increased expression of TLR-2 pathway associated inflammatory mediators, were further reduced by either 2Hz or 15 Hz AES in the prefrontal cortex, hippocampus, and somatosensory cortex. We suggest that AES can successfully control the epileptic seizure by down-regulation of inflammation signaling pathway.

Keywords: auricular electric-stimulation, epileptic seizures, anti-inflammation

Procedia PDF Downloads 183

Authors: Charn Loong Ng, Mamun Bin Ibne Reaz

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As elderly population grows globally, the percentage of people diagnosed with musculoskeletal disorder (MSD) increase proportionally. Electromyography (EMG) is an important biosignal that contributes to MSD’s clinical diagnose and recovery process. Conventional conductive electrode has many disadvantages in the continuous EMG measurement application. This research has design a new surface EMG biosensor based on the parallel-plate capacitive coupling principle. The biosensor is developed by using a double-sided PCB with having one side of the PCB use to construct high input impedance circuitry while the other side of the copper (CU) plate function as biosignal sensing metal plate. The metal plate is insulated using kapton tape for contactless application. The result implicates that capacitive biosensor is capable to constantly capture EMG signal without having galvanic contact to human skin surface. However, there are noticeable noise couple into the measured signal. Post signal processing is needed in order to present a clean and significant EMG signal. A complete design of single ended, non-contact, high input impedance, front end EMG biosensor is presented in this paper.

Keywords: contactless, capacitive, biosensor, electromyography

Procedia PDF Downloads 448

Authors: Kasun U. G. Palihakkara

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Although vaccine coverage in Sri Lanka is close to 100%, with the widely spreading vaccine rejection trend reaching South Asian regions, it is essential to catch on whether Sri Lankans are being misinformed from the common misconceptions regarding vaccines. As the rates of target diseases decrease, parents become less accepting of even minor common adverse events. It is essential to preserve the integrity of immunization programs and protect public health by finding out the prevalence of anti-immunization trends. The primary objective of this study was to assess the immunization practices and prevalence of trends related to anti-immunization among urban community in Sri Lanka. A descriptive cross-sectional quantitative study on 323 participants using convenient sampling with 213 self-administered questionnaires. Additionally, 110 online questionnaires were distributed. 31% of the study population does not maintain immunization records for their children. While majority seek information regarding immunization from reliable sources such as the family physician or specialist pediatricians, 30% also refer to unreliable sources such as online communities for their opinion. 31% of study population had not vaccinated for Japanese encephalitis. 73% of the study population had encountered with side effects of vaccination such as fever & 47% believed that such side effects are rare. 52% of the population had hostile attitude regarding the administration of several doses multiple vaccines within a child’s first year. Diseases like polio had been successfully eradicated from Sri Lanka with the help of vigorous vaccination programs. However, majority of the study population believe that there’s no need to keep vaccinating the children for those eradicated diseases and exposing the child for adverse effects of such vaccines. Majority of the population were aware of the existing misconceptions regarding immunization. The most popular misconceptions about vaccines popular among the study population were the MMR (Measles, Mumps, and Rubella) vaccine being a possible cause leading to autism and bowel disease and children getting infected with the disease even after they get vaccinated, may be due to the inactivated vaccine. Disturbingly 22% of the study population believed that vaccines are useless in preventing diseases nowadays. These data obtained from the urban study population reveals that even though statistically Sri Lankan immunization coverage is 100%, there is a possibility of anti-vaccination trend arising in Sri Lanka due to the prevalence of various misconceptions and rumors related to it. Therefore these data recommend the need for thorough awareness among the mothers.

Keywords: anti-vaccination, immunization, infectious diseases, pediatric health

Procedia PDF Downloads 138

Authors: Hami Ashraf, Farid Kosari

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Graft-versus-host disease (GvHD) is a common complication of allogeneic hematopoietic stem cell transplantation that can lead to significant morbidity and mortality. Histopathological examination of affected tissues is an essential tool for diagnosing and grading GvHD in animal models, which are used to study disease mechanisms and evaluate new therapies. In this systematic review, we identified and analyzed original research articles in PubMed, Scopus, Web of Science, and Google Scholar that described grading systems for GvHD in animal models based on histopathological features. We found that several grading systems have been developed, which vary in the tissues and criteria they assess, the severity scoring scales they use, and the level of detail they provide. Skin, liver, and gut are the most commonly evaluated tissues, but lung and thymus are also included in some systems. Our analysis highlights the need for standardized criteria and consistent use of grading systems to enable comparisons between studies and facilitate the translation of preclinical findings to clinical practice.

Keywords: graft-versus-host disease, GvHD, animal model, histopathology, grading system

Procedia PDF Downloads 63