Search results for: medical image processing
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8693

Search results for: medical image processing

6233 An Automatic Large Classroom Attendance Conceptual Model Using Face Counting

Authors: Sirajdin Olagoke Adeshina, Haidi Ibrahim, Akeem Salawu

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large lecture theatres cannot be covered by a single camera but rather by a multicamera setup because of their size, shape, and seating arrangements. Although, classroom capture is achievable through a single camera. Therefore, a design and implementation of a multicamera setup for a large lecture hall were considered. Researchers have shown emphasis on the impact of class attendance taken on the academic performance of students. However, the traditional method of carrying out this exercise is below standard, especially for large lecture theatres, because of the student population, the time required, sophistication, exhaustiveness, and manipulative influence. An automated large classroom attendance system is, therefore, imperative. The common approach in this system is face detection and recognition, where known student faces are captured and stored for recognition purposes. This approach will require constant face database updates due to constant changes in the facial features. Alternatively, face counting can be performed by cropping the localized faces on the video or image into a folder and then count them. This research aims to develop a face localization-based approach to detect student faces in classroom images captured using a multicamera setup. A selected Haar-like feature cascade face detector trained with an asymmetric goal to minimize the False Rejection Rate (FRR) relative to the False Acceptance Rate (FAR) was applied on Raspberry Pi 4B. A relationship between the two factors (FRR and FAR) was established using a constant (λ) as a trade-off between the two factors for automatic adjustment during training. An evaluation of the proposed approach and the conventional AdaBoost on classroom datasets shows an improvement of 8% TPR (output result of low FRR) and 7% minimization of the FRR. The average learning speed of the proposed approach was improved with 1.19s execution time per image compared to 2.38s of the improved AdaBoost. Consequently, the proposed approach achieved 97% TPR with an overhead constraint time of 22.9s compared to 46.7s of the improved Adaboost when evaluated on images obtained from a large lecture hall (DK5) USM.

Keywords: automatic attendance, face detection, haar-like cascade, manual attendance

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6232 Effects of an Educational Program on Nurses Knowledge and Practice Related to Hepatitis-B: Pre-Experimental Design

Authors: R. S. Mehta, G. N. Mandal

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Hepatitis-B is the major infectious disease of mankind. In Nepal it is reported that more than 4.3% of Nepalese population at any time in their life has been infected with Hepatitis-B virus (HBV). The objective of this study was to evaluate the effectiveness of planned educational programme regarding knowledge and practice of hepatitis-B among the nurses working at medical units of BPKIHS. Pre-experimental research design was used to conduct the study among the nurses working in medical units of BPKIHS. Total 40 nurses were included in the pre-test and 34 in the post-test. The education intervention was arranged on 24th May 2012 from 2:15 pm to 4:45 pm i.e. two and half hours. After two weeks of education intervention post-test was conducted. Most of the participants (60%) were of the age group of 18-22 years, Hindu (82.5%), and unmarried (65%). After education intervention there is significant differences in knowledge on the components of Hepatitis-B at 0.05 level of significance. There is no difference in the attitude components after post-test except the component patient contaminated with Hepatitis-B must be called as the last patient (p=0.035). It can conclude that hepatitis-B educational program improved knowledge and practice among the nurses.

Keywords: educational program, Hepatitis-B, pre-experimental design, medical units

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6231 Developing an Accurate AI Algorithm for Histopathologic Cancer Detection

Authors: Leah Ning

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This paper discusses the development of a machine learning algorithm that accurately detects metastatic breast cancer (cancer has spread elsewhere from its origin part) in selected images that come from pathology scans of lymph node sections. Being able to develop an accurate artificial intelligence (AI) algorithm would help significantly in breast cancer diagnosis since manual examination of lymph node scans is both tedious and oftentimes highly subjective. The usage of AI in the diagnosis process provides a much more straightforward, reliable, and efficient method for medical professionals and would enable faster diagnosis and, therefore, more immediate treatment. The overall approach used was to train a convolution neural network (CNN) based on a set of pathology scan data and use the trained model to binarily classify if a new scan were benign or malignant, outputting a 0 or a 1, respectively. The final model’s prediction accuracy is very high, with 100% for the train set and over 70% for the test set. Being able to have such high accuracy using an AI model is monumental in regard to medical pathology and cancer detection. Having AI as a new tool capable of quick detection will significantly help medical professionals and patients suffering from cancer.

Keywords: breast cancer detection, AI, machine learning, algorithm

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6230 Utilizing Street Medicine to Reduce Communicable Disease Prevalence in a Cost-Effective Way

Authors: Bailey Hall, Athena Hoppe, Tevyn Kagele, Anna Nichols, Breeanna Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to people experiencing homelessness in Spokane, Washington. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to a largely underserved population. In this analysis, the SSM Program’s medical charts from street and shelter encounters in early 2021 were reviewed in order to identify illness and diseases in people experiencing homelessness in Spokane. More than half of the prescriptions written during these encounters were for either an antibacterial, an antibiotic, or an antifungal. Estimates of the cost to the local healthcare system are included. Initiating treatment for communicable diseases in people experiencing homelessness via street medicine efforts greatly reduces economic costs while improving health outcomes.

Keywords: ethical issues in public health, equity issues in public health, health economics, health disparities, healthcare costs, medical public health, public health ethics, street medicine

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6229 Quantification of E-Waste: A Case Study in Federal University of Espírito Santo, Brazil

Authors: Andressa S. T. Gomes, Luiza A. Souza, Luciana H. Yamane, Renato R. Siman

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The segregation of waste of electrical and electronic equipment (WEEE) in the generating source, its characterization (quali-quantitative) and identification of origin, besides being integral parts of classification reports, are crucial steps to the success of its integrated management. The aim of this paper was to count WEEE generation at the Federal University of Espírito Santo (UFES), Brazil, as well as to define sources, temporary storage sites, main transportations routes and destinations, the most generated WEEE and its recycling potential. Quantification of WEEE generated at the University in the years between 2010 and 2015 was performed using data analysis provided by UFES’s sector of assets management. EEE and WEEE flow in the campuses information were obtained through questionnaires applied to the University workers. It was recorded 6028 WEEEs units of data processing equipment disposed by the university between 2010 and 2015. Among these waste, the most generated were CRT screens, desktops, keyboards and printers. Furthermore, it was observed that these WEEEs are temporarily stored in inappropriate places at the University campuses. In general, these WEEE units are donated to NGOs of the city, or sold through auctions (2010 and 2013). As for recycling potential, from the primary processing and further sale of printed circuit boards (PCB) from the computers, the amount collected could reach U$ 27,839.23. The results highlight the importance of a WEEE management policy at the University.

Keywords: solid waste, waste of electrical and electronic equipment, waste management, institutional solid waste generation

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6228 Osteoarthritis (OA): A Total Knee Replacement Surgery

Authors: Loveneet Kaur

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Introduction: Osteoarthritis (OA) is one of the leading causes of disability, and the knee is the most commonly affected joint in the body. The last resort for treatment of knee OA is Total Knee Replacement (TKR) surgery. Despite numerous advances in prosthetic design, patients do not reach normal function after surgery. Current surgical decisions are made on 2D radiographs and patient interviews. Aims: The aim of this study was to compare knee kinematics pre and post-TKR surgery using computer-animated images of patient-specific models under everyday conditions. Methods: 7 subjects were recruited for the study. Subjects underwent 3D gait analysis during 4 everyday activities and medical imaging of the knee joint pre- and one-month post-surgery. A 3D model was created from each of the scans, and the kinematic gait analysis data was used to animate the images. Results: Improvements were seen in a range of motion in all 4 activities 1-year post-surgery. The preoperative 3D images provide detailed information on the anatomy of the osteoarthritic knee. The postoperative images demonstrate potential future problems associated with the implant. Although not accurate enough to be of clinical use, the animated data can provide valuable insight into what conditions cause damage to both the osteoarthritic and prosthetic knee joints. As the animated data does not require specialist training to view, the images can be utilized across the fields of health professionals and manufacturing in the assessment and treatment of patients pre and post-knee replacement surgery. Future improvements in the collection and processing of data may yield clinically useful data. Conclusion: Although not yet of clinical use, the potential application of 3D animations of the knee joint pre and post-surgery is widespread.

Keywords: Orthoporosis, Ortharthritis, knee replacement, TKR

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6227 Event Data Representation Based on Time Stamp for Pedestrian Detection

Authors: Yuta Nakano, Kozo Kajiwara, Atsushi Hori, Takeshi Fujita

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In association with the wave of electric vehicles (EV), low energy consumption systems have become more and more important. One of the key technologies to realize low energy consumption is a dynamic vision sensor (DVS), or we can call it an event sensor, neuromorphic vision sensor and so on. This sensor has several features, such as high temporal resolution, which can achieve 1 Mframe/s, and a high dynamic range (120 DB). However, the point that can contribute to low energy consumption the most is its sparsity; to be more specific, this sensor only captures the pixels that have intensity change. In other words, there is no signal in the area that does not have any intensity change. That is to say, this sensor is more energy efficient than conventional sensors such as RGB cameras because we can remove redundant data. On the other side of the advantages, it is difficult to handle the data because the data format is completely different from RGB image; for example, acquired signals are asynchronous and sparse, and each signal is composed of x-y coordinate, polarity (two values: +1 or -1) and time stamp, it does not include intensity such as RGB values. Therefore, as we cannot use existing algorithms straightforwardly, we have to design a new processing algorithm to cope with DVS data. In order to solve difficulties caused by data format differences, most of the prior arts make a frame data and feed it to deep learning such as Convolutional Neural Networks (CNN) for object detection and recognition purposes. However, even though we can feed the data, it is still difficult to achieve good performance due to a lack of intensity information. Although polarity is often used as intensity instead of RGB pixel value, it is apparent that polarity information is not rich enough. Considering this context, we proposed to use the timestamp information as a data representation that is fed to deep learning. Concretely, at first, we also make frame data divided by a certain time period, then give intensity value in response to the timestamp in each frame; for example, a high value is given on a recent signal. We expected that this data representation could capture the features, especially of moving objects, because timestamp represents the movement direction and speed. By using this proposal method, we made our own dataset by DVS fixed on a parked car to develop an application for a surveillance system that can detect persons around the car. We think DVS is one of the ideal sensors for surveillance purposes because this sensor can run for a long time with low energy consumption in a NOT dynamic situation. For comparison purposes, we reproduced state of the art method as a benchmark, which makes frames the same as us and feeds polarity information to CNN. Then, we measured the object detection performances of the benchmark and ours on the same dataset. As a result, our method achieved a maximum of 7 points greater than the benchmark in the F1 score.

Keywords: event camera, dynamic vision sensor, deep learning, data representation, object recognition, low energy consumption

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6226 Architecture - Performance Relationship in GPU Computing - Composite Process Flow Modeling and Simulations

Authors: Ram Mohan, Richard Haney, Ajit Kelkar

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Current developments in computing have shown the advantage of using one or more Graphic Processing Units (GPU) to boost the performance of many computationally intensive applications but there are still limits to these GPU-enhanced systems. The major factors that contribute to the limitations of GPU(s) for High Performance Computing (HPC) can be categorized as hardware and software oriented in nature. Understanding how these factors affect performance is essential to develop efficient and robust applications codes that employ one or more GPU devices as powerful co-processors for HPC computational modeling. This research and technical presentation will focus on the analysis and understanding of the intrinsic interrelationship of both hardware and software categories on computational performance for single and multiple GPU-enhanced systems using a computationally intensive application that is representative of a large portion of challenges confronting modern HPC. The representative application uses unstructured finite element computations for transient composite resin infusion process flow modeling as the computational core, characteristics and results of which reflect many other HPC applications via the sparse matrix system used for the solution of linear system of equations. This work describes these various software and hardware factors and how they interact to affect performance of computationally intensive applications enabling more efficient development and porting of High Performance Computing applications that includes current, legacy, and future large scale computational modeling applications in various engineering and scientific disciplines.

Keywords: graphical processing unit, software development and engineering, performance analysis, system architecture and software performance

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6225 Analysis on the Feasibility of Landsat 8 Imagery for Water Quality Parameters Assessment in an Oligotrophic Mediterranean Lake

Authors: V. Markogianni, D. Kalivas, G. Petropoulos, E. Dimitriou

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Lake water quality monitoring in combination with the use of earth observation products constitutes a major component in many water quality monitoring programs. Landsat 8 images of Trichonis Lake (Greece) acquired on 30/10/2013 and 30/08/2014 were used in order to explore the possibility of Landsat 8 to estimate water quality parameters and particularly CDOM absorption at specific wavelengths, chlorophyll-a and nutrient concentrations in this oligotrophic freshwater body, characterized by inexistent quantitative, temporal and spatial variability. Water samples have been collected at 22 different stations, on late August of 2014 and the satellite image of the same date was used to statistically correlate the in-situ measurements with various combinations of Landsat 8 bands in order to develop algorithms that best describe those relationships and calculate accurately the aforementioned water quality components. Optimal models were applied to the image of late October of 2013 and the validation of the results was conducted through their comparison with the respective available in-situ data of 2013. Initial results indicated the limited ability of the Landsat 8 sensor to accurately estimate water quality components in an oligotrophic waterbody. As resulted by the validation process, ammonium concentrations were proved to be the most accurately estimated component (R = 0.7), followed by chl-a concentration (R = 0.5) and the CDOM absorption at 420 nm (R = 0.3). In-situ nitrate, nitrite, phosphate and total nitrogen concentrations of 2014 were measured as lower than the detection limit of the instrument used, hence no statistical elaboration was conducted. On the other hand, multiple linear regression among reflectance measures and total phosphorus concentrations resulted in low and statistical insignificant correlations. Our results were concurrent with other studies in international literature, indicating that estimations for eutrophic and mesotrophic lakes are more accurate than oligotrophic, owing to the lack of suspended particles that are detectable by satellite sensors. Nevertheless, although those predictive models, developed and applied to Trichonis oligotrophic lake are less accurate, may still be useful indicators of its water quality deterioration.

Keywords: landsat 8, oligotrophic lake, remote sensing, water quality

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6224 Processing Methods for Increasing the Yield, Nutritional Value and Stability of Coconut Milk

Authors: Archana G. Lamdande, Shyam R. Garud, K. S. M. S. Raghavarao

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Coconut has two edible parts, that is, a white kernel (solid endosperm) and coconut water (liquid endosperm). The white kernel is generally used in fresh or dried form for culinary purposes. Coconut testa, is the brown skin, covering the coconut kernel. It is removed by paring of wet coconut and obtained as a by-product in coconut processing industries during the production of products such as desiccated coconut, coconut milk, whole coconut milk powder and virgin coconut oil. At present, it is used as animal feed component after drying and recovering the residual oil (by expelling). Experiments were carried out on expelling of coconut milk for shredded coconut with and without testa removal, in order to explore the possibility of increasing the milk yield and value addition in terms of increased polyphenol content. The color characteristics of coconut milk obtained from the grating without removal of testa were observed to be L* 82.79, a* 0.0125, b* 6.245, while that obtained from grating with removal of testa were L* 83.24, a* -0.7925, b* 3.1. A significant increase was observed in total phenol content of coconut milk obtained from the grating with testa (833.8 µl/ml) when compared to that from without testa (521.3 µl/ml). However, significant difference was not observed in protein content of coconut milk obtained from the grating with and without testa (4.9 and 5.0% w/w, respectively). Coconut milk obtained from grating without removal of testa showed higher milk yield (62% w/w) when compared to that obtained from grating with removal of testa (60% w/w). The fat content in coconut milk was observed to be 32% (w/w), and it is unstable due to such a high fat content. Therefore, several experiments were carried out for examining its stability by adjusting the fat content at different levels (32, 28, 24, and 20% w/w). It was found that the coconut milk was more stable with a fat content of 24 % (w/w). Homogenization and ultrasonication and their combinations were used for exploring the possibility of increasing the stability of coconut milk. The microscopic study was carried out for analyzing the size of fat globules and the degree of their uniform distribution.

Keywords: coconut milk, homogenization, stability, testa, ultrasonication

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6223 A Comparative Study on the Use of Learning Resources in Learning Biochemistry by MBBS Students at Ras Al Khaimah Medical and Health Sciences University, UAE

Authors: B. K. Manjunatha Goud, Aruna Chanu Oinam

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The undergraduate medical curriculum is oriented towards training the students to undertake the responsibilities of a physician. During the training period, adequate emphasis is placed on inculcating logical and scientific habits of thought; clarity of expression and independence of judgment; and ability to collect and analyze information and to correlate them. At Ras Al Khaimah Medical and Health Sciences University (RAKMHSU), Biochemistry a basic medical science subject is taught in the 1st year of 5 years medical course with vertical interdisciplinary interaction with all subjects, which needs to be taught and learned adequately by the students to be related to clinical case or clinical problem in medicine and future diagnostics so that they can practice confidently and skillfully in the community. Based on these facts study was done to know the extent of usage of library resources by the students and the impact of study materials on their preparation for examination. It was a comparative cross sectional study included 100 and 80 1st and 2nd-year students who had successfully completed Biochemistry course. The purpose of the study was explained to all students [participants]. Information was collected on a pre-designed, pre-tested and self-administered questionnaire. The questionnaire was validated by the senior faculties and pre tested on students who were not involved in the study. The study results showed that 80.30% and 93.15% of 1st and 2nd year students have the clear idea of course outline given in course handout or study guide. We also found a statistically significant number of students agreed that they were benefited from the practical session and writing notes in the class hour. A high percentage of students [50% and 62.02%] disagreed that that reading only the handouts is enough for their examination as compared to other students. The study also showed that only 35% and 41% of students visited the library on daily basis for the learning process, around 65% of students were using lecture notes and text books as a tool for learning and to understand the subject and 45% and 53% of students used the library resources (recommended text books) compared to online sources before the examinations. The results presented here show that students perceived that e-learning resources like power point presentations along with text book reading using SQ4R technique had made a positive impact on various aspects of their learning in Biochemistry. The use of library by students has overall positive impact on learning process especially in medical field enhances the outcome, and medical students are better equipped to treat the patient. But it’s also true that use of library use has been in decline which will impact the knowledge aspects and outcome. In conclusion, a student has to be taught how to use the library as learning tool apart from lecture handouts.

Keywords: medical education, learning resources, study guide, biochemistry

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6222 Sequential Pattern Mining from Data of Medical Record with Sequential Pattern Discovery Using Equivalent Classes (SPADE) Algorithm (A Case Study : Bolo Primary Health Care, Bima)

Authors: Rezky Rifaini, Raden Bagus Fajriya Hakim

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This research was conducted at the Bolo primary health Care in Bima Regency. The purpose of the research is to find out the association pattern that is formed of medical record database from Bolo Primary health care’s patient. The data used is secondary data from medical records database PHC. Sequential pattern mining technique is the method that used to analysis. Transaction data generated from Patient_ID, Check_Date and diagnosis. Sequential Pattern Discovery Algorithms Using Equivalent Classes (SPADE) is one of the algorithm in sequential pattern mining, this algorithm find frequent sequences of data transaction, using vertical database and sequence join process. Results of the SPADE algorithm is frequent sequences that then used to form a rule. It technique is used to find the association pattern between items combination. Based on association rules sequential analysis with SPADE algorithm for minimum support 0,03 and minimum confidence 0,75 is gotten 3 association sequential pattern based on the sequence of patient_ID, check_Date and diagnosis data in the Bolo PHC.

Keywords: diagnosis, primary health care, medical record, data mining, sequential pattern mining, SPADE algorithm

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6221 Managing Data from One Hundred Thousand Internet of Things Devices Globally for Mining Insights

Authors: Julian Wise

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Newcrest Mining is one of the world’s top five gold and rare earth mining organizations by production, reserves and market capitalization in the world. This paper elaborates on the data acquisition processes employed by Newcrest in collaboration with Fortune 500 listed organization, Insight Enterprises, to standardize machine learning solutions which process data from over a hundred thousand distributed Internet of Things (IoT) devices located at mine sites globally. Through the utilization of software architecture cloud technologies and edge computing, the technological developments enable for standardized processes of machine learning applications to influence the strategic optimization of mineral processing. Target objectives of the machine learning optimizations include time savings on mineral processing, production efficiencies, risk identification, and increased production throughput. The data acquired and utilized for predictive modelling is processed through edge computing by resources collectively stored within a data lake. Being involved in the digital transformation has necessitated the standardization software architecture to manage the machine learning models submitted by vendors, to ensure effective automation and continuous improvements to the mineral process models. Operating at scale, the system processes hundreds of gigabytes of data per day from distributed mine sites across the globe, for the purposes of increased improved worker safety, and production efficiency through big data applications.

Keywords: mineral technology, big data, machine learning operations, data lake

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6220 Streamwise Vorticity in the Wake of a Sliding Bubble

Authors: R. O’Reilly Meehan, D. B. Murray

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In many practical situations, bubbles are dispersed in a liquid phase. Understanding these complex bubbly flows is therefore a key issue for applications such as shell and tube heat exchangers, mineral flotation and oxidation in water treatment. Although a large body of work exists for bubbles rising in an unbounded medium, that of bubbles rising in constricted geometries has received less attention. The particular case of a bubble sliding underneath an inclined surface is common to two-phase flow systems. The current study intends to expand this knowledge by performing experiments to quantify the streamwise flow structures associated with a single sliding air bubble under an inclined surface in quiescent water. This is achieved by means of two-dimensional, two-component particle image velocimetry (PIV), performed with a continuous wave laser and high-speed camera. PIV vorticity fields obtained in a plane perpendicular to the sliding surface show that there is significant bulk fluid motion away from the surface. The associated momentum of the bubble means that this wake motion persists for a significant time before viscous dissipation. The magnitude and direction of the flow structures in the streamwise measurement plane are found to depend on the point on its path through which the bubble enters the plane. This entry point, represented by a phase angle, affects the nature and strength of the vortical structures. This study reconstructs the vorticity field in the wake of the bubble, converting the field at different instances in time to slices of a large-scale wake structure. This is, in essence, Taylor’s ”frozen turbulence” hypothesis. Applying this to the vorticity fields provides a pseudo three-dimensional representation from 2-D data, allowing for a more intuitive understanding of the bubble wake. This study provides insights into the complex dynamics of a situation common to many engineering applications, particularly shell and tube heat exchangers in the nucleate boiling regime.

Keywords: bubbly flow, particle image velocimetry, two-phase flow, wake structures

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6219 Pervasive Computing: Model to Increase Arable Crop Yield through Detection Intrusion System (IDS)

Authors: Idowu Olugbenga Adewumi, Foluke Iyabo Oluwatoyinbo

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Presently, there are several discussions on the food security with increase in yield of arable crop throughout the world. This article, briefly present research efforts to create digital interfaces to nature, in particular to area of crop production in agriculture with increase in yield with interest on pervasive computing. The approach goes beyond the use of sensor networks for environmental monitoring but also by emphasizing the development of a system architecture that detect intruder (Intrusion Process) which reduce the yield of the farmer at the end of the planting/harvesting period. The objective of the work is to set a model for setting up the hand held or portable device for increasing the quality and quantity of arable crop. This process incorporates the use of infrared motion image sensor with security alarm system which can send a noise signal to intruder on the farm. This model of the portable image sensing device in monitoring or scaring human, rodent, birds and even pests activities will reduce post harvest loss which will increase the yield on farm. The nano intelligence technology was proposed to combat and minimize intrusion process that usually leads to low quality and quantity of produce from farm. Intranet system will be in place with wireless radio (WLAN), router, server, and client computer system or hand held device e.g PDAs or mobile phone. This approach enables the development of hybrid systems which will be effective as a security measure on farm. Since, precision agriculture has developed with the computerization of agricultural production systems and the networking of computerized control systems. In the intelligent plant production system of controlled greenhouses, information on plant responses, measured by sensors, is used to optimize the system. Further work must be carry out on modeling using pervasive computing environment to solve problems of agriculture, as the use of electronics in agriculture will attracts more youth involvement in the industry.

Keywords: pervasive computing, intrusion detection, precision agriculture, security, arable crop

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6218 The Effect of Electrical Discharge Plasma on Inactivation of Escherichia Coli MG 1655 in Pure Culture

Authors: Zoran Herceg, Višnja Stulić, Anet Režek Jambrak, Tomislava Vukušić

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Electrical discharge plasma is a new non-thermal processing technique which is used for the inactivation of contaminating and hazardous microbes in liquids. Plasma is a source of different antimicrobial species including UV photons, charged particles, and reactive species such as superoxide, hydroxyl radicals, nitric oxide and ozone. Escherichia coli was studied as foodborne pathogen. The aim of this work was to examine inactivation effects of electrical discharge plasma treatment on the Escherichia coli MG 1655 in pure culture. Two types of plasma configuration and polarity were used. First configuration was with titanium wire as high voltage needle and another with medical stainless steel needle used to form bubbles in treated volume and titanium wire as high voltage needle. Model solution samples were inoculated with Escerichia coli MG 1655 and treated by electrical discharge plasma at treatment time of 5 and 10 min, and frequency of 60, 90 and 120 Hz. With the first configuration after 5 minutes of treatment at frequency of 120 Hz the inactivation rate was 1.3 log₁₀ reduction and after 10 minutes of treatment the inactivation rate was 3.0 log₁₀ reduction. At the frequency of 90 Hz after 10 minutes inactivation rate was 1.3 log₁₀ reduction. With the second configuration after 5 minutes of treatment at frequency of 120 Hz the inactivation rate was 1.2 log₁₀ reduction and after 10 minutes of treatment the inactivation rate was also 3.0 log₁₀ reduction. In this work it was also examined the formation of biofilm, nucleotide and protein leakage at 260/280 nm, before and after treatment and recuperation of treated samples. Further optimization of method is needed to understand mechanism of inactivation.

Keywords: electrical discharge plasma, escherichia coli MG 1655, inactivation, point-to-plate electrode configuration

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6217 Flicker Detection with Motion Tolerance for Embedded Camera

Authors: Jianrong Wu, Xuan Fu, Akihiro Higashi, Zhiming Tan

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CMOS image sensors with a rolling shutter are used broadly in the digital cameras embedded in mobile devices. The rolling shutter suffers the flicker artifacts from the fluorescent lamp, and it could be observed easily. In this paper, the characteristics of illumination flicker in motion case were analyzed, and two efficient detection methods based on matching fragment selection were proposed. According to the experimental results, our methods could achieve as high as 100% accuracy in static scene, and at least 97% in motion scene.

Keywords: illumination flicker, embedded camera, rolling shutter, detection

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6216 Generation of Medical Waste in Hospitals in Interior of São Paulo, Brazil

Authors: Silvia Carla Da Silva André, Angela Maria Magosso Takayanagui

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Introduction: The Medical Waste (MW) are responsible per 2% of total waste generated for a city and has merited attention due the risks that offers to the public health and environment, representing an important aspect in waste management. In Brazil, the Resolution 306/04 of the National Health Surveillance Agency classifies the MW into 5 groups as follows: Group A (GA) biological, Group B (GB) chemical, Group C (GC) radioactive waste, Group D (GD) common, and Group E (GE) sharps. Objective: This study aimed to determine the amount of waste generated in hospitals of Ribeirão Preto, São Paulo, Brazil. Material and Methods: This is a field research, exploratory, using quantitative variables. The survey was conducted in 11 hospitals in Ribeirão Preto, located in the State of São Paulo, Brazil. It is noted that the study sample included general hospitals, skilled, university, maternity, and psychiatric; public, private, and philanthropic; and large, medium, and small. To quantify the MW, the weighing of the waste was held for six days, following methodology adapted from PAHO. Data were analyzed using descriptive statistics, determining the average global generation of MW and for each group. This research was carried out after approval by the Ethics in Research of the University of São Paulo. Thus, in order to comply with the ethical principles of research, to present the results hospitals were numbered from 1 to 11. Results: The data revealed a greater generation of biological waste among teaching hospitals, which can be justified by the use of materials for the realization of techniques.

Keywords: environmental health, management of medical waste, medical waste, public health

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6215 Overview of Pre-Analytical Lab Errors in a Tertiary Care Hospital at Rawalpindi, Pakistan

Authors: S. Saeed, T. Butt, M. Rehan, S. Khaliq

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Objective: To determine the frequency of pre-analytical errors in samples taken from patients for various lab tests at Fauji Foundation Hospital, Rawalpindi. Material and Methods: All the lab specimens for diagnostic purposes received at the lab from Fauji Foundation hospital, Rawalpindi indoor and outdoor patients were included. Total number of samples received in the lab is recorded in the computerized program made for the hospital. All the errors observed for pre-analytical process including patient identification, sampling techniques, test collection procedures, specimen transport/processing and storage were recorded in the log book kept for the purpose. Results: A total of 476616 specimens were received in the lab during the period of study including 237931 and 238685 from outdoor and indoor patients respectively. Forty-one percent of the samples (n=197976) revealed pre-analytical discrepancies. The discrepancies included Hemolyzed samples (34.8%), Clotted blood (27.8%), Incorrect samples (17.4%), Unlabeled samples (8.9%), Insufficient specimens (3.9%), Request forms without authorized signature (2.9%), Empty containers (3.9%) and tube breakage during centrifugation (0.8%). Most of these pre-analytical discrepancies were observed in samples received from the wards revealing that inappropriate sample collection by the medical staff of the ward, as most of the outdoor samples are collected by the lab staff who are properly trained for sample collection. Conclusion: It is mandatory to educate phlebotomists and paramedical staff particularly performing duties in the wards regarding timing and techniques of sampling/appropriate container to use/early delivery of the samples to the lab to reduce pre-analytical errors.

Keywords: pre analytical lab errors, tertiary care hospital, hemolyzed, paramedical staff

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6214 A Fact-Finding Analysis on the Expulsions Made under Title 42 in Us

Authors: Avi Shrivastava

Abstract:

Title 42, an emergency health decree, has forced the federal authorities to turn away asylum seekers and all other border crossers since last year. When Title 42 was first deployed in immigration detention centers, where many migrants are held when they arrive at the U.S.-Mexico border, the Trump administration embraced it as a strategy. Expulsions Policy and New Border Challenges will be examined in regard to Title 42 concerns. Humanitarian measures for refugees arriving at the US-Mexico border are the focus of this article. To a large extent, this article addresses the implications of the United States' use of Title 42 in expelling refugees and the possible ramifications of doing away with it. A secondary data collecting strategy was used to gather the information for this study, allowing researchers to examine a large number of previously collected data sets. Information about Title 42 may be found in a variety of places, such as scholarly publications, newspapers, books, and the internet. The inquiry employed qualitative and explanatory research approaches. The claim that 1.7 million individuals were forced to leave the country as a result of it was withdrawn. Since CBP and ICE were limited in their ability to process deportees, it employed a very random patchwork technique in selecting the expelled individuals. As a consequence, repeat offenders, particularly those who were single, got a reduced punishment. The government will be compelled to focus on long-overdue but vital border enhancements if expulsions are halted. Title 42 provisions may help expedite the processing of asylum and other types of humanitarian relief. The government is prepared for an increase in arrivals, but ending the program would lead to a return to arrival levels seen during the Title 42 period.

Keywords: migrants, refugees, title 42, medical, trump administration

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6213 Development of Mobile Application for Internship Program Management Using the Concept of Model View Controller (MVC) Pattern

Authors: Shutchapol Chopvitayakun

Abstract:

Nowadays, especially for the last 5 years, mobile devices, mobile applications and mobile users, through the deployment of wireless communication and mobile phone cellular network, all these components are growing significantly bigger and stronger. They are being integrated into each other to create multiple purposes and pervasive deployments into every business and non-business sector such as education, medicine, traveling, finance, real estate and many more. Objective of this study was to develop a mobile application for seniors or last-year students who enroll the internship program at each tertiary school (undergraduate school) and do onsite practice at real field sties, real organizations and real workspaces. During the internship session, all students as the interns are required to exercise, drilling and training onsite with specific locations and specific tasks or may be some assignments from their supervisor. Their work spaces are both private and government corporates and enterprises. This mobile application is developed under schema of a transactional processing system that enables users to keep daily work or practice log, monitor true working locations and ability to follow daily tasks of each trainee. Moreover, it provides useful guidance from each intern’s advisor, in case of emergency. Finally, it can summarize all transactional data then calculate each internship cumulated hours from the field practice session for each individual intern.

Keywords: internship, mobile application, Android OS, smart phone devices, mobile transactional processing system, guidance and monitoring, tertiary education, senior students, model view controller (MVC)

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6212 X-Ray Diffraction, Microstructure, and Mössbauer Studies of Nanostructured Materials Obtained by High-Energy Ball Milling

Authors: N. Boudinar, A. Djekoun, A. Otmani, B. Bouzabata, J. M. Greneche

Abstract:

High-energy ball milling is a solid-state powder processing technique that allows synthesizing a variety of equilibrium and non-equilibrium alloy phases starting from elemental powders. The advantage of this process technology is that the powder can be produced in large quantities and the processing parameters can be easily controlled, thus it is a suitable method for commercial applications. It can also be used to produce amorphous and nanocrystalline materials in commercially relevant amounts and is also amenable to the production of a variety of alloy compositions. Mechanical alloying (high-energy ball milling) provides an inter-dispersion of elements through a repeated cold welding and fracture of free powder particles; the grain size decreases to nano metric scale and the element mix together. Progressively, the concentration gradients disappear and eventually the elements are mixed at the atomic scale. The end products depend on many parameters such as the milling conditions and the thermodynamic properties of the milled system. Here, the mechanical alloying technique has been used to prepare nano crystalline Fe_50 and Fe_64 wt.% Ni alloys from powder mixtures. Scanning electron microscopy (SEM) with energy-dispersive, X-ray analyses and Mössbauer spectroscopy were used to study the mixing at nanometric scale. The Mössbauer Spectroscopy confirmed the ferromagnetic ordering and was use to calculate the distribution of hyperfin field. The Mössbauer spectrum for both alloys shows the existence of a ferromagnetic phase attributed to γ-Fe-Ni solid solution.

Keywords: nanocrystalline, mechanical alloying, X-ray diffraction, Mössbauer spectroscopy, phase transformations

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6211 Innovation in the Provision of Medical Services in the Field of Qualified Sports and Services Related to the Therapy of Metabolism Disorders and the Treatment of Obesity

Authors: Jerzy Slowik, Elzbieta Grochowska-Niedworok

Abstract:

The analysis of the market needs and trends in both treatment and prophylaxis shows the growing need to implement comprehensive solutions that would enable safe contact of the beneficiaries with the therapeutic and diagnostic support group. Based on the evaluation of the medical and sports industry services market, projects co-financed by the EFRR in the form of comprehensive care systems using IT tools for patients under treatment in the field of obesity and metabolism using the system were implemented under the Regional Operational Program of the Silesian Voivodeship for 2014-2020. SFAO 1.0 (Support for the Fight Against Obesity) number of the WND-RPSL project. 01.02.00-24-06EA / 16) as well as for competitors in qualified sports SK system (qualified sports) project number WND-RPSL. 01.02.00-24-0630 / 17-002. The service provided in accordance with SFAO 1.0 has shown a wide range of therapy possibilities - from monitoring the body's reactions during sports activities of healthy people to remote care for sick patients. As a result of the introduction of an innovative service, it was possible to increase the effectiveness of the therapy, which was manifested in the reduction of the starting doses of drugs by 10%, improvement of the efficiency of the respiratory and blood circulation system, and a 10% increase in bone density. Innovation in the provision of medical services in the field of qualified sports SK was a response to the needs of the athletes and their parents, coaches, physiotherapists, dieticians, and doctors who take care of people actively practicing qualified sports. The creation of the platform made it possible to constantly monitor the trainers necessary for both the proper training process and the control over the health of patients. Monitoring the patient's health by a specialized team in the field of various specialties allows for the proper targeting of the treatment and training process due to the increase in the availability of medical counseling. Specialists taking care of the patient can provide additional advice and modify the medical treatment of the patient on an ongoing basis, which is why we are dealing with a holistic approach.

Keywords: innovation of medical services, sport, obesity, innovation

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6210 Occupational Cumulative Effective Doses of Radiation Workers in Hamad Medical Corporation in Qatar

Authors: Omar Bobes, Abeer Al-Attar, Mohammad Hassan Kharita, Huda Al-Naemi

Abstract:

The number of radiological examinations has increased steadily in recent years. As a result, the risk of possible radiation-induced consequential damage also increases through continuous, lifelong, and increasing exposure to ionizing radiation. Therefore, radiation dose monitoring in medicine became an essential element of medical practice. In this study, the occupational cumulative doses for radiation workers in Hamad medical corporation in Qatar have been assessed for a period of five years. The number of monitored workers selected for this study was 555 (out of a total of 1250 monitored workers) who have been working continuously -with no interruption- with ionizing radiation over the past five years from 2015 to 2019. The aim of this work is to examine the occupational groups and the activities where the higher radiation exposure occurred and in what order of magnitude. The most exposed group was the nuclear medicine technologist staff, with an average cumulative dose of 8.4 mSv. The highest individual cumulative dose was 9.8 mSv recorded for the PET-CT technologist category.

Keywords: cumulative dose, effective dose, monitoring, occupational exposure, dosimetry

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6209 Non-intrusive Hand Control of Drone Using an Inexpensive and Streamlined Convolutional Neural Network Approach

Authors: Evan Lowhorn, Rocio Alba-Flores

Abstract:

The purpose of this work is to develop a method for classifying hand signals and using the output in a drone control algorithm. To achieve this, methods based on Convolutional Neural Networks (CNN) were applied. CNN's are a subset of deep learning, which allows grid-like inputs to be processed and passed through a neural network to be trained for classification. This type of neural network allows for classification via imaging, which is less intrusive than previous methods using biosensors, such as EMG sensors. Classification CNN's operate purely from the pixel values in an image; therefore they can be used without additional exteroceptive sensors. A development bench was constructed using a desktop computer connected to a high-definition webcam mounted on a scissor arm. This allowed the camera to be pointed downwards at the desk to provide a constant solid background for the dataset and a clear detection area for the user. A MATLAB script was created to automate dataset image capture at the development bench and save the images to the desktop. This allowed the user to create their own dataset of 12,000 images within three hours. These images were evenly distributed among seven classes. The defined classes include forward, backward, left, right, idle, and land. The drone has a popular flip function which was also included as an additional class. To simplify control, the corresponding hand signals chosen were the numerical hand signs for one through five for movements, a fist for land, and the universal “ok” sign for the flip command. Transfer learning with PyTorch (Python) was performed using a pre-trained 18-layer residual learning network (ResNet-18) to retrain the network for custom classification. An algorithm was created to interpret the classification and send encoded messages to a Ryze Tello drone over its 2.4 GHz Wi-Fi connection. The drone’s movements were performed in half-meter distance increments at a constant speed. When combined with the drone control algorithm, the classification performed as desired with negligible latency when compared to the delay in the drone’s movement commands.

Keywords: classification, computer vision, convolutional neural networks, drone control

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6208 Myanmar Consonants Recognition System Based on Lip Movements Using Active Contour Model

Authors: T. Thein, S. Kalyar Myo

Abstract:

Human uses visual information for understanding the speech contents in noisy conditions or in situations where the audio signal is not available. The primary advantage of visual information is that it is not affected by the acoustic noise and cross talk among speakers. Using visual information from the lip movements can improve the accuracy and robustness of automatic speech recognition. However, a major challenge with most automatic lip reading system is to find a robust and efficient method for extracting the linguistically relevant speech information from a lip image sequence. This is a difficult task due to variation caused by different speakers, illumination, camera setting and the inherent low luminance and chrominance contrast between lip and non-lip region. Several researchers have been developing methods to overcome these problems; the one is lip reading. Moreover, it is well known that visual information about speech through lip reading is very useful for human speech recognition system. Lip reading is the technique of a comprehensive understanding of underlying speech by processing on the movement of lips. Therefore, lip reading system is one of the different supportive technologies for hearing impaired or elderly people, and it is an active research area. The need for lip reading system is ever increasing for every language. This research aims to develop a visual teaching method system for the hearing impaired persons in Myanmar, how to pronounce words precisely by identifying the features of lip movement. The proposed research will work a lip reading system for Myanmar Consonants, one syllable consonants (င (Nga)၊ ည (Nya)၊ မ (Ma)၊ လ (La)၊ ၀ (Wa)၊ သ (Tha)၊ ဟ (Ha)၊ အ (Ah) ) and two syllable consonants ( က(Ka Gyi)၊ ခ (Kha Gway)၊ ဂ (Ga Nge)၊ ဃ (Ga Gyi)၊ စ (Sa Lone)၊ ဆ (Sa Lain)၊ ဇ (Za Gwe) ၊ ဒ (Da Dway)၊ ဏ (Na Gyi)၊ န (Na Nge)၊ ပ (Pa Saug)၊ ဘ (Ba Gone)၊ ရ (Ya Gaug)၊ ဠ (La Gyi) ). In the proposed system, there are three subsystems, the first one is the lip localization system, which localizes the lips in the digital inputs. The next one is the feature extraction system, which extracts features of lip movement suitable for visual speech recognition. And the final one is the classification system. In the proposed research, Two Dimensional Discrete Cosine Transform (2D-DCT) and Linear Discriminant Analysis (LDA) with Active Contour Model (ACM) will be used for lip movement features extraction. Support Vector Machine (SVM) classifier is used for finding class parameter and class number in training set and testing set. Then, experiments will be carried out for the recognition accuracy of Myanmar consonants using the only visual information on lip movements which are useful for visual speech of Myanmar languages. The result will show the effectiveness of the lip movement recognition for Myanmar Consonants. This system will help the hearing impaired persons to use as the language learning application. This system can also be useful for normal hearing persons in noisy environments or conditions where they can find out what was said by other people without hearing voice.

Keywords: feature extraction, lip reading, lip localization, Active Contour Model (ACM), Linear Discriminant Analysis (LDA), Support Vector Machine (SVM), Two Dimensional Discrete Cosine Transform (2D-DCT)

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6207 Bone Fracture Detection with X-Ray Images Using Mobilenet V3 Architecture

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

Abstract:

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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6206 An Analysis of Brand-Building Characteristics in the Iran Airline Websites

Authors: Pedram Behyar, Zahra Bayat

Abstract:

The internet and web are changing ways of “far reaching scope and potential for transformation of the marketing functions”. The web is developing in a faster rate than any previous new communication medium. The website of destination has become a crucial branding channel, that is why all businesses are changing their way to communicate with their customers to encounter their needs and wants in better ways. Website provides numerous opportunities for businesses to strengthen their relationship with their customers. One of these opportunities is website component that enables internet users to make two-way communication with the businesses.

Keywords: marketing communication, brand image, usability, privacy and security, personalization and customization, responsiveness, customer online web experience

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6205 Isolation and Selection of Strains Perspective for Sewage Sludge Processing

Authors: A. Zh. Aupova, A. Ulankyzy, A. Sarsenova, A. Kussayin, Sh. Turarbek, N. Moldagulova, A. Kurmanbayev

Abstract:

One of the methods of organic waste bioconversion into environmentally-friendly fertilizer is composting. Microorganisms that produce hydrolytic enzymes play a significant role in accelerating the process of organic waste composting. We studied the enzymatic potential (amylase, protease, cellulase, lipase, urease activity) of bacteria isolated from the sewage sludge of Nur-Sultan, Rudny, and Fort-Shevchenko cities, the dacha soil of Nur-Sultan city, and freshly cut grass from the dacha for processing organic waste and identifying active strains. Microorganism isolation was carried out by the cultures enrichment method on liquid nutrient media, followed by inoculating on different solid media to isolate individual colonies. As a result, sixty-one microorganisms were isolated, three of which were thermophiles (DS1, DS2, and DS3). The highest number of isolates, twenty-one and eighteen, were isolated from sewage sludge of Nur-Sultan and Rudny cities, respectively. Ten isolates were isolated from the wastewater of the sewage treatment plant in Fort-Shevchenko. From the dacha soil of Nur-Sultan city and freshly cut grass - 9 and 5 isolates were revealed, respectively. The lipolytic, proteolytic, amylolytic, cellulolytic, ureolytic, and oil-oxidizing activities of isolates were studied. According to the results of experiments, starch hydrolysis (amylolytic activity) was found in 2 isolates - CB2/2, and CB2/1. Three isolates - CB2, CB2/1, and CB1/1 were selected for the highest ability to break down casein. Among isolated 61 bacterial cultures, three isolates could break down fats - CB3, CBG1/1, and IL3. Seven strains had cellulolytic activity - DS1, DS2, IL3, IL5, P2, P5, and P3. Six isolates rapidly decomposed urea. Isolate P1 could break down casein and cellulose. Isolate DS3 was a thermophile and had cellulolytic activity. Thus, based on the conducted studies, 15 isolates were selected as a potential for sewage sludge composting - CB2, CB3, CB1/1, CB2/2, CBG1/1, CB2/1, DS1, DS2, DS3, IL3, IL5, P1, P2, P5, P3. Selected strains were identified on a mass spectrometer (Maldi-TOF). The isolate - CB 3 was referred to the genus Rhodococcus rhodochrous; two isolates CB2 and CB1 / 1 - to Bacillus cereus, CB 2/2 - to Cryseobacterium arachidis, CBG 1/1 - to Pseudoxanthomonas sp., CB2/1 - to Bacillus megaterium, DS1 - to Pediococcus acidilactici, DS2 - to Paenibacillus residui, DS3 - to Brevibacillus invocatus, three strains IL3, P5, P3 - to Enterobacter cloacae, two strains IL5, P2 - to Ochrobactrum intermedium, and P1 - Bacillus lichenoformis. Hence, 60 isolates were isolated from the wastewater of the cities of Nur-Sultan, Rudny, Fort-Shevchenko, the dacha soil of Nur-Sultan city, and freshly cut grass from the dacha. Based on the highest enzymatic activity, 15 active isolates were selected and identified. These strains may become the candidates for bio preparation for sewage sludge processing.

Keywords: sewage sludge, composting, bacteria, enzymatic activity

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6204 Clinical Manifestations, Pathogenesis and Medical Treatment of Stroke Caused by Basic Mitochondrial Abnormalities (Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like Episodes, MELAS)

Authors: Wu Liching

Abstract:

Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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