Search results for: robust diagnosis

Authors: Shishay Kidanu, Abdullah Alhaj

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Sinkholes in the karst terrain of Greene County, Missouri, pose significant geohazards, imposing challenges on construction and infrastructure development, with potential threats to lives and property. To address these issues, understanding the influencing factors and modeling sinkhole susceptibility is crucial for effective mitigation through strategic changes in land use planning and practices. This study utilizes geographic information system (GIS) software to collect and process diverse data, including topographic, geologic, hydrogeologic, and anthropogenic information. Nine key sinkhole influencing factors, ranging from slope characteristics to proximity to geological structures, were carefully analyzed. The Frequency Ratio method establishes relationships between attribute classes of these factors and sinkhole events, deriving class weights to indicate their relative importance. Weighted integration of these factors is accomplished using the Analytic Hierarchy Process (AHP) and the Weighted Linear Combination (WLC) method in a GIS environment, resulting in a comprehensive sinkhole susceptibility index (SSI) model for the study area. Employing Jenk's natural break classifier method, the SSI values are categorized into five distinct sinkhole susceptibility zones: very low, low, moderate, high, and very high. Validation of the model, conducted through the Area Under Curve (AUC) and Sinkhole Density Index (SDI) methods, demonstrates a robust correlation with sinkhole inventory data. The prediction rate curve yields an AUC value of 74%, indicating a 74% validation accuracy. The SDI result further supports the success of the sinkhole susceptibility model. This model offers reliable predictions for the future distribution of sinkholes, providing valuable insights for planners and engineers in the formulation of development plans and land-use strategies. Its application extends to enhancing preparedness and minimizing the impact of sinkhole-related geohazards on both infrastructure and the community.

Keywords: sinkhole, GIS, analytical hierarchy process, frequency ratio, susceptibility, Missouri

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Authors: R. Meier, M. Pander

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In accordance with the industry 4.0 concept, manufacturing process steps as well as the materials themselves are going to be more and more digitalized within the next years. The “digital twin” representing the simulated and measured dataset of the (semi-finished) product can be used to control and optimize the individual processing steps and help to reduce costs and expenditure of time in product development, manufacturing, and recycling. In the present work, two material characterization methods based on Lamb waves were evaluated and compared. For demonstration purpose, both methods were shown at a standard industrial product - copper ribbons, often used in photovoltaic modules as well as in high-current microelectronic devices. By numerical approximation of the Rayleigh-Lamb dispersion model on measured phase velocities second order elastic constants (Young’s modulus, Poisson’s ratio) were determined. Furthermore, the effective third order elastic constants were evaluated by applying elastic, “non-destructive”, mechanical stress on the samples. In this way, small microstructural variations due to mechanical preconditioning could be detected for the first time. Both methods were compared with respect to precision and inline application capabilities. Microstructure of the samples was systematically varied by mechanical loading and annealing. Changes in the elastic ultrasound transport properties were correlated with results from microstructural analysis and mechanical testing. In summary, monitoring the elastic material properties of plate-like structures using Lamb waves is valuable for inline and non-destructive material characterization and manufacturing process control. Second order elastic constants analysis is robust over wide environmental and sample conditions, whereas the effective third order elastic constants highly increase the sensitivity with respect to small microstructural changes. Both Lamb wave based characterization methods are fitting perfectly into the industry 4.0 concept.

Keywords: lamb waves, industry 4.0, process control, elasticity, acoustoelasticity, microstructure

Procedia PDF Downloads 227

Authors: Sumera, Sanila Amber, Fatima Javed Mirza, Amjad Ali, Saadia Zahid

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Glioblastoma multiforme (GBM) is a widely spread and fatal primary brain tumor with an increased risk of relapse in spite of aggressive treatment. The current procedures for GBM diagnosis include invasive procedures i.e. resection or biopsy, to acquire tumor mass. Implementation of negligibly invasive tests as a potential diagnostic technique and biofluid-based monitoring of GBM stresses on discovering biomarkers in CSF and blood. Therefore, we performed a comprehensive in silico analysis to identify potential circulating biomarkers for GBM. Initially, six gene and protein databases were utilized to mine brain-specific proteins. The resulting proteins were filtered using a channel of five tools to predict the secretory proteins. Subsequently, the expression profile of the secreted proteins was verified in the brain and blood using two databases. Additional verification of the resulting proteins was done using Plasma Proteome Database (PPD) to confirm their presence in blood. The final set of proteins was searched in literature for their relationship with GBM, keeping a special emphasis on secretome proteome. 2145 proteins were firstly mined as brain-specific, out of which 69 proteins were identified as secretory in nature. Verification of expression profile in brain and blood eliminated 58 proteins from the 69 proteins, providing a final list of 11 proteins. Further verification of these 11 proteins further eliminated 2 proteins, giving a final set of nine secretory proteins i.e. OPCML, NPTX1, LGI1, CNTN2, LY6H, SLIT1, CREG2, GDF1 and SERPINI1. Out of these 9 proteins, 7 were found to be linked to GBM, whereas 2 proteins are not investigated in GBM so far. We propose that these secretory proteins can serve as potential circulating biomarker signatures of GBM and will facilitate the development of minimally invasive diagnostic methods and novel therapeutic interventions for GBM.

Keywords: glioblastoma multiforme, secretory proteins, brain secretome, biomarkers

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Authors: Noorulaine Maqsood, Saeed Khan

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Background: Concern regarding incident reporting and bio-safety training in clinical laboratories in Pakistan has increased remarkably in the last few years due to rapid increase in diagnosis and research on infectious organisms. In order to ensure the safety of employees, this issue needs to be addressed immediately. Bio-safety training sessions and lectures are necessary for the protection of laboratory workers in order to ensure safe practices and minimize the count of incident reporting in the lab. Objective: To carry out an inter-departmental survey in lab regarding the awareness of bio-safety practices among lab employees before and after conducting bio-safety training sessions. Methodology: We conducted a 30 questions survey of laboratory workers in June 2013 (before training session) to gather information related to bio-safety awareness. Afterwards, we conducted another survey after training sessions and workshops related to bio-safety. Result: The survey regarding bio-safety level showed that before the training session 32% of the participants were aware of bio-safety level being used in their lab whereas after the session this percentage increased to 72%. 48% of the participants had information about the proper usage of PPE which increased to 76%. Awareness regarding proper management of hazardous waste increased from 32% to 64%. The incident reporting practice, sample handling and hand hygiene awareness was previously reported to be 40%, 65%, and 52% that increased to 80%, 85% and 88% respectively after the training session was completed. Conclusion: The first survey results showed lack of awareness that suggest nearly all senior scientists, faculty, medical technologist, lab attendant and housekeeping staff working in laboratories are required to have bio-safety training, and required inspection at least twice a year by a bio-safety officer and also required to renew their bio-safety training. After the training session, significant changes in awareness level and attitude of the participants regarding biosafety practices were observed. Therefore, such bio-safety sessions should be carried out regularly in clinical laboratories.

Keywords: biosafety practices, clinical laboratory, Pakistan, survey

Procedia PDF Downloads 427

Authors: Viktor Müller, Ulman Lindenberger

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Neurophysiological evidence suggests that the physiological states of the system are characterized by specific network structures and network topology dynamics, demonstrating a robust interplay between network topology and function. It is also evident that interpersonal action coordination or social interaction (e.g., playing music in duets or groups) requires strong intra- and interbrain synchronization resulting in a specific hyper brain network activity across two or more brains to support such coordination or interaction. Such complex hyper brain networks can be described as multiplex or multilayer networks that have a specific multidimensional or multilayer network organization characteristic for superordinate systems and their constituents. The aim of the study was to describe multilayer hyper brain networks and synchronization patterns of guitarists playing guitar in a quartet by using electroencephalography (EEG) hyper scanning (simultaneous EEG recording from multiple brains) and following time-frequency decomposition and multilayer network construction, where within-frequency coupling (WFC) represents communication within different layers, and cross-frequency coupling (CFC) depicts communication between these layers. Results indicate that communication or coupling dynamics, both within and between the layers across the brains of the guitarists, play an essential role in action coordination and are particularly enhanced during periods of high demands on musical coordination. Moreover, multilayer hyper brain network topology and dynamical structure of guitar sounds showed specific guitar-guitar, brain-brain, and guitar-brain causal associations, indicating multilevel dynamics with upward and downward causation, contributing to the superordinate system dynamics and hyper brain functioning. It is concluded that the neuronal dynamics during interpersonal interaction are brain-wide and frequency-specific with the fine-tuned balance between WFC and CFC and can best be described in terms of multilayer multi-brain networks with specific network topology and connectivity strengths. Further sophisticated research is needed to deepen our understanding of these highly interesting and complex phenomena.

Keywords: EEG hyper scanning, intra- and interbrain coupling, multilayer hyper brain networks, social interaction, within- and cross-frequency coupling

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Authors: Himanshu Rohela

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BACKGROUND: Ewing sarcoma can arise in either bone or soft tissue. Extraskeletal Ewing sarcoma (EES) is an uncommon primary tumor of the soft tissues, accounting for 20 30% of all reported cases of ES. AIM: Was to investigate demographic distribution, survival analysis and factors affecting the survival and recurrence in patients of EES. METHODS: Retrospective study of 19 biopsy-proven EES was performed. Overall survival (OS) using log-rank test and factors affecting OS and local recurrence (LR) were evaluated for the entire cohort. RESULTS: Patients with EES had a mean age of 19.5 and it was more commonly seen in males (63%). Axial location (58%) and solitary presentation (84%) were more common. The average size was 11 cm, 3 of 19 were metastatic at presentation, with the lung beings the most common site for metastasis. 17 received NACT, 16 with VAC-IE regimen and 1 underwent a second line with GEM/DOCE regimen. Unplanned surgery was done in 2 of 19. 3 patients received definitive RT and 13 underwent surgical-wide local excision. 2 of 13 showed good response to NACT. 10 patients required readmission out of which 6 patients had chemotherapy-related complications, 2 had surgical site complications and one patient developed secondary AML post-completion of treatment. A total of 4 patients had a recurrence. One had local recurrence alone, one had distant recurrence alone and 2 patients had a distant and local recurrence both. Tumor size >10 cm, axial location, and previous unplanned surgery was associated with higher LR rate. The mean overall survival was 32 months (2.66 years), with higher rates seen in non-metastatic and non-recurrent settings. CONCLUSIONS: Early and accurate diagnosis is the key to the management of EES, with promising results seen via NACT and RO resection regimens. But further studies with larger study groups are needed to standardize the treatment protocol and evaluate its efficacy.

Keywords: Ewings, sarcoma, extraskeletal, chemotherapy

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Authors: Kholod Khairy Salama, Shabban Hassan Thabet

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In the present study, a comprehensive investigation has been undertaken into an Egyptian mural painting with feet wear slippers approach to choose the most successful restoration methods. The mural painting under examination dates back to the Amarna period; it was detached from a wall of an unknown tomb in Egypt, and currently, it is initially displayed in a showcase at the Egyptian Museum – Tahrir Square – Cairo, Egypt. The main objectives of this research were to (a) reveal the pigment used in the mural painting, (b) reveal the medium used with colours, (c) determine the technique of manufacturing, (e) determine the ground support, and (f) reveal the main deterioration aspects. The analytical techniques used for investigation were Optical Microscopy, Raman, X-ray Florescence, X-ray diffraction, and Fourier transform infrared coupled with attenuated total reflectance “FTIR-ATR”. The investigation revealed that the vital deterioration factors affecting the object. This research aims to examine and analyze the mural painting to choose the suitable method for the restoration process (a) define the colours through comparative analysis to choose the suitable material for cleaning, (b) define the natural structure of the ground support layer, which appeared as mud layer (c) determine the medium used with colours (d) diagnosis the presence of the white wash layer, and (e) choose the suitable restoration methods according to the results. Conclusion: This study focused mainly on the physical and chemical properties of the mural painting compound and the main changes that happened to the mural painting material, which caused deterioration and fall down of the painting parts, so we can find the best and optimum restoration ways for this object.

Keywords: mural paintings, Tal Al-Amarna, digital microscope, Raman, XRF, XRD, FTIR

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Authors: Stephanie Nihan, Jayson M. Fadrigalan, Pyay P. San, Steven M. Santos, Weihui Li

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People of all ages who use wheelchairs are left with the inconvenience of not having an easy way to take their vital signs. Typically, patients are required to visit the hospital in order to take the vital signs. VitalGO is a wheel chair system that equipped with medical devices to take vital signs and then transmit data to a mobile application for convenient, long term health monitoring. The vital signs include oxygen saturation, heart rate, and blood pressure, breathing rate and body temperature. Oxygen saturation and heart rate are monitored through pulse oximeter. Blood pressure is taken through a radar sensor. Breathing rate is derived through thoracic impedance while body temperature is measured through an infrared thermometer. The application receives data through bluetooth and stores in a database for review in a simple graphical interface. The application will have the ability to display this data over various time intervals such as a day, week, month, 3 months, 6 months and a year. The final system for the mobile app can also provide an interface for both the user and their physician(s) to record notes or keep record of daily symptoms that a patient might be having. The user’s doctor will be granted access by the user to view the patient information for assistance with a more accurate diagnosis. Also, this wheelchair accessory conveniently includes a foldable table/desk as somewhere to place an electronic device that may be used to access the app. The foldable table will overall contribute to the wheelchair user’s increased comfort and will give them somewhere to place food, a book, or any other form of entertainment that would normally be hard to juggle on their lap.

Keywords: wheel chair, vital sign, mobile application, telemedicine

Procedia PDF Downloads 331

Authors: Kgolagano Mpejane

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The study applies a New Institutional Economics (NIE) analytical framework to trade in developing economies by assessing the impacts of institutional quality and institutional quality distance on agricultural trade using a panel data of 15 Southern African Development Community (SADC) countries from the years 1991-2010. The issue of institutions on agricultural trade has not been accorded the necessary attention in the literature, particularly in developing economies. Therefore, the paper empirically tests the gravity model of international trade by measuring the impact of political, economic and legal institutions on intra SADC agricultural trade. The gravity model is noted for its exploratory power and strong theoretical foundation. However, the model has statistical shortcomings in dealing with zero trade values and heteroscedasticity residuals leading to biased results. Therefore, this study employs a two stage Heckman selection model with a Probit equation to estimate the influence of institutions on agricultural trade. The selection stages include the inverse Mills ratio to account for the variable bias of the gravity model. The Heckman model accounts for zero trade values and is robust in the presence of heteroscedasticity. The empirical results of the study support the NIE theory premise that institutions matter in trade. The results demonstrate that institutions determine bilateral agricultural trade on different margins with political institutions having positive and significant influence on bilateral agricultural trade flows within the SADC region. Legal and economic institutions have significant and negative effects on SADC trade. Furthermore, the results of this study confirm that institutional quality distance influences agricultural trade. Legal and political institutional distance have a positive and significant influence on bilateral agricultural trade while the influence of economic, institutional quality is negative and insignificant. The results imply that nontrade barriers, in the form of institutional quality and institutional quality distance, are significant factors limiting intra SADC agricultural trade. Therefore, gains from intra SADC agricultural trade can be attained through the improvement of institutions within the region.

Keywords: agricultural trade, institutions, gravity model, SADC

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Authors: Jorge Rodriguez-Guerra, Carlos Calleja, Aron Pujana, Iker Elorza, Ana Maria Macarulla

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Society demands more reliable manufacturing processes capable of producing high quality products in shorter production cycles. New control algorithms have been studied to satisfy this paradigm, in which Fault-Tolerant Control (FTC) plays a significant role. It is suitable to detect, isolate and adapt a system when a harmful or faulty situation appears. In this paper, a general overview about FTC characteristics are exposed; highlighting the properties a system must ensure to be considered faultless. In addition, a research to identify which are the main FTC techniques and a classification based on their characteristics is presented in two main groups: Active Fault-Tolerant Controllers (AFTCs) and Passive Fault-Tolerant Controllers (PFTCs). AFTC encompasses the techniques capable of re-configuring the process control algorithm after the fault has been detected, while PFTC comprehends the algorithms robust enough to bypass the fault without further modifications. The mentioned re-configuration requires two stages, one focused on detection, isolation and identification of the fault source and the other one in charge of re-designing the control algorithm by two approaches: fault accommodation and control re-design. From the algorithms studied, one has been selected and applied to a case study based on an industrial hydraulic-press. The developed model has been embedded under a real-time validation platform, which allows testing the FTC algorithms and analyse how the system will respond when a fault arises in similar conditions as a machine will have on factory. One AFTC approach has been picked up as the methodology the system will follow in the fault recovery process. In a first instance, the fault will be detected, isolated and identified by means of a neural network. In a second instance, the control algorithm will be re-configured to overcome the fault and continue working without human interaction.

Keywords: fault-tolerant control, electro-hydraulic actuator, fault detection and isolation, control re-design, real-time

Procedia PDF Downloads 177

Authors: Wania Mohammad Akram, Swetha Kannan, Urooj Shahid, Aisha Sajjad

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Ovarian ectopic pregnancy, a rare manifestation of ectopic gestation, involves the implantation of a fertilized egg on the ovarian surface. This condition poses diagnostic challenges and is associated with significant maternal morbidity if not promptly managed. This report presents the case of a 33-year-old nulliparous woman with a history of polycystic ovary syndrome (PCOS) undergoing ovulation induction therapy. Following her first conception in October 2021, she presented with symptoms of per vaginal spotting and low back pain, prompting a diagnosis of left adnexal ectopic pregnancy confirmed by transvaginal ultrasound and serum beta-human chorionic gonadotropin (B-HCG) levels. Medical management with methotrexate was initiated successfully. In August 2022, the patient conceived again, with subsequent ultrasound revealing a large pelvic collection suggestive of a complex ectopic pregnancy involving both ovaries. Despite initial stability, she developed abdominal pain necessitating emergency laparoscopy, which revealed an ovarian ectopic pregnancy with hemoperitoneum. Laparotomy was performed due to the complexity of the presentation, and histopathology confirmed viable chorionic villi within ovarian tissue. This case underscores the clinical management challenges posed by ovarian ectopic pregnancies, particularly in patients with previous ectopic pregnancies. The discussion reviews current literature on diagnostic modalities, treatment strategies, and outcomes associated with ovarian ectopic pregnancies, emphasizing the role of surgical intervention in cases refractory to conservative management. Tailored approaches considering individual patient factors are crucial to optimize outcomes and preserve fertility in such complex scenarios.

Keywords: obgyn, ovarian ectopic pregnancy, laproscopy, pcos

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Authors: Edward Poluyi, Eghosa Morgan, Charles Poluyi, Chibuikem Ikwuegbuenyi, Grace Imaguezegie

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Background: Current epidemiological studies have examined the associations between moderate and severe traumatic brain injury (TBI) and their risks of developing neurodegenerative diseases. Concussion, also known as mild TBI (mTBI), is however quite distinct from moderate or severe TBIs. Only few studies in this burgeoning area have examined concussion—especially repetitive episodes—and neurodegenerative diseases. Thus, no definite relationship has been established between them. Objectives : This review will discuss the available literature linking concussion and amyotrophic lateral sclerosis (ALS) and Alzheimer’s disease (AD). Materials and Methods: Given the complexity of this subject, a realistic review methodology was selected which includes clarifying the scope and developing a theoretical framework, developing a search strategy, selection and appraisal, data extraction, and synthesis. A detailed literature matrix was set out in order to get relevant and recent findings on this topic. Results: Presently, there is no objective clinical test for the diagnosis of concussion because the features are less obvious on physical examination. Absence of an objective test in diagnosing concussion sometimes leads to skepticism when confirming the presence or absence of concussion. Intriguingly, several possible explanations have been proposed in the pathological mechanisms that lead to the development of some neurodegenerative disorders (such as ALS and AD) and concussion but the two major events are deposition of tau proteins (abnormal microtubule proteins) and neuroinflammation, which ranges from glutamate excitotoxicity pathways and inflammatory pathways (which leads to a rise in the metabolic demands of microglia cells and neurons), to mitochondrial function via the oxidative pathways.

Keywords: amyotrophic lateral sclerosis, Alzheimer's disease, mild traumatic brain injury, neurodegeneration

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Authors: Anwaar Anwar Tayel

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Background: Rheumatic arthritis (RA) affect all aspects of patients' life, lead to various degrees of disability, and ultimately has a profound impact on the social, economic, psychological, and sexual aspects of the patient's life. Aim of the study: Identify physical, psychological, and sexual implications of rheumatoid arthritis among women in reproductive age. In addition to investigating the correlations between physical functional disability, psychological problems, and sexual dysfunction.Settings: The study was conducted at Rheumatology Clinic at the Main University Hospital of Alexandria. Subjects: Purposive sample was chosen from women patients with rheumatoid arthritis to be subjects of this study (n=250). Tools: Four tools were used to collect data. Tool I: Socio-demographic questionnaire. Tool II: Stanford Health Assessment Questionnaire Disability Index (HAQ- DI). Tool III: Depression Anxiety Stress Scale (DASS). Tool IV: The Sexual Dysfunction Questionnaire (SDQ) Results: The majority of the studied women suffer from severe physical disability, extreme level of depression, anxiety, and about half of them had an extreme level of stress. Also, the majority of the studied women had a severe level of sexual dysfunction. Also, statistically significant correlations between women's physical disability index, psychological problems, and sexual dysfunction were detected. Conclusion: The findings from this study confirm that women patients with RA suffer from multiple negative implications on the physical, psychological and sexual functions. Recommendations: Provide ongoing support to the patients from the time of diagnosis throughout their care and management. To help them to manage their pain and disabilities, improve their sexual function, promote their mental health, and optimize psychosocial functioning

Keywords: pysical, spycholgical, sexual, implication, rheumatic arthritis

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Authors: Faiza Marrium, Masood Rabbani, Ali Ahmad Sheikh, Muhammad Yasin Tipu Javed Muhammad, Sohail Raza

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More than 75% diseases spreading in the past 10 years in human population globally are linked to veterinary sector. Veterinary diagnostic labs are the powerful ally for diagnosis, prevention and monitoring of animal diseases in any country. In order to avoid detrimental effects of errors in disease diagnostic and biorisk management, there is a dire need to establish quality control system. In current study, 3 private and 6 public sectors veterinary diagnostic labs were selected for survey. A questionnaire survey in biorisk management guidelines of CWA 15793 was designed to find quality control breaches in lab design, personal, equipment and consumable, quality control measures adopted in lab, waste management, environmental monitoring and customer care. The data was analyzed through frequency distribution statistically by using (SPSS) version 18.0. A non-significant difference was found in all parameters of lab design, personal, equipment and consumable, quality control measures adopted in lab, waste management, environmental monitoring and customer care with an average percentage of 46.6, 57.77, 52.7, 55.5, 54.44, 48.88 and 60, respectively. A non-significant difference among all nine labs were found, with highest average compliance percentage of all parameters are lab 2 (78.13), Lab 3 (70.56), Lab 5 (57.51), Lab 6 (56.37), Lab 4 (55.02), Lab 9 (49.58), Lab 7 (47.76), Lab 1 (41.01) and Lab 8 (36.09). This study shows that in Lahore district veterinary diagnostic labs are not giving proper attention to quality of their system and there is no significant difference between setups of private and public sector laboratories. These results show that most of parameters are between 50 and 80 percent, which needs some work and improvement as per WHO criteria.

Keywords: veterinary lab, quality management system, accreditation, regulatory body, disease identification

Procedia PDF Downloads 146

Authors: Mohamed Abdalla, Ruixue Cheng, Jianyong Zhang

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In pneumatic conveying, the solids are mixed with air or gas. In industries such as coal fired power stations, blast furnaces for iron making, cement and flour processing, the mass flow rate of solids needs to be monitored or controlled. However the current gas-solids two-phase flow measurement techniques are not as accurate as the flow meters available for the single phase flow. One of the problems that the multi-phase flow meters to face is that the flow profiles vary with measurement locations and conditions of pipe routing, bends, elbows and other restriction devices in conveying system as well as conveying velocity and concentration. To measure solids flow rate or concentration with non-even distribution of solids in gas, a uniform spatial sensitivity is required for a multi-phase flow meter. However, there are not many meters inherently have such property. The circular electrostatic meter is a popular choice for gas-solids flow measurement with its high sensitivity to flow, robust construction, low cost for installation and non-intrusive nature. However such meters have the inherent non-uniform spatial sensitivity. This paper first analyses the spatial sensitivity of circular electrostatic meter in general and then by combining the effect of the sensitivity to a single particle and the sensing volume for a given electrode geometry, the paper reveals first time how a circular electrostatic meter responds to a roping flow stream, which is much more complex than what is believed at present. The paper will provide the recent research findings on spatial sensitivity investigation at the University of Tees side based on Finite element analysis using Ansys Fluent software, including time and frequency domain characteristics and the effect of electrode geometry. The simulation results will be compared tothe experimental results obtained on a large scale (14” diameter) rig. The purpose of this research is paving a way to achieve a uniform spatial sensitivity for the circular electrostatic sensor by mean of compensation so as to improve overall accuracy of gas-solids flow measurement.

Keywords: spatial sensitivity, electrostatic sensor, pneumatic conveying, Ansys Fluent software

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Authors: Sungmin Park, Gyungmok Nam, Seungpyo Woo, Young Choi, Sangheon Park, Sang-Hee Yoon

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Puncturing human skin with microneedles is critically important for microneedle-mediate drug delivery. Despite of extensive efforts in the past decades, the scale-up fabrication of sharp-tipped and high-aspect-ratio microneedles, especially made of biodegradable polymers, is still a long way off. Here, we present a UV dose insensitive and cost-effective microfabrication method for the biodegradable polymer microneedles with sharp tips and long lengths which can pierce human skin with low insertion force. The biodegradable polymer microneedles are fabricated with the polymer solution casting where a poly(lactic-co-glycolic acid) (PLGA, 50:50) solution is coated onto a SU-8 mold prepared with a reverse, ramped, and rotational (R3) UV exposure. The R3 UV exposure is modified from the multidirectional UV exposure both to suppress UV reflection from the bottom surface without anti-reflection layers and to optimize solvent concentration in the SU-8 photoresist, therefore achieving robust (i.e., highly insensitive to UV dose) and cost-effective fabrication of biodegradable polymer microneedles. An optical model for describing the spatial distribution of UV irradiation dose of the R3 UV exposure is also developed to theoretically predict the microneedle geometry fabricated with the R3 UV exposure and also to demonstrate the insensitiveness of microneedle geometry to UV dose. In the experimental characterization, the microneedles fabricated with the R3 UV exposure are compared with those fabricated with a conventional method (i.e., multidirectional UV exposure). The R3 UV exposure-based microfabrication reduces the end-tip radius by a factor of 5.8 and the deviation from ideal aspect ratio by 74.8%, compared with conventional method-based microfabrication. The PLGA microneedles fabricated with the R3 UV exposure pierce full-thickness porcine skins successfully and are demonstrated to completely dissolve in PBS (phosphate-buffered saline). The findings of this study will lead to an explosive growth of the microneedle-mediated drug delivery market.

Keywords: R³ UV exposure, optical model, UV dose, reflection, solvent concentration, biodegradable polymer microneedle

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Authors: Katharina Fellnhofer, Kaisu Puumalainen

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Despite the current worldwide increasing interest in entrepreneurship education (EE), little attention has been paid to innovative web-based ways such as the narrative approach by telling individual stories of entrepreneurs via multimedia for demonstrating the impact on individuals towards entrepreneurship. In addition, this research discipline is faced with no consensus regarding its effective content of teaching materials and tools. Therefore, a qualitative hypothesis-generating research contribution is required to aim at drawing new insights from published works in the EE field of research to serve for future research related to multimedia entrepreneurial narratives. Based on this background, our effort will focus on finding support regarding following introductory statement: Multimedia success and failure stories of real entrepreneurs show potential to change perceptions towards entrepreneurship in a positive way. The proposed qualitative conceptual paper will introduce the underlying background for this research framework. Therefore, as a qualitative hypothesis-generating research contribution it aims at drawing new insights from published works in the EE field of research related to entrepreneurial narratives to serve for future research. With the means of the triangulation of multiple theories, we will utilize the foundation for multimedia-based entrepreneurial narratives applying a learning-through-multimedia-real-entrepreneurial-narratives pedagogical tool to facilitate entrepreneurship. Our effort will help to demystify how value-oriented entrepreneurs telling their stories multimedia can simultaneously enhance EE. Therefore, the paper will build new-fangled bridges between well-cited theoretical constructs to build a robust research framework. Overall, the intended contribution seeks to emphasize future research of currently under-researched issues in the EE sphere, which are considered to be essential not only to academia, as well as to business and society having future jobs-providing growth-oriented entrepreneurs in mind. The Authors would like to thank the Austrian Science Fund FWF: [J3740 – G27].

Keywords: entrepreneurship education, entrepreneurial attitudes and perceptions, entrepreneurial intention, entrepreneurial narratives

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Authors: Amira ben Hassine, A. Valverde, V. Serafín, C. Muñoz-San Martín, M. Garranzo-Asensio, M. Gamella, R. Barderas, M. Pedrero, N. Raouafi, S. Campuzano, P. Yáñez-Sedeño, J. M. Pingarrón

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This work describes the development of a dual electrochemical immunosensing platform for accurate determination of two target proteins, IL-13 Receptor α2 (IL-13Rα2) and E-cadherin (E-cad). The proposed methodology is based on the use of sandwich immunosensing approaches (involving horseradish peroxidase-labeled detector antibodies) implemented onto magnetic microbeads (MBs) and amperometric transduction at screen-printed dual carbon electrodes (SPdCEs). The magnetic bioconjugates were captured onto SPdCEs and the amperometric transduction was performed using the H2O2/hydroquinone (HQ) system. Under optimal experimental conditions, the developed bio platform demonstrates linear concentration ranges of 1.0–25 and 5.0-100 ng mL-1, detection limits of 0.28 and 1.04 ng mL-1 for E-cad and IL-13Rα2, respectively, and excellent selectivity against other non-target proteins. The developed immuno-platform also offers a good reproducibility among amperometric responses provided by nine different sensors constructed in the same manner (Relative Standard Deviation values of 3.1% for E-cad and 4.3% for IL-13Rα2). Moreover, obtained results confirm the practical applicability of this bio-platform for the accurate determination of the endogenous levels of both extracellular receptors in colon cancer cells (both intact and lysed) with different metastatic potential and serum and tissues from patients diagnosed with colorectal cancer at different grades. Interesting features in terms of, simplicity, speed, portability and sample amount required to provide quantitative results, make this immuno-platform more compatible than conventional methodologies with the clinical diagnosis and prognosis at the point of care.

Keywords: electrochemistry, mmunosensors, biosensors, E-cadherin, IL-13 receptor α2, cancer colorectal

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Authors: Samar Mousa, Galini Mavromatidou, Rebecca Shirley

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Surgeons carry out numerous operations in the busy burns and plastic surgery department daily. Writing an accurate operation note with all the essential information is crucial for communication not only within the plastics team but also to the multi-disciplinary team looking after the patient, including other specialties, nurses and GPs. The Royal college of surgeons of England, in its guidelines of good surgical practice, mentioned that the surgeon should ensure that there are clear (preferably typed) operative notes for every procedure. The notes should accompany the patient into recovery and to the ward and should give sufficient detail to enable continuity of care by another doctor. The notes should include the Date and time, Elective/emergency procedure, Names of the operating surgeon and assistant, Name of the theatre anesthetist, Operative procedure carried out, Incision, Operative diagnosis, Operative findings, Any problems/complications, Any extra procedure performed and the reason why it was performed, Details of tissue removed, added or altered, Identification of any prosthesis used, including the serial numbers of prostheses and other implanted materials, Details of closure technique, Anticipated blood loss, Antibiotic prophylaxis (where applicable), DVT prophylaxis (where applicable), Detailed postoperative care instructions and Signature. Fourteen random days were chosen in December 2021 to assess the accuracy of operative notes and post-operative care. A total of 163 operative notes were examined. The average completion rates in all domains were 85.4%. An electronic operative note template was designed to cover all domains mentioned in the Royal College of surgeons' good surgical practice. It is kept in the hospital drive for all surgeons to use.

Keywords: operative notes, plastic surgery, documentation, electronic

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Authors: Joy Cao, Min Zhou

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Purpose: Acute Type A aortic dissection is a well-known cause of extremely high mortality rate. A highly accurate and cost-effective non-invasive predictor is critically needed so that the patient can be treated at earlier stage. Although various CFD approaches have been tried to establish some prediction frameworks, they are sensitive to uncertainty in both image segmentation and boundary conditions. Tedious pre-processing and demanding calibration procedures requirement further compound the issue, thus hampering their clinical applicability. Using the latest physics informed deep learning methods to establish an accurate and cost-effective predictor framework are amongst the main goals for a better Type A aortic dissection treatment. Methods: Via training a novel physics-informed deep residual network, with non-invasive 4D MRI displacement vectors as inputs, the trained model can cost-effectively calculate all these biomarkers: aortic blood pressure, WSS, and OSI, which are used to predict potential type A aortic dissection to avoid the high mortality events down the road. Results: The proposed deep learning method has been successfully trained and tested with both synthetic 3D aneurysm dataset and a clinical dataset in the aortic dissection context using Google colab environment. In both cases, the model has generated aortic blood pressure, WSS, and OSI results matching the expected patient’s health status. Conclusion: The proposed novel physics-informed deep residual network shows great potential to create a cost-effective, non-invasive predictor framework. Additional physics-based de-noising algorithm will be added to make the model more robust to clinical data noises. Further studies will be conducted in collaboration with big institutions such as Cleveland Clinic with more clinical samples to further improve the model’s clinical applicability.

Keywords: type-a aortic dissection, deep residual networks, blood flow modeling, data-driven modeling, non-invasive diagnostics, deep learning, artificial intelligence.

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Authors: Choki, Supatchai Boonpratham, Suwannee Luppanapornlarp

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The objective of this study was to find a correlation between cephalometric measurements and visual perception of facial profile in skeletal type II patients. In this study, 250 lateral cephalograms of female patients from age, 20 to 22 years were analyzed. The profile outlines of all the samples were hand traced and transformed into silhouettes by the principal investigator. Profile ratings were done by 9 orthodontists on Visual Analogue Scale from score one to ten (increasing level of convexity). 37 hard issue and soft tissue cephalometric measurements were analyzed by the principal investigator. All the measurements were repeated after 2 weeks interval for error assessment. At last, the rankings of visual perceptions were correlated with cephalometric measurements using Spearman correlation coefficient (P < 0.05). The results show that the increase in facial convexity was correlated with higher values of ANB (A point, nasion and B point), AF-BF (distance from A point to B point in mm), L1-NB (distance from lower incisor to NB line in mm), anterior maxillary alveolar height, posterior maxillary alveolar height, overjet, H angle hard tissue, H angle soft tissue and lower lip to E plane (absolute correlation values from 0.277 to 0.711). In contrast, the increase in facial convexity was correlated with lower values of Pg. to N perpendicular and Pg. to NB (mm) (absolute correlation value -0.302 and -0.294 respectively). From the soft tissue measurements, H angles had a higher correlation with visual perception than facial contour angle, nasolabial angle, and lower lip to E plane. In conclusion, the findings of this study indicated that the correlation of cephalometric measurements with visual perception was less than expected. Only 29% of cephalometric measurements had a significant correlation with visual perception. Therefore, diagnosis based solely on cephalometric analysis can result in failure to meet the patient’s esthetic expectation.

Keywords: cephalometric measurements, facial profile, skeletal type II, visual perception

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Authors: Engy S. El-Kayal, Mohamed M. S. Arafa

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There are various causes of ankle pain including traumatic and non-traumatic causes. Various imaging techniques are available for assessment of AP. MRI is considered to be the imaging modality of choice for ankle joint evaluation with an advantage of its high spatial resolution, multiplanar capability, hence its ability to visualize small complex anatomical structures around the ankle. However, the high costs and the relatively limited availability of MRI systems, as well as the relatively long duration of the examination all are considered disadvantages of MRI examination. Therefore there is a need for a more rapid and less expensive examination modality with good diagnostic accuracy to fulfill this gap. HRU has become increasingly important in the assessment of ankle disorders, with advantages of being fast, reliable, of low cost and readily available. US can visualize detailed anatomical structures and assess tendinous and ligamentous integrity. The aim of this study was to compare the diagnostic accuracy of HRU with MRI in the assessment of patients with AP. We included forty patients complaining of AP. All patients were subjected to real-time HRU and MRI of the affected ankle. Results of both techniques were compared to surgical and arthroscopic findings. All patients were examined according to a defined protocol that includes imaging the tendon tears or tendinitis, muscle tears, masses, or fluid collection, ligament sprain or tears, inflammation or fluid effusion within the joint or bursa, bone and cartilage lesions, erosions and osteophytes. Analysis of the results showed that the mean age of patients was 38 years. The study comprised of 24 women (60%) and 16 men (40%). The accuracy of HRU in detecting causes of AP was 85%, while the accuracy of MRI in the detection of causes of AP was 87.5%. In conclusions: HRU and MRI are two complementary tools of investigation with the former will be used as a primary tool of investigation and the latter will be used to confirm the diagnosis and the extent of the lesion especially when surgical interference is planned.

Keywords: ankle pain (AP), high-resolution ultrasound (HRU), magnetic resonance imaging (MRI) ultrasonography (US)

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Authors: Abdurrauf M. Gusbi, Mahmud H. Arhima, Abdurrahim A. Elouzi, Ebtisam A. Benomran, Salsabeela Elmezwghi, Aram Elhatan, Nafesa Elgusbi

Abstract:

Mass poisonings with methanol are rare but occur regularly both in developed and in non-developing countries. As a result of the tragedy that happened in the city of Tripoli Libya in March during year 2013 a number of patients were admitted to Tripoli Medical Center and Tripoli Central Hospital suffering from poisoning following ingestion of methanol by mistake. Our aims have been formulated to collect Information about those cases as much as we can from the archiving departments from the two hospitals including the number of cases that had been admitted, recovered patients and died victims. This retrospective study was planned to find out the reasons which allow those patients to drink methanol in our Muslim community and also the role of pharmacist to prevent such a disaster that claimed the lives of many people. During this tragedy 291 ospitalized patients their ages between 16-32 years old were admitted to both hospitals, total number of died 189 (121 at Tripoli medical center) and (68 at Tripoli central hospital), demographic data also shows that most of them are male (97%) and (3% female), about 4% of the patients foreigners and 96% were Libyans. There were a lot of obstacles and poor facilities at the time of patient admission as recognized in many cases including lack of first line of treatment. The morbidity was high due to the lack of antidote and availability of dialysis machines at this two main hospitals in Tripoli also according to survey done to the medical staff and also a random number of medical students shows about 28% have no idea about the first aid procedure used for methanol poisoning cases and this due to the absence of continuing education for all medical staff through the establishment of training courses on first aid, rapid diagnosis of poisoning and follow the written procedures to dealing with such cases.

Keywords: ethanol, fomepizole, methanol, poisoning

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Authors: Jorge Iván Bañol-Betancur, Lina María Martínez-Sánchez, María de los Ángeles Rodríguez-Gázquez, Estefanía Bahamonde-Olaya, Ana María Gutiérrez-Tamayo, Laura Isabel Jaramillo-Jaramillo, Camilo Ruiz-Mejía, Natalia Morales-Quintero

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Acute chest pain is a distressing sensation between the diaphragm and the base of the neck and it represents a diagnostic challenge for any physician in the emergency department. Objective: To establish the main clinical and epidemiological characteristics of patients who present with chest pain to the emergency department in a private clinic from the city of Medellin, during 2014-2015. Methods: Cross-sectional retrospective observational study. Population and sample were patients who consulted for chest pain in the emergency department who met the eligibility criteria. The information was analyzed in SPSS program vr.21; qualitative variables were described through relative frequencies, and the quantitative through mean and standard deviation ‬or medians according to their distribution in the study population. Results: A total of 231 patients were evaluated, the mean age was 49.5 ± 19.9 years, 56.7% were females. The most frequent pathological antecedents were hypertension 35.5%, diabetes 10,8%, dyslipidemia 10.4% and coronary disease 5.2%. Regarding pain features, in 40.3% of the patients the pain began abruptly, in 38.2% it had a precordial location, for 20% of the cases physical activity acted as a trigger, and 60.6% was oppressive. Costochondritis was the most common cause of chest pain among patients with an established etiologic diagnosis, representing the 18.2%. Conclusions: Although the clinical features of pain reported coincide with the clinical presentation of an acute coronary syndrome, the most common cause of chest pain in study population was costochondritis instead, indicating that it is a differential diagnostic in the approach of patients with pain acute chest.

Keywords: acute coronary syndrome, chest pain, epidemiology, osteochondritis

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Authors: Ying-Yi Laio, Yea-Ru Yang, Yih-Ru Wu, Ray-Yau Wang

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Background: Virtual reality (VR) systems are proved to increase motor performance in stroke and elderly. However, the effects have not been established in patients with Parkinson’s disease (PD). Purpose: To examine the effects of VR based training in improving muscle strength, sensory integration ability and walking abilities in patients with PD by a randomized controlled trial. Method: Thirty six participants with diagnosis of PD were randomly assigned to one of the three groups (n=12 for each group). Participants received VR-based Wii Fit exercise (VRWii group) or traditional exercise (TE group) for 45 minutes, followed by treadmill training for another 15 minutes for 12 sessions in 6 weeks. Participants in the control group received no structured exercise program but fall-prevention education. Outcomes included lower extremity muscle strength, sensory integration ability, walking velocity, stride length, and functional gait assessment (FGA). All outcomes were assessed at baseline, after training and at 1-month follow-up. Results: Both VRWii and TE groups showed more improvement in level walking velocity, stride length, FGA, muscle strength and vestibular system integration than control group after training and at 1-month follow-up. The VRWii training, but not the TE training, resulted in more improvement in visual system integration than the control. Conclusions: VRWii training is as beneficial as traditional exercise in improving walking abilities, sensory integration ability and muscle strength in patients with PD, and such improvements persisted at least for 1 month. The VRWii training is then suggested to be implemented in patients with PD.

Keywords: virtual reality, walking, sensory integration, muscle strength, Parkinson’s disease

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Authors: Domenica Tambasco, Riina Bray, Sophia Jaworski, Gillian Grant, Celeste Corkery

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Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and reduced function. Management of symptoms include medications, physical treatments and mindfulness therapies. Myofascial Release is a modality that has been successfully applied in var-ious musculoskeletal conditions. However, to the author’s best knowledge, it is not yet recog-nized as a self-management therapy option in Fibromyalgia. In this study, we investigated whether Self-applied Myofascial Release (SMR) is associated with overall improved function and symptoms in Fibromyalgia. Methods: Eligible adult patients with a confirmed diagnosis of Fibromyalgia at Women’s College Hospital were recruited to SMR. Sessions ran for 1 hour once a week for 7 weeks, led by the same two Physiotherapists knowledgeable in this physical treat-ment modality. The main outcome measure was an overall impact score for function and symp-toms based on the validated assessment tool for Fibromyalgia, the Revised Fibromyalgia Impact Questionnaire (FIQR), measured pre and post-intervention. Both descriptive and analytical methods were applied and reported. Results: We analyzed results using a paired t-test to deter-mine if there was a statistically significant difference in mean FIQR scores between initial (pre-intervention) and final (post-intervention) scores. A clinically significant difference in FIQR was defined as a reduction in score by 10 or more points. Conclusions: Our pilot study showed that SMR appeared to be a safe and effective intervention for our Fibromyalgia participants and the overall impact on function and symptoms occurred in only 7 weeks. Further studies with larger sample sizes comparing SMR to other physical treatment modalities (such as stretching) in an RCT are recommended.

Keywords: fibromyalgia, myofascial release, physical therapy, FIQR

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Authors: Murat Emre, Zeynep Tufekcioglu

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Objective: We describe a patient with late onset phenylketonuria which presented with rapidly progressive dementia and parkinsonism that were reversible after management. Background: Phenylketonuria is an autosomal recessive disorder due to mutations in the phenylalanine hydroxlase gene. It normally presents in childhood, in rare cases, however, it may have its onset in adulthood and may mimic other neurological disorders. Case description: A previously normal functioning, 59 year old man was admitted for blurred vision, cognitive impairment and gait difficulty which emerged over the past eight months. In neurological examination he had brisk reflexes, slow gait and left-dominant parkinsonism. Mini-mental state examination score was 25/30, neuropsychological testing revealed a dysexecutive syndrome with constructional apraxia and simultanagnosia. In cranial MRI there were bilateral diffuse hyper-intense lesions in parietal and occipital white matter with no significant atrophy. Electroencephalography showed diffuse slowing with predominance of teta waves. In cerebrospinal fluid examination protein level was slightly elevated (61mg/dL), oligoclonal bands were negative. Electromyography was normal. Routine laboratory examinations for rapidly progressive dementia and parkinsonism were also normal. Serum amino acid levels were determined to explore metabolic leukodystrophies and phenylalanine level was found to be highly elevated (1075 µmol/L) with normal tyrosine (61,20 µmol/L). His cognitive impairment and parkinsonian symptoms improved following three months of phenylalanine restricted diet. Conclusions: Late onset phenylketonuria is a rare, potentially reversible cause of rapidly progressive parkinsonism with dementia. It should be considered in the differential diagnosis of patients with suspicious features.

Keywords: dementia, neurology, Phenylketonuria, rapidly progressive parkinsonism

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Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani

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Background And Objective: Haematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects And Methods: A retrospective audit was conducted for packed red cell transfusion ordering practice over a period from March 2017 to march 2018. All consecutive patients admitted for stem cell transplant procedure for various underlying diseases were included. Outcome measures used in this study were (i) cross match to transfusion (C: T) ratio and (ii) transfusion trigger. Results: During the study period, n=13 patients underwent a haematopoietic stem cell transplant. There were n=10 males and n=3 females. One patient was less than 15 years of age, while rests were adults. Median age±SD was 26.5±14.5 years (12∼54 years). The underlying diagnosis included Aplastic anemia (n=4), Thalassemia major (n=1), Multiple Myeloma (n=3), Acute leukemia (n=3), Hodgkin's lymphoma (n=1), PRCA (n=1). Grand total consumption of PRBCs during the study period was 204, while 258 products were crossmatch. The C:T ratio was 1.26. The transfusion trigger was Hb level of less than 8 gr/dl. Conclusion: The results of our BMT unit indicate that the C:T ratio and transfusion trigger is comparable to the international criteria and pioneer country in BMT transplantation. Also, we hope that our blood consumption become less than it is now.

Keywords: blood consumption, C: T ratio, PRBCs, stem cell transplant, tabriz, Iran

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Authors: Sofia Ait Bouazza

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We consider the problem of finding a minimum identifying code in a graph. This problem was initially introduced in 1998 and has been since fundamentally connected to a wide range of applications (fault diagnosis, location detection …). Suppose we have a building into which we need to place fire alarms. Suppose each alarm is designed so that it can detect any fire that starts either in the room in which it is located or in any room that shares a doorway with the room. We want to detect any fire that may occur or use the alarms which are sounding to not only to not only detect any fire but be able to tell exactly where the fire is located in the building. For reasons of cost, we want to use as few alarms as necessary. The first problem involves finding a minimum domination set of a graph. If the alarms are three state alarms capable of distinguishing between a fire in the same room as the alarm and a fire in an adjacent room, we are trying to find a minimum locating domination set. If the alarms are two state alarms that can only sound if there is a fire somewhere nearby, we are looking for a differentiating domination set of a graph. These three areas are the subject of much active research; we primarily focus on the third problem. An identifying code of a graph G is a dominating set C such that every vertex x of G is distinguished from other vertices by the set of vertices in C that are at distance at most r≥1 from x. When only vertices out of the code are asked to be identified, we get the related concept of a locating dominating set. The problem of finding an identifying code (resp a locating dominating code) of minimum size is a NP-hard problem, even when the input graph belongs to a number of specific graph classes. Therefore, we study this problem in some restricted classes of undirected graphs like split graph, line graph and path in a directed graph. Then we present some results on the identifying code by giving an exact value of upper total locating domination and a total 2-identifying code in directed and undirected graph. Moreover we determine exact values of locating dominating code and edge identifying code of thin headless spider and locating dominating code of complete suns.

Keywords: identiying codes, locating dominating set, split graphs, thin headless spider

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Authors: Garreth Kestell, Lukah Dykes, Danielle Zerk, Kyla Trewartha, Rhianon Marshall, Elena Rudnik

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Adolescent mental health is an international priority and the impact of innovative service models must be evaluated. Secondary school-based mental health services (SBMHS) involving private general practitioners and psychologists are a model of care being trialed in South Australia. Measures of depression, anxiety, and stress are routinely collected throughout psychotherapy sessions. This research set out to quantify the impact of psychotherapy for rural adolescents in a school setting and explore the importance of session frequency. Methods: Demographics, session date and DASS21 scores from students (n=65) seen in 2016 by three psychologists working at the SBMHS were recorded. Students were aged 13-18 years (M=15.43, SD= 1.24), mostly female (F=51, M=14), attended between 1 and 23 sessions with a median of 6 sessions (MAD 5.93) in one-year. The treating psychologist collected self-administered DASS21 scores. A mixed model analysis was used with age, sex, treating psychologist, months from first session, and session number as fixed effects, with response variables of DASS depression, anxiety, and stress scores. Results: 71.5% were classified as having extreme or severe anxiety and half had extreme or severe depression and/or stress scores. On average males had a greater increase in DASS scores over time but males attending more sessions benefited most from therapy. Discussion: Psychologists are treating rural adolescents in schools for severe anxiety, depression, and stress. This pilot study indicates that a predictive model combining demographics, session frequency, and DASS scores may help identify who is most likely to benefit from individual psychotherapy. Variations in DAS scores of individuals over time indicate the need for the collection of information such as living situation and exposure to alcohol. A larger sample size and additional data are currently being collected to allow for a more robust analysis.

Keywords: adolescent health, psychotherapy, school based mental health services, DAS21

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