Search results for: TS patient selection

Authors: Nasrudin Andi Mappaware, Muh. Wirawan Harahap, Erlin Syahril, Farah Ekawati Mulyadi

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Cesarean section procedures are currently increasing, both for medical indications and without medical indications, better known as caesarean section on request. Cesarean section by self-request raises many dilemmas from the doctor's side regarding medical issues, professionalism, and bioethics. We report the case of a 27-year-old woman G1P0A0 gravid 38 weeks admitted to the hospital for a planned cesarean section on request for the reason that she could not tolerate pain and requested on a date that corresponded to the date and month of her mother's birth. Currently, there is no medical indication for a cesarean section. Anesthesia during cesarean section at self-request without medical indications is a dilemma for anesthesiologists considering the risks and complications of anesthesia for both the fetus and the mother. Cesarean section delivery without medical indications is still justified and does not conflict with ethics and professionalism. Because it fulfills the principle of autonomy which states that patients have the right to themselves. However, this medical procedure is still considered no safer and riskier even though medical technology has developed rapidly. The trend in increasing the number of cesarean sections is influenced by patient reasons such as: not being able to tolerate pain, trust factors and worry about damage to the birth canal.

Keywords: anesthesia, bioethics, medical, self-request, professionalism

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Authors: Canan Mesutoglu, Evrim Baran

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Teachers have a prominent role in facilitating the place of engineering in K-12 classrooms. This study addresses the need to understand how teacher professional development programs focusing on K-12 engineering education can be designed and delivered more effectively. A systematic review of the literature on such programs can offer possible ideas and recommendations. The purpose of this study is to systematically synthesize the peer-reviewed articles published on K-12 engineering education teacher professional development programs. The methodology that guided the study was comprised of four phases: search, selection, coding, and synthesis. The search phase included articles published in the time period between 2000 and 2016. With a comprehensive search in databases, inclusion criteria were applied. This was followed by evaluation of the quality of articles with a checklist, and finally analysis of the results. The results revealed two categories of themes. These were 1) five themes related to the overarching agenda of the PD programs, and 2) five themes related to the instructional techniques of the PD programs. Finally, core elements were generated to guide the design and delivery of teacher PD programs for K-12 engineering education. The results aimed to provide a conceptual basis for future research and practice on teacher PD programs for K-12 engineering education.

Keywords: core elements, K-12 engineering education, systematic literature review, teacher professional development programs

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

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

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

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Authors: Peter Akayuure, Michael Johnson Nabie

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Similar to many colonized nations in the world, one indelible mark left by colonial masters after Ghana’s independence in 1957 has been the fact that many contexts used to teach statistics and probability concepts are often alien and do not resonate with the social domain of our indigenous Ghanaian child. This has seriously limited the understanding, discoveries, and applications of mathematics for national developments. With the recent curriculum demands of making the Ghanaian child mathematically literate, this qualitative study involved video recordings and mathematical analysis of play sessions of an indigenous girl game called Ampe with the aim to demystify the concepts in probability theorem, which is applied in mathematics related fields of study. The mathematical analysis shows that the game of Ampe, which is widely played by school girls in Ghana, is suitable for learning concepts of the probability theorems. It was also revealed that as a girl game, the use of Ampe provides good lessons to educators, textbook writers, and teachers to rethink about the selection of mathematics tasks and learning contexts that are sensitive to gender. As we undertake to transform teacher education and student learning, the use of indigenous games should be critically revisited.

Keywords: Ampe, mathematical analysis, probability theorem, Ghanaian girl game

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Authors: Aofan Liu, Qianqian Tan, Burra Venkata Durga Kumar

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Data security is of the utmost importance in the healthcare area, as sensitive patient information is constantly sent around and analyzed by many different parties. The use of federated learning, which enables data to be evaluated locally on devices rather than being transferred to a central server, has emerged as a potential solution for protecting the privacy of user information. To protect against data breaches and unauthorized access, federated learning alone might not be adequate. In this context, the application of blockchain technology could provide the system extra protection. This study proposes a distributed federated learning system that is built on blockchain technology in order to enhance security in healthcare. This makes it possible for a wide variety of healthcare providers to work together on data analysis without raising concerns about the confidentiality of the data. The technical aspects of the system, including as the design and implementation of distributed learning algorithms, consensus mechanisms, and smart contracts, are also investigated as part of this process. The technique that was offered is a workable alternative that addresses concerns about the safety of healthcare while also fostering collaborative research and the interchange of data.

Keywords: data privacy, distributed system, federated learning, machine learning

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Authors: Soma Gholamveisy, Vahid Mirghavameddin

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Aquaculture activities face wide environmental, social, and economic problems today. To deal with these problems, the aquaculture business, which is already a highly significant agricultural activity, is influenced by sustainability, which can assure the rural community's safety and food health with minimal environmental damage. The objective of this study's systematic review of the literature (SLR) is to look into the use of global perspective Promotion of Sustainable Fisheries and Aquaculture. SLR aims to identify the goals of a promotional system, also one of its main components. This research seeks to empower, increase economic productivity, facilitate, pay more attention to the sustainability of the environment and inform the audience in this regard. A method used to assess hypotheses, condense the results of past studies or verify the consistency of studies. It presents a succinct analysis of original research using an unambiguous and verifiable approach. A thorough repository with a vast array of papers and effective exploration methods are frequently utilized in a systematic literature review, enabling the application of advanced logical statements. A comprehensive literature review was carried out to ensure that the most relevant studies were included. This type of review clarifies publication selection criteria and allows evaluation of the studies conducted and their repetition or extension.

Keywords: systematic review, sustainable, fisheries, aquaculture

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Authors: Lamia Bouzgarrou, Amira Omrane, Naima Bouatay, Chaima Harrathi, Samia Machroughl, Ahmed Mhalla

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Background and Aims: Professionals of health care sector are exposed to psychosocial constraints like stress, harassment, violence, which can lead to many mental health problems such as, depression, addictive behavior, and burn-out. Moreover, it’s well established that caregivers affected to intensive care units are more likely to experience such constraints and mental health problems. For these caregivers, the mental health state may affect care quality and patient’s safety. This study aims either to identify occupational psychosocial constraints and their mental health consequences among paramedical and medical caregivers affected to intensive units in Tunisian public hospital. Methods: An exhaustive three months cross-sectional study conducted among medical and paramedical staffs of intensive care units in three Tunisian university hospitals. After informed consent collection, we evaluated work-related stress, workplace harassment, depression, anxious troubles, addictive behavior, and self-esteems through an anonymous self-completed inquiry form. Five validated questionnaires and scales were included in this form: Karasek's Job Content Questionnaire, Negative Acts Questionnaire, Rosenberg, Beck depression inventory and Hamilton Anxiety scale. Results: We included 129 intensive unit caregivers; with a mean age of 36.1 ± 1.1 years and a sex ratio of 0.58. Among these caregivers, 30% were specialist or under-specialization doctors. The average seniority in the intensive care was 6.1 ± 1.2 (extremes=1 to 40 years). Atypical working schedules were noted among 36.7% of the subjects with an imposed choice in 52.4% of cases. During the last 12 months preceding the survey, 51.7% of care workers were absent from work because of a health problem with stops exceeding 15 days in 11.7%. Job strain was objective among 15% of caregivers and 38.33% of them were victims of moral harassment. A low or very low self-esteem was noted among 40% of respondents. Moreover, active smoking was reported by 20% subjects, alcohol consumption by 13.3% and psychotropic substance use by 1.7% of them. According to Beck inventory and Hamilton Anxiety scale, we concluded that 61.7% of intensive care providers were depressed, with 'severe' depression in 13.3% of cases and 49.9% of them present anxious disorders. Multivariate analysis objective that, job strain was correlated with young age (p=0.005) and shorter work seniority (p=0.001). Workplace and moral harassment was more prevalent among females (p=0.009), under-specialization doctor (p=0.021), those affected to atypical schedules (p=0.008). Concerning depression, it was more prevalent among staff in job strain situation (p = 0.004), among smokers caregivers (p = 0.048), and those with no leisure activity (p < 0.001). Anxious disorders were positively correlated to chronic diseases history (p = 0.001) and work-bullying exposure (p = 0.004). Conclusions: Our findings reflected a high frequency of caregivers who are under stress at work and those who are victims of moral harassment. These health professionals were at increased risk for developing psychiatric illness such depressive and anxious disorders and addictive behavior. Our results suggest the necessity of preventive strategies of occupational psychosocial constraints in order to preserve professional’s mental health and maximize patient safety and quality of care.

Keywords: health care sector, intensive care units, mental health, psychosocial constraints

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Authors: Swapneel U. Naphade, Dushyant A. Patil, Satyabodh M. Kulkarni

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In this work, we propose the concept and geometrical design of a soil moisture control system (SMCS) module by following the product development approach to develop an inexpensive, easy to use and quick to install product targeted towards agriculture practitioners. The module delivers water to the agricultural land efficiently by sensing the soil moisture and activating the delivery valve. We start with identifying the general needs of the potential customer. Then, based on customer needs we establish product specifications and identify important measuring quantities to evaluate our product. Keeping in mind the specifications, we develop various conceptual solutions of the product and select the best solution through concept screening and selection matrices. Then, we develop the product architecture by integrating the systems into the final product. In the end, the geometric design is done using human factors engineering concepts like heuristic analysis, task analysis, and human error reduction analysis. The result of human factors analysis reveals the remedies which should be applied while designing the geometry and software components of the product. We find that to design the best grip in terms of comfort and applied force, for a power-type grip, a grip-diameter of 35 mm is the most ideal.

Keywords: agriculture, human factors, product design, soil moisture control

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Authors: Amin Nezarat, Naeime Seifadini

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Trip mode selection is a behavioral characteristic of passengers with immense importance for travel demand analysis, transportation planning, and traffic management. Identification of trip mode distribution will allow transportation authorities to adopt appropriate strategies to reduce travel time, traffic and air pollution. The majority of existing trip mode inference models operate based on human selected features and traditional machine learning algorithms. However, human selected features are sensitive to changes in traffic and environmental conditions and susceptible to personal biases, which can make them inefficient. One way to overcome these problems is to use neural networks capable of extracting high-level features from raw input. In this study, the convolutional neural network (CNN) architecture is used to predict the trip mode distribution based on raw GPS trajectory data. The key innovation of this paper is the design of the layout of the input layer of CNN as well as normalization operation, in a way that is not only compatible with the CNN architecture but can also represent the fundamental features of motion including speed, acceleration, jerk, and Bearing rate. The highest prediction accuracy achieved with the proposed configuration for the convolutional neural network with batch normalization is 85.26%.

Keywords: predicting, deep learning, neural network, urban trip

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Authors: L. Abdou, O. Taibaoui, A. Moumen, A. Talib Ahmed

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This paper proposes an application of the simulated annealing to optimize the detection threshold in an ordered statistics constant false alarm rate (OS-CFAR) system. Using conventional optimization methods, such as the conjugate gradient, can lead to a local optimum and lose the global optimum. Also for a system with a number of sensors that is greater than or equal to three, it is difficult or impossible to find this optimum; Hence, the need to use other methods, such as meta-heuristics. From a variety of meta-heuristic techniques, we can find the simulated annealing (SA) method, inspired from a process used in metallurgy. This technique is based on the selection of an initial solution and the generation of a near solution randomly, in order to improve the criterion to optimize. In this work, two parameters will be subject to such optimisation and which are the statistical order (k) and the scaling factor (T). Two fusion rules; “AND” and “OR” were considered in the case where the signals are independent from sensor to sensor. The results showed that the application of the proposed method to the problem of optimisation in a distributed system is efficiency to resolve such problems. The advantage of this method is that it allows to browse the entire solutions space and to avoid theoretically the stagnation of the optimization process in an area of local minimum.

Keywords: distributed system, OS-CFAR system, independent sensors, simulating annealing

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Authors: Abdu Qayyum, Hafiz Muhammad Saeed, Mamoona Hanif, Etrat Noor, Waqas Malik, Shoaib Liaqat

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Salinity is extremely serious problem that has a drastic effect on maize crop, environment and causes economic losses of country. An advance technique to overcome salinity is to develop salt tolerant geno types which require screening of huge germ plasm to start a breeding program. Therefore, present study was undertaken to screen out 25 maize hybrids of different origin for salinity tolerance at seedling stage under three levels of salt stress 250 and 300 mM NaCl including one control. The existence of variation for tolerance to enhanced NaCl salinity levels at seedling stage in maize proved that hybrids had differing ability to grow under saline environment and potential variability within specie. Almost all the twenty five maize hybrids behaved varyingly in response to different salinity levels. However, the maize hybrids H6, H13, H21, H23 and H24 expressed better performance under salt stress in terms of all six characters and proved to be as highly tolerant while H22, H17 H20, H18, H4, H9, and H8 were identified as moderately tolerant. Hybrids H14, H5, H11 and H3 H12, H2, were expressed as most sensitive to salinity suggesting that screening is an effective tool to exploit genetic variation among maize hybrids and salt tolerance in maize can be enhanced through selection and breeding procedure.

Keywords: salinity, hybrids, maize, variation

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Authors: Li Mengmeng, Kang Jian

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With the rapid development of the city, the noise pollution becomes more and more serious. Noise has seriously affected people's normal life, study and work. In addition, noise has seriously affected the city's ecological environment and the migration of birds. Therefore, it is urgent to control the noise. As one of natural noise-reducing materials, plants have been paid more and more attention. In urban landscape design, it is very important to choose plant species with good noise reduction effect to the sustainable development of urban ecology. The aim of this paper is to find out the characteristics of the plant with good noise reduction effect and apply it in urban landscape design. This study investigated the vibration of leaves of six plant species in a sound field using a Keyence (IG-1000/CCD) Laser Micrometer. The results of the experiments showed that the vibration speed of plant leaves increased obviously after being stimulated by sound source, about 5-10 times. In addition, when driven by the same sound, the speed of all leaves varied with the difference of leaf thickness, leaf size and leaf mass. The speed of all leaves would increase with the increase of leaf size and leaf mass, while those would decrease with the increase of leaf thickness.

Keywords: landscape design, leaf vibration , noise attenuation, plants configuration

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Authors: Boumesbah Asma, Chergui Mohamed El-amine

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Since it has been shown that the multi-objective minimum spanning tree problem (MOST) is NP-hard even with two criteria, we propose in this study a hybrid NSGA-II algorithm with an exact mutation operator, which is only used with low probability, to find an approximation to the Pareto front of the problem. In a connected graph G, a spanning tree T of G being a connected and cycle-free graph, if k edges of G\T are added to T, we obtain a partial graph H of G inducing a reduced size multi-objective spanning tree problem compared to the initial one. With a weak probability for the mutation operator, an exact method for solving the reduced MOST problem considering the graph H is then used to give birth to several mutated solutions from a spanning tree T. Then, the selection operator of NSGA-II is activated to obtain the Pareto front approximation. Finally, an adaptation of the VNS metaheuristic is called for further improvements on this front. It allows finding good individuals to counterbalance the diversification and the intensification during the optimization search process. Experimental comparison studies with an exact method show promising results and indicate that the proposed algorithm is efficient.

Keywords: minimum spanning tree, multiple objective linear optimization, combinatorial optimization, non-sorting genetic algorithm, variable neighborhood search

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Authors: Ishapathik Das

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The purpose of this article is to find a method of comparing designs for ordinal regression models using quantile dispersion graphs in the presence of linear predictor misspecification. The true relationship between response variable and the corresponding control variables are usually unknown. Experimenter assumes certain form of the linear predictor of the ordinal regression models. The assumed form of the linear predictor may not be correct always. Thus, the maximum likelihood estimates (MLE) of the unknown parameters of the model may be biased due to misspecification of the linear predictor. In this article, the uncertainty in the linear predictor is represented by an unknown function. An algorithm is provided to estimate the unknown function at the design points where observations are available. The unknown function is estimated at all points in the design region using multivariate parametric kriging. The comparison of the designs are based on a scalar valued function of the mean squared error of prediction (MSEP) matrix, which incorporates both variance and bias of the prediction caused by the misspecification in the linear predictor. The designs are compared using quantile dispersion graphs approach. The graphs also visually depict the robustness of the designs on the changes in the parameter values. Numerical examples are presented to illustrate the proposed methodology.

Keywords: model misspecification, multivariate kriging, multivariate logistic link, ordinal response models, quantile dispersion graphs

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Authors: Haira Rizka, Imas Istiani

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The way women and men use language is an interesting topic to discuss. Nowadays, Instagram shows many videos which illustrate the difference of women’s and men’s language. Furthermore, the videos show how different genders behave in daily communication. This research aims to (1) investigate conversational characteristics of women represented in Indonesian Instagram videos, and (2) investigate how different genders behave in daily communication. To analyze the two research problems, this research employs Tannen’s theory of language and gender (1996). This is a descriptive qualitative research which describes phenomena of language and gender shown in Indonesian Instagram videos. The data were collected through observation. The collected data were then analyzed by employing ethnography and textual analysis. The research results show that in Indonesian Instagram videos, women dominate the conversation than men. Women’s are portrayed as a figure who are talkative, never wrong, and sensitive. Women’s dominating men proves that women always want to be understood, produce more words than men, and are more creative in producing verbal communication. Meanwhile, men are portrayed as calm, gentle, and patient creature who listen to women’s talk. Furthermore, men are portrayed to prefer being silent for avoiding conflict.

Keywords: gender, Instagram videos, language variety, women's language

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Authors: Delly C. Lestari, Linosefa, Ardiana Kusumaningrum, Andi Yasmon, Anis Karuniawati

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The objective of this study is to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mecA genes from screening isolates among intensive care unit (ICU) patients. All MRSA screening isolates from ICU’s patients of Cipto Mangunkusumo Hospital during 2011 and 2014 were included in this study. Identification and susceptibility test was performed using Vitek2 system (Biomereux®). PCR was conducted to characterize the SCCmec of S. aureus harboring the mecA gene on each isolate. Patient’s history of illness was traced through medical record. 24 isolates from 327 screening isolates were MRSA positive (7.3%). From PCR, we found 17 (70.8%) isolates carrying SCCmec type I, 3 (12.5%) isolates carrying SCCmec type III, and 2 (8.3%) isolates carrying SCCmec type IV. In conclusion, SCCmec type I is the most prevalent MRSA colonization among ICU patients in Cipto Mangunkusumo Hospital.

Keywords: MRSA, mecA genes, ICU, colonization

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Authors: Maryum Nawaz

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

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

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Authors: Mohsen Rezaei Aghdam

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Recombinant DNA technology has meaningfully augmented the conventional crop improvement and has a great possibility to contribution plant breeders to encounter the augmented food request foretold for the 21st century. Predictable changes in weather and its erraticism, chiefly extreme fevers and vicissitudes in rainfall are expected to brand crop upgrading even more vital for food manufacture. Tissue attitude has been downtrodden to create genetic erraticism from which harvest plants can be better, to improve the state of health of the recognized physical and to upsurge the number of wanted germplasms obtainable to the plant breeder. This appraisal delivers an impression of the chances obtainable by the integration of vegetable biotechnology into plant development efforts and increases some of the social subjects that need to be considered in their application. Public-private companies offer chances to catalyze new approaches and investment while accelerating integrated research and development and commercial supply chain-based solutions. Novel varieties derivative by encouraged mutatgenesis are used commonly: rice in Thailand. These paper combinations obtainable data about the influence of change breeding-derived crop changes around the world, traveler magnetism the possibility of mutation upbringing as a flexible and feasible approach appropriate to any crop if that suitable objectives and selection approaches are used.

Keywords: crop, improve, genetic, agricultural

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Authors: Allmin Susaiyah, Aki Härmä, Milan Petković

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Automatic generation of insights from data using insight mining systems (IMS) is useful in many applications, such as personal health tracking, patient monitoring, and business process management. Existing IMS face challenges in controlling insight extraction, scaling to large databases, and generalising to unseen domains. In this work, we propose a hybrid approach consisting of rule-based and neural components for generating insights from data while overcoming the aforementioned challenges. Firstly, a rule-based data 2CNL component is used to extract statistically significant insights from data and represent them in a controlled natural language (CNL). Secondly, a BERTSum-based CNL2NL component is used to convert these CNLs into natural language texts. We improve the model using task-specific and domain-specific fine-tuning. Our approach has been evaluated using statistical techniques and standard evaluation metrics. We overcame the aforementioned challenges and observed significant improvement with domain-specific fine-tuning.

Keywords: data mining, insight mining, natural language generation, pre-trained language models

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Authors: Julinda Keçi

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In many countries, governments have been promoting the involvement of private sector entities to enter into long-term agreements for the development and delivery of large infrastructure projects, with a focus on overcoming the limitations upon public fund of the traditional approach. The involvement of private sector through public-private partnerships (PPP) brings in new capital investments, value for money and additional risks to handle. Worldwide research studies have shown that an objective, systematic, reliable and user-oriented risk assessment process and an optimal allocation mechanism among different stakeholders is crucial to the successful completion. In this framework this paper, which is the first stage of a research study, aims to identify the main risks for the delivery of PPP projects. A review of cross-countries research projects and case studies was performed to map the key risks affecting PPP infrastructure delivery. The matrix of mapping offers a summary of the frequency of factors, clustered in eleven categories: Construction, Design, Economic, Legal, Market, Natural, Operation, Political, Project finance, Project selection and Relationship. Results will highlight the most critical risk factors, and will hopefully assist the project managers in directing the managerial attention in the further stages of risk allocation.

Keywords: construction, infrastructure, public private partnerships, risks

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Authors: Joshua Abraham, Craig Wales

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Abstract—SIGN Guideline 122 recommends that all patients who are admitted to hospital are assessed for venous thromboembolism risk within 24 hours of admission. NHS Greater Glasgow and Clyde provide guidance on this in the form of a proforma. Patients are then subsequently prescribed either thrombo-embolic-deterrent stockings (TEDS)/low molecular weight heparin (LMWH) for the prevention of VTE based on their score. A retrospective casenote audit of a random sample of fifty oncology and trauma inpatients at the QEUH in December 2019 was performed. 90% of patients had a risk assessment conducted as evidenced by a completed proforma. In 78% of these patients, the proforma fully completed. Overall 94% of patients had some for of thromboprophylaxis prescribed in the form of TEDS or LMWH. A lack of 100% compliance against the given standards highlighted potential implications for patient safety, but also medico-legal ramifications for staff. Clinical judgement can only be relied upon if there is written documentation as evidence. Further staff education and the suggestion of a written prompt to the clerk-in documentation will hopefully improve compliance, whilst a repeat audit should demonstrate any improvement.

Keywords: Maxillofacial , Thromboembolism, Thromboprophylaxis , Prescription

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Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh

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Introduction: Chemical peeling is a popular, relatively inexpensive day procedure and generally safe method for treatment of pigmentary skin disorders and for skin rejuvenation. Chemical peels are classified by the depth of action into superficial, medium, and deep peels.Various facial pigmentary conditions have significant impact on quality of life causing psychological stress, necessitating its safe and effective treatment.Aim & Objectives:To compare the efficacy of Salicylic acid, Trichloroaceticacid & Glycolic Acid in facial melanosis(melasma,photomelanosis& post acne pigmentation).To study the side effects of above mentioned peeling agents. Method and Materials:It was a randomized parallel control single blind study consisting of total of 36 cases, 12 cases each of melasma, photo melanosis and post acne pigmentation within age group 20-50 years having fitzpatrick’s skin type4. Woods lamp examination was done to confirm the type of melasma.Patients with keloidal tendency, active herpes infection or past history of hypersensitivity to salicylic acid, trichloroaceticand glycolic acid as well aspatients on systemic isotretinoin were excluded.Clinical photographs at the beginning of therapy and then serially, were taken to assess the clinical response. Prior to application a written informed consent was obtained. A post auricular test peel was performed. Patients were divided into 3 groups, containing 12 patients each of melasma, photomelanosis and post acnepigmentation.All the three peels SA peel 20% (done once in 2 weeks), GA peel 50% (done once in 3 weeks) and TCA 15% (done once in 3 weeks) were used with total six settings for each patient. Before application of peel patients were counseled to wash the face with soap and water. Then face was dried and cleaned with spirit and acetone to remove all cutaneous oils. GA, TCA, SA were applied with cotton buds/gauze withmild strokes. After a contact period off 5-10mins neutralization was done with cold water. Post peel topical sunscreen application was mandatory. MASI was used pre and post treatment to assess melasma. Investigator’s global improvement scale- overall hyperpigmentation (4-significant, 3-moderate, 2-mild, 1-minimal, 0-no change ) and Patient’s satisfaction grading scale (>70%- excellent response, 50-70%- good response, <50%- average response) was used to assess improvement in all the three facial melanosis.Results:In our study of 12 patients of melasma, 4 (33.33%)patients showed excellent results;3 (25%) with GAand 1(8.33%) of TCA.Good response was seen in 4 (33.33%) patients;1(8.33%) each for GA & SA and 2(16.66%) for TCA.Poor response was seen in 4(33.33%) patients;1(8.33%) for TCA and 3 (25%) for SA.Of 12 patients of photomelanosis, excellent resultswas seen in 3(25%)patients of TCA. Good response was seen in 4 (33.33%) patients, 1(8.33%) each of TCA &SA and 2(16.66%) of GA.Poor responsewas seen in 5(41.66%) patients;3 (25%) for SA and 2(16.66%) of GA.Of 12 patients of post acne pigmentation, excellent responsein 3 (25%) patients;2(16.66%) of SA and 1(8.33%) of TCA.Good responsewas seen in 5(41.66%) patients;2(16.66%) of SA and GA and1(8.33%) of TCA.Poor response was seen in 4 (33.33%) patients; 2 (16.66%) for SA and TCA both. No major side effects in the form of scarring or persistant pigmentation was seen. Transient blackening of skin with burning sensation was seen in cases treated with TCA and SA. Post procedural itching and redness was noted with GA peel. Conclusion- In our study GA(50%),TCA(15%) & SA(20%) peels showed excellent response in melasma, photomelanosis and post-acne pigmentation respectively.All the 3 peeling agents were well tolerated without any significant side-effects in the above specified concentrations.

Keywords: facial melanosis, gycolic acid, salicylic acid, trichloroacetic acid

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Authors: Wan Shan Chiang, Charn Ting Wang, Wei-Chih Kan, Hui-Chen Huang

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Dialysis patients have risk in Zoster virus because of low immune. Valacyclovir (product name: Valtex) 500mg/tab, an anti-zoster virus medicine, is digested in kidney and it has side-effect of nervous system in patients with malfunction kidneys. Although the clinical basis of the proposed administration, we found that patients still have side effects. So we want to explore the appropriate dose of peritoneal dialysis patients. We read small samples of case reports and analyze 8 cases in our hospital, some patients’ Kt/v, match the standard of dialysis, and still go to the toilet, they still have side effect seriously with 500mg portion. The solution to this includes stopping medicine, reduction of medicine, increase of liquid change and timely hemodialysis and all of them speed up the recovery. The safety of medication needs extra attention of medical care employee. If they can tell the doctor if the patient has urine or not in his or her Kt/v, the doctor can prescribe the medicine accordingly. About the limitation, due to the lack of cases and related pharmacokinetics numbers. Therefore, for peritoneal patients, we think 500mg/48hoursis the saves. We also want to remind pharmaceuticals to revise the portion taken by patients, so that the doctor may judge the use.

Keywords: herpes zoster, Valacyclovir, peritoneal dialysis, health education

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Authors: Pranjali Avinash Yadav-Deshmukh

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Remarkable development of the Internet along with the new technological innovation, such as high-speed systems and affordable large storage space have led to a tremendous increase in the amount and accessibility to digital records. For any person, studying of all these data is tremendously time intensive, so there is a great need to access effective multi-document summarization (MDS) systems, which can successfully reduce details found in several records into a short, understandable summary or conclusion. For semantic representation of textual details in ontology area, as a theoretical design, our system provides a significant structure. The stability of using the ontology in fixing multi-document summarization problems in the sector of catastrophe control is finding its recommended design. Saliency ranking is usually allocated to each phrase and phrases are rated according to the ranking, then the top rated phrases are chosen as the conclusion. With regards to the conclusion quality, wide tests on a selection of media announcements are appropriate for “Jammu Kashmir Overflow in 2014” records. Ontology centered multi-document summarization methods using “NLP centered extraction” outshine other baselines. Our participation in recommended component is to implement the details removal methods (NLP) to enhance the results.

Keywords: disaster management, extraction technique, k-means, multi-document summarization, NLP, ontology, sentence extraction

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Authors: Georges F. Hatoum, Thomas H. Temple, Silvio Garcia, Xiaodong Wu

Abstract:

Soft Tissue Sarcomas (STS) represent a diverse group of malignancies with heterogeneous clinical and pathological features. The treatment of extremity STS aims to achieve optimal local tumor control, improved survival, and preservation of limb function. The National Comprehensive Cancer Network guidelines, based on the cumulated clinical data, recommend radiation therapy (RT) in conjunction with limb-sparing surgery for large, high-grade STS measuring greater than 5 cm in size. Such treatment strategy can offer a cure for patients. However, when recurrence occurs (in nearly half of patients), the prognosis is poor, with a median survival of 12 to 15 months and with only palliative treatment options available. The spatially-fractionated-radiotherapy (SFRT), with a long history of treating bulky tumors as a non-mainstream technique, has gained new attention in recent years due to its unconventional therapeutic effects, such as bystander/abscopal effects. Combining single fraction of GRID, the original form of SFRT, with conventional RT was shown to have marginally increased the rate of pathological necrosis, which has been recognized to have a positive correlation to overall survival. In an effort to consistently increase the pathological necrosis rate over 90%, multiple fractions of Lattice RT (LRT), a newer form of 3D SFRT, interdigitated with the standard RT as neoadjuvant therapy was conducted in a preliminary clinical setting. With favorable results of over 95% of necrosis rate in a small cohort of patients, a Phase I/II clinical study was proposed to exam the safety and feasibility of this new strategy. Herein the design of the clinical study is presented. In this single-arm, two-stage phase I/II clinical trial, the primary objectives are >80% of the patients achieving >90% tumor necrosis and to evaluation the toxicity; the secondary objectives are to evaluate the local control, disease free survival and overall survival (OS), as well as the correlation between clinical response and the relevant biomarkers. The study plans to accrue patients over a span of two years. All patient will be treated with the new neoadjuvant RT regimen, in which one of every five fractions of conventional RT is replaced by a LRT fraction with vertices receiving dose ≥10Gy while keeping the tumor periphery at or close to 2 Gy per fraction. Surgical removal of the tumor is planned to occur 6 to 8 weeks following the completion of radiation therapy. The study will employ a Pocock-style early stopping boundary to ensure patient safety. The patients will be followed and monitored for a period of five years. Despite much effort, the rarity of the disease has resulted in limited novel therapeutic breakthroughs. Although a higher rate of treatment-induced tumor necrosis has been associated with improved OS, with the current techniques, only 20% of patients with large, high-grade tumors achieve a tumor necrosis rate exceeding 50%. If this new neoadjuvant strategy is proven effective, an appreciable improvement in clinical outcome without added toxicity can be anticipated. Due to the rarity of the disease, it is hoped that such study could be orchestrated in a multi-institutional setting.

Keywords: lattice RT, necrosis, SFRT, soft tissue sarcoma

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Authors: E.A. Kuchma

Abstract:

Photodynamic therapy (PDT) is considered an alternative and minimally invasive cancer treatment modality compared to chemotherapy and radiation therapy. PDT includes three main components: a photosensitizer (PS), oxygen, and a light source. PS is injected into the patient's body and then selectively accumulates in the tumor. However, the light used in PDT (spectral range 400–700 nm) is limited to superficial lesions, and the light penetration depth does not exceed a few cm. The problem of PDT (poor visible light transmission) can be solved by using X-rays. The penetration depth of X-rays is ten times greater than that of visible light. Therefore, X-ray radiation easily penetrates through the tissues of the body. The aim of this work is to develop universal nanocomposites for X-ray photodynamic therapy of deep and superficial tumors using scintillation nanoparticles of gadolinium fluoride (GdF3), doped with Tb3+, coated with a biocompatible coating (PEG) and photosensitizer RB (Rose Bengal). PEG@GdF3:Tb3+(15%) – RB could be used as an effective X-ray, UV, and photoluminescent mediator to excite a photosensitizer for generating reactive oxygen species (ROS) to kill tumor cells via photodynamic therapy. GdF3 nanoparticles can also be used as contrast agents for computed tomography (CT) and magnetic resonance imaging (MRI).

Keywords: X-ray induced photodynamic therapy, scintillating nanoparticle, radiosensitizer, photosensitizer

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Authors: Amina Bayazid, Habiba Fetati, Houari Toumi

Abstract:

Introduction: The clinical value of vitamin K antagonists (VKA) has been widely demonstrated in numerous indications. Unfortunately, VKA are not devoid of drawbacks and risk of serious bleeding. The iatrogenic induced by these drugs is a major public health problem. Patients & Methods: We conducted a retrospective study period extending from February 2012 to August 2013 in the pharmacovigilance service of EHUO (clinical pharmacology unit). The prescription of painkillers was analyzed in patients on VKA followed at our level. The influence of these analgesics on the evolution of the INR is an important component in our work. Results: We counted a total of 195 patients, of whom 32 (or 16.41% of the total population) had received analgesic treatment. The frequencies of different categories of analgesics administered were: • Analgesics opioids: 0% • Analgesics weak opioids: Tramadol: 21.87% • The non-opioid analgesics: -AINS: 71.87% (indomethacin: 68.75% ibuprofen: 3.12%) - Paracetamol: 6.25% -Salicyles (Acetylsalicylic acid): 0%. Conclusion: The management of pain in patients under vitamin K antagonists has special features, given their many drug interactions with analgesics and their influence on the evolution of the INR which can have dramatic consequences. As such, special attention must be paid to the use of analgesics in this type of patient.

Keywords: vitamin K antagonists, pain killers, interactions, INR

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Authors: Wiem Zemzem, Moncef Tagina

Abstract:

In this work, we are addressing the problem of an autonomous mobile robot navigating in a large, unknown and dynamic environment using reinforcement learning abilities. This problem is principally related to the exploration/exploitation dilemma, especially the need to find a solution letting the robot detect the environmental change and also learn in order to adapt to the new environmental form without ignoring knowledge already acquired. Firstly, a new action selection strategy, called ε-greedy-MPA (the ε-greedy policy favoring the most promising actions) is proposed. Unlike existing exploration/exploitation policies (EEPs) such as ε-greedy and Boltzmann, the new EEP doesn’t only rely on the information of the actual state but also uses those of the eventual next states. Secondly, as the environment is large, an exploration favoring least recently visited states is added to the proposed EEP in order to accelerate learning. Finally, various simulations with ball-catching problem have been conducted to evaluate the ε-greedy-MPA policy. The results of simulated experiments show that combining this policy with the Qlearning method is more effective and efficient compared with the ε-greedy policy in stationary environments and the utility-based reinforcement learning approach in non stationary environments.

Keywords: autonomous mobile robot, exploration/ exploitation policy, large, dynamic environment, reinforcement learning

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Authors: S. Saju, G. Thirugnanam

Abstract:

In this paper, a medical image watermarking algorithm based on contourlet is proposed. Medical image watermarking is a special subcategory of image watermarking in the sense that images have special requirements. Watermarked medical images should not differ perceptually from their original counterparts because clinical reading of images must not be affected. Watermarking techniques based on wavelet transform are reported in many literatures but robustness and security using contourlet are better when compared to wavelet transform. The main challenge in exploring geometry in images comes from the discrete nature of the data. In this paper, original image is decomposed to two level using contourlet and the watermark is embedded in the resultant sub-bands. Sub-band selection is based on the value of Peak Signal to Noise Ratio (PSNR) that is calculated between watermarked and original image. To extract the watermark, Kernel ICA is used and it has a novel characteristic is that it does not require the transformation process to extract the watermark. Simulation results show that proposed scheme is robust against attacks such as Salt and Pepper noise, Median filtering and rotation. The performance measures like PSNR and Similarity measure are evaluated and compared with Discrete Wavelet Transform (DWT) to prove the robustness of the scheme. Simulations are carried out using Matlab Software.

Keywords: digital watermarking, independent component analysis, wavelet transform, contourlet

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Authors: Yun-Ching Tu, Yu-Chun Chih

Abstract:

People with aphasia (PWA) may have communicative difficulties in their daily lives, but research on functional communication in aphasia is still limited in Taiwan. The aim of the study was to investigate the impact of aphasia-related factors on functional communication assessment. This study adopted a convenience sampling method. Thirty aphasic participants participated in the study. During the test, the examiner would ask questions that are encountered in daily life and record the participant‘s responses. Some questions would provide pictures to simulate situations in daily life. The results showed that the non-fluent aphasia group performed significantly worse than the fluent aphasia group. In addition, patients with severe aphasia performed significantly lower scores than patients with moderate aphasia and mild aphasia. However, group differences in the chronic stage and acute stage were not significant. In sum, since communication in daily life is diverse and language is still needed in the communication process, patients with aphasia who have better language ability may have relatively better functional communication. In contrast, the more severely impaired the language ability of a patient with aphasia is, the more functional communication will be affected, resulting in poor communication performance in daily life.

Keywords: adult, aphasia, assessment, functional communication

Procedia PDF Downloads 62