Search results for: advanced adenoma

Authors: Rajendra N. Ghosh, Paramjeet Singh, Niranjan Khandelwal, Sameer Vyas, Pratibha Singhi, Naveen Sankhyan

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Background: Tuberculoma and neurocysticercosis (NCC) are two most common intracranial infections in developing country. They often simulate on neuroimaging and in absence of typical imaging features cause significant diagnostic dilemmas. Differentiation is extremely important to avoid empirical exposure to antitubercular medications or nonspecific treatment causing disease progression. Purpose: Better characterization and differentiation of CNS tuberculoma and NCC by using morphological and multiple advanced functional MRI. Material and Methods: Total fifty untreated patients (20 tuberculoma and 30 NCC) were evaluated by using conventional and advanced sequences like CISS, SWI, DWI, DTI, Magnetization transfer (MT), T2Relaxometry (T2R), Perfusion and Spectroscopy. rCBV,ADC,FA,T2R,MTR values and metabolite ratios were calculated from lesion and normal parenchyma. Diagnosis was confirmed by typical biochemical, histopathological and imaging features. Results: CISS was most useful sequence for scolex detection (90% on CISS vs 73% on routine sequences). SWI showed higher scolex detection ability. Mean values of ADC, FA,T2R from core and rCBV from wall of lesion were significantly different in tuberculoma and NCC (P < 0.05). Mean values of rCBV, ADC, T2R and FA for tuberculoma and NCC were (3.36 vs1.3), (1.09x10⁻³vs 1.4x10⁻³), (0.13 x10⁻³ vs 0.09 x10⁻³) and (88.65 ms vs 272.3 ms) respectively. Tuberculomas showed high lipid peak, more choline and lower creatinine with Ch/Cr ratio > 1. T2R value was most significant parameter for differentiation. Cut off values for each significant parameters have proposed. Conclusion: Quantitative MRI in combination with conventional sequences can better characterize and differentiate similar appearing tuberculoma and NCC and may be incorporated in routine protocol which may avoid brain biopsy and empirical therapy.

Keywords: advanced functional MRI, differentiation, neurcysticercosis, tuberculoma

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Authors: Ogunrinde Roseline Bosede, Ogunrinde Rowland Rotimi

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Just as the development of ideas of early mathematics was essentially motivated by social needs, the invention of the computer was equally inspired by social needs. The early years of the twenty-first century have been remarkable in advances in mathematical and computer sciences. Mathematical and computer sciences work are fast becoming an increasingly integral and essential components of a growing catalogues of areas of interests in biology, business, military, medicine, social sciences, advanced design, advanced materials, climate, banking and finance, and many other fields of disciplines. This paper seeks to highlight the trend and impacts of the duo in the technological advancements being witnessed in our today's world.

Keywords: computer, impacts, mathematics, modern society

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Authors: Nagarjuna Pitty

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It is believed invention “Advanced Method and Process Quick Electric Vehicle Charging” is an Electric Vehicles (EVs) are quickly turning into the heralds of vehicle innovation. This study endeavors to address the inquiries of how module charging process correspondence has been performed between the EV and Electric Vehicle Supply Equipment (EVSE). The energy utilization of gas-powered motors is higher than that of electric engines. An invention is related to an Advanced Method and Process Quick Electric Vehicle Charging. In this research paper, readings on the electric vehicle charging approaches will be checked, and the module charging phases will be described comprehensively.

Keywords: electric, vehicle, charging, notification, IoT, supply, equipment

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Authors: Pelin Yılmaz Çetiner, Metin Mert İlgün, Nazlı Çetindağ, Emine Birci, Gizemnur Yıldız Uysal, Özcan Hatipoğlu, Ehsan Tuzcuoğlu, Gökhan Sır

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Water scarcity is an inevitable problem affecting more and more people day by day. It is a worldwide crisis and a consequence of rapid population growth, urbanization and overexploitation. Thus, the solutions providing the reclamation of the wastewater are the desired approach. Wastewater contains various substances such as organic, soaps and detergents, solvents, biological substances, and inorganic substances. The physical properties of the wastewater differs regarding to its origin such as commerical, domestic or hospital usage. Thus, the treatment strategy of this type of wastewater is should be comprehensively investigated and properly treated. The advanced oxidation process comes up as a hopeful method associated with the formation of reactive hydroxyl radicals that are highly reactive to oxidize of organic pollutants. This process has a priority on other methods such as coagulation, flocuation, sedimentation and filtration since it was not cause any undesirable by-products. In the present study, it was aimed to investigate the applicability of advanced oxidation process for the treatment of household appliances wastewater. For this purpose, the laboratory studies providing the effectively addressing of the formed radicals to organic pollutants were carried out. Then the effect of process parameters were comprehensively studied by using response surface methodology, Box-Benhken experimental desing. The final chemical oxygen demand (COD) was the main output to evaluate the optimum point providing the expected COD removal. The linear alkyl benzene sulfonate (LAS), total dissolved solids (TDS) and color were measured for the optimum point providing the expected COD removal. Finally, present study pointed out that advanced oxidation process might be efficiently preffered to treat of the household appliances wastewater and the optimum process parameters provided that expected removal of COD.

Keywords: advanced oxidation process, household appliances wastewater, modelling, water reuse

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Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

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In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

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Authors: X. Cervantes-López, C. Arriaga-Canon, L. Contreras Espinosa

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The goal of this study is to validate the overexpression of the lncRNA GATA3-AS1 associated with resistance to neoadjuvant chemotherapy of female patients with locally advanced mammary adenocarcinoma of luminal B subtype This study involved a cohort of one hundred thirty-seven samples for which total RNA was isolated from formalin fixed paraffin embedded (FFPE) tissue. Samples were cut using a Microtome Hyrax M25 Zeiss and RNA was isolated using the RNeasy FFPE kit and a deparaffinization solution, the next step consisted in the analysis of RNA concentration and quality, then 18 µg of RNA was treated with DNase I, and cDNA was synthesized from 50 ng total RNA, finally real-time PCR was performed with SYBR Green/ROX qPCR Master Mix in order to determined relative gene expression using RPS28 as a housekeeping gene to normalize in a fold calculation ΔCt. As a result, we validated by real-time PCR that the overexpression of the lncRNA GATA3-AS1 is associated with resistance to neoadjuvant chemotherapy in locally advanced breast cancer patients of luminal B subtype.

Keywords: breast cancer, biomarkers, genomics, neoadjuvant chemotherapy, lncRNAS

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Authors: Moon Ho Do, Sin-Hee Park, Jae Hyuk Lee, Kyo Hee Cho, Jae Kyung Chae, Sun Yeou Kim

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Long-term hyperglycemic conditions associated with diabetes lead to the formation of advanced glycation end-products (AGEs). Highly reactive glucose metabolites, methylglyoxal (MGO) and glyoxal (GO), induced carbonyl stress and it may induce cellular damage, cross-linking of proteins, and glycation, playing an important role in the impairment of kidney function. Small molecules that have the ability to inhibit AGE formation, and even break preformed AGEs have a beneficial impact on metabolic syndrome, diabetes, and cancer. We quantified contents of polyphenols in nuts and investigated the protective effect of nuts and polyphenols on MGO-induced cytotoxicity in porcine kidney epithelial cells (LLC-PK1). Moreover, we evaluated the inhibitory effect of AGEs formation in the presence of MGO or GO and possess the ability to break preformed AGEs. In this study, we confirmed twenty polyphenols in diverse nuts using LC-MS/MS system. Nuts and polyphenols play a protective role in LLC-PK1 cells by reducing MGO-induced cytotoxicity. They could also prevent the formation of MGO or GO-mediated AGEs and Break AGEs crosslink. It can be surmised that increased consumption of nuts would be an effective means of preventing diabetic diseases.

Keywords: advanced glycation end products, LLC-PK1, methylglyoxal, nut, polyphenol

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Authors: Prasansha Kumari

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Financial Literacy is the possession of knowledge and understanding of financial matters. Financial Literacy often entails the knowledge of properly making decisions pertaining to certain personal financial areas like real estate, insurance investing, and savings. This paper intends to identify and analyze the financial knowledge among university undergraduates by using 200 undergraduates in four faculties of University of Kelaniya, Sri Lanka. Collected data will be analyzed by descriptive research method using SPSS package. Expected outcomes are considerable percentage of undergraduates have basic knowledge on financial matters while it has a law percentage for advanced financial literacy among undergraduates. Students from faculty of Commerce and Management and Science have good understanding about financial matters than undergraduates in other two faculties

Keywords: advanced finance, undergraduates, financial literacy, savings

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Authors: Mohamed Osama Hassaan

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Recent earthquakes have demonstrated the vulnerability of older reinforced concrete buildings to fail under imposed seismic loads. Accordingly, the need to strengthen existing reinforced concrete structures, mainly columns, to resist high seismic loads has increased. Conventional strengthening techniques such as using steel plates, steel angles and concrete overlay are used to achieve the required increase in strength or ductility. However, techniques using advanced composite materials are established. The column's splice zone is the most critical zone that failed under seismic loads. There are three types of splice zone failure that can be observed under seismic action, namely, Failure of the flexural plastic hinge region, shear failure and failure due to short lap splice. A lapped splice transfers the force from one bar to another through the concrete surrounding both bars. At any point along the splice, force is transferred from one bar by a bond to the surrounding concrete and also by a bond to the other bar of the pair forming the splice. The integrity of the lap splice depends on the development of adequate bond length. The R.C. columns built in seismic regions are expected to undergo a large number of inelastic deformation cycles while maintaining the overall strength and stability of the structure. This can be ensured by proper confinement of the concrete core. The last type of failure is focused in this research. There are insufficient studies that address the problem of strengthening existing reinforced concrete columns at splice zone through confinement with “advanced composite materials". Accordingly, more investigation regarding the seismic behavior of strengthened reinforced concrete columns using the new generation of composite materials such as (Carbon fiber polymer), (Glass fiber polymer), (Armiad fiber polymer).

Keywords: strengthening, columns, advanced composite materials, earthquakes

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Authors: Jiaqian Yin, Ruoling Chen, David Churchill, Huijuan Zou, Peipei Guo, Chunmei Liang, Xiaoqing Peng, Zhikang Zhang, Weiju Zhou, Yunxia Cao

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Purpose: This study aimed to explore the interaction of male and female age on implantation failure from in vitro fertilisation (IVF)/ intracytoplasmic sperm injection (ICSI) treatments in couples following their first cycles using the Anhui Maternal-Child Health Study (AMCHS). Methods: The AMCHS recruited 2042 infertile couples who were physically fit for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment at the Reproductive Centre of the First Affiliated Hospital of Anhui Medical University between May 2017 to April 2021. This prospective cohort study analysed the data from 1910 cohort couples for the current paper data analysis. The multivariate logistic regression model was used to identify the effect of male and female age on implantation failure after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40; female age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40) predictors. Results: Logistic regression indicated that advanced maternal age was associated with increased implantation failure (P<0.001). There was evidence of an interaction between maternal age (30-<35 and ≥ 35) and paternal age (≥35) on implantation failure. (p<0.05). Only when the male was ≥35 years of increased maternal age was associated with the risk of implantation failure. Conclusion: In conclusion, there was an additive effect on implantation failure with advanced parental age. The impact of advanced maternal age was only seen in the older paternal age group. The delay of childbearing in both men and women will be a serious public issue that may contribute to a higher risk of implantation failure in patients needing assisted reproductive technology (ART).

Keywords: parental age, infertility, cohort study, IVF

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Authors: Sayor Ajfar Aaron, Md. Mushfiqur Rahman, Sajjat Hossain Abir, Ashif Newaz

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This paper examines the transformative potential of quantum computing in the field of cybersecurity, with a focus on advanced penetration testing and forensics. It explores how quantum technologies can be leveraged to identify and exploit vulnerabilities more efficiently than traditional methods and how they can enhance the forensic analysis of cyber-attacks. Through theoretical analysis and practical simulations, this study highlights the enhanced capabilities of quantum algorithms in detecting and responding to sophisticated cyber threats, providing a pathway for developing more resilient cybersecurity infrastructures.

Keywords: cybersecurity, cyber forensics, penetration testing, quantum computing

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Authors: J. Ikome, M. Ndeley

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When a machine breakdown forces a Modified Flow Shop (MFS) out of the prescribed state, the proposed strategy reschedules part of the initial schedule to match up with the preschedule at some point. The objective is to create a new schedule that is consistent with the other production planning decisions like material flow, tooling and purchasing by utilizing the time critical decision making concept. We propose a new rescheduling strategy and a match-up point determination procedure through a feedback mechanism to increase both the schedule quality and stability. The proposed approach is compared with alternative reactive scheduling methods under different experimental settings.

Keywords: advanced critical task methods modified flow shop (MFS), Manufacturing, experiment, determination

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Authors: Berkan Ural, Arif Eser, Sinan Apaydin

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Medical image processing is generally become a challenging task nowadays. Indeed, processing of brain MRI images is one of the difficult parts of this area. This study proposes a hybrid well-defined approach which is consisted from tumor detection, extraction and analyzing steps. This approach is mainly consisted from a computer aided diagnostics system for identifying and detecting the tumor formation in any region of the brain and this system is commonly used for early prediction of brain tumor using advanced image processing and probabilistic neural network methods, respectively. For this approach, generally, some advanced noise removal functions, image processing methods such as automatic segmentation and morphological operations are used to detect the brain tumor boundaries and to obtain the important feature parameters of the tumor region. All stages of the approach are done specifically with using MATLAB software. Generally, for this approach, firstly tumor is successfully detected and the tumor area is contoured with a specific colored circle by the computer aided diagnostics program. Then, the tumor is segmented and some morphological processes are achieved to increase the visibility of the tumor area. Moreover, while this process continues, the tumor area and important shape based features are also calculated. Finally, with using the probabilistic neural network method and with using some advanced classification steps, tumor area and the type of the tumor are clearly obtained. Also, the future aim of this study is to detect the severity of lesions through classes of brain tumor which is achieved through advanced multi classification and neural network stages and creating a user friendly environment using GUI in MATLAB. In the experimental part of the study, generally, 100 images are used to train the diagnostics system and 100 out of sample images are also used to test and to check the whole results. The preliminary results demonstrate the high classification accuracy for the neural network structure. Finally, according to the results, this situation also motivates us to extend this framework to detect and localize the tumors in the other organs.

Keywords: image processing algorithms, magnetic resonance imaging, neural network, pattern recognition

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Authors: Benchalak Muangmeesri

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The purpose of this paper is to discuss how to test the best control performance of a ceramics. Hydraulic press machine (HPM) is the most common shaping of advanced ceramic with products, dimensions, and ceramic products mainly from synthetic powders. A microcontroller can be achieved to control process and has set high standards in the shaping of raw materials in powder form. HPM was proposed to develop a position control system that linked to the embedded controller PIC16F877 via Proportional and Derivative (PD) controller. The model is performed using MATLAB/SIMULINK and the best control performance of an HPM. Finally, PD controller results, showing the best performance as it had the smallest overshoot and highest quality using a microcontroller control.

Keywords: ceramics, hydraulic press, microcontroller, PD controller

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Authors: Ondrej Lufinka, Jan Kaderabek, Juraj Prstek, Jiri Skala, Kamil Kosturik

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This paper deals with the problem of using Autonomous Robotic Platforms (ARP) for the ADAS (Advanced Driver Assistance Systems) testing in automotive. There are different possibilities of the testing already in development, and lately, the autonomous robotic platforms are beginning to be used more and more widely. Autonomous Robotic Platform discussed in this paper explores the hardware and software design possibilities related to the field of embedded systems. The paper focuses on its chapters on the introduction of the problem in general; then, it describes the proposed prototype concept and its principles from the embedded HW and SW point of view. It talks about the key features that can be used for the innovation of these platforms (e.g., modularity, omnidirectional movement, common and non-traditional sensors used for localization, synchronization of more platforms and cars together, or safety mechanisms). In the end, the future possible development of the project is discussed as well.

Keywords: advanced driver assistance systems, ADAS, autonomous robotic platform, embedded systems, hardware, localization, modularity, multiple robots synchronization, omnidirectional movement, safety mechanisms, software

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Authors: Abraham J. Rizkalla, Tristan D. Yan

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Purpose: Durable mitral valve repair is preferred to a replacement, avoiding the need for anticoagulation or re-intervention, with a reduced risk of endocarditis. Robotic mitral repair has been gaining favour globally as a safe, effective, and reproducible method of minimally invasive valve repair. In this work, we showcase the use of the Davinci© Xi robotic platform to perform several advanced techniques, working synergistically to achieve successful mitral repair in advanced mitral disease. Techniques: We present the case of a Barlow type mitral valve disease with a tall and redundant posterior leaflet resulting in severe mitral regurgitation and systolic anterior motion. Firstly, quadrangular resection of P2 is performed to remove the excess and redundant leaflet. Secondly, a sliding leaflet plasty of P1 and P3 is used to reconstruct the posterior leaflet. To anchor the newly formed posterior leaflet to the papillary muscle, CV-4 Goretex neochordae are fashioned using the innovative string, ruler, and bulldog technique. Finally, mitral valve annuloplasty and closure of a patent foramen ovale complete the repair. Results: There was no significant residual mitral regurgitation and complete resolution of the systolic anterior motion of the mitral valve on post operative transoesophageal echocardiography. Conclusion: This work highlights the robotic approach to complex repair techniques for advanced mitral valve disease. Familiarity with resection and sliding plasty, neochord implantation, and annuloplasty allows the modern cardiac surgeon to achieve a minimally-invasive and durable mitral valve repair when faced with complex mitral valve pathology.

Keywords: robotic mitral valve repair, Barlow's valve, sliding plasty, neochord, annuloplasty, quadrangular resection

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Authors: Maria Dora Horvath, Norbert Buzas, Zsanett Tesch

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Diabetes management poses many unique challenges for children and their parents. The use of a diabetes management device should not be one of these challenges as the purpose of these devices is to make the management more convenient. The objective of our study was to examine how demographical, psychological and diabetes-related factors determine the choices parents make regarding their child’s diabetes management technologies and how they perceive advanced devices. We conducted the study using an online questionnaire with 318 parents (mostly mothers). The questions of the survey were about demographical, diabetes-related and psychological factors (diabetes management problems, diabetes management competence). In addition, we asked the parents opinions about advanced diabetes management devices. We expanded our data with semi-structured in-depth interviews. 61 % of the participants Self-Monitored Blood Glucose (SMBG), and 39 % used a Continuous Glucose Monitoring System (CGM). Considering insulin administration, 58 % used Multiple Daily Insulin Injections (MDII) and 42 % used Continuous Subcutaneous Insulin Infusion (CSII). Parents who used diverse combinations of diabetes management devices showed significant differences in age (parents’ and child’s), the monthly cost of diabetes, the duration of diabetes, the highest level of education and average monthly household income. CGM users perceived diabetes management problems significantly more severe than SMBG users and CSII users felt significantly more competent in diabetes management than MDII users. Avoiding CGM use due to lack of financial resources was determined by diagnosis duration. While avoiding its use by the cause of the child rejecting, it was determined by the child’s age and diabetes competence. Using MDII instead of CSII because of the child’s rejection was determined by the monthly cost of diabetes and child’s age. We conducted a complex empirical study in which we examined perceptions and experiences of advanced and less advanced diabetes management technologies comprehensively. Our study highlights the factors that fundamentally influence parents’ motivations and choices about diabetes management technologies. These results could contribute to developing diabetes management technologies more suitable for children living with type 1 diabetes and their parents.

Keywords: advanced diabetes management technologies, children living with type 1 diabetes, diabetes management, motivation, parents

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Authors: Xi Wang, Yoshio Bando

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Lithium-ion batteries (LIBs) can deliver high levels of energy storage density and offer long operating lifetimes, but their power density is too low for many important applications. Therefore, we developed some new strategies and fabricated novel electrodes for fast Li transport and its facile synthesis including N-doped graphene-SnO2 sandwich papers, bicontinuous nanoporous Cu/Li4Ti5O12 electrode, and binder-free N-doped graphene papers. In addition, by using advanced in-TEM, STEM techniques and the theoretical simulations, we systematically studied and understood their storage mechanisms at the atomic scale, which shed a new light on the reasons of the ultrafast lithium storage property and high capacity for these advanced anodes. For example, by using advanced in-situ TEM, we directly investigated these processes using an individual CuO nanowire anode and constructed a LIB prototype within a TEM. Being promising candidates for anodes in lithium-ion batteries (LIBs), transition metal oxide anodes utilizing the so-called conversion mechanism principle typically suffer from the severe capacity fading during the 1st cycle of lithiation–delithiation. Also we report on the atomistic insights of the GN energy storage as revealed by in situ TEM. The lithiation process on edges and basal planes is directly visualized, the pyrrolic N "hole" defect and the perturbed solid-electrolyte-interface (SEI) configurations are observed, and charge transfer states for three N-existing forms are also investigated. In situ HRTEM experiments together with theoretical calculations provide a solid evidence that enlarged edge {0001} spacings and surface "hole" defects result in improved surface capacitive effects and thus high rate capability and the high capacity is owing to short-distance orderings at the edges during discharging and numerous surface defects; the phenomena cannot be understood previously by standard electron or X-ray diffraction analyses.

Keywords: in-situ TEM, STEM, advanced anode, lithium-ion batteries, storage mechanism

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Authors: Ala Abdessemed, Mohamed Seddik Oussama Belahmadi, Nabil Charchar, Abdefettah Gherib, Bradai Fares, Boussadia Chouaib Nour El-Islem

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Algerian cities are confronted with large quantities of waste generated by the disposal of household and similar residues in technical landfills (CET), such as the one in the location of Batna. The interaction between waste components and incoming water generates leachates rich in organic matter and trace elements, which require treatment before discharge. The aim of this study was to propose an effective process for treating the leachates, which were subjected to an initial chemical treatment using the (H₂O₂/UV) system. Optimal treatment conditions were determined at [H₂O₂] of 0.3 M and pH of 8.6. Next, two hybrid biological treatment systems were applied: hybrid system I (H₂O₂/UV/bacteria) and hybrid system II (H₂O₂/UV/bacteria/microalgae). The three processes resulted in the following degradation rates, expressed in terms of total organic carbon (TOC) 27.4% for the (H₂O₂/UV) system; 58.1% for the hybrid system I (H₂O₂/UV/Bacteria); 67.86% for the hybrid system II (H₂O₂/UV/Bacteria/Microalgae). This study demonstrates that a hybrid approach combining advanced oxidation processes and biological treatments is a highly effective alternative to achieve satisfactory treatment.

Keywords: leachate, landfill, advanced oxidation processes, biological treatment, bacteria, microalgae, total organic carbon

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Authors: Ali Yasin, Ali Kamran, Muhammad Safdar

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In order to reduce the hefty cost involved in terms of time and project cost, the development and application of advanced numerical tools to address the burn-back analysis problem in solid rocket motor design and development is the need of time. Several advanced numerical schemes have been developed in recent times, but their usage in the design of propellant grain of solid rocket motors is very rare. In this paper, an advanced numerical technique named the Level-Set method has been utilized for the burn-back analysis of star grain to study the effect of geometrical parameters on ballistic performance indicators such as solid loading, neutrality, and sliver percentage. In the level set technique, simple finite difference methods may fail quickly and require more sophisticated non-oscillatory schemes for feasible long-time simulation. For internal ballistic calculations, a simplified equilibrium pressure method is utilized. Preliminary results of the operative conditions, for all the combustion time, of star grain burn-back using level set techniques are compared with published results using CAD technique to test the developed numerical model.

Keywords: solid rocket motor, internal ballistic, level-set technique, star grain

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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Authors: George Nyori Makari, J. M. Ogola

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Over the past few decades, manufacturing has evolved from a more labor-intensive set of mechanical processes to a sophisticated set of information based technology processes. With the existence of various advanced manufacturing technologies (AMTs), more and more functions or jobs are performed by these machines instead of human labour. This study was undertaken in order to research the extent of AMTs adoption in manufacturing companies in Kenya. In order to investigate a survey was conducted via questionnaires that were sent to 183 selected AMT manufacturing companies in Kenya. 92 companies responded positively. All the surveyed companies were found to have a measure of investment in at least two of the 14 types of AMTs investigated. In general the company surveyed showed that the level of AMT adoption in Kenya is very low with investments levels at a mean of 2.057 and integration levels at a mean of 1.639 in a scale of 1-5.

Keywords: AMT adoption, AMT investments, AMT integration, companies in Kenya

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Authors: Y. Venturini, C. Tintori

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Given the continuous demand for improved readout performances in particle and dark matter physics, CAEN SpA is pushing on the development of advanced technologies for detector readout. We present the Digitizers 2.0, the result of the success of the previous Digitizers generation, combined with expanded capabilities and a renovation of the user experience introducing the open FPGA. The first product of the family is the VX2740 (64 ch, 125 MS/s, 16 bit) for advanced waveform recording and Digital Pulse Processing, fitting with the special requirements of Dark Matter and Neutrino experiments. In parallel, CAEN is developing the FERS-5200 platform, a Front-End Readout System designed to read out large multi-detector arrays, such as SiPMs, multi-anode PMTs, silicon strip detectors, wire chambers, GEM, gas tubes, and others. This is a highly-scalable distributed platform, based on small Front-End cards synchronized and read out by a concentrator board, allowing to build extremely large experimental setup. We plan to develop a complete family of cost-effective Front-End cards tailored to specific detectors and applications. The first one available is the A5202, a 64-channel unit for SiPM readout based on CITIROC ASIC by Weeroc.

Keywords: dark matter, digitizers, front-end electronics, open FPGA, SiPM

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Authors: Musaab Hasan, Farkhund Iqbal, Patrick C. K. Hung, Benjamin C. M. Fung, Laura Rafferty

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In modern societies, the smart cities concept raised simultaneously with the projection towards adopting smart devices. A smart grid is an essential part of any smart city as both consumers and power utility companies benefit from the features provided by the power grid. In addition to advanced features presented by smart grids, there may also be a risk when the grids are exposed to malicious acts such as security attacks performed by terrorists. Considering advanced security measures in the design of smart meters could reduce these risks. This paper presents a security study for smart metering systems with a prototype implementation of the user interfaces for future works.

Keywords: security design, smart city, smart meter, smart grid, smart metering system

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Authors: Mohamed H. Khalil

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Water is one of the most crucial elements which influence human lives and development. Noteworthy, over the last few years, GIS plays a significant role in optimizing water management systems, especially after exponential developing in this sector. In this context, the Egyptian government initiated an advanced ‘GIS-Web Based System’. This system is efficiently designed to tangibly assist and optimize the complement and integration of data between departments of Call Center, Operation and Maintenance, and laboratory. The core of this system is a unified ‘Data Model’ for all the spatial and tabular data of the corresponding departments. The system is professionally built to provide advanced functionalities such as interactive data collection, dynamic monitoring, multi-user editing capabilities, enhancing data retrieval, integrated work-flow, different access levels, and correlative information record/track. Noteworthy, this cost-effective system contributes significantly not only in the completeness of the base-map (93%), the water network (87%) in high level of details GIS format, enhancement of the performance of the customer service, but also in reducing the operating costs/day-to-day operations (~ 5-10 %). In addition, the proposed system facilitates data exchange between different departments (Call Center, Operation and Maintenance, and laboratory), which allowed a better understanding/analyzing of complex situations. Furthermore, this system reflected tangibly on: (i) dynamic environmental monitor/water quality indicators (ammonia, turbidity, TDS, sulfate, iron, pH, etc.), (ii) improved effectiveness of the different water departments, (iii) efficient deep advanced analysis, (iv) advanced web-reporting tools (daily, weekly, monthly, quarterly, and annually), (v) tangible planning synthesizing spatial and tabular data; and finally, (vi) scalable decision support system. It is worth to highlight that the proposed future plan (second phase) of this system encompasses scalability will extend to include integration with departments of Billing and SCADA. This scalability will comprise advanced functionalities in association with the existing one to allow further sustainable contributions.

Keywords: GIS Web-Based, base-map, water network, decision support system

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Authors: Monika Michałowska, Anna Alichniewicz

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Detrimental outcomes of advanced maternal age on the chances of fertilization, pregnancy as well as mother and fetus health have been recognized for several decades. It seemed interesting to investigate whether there is a comparable awareness of the detrimental influence on the reproductive outcomes of late fatherhood, given that it has been already ten years since an intense and growing interest concerning later-age fatherhood commenced in medical research. To address that issue a two-step research was done. First, we performed a review of the subject literature to answer the following questions: 1) What age is defined as advanced?; 2) Is the same age defined as advanced in both genders?; 3) What terminology concerning age issues is used?; 4) Is the same age terminology used regarding both genders? The second part of our studies was devoted to the views of medical students. This part of our research comprised both quantitative and qualitative studies. Opinions of medical students in one of the Polish medical universities on several issues connected with assisted reproduction technology (ART) were gathered: 1) students’ attitude to in vitro fertilization (IVF) for women over 40 and for postmenopausal women; 2) students’ attitude to late fatherhood; 3) students’ reasoning given against acceptability of IVF procedure for all of these group of patients involved in an IVF procedure. Our analyses revealed that: First, there is no universal definition of the term ‘advanced age’; secondly, there is a general tendency to adopt different age limits depending on whether they refer to maternal or paternal age, but no justification is provided by the researchers explaining why they set different age limits for women and men; thirdly, the image of postponed fatherhood stands in stark contrast to postponed motherhood - while postponed fatherhood is frequently portrayed as a reasonable and conscious decision enabling a stable family environment for a child, the reasonableness of postponed motherhood is often questioned; finally, the bias regarding maternal versus paternal age is deeply embedded in medical students’ attitude to IVF for women over 40 and for postmenopausal women.

Keywords: gender stereotypes, reproductive medicine, maternal age, paternal age

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Authors: Shu-Ching Chen, Li-Yun Lee

Abstract:

The purpose of the study was to identify the factors associated with head and neck cancer-related lymphoedema (HNCRL)-related symptoms, body image, and HNCRL-related functional outcomes among patients with resected advanced head and neck cancer. A cross-sectional correlational design was conducted to examine the predictors of HNCRL-related functional outcomes in patients with resected advanced head and neck cancer. Eligible patients were recruited from a single medical center in northern Taiwan. Consecutive patients were approached and recruited from the Radiation Head and Neck Outpatient Department of this medical center. Eligible subjects were assessed for the Symptom Distress Scale–Modified for Head and Neck Cancer (SDS-mhnc), Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Head and Neck Cancer (BCSQ-H&N), Body Image Scale–Modified (BIS-m), The MD Anderson Head and Neck Lymphedema Rating Scale (MDAHNLRS), The Foldi’s Stages of Lymphedema (Foldi’s Scale), Patterson’s Scale, UCLA Shoulder Rating Scale (UCLA SRS), and Karnofsky’s Performance Status Index (KPS). The results showed that the worst problems with body HNCRL functional outcomes. Patients’ HNCRL symptom distress and performance status are robust predictors across over for overall HNCRL functional outcomes, problems with body HNCRL functional outcomes, and activity and social functioning HNCRL functional outcomes. Based on the results of this period research program, we will develop a Cancer Rehabilitation and Lymphedema Care Program (CRLCP) to use in the care of patients with resected advanced head and neck cancer.

Keywords: head and neck cancer, resected, lymphedema, symptom, body image, functional outcome

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Authors: Atef Alaaeddine Sarraj, Brendan Jackman, Frank Walsh

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Tomorrow’s car will be more automated and increasingly connected. Innovative and intuitive interfaces are essential to accompany this functional enrichment. For that, today the automotive companies are competing to offer an advanced driver assistance system (ADAS) which will be able to provide enhanced navigation, collision avoidance, intersection support and lane keeping. These vision-based functions require an accurately calibrated camera. To achieve such differentiation in ADAS requires sophisticated sensors and efficient algorithms. This paper explores the different calibration methods applicable to vehicle-mounted fish-eye cameras with arbitrary fields of view and defines the first steps towards a self-calibration method that adequately addresses ADAS requirements. In particular, we present a self-calibration method after comparing different camera calibration algorithms in the context of ADAS requirements. Our method gathers data from unknown scenes while the car is moving, estimates the camera intrinsic and extrinsic parameters and corrects the wide-angle distortion. Our solution enables continuous and real-time detection of objects, pedestrians, road markings and other cars. In contrast, other camera calibration algorithms for ADAS need pre-calibration, while the presented method calibrates the camera without prior knowledge of the scene and in real-time.

Keywords: advanced driver assistance system (ADAS), fish-eye, real-time, self-calibration

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Authors: C. Fernanda da S. Sampaio, M. Gabriela Sadith Perez Paredes, V. Antonio de O. Martins

Abstract:

Today the transport sector is undergoing a revolution, with the rise of Advanced Driver Assistance Systems (ADAS), industry and society itself will undergo a major transformation. However, the technological development of these applications is a challenge that requires new techniques and great machine learning and artificial intelligence. The study proposes to develop a vehicular perception system called Veibra, which consists of two front cameras for day/night viewing and an embedded device capable of working with Yolov2 image processing algorithms with low computational cost. The strategic version for the market is to assist the driver on the road with the detection of day/night objects, such as road signs, pedestrians, and animals that will be viewed through the screen of the phone or tablet through an application. The system has the ability to perform real-time driver detection and recognition to identify muscle movements and pupils to determine if the driver is tired or inattentive, analyzing the student's characteristic change and following the subtle movements of the whole face and issuing alerts through beta waves to ensure the concentration and attention of the driver. The system will also be able to perform tracking and monitoring through GSM (Global System for Mobile Communications) technology and the cameras installed in the vehicle.

Keywords: advanced driver assistance systems, tracking, traffic signal detection, vehicle perception system

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Authors: Elzbieta Sikorska-Simmons

Abstract:

Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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