Search results for: congenital anomalies
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 371

Search results for: congenital anomalies

341 Body Dysmorphia in Adolescent's Fixation on Cosmetic Surgeries

Authors: Noha El Toukhy

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The ‘beauty is good” stereotype suggests that people perceive attractive people as having several positive characteristics. Likewise, an “anomalous-is-bad” stereotype is hypothesized to facilitate biases against people with anomalous or less attractive faces. Researchers integrated both into a stereotype content model, which is one of the frameworks used in this study to assess how facial anomalies influence people’s social attitudes and, specifically, people’s ratings of warmth and competence. The mind perception theory, as well as the assessment of animalistic and mechanistic dehumanization against facially anomalous people, are two further frameworks that we are using in this study. This study will test the hypothesis that people have negative attitudes towards people with facial anomalies. We also hypothesize that people have negative biases toward faces with visible differences compared to faces without such differences regardless of the specific type of anomaly, as well as that individual differences in psychological dispositions bear on the expression of the anomalous-is-bad stereotype. Using highly controlled and some never-before-used face stimuli, this pre-registered study examines whether moral character influences perceptions of attractiveness, warmth, and competence for facial anomalies.

Keywords: adolescents, attractiveness, competence, social attitudes, warmth

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340 Hg Anomalies and Soil Temperature Distribution to Delineate Upflow and Outflow Zone in Bittuang Geothermal Prospect Area, south Sulawesi, Indonesia

Authors: Adhitya Mangala, Yobel

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Bittuang geothermal prospect area located at Tana Toraja district, South Sulawesi. The geothermal system of the area related to Karua Volcano eruption product. This area has surface manifestation such as fumarole, hot springs, sinter silica and mineral alteration. Those prove that there are hydrothermal activities in the subsurface. However, the project and development of the area have not implemented yet. One of the important elements in geothermal exploration is to determine upflow and outflow zone. This information very useful to identify the target for geothermal wells and development which it is a risky task. The methods used in this research were Mercury (Hg) anomalies in soil, soil and manifestation temperature distribution and fault fracture density from 93 km² research area. Hg anomalies performed to determine the distribution of hydrothermal alteration. Soil and manifestation temperature distribution were conducted to estimate heat distribution. Fault fracture density (FFD) useful to determine fracture intensity and trend from surface observation. Those deliver Hg anomaly map, soil and manifestation temperature map that combined overlayed to fault fracture density map and geological map. Then, the conceptual model made from north – south, and east – west cross section to delineate upflow and outflow zone in this area. The result shows that upflow zone located in northern – northeastern of the research area with the increase of elevation and decrease of Hg anomalies and soil temperature. The outflow zone located in southern - southeastern of the research area which characterized by chloride, chloride - bicarbonate geothermal fluid type, higher soil temperature, and Hg anomalies. The range of soil temperature distribution from 16 – 19 °C in upflow and 19 – 26.5 °C in the outflow. The range of Hg from 0 – 200 ppb in upflow and 200 – 520 ppb in the outflow. Structural control of the area show northwest – southeast trend. The boundary between upflow and outflow zone in 1550 – 1650 m elevation. This research delivers the conceptual model with innovative methods that useful to identify a target for geothermal wells, project, and development in Bittuang geothermal prospect area.

Keywords: Bittuang geothermal prospect area, Hg anomalies, soil temperature, upflow and outflow zone

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339 Epidemiological Analysis of the Patients Supplied with Foot Orthoses in Ortho-Prosthetic Center of Kosovo

Authors: Ardiana Murtezani, Ilirijana Dallku, Teuta Osmani Vllasolli, Sabit Sllamniku

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Background: The use of foot orthoses are always indicated when there are alterations of the optimal biomechanics' position of the foot. Orthotics are very effective and very suitable for the majority of patients with pain due to overload which can be related to biomechanical disorders. Aim: To assess the frequency of patients requiring foot orthoses, type of orthoses and analysis of their disease leading to the use of foot orthoses. Material and Methods: Our study included 128 patients with various foot pathologies, treated at the outpatient department of the Ortho-Prosthetic Center of Kosovo (OPCK) in Prishtina. Prospective-descriptive clinical method was used during this study. Functional status of patients was examined, and the following parameters are noted: range of motion measurements for the affected joints/lower extremities, manual test for muscular strength below the knee and foot of the affected extremity, perimeter measurements of the lower extremities, measurements of lower extremities, foot length measurement, foot width measurements and size. In order to complete the measurements the following instruments are used: plantogram, pedogram, meter and cork shoe lift appliances. Results: The majority of subjects in this study are male (60.2% vs. 39.8%), and the dominant age group was 0-9 (47.7%), 61 subjects respectively. Most frequent foot disorders were: congenital disease 60.1%, trauma cases 13.3%, consequences from rheumatologic disease 12.5%, neurologic dysfunctions 11.7%, and the less frequented are the infectious cases 1.6%. Congenital anomalies were the most frequent cases, and from this group majority of cases suffered from pes planovalgus (37.5%), eqinovarus (15.6%) and discrepancies between extremities (6.3%). Furthermore, traumatic amputations (2.3%) and arthritis (0.8%). As far as neurologic disease, subjects with cerebral palsy are represented with (3.1%), peroneal nerve palsy (2.3%) and hemiparesis (1.6%). Infectious disease osteomyelitis sequels are represented with (1.6%). Conclusion: Based on our study results, we have concluded that the use of foot orthoses for patients suffering from rheumatoid arthritis and nonspecific arthropaty was effective treatment choice, leading to decrease of pain, less deformities and improves the quality of life.

Keywords: orthoses, epidemiological analysis, rheumatoid arthritis, rehabilitation

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338 Seismic Activity and Groundwater Behavior at Kalabsha Area, Aswan, Egypt

Authors: S. M. Moustafa, A. Ezzat, Y. S. Taha, G. H. Hassib, S. Hamada

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After the occurrence of 14, Nov, 1981 earthquake (M = 5.3), on Kalabska fault, south of Egypt, seismic stations distributed in and around the Kalabsha area, in order to monitoring, recording and studying the seismic activity in the area. In addition of that, from 1989 a number of piezometer wells drilled in the same area, distribed on at the both side of the active faults area and in different water bearing formations, in order to measuring the groundwater parameters (level, temperature, ph, and conductivity) to monitoring the relationship between those parameters and the seismic activity at Kalabsha area. The behavior of groundwater due to seismic activity over the world studied by several scientists i.e. H. Wakita (1979) on Izu-Oshima earthquake (M= 7.0) at Japan, M. E. Contadakis & G.asteriadis (1972), and Evans (1966), they found an anomalies on groundwater measurements prior, co, and post the occurrence of bigger earthquakes, referring to the probability of precursory evidence of impending earthquakes. In Kalabsha area south of Egypt, this study has been done using recorded seismic data, and the measurements of underground water parameters. same phenomena of anomalies founded on groundwater measurements pre, co. and post the occurrence of earthquakes with magnitude bigger than 3, and no systematic regularity exists for epicenter distance, duration of anomalies or time lag between anomalies appear and occurrence of events. Also the results found present strong relation between the groundwater in the upper unconfined aquifer Nubian Sandstone formation, and Kalabsha seismic activity, otherwise no relation between the seismic activities in the area with the deep groundwater in the lower confined aquifer Sandstone.

Keywords: seismicity, groundwater, Aswan, Egypt

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337 Combining ASTER Thermal Data and Spatial-Based Insolation Model for Identification of Geothermal Active Areas

Authors: Khalid Hussein, Waleed Abdalati, Pakorn Petchprayoon, Khaula Alkaabi

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In this study, we integrated ASTER thermal data with an area-based spatial insolation model to identify and delineate geothermally active areas in Yellowstone National Park (YNP). Two pairs of L1B ASTER day- and nighttime scenes were used to calculate land surface temperature. We employed the Emissivity Normalization Algorithm which separates temperature from emissivity to calculate surface temperature. We calculated the incoming solar radiation for the area covered by each of the four ASTER scenes using an insolation model and used this information to compute temperature due to solar radiation. We then identified the statistical thermal anomalies using land surface temperature and the residuals calculated from modeled temperatures and ASTER-derived surface temperatures. Areas that had temperatures or temperature residuals greater than 2σ and between 1σ and 2σ were considered ASTER-modeled thermal anomalies. The areas identified as thermal anomalies were in strong agreement with the thermal areas obtained from the YNP GIS database. Also the YNP hot springs and geysers were located within areas identified as anomalous thermal areas. The consistency between our results and known geothermally active areas indicate that thermal remote sensing data, integrated with a spatial-based insolation model, provides an effective means for identifying and locating areas of geothermal activities over large areas and rough terrain.

Keywords: thermal remote sensing, insolation model, land surface temperature, geothermal anomalies

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336 Investigation of Geothermal Gradient of the Niger Delta from Recent Studies

Authors: Adedapo Jepson Olumide, Kurowska Ewa, K. Schoeneich, Ikpokonte A. Enoch

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In this paper, subsurface temperature measured from continuous temperature logs were used to determine the geothermal gradient of NigerDelta sedimentary basin. The measured temperatures were corrected to the true subsurface temperatures by applying the American Association of Petroleum Resources (AAPG) correction factor, borehole temperature correction factor with La Max’s correction factor and Zeta Utilities borehole correction factor. Geothermal gradient in this basin ranges from 1.20C to 7.560C/100m. Six geothermal anomalies centres were observed at depth in the southern parts of the Abakaliki anticlinorium around Onitsha, Ihiala, Umuaha area and named A1 to A6 while two more centre appeared at depth of 3500m and 4000m named A7 and A8 respectively. Anomaly A1 describes the southern end of the Abakaliki anticlinorium and extends southwards, anomaly A2 to A5 were found associated with a NW-SE structural alignment of the Calabar hinge line with structures describing the edge of the Niger Delta basin with the basement block of the Oban massif. Anomaly A6 locates in the south-eastern part of the basin offshore while A7 and A8 are located in the south western part of the basin offshore. At the average exploratory depth of 3500m, the geothermal gradient values for these anomalies A1, A2, A3, A4, A5, A6, A7, and A8 are 6.50C/100m, 1.750C/100m, 7.50C/100m, 1.250C/100m, 6.50C/100m, 5.50C/100m, 60C/100m, and 2.250C/100m respectively. Anomaly A8 area may yield higher thermal value at greater depth than 3500m. These results show that anomalies areas of A1, A3, A5, A6 and A7 are potentially prospective and explorable for geothermal energy using abandoned oil wells in the study area. Anomalies A1, A3.A5, A6 occur at areas where drilled boreholes were not exploitable for oil and gas but for the remaining areas where wells are so exploitable there appears no geothermal anomaly. Geothermal energy is environmentally friendly, clean and reversible.

Keywords: temperature logs, geothermal gradient anomalies, alternative energy, Niger delta basin

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335 Hybrid Gravity Gradient Inversion-Ant Colony Optimization Algorithm for Motion Planning of Mobile Robots

Authors: Meng Wu

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Motion planning is a common task required to be fulfilled by robots. A strategy combining Ant Colony Optimization (ACO) and gravity gradient inversion algorithm is proposed for motion planning of mobile robots. In this paper, in order to realize optimal motion planning strategy, the cost function in ACO is designed based on gravity gradient inversion algorithm. The obstacles around mobile robot can cause gravity gradient anomalies; the gradiometer is installed on the mobile robot to detect the gravity gradient anomalies. After obtaining the anomalies, gravity gradient inversion algorithm is employed to calculate relative distance and orientation between mobile robot and obstacles. The relative distance and orientation deduced from gravity gradient inversion algorithm is employed as cost function in ACO algorithm to realize motion planning. The proposed strategy is validated by the simulation and experiment results.

Keywords: motion planning, gravity gradient inversion algorithm, ant colony optimization

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334 Examining Statistical Monitoring Approach against Traditional Monitoring Techniques in Detecting Data Anomalies during Conduct of Clinical Trials

Authors: Sheikh Omar Sillah

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Introduction: Monitoring is an important means of ensuring the smooth implementation and quality of clinical trials. For many years, traditional site monitoring approaches have been critical in detecting data errors but not optimal in identifying fabricated and implanted data as well as non-random data distributions that may significantly invalidate study results. The objective of this paper was to provide recommendations based on best statistical monitoring practices for detecting data-integrity issues suggestive of fabrication and implantation early in the study conduct to allow implementation of meaningful corrective and preventive actions. Methodology: Electronic bibliographic databases (Medline, Embase, PubMed, Scopus, and Web of Science) were used for the literature search, and both qualitative and quantitative studies were sought. Search results were uploaded into Eppi-Reviewer Software, and only publications written in the English language from 2012 were included in the review. Gray literature not considered to present reproducible methods was excluded. Results: A total of 18 peer-reviewed publications were included in the review. The publications demonstrated that traditional site monitoring techniques are not efficient in detecting data anomalies. By specifying project-specific parameters such as laboratory reference range values, visit schedules, etc., with appropriate interactive data monitoring, statistical monitoring can offer early signals of data anomalies to study teams. The review further revealed that statistical monitoring is useful to identify unusual data patterns that might be revealing issues that could impact data integrity or may potentially impact study participants' safety. However, subjective measures may not be good candidates for statistical monitoring. Conclusion: The statistical monitoring approach requires a combination of education, training, and experience sufficient to implement its principles in detecting data anomalies for the statistical aspects of a clinical trial.

Keywords: statistical monitoring, data anomalies, clinical trials, traditional monitoring

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333 System Detecting Border Gateway Protocol Anomalies Using Local and Remote Data

Authors: Alicja Starczewska, Aleksander Nawrat, Krzysztof Daniec, Jarosław Homa, Kacper Hołda

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Border Gateway Protocol is the main routing protocol that enables routing establishment between all autonomous systems, which are the basic administrative units of the internet. Due to the poor protection of BGP, it is important to use additional BGP security systems. Many solutions to this problem have been proposed over the years, but none of them have been implemented on a global scale. This article describes a system capable of building images of real-time BGP network topology in order to detect BGP anomalies. Our proposal performs a detailed analysis of BGP messages that come into local network cards supplemented by information collected by remote collectors in different localizations.

Keywords: BGP, BGP hijacking, cybersecurity, detection

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332 Use of Hierarchical Temporal Memory Algorithm in Heart Attack Detection

Authors: Tesnim Charrad, Kaouther Nouira, Ahmed Ferchichi

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In order to reduce the number of deaths due to heart problems, we propose the use of Hierarchical Temporal Memory Algorithm (HTM) which is a real time anomaly detection algorithm. HTM is a cortical learning algorithm based on neocortex used for anomaly detection. In other words, it is based on a conceptual theory of how the human brain can work. It is powerful in predicting unusual patterns, anomaly detection and classification. In this paper, HTM have been implemented and tested on ECG datasets in order to detect cardiac anomalies. Experiments showed good performance in terms of specificity, sensitivity and execution time.

Keywords: cardiac anomalies, ECG, HTM, real time anomaly detection

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331 Whitnall’s Sling Will Be an Alternative Method for the Surgical Correction of Poor Function Ptosis

Authors: Titap Yazicioglu

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To examine the results of two different surgery in patients with severe ptosis and poor levator function. The records of 10 bilateral congenital ptosis patients, who underwent Whitnall’s sling surgery on one eyelid and frontalis sling surgery on the other were analyzed retrospectively. All patients had severe congenital ptosis(>4mm) and poor levator function (LF<4mm). Data regarding eyelid position, cosmetic outcomes, and postoperative complications were evaluated. All patients were assessed for a minimum of one year with regard to the amount of correction, residual ptosis and lagophthalmos. The study consisted of 10 patients, with an average age of 9.2±2.4 years. Preoperative diagnosis for all patients was noted as, the average LF was 3.4±0.51mm, vertical lid height was 3.5±0.52 mm and margin reflex distance-1 (MRD-1) was 0.4±0.51mm. The mean vertical lid height was measured as 7.1±0.73 mm in the frontalis sling group and 7.2±0.63 mm in the Whitnall’s sling group at the postoperative 1st month control. However, in patients with Whitnall’s sling, revision was performed with frontalis sling surgery due to failure in vertical lid height in the late postoperative period, and an average of 7.5±0.52 mm was achieved. Satisfactory results were obtained in all patients. Although postoperative lagophthalmitis developed in the frontalis sling group, none of them developed exposure keratitis. Granuloma was observed as sling infection in 2(20%) of the patients. Although Whitnall’s sling technique provides a natural look appearance without interfering with the functional result, we did not find it as successful as frontalis sling surgery in severe ptosis.

Keywords: congenital ptosis, frontalis suspension, Whitnall ligament, complications

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330 Nursing System Development in Patients Undergoing Operation in 3C Ward

Authors: Darawan Augsornwan, Artitaya Sabangbal, Maneewan Srijan, Kanokarn Kongpitee, Lalida Petphai, Palakorn Surakunprapha

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Background: Srinagarind Hospital, Ward 3C, has patients with head and neck cancer, congenital urology anomalies such as hypospadis, cleft lip and cleft palate and congenital megacolon who need surgery. Undergoing surgery is a difficult time for patients/ family; they feel fear and anxiety. Nurses work closely with patients and family for 24 hours in the process of patients care, so should have the good nursing ability, innovation and an efficient nursing care system to promote patients self-care ability reducing suffering and preventing complications. From previous nursing outcomes we found patients did not receive appropriate information, could not take care of their wound, not early ambulation after the operation and lost follow-up. Objective: to develop the nursing system for patients who were undergoing an operation. Method: this is a participation action research. The sample population was 11 nurses and 60 patients. This study was divided into 3 phase: Phase 1. Situation review In this phase we review the clinical outcomes, the process of care from documents such as nurses note and interview nurses, patients and family about the process of care by nurses. Phase 2: focus group with 11 nurses, searching guideline for specific care, nursing care system then establish the protocol. This phase we have the protocol for giving information, teaching protocol and teaching record, leaflet for all of top five diseases, make video media to convey information, ambulation package and protocol for patients with head and neck cancer, patients zoning, primary nurse, improved job description for each staff level. Program to record number of patients, kind of medical procedures for showing nurses activity each day. Phase 3 implementation and evaluation. Result: patients/family receive appropriate information about deep breathing exercise, cough, early ambulation after the operation, information during the stay in the hospital. Patients family satisfaction is 95.04 percent, appropriate job description for a practical nurse, nurse aid, and worker. Nurses satisfaction is 95 percent. The complications can be prevented. Conclusion: the nursing system is the dynamic process using evidence to develop nursing care. The appropriate system depends on context and needs to keep an eye on every event.

Keywords: development, nursing system, patients undergoing operation, 3C Ward

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329 Congenital Malformations in Neonate Dogs in the Sao Paulo State University Veterinary Hospital, Botucatu, Sao Paulo, Brazil

Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Congenital malformations are organ defects due to genetic or teratogenic causes, which can lead to high mortality in dog litters. This study assessed and described the congenital malformations in newborn dogs. The study included litters attend in the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil. One hundred seventy-eight litters and 803 newborns were evaluated. The occurrence of litters with malformations was 24.7%, and of newborns was 6.7%. Twenty-seven different malformations were registered: anasarca, anal atresia, cleft lip, cleft palate, duplicated right ribcage, equinovarus, exencephaly, gastroschisis, hydrocephaly, lissencephaly, macroglossia, microphthalmia, mitral valve dysplasia, omphalocele, eyelid agenesis, persistent urachus, polydactyly, pulmonary hypoplasia, pulmonary valve stenosis, rectovaginal fistula, agenesis of abdominal muscles, rib hypoplasia, scoliosis, segmental aplasia of the intestines, tricuspid valve dysplasia, unilateral kidney agenesis, and vaginal atresia. 68.7% of newborns died as a result of malformations. The pure breeds with the highest chances of manifesting malformations in contrast with mixed breeds were French Bulldog, Pug, English Bulldog, Rottweiler, German Spitz, Pinscher, Pitbull, Yorkshire Terrier, and Shih-Tzu. Significant values (P<0.05) occurred in races French Bulldogs and Pugs. The causes of congenital disabilities are possibly related to hereditary genetic factors considering that the highest incidence of malformations was observed among purebreds. There as one case of exposure to a teratogenic agent, but no other mothers were exposed to such agents during pregnancy. Two cases of consanguineal breeding between siblings were reported. The mortality rate was high. Genetic breeding programs for reproduction, avoiding consanguineous mating, care in choosing parents, and avoiding maternal exposure to teratogenic agents are of utmost importance in reducing dog malformations and consequent mortality.

Keywords: congenital defects, teratogenesis, canine neonatology, newborn puppy

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328 Ultrasonic Densitometry of Alveolar Bone Jaw during Retention Period of Orthodontic Treatment

Authors: Margarita A. Belousova, Sergey N. Ermoliev, Nina K. Loginova

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The method of intraoral ultrasound densitometry developed to diagnose mineral density of alveolar bone jaws during retention period of orthodontic treatment (Patent of Russian Federation № 2541038). It was revealed significant decrease of the ultrasonic wave speed and bone mineral density in patients with relapses dentition anomalies during retention period of orthodontic treatment.

Keywords: intraoral ultrasonic densitometry, speed of sound, alveolar jaw bone, relapses of dentition anomalies, retention period of orthodontic treatment

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327 A Machine Learning Framework Based on Biometric Measurements for Automatic Fetal Head Anomalies Diagnosis in Ultrasound Images

Authors: Hanene Sahli, Aymen Mouelhi, Marwa Hajji, Amine Ben Slama, Mounir Sayadi, Farhat Fnaiech, Radhwane Rachdi

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Fetal abnormality is still a public health problem of interest to both mother and baby. Head defect is one of the most high-risk fetal deformities. Fetal head categorization is a sensitive task that needs a massive attention from neurological experts. In this sense, biometrical measurements can be extracted by gynecologist doctors and compared with ground truth charts to identify normal or abnormal growth. The fetal head biometric measurements such as Biparietal Diameter (BPD), Occipito-Frontal Diameter (OFD) and Head Circumference (HC) needs to be monitored, and expert should carry out its manual delineations. This work proposes a new approach to automatically compute BPD, OFD and HC based on morphological characteristics extracted from head shape. Hence, the studied data selected at the same Gestational Age (GA) from the fetal Ultrasound images (US) are classified into two categories: Normal and abnormal. The abnormal subjects include hydrocephalus, microcephaly and dolichocephaly anomalies. By the use of a support vector machines (SVM) method, this study achieved high classification for automated detection of anomalies. The proposed method is promising although it doesn't need expert interventions.

Keywords: biometric measurements, fetal head malformations, machine learning methods, US images

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326 Delineation of Subsurface Tectonic Structures Using Gravity, Magnetic and Geological Data, in the Sarir-Hameimat Arm of the Sirt Basin, NE Libya

Authors: Mohamed Abdalla Saleem, Hana Ellafi

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The study area is located in the eastern part of the Sirt Basin, in the Sarir-Hameimat arm of the basin, south of Amal High. The area covers the northern part of the Hamemat Trough and the Rakb High. All of these tectonic elements are part of the major and common tectonics that were created when the old Sirt Arch collapsed, and most of them are trending NW-SE. This study has been conducted to investigate the subsurface structures and the sedimentology characterization of the area and attempt to define its development tectonically and stratigraphically. About 7600 land gravity measurements, 22500 gridded magnetic data, and petrographic core data from some wells were used to investigate the subsurface structural features both vertically and laterally. A third-order separation of the regional trends from the original Bouguer gravity data has been chosen. The residual gravity map reveals a significant number of high anomalies distributed in the area, separated by a group of thick sediment centers. The reduction to the pole magnetic map also shows nearly the same major trends and anomalies in the area. Applying the further interpretation filters reveals that these high anomalies are sourced from different depth levels; some are deep-rooted, and others are intruded igneous bodies within the sediment layers. The petrographic sedimentology study for some wells in the area confirmed the presence of these igneous bodies and defined their composition as most likely to be gabbro hosted by marine shale layers. Depth investigation of these anomalies by the average depth spectrum shows that the average basement depth is about 7.7 km, while the top of the intrusions is about 2.65 km, and some near-surface magnetic sources are about 1.86 km. The depth values of the magnetic anomalies and their location were estimated specifically using the 3D Euler deconvolution technique. The obtained results suggest that the maximum depth of the sources is about 4938m. The total horizontal gradient of the magnetic data shows that the trends are mostly extending NW-SE, others are NE-SW, and a third group has an N-S extension. This variety in trend direction shows that the area experienced different tectonic regimes throughout its geological history.

Keywords: sirt basin, tectonics, gravity, magnetic

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325 The Effectiveness of Laser In situ Keratomileusis for Correction Various Types of Refractive Anomalies

Authors: Yuliya Markava

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The laser in situ keratomileusis (LASIK) is widely common surgical procedure, which has become an alternative for patients who are not satisfied with the performance of other correction methods. A high level of patient satisfaction functional outcomes after refractive surgery confirms the high reliability and safety of LASIK and provides a significant improvement in the quality of life and social adaptation. Purpose: To perform clinical analysis of the results of correction made to the excimer laser system SCHWIND AMARIS 500E in patients with different types of refractive anomalies. Materials and Methods: This was a retrospective analysis of 1581 operations (812 patients): 413 males (50.86%) and 399 females (49.14%) at the age from 18 to 47 years with different types of ametropia. All operations were performed on excimer laser SCHWIND AMARIS 500E in the LASIK procedure. Formation of the corneal flap was made by mechanical microkeratome SCHWIND. Results: Analyzing the structure of refractive anomalies: The largest number of interventions accounted for myopia: 1505 eyes (95.2%), of which about a low myopia: 706 eyes (44.7%), moderate myopia: 562 eyes (35.5 %), high myopia: eyes 217 (13.7%) and supermyopia: 20 eyes (1.3%). Hyperopia was 0.7% (11 eyes), mixed astigmatism: 4.1% (65 eyes). The efficiency was 80% (in patients with supermyopia) to 91.6% and 95.4% (in groups with myopia low and moderate, respectively). Uncorrected visual acuity average values before and after laser operation was in groups: a low myopia 0.18 (up 0.05 to 0.31) and 0.80 (up 0.60 to 1.0); moderate myopia 0.08 (up 0.03 to 0.13) and 0.87 ( up 0.74 to 1.0); high myopia 0.05 (up 0.02 to 0.08) and 0.83 (up 0.66 to 1.0); supermyopia 0.03 (up 0.02 to 0.04) and 0.59 ( up 0.34 to 0.84); hyperopia 0.27 (up 0.16 to 0.38) and 0.57 (up 0.27 to 0.87); mixed astigmatism of 0.35 (up 0.19 to 0.51) and 0.69 (up 0.44 to 0.94). In all cases, after LASIK indicators uncorrected visual acuity significantly increased. Reoperation was 4.43%. Significance: Clinical results of refractive surgery at the excimer laser system SCHWIND AMARIS 500E in different ametropia correction is characterized by high efficiency.

Keywords: effectiveness of laser correction, LASIK, refractive anomalies, surgical treatment

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324 Possibilities of Postmortem CT to Detection of Gas Accumulations in the Vessels of Dead Newborns with Congenital Sepsis

Authors: Uliana N. Tumanova, Viacheslav M. Lyapin, Vladimir G. Bychenko, Alexandr I. Shchegolev, Gennady T. Sukhikh

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It is well known that the gas formed as a result of postmortem decomposition of tissues can be detected already 24-48 hours after death. In addition, the conditions of keeping and storage of the corpse (temperature and humidity of the environment) significantly determine the rate of occurrence and development of posthumous changes. The presence of sepsis is accompanied by faster postmortem decomposition and decay of the organs and tissues of the body. The presence of gas in the vessels and cavities can be revealed fully at postmortem CT. Radiologists must certainly report on the detection of intraorganic or intravascular gas, wich was detected at postmortem CT, to forensic experts or pathologists before the autopsy. This gas can not be detected during autopsy, but it can be very important for establishing a diagnosis. To explore the possibility of postmortem CT for the evaluation of gas accumulations in the newborns' vessels, who died from congenital sepsis. Researched of 44 newborns bodies (25 male and 19 female sex, at the age from 6 hours to 27 days) after 6 - 12 hours of death. The bodies were stored in the refrigerator at a temperature of +4°C in the supine position. Grouped 12 bodies of newborns that died from congenital sepsis. The control group consisted of 32 bodies of newborns that died without signs of sepsis. Postmortem CT examination was performed at the GEMINI TF TOF16 device, before the autopsy. The localizations of gas accumulations in the vessels were determined on the CT tomograms. The sepsis diagnosis was on the basis of clinical and laboratory data and autopsy results. Gases in the vessels were detected in 33.3% of cases in the group with sepsis, and in the control group - in 34.4%. A group with sepsis most often the gas localized in the heart and liver vessels - 50% each, of observations number with the detected gas in the vessels. In the heart cavities, aorta and mesenteric vessels - 25% each. In control most often gas was detected in the liver (63.6%) and abdominal cavity (54.5%) vessels. In 45.5% the gas localized in the cavities, and in 36.4% in the vessels of the heart. In the cerebral vessels and in the aorta gas was detected in 27.3% and 9.1%, respectively. Postmortem CT has high diagnostic capabilities to detect free gas in vessels. Postmortem changes in newborns that died from sepsis do not affect intravascular gas production within 6-12 hours. Radiation methods should be used as a supplement to the autopsy, including as a kind of ‘guide’, with the indication to the forensic medical expert of certain changes identified during CT studies, for better definition of pathological processes during the autopsy. Postmortem CT can be recommend as a first stage of autopsy.

Keywords: congenital sepsis, gas, newborn, postmortem CT

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323 Congenital Diaphragmatic Hernia Outcomes in a Low-Volume Center

Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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322 Screening of Congenital Heart Diseases with Fetal Phonocardiography

Authors: F. Kovács, K. Kádár, G. Hosszú, Á. T. Balogh, T. Zsedrovits, N. Kersner, A. Nagy, Gy. Jeney

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The paper presents a novel screening method to indicate congenital heart diseases (CHD), which otherwise could remain undetected because of their low level. Therefore, not belonging to the high-risk population, the pregnancies are not subject to the regular fetal monitoring with ultrasound echocardiography. Based on the fact that CHD is a morphological defect of the heart causing turbulent blood flow, the turbulence appears as a murmur, which can be detected by fetal phonocardiography (fPCG). The proposed method applies measurements on the maternal abdomen and from the recorded sound signal a sophisticated processing determines the fetal heart murmur. The paper describes the problems and the additional advantages of the fPCG method including the possibility of measurements at home and its combination with the prescribed regular cardiotocographic (CTG) monitoring. The proposed screening process implemented on a telemedicine system provides an enhanced safety against hidden cardiac diseases.

Keywords: cardiac murmurs, fetal phonocardiography, screening of CHDs, telemedicine system

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321 Empowering Volunteers at Tawanchai Centre for Patients with Cleft Lip and Palate

Authors: Suteera Pradubwong, Darawan Augsornwan, Pornpen Pathumwiwathana, Benjamas Prathanee, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) congenital anomalies have a high prevalence in the Northeast of Thailand. A care team’s understand of treatment plan would help to guide the family of patients with CLP to achieve the treatment. Objectives: To examine the impact of the empowering volunteer project, established in the northeast Thailand. Materials and Methods: The Empowering Volunteer project was conducted in 2008 under the Tawanchai Royal Granted project. The patients and family’s general information, treatment, the group brainstorming, and satisfaction with the project were analyzed. Results: Participants were 12 children with CLP, their families and five volunteers with CLP; the participating patients were predominantly females and the mean, age was 12.2 years. The treatment comprised of speech training, dental hygiene care, bone graft and orthodontic treatment. Four issues were addressed including: problems in taking care of breast feeding; instructions’ needs for care at birth; difficulty in access information and society impact; and needs in having a network of volunteers. Conclusions: Empowering volunteer is important for holistic care of patients with CLP which provides easy access and multiple channels for patients and their families. It should be developed as part of the self-help and family support group, the development of community based team and comprehensive CLP care program.

Keywords: self-help and family support group, community based model, volunteer, cleft lip-cleft palate

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320 Avidity and IgE versus IgG and IgM in Diagnosis of Maternal Toxoplasmosis

Authors: Ghada A. Gamea, Nabila A. Yaseen, Ahmed A. Othman, Ahmed S. Tawfik

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Infection with Toxoplasma gondii can cause serious complications in pregnant women, leading to abortion, stillbirth, and congenital anomalies in the fetus. Definitive diagnosis of T. gondii acute infection is therefore critical for the clinical management of a mother and her fetus. This study was conducted on 250 pregnant females in the first trimester who were inpatients or outpatients at Obstetrics and Gynaecology Department at Tanta University Hospital. Screening of the selected females was done for the detection of immunoglobulin (IgG and IgM), and all subjects were submitted to history taking through a questionnaire including personal data, risk factors for Toxoplasma, complaint and history of the present illness. Thirty-eight samples, including 18 IgM +ve and 20 IgM-ve cases were further investigated by the avidity and IgE ELISA tests. The seroprevalence of toxoplasmosis in pregnant women was (42.8%) based on the presence of IgG antibodies in their sera. Contact with cats and consumption of raw or undercooked meat are important risk factors that were associated with toxoplasmosis in pregnant women. By serology, it could be observed that in the IgM +ve group, only one case (5.6%) showed an acute pattern by using the avidity test, though 10 (55.6%) cases were found to be acute by the IgE assay. On the other hand, in the IgM –ve group, 3 (15%) showed low avidity, but none of them was positive by using the IgE assay. In conclusion, there is no single serological test that can be used to confirm whether T. gondii infection is recent or was acquired in the distant past. A panel of tests for detection of toxoplasmosis will certainly have higher discriminatory power than any test alone.

Keywords: diagnosis, serology, seroprevalence, toxoplasmosis

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319 Molecular Defects Underlying Genital Ambiguity in Egyptian Patients: A Systematic Review

Authors: Y. Z. Gad

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Disorders of Sex Development (DSD) are defined as congenital conditions in which development of chromosomal, gonadal or anatomical sex is atypical. The DSD are relatively prevalent in Egypt. In spite of that, the relative rarity of the individual disease types or their molecular pathologies frequently resulted in reporting on single or few cases. This augmented the challenging nature of phenotype-genotype correlation in this disease group and its utilization in the management of such medical emergency. Through critical assessment of the published DSD reports, the current review aims at analyzing the clinical characteristics of the various DSD forms in relation to the underlying molecular pathologies. A systematic literature search was done in Pubmed, using relevant keywords (Egypt versus DSD, genital ambiguity or ambiguous genitalia, the old terms of 'intersex, hermaphroditism and pseudohermaphroditism', and a list of the DSD entities and their related genes). The search yielded 24 reports of molecular data in Egyptian patients presenting with ambiguous genitalia. However, only 21 publications fulfilled the criteria of inclusion of detailed clinical descriptions and definitive molecular diagnoses of individual patients. Curation of the data yielded a total of 53 cases that were ascertained from 40 families. Fifty-one patients present with ambiguous genitalia only while 2 had multiple congenital anomalies. Parental consanguinity was noted in 60% of cases. Sex of rearing at initial presentation was female in 75% and 60% in 46,XY and 46,XX DSD cases, respectively. The external genital phenotype in 2/3 of the 46,XY DSD cases showed moderate undermasculinization [Quigley scores 3 & 4] and 1/3 had severe presentations [scores 5 & 6]. For 46,XX subjects, 1 had severe virilization of the external genitalia while 8 had moderate phenotype. Hormonal data were inconclusive or contradictory to final diagnosis in a forth of cases. Collectively, 31 families [31/40, 77.5%] with 46,XY DSD had molecular defects in the genes, 5 alpha reductase 2 (SRD5A2) [12/31], 17 beta-hydroxysteroid dehydrogenase 3 [8/31], androgen receptor [7/31], Steroidogenic factor 1 [2/31], luteinizing hormone receptor [1/31], and fibroblast growth factor receptor 1 [1/31]. In a multiethnic study, 9 families afflicted with 46,XX DSD due to 11 beta hydroxylase (CYP11B1) deficiency were documented. Two recurrent mutations, G34R and N160D, in SRD5A2 were present, respectively, in 42 and 17% of cases. Similarly, 4 recurrent mutations resulted in 89% of the CYP11B1 presentations. In conclusion, this analysis highlights the importance of autosomal recessive inheritance and inbreeding among DSD presentations, the importance of founder effect in at least 2 disorders, the difficulties in relating the genotype with the indeterminate genital phenotype, the under-reporting of some DSD subtypes, and the notion that the reported mutational profiles among Egyptian DSD cases are relatively different from those reported in other ethnic groups.

Keywords: disorders of sex development, genital ambiguity, mutation, molecular diagnosis, Egypt

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318 A Case Study: Remediation of Abandoned Mines for Residential Development

Authors: Issa S. Oweis, Gary Gartenberg, Luma J. Oweis

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The site for a residential apartment building overlies an abandoned iron mine in granitic gneiss in northern New Jersey. The mine stope is about 137 m (450 long) and dipping over 344m (800 feet) at 450 to 500. As the building footprint straddles, the mine site needed remediation. The remediation scheme consisted of compaction grouting a minimum 10 m (30 ft.) depth of the mine stope in rock to establish a buttress for the hanging wall and allow support of the building foundation. The rock strength parameters (friction and cohesion) were established based on Hoek Geologic Strength Index (GSI). The derived strength parameters were used in the wedge analysis to simulate rock cave-in. It was concluded that a cave-in would be unlikely. Verification holes confirmed the effectiveness of grouting. Although post grouting micro gravity survey depicted a few anomalies, no anomalies were found to exist by further drilling and excavation.

Keywords: grout, stope, rock, properties

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317 The Evaluation of Gravity Anomalies Based on Global Models by Land Gravity Data

Authors: M. Yilmaz, I. Yilmaz, M. Uysal

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The Earth system generates different phenomena that are observable at the surface of the Earth such as mass deformations and displacements leading to plate tectonics, earthquakes, and volcanism. The dynamic processes associated with the interior, surface, and atmosphere of the Earth affect the three pillars of geodesy: shape of the Earth, its gravity field, and its rotation. Geodesy establishes a characteristic structure in order to define, monitor, and predict of the whole Earth system. The traditional and new instruments, observables, and techniques in geodesy are related to the gravity field. Therefore, the geodesy monitors the gravity field and its temporal variability in order to transform the geodetic observations made on the physical surface of the Earth into the geometrical surface in which positions are mathematically defined. In this paper, the main components of the gravity field modeling, (Free-air and Bouguer) gravity anomalies are calculated via recent global models (EGM2008, EIGEN6C4, and GECO) over a selected study area. The model-based gravity anomalies are compared with the corresponding terrestrial gravity data in terms of standard deviation (SD) and root mean square error (RMSE) for determining the best fit global model in the study area at a regional scale in Turkey. The least SD (13.63 mGal) and RMSE (15.71 mGal) were obtained by EGM2008 for the Free-air gravity anomaly residuals. For the Bouguer gravity anomaly residuals, EIGEN6C4 provides the least SD (8.05 mGal) and RMSE (8.12 mGal). The results indicated that EIGEN6C4 can be a useful tool for modeling the gravity field of the Earth over the study area.

Keywords: free-air gravity anomaly, Bouguer gravity anomaly, global model, land gravity

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316 Eight-Week Exercise for Women: Impact on Anomalies in Width Depth and Environmental Dimension

Authors: Yalcin Kaya, Fatma Arslan, Ahmet Selim Kaya

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This study aimed to determine the undesirable hypertrophic anomalies in the body of females and to investigate how they can be affected by the exercise program according to the applied 8 week individual conditions. The research was carried out on 35 women who did not have any regular previous sports practice and had an approximate age of 30 ± 5.0 at the gymnasium because of their asymmetric structure and weight gain of the body. Measurements of width, depth, and periphery were taken from the participants' body, and the exercise protocol was applied for 8 weeks according to the individual measurements in accordance with the obtained measurements. After 8 weeks, the same measurements were applied again. Measurements were made by using ruler and paper tape. The findings were evaluated and differences were analyzed by paired sample t test. According to the findings obtained, ulnae distal proiecturas width averages were 44.77 ± 3.65 and 43.52 ± 3.47 pre- and post-exercise respectively. Bithorachanteric width averages were 29.3 ± 3.12 before exercise and 26.67 ± 3.27 after exercise. Average abdominal widths were observed as 18.64 ± 4.14 (before exercise) and 18.01 ± 6.27 (after exercise). The distances between the malleolus were measured as 16.98 ± 1.62 (before exercise) and 16.70 ± 1.64 (after exercise). The results were statistically significant (p < 0.05). The mean of pre-exercise Externus abdominis circumference was 93.97 ± 8.91, and the mean of post-exercise mean was 90.82 ± 8.24. The results are statistically significant (p < 0.05). In conclusion, findings of the study show that inactivity, daily uncontrolled activities or erroneous postural postures, malnutrition cause some anomalies in the human body. However, with consciously standardized and regular exercises, these abnormalities are reduced by an eight-week exercise protocol in parallel with the expulsion of excess kilos and can be removed when working much longer and fitter, it is proposed to be healthier and more beautiful in appearance.

Keywords: women, body, circumference-width and depth measurements, hypertrophy, exercise

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315 Anomalous Origin of Bilateral Testicular Arteries: A Case Report

Authors: Arthi Ganapathy, Arithra Banerjee, Saroj Kaler

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Abdominal aorta is the sole purveyor of all organs in the abdomen. Anomalies of its main trunk or its branches are to be meticulously observed as it effects the perfusion of an organ. Varying patterns of the testicular artery is one of them. The origin and course of testicular arteries have to be identified carefully during various surgical procedures like renal transplant, intra abdominal surgeries and even in orthopedic surgery like spine surgery. With the advent of new intra-abdominal therapeutic and diagnostic techniques, the anatomy of testicular arteries has assumed much more significance. Though the variations of the testicular vein are well documented, the variations of the testicular artery are not so frequent in incidence. We report a case of the bilateral aberrant origin of the testicular artery from polar renal arteries. We also discuss its developmental basis. Such anomalies if left unnoticed will lead to serious intraoperative complications during procedures on retroperitoneal organs. Any damage to testicular arteries will compromise the function of the gonads.

Keywords: cadaver, gonadal, renal, surgery

Procedia PDF Downloads 197
314 STTS-EAD: Improving Spatio-Temporal Learning Based Time Series Prediction via Embedded Anomaly Detection

Authors: Tianhao Zhang, Cen Chen, Dawei Cheng, Yuqi Liang, Yuanyuan Liang

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Dealing with anomalies is a crucial preprocessing step for multivariate time series prediction. However, existing methods that separate anomaly preprocessing and model training into two stages have certain limitations. Specifically, these methods fail to leverage auxiliary information necessary to distinguish latent anomalies related to spatiotemporal factors during the preprocessing stage. Instead, they solely rely on data distribution for detection which may lead to incorrect processing of many samples that are beneficial for training. To address this, we propose STTS-EAD, an end-to-end method that seamlessly integrates anomaly detection into the training process of multivariate time series forecasting and aims to improve Spatio-Temporal learning based Time Series prediction via Embedded Anomaly Detection. Our proposed STTS-EAD leverages spatio-temporal information for forecasting and anomaly detection, with the two parts alternately executed and optimized for each other. To the best of our knowledge, STTS-EAD is the first to integrate anomaly detection and forecasting tasks in the training phase for improving the accuracy of multivariate time series forecasting. Extensive experiments on a public stock dataset and two real-world sales datasets from a renowned coffee chain enterprise show that our proposed method can effectively process detected anomalies in the training stage to improve forecasting performance in the inference stage and significantly outperform baselines.

Keywords: multivariate time series, anomaly detection, time series forecasting, spatiotemporal feature learning

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313 Winter – Not Spring - Climate Drives Annual Adult Survival in Common Passerines: A Country-Wide, Multi-Species Modeling Exercise

Authors: Manon Ghislain, Timothée Bonnet, Olivier Gimenez, Olivier Dehorter, Pierre-Yves Henry

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Climatic fluctuations affect the demography of animal populations, generating changes in population size, phenology, distribution and community assemblages. However, very few studies have identified the underlying demographic processes. For short-lived species, like common passerine birds, are these changes generated by changes in adult survival or in fecundity and recruitment? This study tests for an effect of annual climatic conditions (spring and winter) on annual, local adult survival at very large spatial (a country, 252 sites), temporal (25 years) and biological (25 species) scales. The Constant Effort Site ringing has allowed the collection of capture - mark - recapture data for 100 000 adult individuals since 1989, over metropolitan France, thus documenting annual, local survival rates of the most common passerine birds. We specifically developed a set of multi-year, multi-species, multi-site Bayesian models describing variations in local survival and recapture probabilities. This method allows for a statistically powerful hierarchical assessment (global versus species-specific) of the effects of climate variables on survival. A major part of between-year variations in survival rate was common to all species (74% of between-year variance), whereas only 26% of temporal variation was species-specific. Although changing spring climate is commonly invoked as a cause of population size fluctuations, spring climatic anomalies (mean precipitation or temperature for March-August) do not impact adult survival: only 1% of between-year variation of species survival is explained by spring climatic anomalies. However, for sedentary birds, winter climatic anomalies (North Atlantic Oscillation) had a significant, quadratic effect on adult survival, birds surviving less during intermediate years than during more extreme years. For migratory birds, we do not detect an effect of winter climatic anomalies (Sahel Rainfall). We will analyze the life history traits (migration, habitat, thermal range) that could explain a different sensitivity of species to winter climate anomalies. Overall, we conclude that changes in population sizes for passerine birds are unlikely to be the consequences of climate-driven mortality (or emigration) in spring but could be induced by other demographic parameters, like fecundity.

Keywords: Bayesian approach, capture-recapture, climate anomaly, constant effort sites scheme, passerine, seasons, survival

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312 Analysis of Diabetes Patients Using Pearson, Cost Optimization, Control Chart Methods

Authors: Devatha Kalyan Kumar, R. Poovarasan

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In this paper, we have taken certain important factors and health parameters of diabetes patients especially among children by birth (pediatric congenital) where using the above three metrics methods we are going to assess the importance of each attributes in the dataset and thereby determining the most highly responsible and co-related attribute causing diabetics among young patients. We use cost optimization, control chart and Spearmen methodologies for the real-time application of finding the data efficiency in this diabetes dataset. The Spearmen methodology is the correlation methodologies used in software development process to identify the complexity between the various modules of the software. Identifying the complexity is important because if the complexity is higher, then there is a higher chance of occurrence of the risk in the software. With the use of control; chart mean, variance and standard deviation of data are calculated. With the use of Cost optimization model, we find to optimize the variables. Hence we choose the Spearmen, control chart and cost optimization methods to assess the data efficiency in diabetes datasets.

Keywords: correlation, congenital diabetics, linear relationship, monotonic function, ranking samples, pediatric

Procedia PDF Downloads 233