Search results for: critical diagnostic distinctions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6042

Search results for: critical diagnostic distinctions

5772 Audit of Urgent and Non-Urgent Patient Visits to the Emergency: A Case-Control Study

Authors: Peri Harish Kumar, Rafique Umer Harvitkar

Abstract:

Background: The emergency department mandates maximum efficacy in the utilization of the available resources. Non-urgent patient visits pose a serious concern to the treatment, patient triage, and resources available. Aims and Objectives: We conducted a retrospective case-control study of the emergency department patient list from October 2019 to November 2022. A total of 839 patients formed part of the study. Somatic complaints, vital signs, diagnostic test results, admission to the hospital, etc., were some of the criteria used for the categorization of patients. Results: The proportion of non-urgent visits varied from 7.2% to 43%, with a median of 21%. Somatic complaints were the least associated with further hospital admissions (n=28%), while diagnostic test results were the most significant indicator of further hospital admissions (n=74%). Effective triage helped minimize emergency department admissions by 36%. Conclusion: Our study shows that effective triaging, patient counselling, and round-the-clock consumable monitoring helped in the effective management of patients admitted and also significantly helped provide treatment to the patients most in need.

Keywords: urgent visits, non-urgent visits, traiging, emergency department admissions

Procedia PDF Downloads 79
5771 Humeral Head and Scapula Detection in Proton Density Weighted Magnetic Resonance Images Using YOLOv8

Authors: Aysun Sezer

Abstract:

Magnetic Resonance Imaging (MRI) is one of the advanced diagnostic tools for evaluating shoulder pathologies. Proton Density (PD)-weighted MRI sequences prove highly effective in detecting edema. However, they are deficient in the anatomical identification of bones due to a trauma-induced decrease in signal-to-noise ratio and blur in the traumatized cortices. Computer-based diagnostic systems require precise segmentation, identification, and localization of anatomical regions in medical imagery. Deep learning-based object detection algorithms exhibit remarkable proficiency in real-time object identification and localization. In this study, the YOLOv8 model was employed to detect humeral head and scapular regions in 665 axial PD-weighted MR images. The YOLOv8 configuration achieved an overall success rate of 99.60% and 89.90% for detecting the humeral head and scapula, respectively, with an intersection over union (IoU) of 0.5. Our findings indicate a significant promise of employing YOLOv8-based detection for the humerus and scapula regions, particularly in the context of PD-weighted images affected by both noise and intensity inhomogeneity.

Keywords: YOLOv8, object detection, humerus, scapula, IRM

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5770 Detection of Coupling Misalignment in a Rotor System Using Wavelet Transforms

Authors: Prabhakar Sathujoda

Abstract:

Vibration analysis of a misaligned rotor coupling bearing system has been carried out while decelerating through its critical speed. The finite element method (FEM) is used to model the rotor system and simulate flexural vibrations. A flexible coupling with a frictionless joint is considered in the present work. The continuous wavelet transform is used to extract the misalignment features from the simulated time response. Subcritical speeds at one-half, one-third, and one-fourth the critical speed have appeared in the wavelet transformed vibration response of a misaligned rotor coupling bearing system. These features are also verified through a parametric study.

Keywords: Continuous Wavelet Transform, Flexible Coupling, Rotor System, Sub Critical Speed

Procedia PDF Downloads 127
5769 Derivation of a Risk-Based Level of Service Index for Surface Street Network Using Reliability Analysis

Authors: Chang-Jen Lan

Abstract:

Current Level of Service (LOS) index adopted in Highway Capacity Manual (HCM) for signalized intersections on surface streets is based on the intersection average delay. The delay thresholds for defining LOS grades are subjective and is unrelated to critical traffic condition. For example, an intersection delay of 80 sec per vehicle for failing LOS grade F does not necessarily correspond to the intersection capacity. Also, a specific measure of average delay may result from delay minimization, delay equality, or other meaningful optimization criteria. To that end, a reliability version of the intersection critical degree of saturation (v/c) as the LOS index is introduced. Traditionally, the level of saturation at a signalized intersection is defined as the ratio of critical volume sum (per lane) to the average saturation flow (per lane) during all available effective green time within a cycle. The critical sum is the sum of the maximal conflicting movement-pair volumes in northbound-southbound and eastbound/westbound right of ways. In this study, both movement volume and saturation flow are assumed log-normal distributions. Because, when the conditions of central limit theorem obtain, multiplication of the independent, positive random variables tends to result in a log-normal distributed outcome in the limit, the critical degree of saturation is expected to be a log-normal distribution as well. Derivation of the risk index predictive limits is complex due to the maximum and absolute value operators, as well as the ratio of random variables. A fairly accurate functional form for the predictive limit at a user-specified significant level is yielded. The predictive limit is then compared with the designated LOS thresholds for the intersection critical degree of saturation (denoted as X

Keywords: reliability analysis, level of service, intersection critical degree of saturation, risk based index

Procedia PDF Downloads 109
5768 Indecisiveness in 'The Road Not Taken' by Robert Frost: An Expressive Critical Analysis

Authors: Kurt S. Candilas

Abstract:

This expressive critical study is an effort to bring in light new interpretation of Robert Frost poem 'The Road Not Taken' as a reflection of his indecisiveness in life. Specifically, it aims at examining Frost’s inner being, emphasizing his own self and experiences in the poem or text. The study employs the qualitative research design which made use of discourse analysis using the critical theory of expressivism as the main guide. In acquiring the data of the study, the art of historiography is used such as autobiographical and/or biographical notes, sources documents, and web information. In executing the methods involved in this study, it is observed that the poem shows a naturalist implicatures, expressing Frost’s strong feelings and emotions being devoid of free will and a narrow bit of confusions and ambiguities with his indecisions in life.

Keywords: The Road Not Taken, expressivism, indecisiveness, naturalist implicatures

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5767 Rapid and Cheap Test for Detection of Streptococcus pyogenes and Streptococcus pneumoniae with Antibiotic Resistance Identification

Authors: Marta Skwarecka, Patrycja Bloch, Rafal Walkusz, Oliwia Urbanowicz, Grzegorz Zielinski, Sabina Zoledowska, Dawid Nidzworski

Abstract:

Upper respiratory tract infections are one of the most common reasons for visiting a general doctor. Streptococci are the most common bacterial etiological factors in these infections. There are many different types of Streptococci and infections vary in severity from mild throat infections to pneumonia. For example, S. pyogenes mainly contributes to acute pharyngitis, palatine tonsils and scarlet fever, whereas S. Streptococcus pneumoniae is responsible for several invasive diseases like sepsis, meningitis or pneumonia with high mortality and dangerous complications. There are only a few diagnostic tests designed for detection Streptococci from the infected throat of patients. However, they are mostly based on lateral flow techniques, and they are not used as a standard due to their low sensitivity. The diagnostic standard is to culture patients throat swab on semi selective media in order to multiply pure etiological agent of infection and subsequently to perform antibiogram, which takes several days from the patients visit in the clinic. Therefore, the aim of our studies is to develop and implement to the market a Point of Care device for the rapid identification of Streptococcus pyogenes and Streptococcus pneumoniae with simultaneous identification of antibiotic resistance genes. In the course of our research, we successfully selected genes for to-species identification of Streptococci and genes encoding antibiotic resistance proteins. We have developed a reaction to amplify these genes, which allows detecting the presence of S. pyogenes or S. pneumoniae followed by testing their resistance to erythromycin, chloramphenicol and tetracycline. What is more, the detection of β-lactamase-encoding genes that could protect Streptococci against antibiotics from the ampicillin group, which are widely used in the treatment of this type of infection is also developed. The test is carried out directly from the patients' swab, and the results are available after 20 to 30 minutes after sample subjection, which could be performed during the medical visit.

Keywords: antibiotic resistance, Streptococci, respiratory infections, diagnostic test

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5766 The Effectiveness Of Concept Mapping As A Tool For Developing Critical Thinking In Undergraduate Medical Education – A Systematic Review

Authors: Marta Fonseca, Pedro Marvão, Beatriz Oliveira, Bruno Heleno, Pedro Carreiro-Martins, Nuno Neuparth, António Rendas

Abstract:

BACKGROUND: Concept maps (CMs) visually represent hierarchical connections among related ideas. They foster logical organization and clarify idea relationships, potentially aiding medical students in critical thinking (to think clearly and rationally about what to do or what to believe). However, there are inconsistent claims about the use of CM in undergraduate medical education. the three research questions are 1) What studies have been published on concept mapping in undergraduate medical education; 2) What was the impact of CMs on students’ critical thinking; 3) How and why have these interventions had an educational impact? METHODS: Eight databases were systematically searched (plus a manual and an additional search were conducted). After eliminating duplicate entries, titles and, abstracts and full-texts were independently screened by two authors. Data extraction and quality assessment of the studies were independently performed by two authors. Qualitative and quantitative data were integrated using mixed-methods. The results were reported using the STructured apprOach to the Reporting In healthcare education of Evidence Synthesis statement. RESULTS: Thirty-nine studies were included from 26 journals (19 quantitative, 8 qualitative and 12 mixed-methods studies). CMs were considered as a tool to promote critical thinking, both in the perception of students and tutors, as well as in assessing students' knowledge and/or skills. In addition to their role as facilitators of knowledge integration and critical thinking, CMs were considered both a teaching and a learning methods. CONCLUSIONS: CMs are teaching and learning tools which seem to help medical students develop critical thinking. This is due to the flexibility of the tool as a facilitator of knowledge integration, as a learning and teaching method. The wide range of contexts, purposes, and variations in how CMs and instruments to assess critical thinking are used increases our confidence that the positive effects are consistent.

Keywords: concept map, medical education, undergraduate, critical thinking, meaningful learning

Procedia PDF Downloads 57
5765 Diabetes Diagnosis Model Using Rough Set and K- Nearest Neighbor Classifier

Authors: Usiobaifo Agharese Rosemary, Osaseri Roseline Oghogho

Abstract:

Diabetes is a complex group of disease with a variety of causes; it is a disorder of the body metabolism in the digestion of carbohydrates food. The application of machine learning in the field of medical diagnosis has been the focus of many researchers and the use of recognition and classification model as a decision support tools has help the medical expert in diagnosis of diseases. Considering the large volume of medical data which require special techniques, experience, and high diagnostic skill in the diagnosis of diseases, the application of an artificial intelligent system to assist medical personnel in order to enhance their efficiency and accuracy in diagnosis will be an invaluable tool. In this study will propose a diabetes diagnosis model using rough set and K-nearest Neighbor classifier algorithm. The system consists of two modules: the feature extraction module and predictor module, rough data set is used to preprocess the attributes while K-nearest neighbor classifier is used to classify the given data. The dataset used for this model was taken for University of Benin Teaching Hospital (UBTH) database. Half of the data was used in the training while the other half was used in testing the system. The proposed model was able to achieve over 80% accuracy.

Keywords: classifier algorithm, diabetes, diagnostic model, machine learning

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5764 Requirements Engineering via Controlling Actors Definition for the Organizations of European Critical Infrastructure

Authors: Jiri F. Urbanek, Jiri Barta, Oldrich Svoboda, Jiri J. Urbanek

Abstract:

The organizations of European and Czech critical infrastructure have specific position, mission, characteristics and behaviour in European Union and Czech state/ business environments, regarding specific requirements for regional and global security environments. They must respect policy of national security and global rules, requirements and standards in all their inherent and outer processes of supply-customer chains and networks. A controlling is generalized capability to have control over situational policy. This paper aims and purposes are to introduce the controlling as quite new necessary process attribute providing for critical infrastructure is environment the capability and profit to achieve its commitment regarding to the effectiveness of the quality management system in meeting customer/ user requirements and also the continual improvement of critical infrastructure organization’s processes overall performance and efficiency, as well as its societal security via continual planning improvement via DYVELOP modelling.

Keywords: added value, DYVELOP, controlling, environments, process approach

Procedia PDF Downloads 384
5763 A Pragmatic Study of Falnama Texts Based on Critical Discourse Analysis Approach

Authors: Raziyeh Mashhadi Moghadam

Abstract:

Persian writings in the form of stories, scientific articles, historiographies, biographies, and philosophical, religious, and poetic arguments have established their presence in the past and present. Any piece of text is composed in a unique style depending on its content and subject. In this paper, a manuscript called Falnama of the Prophet is reviewed. Only a few scattered pages of this version are extant, and the author, using the name of twenty-four prophets, seeks to explore the presence and future of the reader. This version is analyzed based on Norman Fairclough’s Critical Discourse Analysis (CDA) approach to unravel the underlying processes in this type of manuscript. The spelling of some words and sentences is different from that of the new written Persian version.

Keywords: application of Falnama texts, critical discourse analysis, Fairclough’s approach

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5762 Comparison of Two Theories for the Critical Laser Radius in Thermal Quantum Plasma

Authors: Somaye Zare

Abstract:

The critical beam radius is a significant factor that predicts the behavior of the laser beam in the plasma, so if the laser beam radius is adequately greater in comparison to it, the beam will experience stable focusing on the plasma; otherwise, the beam will diverge after entering into the plasma. In this work, considering the paraxial approximation and moment theories, the localization of a relativistic laser beam in thermal quantum plasma is investigated. Using the dielectric function obtained in the quantum hydrodynamic model, the mathematical equation for the laser beam width parameter is attained and solved numerically by the fourth-order Runge-Kutta method. The results demonstrate that the stouter focusing effect is occurred in the moment theory compared to the paraxial approximation. Besides, similar to the two theories, with increasing Fermi temperature, plasma density, and laser intensity, the oscillation rate of the beam width parameter growths and focusing length reduces which means improving the focusing effect. Furthermore, it is understood that behaviors of the critical laser radius are different in the two theories, in the paraxial approximation, the critical radius after a minimum value is enhanced with increasing laser intensity, but in the moment theory, with increasing laser intensity, the critical radius decreases until it becomes independent of the laser intensity.

Keywords: laser localization, quantum plasma, paraxial approximation, moment theory, quantum hydrodynamic model

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5761 Comparison of Dubbing and Subtitling through Critical Discourse Analysis: Detecting Lexical Differences and Similarities in the Movie 'The Girl with the Dragon Tattoo'

Authors: Saber Noie, F. Jafarpour

Abstract:

Translation of the movies was one of important issues of the translators. In this study, the notions of ‘foreignization’, ‘domestication’, and ‘critical discourse analysis’ (CDA) in translation studies were discussed. This study is a comparative study and attempts towards clarifying the lexical differences and similarities between dubbing and subtitling in audiovisual translation through CDA. The strategies proposed by Venuti (1995) and Newmark (1988) used first by researcher and then, the researcher went back to the Van Dijk’s CDA (1995), in the part dominance. This study shows that according to CDA, the dominant strategy in subtitling is foreignization and dominant strategy in dubbing is domestication.

Keywords: critical discourse analysis, CDA, dub, subtitle, foreignization, domestication

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5760 Numerical Investigation for Ductile Fracture of an Aluminium Alloy 6061 T-6: Assessment of Critical J-Integral

Authors: R. Bensaada, M. Almansba, M. Ould Ouali, R. Ferhoum, N. E. Hannachi

Abstract:

The aim of this work is to simulate the ductile fracture of SEN specimens in aluminium alloy. The assessment of fracture toughness is performed with the calculation of Jc (the critical value of J-Integral) through the resistance curves. The study is done using finite element code calculation ABAQUSTM including an elastic plastic with damage model of material’s behaviour. The procedure involves specimens of four different thicknesses and four ligament sizes for every thickness. The material of study is an aluminium alloy 6061-T6 for which the necessary parameters to complete the study are given. We found the same results for the same specimen’s thickness and for different ligament sizes when the fracture criterion is evaluated.

Keywords: j-integral, critical-j, damage, fracture toughness

Procedia PDF Downloads 335
5759 Diagnosis of Alzheimer Diseases in Early Step Using Support Vector Machine (SVM)

Authors: Amira Ben Rabeh, Faouzi Benzarti, Hamid Amiri, Mouna Bouaziz

Abstract:

Alzheimer is a disease that affects the brain. It causes degeneration of nerve cells (neurons) and in particular cells involved in memory and intellectual functions. Early diagnosis of Alzheimer Diseases (AD) raises ethical questions, since there is, at present, no cure to offer to patients and medicines from therapeutic trials appear to slow the progression of the disease as moderate, accompanying side effects sometimes severe. In this context, analysis of medical images became, for clinical applications, an essential tool because it provides effective assistance both at diagnosis therapeutic follow-up. Computer Assisted Diagnostic systems (CAD) is one of the possible solutions to efficiently manage these images. In our work; we proposed an application to detect Alzheimer’s diseases. For detecting the disease in early stage we used the three sections: frontal to extract the Hippocampus (H), Sagittal to analysis the Corpus Callosum (CC) and axial to work with the variation features of the Cortex(C). Our method of classification is based on Support Vector Machine (SVM). The proposed system yields a 90.66% accuracy in the early diagnosis of the AD.

Keywords: Alzheimer Diseases (AD), Computer Assisted Diagnostic(CAD), hippocampus, Corpus Callosum (CC), cortex, Support Vector Machine (SVM)

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5758 Comparison of Receiver Operating Characteristic Curve Smoothing Methods

Authors: D. Sigirli

Abstract:

The Receiver Operating Characteristic (ROC) curve is a commonly used statistical tool for evaluating the diagnostic performance of screening and diagnostic test with continuous or ordinal scale results which aims to predict the presence or absence probability of a condition, usually a disease. When the test results were measured as numeric values, sensitivity and specificity can be computed across all possible threshold values which discriminate the subjects as diseased and non-diseased. There are infinite numbers of possible decision thresholds along the continuum of the test results. The ROC curve presents the trade-off between sensitivity and the 1-specificity as the threshold changes. The empirical ROC curve which is a non-parametric estimator of the ROC curve is robust and it represents data accurately. However, especially for small sample sizes, it has a problem of variability and as it is a step function there can be different false positive rates for a true positive rate value and vice versa. Besides, the estimated ROC curve being in a jagged form, since the true ROC curve is a smooth curve, it underestimates the true ROC curve. Since the true ROC curve is assumed to be smooth, several smoothing methods have been explored to smooth a ROC curve. These include using kernel estimates, using log-concave densities, to fit parameters for the specified density function to the data with the maximum-likelihood fitting of univariate distributions or to create a probability distribution by fitting the specified distribution to the data nd using smooth versions of the empirical distribution functions. In the present paper, we aimed to propose a smooth ROC curve estimation based on the boundary corrected kernel function and to compare the performances of ROC curve smoothing methods for the diagnostic test results coming from different distributions in different sample sizes. We performed simulation study to compare the performances of different methods for different scenarios with 1000 repetitions. It is seen that the performance of the proposed method was typically better than that of the empirical ROC curve and only slightly worse compared to the binormal model when in fact the underlying samples were generated from the normal distribution.

Keywords: empirical estimator, kernel function, smoothing, receiver operating characteristic curve

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5757 A Study on the Annual Doses Received by the Workers of Some Medical Practices

Authors: Eltayeb Hamad Elneel Yousif

Abstract:

This paper describes occupational radiation doses of workers in non-destructive testing (NDT) and some medical practices during the year 2007. The annual doses received by the workers of a public hospital are presented in this report. The Department is facilitated with HARSHAW Reader model 6600 and assigned the rule of personal monitoring to contribute in controlling and reducing the doses received by radiation workers. TLD cards with two TLD chips type LiF: Mg, Ti (TLD-100) were calibrated to measure the personal dose equivalent Hp(10). Around 150 medical radiation workers were monitored throughout the year. Each worker received a single TLD card worn on the chest above lead apron and returned for laboratory reading every two months. The average annual doses received by the workers of radiotherapy, nuclear medicine and diagnostic radiology were evaluated. The annual doses for individual radiation workers ranged between 0.55-4.42 mSv, 0.48-1.86 mSv, and 0.48-0.91 mSv for the workers of radiotherapy, nuclear medicine and diagnostic radiology, respectively. The mean dose per worker was 1.29±1, 1.03±0.4, and 0.69±0.2 mSv, respectively. The results showed compliance with international dose limits. Our results reconfirm the importance of personal dosimetry service in assuring the radiation protection of medical staff in developing countries.

Keywords: radiation medicine, non-destructive testing, TLD, public hospital

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5756 Theta-Phase Gamma-Amplitude Coupling as a Neurophysiological Marker in Neuroleptic-Naive Schizophrenia

Authors: Jun Won Kim

Abstract:

Objective: Theta-phase gamma-amplitude coupling (TGC) was used as a novel evidence-based tool to reflect the dysfunctional cortico-thalamic interaction in patients with schizophrenia. However, to our best knowledge, no studies have reported the diagnostic utility of the TGC in the resting-state electroencephalographic (EEG) of neuroleptic-naive patients with schizophrenia compared to healthy controls. Thus, the purpose of this EEG study was to understand the underlying mechanisms in patients with schizophrenia by comparing the TGC at rest between two groups and to evaluate the diagnostic utility of TGC. Method: The subjects included 90 patients with schizophrenia and 90 healthy controls. All patients were diagnosed with schizophrenia according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) by two independent psychiatrists using semi-structured clinical interviews. Because patients were either drug-naïve (first episode) or had not been taking psychoactive drugs for one month before the study, we could exclude the influence of medications. Five frequency bands were defined for spectral analyses: delta (1–4 Hz), theta (4–8 Hz), slow alpha (8–10 Hz), fast alpha (10–13.5 Hz), beta (13.5–30 Hz), and gamma (30-80 Hz). The spectral power of the EEG data was calculated with fast Fourier Transformation using the 'spectrogram.m' function of the signal processing toolbox in Matlab. An analysis of covariance (ANCOVA) was performed to compare the TGC results between the groups, which were adjusted using a Bonferroni correction (P < 0.05/19 = 0.0026). Receiver operator characteristic (ROC) analysis was conducted to examine the discriminating ability of the TGC data for schizophrenia diagnosis. Results: The patients with schizophrenia showed a significant increase in the resting-state TGC at all electrodes. The delta, theta, slow alpha, fast alpha, and beta powers showed low accuracies of 62.2%, 58.4%, 56.9%, 60.9%, and 59.0%, respectively, in discriminating the patients with schizophrenia from the healthy controls. The ROC analysis performed on the TGC data generated the most accurate result among the EEG measures, displaying an overall classification accuracy of 92.5%. Conclusion: As TGC includes phase, which contains information about neuronal interactions from the EEG recording, TGC is expected to be useful for understanding the mechanisms the dysfunctional cortico-thalamic interaction in patients with schizophrenia. The resting-state TGC value was increased in the patients with schizophrenia compared to that in the healthy controls and had a higher discriminating ability than the other parameters. These findings may be related to the compensatory hyper-arousal patterns of the dysfunctional default-mode network (DMN) in schizophrenia. Further research exploring the association between TGC and medical or psychiatric conditions that may confound EEG signals will help clarify the potential utility of TGC.

Keywords: quantitative electroencephalography (QEEG), theta-phase gamma-amplitude coupling (TGC), schizophrenia, diagnostic utility

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5755 Analyzing Medical Workflows Using Market Basket Analysis

Authors: Mohit Kumar, Mayur Betharia

Abstract:

Healthcare domain, with the emergence of Electronic Medical Record (EMR), collects a lot of data which have been attracting Data Mining expert’s interest. In the past, doctors have relied on their intuition while making critical clinical decisions. This paper presents the means to analyze the Medical workflows to get business insights out of huge dumped medical databases. Market Basket Analysis (MBA) which is a special data mining technique, has been widely used in marketing and e-commerce field to discover the association between products bought together by customers. It helps businesses in increasing their sales by analyzing the purchasing behavior of customers and pitching the right customer with the right product. This paper is an attempt to demonstrate Market Basket Analysis applications in healthcare. In particular, it discusses the Market Basket Analysis Algorithm ‘Apriori’ applications within healthcare in major areas such as analyzing the workflow of diagnostic procedures, Up-selling and Cross-selling of Healthcare Systems, designing healthcare systems more user-friendly. In the paper, we have demonstrated the MBA applications using Angiography Systems, but can be extrapolated to other modalities as well.

Keywords: data mining, market basket analysis, healthcare applications, knowledge discovery in healthcare databases, customer relationship management, healthcare systems

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5754 A Risk Management Approach to the Diagnosis of Attention Deficit-Hyperactivity Disorder

Authors: Lloyd A. Taylor

Abstract:

An increase in the prevalence of Attention Deficit-Hyperactivity Disorder (ADHD) highlights the need to consider factors that may be exacerbating symptom presentation. Traditional diagnostic criteria provide a little framework for healthcare providers to consider as they attempt to diagnose and treat children with behavioral problems. In fact, aside from exclusion criteria, limited alternative considerations are available, and approaches fail to consider the impact of outside factors that could increase or decrease the likelihood of appropriate diagnosis and success of interventions. This paper will consider specific systems-based factors that influence behavior and intervention successes that, when not considered, could account for the upsurge of diagnoses. These include understanding (1) challenges in the healthcare system, (2) the influence and impact of educators and the educational system, (3) technology use, and (4) patient and parental attitudes about the diagnosis of ADHD. These factors must be considered both individually and as a whole when considering both the increase in diagnoses and the subsequent increases in prescriptions for psychostimulant medication. A theoretical model based on a risk management approach will be presented. Finally, data will be presented that demonstrates pediatric provider satisfaction with this approach to diagnoses and treatment of ADHD as it relates to practice trends.

Keywords: ADHD, diagnostic criteria, risk management model, pediatricians

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5753 Rethinking Peace Journalism in Pakistan: A Critical Analysis of News Discourse on the Afghan Refugee Repatriation Conflict

Authors: Ayesha Hasan

Abstract:

This study offers unique perspectives and analyses of peace and conflict journalism through interpretative repertoire, media frames, and critical discourse analyses. Two major English publications in Pakistan, representing both long and short-form journalism, are investigated to uncover how the Afghan refugee repatriation from Pakistan in 2016-17 has been framed in Pakistani English media. Peace journalism focuses on concepts such as peace initiatives and peace building, finding common ground, and preventing further conflict. This study applies Jake Lynch’s Coding Criteria to guide the critical discourse analysis and Lee and Maslog’s Peace Journalism Quotient to examine the extent of peace journalism in each text. This study finds that peace journalism is missing in Pakistani English press, but represented, to an extent, in long-form print and online coverage. Two new alternative frames are also proposed. This study gives an in-depth understanding of if and how journalists in Pakistan are covering conflicts and framing stories that can be identified as peace journalism. This study represents significant contributions to the remarkably limited scholarship on peace and conflict journalism in Pakistan and extends Shabbir Hussain’s work on critical pragmatic perspectives on peace journalism in Pakistan.

Keywords: Afghan refugee repatriation, Critical discourse analysis, Media framing , Peace and conflict journalism

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5752 Nano-Plasmonic Diagnostic Sensor Using Ultraflat Single-Crystalline Au Nanoplate and Cysteine-Tagged Protein G

Authors: Hwang Ahreum, Kang Taejoon, Kim Bongsoo

Abstract:

Nanosensors for high sensitive detection of diseases have been widely studied to improve the quality of life. Here, we suggest robust nano-plasmonic diagnostic sensor using cysteine tagged protein G (Cys3-protein G) and ultraflat, ultraclean and single-crystalline Au nanoplates. Protein G formed on an ultraflat Au surface provides ideal background for dense and uniform immobilization of antibodies. The Au is highly stable in diverse biochemical environment and can immobilize antibodies easily through Au-S bonding, having been widely used for various biosensing applications. Especially, atomically smooth single-crystalline Au nanomaterials synthesized using chemical vapor transport (CVT) method are very suitable to fabricate reproducible sensitive sensors. As the C-reactive protein (CRP) is a nonspecific biomarker of inflammation and infection, it can be used as a predictive or prognostic marker for various cardiovascular diseases. Cys3-protein G immobilized uniformly on the Au nanoplate enable CRP antibody (anti-CRP) to be ordered in a correct orientation, making their binding capacity be maximized for CRP detection. Immobilization condition for the Cys3-protein G and anti-CRP on the Au nanoplate is optimized visually by AFM analysis. Au nanoparticle - Au nanoplate (NPs-on-Au nanoplate) assembly fabricated from sandwich immunoassay for CRP can reduce zero-signal extremely caused by nonspecific bindings, providing a distinct surface-enhanced Raman scattering (SERS) enhancement still in 10-18 M of CRP concentration. Moreover, the NP-on-Au nanoplate sensor shows an excellent selectivity against non-target proteins with high concentration. In addition, comparing with control experiments employing a Au film fabricated by e-beam assisted deposition and linker molecule, we validate clearly contribution of the Au nanoplate for the attomolar sensitive detection of CRP. We expect that the devised platform employing the complex of single-crystalline Au nanoplates and Cys3-protein G can be applied for detection of many other cancer biomarkers.

Keywords: Au nanoplate, biomarker, diagnostic sensor, protein G, SERS

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5751 Description and Evaluation of the Epidemiological Surveillance System for Meningitis in the Province of Taza Between 2016 and 2020

Authors: Bennasser Samira

Abstract:

Meningitis, especially the meningococcal one, is a serious problem of public health. A system of vigilanceand surveillance is in place to allow effective actions to be taken on actual or potential health problems caused by all forms of meningitis. Objectives: 1. Describe the epidemiological surveillance system for meningitis in the province of Taza. 2. Evaluate the quality and responsiveness of the epidemiological surveillance system for meningitis in the province of Taza. 3. Propose measures to improve this system at the provincial level. Methods: This was a descriptive study with a purely quantitative approach by evaluating the quality and responsiveness of the system during 5 years between January 2016 and December 2020. We usedfor that the investigation files of meningitis cases and the provincial database of meningitis. We calculated some quality indicators of surveillance system already defined by the National Program for the Prevention and Control of Meningitis. Results: The notification is passive, the completeness of the data is quite good (94%), and the timeliness don’t exceed 71%. The quality of the data is acceptable (91% agreement). The systematic and rapid performance of lumbar punctures increases the diagnostic capabilities of the system. The local response actions are effected in 100%. Conclusion: The improvement of this surveillance system depends on strengthening the staff skills in diagnostic, reviewing surveillance tools, and encouraging judicious use of the data.

Keywords: evaluation, meningitis, system, taza, morocco

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5750 Assessing Diagnostic and Evaluation Tools for Use in Urban Immunisation Programming: A Critical Narrative Review and Proposed Framework

Authors: Tim Crocker-Buque, Sandra Mounier-Jack, Natasha Howard

Abstract:

Background: Due to both the increasing scale and speed of urbanisation, urban areas in low and middle-income countries (LMICs) host increasingly large populations of under-immunized children, with the additional associated risks of rapid disease transmission in high-density living environments. Multiple interdependent factors are associated with these coverage disparities in urban areas and most evidence comes from relatively few countries, e.g., predominantly India, Kenya, Nigeria, and some from Pakistan, Iran, and Brazil. This study aimed to identify, describe, and assess the main tools used to measure or improve coverage of immunisation services in poor urban areas. Methods: Authors used a qualitative review design, including academic and non-academic literature, to identify tools used to improve coverage of public health interventions in urban areas. Authors selected and extracted sources that provided good examples of specific tools, or categories of tools, used in a context relevant to urban immunization. Diagnostic (e.g., for data collection, analysis, and insight generation) and programme tools (e.g., for investigating or improving ongoing programmes) and interventions (e.g., multi-component or stand-alone with evidence) were selected for inclusion to provide a range of type and availability of relevant tools. These were then prioritised using a decision-analysis framework and a tool selection guide for programme managers developed. Results: Authors reviewed tools used in urban immunisation contexts and tools designed for (i) non-immunization and/or non-health interventions in urban areas, and (ii) immunisation in rural contexts that had relevance for urban areas (e.g., Reaching every District/Child/ Zone). Many approaches combined several tools and methods, which authors categorised as diagnostic, programme, and intervention. The most common diagnostic tools were cross-sectional surveys, key informant interviews, focus group discussions, secondary analysis of routine data, and geographical mapping of outcomes, resources, and services. Programme tools involved multiple stages of data collection, analysis, insight generation, and intervention planning and included guidance documents from WHO (World Health Organisation), UNICEF (United Nations Children's Fund), USAID (United States Agency for International Development), and governments, and articles reporting on diagnostics, interventions, and/or evaluations to improve urban immunisation. Interventions involved service improvement, education, reminder/recall, incentives, outreach, mass-media, or were multi-component. The main gaps in existing tools were an assessment of macro/policy-level factors, exploration of effective immunization communication channels, and measuring in/out-migration. The proposed framework uses a problem tree approach to suggest tools to address five common challenges (i.e. identifying populations, understanding communities, issues with service access and use, improving services, improving coverage) based on context and available data. Conclusion: This study identified many tools relevant to evaluating urban LMIC immunisation programmes, including significant crossover between tools. This was encouraging in terms of supporting the identification of common areas, but problematic as data volumes, instructions, and activities could overwhelm managers and tools are not always suitably applied to suitable contexts. Further research is needed on how best to combine tools and methods to suit local contexts. Authors’ initial framework can be tested and developed further.

Keywords: health equity, immunisation, low and middle-income countries, poverty, urban health

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5749 Development of a Device for Detecting Fluids in the Esophagus

Authors: F. J. Puertas, M. Castro, A. Tebar, P. J. Fito, R. Gadea, J. M. Monzó, R. J. Colom

Abstract:

There is a great diversity of diseases that affect the integrity of the walls of the esophagus, generally of a digestive nature. Among them, gastroesophageal reflux is a common disease in the general population, affecting the patient's quality of life; however, there are still unmet diagnostic and therapeutic issues. The consequences of untreated or asymptomatic acid reflux on the esophageal mucosa are not only pain, heartburn, and acid regurgitation but also an increased risk of esophageal cancer. Currently, the diagnostic methods to detect problems in the esophageal tract are invasive and annoying, as 24-hour impedance-pH monitoring forces the patient to be uncomfortable for hours to be able to make a correct diagnosis. In this work, the development of a sensor able to measure in depth is proposed, allowing the detection of liquids circulating in the esophageal tract. The multisensor detection system is based on radiofrequency photospectrometry. At an experimental level, consumers representative of the population in terms of sex and age have been used, placing the sensors between the trachea and the diaphragm analyzing the measurements in vacuum, water, orange juice and saline medium. The results obtained have allowed us to detect the appearance of different liquid media in the esophagus, segregating them based on their ionic content.

Keywords: bioimpedance, dielectric spectroscopy, gastroesophageal reflux, GERD

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5748 Inflammatory Cytokine (Interleukin-8): A Diagnostic Marker in Leukemia

Authors: Sandeep Pandey, Nimra Habib, Ranjana Singh, Abbas Ali Mahdi

Abstract:

Leukemia is a malignancy of blood that mainly affects children and young adults; while advancement in the early diagnosis will have the potential to improve the outcome of diseases. A wide range of disease including leukemia shows inflammatory signals in their pathogenesis. In a pilot study conducted in our laboratory, 52 people were screened, of which 26 had leukemia and 26 were free from any kind of malignancy. We performed the estimation of the inflammatory cytokine Interleukin-8 and it was found significantly raised in all the leukemia patients concerning healthy volunteers who participated in the study. Flow cytometry had been performed for the confirmation of leukemia and further genomic, and proteomic, analyses of the sample revealed that IL-8 levels showed a positive correlation in patients with leukemia. The results had shown constitutive secretion of interleukin-8 by leukemia cells. So, our finding demonstrated that IL-8 is considered to have a role in the pathogenesis of leukemia, and quantification of IL-8 levels in leukemia conditions might be more useful and feasible in the clinical setting for the prediction of drug responses where it may represent a putative target for innovative diagnostic toward effective therapeutic approaches. However, further research explorations in this area are needed that include a greater number of patients with all different forms of leukemia, and estimating their IL-8 levels may hold the key for the additional predictive values on the recurrence of leukemia and its prognosis.

Keywords: T-ALL, IL-8, leukemia pathogenesis, cancer therapeutics

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5747 Positive Psychology and the Social Emotional Ability Instrument (SEAI)

Authors: Victor William Harris

Abstract:

This research is a validation study of the Social Emotional Ability Inventory (SEAI), a multi-dimensional self-report instrument informed by positive psychology, emotional intelligence, social intelligence, and sociocultural learning theory. Designed for use in tandem with the Social Emotional Development (SEAD) theoretical model, the SEAI provides diagnostic-level guidance for professionals and individuals interested in investigating, identifying, and understanding social, emotional strengths, as well as remediating specific social competency deficiencies. The SEAI was shown to be psychometrically sound, exhibited strong internal reliability, and supported the a priori hypotheses of the SEAD. Additionally, confirmatory factor analysis provided evidence of goodness of fit, convergent and divergent validity, and supported a theoretical model that reflected SEAD expectations. The SEAI and SEAD hold potentially far-reaching and important practical implications for theoretical guidance and diagnostic-level measurement of social, emotional competency across a wide range of domains. Strategies researchers, practitioners, educators, and individuals might use to deploy SEAI in order to improve quality of life outcomes are discussed.

Keywords: emotion, emotional ability, positive psychology-social emotional ability, social emotional ability, social emotional ability instrument

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5746 The Accuracy of Measures for Screening Adults for Spiritual Suffering in Health Care Settings: A Systematic Review

Authors: Sayna Bahraini, Wendy Gifford, Ian Graham, Liquaa Wazni, Suzettee Bremault-Phillips, Rebekah Hackbusch, Catrine Demers, Mary Egan

Abstract:

Objective: Guidelines for palliative and spiritual care emphasize the importance of screening patients for spiritual suffering. The aim of this review was to synthesize the research evidence on the accuracy of measures used to screen adults for spiritual suffering. Methods: A systematic review has been conducted. We searched five scientific databases to identify relevant articles. Two independent reviewers screened extracted data and assessed study methodological quality. Results: We identified five articles that yielded information on 24 spiritual screening measures. Among all identified measures, the 2-item Meaning/Joy & Self-Described Struggle has the highest sensitivity (82-87%), and the revised Rush protocol has the highest specificity (81-90%). The methodological quality of all included studies was low. Significance of Results: While most of the identified spiritual screening measures are brief (comprise 1 to 12 number of items), few have sufficient accuracy to effectively screen patients for spiritual suffering. We advise clinicians to use their critical appraisal skills and clinical judgment when selecting and using any of the identified measures to screen for spiritual suffering.

Keywords: screening, suffering, spirituality, diagnostic test accuracy, systematic review

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5745 Analyzing the Critical Factors Influencing Employees' Tacit and Explicit Knowledge Sharing Intentions for Sustainable Competitive Advantage: A Systematic Review and a Conceptual Framework

Authors: Made Ayu Aristyana Dewi

Abstract:

Due to the importance of knowledge in today’s competitive world, an understanding of how to enhance employee knowledge sharing has become critical. This study discerning employees’ knowledge sharing intentions according to the type of knowledge to be shared, whether tacit or explicit. This study provides a critical and systematic review of the current literature on knowledge sharing, with a particular focus on the most critical factors influencing employees’ tacit and explicit knowledge sharing intentions. The extant literature was identified through four electronic databases, from 2006 to 2016. The findings of this review reveal that most of the previous studies only focus on individual and social factors as the antecedents of knowledge sharing intention. Therefore, those previous studies did not consider some other potential factors, like organizational and technological factors that may hinder the progress of knowledge sharing processes. Based on the findings of the critical review, a conceptual framework is proposed, which presents the antecedents of employees’ tacit and explicit knowledge sharing intentions and its impact on innovation and sustainable competitive advantage.

Keywords: antecedents, explicit knowledge, individual factors, innovation, intentions, knowledge sharing, organizational factors, social factors, sustainable competitive advantage, tacit knowledge, technological factors

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5744 Asymptotic Expansion of Double Oscillatory Integrals: Contribution of Non Stationary Critical Points of the Second Kind

Authors: Abdallah Benaissa

Abstract:

In this paper, we consider the problem of asymptotics of double oscillatory integrals in the case of critical points of the second kind, the order of contact between the boundary and a level curve of the phase being even, the situation when the order of contact is odd will be studied in other occasions. Complete asymptotic expansions will be derived and the coefficient of the leading term will be computed in terms of the original data of the problem. A multitude of people have studied this problem using a variety of methods, but only in a special case when the order of contact is minimal: the more cited papers are a paper of Jones and Kline and an other one of Chako. These integrals are encountered in many areas of science, especially in problems of diffraction of optics.

Keywords: asymptotic expansion, double oscillatory integral, critical point of the second kind, optics diffraction

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5743 Computer Aided Analysis of Breast Based Diagnostic Problems from Mammograms Using Image Processing and Deep Learning Methods

Authors: Ali Berkan Ural

Abstract:

This paper presents the analysis, evaluation, and pre-diagnosis of early stage breast based diagnostic problems (breast cancer, nodulesorlumps) by Computer Aided Diagnosing (CAD) system from mammogram radiological images. According to the statistics, the time factor is crucial to discover the disease in the patient (especially in women) as possible as early and fast. In the study, a new algorithm is developed using advanced image processing and deep learning method to detect and classify the problem at earlystagewithmoreaccuracy. This system first works with image processing methods (Image acquisition, Noiseremoval, Region Growing Segmentation, Morphological Operations, Breast BorderExtraction, Advanced Segmentation, ObtainingRegion Of Interests (ROIs), etc.) and segments the area of interest of the breast and then analyzes these partly obtained area for cancer detection/lumps in order to diagnosis the disease. After segmentation, with using the Spectrogramimages, 5 different deep learning based methods (specified Convolutional Neural Network (CNN) basedAlexNet, ResNet50, VGG16, DenseNet, Xception) are applied to classify the breast based problems.

Keywords: computer aided diagnosis, breast cancer, region growing, segmentation, deep learning

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