Search results for: diagnostic investigation process

Authors: M. Jalali Azizpour

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In this paper, the effect of WC-12Co particle Temperature in HVOF thermal spraying process on the coating thickness has been studied. The statistical results show that the spray distance and oxygen-to-fuel ratio are more effective factors on particle characterization and thickness of HVOF thermal spraying coatings. Spray Watch diagnostic system, scanning electron microscopy (SEM), X-ray diffraction and thickness measuring system were used for this purpose.

Keywords: HVOF, temperature thickness, velocity, WC-12Co

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Authors: V. Prasannavenkadesan, A. Elango, S. Chockalingam

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During machining process, chatter is an unavoidable phenomenon. Boring bars possess the cantilever shape and due to this, it is subjected to chatter. The adverse effect of chatter includes the increase in temperature which will leads to excess tool wear. To overcome these problems, in this investigation, Cartridge brass (Cu – 70% and Zn – 30%) is passively fixed on the boring bar and also clearance is provided in order to reduce the displacement, tool wear and cutting temperature. A conventional all geared lathe is attached with vibrometer and pyrometer is used to measure the displacement and temperature. The influence of input parameters such as cutting speed, depth of cut and clearance on temperature, tool wear and displacement are investigated for various cutting conditions. From the result, the optimum conditions to obtain better damping in boring process for chatter reduction is identified.

Keywords: boring, chatter, mass damping, passive damping

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Authors: Saeed Pourhassan, Nastaran Maghbouli

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1) Background It has been hypothesized that, in individuals with diabetes mellitus, the peripheral nerve is swollen due to sorbitol over-accumulation. Additionally growing evidence supported electro diagnostic study of diabetes induced neuropathy as a method having some challenges. 2) Objective To examine the performance of sonographic cross-sectional area (CSA) measurements in the diagnosis of diabetic polyneuropathy (DPN). 3) Data Sources Electronic databases, comprising PubMed and EMBASE and Google scholar, were searched for the appropriate studies before Jan 1, 2020. 4) Study Selection Eleven trials comparing different peripheral nerve CSA measurements between participants with and without DPN were included. 5) Data Extraction Study design, participants' demographic characteristics, diagnostic reference of DPN, and evaluated peripheral nerves and methods of CSA measurement. 6) Data Synthesis Among different peripheral nerves, Tibial nerve diagnostic odds ratios pooled from five studies (713 participants) were 4.46 (95% CI, 0.35–8.57) and the largest one with P<0.0001, I²:64%. Median nerve CSA at wrist and mid-arm took second and third place with ORs= 2.82 (1.50-4.15), 2.02(0.26-3.77) respectively. The sensitivities and specificities pooled from two studies for Sural nerve were 0.78 (95% CI, 0.68–0.89), and 0.68 (95% CI, 0.53–0.74). Included studies for other nerves were limited to one study. The largest sensitivity was for Sural nerve and the largest specificity was for Tibial nerve. 7) Conclusions The peripheral nerves CSA measured by ultrasound imaging is useful for the diagnosis of DPN and is most significantly different between patients and participants without DPN at the Tibial nerve. Because the Tibial nerve CSA in healthy participants, at various locations, rarely exceeds 24 mm2, this value can be considered as a cutoff point for diagnosing DPN.

Keywords: diabetes, diagnosis, polyneuropathy, ultrasound

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Authors: Tripta Dixit, Smita Sahu, William Selvamurthy, Sadhana Srivastava

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The translation of healthcare technologies is an expensive, complex affair, current healthcare challenges in Asian countries and their efforts to meet Millennium Development Goals (MDGs), necessitates continuous technology advancement to save countless lives, improve the quality of life and for socio-economic development. India’s consistently improving global innovation index (57) demonstrates its innovation potential, but access to health care is asymmetric and lacks priority in India. Therefore, there is utmost need of a robust translation system for point-of-care (POC) solutions, inexpensive, low-maintenance, reliable, and easy-to-use diagnostic technologies. Few cases of POC technologies viz. Elisa based diagnostic kits for regional viral disease, a device for detection of cancerous lesions were studied to understand the process and challenges involved in their translation. Accordingly, the entire translation ecosystem was summarized proposing a nexus of various actors such as technology developer, technology transferor technology receiver, funding entities, government/regulatory bodies and their effect on translation of different medical technologies. This study highlights the role and concerns pertaining to these actors for POC such as unsystematic and unvalidated research roadmap, low profit preposition, unfocused approach of up-scaling, low market acceptability and multiple window regulatory framework, etc. This provides an opportunity to devise solutions to overcome problem areas in translation path.

Keywords: healthcare technologies, point-of-care solutions, public health, translation

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Authors: Luiz Carlos Wrobel, Matjaz Hribersek, Jure Marn, Jurij Iljaz

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Dynamic thermography has been clinically proven to be a valuable diagnostic technique for skin tumor detection as well as for other medical applications such as breast cancer diagnostics, diagnostics of vascular diseases, fever screening, dermatological and other applications. Thermography for medical screening can be done in two different ways, observing the temperature response under steady-state conditions (passive or static thermography), and by inducing thermal stresses by cooling or heating the observed tissue and measuring the thermal response during the recovery phase (active or dynamic thermography). The numerical modelling of heat transfer phenomena in biological tissue during dynamic thermography can aid the technique by improving process parameters or by estimating unknown tissue parameters based on measured data. This paper presents a nonlinear numerical model of multilayer skin tissue containing a skin tumor, together with the thermoregulation response of the tissue during the cooling-rewarming processes of dynamic thermography. The model is based on the Pennes bioheat equation and solved numerically by using a subdomain boundary element method which treats the problem as axisymmetric. The paper includes computational tests and numerical results for Clark II and Clark IV tumors, comparing the models using constant and temperature-dependent thermophysical properties, which showed noticeable differences and highlighted the importance of using a local thermoregulation model.

Keywords: boundary element method, dynamic thermography, static thermography, skin tumor diagnostic

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Authors: R. M. Chandima Ratnayake, Daniel Dyakov

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Super steel materials play vital role in construction and fabrication of structural, piping and pipeline components. They enable to minimize the life cycle costs in assuring the integrity of onshore and offshore operating systems. In this context, Duplex stainless steel (DSS) material related welding on constructions and fabrications play a significant role in maintaining and assuring integrity at an optimal expenditure over the life cycle of production and process systems as well as associated structures. In DSS welding, the factors such as gap geometry, shielding gas supply rate, welding current, and type of the welding process play a vital role on the final joint performance. Hence, an experimental investigation has been performed using engineering robust design approach (ERDA) to investigate the optimal settings that generate optimal super DSS (i.e. UNS S32750) joint performance. This manuscript illustrates the mathematical approach and experimental design, optimal parameter settings and results of verification experiment.

Keywords: duplex stainless steel welding, engineering robust design, mathematical framework, optimal parameter settings

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Authors: Areti Angeliki Veroniki, Sofia Tsokani, Evangelos Paraskevaidis, Dimitris Mavridis

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The plethora of diagnostic test accuracy (DTA) studies has led to the increased use of systematic reviews and meta-analysis of DTA studies. Clinicians and healthcare professionals often consult DTA meta-analyses to make informed decisions regarding the optimum test to choose and use for a given setting. For example, the human papilloma virus (HPV) DNA, mRNA, and cytology can be used for the cervical intraepithelial neoplasia grade 2+ (CIN2+) diagnosis. But which test is the most accurate? Studies directly comparing test accuracy are not always available, and comparisons between multiple tests create a network of DTA studies that can be synthesized through a network meta-analysis of diagnostic tests (DTA-NMA). The aim is to summarize the DTA-NMA methods for at least three index tests presented in the methodological literature. We illustrate the application of the methods using a real data set for the comparative accuracy of HPV DNA, HPV mRNA, and cytology tests for cervical cancer. A search was conducted in PubMed, Web of Science, and Scopus from inception until the end of July 2019 to identify full-text research articles that describe a DTA-NMA method for three or more index tests. Since the joint classification of the results from one index against the results of another index test amongst those with the target condition and amongst those without the target condition are rarely reported in DTA studies, only methods requiring the 2x2 tables of the results of each index test against the reference standard were included. Studies of any design published in English were eligible for inclusion. Relevant unpublished material was also included. Ten relevant studies were finally included to evaluate their methodology. DTA-NMA methods that have been presented in the literature together with their advantages and disadvantages are described. In addition, using 37 studies for cervical cancer obtained from a published Cochrane review as a case study, an application of the identified DTA-NMA methods to determine the most promising test (in terms of sensitivity and specificity) for use as the best screening test to detect CIN2+ is presented. As a conclusion, different approaches for the comparative DTA meta-analysis of multiple tests may conclude to different results and hence may influence decision-making. Acknowledgment: This research is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning 2014-2020» in the context of the project “Extension of Network Meta-Analysis for the Comparison of Diagnostic Tests ” (MIS 5047640).

Keywords: colposcopy, diagnostic test, HPV, network meta-analysis

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Authors: Hailye Tekleselassie

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Edge computing is a spread computing outline that transports initiative applications closer to data sources such as IoT devices or local edge servers, and possible happenstances would skull the action of new technologies. However, this investigation was attained to investigation the consciousness of technology and communications organization workers and computer users who support the service cloud. Surveys were used to achieve these objectives. Surveys were intended to attain these aims, and it is the functional using survey. Enquiries about confidence are also a key question. Problems like data privacy, integrity, and availability are the factors affecting the company’s acceptance of the service cloud.

Keywords: IoT, data, security, edge computing

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Authors: Azizollah Khodakaram- Tafti, Ali Mohammadi, Ghasem Farjanikish

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Bovine viral diarrhea virus (BVDV) is one of the most important viral pathogens of cattle worldwide caused by Pestivirus genus, Flaviviridae family.The aim of the present study was to comparison several diagnostic methods and determine the prevalence of BVDV infection for the first time in dairy herds of Fars province, Iran. For initial screening, a total of 400 blood samples were randomly collected from 12 industrial dairy herds and analyzed using reverse transcription (RT)-PCR on the buffy coat. In the second step, blood samples and also ear notch biopsies were collected from 100 cattle of infected farms and tested by antigen capture ELISA (ACE), RT-PCR and immunohistochemistry (IHC). The results of nested RT-PCR (outer primers 0I100/1400R and inner primers BD1/BD2) was successful in 16 out of 400 buffy coat samples (4%) as acute infection in initial screening. Also, 8 out of 100 samples (2%) were positive as persistent infection (PI) by all of the diagnostic tests similarly including RT-PCR, ACE and IHC on buffy coat, serum and skin samples, respectively. Immunoreactivity for bovine BVDV antigen as brown, coarsely to finely granular was observed within the cytoplasm of epithelial cells of epidermis and hair follicles and also subcutaneous stromal cells. These findings confirm the importance of monitoring BVDV infection in cattle of this region and suggest detection and elimination of PI calves for controlling and eradication of this disease.

Keywords: antigen capture ELISA, bovine viral diarrhea virus, immunohistochemistry, RT-PCR, cattle

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Authors: Ali Hamza

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Accurate segmentation of breast ultrasound images is of paramount importance in enhancing the diagnostic capabilities of breast cancer detection. This study presents an approach utilizing the U-Net architecture for segmenting breast ultrasound images aimed at improving the accuracy and reliability of mass identification within the breast tissue. The proposed method encompasses a multi-stage process. Initially, preprocessing techniques are employed to refine image quality and diminish noise interference. Subsequently, the U-Net architecture, a deep learning convolutional neural network (CNN), is employed for pixel-wise segmentation of regions of interest corresponding to potential breast masses. The U-Net's distinctive architecture, characterized by a contracting and expansive pathway, enables accurate boundary delineation and detailed feature extraction. To evaluate the effectiveness of the proposed approach, an extensive dataset of breast ultrasound images is employed, encompassing diverse cases. Quantitative performance metrics such as the Dice coefficient, Jaccard index, sensitivity, specificity, and Hausdorff distance are employed to comprehensively assess the segmentation accuracy. Comparative analyses against traditional segmentation methods showcase the superiority of the U-Net architecture in capturing intricate details and accurately segmenting breast masses. The outcomes of this study emphasize the potential of the U-Net-based segmentation approach in bolstering breast ultrasound image analysis. The method's ability to reliably pinpoint mass boundaries holds promise for aiding radiologists in precise diagnosis and treatment planning. However, further validation and integration within clinical workflows are necessary to ascertain their practical clinical utility and facilitate seamless adoption by healthcare professionals. In conclusion, leveraging the U-Net architecture for breast ultrasound image segmentation showcases a robust framework that can significantly enhance diagnostic accuracy and advance the field of breast cancer detection. This approach represents a pivotal step towards empowering medical professionals with a more potent tool for early and accurate breast cancer diagnosis.

Keywords: mage segmentation, U-Net, deep learning, breast cancer detection, diagnostic accuracy, mass identification, convolutional neural network

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Authors: Ahmed Mohammed Mohagir, Ahmat-Charfadine Mahamat, Nde Divine Bup, Richard Kamga, César Kapseu

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In this investigation, kinetics studies of adsorption of colour material of shea butter showed a peak at the wavelength 440 nm and the equilibrium time was found to be 30 min. Response surface methodology applying Doehlert experimental design was used to investigate decolourisation parameters of crude shea butter. The decolourisation process was significantly influenced by three independent parameters: contact time, decolourisation temperature and adsorbent dose. The responses of the process were oil loss, acid value, peroxide value and colour index. Response surface plots were successfully made to visualise the effect of the independent parameters on the responses of the process.

Keywords: decolourisation, doehlert experimental design, physicochemical characterisation, RSM, shea butter

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Authors: Sonia Sirtoli Färber

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Objective: This study aims to investigate selective attention in the process of mourning, as a normal reaction to loss. Method: In order to develop this research, we used a systematic bibliographic review, following the process of investigation, cataloging, careful evaluation and synthesis of the documentation, associated with the method of thanatological hemenutics proposed by Elisabeth Kübler-Ross. Conclusion: After a significant loss, especially the death of a loved one or family member, it is normal for the mourner, motivated by absence, to have a false perception of the presence of the deceased. This phenomenon happens whenever the mourner is in the middle of the crowd, because his selective attention causes him to perceive physical characteristics, tone of voice, or feel fragrance of the perfume that the deceased possessed. Details characterizing the dead are perceived by the mourner because he seeks the presence in the absence.

Keywords: Elisabeth Kübler-Ross, mourning, selective attention, thanatology

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Authors: Pankaj Chandna, Dinesh Kumar

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The present work analyses different parameters of end milling to minimize the surface roughness for AISI D2 steel. D2 Steel is generally used for stamping or forming dies, punches, forming rolls, knives, slitters, shear blades, tools, scrap choppers, tyre shredders etc. Surface roughness is one of the main indices that determines the quality of machined products and is influenced by various cutting parameters. In machining operations, achieving desired surface quality by optimization of machining parameters, is a challenging job. In case of mating components the surface roughness become more essential and is influenced by the cutting parameters, because, these quality structures are highly correlated and are expected to be influenced directly or indirectly by the direct effect of process parameters or their interactive effects (i.e. on process environment). In this work, the effects of selected process parameters on surface roughness and subsequent setting of parameters with the levels have been accomplished by Taguchi’s parameter design approach. The experiments have been performed as per the combination of levels of different process parameters suggested by L9 orthogonal array. Experimental investigation of the end milling of AISI D2 steel with carbide tool by varying feed, speed and depth of cut and the surface roughness has been measured using surface roughness tester. Analyses of variance have been performed for mean and signal-to-noise ratio to estimate the contribution of the different process parameters on the process.

Keywords: D2 steel, orthogonal array, optimization, surface roughness, Taguchi methodology

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Authors: Alinka Molnár-Tóth, Tímea Tánczos, Regina Barna, Katalin Jakab, Péter Klivényi

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Supported by neuroscientific findings, the so-called Hub-and-Spoke model of the human semantic system is based on two subcomponents of semantic cognition, namely the semantic control process and semantic representation. Our semantic knowledge is multimodal in nature, as the knowledge system stored in relation to a conception is extensive and broad, while different aspects of the conception may be relevant depending on the purpose. The motivation of our research is to develop a new diagnostic measurement procedure based on the preservation of semantic representation, which is appropriate to the specificities of the Hungarian language and which can be used to compare the non-verbal semantic knowledge of healthy and aphasic persons. The development of the test will broaden the Hungarian clinical diagnostic toolkit, which will allow for more specific therapy planning. The sample of healthy persons (n=480) was determined by the last census data for the representativeness of the sample. Based on the concept of the Pyramids and Palm Tree Test, and according to the characteristics of the Hungarian language, we have elaborated a test based on different types of semantic information, in which the subjects are presented with three pictures: they have to choose the one that best fits the target word above from the two lower options, based on the semantic relation defined. We have measured 5 types of semantic knowledge representations: associative relations, taxonomy, motional representations, concrete as well as abstract verbs. As the first step in our data analysis, we examined the normal distribution of our results, and since it was not normally distributed (p < 0.05), we used nonparametric statistics further into the analysis. Using descriptive statistics, we could determine the frequency of the correct and incorrect responses, and with this knowledge, we could later adjust and remove the items of questionable reliability. The reliability was tested using Cronbach’s α, and it can be safely said that all the results were in an acceptable range of reliability (α = 0.6-0.8). We then tested for the potential gender differences using the Mann Whitney-U test, however, we found no difference between the two (p < 0.05). Likewise, we didn’t see that the age had any effect on the results using one-way ANOVA (p < 0.05), however, the level of education did influence the results (p > 0.05). The relationships between the subtests were observed by the nonparametric Spearman’s rho correlation matrix, showing statistically significant correlation between the subtests (p > 0.05), signifying a linear relationship between the measured semantic functions. A margin of error of 5% was used in all cases. The research will contribute to the expansion of the clinical diagnostic toolkit and will be relevant for the individualised therapeutic design of treatment procedures. The use of a non-verbal test procedure will allow an early assessment of the most severe language conditions, which is a priority in the differential diagnosis. The measurement of reaction time is expected to advance prodrome research, as the tests can be easily conducted in the subclinical phase.

Keywords: communication disorders, diagnostic toolkit, neurorehabilitation, semantic knowlegde

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Authors: Sudhanshu Kumar

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Electrical discharge machining, also known as EDM, process is one of the most applicable machining process for removal of material in hard to machine materials like superalloy metals. EDM process utilizes electrical energy into sparks to erode the metals in presence of dielectric medium. In the present investigation, superalloy, Inconel 718 has been selected as workpiece and electrolytic copper as tool electrode. Attempt has been made to understand the effect of size of tool with varying cavity depth during drilling of hole through EDM process. In order to systematic investigate, tool size in terms of tool diameter and cavity depth along with other important electrical parameters namely, peak current, pulse-on time and servo voltage have been varied at three different values and the experiments has been designed using fractional factorial (Taguchi) method. Each experiment has been repeated twice under the same condition in order to understand the variability within the experiments. The effect of variations in parameters has been evaluated in terms of material removal rate, tool wear rate and surface roughness. Results revel that change in tool diameter during machining affects the response characteristics significantly. Larger tool diameter yielded 13% more material removal rate than smaller tool diameter. Analysis of the effect of variation in cavity depth is notable. There is no significant effect of cavity depth on material removal rate, tool wear rate and surface quality. This indicates that number of experiments can be performed to analyze other parameters effect even at smaller depth of cavity which can reduce the cost and time of experiments. Further, statistical analysis has been carried out to identify the interaction effect between parameters.

Keywords: EDM, Inconel 718, material removal rate, roughness, tool wear, tool size

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Authors: W. S. Li, S. T. Yang, H. C. Cheng

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The power conversion efficiency (PCE) of the perovskite solar cells has been achieved by inserting vertically-aligned ZnO nanowires (NWs) between the cathode and the active layer and shows better solar cells performance. Perovskite solar cells have drawn significant attention due to the superb efficiency and low-cost fabrication process. In this experiment, ZnO nanowires are used as the electron transport layer (ETL) due to its low temperature process. The main idea of this thesis is utilizing the 3D structures of the hydrothermally-grown ZnO nanowires to increase the junction area to improve the photovoltaic performance of the perovskite solar cells. The infiltration and the surface coverage of the perovskite precursor solution changed as tuning the length of the ZnO nanowires. It is revealed that the devices with ZnO nanowires of 150 nm demonstrated the best PCE of 8.46 % under the AM 1.5G illumination (100 mW/cm2).

Keywords: hydrothermally-grown ZnO nanowires, perovskite solar cells, low temperature process, pinholes

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Authors: Guo Haonan, Chen Peiyu, Zhao Hanyu, Burra Venkata Durga Kumar

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Unix and Unix-like operating systems are widely used due to their high stability but are limited by the parent-child process structure, and the child process depends on the parent process, so the crash of a single process may cause the entire process group or even the entire system to fail. Another possibility of unexpected process termination is that the system administrator inadvertently closed the terminal or pseudo-terminal where the application was launched, causing the application process to terminate unexpectedly. This paper mainly analyzes the reasons for the problems and proposes two solutions.

Keywords: process management, daemon, login-bash and non-login bash, process group

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Authors: Wu Defu, Kiefer Chiam, Yang Kin Seng

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The planning of geological survey works is an iterative process which involves planner, geologist, civil engineer and other stakeholders, who perform different roles and have different points of view. Traditionally, the team used paper maps or CAD drawings to present the proposal which is not an efficient way to present and share idea on the site investigation proposal such as sitting of borehole location or seismic survey lines. This paper focuses on how a GIS approach can be utilised to develop a web-based system to support decision making process in the planning of geological survey works and also to plan site activities carried out by Singapore Geological Office (SGO). The authors design a framework of building an interactive web-based GIS system, and develop a prototype, which enables the users to obtain rapidly existing geological information and also to plan interactively borehole locations and seismic survey lines via a web browser. This prototype system is used daily by SGO and has shown to be effective in increasing efficiency and productivity as the time taken in the planning of geological survey works is shortened. The prototype system has been developed using the ESRI ArcGIS API 3.7 for Flex which is based on the ArcGIS 10.2.1 platform.

Keywords: engineering geology, flex, geological survey planning, geoscience, GIS, site investigation, WebGIS

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Authors: Mohammed Ali Faqeeh

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SCADA System Alarms Optimization Process has been introduced recently and applied accordingly in different implemented stages. First, MODBUS communication protocols between RTU/SCADA were improved at the level of I/O points scanning intervals. Then, some of the technical issues related to manufacturing limitations were resolved. Afterward, another approach was followed to take a decision on the configured alarms database. So, a couple of meetings and workshops were held among all system stakeholders, which resulted in an agreement of disabling unnecessary (Diagnostic) alarms. Moreover, a leap forward step was taken to segregate the SCADA Operator Graphics in a way to show only process-related alarms while some other graphics will ensure the availability of field alarms related to maintenance and engineering purposes. This overall system management and optimization have resulted in a huge effective impact on all operations, maintenance, and engineering. It has reduced unneeded open tickets for maintenance crews which led to reduce the driven mileages accordingly. Also, this practice has shown a good impression on the operation reactions and response to the emergency situations as the SCADA operators can be staying much vigilant on the real alarms rather than gets distracted by noisy ones. SCADA System Alarms Optimization process has been executed utilizing all applicable in-house resources among engineering, maintenance, and operations crews. The methodology of the entire enhanced scopes is performed through various stages.

Keywords: SCADA, RTU Communication, alarm management system, SCADA alarms, Modbus, DNP protocol

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Authors: Wael El-Deeb

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The present study aimed to investigate the diagnostic importance of acute phase proteins in urinary tract infection (UTI) in cattle. We describe the clinical, bacteriological and biochemical findings in 99 lactating cows. Blood and urine samples from diseased (n=84) and control healthy cows (n=15) were submitted to laboratory investigations. The urine analysis revealed hematuria and pyuria in UTI group. The isolated bacteria were E.coli (43/84) Corynebacterium spp, (31/84), Proteus spp. (6/84) and Streptococcus spp (4/84). The concentrations of Haptoglobin (Hp), serum amyloid A (SAA), α1-Acid glycoprotein (AGP), fibrinogen (Fb), total protein, albumen, and globulin were higher in cows with UTI when compared to healthy ones. Fifty-one of 84 cows with UTI were successfully treated. The levels of Hp, SAA, AGP, total protein, and globulin were associated with the odds of treatment failure. Conclusively, acute phase proteins could be used as diagnostic and prognostic biomarkers in cows with UTI.

Keywords: cows, urinary, infections, haptoglobin, serum Amyloid A

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Authors: Ashish Sinha, Pushpend Agrawal

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Background: Patients with undiagnosed pulmonary TB predominantly act as reservoirs for its transmission through 10-15 secondary infections in the next 1-5 Yrs. Delays in the diagnosis and treatment may worsen the disease with increase the risk of death. Factors responsible for such delays by tracking patient pathways to treatment may help in planning better interventions. The provision of ‘free diagnosis and treatment’ forms the cornerstone of the National Tuberculosis Elimination Programme (NTEP). OOPE is defined as the money spent by the patient during TB care other than public health facilities. Free TB care at all health facilities could reduce out-of-pocket expenses to the minimum possible levels. Material and Methods: This cross-sectional study was conducted among randomly selected 252 TB patients from Nov – Oct 2022 by taking in-depth interviews following informed verbal consent. We documented their journey from initial symptoms until they reached the public health facility, along with their ‘out-of-pocket expenditure’ (OOPE) pertaining to TB care. Results: Total treatment delay was 91±72 days on average (median: 77days, IQR: 45-104 days), while the isolated patient delay was 31±45 days (median: 15 days, IQR: 0 days to 43 days); diagnostic delay; 57±60 days (median: 42days, IQR 14-78 days), treatment delay 19 ± 18 days (median: 15days, IQR: 11-19 days). A patient delay (> 30 days) was significantly associated with ignorance about classic symptoms of pulmonary TB, adoption of self-medication, illiteracy, and middle and lower social class. Diagnostic delay was significantly higher among those who contacted private health facilities, were unaware of signs and symptoms, had >2 consultations, and not getting an appropriate referral for TB care. Most (97%) of the study participants interviewed claimed to have incurred some expenditure.Median total expenses were 6155(IQR: 2625-15175) rupees. More than half 141 (56%) of the study participants had expenses >5000 rupees. Median transport expenses were 525(IQR: 200-1012) rupees; Median consultation expenses were 700(IQR: 200-1600) rupees; Median investigation expenses were 1000(IQR: 0-3025) rupees and the Median medicine expenses were 3350(IQR: 1300-7525).OOPE for consultation, investigation, and medicine was observed to be significantly higher among patients who ignored classical signs& symptoms of TB, repeated visits to private health facilities, and due to self-medication practices. Transport expenses and delays in seeking care at facilities were observed to have an upward trend with OOP Expenses (r =1). Conclusion: Delay in TB care due to low awareness about signs and symptoms of TB and poor seeking care, lack of proper consultation, and appropriate referrals reported by the study subjects indicate the areas which need proper attention by the program managers. Despite a centrally sponsored programme, the financial burden on TB patients is still in the unacceptable range. OOPE could be reduced as low as possible by addressing the responsible factors linked to it.

Keywords: patient pathway, delay, pulmonary tuberculosis, out of pocket expenses

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Authors: Tony Bediako Arthur, Nejat Rahmanian, Nana Gyan Sekyi

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The possibility of producing seeded granules from fine and course powders is a major challenge as the control parameters that affect its producibility is still under investigation. The seeded granulation is a novel form of producing granules where the granule is made up of larger particles at the core, which are surrounded by fine particles. The possibility of managing granulation through course particle feed rate control makes seeded granulation in continuous granulation useful in terms of process control. Twin screw granulation is now a major process of choice for the wet continuous granulation process in the industry. It is, therefore, imperative to investigate the process control parameters that influence the formation of seeded granules in twin screw granulation. In this paper, the effect of the twin screws rotating speed on the production of seeded granules has been examined. Pictorial and quantitative analysis indicates a high number of seeded granules forming at low screw rotating speeds. It is also instructive to say that higher tensile stress occurs at the kneading section of the screws; thus, higher rotating speed courses the fines for breaking off from the seed particle.

Keywords: DEM, twin-screw, Seeded granules, Simulation

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Authors: Mahdi Fakoor, Seyed Mohammad Navid Ghoreishi

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Investigation of fracture of wood components can prevent from catastrophic failures. Created fracture process zone (FPZ) in crack tip vicinity has important effect on failure of cracked composite materials. In this paper, a failure criterion for fracture investigation of cracked wood specimens under mixed mode I/II loading is presented. This criterion is based on maximum strain energy release rate and material nonlinearity in the vicinity of crack tip due to presence of microcracks. Verification of results with available experimental data proves the coincidence of the proposed criterion with the nature of fracture of wood. To simplify the estimation of nonlinear properties of FPZ, a damage factor is also introduced for engineering and application purposes.

Keywords: fracture criterion, mixed mode loading, damage zone, micro cracks

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Authors: Kieren Wilson, Gulnaz Majeed

Abstract:

NHS constitution gives rights to the patient with suspected cancer to be seen by a cancer specialist within 2 weeks of referral. Guys and St Thomas Hospital (GSTT) is one of the largest cancer centres in London. NICE guidelines have provided guidance for health professionals to refer patients appropriately to RAC. In GSTT suspected gynae cancer referrals are mostly by NHS e-Referral Service with some fax, emails as well as paper referrals. The objective of this study was to evaluate compliance with 2-week referral pathway with emphasis on one stop diagnostic service with supporting efficient pathways. A prospective evaluation over 3 months (1 Jan 2017 to 31 Mar 2017) was undertaken. There were 26 clinics, 761 patients were booked in the clinics with a DNA rate of 13% (n=101) hence 606 patients were seen. Majority of referrals were for post menopausal bleeding (PMB) 25% (n=194) followed by cervical, vaginal, vulval reasons 23% (n=179) (abnormal cytology excluded as patients directly referred to colposcopy unit in GSTT), ovarian 7% (n=54) and endometrial 5% (n=41). Women with new or previous established diagnosis of cancer were 24, cervical (n=17), vulva (n=6) and vagina (n=1). Multifocal preinvasive disease vulva (VIN), vagina (VAIN) and cervix (CIN) was confirmed in twenty-six patients 4% (high prevalence in HIV patients). Majority of cervical referrals: PCB (n=14), cervical erosion (n=7), polyps (n=9) and cervical cyst were benign. However, two women with PMB had cervical cancer. Only 2 out of 13 referrals with vaginal concerns had VAIN. One case with non-cervical glandular cytology was confirmed to have endometrial cancer. One stop service based on the diagnostic support of ultrasound, colposcopy and hysteroscopy was achieved in 54% (n=359). Patients were discharged to GP, benign gynaecology, endometriosis, combined vulval/dermatology clinic or gynae oncology. 33% (n=202) required a second visit, 12% (n=70) third visit, 3% (n=19) fourth visit, 1% (n=4) fifth visit and 1% (n=6) sixth visit. Main reasons for follow ups were the unavailability of diagnostic slots, patient choice, need for interpreters, the discussion following gynae MDM review for triage to benign gynae, delay in availability of diagnostic results like histology/MRI/CT. Recommendations following this study are multi disciplinary review of pathways with the availability of additional diagnostic procedure slots to aim for one stop service. Furthermore, establishment of virtual and telephone consultations to reduce follow ups.

Keywords: multifocal disease, post menopausal bleeding, preinvasive disease, rapid access clinic

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Authors: Di Luo, Maria Buchberger, Anja Pickhard

Abstract:

Objectives: The purpose of this study was to assess and compare the diagnostic accuracy of four common morphological approaches, including sonography, computed tomography (CT), positron emission tomography/computed tomography (PET/CT), and magnetic resonance imaging (MRI) for the evaluation of cervical lymph node metastases in head and neck squamous cell carcinoma (HNSCC) patients. Material and Methods: Included in this retrospective study were 26 patients diagnosed with HNSCC between 2010 and 2011 who all underwent sonography, CT, PET/CT, and MRI imaging before neck dissection. Morphological data were compared to the corresponding histopathological results. Statistical analysis was performed with SPSS statistic software (version 26.0), calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detection of cervical lymph node metastases. Results: The 5-year survival rate of the patient collective was 55.5%.Risk factors for survival included initial primary tumor stage, initial lymph node stage, initial metastasis status, and therapeutic approaches. Cox regression showed initial metastasis status(HR 8.671, 95%CI 1.316-57.123, p=0.025) and therapeutic approaches(HR 6.699, 95%CI 1.746-25.700, p=0.006)to be independent predictive risk factors for survival. Sensitivity was highest for MRI (96% compared to 85% for sonography and 89% for CT and PET/CT). Specificity was comparable with 95 % for CT and 98 % for sonography and PET/CT, but only 68% for MRI. While the MRI showed the least PPV (34%) compared to all other methods (85% for sonography,75% for CT, and 86% for PET/CT), the NPV was comparable in all methods(98-99%). The overall accuracy of cervical lymph node metastases detection was comparable for sonography, CT, and PET/CT with 96%,97%,94%, respectively, while MRI had only 72% accuracy. Conclusion: Since the initial status of metastasis is an independent predictive risk factor for patients’ survival, efficient detection is crucial to plan adequate therapeutic approaches. Sonography, CT, and PET/CT have better diagnostic accuracy than MRI for the evaluation of cervical lymph node metastases in HNSCC patients.

Keywords: cervical lymph node metastases, diagnostic accuracy, head and neck squamous carcinoma, risk factors, survival

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Authors: Shilpesh R. Rajpurohit, Harshit K. Dave

Abstract:

Additive manufacturing gains the popularity in recent times, due to its capability to create prototype as well functional as end use product directly from CAD data without any specific requirement of tooling. Fused deposition modeling (FDM) is one of the widely used additive manufacturing techniques that are used to create functional end use part of polymer that is comparable with the injection-molded parts. FDM printed part has an application in various fields such as automobile, aerospace, medical, electronic, etc. However, application of FDM part is greatly affected by poor mechanical properties. Proper selection of the process parameter could enhance the mechanical performance of the printed part. In the present study, experimental investigation has been carried out to study the behavior of the mechanical performance of the printed part with respect to process variables. Three process variables viz. raster angle, raster width and layer height have been varied to understand its effect on tensile strength. Further, effect of process variables on fractured surface has been also investigated.

Keywords: 3D Printing, fused deposition modeling, layer height, raster angle, raster width, tensile strength

Procedia PDF Downloads 195

Authors: M. Barański

Abstract:

The article presents a new vibration diagnostic method designed to (PM) machines with permanent magnets. Those devices are commonly used in small wind and water systems or vehicles drives. The author’s method is very innovative and unique. Specific structural properties of PM machines are used in this method - electromotive force (EMF) generated due to vibrations. There was analysed number of publications which describe vibration diagnostic methods and tests of electrical PM machines and there was no method found to determine the technical condition of such machine basing on their own signals. In this article, the method genesis, the similarity of machines with permanent magnet to vibration sensor and simulation and laboratory tests results will be discussed. The method of determination the technical condition of electrical machine with permanent magnets basing on its own signals is the subject of patent application No P.405669, and it is the main thesis of author’s doctoral dissertation.

Keywords: vibrations, generator, permanent magnet, traction drive, electrical vehicle

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Metabolic syndrome (MetS) is a disease associated with obesity. It is a complicated clinical problem possibly affecting body composition as well as macrominerals. These parameters gain further attention, particularly in the pediatric population. The aim of this study is to investigate the amount of discrete body composition fractions in groups that differ in the severity of obesity. Also, the possible associations with calcium (Ca), phosphorus (P), magnesium (Mg) will be examined. The study population was divided into four groups. Twenty-eight, 29, 34, and 34 children were involved in Group 1 (healthy), 2 (obese), 3 (morbid obese), and 4 (MetS), respectively. Institutional Ethical Committee approved the study protocol. Informed consent forms were obtained from the participants. The classification of obese groups was performed based upon the recommendations of the World Health Organization. Metabolic syndrome components were defined. Serum Ca, P, Mg concentrations were measured. Within the scope of body composition, fat mass, fat-free mass, protein mass, mineral mass were determined by a body composition monitor using bioelectrical impedance analysis technology. Weight, height, waist circumference, hip circumference, head circumference, and neck circumference values were recorded. Body mass index, diagnostic obesity notation model assessment index, fat mass index, and fat-free mass index values were calculated. Data were statistically evaluated and interpreted. There was no statistically significant difference among the groups in terms of Ca and P concentrations. Magnesium concentrations differed between Group 1 and Group 4. Strong negative correlations were detected between P as well as Mg and fat mass index as well as diagnostic obesity notation model assessment index in Group 4, the group, which comprised morbid obese children with MetS. This study emphasized unique associations of P and Mg minerals with diagnostic obesity notation model assessment index and fat mass index during the evaluation of morbid obese children with MetS. It was also concluded that diagnostic obesity notation model assessment index and fat mass index were more proper indices in comparison with body mass index and fat-free mass index for the purpose of defining body composition in children.

Keywords: children, fat mass, fat-free mass, macrominerals, obesity

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Authors: Zohreh Sheidaei, Farhad Sadegh Moghanlou, Rahim Vesal

Abstract:

Diseases related to leg venous system are common worldwide. An incompetent vein with deformed wall and insufficient valves affects flow field of blood and disrupts the process of blood circulating system. Having enough knowledge about the flow field through veins will help find new ways to cure the related diseases. In the present study, blood flow around a leaflet valve of a perforating vein is investigated numerically by Finite Element Method. Flow behavior and vortexes, generated around the leaflet valves, are studied considering valve opening percentage. Obtained velocity and pressure fields show mechanical stresses on vein wall and these valves and consequently introduce the regions susceptible to deformation.

Keywords: fluid flow, leaflet valve, numerical investigation, perforating vein

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Authors: Christine Li, Amanda Robertson

Abstract:

Epidermal inclusion cysts occur when epidermal cells are implanted in the dermis following trauma, or surgery. They are a rare cause of an umbilical mass, with very few cases previously reported following abdominal surgery. These lesions can present with a range of symptoms, including palpable mass, pain, redness, or discharge. This paper reports a case of an umbilical epidermal inclusion cyst in a 52-year-old female presenting with a six-week history of a painful, red umbilical lump on a background of two previous diagnostic laparoscopies. Abdominal computed tomography (CT) scans revealed non-specific soft tissue thickening in the umbilical region. This was successfully treated with complete excision of the lesion. Umbilical lumps are a common presentation but can represent a diagnostic challenge. The differential diagnosis should include an epidermal inclusion cyst, particularly in a patient who has had previous abdominal surgery, including laparoscopic surgery.

Keywords: epidermal inclusion cyst, laparoscopy, umbilical mass, umbilicus

Procedia PDF Downloads 78