Search results for: Medical treatment.

Authors: M. McHugh, D. Lillis

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Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.

Keywords: Medical, mobile, applications, software Engineering, FDA, standards, regulations, agile.

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Authors: Mahmoud M. Tash

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The present study was carried out to investigate the effect of alloying elements and thermo-mechanical treatment (TMT) i.e. hot rolling and forging with different reduction ratios on the hardness (HV) and impact toughness (J) of heat-treated low alloy steels. An understanding of the combined effect of TMT and alloying elements and by measuring hardness, impact toughness, resulting from different heat treatment following TMT of the low alloy steels, it is possible to determine which conditions yielded optimum mechanical properties and high strength to weight ratio. Experimental Correlations between hot work reduction ratio, hardness and impact toughness for thermo-mechanically heat treated low alloy steels are analyzed quantitatively, and both regression and mathematical hardness and impact toughness models are developed.

Keywords: Hot Forging, hot rolling, heat treatment, hardness (hv), impact toughness (j), microstructure, low alloy steels.

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Authors: Erfan Asghari Fesaghandis, Reza Ghaffari Adli, Abbas Kianvash, Hossein Aghajani, Homa Homaie

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NiTi alloys possess magnificent superelastic, shape memory, high strength and biocompatible properties. For improving mechanical properties, foremost, superelasticity behavior, heat treatment process is carried out. In this paper, two different heat treatment methods were undertaken: (1) solid solution, and (2) aging. The effect of each treatment in a constant time is investigated. Five samples were prepared to study the structure and optimize mechanical properties under different time and temperature. For measuring the upper plateau stress, lower plateau stress and residual strain, tensile test is carried out. The samples were aged at two different temperatures to see difference between aging temperatures. The sample aged at 500 °C has a bigger crystallite size and lower amount of Ni which causes the mentioned sample to possess poor pseudo elasticity behaviour than the other aged sample. The sample aged at 460 °C has shown remarkable superelastic properties. The mentioned sample’s higher plateau is 580 MPa with the lowest residual strain (0.17%) while other samples have possessed higher residual strains. X-ray diffraction was used to investigate the produced phases.

Keywords: Heat treatment, phase transformation, superelasticity, NiTi alloy.

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Authors: Manar AlJazzazi, Mohammed Rawashdeh, Tariq Alshawaheen, Aktham Malkawi

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This paper is a part of research, in which the way the biomedical engineers follow in their work is analyzed. The goal of this paper is to present a method for specification of user requirements in the medical devices maintenance process. Data Gathering Methods, Research Model Phases and Descriptive Analysis is presented. These technology and verification rules can be implemented in Medical devices maintenance management process to the maintenance process.

Keywords: Quality Function Deployment (QFD), User - requirements approach.

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Authors: Dinh-Ha Tran, Chung-Ruey Yen, Yu-Kuang H. Chen

Abstract:

A collection of thirty cultivars/clones of a red pitaya was used to investigate flowering response to lighting supplementation in the winter season of 2013-2014 in southern Taiwan. The night-breaking treatment was conducted during the period of 10 Oct. 2013 to 5 Mar. 2014 with 4-continuous hours (22.00 – 02.00 hrs) of additional lighting daily using incandescent bulbs (100W). Among cultivars and clones tested, twenty-three genotypes, most belonging to the red-magenta flesh type, were found to have positively flowering response to the lighting treatment. The duration of night-breaking treatment for successful flowering initiation varied from 33- 48 days. The lighting-sensitive genotypes bore 1-2 flowering flushes. Floral and fruiting stages took 21-26 and 46-59 days, respectively. Among sixteen fruiting genotypes, the highest fruit set rates were found in Damao 9, D4, D13, Chaozou large, Chaozhou 5, Small Nick and F22. Five cultivars and clones (Orejona, D4, Chaozhou large, Chaozhou 5 and Small Nick) produced fruits with an average weight of more than 300 g per fruit which were higher than those of the fruits formed in the summer of 2013. Fruits produced during off-season containing total soluble solids (TSS) from 17.5 to 20.7oBrix, which were higher than those produced inseason.

Keywords: Flowering response, long-day plant, night-breaking treatment, off-season production, pitaya.

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Authors: HaeNa Lee, Sun K. Yoo

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Volume rendering is widely used in medical CT image visualization. Applying 3D image visualization to diagnosis application can require accurate volume rendering with high resolution. Interpolation is important in medical image processing applications such as image compression or volume resampling. However, it can distort the original image data because of edge blurring or blocking effects when image enhancement procedures were applied. In this paper, we proposed adaptive tension control method exploiting gradient information to achieve high resolution medical image enhancement in volume visualization, where restored images are similar to original images as much as possible. The experimental results show that the proposed method can improve image quality associated with the adaptive tension control efficacy.

Keywords: Tension control, Interpolation, Ray-casting, Medical imaging analysis.

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Authors: M. Vesali Naseh, A. A. Khodadadi, Y. Mortazavi, O. Alizadeh Sahraei, F. Pourfayaz, S. Mosadegh Sedghi

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In this study, multiwall carbon nanotubes (MWNTs) were modified with nitric acid chemically and by dielectric barrier discharge (DBD) plasma in an oxygen-based atmosphere. Used carbon nanotubes (CNTs) were prepared by chemical vapour deposition (CVD) floating catalyst method. For removing amorphous carbon and metal catalyst, MWNTs were exposed to dry air and washed with hydrochloric acid. Heating purified CNTs under helium atmosphere caused elimination of acidic functional groups. Fourier transformed infrared spectroscopy (FTIR) shows formation of oxygen containing groups such as C=O and COOH. Brunauer, Emmett, Teller (BET) analysis revealed that functionalization causes generation of defects on the sidewalls and opening of the ends of CNTs. Results of temperature-programmed desorption (TPD) and gas chromatography(GC) indicate that nitric acid treatment create more acidic groups than plasma treatment.

Keywords: Carbon nanotubes (CNTs), chemical treatment, functionalization, plasma.

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Authors: Freeman Ntuli

Abstract:

An overview of the important aspects of managing and controlling industrial effluent discharges to public sewers namely sampling, characterization, quantification and legislative controls has been presented. The findings have been validated by means of a case study covering three industrial sectors namely, tanning, textile finishing and food processing industries. Industrial effluents discharges were found to be best monitored by systematic and automatic sampling and quantified using water meter readings corrected for evaporative and consumptive losses. Based on the treatment processes employed in the public owned treatment works and the chemical oxygen demand and biochemical oxygen demand levels obtained, the effluent from all the three industrial sectors studied were found to lie in the toxic zone. Thus, physico-chemical treatment of these effluents is required to bring them into the biodegradable zone. KL values (quoted to base e) were greater than 0.50 day-1 compared to 0.39 day-1 for typical municipality wastewater.

Keywords: biodegradability, industrial effluent, pollution control, public sewers

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Authors: Albana Hasimi, Edlira Tako, Partizan Malkaj, Elvin Çomo, Blerina Papajani, Mirela Ndrita, Ledjan Malaj

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Many endeavors have been exerted during the last years for developing new artificial polymeric membranes, which fulfill the demanded conditions for biomedical uses. One of the most tested polymers is Poly(vinyl alcohol) [PVA]. Our teams are based on the possibility of using PVA for personal protective equipment against COVID-19. In personal protective equipment, we explore the possibility of modifying the properties of the polymer by adding Montmorillonite [MMT]. Heat-treatment above the glass transition temperature is used to improve mechanical properties mainly by increasing the crystallinity of the polymer, which acts as a physical network. Temperature-Modulated Differential Scanning Calorimetry (TMDSC) measurements indicated that the presence of 0.5% MMT in PVA causes a higher Tg value and shaped peak of crystallinity. Decomposition is observed at two of the melting points of the crystals during heating 25-240 oC and overlap of the recrystallization ridges during cooling 240-25 oC. This is indicative of the presence of two types (quality or structure) of polymer crystals. On the other hand, some indication of improvement of the quality of the crystals by heat-treatment is given by the distinct non-reversing contribution to melting. Data on sorption and transport of water in PVA films: PVA pure and PVA/MMT matrix, modified by thermal treatment are presented. The membranes become more rigid as a result of the heat treatment and because of this the water uptake is significantly lower in membranes. That is indicated by analysis of the resulting water uptake kinetics. The presence of 0.5% w/w of MMT has no significant impact on the properties of PVA membranes. Water uptake kinetics deviate from Fick’s law due to slow relaxation of glassy polymer matrix for all types of membranes.

Keywords: Crystallinity, montmorillonite, nanocomposite, poly(vinyl alcohol).

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Authors: B. Bergström, A. Ladd, A. Jones, L. Rosso, P. Michael

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Attitudes toward treatment manuals serve as a meaningful predictor of general attitudes toward evidence-based practice. Despite demonstrating high effectiveness in treating many mental disorders, manualized treatments have been underutilized by practitioners. Thus, one can assess the state of the field regarding the adoption of evidence-based practices by surveying practitioner attitudes towards manualized treatments. This study is an adapted replication that assesses psychology graduate student attitudes towards manualized treatments, as a general marker for attitudes towards evidence-based practice. Training programs provide future clinicians with the foundation for critical skills in clinical practice. Research demonstrates that post-graduate continuing education has little to no effect on clinical practice; thus, graduate programs serve as the primary, and often final platform for all future practice. However, there are little empirical data identifying the attitudes and training of graduate students in utilizing manualized treatments. The empirical analysis of this study indicates an increase in positive attitudes among graduate student attitudes towards manualized treatments (within the United States), when compared to past surveys of professional psychologists. Findings from this study may inform graduate programs of barriers for students in developing positive attitudes toward manualized treatments and evidence-based practice. This study also serves as a preliminary predictor of the state-of-the field, in regards to professional psychologists attitudes towards evidence-based practice, if attitudes remain stable. This study indicates that the attitudes toward utilizing evidence-based practices, such as treatment manuals, has become more positive since year 2000.

Keywords: Evidence based treatment, Future of clinical science, Manualized treatment, Student attitudes towards evidence based treatments.

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Authors: R. J. Kuo, W. C. Cheng, W. C. Lien, T. J. Yang

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Taiwan is a hyper endemic area for the Hepatitis B virus (HBV). The estimated total number of HBsAg carriers in the general population who are more than 20 years old is more than 3 million. Therefore, a case record review is conducted from January 2003 to June 2007 for all patients with a diagnosis of acute hepatitis who were admitted to the Emergency Department (ED) of a well-known teaching hospital. The cost for the use of medical resources is defined as the total medical fee. In this study, principal component analysis (PCA) is firstly employed to reduce the number of dimensions. Support vector regression (SVR) and artificial neural network (ANN) are then used to develop the forecasting model. A total of 117 patients meet the inclusion criteria. 61% patients involved in this study are hepatitis B related. The computational result shows that the proposed PCA-SVR model has superior performance than other compared algorithms. In conclusion, the Child-Pugh score and echogram can both be used to predict the cost of medical resources for patients with acute hepatitis in the ED.

Keywords: Acute hepatitis, Medical resource cost, Artificial neural network, Support vector regression.

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Authors: Y. Cifuentes, L. Beltrán, L. Ramírez

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The availability to deploy mobile applications for health care is increasing daily thru different mobile app stores. But within these capabilities the number of hacking attacks has also increased, in particular into medical mobile applications. The security vulnerabilities in medical mobile apps can be triggered by errors in code, incorrect logic, poor design, among other parameters. This is usually used by malicious attackers to steal or modify the users’ information. The aim of this research is to analyze the vulnerabilities detected in mobile medical apps according to risk factor standards defined by OWASP in 2014.

Keywords: mHealth apps, OWASP, protocols, security vulnerabilities, risk factors.

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Authors: V. Durmus, M. Uydaci

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In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: Malpractice mediation, medical disputes, reconciliation, health litigation, Turkish Health Law.

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Authors: Aline Alves Bandeira, Maria Cecília de Paula Silva

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The existing legal gap regarding thes treatment and final disposal of industrial effluents in Brazil promotes legal uncertainty. The government has not structured itself to guarantee environmental protection. The current legal system and public policies must guarantee the protection of bodies of water and an effective treatment of industrial effluents. This is because economic progress, eco-efficiency and industrial ecology are inseparable. The lack of protection for the water bodies weakens environmental protection, with abuses by companies that do not give due treatment to their effluents, or fail to present the water balance of their factories. It is considered necessary to enact a specific law on industrial effluents related to a National Industrial Effluent Policy, because it is the location of the largest Integrated Industrial Complex in the Southern Hemisphere. The regulation of this subject cannot be limited by decrees of the local Executive Branch, allowing the inspection of the industrial activity or enterprise to be affected fundamentally by environmental self-control, or by private institutions.

Keywords: Effluent policy, environmental law, environmental management, industrial effluents.

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Authors: Anika Zafiah M. Rus, S. Shafizah

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This study was developed to compare the behavior and the ability of polymer foam composites towards sound absorption test of Shorea leprosula wood (SL) of acid hydrolysis treatment with particle size <355μm. Three different weight ratio of polyol to wood particle has been selected which are 10wt%, 15wt% and 20wt%. The acid hydrolysis treatment is to optimize the surface interaction of wood particle with polymer foam matrix. In addition, the acoustic characteristic of sound absorption coefficient (α) was determined. Further treatment is to expose the polymer composite in UV irradiation by using UV-Weatherometer. Polymer foam composite of untreated Shorea leprosula particle (SL-B) with respective percentage loading shows uniform pore structure as compared with treated wood particle (SL-A). As the filler percentage loading in polymer foam increases, the α value approaching 1 for both samples. Furthermore, SL-A shows better α value at 3500-4500 frequency absorption level (Hz), meanwhile α value for SL-B is maximum at 4000-5000 Hz. The frequencies absorption level for both SL-B and SL-A after UV exposure was increased with the increasing of exposure time from 0-1000 hours. It is therefore, concluded that the α for each sound absorbing material, with or without acid hydrolysis treatment of wood particles and it’s percentages loading in polymer matrix effect the sound absorption behavior.

Keywords: Polymer foam composite, sound absorption coefficient, UV-irradiation, wood.

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Authors: Vasudha Bansal, M. L. Singla, C. Ghanshyam

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The effect of nonthermal pulsed electric field (PEF) and thermal treatment (90⁰C for 60s) was studied on quality parameters of emblica officinalis juice for the period of 6 weeks at 4⁰C using monopolar rectangular pulse of 1µs width. The PEF treatment was given using static chamber at 24kV/cm for 500µs. The quality of emblica officinalis juice was investigated in terms of non enzymatic browning index (NEBI), 5-hydroxymethyl-2-furfural (HMF), total polyphenol content and antioxidant capacity. ⁰Brix, pH and conductivity were evaluated as physical parameters. The aim of the work was to investigate the effect of PEF on the retention of bioactive compounds and retardation of browning activity. The results showed that conventional thermal treatment had led to a significant (p < 0.05) decrease of 48.15% in polyphenol content (129.56 mg of GAE L^-1), with higher NEBI and HMF formation (p < 0.05) whilst PEF suppressed NEBI and retained higher polyphenol compounds (168.59 mg GAE L^-1) with limiting the loss to 32.56% along maximum free radical scavenging activity (92.07%). However, pH, ⁰brix and electrical conductivity of treated juice samples remain unaffected. Therefore, PEF can be considered as an effective nonthermal treatment for retaining bioactive compounds along suppressing browning of emblica juice.

 

Keywords: Emblica officinalis juice, Free radical scavenging activity, Pulsed electric field, Total polyphenol content.

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Authors: Amal E. Shehata, Manal E. Fareed

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Osteoarthritis (OA) is the most prevalent and far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint. Patients suffering from osteoarthritis often complain of dull ache pain on movement. Physical agents can fight the painful process when correctly indicated and used such as heat or cold therapy Aim. This study was carried out to: Compare the effect of cold, warm and contrast therapy on controlling knee osteoarthritis associated problems. Setting: The study was carried out in orthopedic outpatient clinics of Menoufia University and teaching Hospitals, Egypt. Sample: A convenient sample of 60 adult patients with unilateral knee osteoarthritis. Tools: three tools were utilized to collect the data. Tool I : An interviewing questionnaire. It comprised of three parts covering  sociodemographic data, medical data and adverse effects of the treatment protocol. Tool II : Knee Injury and Osteoarthritis Outcome Score (KOOS) It consists of five main parts. Tool II1 : 0-10 Numeric pain rating scale. Results: reveled that the total knee symptoms score was decreased from moderate symptoms pre intervention to mild symptoms after warm and contrast method of therapy, but the contrast therapy had significant effect in reducing the knee symptoms and pain than the other symptoms. Conclusions: all of the three methods of therapy resulted in improvement in all knee symptoms and pain but the most appropriate protocol of treatment to relive symptoms and pain was contrast therapy.

Keywords: Knee Osteoarthritis, Cold, Warm and Contrast Therapy.

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Authors: Alfrina Marwan, Erna Sulistyawati

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Class III malocclusion shows both skeletal and dentoalveolar component. Sketal Class III malocclusion can have variants in different region, maxilla or mandibular. Skeletal Class III malocclusion during growth period is considered to treat to prevent its severity in adulthood. Orthopedics treatment of skeletal Class III malocclusion in growing patient can be treated by using reverse twin block with expansion screw to modify the growth pattern. The objective of this case report was to describe the functional correction of skeletal Class III maloclussion using reverse twin block with expansion screw in growing patient. A patient with concave profile came with a chief complaint of aesthetic problems. The cephalometric analysis showed that patient had skeletal Class III malocclusion (ANB -5⁰, SNA 75º, Wits appraisal -3 mm) with anterior cross bite and deep bite (overjet -3 mm, overbite 6 mm). In this case report, the patient was treated with reverse twin block appliance with expansion screw. After three months of treatment, the skeletal problems have been corrected (ANB -1°), overjet, overbite and aesthetic were improved. Reverse twin block appliance with expansion screw can be used as orthopedics treatment for skeletal Class III malocclusion in growing patient and can improve the aesthetic with great satisfaction which was the main complaint in this patient.

Keywords: Growing patient, maxilla retrognatism, reverse twin blocks, skeletal Class III malocclusion.

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Authors: Nurul' Ain Ab Jalil, Hassan Basri

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This paper reviews the objectives, methods and results of previous studies on biodrying of solid waste in several countries. Biodrying of solid waste is a novel technology in developing countries such as in Malaysia where high moisture content in organic waste makes the segregation process for recycling purposes complicated and diminishes the calorific value for the use of fuel source. In addition, the high moisture content also encourages the breeding of vectors and disease-bearing animals. From the laboratory results, the average moisture content of organic waste, paper, plastics and metals are 58.17%, 37.93%, 29.79% and 1.03% respectively for UKM campus. Biodrying of solid waste is a simple method of waste treatment as well as a cost-efficient technology to dry the solid waste. The process depends on temperature monitoring and air flow control along with the natural biodegradable process of organic waste. This review shows that the biodrying of solid waste method has high potential in treatment and recycling of solid waste, be useful for biodrying study and implementation in Malaysia.

Keywords: Biodrying of solid waste, Organic waste, Fuel source.

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Authors: Shirin Shafaei, James R. Bolton, Mohamed Gamal El Din

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Ultraviolet (UV) disinfection causes damage to the DNA or RNA of microorganisms, but many microorganisms can repair this damage after exposure to near-UV or visible wavelengths (310–480 nm) by a mechanism called photoreactivation. Photoreactivation is gaining more attention because it can reduce the efficiency of UV disinfection of wastewater several hours after treatment. The focus of many photoreactivation research activities on the single species has caused a considerable lack in knowledge about complex natural communities of microorganisms and their response to UV treatment. In this research, photoreactivation experiments were carried out on the influent of the UV disinfection unit at a municipal wastewater treatment plant (WWTP) in Edmonton, Alberta after exposure to a Medium-Pressure (MP) UV lamp system to evaluate the effect of environmental factors on photoreactivation of microorganisms in the actual municipal wastewater. The effect of reactivation fluence, temperature, and river water on photoreactivation of total coliforms was examined under indoor conditions. The results showed that higher effective reactivation fluence values (up to 20 J/cm²) and higher temperatures (up to 25 °C) increased the photoreactivation of total coliforms. However, increasing the percentage of river in the mixtures of the effluent and river water decreased the photoreactivation of the mixtures. The results of this research can help the municipal wastewater treatment industry to examine the environmental effects of discharging their effluents into receiving waters.

Keywords: Photoreactivation, reactivation fluence, river water, temperature, ultraviolet disinfection, wastewater effluent.

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Authors: M. Sadeghi, A.H. Jafari, S.M.P. Firoozabadi

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Deep Brain Stimulation or DBS is a surgical treatment for Parkinson-s Disease with three stimulation parameters: frequency, pulse width, and voltage. The parameters should be selected appropriately to achieve effective treatment. This selection now, performs clinically. The aim of this research is to study chaotic behavior of recorded tremor of patients under DBS in order to present a computational method to recognize stimulation optimum voltage. We obtained some chaotic features of tremor signal, and discovered embedding space of it has an attractor, and its largest Lyapunov exponent is positive, which show tremor signal has chaotic behavior, also we found out, in optimal voltage, entropy and embedding space variance of tremor signal have minimum values in comparison with other voltages. These differences can help neurologists recognize optimal voltage numerically, which leads to reduce patients' role and discomfort in optimizing stimulation parameters and to do treatment with high accuracy.

Keywords: Chaos, Deep Brain Stimulation, Parkinson's Disease, Stimulation Parameters, tremor.

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Authors: A. Talapatra, N. R. Bandhyopadhyay, J. Datta

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In the present study, two TRIP-assisted steels were designated as A (having no Cr and Cu content) and B (having higher Ni, Cr and Cu content) heat treated under different conditions, and the correlation between its heat treatment, microstructure and properties were investigated. Micro structural examination was carried out by optical microscope and scanning electron microscope after electrolytic etching. Non-destructive electrochemical and ultrasonic testing on two TRIP-assisted steels was used to find out corrosion and mechanical properties of different alter microstructure phase’s steels. Furthermore, micro structural studies accompanied by the evaluation of mechanical properties revealed that steels having martensite phases with higher corrosive and hardness value were less sound velocity and also steel’s microstructure having finer grains that was more grain boundary was less corrosion resistance. Steel containing more Cu, Ni and Cr was less corrosive compared to other steels having same processing or microstructure.

Keywords: TRIP-assisted steels, heat treatment, corrosion, electrochemical techniques, micro-structural characterization, non-destructive (ultrasonic) technique.

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support operational decisions in Emergency Medical Service (EMS) systems regarding the assignment of medical emergency requests to Emergency Departments (ED). This problem is called “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of a first phase of review of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a mission. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the travelling time and to free-up the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs also considering the expected time performance in the subsequent phases of the process, such as the case mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to compare different hospital selection policies. The model was implemented with the AnyLogic software and finally validated on a realistic case. The hospital selection policy that returned the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, based on a retrospective estimation of the TTP, and a dynamic approach, focused on a predictive estimation of the TTP which is determined with a constantly updated Winters forecasting model. Findings reveal that considering the minimization of TTP is the best hospital selection policy. It allows to significantly reducing service throughput times in the ED with a negligible increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms on TTP estimation, than a retrospective approach. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: Emergency medical services, hospital selection, discrete event simulation, forecast model.

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Authors: Deepak Mohan, Sushma Sharma

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Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are a group of widely used drugs for the treatment of rheumatoid diseases and to relieve pain and inflammation due to their analgesic anti-pyretic and anti-inflammatory properties. The therapeutic and many of the toxic effects of NSAIDs result from reversible inhibition of enzymes in the cyclooxygenase (COX) group. In the present investigation the effect of the drug on the concentration of lipids, and on the activity of the enzymes i.e. acid and alkaline phosphatase, GOT, GPT and lipid peroxidase were studied. There was a significant enhancement in the activities of both acid and alkaline phosphatase after 21 days of treatment. Proportionate increase in the MDA contents was observed after different days of diclofenac treatment. Cellular damage in the liver resulted in decrease in the activity of both GOT (Glutamate oxaloacetate transaminase) and GPT (Glutamate pyruvate transaminase) in both low and high dose groups. Significant decrease in the liver contents was also observed in both dose groups.

Keywords: Anti-inflammatory, cyclooxygenase, glutamate oxaloacetate transaminase, malondialdehyde.

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Authors: Mohammad Aziz Shah Mohamed Arip, Aslina Ahmad, Fauziah Mohd Sa'ad, Samsiah Mohd Jais, Syed Sofian Syed Salim

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This experimental study evaluates the effect of using Cognitive-Behavioral Therapy (CBT) and Multidimensional Self- Concept Model (MSCM) in a drug prevention programme to increase resiliency and reduce aggression among at-risk youth in Malaysia. A number of 60 (N=60) university students who were at-risk of taking drugs were involved in this study. Participants were identified with self-rating scales, Adolescent Resilience Attitude Scale (ARAS) and Aggression Questionnaire. Based on the mean score of these instruments, the participants were divided into the treatment group, and the control group. Data were analyzed using t-test. The finding showed that the mean score of resiliency was increased in the treatment group compared to the control group. It also shows that the mean score of aggression was reduced in the treatment group compared to the control group. Drug Prevention Programme was found to help in enhancing resiliency and reducing aggression among participants in the treatment group compared to the controlled group. Implications were given regarding the preventive actions on drug abuse among youth in Malaysia.

Keywords: Drug Prevention Programme, Cognitive-Behavioral Therapy (CBT), Multidimensional Self Concept Model (MSCM), resiliency, aggression, at-risk youth.

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Authors: Mohd Yussni Hashim, Mohd Nazrul Roslan, Azriszul Mohd Amin, Ahmad Mujahid Ahmad Zaidi, Saparudin Ariffin

Abstract:

Environmental awareness and depletion of the petroleum resources are among vital factors that motivate a number of researchers to explore the potential of reusing natural fiber as an alternative composite material in industries such as packaging, automotive and building constructions. Natural fibers are available in abundance, low cost, lightweight polymer composite and most importance its biodegradability features, which often called “ecofriendly" materials. However, their applications are still limited due to several factors like moisture absorption, poor wettability and large scattering in mechanical properties. Among the main challenges on natural fibers reinforced matrices composite is their inclination to entangle and form fibers agglomerates during processing due to fiber-fiber interaction. This tends to prevent better dispersion of the fibers into the matrix, resulting in poor interfacial adhesion between the hydrophobic matrix and the hydrophilic reinforced natural fiber. Therefore, to overcome this challenge, fiber treatment process is one common alternative that can be use to modify the fiber surface topology by chemically, physically or mechanically technique. Nevertheless, this paper attempt to focus on the effect of mercerization treatment on mechanical properties enhancement of natural fiber reinforced composite or so-called bio composite. It specifically discussed on mercerization parameters, and natural fiber reinforced composite mechanical properties enhancement.

Keywords: Mercerization treatment, mechanical properties, natural fiber and bio composite

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Authors: Claude Takenga, Rolf-Dietrich Berndt, Erling Si, Markus Diem, Guohui Qiao, Melanie Gau, Michael Brandstoetter, Martin Kampel, Michael Dworzak

Abstract:

In patients with acute lymphoblastic leukaemia (ALL), treatment response is increasingly evaluated with minimal residual disease (MRD) analyses. Flow Cytometry (FCM) is a fast and sensitive method to detect MRD. However, the interpretation of these multi-parametric data requires intensive operator training and experience. This paper presents a pipeline-software, as a ready-to-use FCM-based MRD-assessment tool for the daily clinical practice for patients with ALL. The new tool increases accuracy in assessment of FCM-MRD in samples which are difficult to analyse by conventional operator-based gating since computer-aided analysis potentially has a superior resolution due to utilization of the whole multi-parametric FCM-data space at once instead of step-wise, two-dimensional plot-based visualization. The system developed as a telemedical network reduces the work-load and lab-costs, staff-time needed for training, continuous quality control, operator-based data interpretation. It allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise for the benefit of an even larger community of diseased children worldwide. We established a telemedical network system for analysis and clinical follow-up and treatment monitoring of Leukaemia. The system is scalable and adapted to link several centres and laboratories worldwide.

Keywords: Data security, flow cytometry, leukaemia, telematics platform, telemedicine.

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Authors: M. Z. Othman

Abstract:

The aim of this study was to investigate the effectiveness of anaerobic digestion for the treatment of wool scouring wastes. The experiments design comprised three ratios of waste (W) to seed(S) (W:S) of 25:75, 50:50 and 75:25, corresponding to 1.9. 1.7 and 1.5g tCOD/g TS, respectively, with or without chemicals addition. NH4Cl was added to the reactors as a source for nitrogen to achieve C:N:P of 420:14:3. A cationic flocculent was added at 0.5 and 0.75% to enhance flocculation of sludge. The results showed that the reactors that received W:S at a ratio of 25:75 produced the largest volume of biogas. The final soluble COD (sCOD) was below the limits for discharge to the sewer system.

Keywords: Anaerobic digestion, wool processing waste, organicloading, biogas.

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Authors: Panos Kotsas

Abstract:

This paper presents the application of a signal intensity independent registration criterion for non-rigid body registration of medical images. The criterion is defined as the weighted ratio image of two images. The ratio is computed on a voxel per voxel basis and weighting is performed by setting the ratios between signal and background voxels to a standard high value. The mean squared value of the weighted ratio is computed over the union of the signal areas of the two images and it is minimized using the Chebyshev polynomial approximation. The geometric transformation model adopted is a local cubic B-splines based model.

Keywords: Medical image, non-rigid, registration.

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Authors: Chan-Jung Liang, Shu-Huei Wang, Pei-Jhen Wu, Jaw-Shiun Tsai, Chau-Chung Wu, Yuh-Lien Chen

Abstract:

Heme oxygenase-1 (HO-1), an enzyme degrading heme to carbon monoxide, iron, and biliverdin, has been recognized as playing a crucial role in cellular defense against stressful conditions, not only related to heme release. In the present study, the effects of TNF-a on the expression of heme oxygenase-1 (HO-1) in human aortic endothelial cells (HAECs) as well as the related mechanisms were investigated. 10 ng/mL TNF-α treatment significantly increased HO-1 expression after 6h, then a further increase at 12h and declined at 24h. Treatment with 2 ng/mL of TNF-a after 12 h resulted in a significant increase in HO-1 expression, which peaked at 10 ng/mL, then declined at 20 ng/mL. TNF-α induced HO-1 expression and then HO-1 expression reduced  vascular cell adhesion molecule-1 (VCAM-1) expression. Phosphorylation studies of ERK1/2, JNK, and p38, three subgroups of mitogen-activated protein kinases (MAPKs) demonstrated TNF-α-induced ERK1/2, JNK, and p38 phosphorylation. The increase in HO-1 expression in response to TNF-α treatment was affected by pretreatment with SP600125 (a JNK inhibitor) and SB203580 (a p38 inhibitor), not with PD98059 (an ERK1/2 inhibitor). The expression of HO-1 was stronger in aortas of TNF-α-treated apo-E deficient mice when compared with control mice. These results suggest that low dose of TNF-α treatment notably induced HO-1 expression was mediated through JNK/p38 phosphorylation and may have a protective potential in cardiovascular diseases and inflammatory response through the regulation of HO-1 expression.

Keywords: Heme oxygenase-1 inflammation, endothelial cells, mitogen-activated protein kinases (MAPKs).

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