Search results for: clinical presentation.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 544

Search results for: clinical presentation.

244 Antidiabetic and Antioxidative Activities of Butyrolactone I from Aspergillus terreus MC751

Authors: Rizna Triana Dewi, Sanro Tachibana, Ahmad Darmawan

Abstract:

The bioassay-guided isolation and purification of an ethyl acetate extract of Aspergillus terreus MC751 led to the characterization of butyrolactone I as an antidiabetic and antioxidant. The antidiabetic activity of butyrolactone I was evaluated by α- glucosidase and α-amylase inhibition assays. Butyrolactone I demonstrated significant concentration-dependent, mixed-type inhibitory activity against yeast α-glucosidase with an IC50 of 54μM. However, the compound exhibited less activity against rat intestinal α-glucosidase and α-amylase. This is the first report on α-glucosidase inhibitory activity of butyrolactone I. The antioxidative activity of butyrolactone I was evaluated based on scavenging effects on 1,1- diphenyl-2-picrylhydrazyl (DPPH) (IC50 =51 μM) and hydrogen peroxide (IC50= 141 μM) radicals as well as a reducing power assay. The results suggest that butyrolactone I is a promising antidiabetic as well as antioxidant and should be considered for clinical trials.

Keywords: Aspergillus terreus MC751, antidiabetic, antioxidant, Butyrolactone I.

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243 Analytics Model in a Telehealth Center Based on Cloud Computing and Local Storage

Authors: L. Ramirez, E. Guillén, J. Sánchez

Abstract:

Some of the main goals about telecare such as monitoring, treatment, telediagnostic are deployed with the integration of applications with specific appliances. In order to achieve a coherent model to integrate software, hardware, and healthcare systems, different telehealth models with Internet of Things (IoT), cloud computing, artificial intelligence, etc. have been implemented, and their advantages are still under analysis. In this paper, we propose an integrated model based on IoT architecture and cloud computing telehealth center. Analytics module is presented as a solution to control an ideal diagnostic about some diseases. Specific features are then compared with the recently deployed conventional models in telemedicine. The main advantage of this model is the availability of controlling the security and privacy about patient information and the optimization on processing and acquiring clinical parameters according to technical characteristics.

Keywords: Analytics, telemedicine, internet of things, cloud computing.

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242 A Novel Compression Algorithm for Electrocardiogram Signals based on Wavelet Transform and SPIHT

Authors: Sana Ktata, Kaïs Ouni, Noureddine Ellouze

Abstract:

Electrocardiogram (ECG) data compression algorithm is needed that will reduce the amount of data to be transmitted, stored and analyzed, but without losing the clinical information content. A wavelet ECG data codec based on the Set Partitioning In Hierarchical Trees (SPIHT) compression algorithm is proposed in this paper. The SPIHT algorithm has achieved notable success in still image coding. We modified the algorithm for the one-dimensional (1-D) case and applied it to compression of ECG data. By this compression method, small percent root mean square difference (PRD) and high compression ratio with low implementation complexity are achieved. Experiments on selected records from the MIT-BIH arrhythmia database revealed that the proposed codec is significantly more efficient in compression and in computation than previously proposed ECG compression schemes. Compression ratios of up to 48:1 for ECG signals lead to acceptable results for visual inspection.

Keywords: Discrete Wavelet Transform, ECG compression, SPIHT.

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241 Indicator of Small Calcification Detection in Ultrasonography using Decorrelation of Forward Scattered Waves

Authors: Hirofumi Taki, Takuya Sakamoto, Makoto Yamakawa, Tsuyoshi Shiina, Toru Sato

Abstract:

For the improvement of the ability in detecting small calcifications using Ultrasonography (US) we propose a novel indicator of calcifications in an ultrasound B-mode image without decrease in frame rate. Since the waveform of an ultrasound pulse changes at a calcification position, the decorrelation of adjacent scan lines occurs behind a calcification. Therefore, we employ the decorrelation of adjacent scan lines as an indicator of a calcification. The proposed indicator depicted wires 0.05 mm in diameter at 2 cm depth with a sensitivity of 86.7% and a specificity of 100%, which were hardly detected in ultrasound B-mode images. This study shows the potential of the proposed indicator to approximate the detectable calcification size using an US device to that of an X-ray imager, implying the possibility that an US device will become a convenient, safe, and principal clinical tool for the screening of breast cancer.

Keywords: Ultrasonography, Calcification, Decorrelation, Forward scattered wave

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240 The Impact of COVID-19 Pandemic on Acute Urology Admissions in a Busy District General Hospital in the UK

Authors: D. Bheenick, M. Young, M. Elmussareh, A. Ali

Abstract:

Coronavirus disease 2019 (COVID-19) has had unprecedented effects on the healthcare system in the UK. The pandemic has impacted every service within secondary care, including urology. Our objective is to determine how COVID-19 has influenced acute urology admissions in a busy district general hospital in the UK. To conduct the study, retrospective data of patients presenting acutely to the urology department were collected between January 13 to March 22, 2020 (pre-lockdown period) and March 23 to May 31, 2020 (lockdown period). The nature of referrals, types of admission encountered, and management required in accordance with the new set of protocols established during the lockdown period were analysed and compared to the same data prior to UK lockdown. Included in the study were 1092 patients. The results show that an overall reduction of 32.5% was seen in the total number of admissions. A marked decrease was seen in non-urological pathology as compared to other categories. Urolithiasis showed the highest proportional increase. Treatment varied proportionately to the diagnosis, with conservative management accounting for the most likely treatment during lockdown. However, the proportion of patients requiring interventions during the lockdown period increased overall. No comparative differences were observed during the two periods in terms of source of referral, length of stay and patient age. The results of the study concluded that the admission rate showed a decrease, with no significant difference in the nature and timing of presentation. Our department was able to continue providing effective management to patients presenting acutely during the COVID-19 outbreak.

Keywords: COVID-19, lockdown, admissions, urology

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239 Polymerisation Shrinkage of Light−Cured Hydroxyapatite (HA)−Reinforced Dental Composites

Authors: Bilge S. Oduncu, Sevil Yucel, Ismail Aydin, Isil D. Sener, Gokhan Yamaner

Abstract:

The dental composites are preferably used as filling materials due to their esthetic appearances. Nevertheless one of the major problems, during the application of the dental composites, is shape change named as “polymerisation shrinkage" affecting clinical success of the dental restoration while photo-polymerisation. Polymerisation shrinkage of composites arises basically from the formation of a polymer due to the monomer transformation which composes of an organic matrix phase. It was sought, throughout this study, to detect and evaluate the structural polymerisation shrinkage of prepared dental composites in order to optimize the effects of various fillers included in hydroxyapatite (HA)-reinforced dental composites and hence to find a means to modify the properties of these dental composites prepared with defined parameters. As a result, the shrinkage values of the experimental dental composites were decreased by increasing the filler content of composites and the composition of different fillers used had effect on the shrinkage of the prepared composite systems.

Keywords: Dental composites, hydroxyapatite (HA), BisGMA, shrinkage.

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238 Comparative Study of Filter Characteristics as Statistical Vocal Correlates of Clinical Psychiatric State in Human

Authors: Thaweesak Yingthawornsuk, Chusak Thanawattano

Abstract:

Acoustical properties of speech have been shown to be related to mental states of speaker with symptoms: depression and remission. This paper describes way to address the issue of distinguishing depressed patients from remitted subjects based on measureable acoustics change of their spoken sound. The vocal-tract related frequency characteristics of speech samples from female remitted and depressed patients were analyzed via speech processing techniques and consequently, evaluated statistically by cross-validation with Support Vector Machine. Our results comparatively show the classifier's performance with effectively correct separation of 93% determined from testing with the subjectbased feature model and 88% from the frame-based model based on the same speech samples collected from hospital visiting interview sessions between patients and psychiatrists.

Keywords: Depression, SVM, Vocal Extract, Vocal Tract

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237 Bayesian Network Based Intelligent Pediatric System

Authors: Jagmohan Mago, Parvinder S. Sandhu, Neeru Chawla

Abstract:

In this paper, a Bayesian Network (BN) based system is presented for providing clinical decision support to healthcare practitioners in rural or remote areas of India for young infants or children up to the age of 5 years. The government is unable to appoint child specialists in rural areas because of inadequate number of available pediatricians. It leads to a high Infant Mortality Rate (IMR). In such a scenario, Intelligent Pediatric System provides a realistic solution. The prototype of an intelligent system has been developed that involves a knowledge component called an Intelligent Pediatric Assistant (IPA); and User Agents (UA) along with their Graphical User Interfaces (GUI). The GUI of UA provides the interface to the healthcare practitioner for submitting sign-symptoms and displaying the expert opinion as suggested by IPA. Depending upon the observations, the IPA decides the diagnosis and the treatment plan. The UA and IPA form client-server architecture for knowledge sharing.

Keywords: Network, Based Intelligent, Pediatric System

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236 Segmentation of Breast Lesions in Ultrasound Images Using Spatial Fuzzy Clustering and Structure Tensors

Authors: Yan Xu, Toshihiro Nishimura

Abstract:

Segmentation in ultrasound images is challenging due to the interference from speckle noise and fuzziness of boundaries. In this paper, a segmentation scheme using fuzzy c-means (FCM) clustering incorporating both intensity and texture information of images is proposed to extract breast lesions in ultrasound images. Firstly, the nonlinear structure tensor, which can facilitate to refine the edges detected by intensity, is used to extract speckle texture. And then, a spatial FCM clustering is applied on the image feature space for segmentation. In the experiments with simulated and clinical ultrasound images, the spatial FCM clustering with both intensity and texture information gets more accurate results than the conventional FCM or spatial FCM without texture information.

Keywords: fuzzy c-means, spatial information, structure tensor, ultrasound image segmentation

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235 Attention Multiple Instance Learning for Cancer Tissue Classification in Digital Histopathology Images

Authors: Afaf Alharbi, Qianni Zhang

Abstract:

The identification of malignant tissue in histopathological slides holds significant importance in both clinical settings and pathology research. This paper presents a methodology aimed at automatically categorizing cancerous tissue through the utilization of a multiple instance learning framework. This framework is specifically developed to acquire knowledge of the Bernoulli distribution of the bag label probability by employing neural networks. Furthermore, we put forward a neural network-based permutation-invariant aggregation operator, equivalent to attention mechanisms, which is applied to the multi-instance learning network. Through empirical evaluation on an openly available colon cancer histopathology dataset, we provide evidence that our approach surpasses various conventional deep learning methods.

Keywords: Attention Multiple Instance Learning, Multiple Instance Learning, transfer learning, histopathological slides, cancer tissue classification.

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234 Experimental Validation of Treatment Planning for Multiple Radiotherapy Fields by EDR2 Film Dosimeter

Authors: Vahid Fayaz , Asieh Tavakol

Abstract:

To investigate the applicability of the EDR-2 film for clinical radiation dosimetry, percentage depth-doses, profiles and distributions in open and dynamically wedged fields were measured using film and compared with data from a Treatment Planning system.The validity of the EDR2 film to measure dose in a plane parallel to the beam was tested by irradiating 10 cm×10 cm and 4 cm×4 cm fields from a Siemens, primus linac with a 6MV beam and a source-to-surface distance of 100 cm. The film was placed Horizontally between solid water phantom blocks and marked with pin holes at a depth of 10 cm from the incident beam surface. The film measurement results, in absolute dose, were compared with ion chamber measurements using a Welhoffer scanning water tank system and Treatment Planning system. Our results indicate a maximum underestimate of calculated dose of 8 % with Treatment Planning system.

Keywords: 6MV Photon , EDR-2 film, Radiotherapy, TreatmentPlanning system

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233 X-Ray Fluorescence Molecular Imaging with Improved Sensitivity for Biomedical Applications

Authors: Guohua Cao, Xu Dong

Abstract:

X-ray Fluorescence Molecular Imaging (XFMI) holds great promise as a low-cost molecular imaging modality for biomedical applications with high chemical sensitivity. However, for in vivo biomedical applications, a key technical bottleneck is the relatively low chemical sensitivity of XFMI, especially at a reasonably low radiation dose. In laboratory x-ray source based XFMI, one of the main factors that limits the chemical sensitivity of XFMI is the scattered x-rays. We will present our latest findings on improving the chemical sensitivity of XFMI using excitation beam spectrum optimization. XFMI imaging experiments on two mouse-sized phantoms were conducted at three different excitation beam spectra. Our results show that the minimum detectable concentration (MDC) of iodine can be readily increased by five times via excitation spectrum optimization. Findings from this investigation could find use for in vivo pre-clinical small-animal XFMI in the future.

Keywords: Molecular imaging, X-ray fluorescence, chemical sensitivity, X-ray scattering.

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232 Oxidantantioxidant Status in Calves Supplemented with Green Tea Extract

Authors: Ibrahim I. Elshahawy

Abstract:

The objective of the present study was to investigate the effect of green tea extract on serum oxidant and antioxidant profile, liver and kidney function. 40 Friesian calves are included in this study and allocated into two groups: Group I (n=20) clinically healthy calves showing no clinical abnormalities, not receiving any treatment and served as control; group II (n=20) received green tea extract (GTE) for 30 days. Non-significant changes in blood urea nitrogen (BUN) were detected between groups, on contrary, serum creatinine and activities of liver enzymes aspartate transaminase (AST) and alanine transaminase (ALT) were significantly different between two groups. There were significant increases in the mean values of serum antioxidative parameters (total antioxidant capacity, catalase, superoxide dismutase, reduced glutathione and glutathione peroxidase) in group II. Whereas, the activity of lipid peroxidase significantly decreased in GTE treated calves when compared to control.

Keywords: Green tea extract, antioxidants, oxidants, calves.

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231 Applying Kinect on the Development of a Customized 3D Mannequin

Authors: Shih-Wen Hsiao, Rong-Qi Chen

Abstract:

In the field of fashion design, 3D Mannequin is a kind of assisting tool which could rapidly realize the design concepts. While the concept of 3D Mannequin is applied to the computer added fashion design, it will connect with the development and the application of design platform and system. Thus, the situation mentioned above revealed a truth that it is very critical to develop a module of 3D Mannequin which would correspond with the necessity of fashion design. This research proposes a concrete plan that developing and constructing a system of 3D Mannequin with Kinect. In the content, ergonomic measurements of objective human features could be attained real-time through the implement with depth camera of Kinect, and then the mesh morphing can be implemented through transformed the locations of the control-points on the model by inputting those ergonomic data to get an exclusive 3D mannequin model. In the proposed methodology, after the scanned points from the Kinect are revised for accuracy and smoothening, a complete human feature would be reconstructed by the ICP algorithm with the method of image processing. Also, the objective human feature could be recognized to analyze and get real measurements. Furthermore, the data of ergonomic measurements could be applied to shape morphing for the division of 3D Mannequin reconstructed by feature curves. Due to a standardized and customer-oriented 3D Mannequin would be generated by the implement of subdivision, the research could be applied to the fashion design or the presentation and display of 3D virtual clothes. In order to examine the practicality of research structure, a system of 3D Mannequin would be constructed with JAVA program in this study. Through the revision of experiments the practicability-contained research result would come out.

Keywords: 3D Mannequin, kinect scanner, interactive closest point, shape morphing, subdivision.

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230 Trabecular Bone Radiograph Characterization Using Fractal, Multifractal Analysis and SVM Classifier

Authors: I. Slim, H. Akkari, A. Ben Abdallah, I. Bhouri, M. Hedi Bedoui

Abstract:

Osteoporosis is a common disease characterized by low bone mass and deterioration of micro-architectural bone tissue, which provokes an increased risk of fracture. This work treats the texture characterization of trabecular bone radiographs. The aim was to analyze according to clinical research a group of 174 subjects: 87 osteoporotic patients (OP) with various bone fracture types and 87 control cases (CC). To characterize osteoporosis, Fractal and MultiFractal (MF) methods were applied to images for features (attributes) extraction. In order to improve the results, a new method of MF spectrum based on the q-stucture function calculation was proposed and a combination of Fractal and MF attributes was used. The Support Vector Machines (SVM) was applied as a classifier to distinguish between OP patients and CC subjects. The features fusion (fractal and MF) allowed a good discrimination between the two groups with an accuracy rate of 96.22%.

Keywords: Fractal, micro-architecture analysis, multifractal, SVM, osteoporosis.

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229 Automation of Heat Exchanger using Neural Network

Authors: Sudhir Agashe, Ashok Ghatol, Sujata Agashe

Abstract:

In this paper the development of a heat exchanger as a pilot plant for educational purpose is discussed and the use of neural network for controlling the process is being presented. The aim of the study is to highlight the need of a specific Pseudo Random Binary Sequence (PRBS) to excite a process under control. As the neural network is a data driven technique, the method for data generation plays an important role. In light of this a careful experimentation procedure for data generation was crucial task. Heat exchange is a complex process, which has a capacity and a time lag as process elements. The proposed system is a typical pipe-in- pipe type heat exchanger. The complexity of the system demands careful selection, proper installation and commissioning. The temperature, flow, and pressure sensors play a vital role in the control performance. The final control element used is a pneumatically operated control valve. While carrying out the experimentation on heat exchanger a welldrafted procedure is followed giving utmost attention towards safety of the system. The results obtained are encouraging and revealing the fact that if the process details are known completely as far as process parameters are concerned and utilities are well stabilized then feedback systems are suitable, whereas neural network control paradigm is useful for the processes with nonlinearity and less knowledge about process. The implementation of NN control reinforces the concepts of process control and NN control paradigm. The result also underlined the importance of excitation signal typically for that process. Data acquisition, processing, and presentation in a typical format are the most important parameters while validating the results.

Keywords: Process identification, neural network, heat exchanger.

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228 Radiobiological Model in Radiotherapy Planning for Prostate Cancer Treatment

Authors: Pradip Deb

Abstract:

Quantitative radiobiological models can be used to assess the optimum clinical outcome from sophisticated therapeutic modalities by calculating tumor control probability (TCP) and normal tissue complication probability (NTCP). In this study two 3D-CRT and an IMRT treatment plans were developed with an initial prescription dose of 60 Gy in 2 Gy/fraction to prostate. Sensitivity of TCP and Complication free tumor control probability (P+) to the different values of α/β ratio was investigated for various prescription doses planned to be delivered in either a fixed number of fractions (I) or in a fixed dose per fraction (II) in each of the three different treatment plans. High dose/fraction and high α/β value result in comparatively smaller P+ and IMRT plans resulted in the highest P+, mainly due to the decrease in NTCP. If α/β is lower than expected, better tumor control can be achieved by increasing dose/fraction but decreasing the number of fractions.

Keywords: Linear Quadratic Model, TCP, NTCP, α/β ratio.

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227 Multiaxial Fatigue Analysis of a High Performance Nickel-Based Superalloy

Authors: P. Selva, B. Lorrain, J. Alexis, A. Seror, A. Longuet, C. Mary, F. Denard

Abstract:

Over the past four decades, the fatigue behavior of nickel-based alloys has been widely studied. However, in recent years, significant advances in the fabrication process leading to grain size reduction have been made in order to improve fatigue properties of aircraft turbine discs. Indeed, a change in particle size affects the initiation mode of fatigue cracks as well as the fatigue life of the material. The present study aims to investigate the fatigue behavior of a newly developed nickel-based superalloy under biaxial-planar loading. Low Cycle Fatigue (LCF) tests are performed at different stress ratios so as to study the influence of the multiaxial stress state on the fatigue life of the material. Full-field displacement and strain measurements as well as crack initiation detection are obtained using Digital Image Correlation (DIC) techniques. The aim of this presentation is first to provide an in-depth description of both the experimental set-up and protocol: the multiaxial testing machine, the specific design of the cruciform specimen and performances of the DIC code are introduced. Second, results for sixteen specimens related to different load ratios are presented. Crack detection, strain amplitude and number of cycles to crack initiation vs. triaxial stress ratio for each loading case are given. Third, from fractographic investigations by scanning electron microscopy it is found that the mechanism of fatigue crack initiation does not depend on the triaxial stress ratio and that most fatigue cracks initiate from subsurface carbides.

Keywords: Cruciform specimen, multiaxial fatigue, Nickelbased superalloy.

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226 Automatic LV Segmentation with K-means Clustering and Graph Searching on Cardiac MRI

Authors: Hae-Yeoun Lee

Abstract:

Quantification of cardiac function is performed by calculating blood volume and ejection fraction in routine clinical practice. However, these works have been performed by manual contouring, which requires computational costs and varies on the observer. In this paper, an automatic left ventricle segmentation algorithm on cardiac magnetic resonance images (MRI) is presented. Using knowledge on cardiac MRI, a K-mean clustering technique is applied to segment blood region on a coil-sensitivity corrected image. Then, a graph searching technique is used to correct segmentation errors from coil distortion and noises. Finally, blood volume and ejection fraction are calculated. Using cardiac MRI from 15 subjects, the presented algorithm is tested and compared with manual contouring by experts to show outstanding performance.

Keywords: Cardiac MRI, Graph searching, Left ventricle segmentation, K-means clustering.

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225 Effect of FES Cycling Training on Spasticity in Spinal Cord Injured Subjects

Authors: Werner Reichenfelser, Harald Hackl, Josef Hufgard, Karin Gstaltner, Margit Gfoehler

Abstract:

Training with Functional Electrical Stimulation (FES) has both physiological and psychological benefits for spinal cord injured subjects. Commonly used methods for quantification of spasticity have shown controversial reliability. In this study we propose a method for quick determination of spasticity in spinal cord injured subjects on a cycling and measurement system. 23 patients did training sessions on an instrumented mobile FES cycle three times a week over two months as part of their clinical rehabilitation program. Spasticity (MAS) and the legs resistance to the pedaling motion were assessed before and after the FES training and measurements were done on the subjects ability to pedal with our without motor assistance. Measurements with test persons with incomplete spastic paraplegia have shown that spasticity is decreased after a 30 min cycling training with functional electrical stimulation (FES).

Keywords: Spasticity, paraplegia, spinal cord injury, functional electrical stimulation.

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224 Microorganisms Isolated from Surgical Wounds Infection and Treatment with Different Natural Products and Medications

Authors: Amany S. Youssef, Suzan A.M. El Feky, Samy A. El-Asser, Rasha A.M. Abd Allah

Abstract:

Surgical site infections (SSIs) are the most common nosocomial infection in surgical patients resulting in significant increases in postoperative morbidity and mortality. The commonly causative bacteria developed resistance to virtually all antibiotics available. The aim of this study was to isolation and identification the most common bacteria that cause SSIs in Medical Research Institute, and to compare their sensitivity to selected group of antibiotics and natural products (garlic, oregano, olive, and Nigella sativa oils). The isolated pathogens collected from infected surgical wounds were identified, and their sensitivities to the antibiotics commonly available for clinical use, and also to the different concentrations of the used natural products were investigated. The results indicate to the potential therapeutic effect of the tested natural products in treatment of surgical wound infections.

Keywords: Surgical wounds, multi-resistant bacteria, bacterial sensitivity, natural oils.

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223 A New blaVIM Gene in a Pseudomonas putida Isolated from ENT Units in Sulaimani Hospitals

Authors: Dalanya Asaad Mohammed, Dara Abdul Razaq

Abstract:

A total of twenty tensile biopsies were collected from children undergoing tonsillectomy from teaching hospital ENT department and Kurdistan private hospital in sulaimani city. All biopsies were homogenized and cultured; the obtained bacterial isolates were purified and identified by biochemical tests and VITEK 2 compact system. Among the twenty studied samples, only one Pseudomonas putida with probability of 99% was isolated. Antimicrobial susceptibility was carried out by disk diffusion method, Pseudomonas putida showed resistance to all antibiotics used except vancomycin. The isolate further subjected to PCR and DNA sequence analysis of blaVIM gene using different set of primers for different regions of VIM gene. The results were found to be PCR positive for the blaVIM gene. To determine the sequence of blaVIM gene, DNA sequencing performed. Sequence alignment of blaVIM gene with previously recorded blaVIM gene in NCBI- database showed that P. putida isolate have different blaVIM gene.

Keywords: Clinical isolates, Putida, Sulaimani, Vim gene.

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222 DYVELOP Method Implementation for the Research Development in Small and Middle Enterprises

Authors: Jiří F. Urbánek, David Král

Abstract:

Small and Middle Enterprises (SME) have a specific mission, characteristics, and behavior in global business competitive environments. They must respect policy, rules, requirements and standards in all their inherent and outer processes of supply - customer chains and networks. Paper aims and purposes are to introduce computational assistance, which enables us the using of prevailing operation system MS Office (SmartArt...) for mathematical models, using DYVELOP (Dynamic Vector Logistics of Processes) method. It is providing for SMS´s global environment the capability and profit to achieve its commitment regarding the effectiveness of the quality management system in customer requirements meeting and also the continual improvement of the organization’s and SME´s processes overall performance and efficiency, as well as its societal security via continual planning improvement. DYVELOP model´s maps - the Blazons are able mathematically - graphically express the relationships among entities, actors, and processes, including the discovering and modeling of the cycling cases and their phases. The blazons need live PowerPoint presentation for better comprehension of this paper mission – added value analysis. The crisis management of SMEs is obliged to use the cycles for successful coping of crisis situations.  Several times cycling of these cases is a necessary condition for the encompassment of the both the emergency event and the mitigation of organization´s damages. Uninterrupted and continuous cycling process is a good indicator and controlling actor of SME continuity and its sustainable development advanced possibilities.

Keywords: Blazons, computational assistance, DYVELOP method, small and middle enterprises.

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221 An Evaluation of Sputum Smear Conversion and Haematological Parameter Alteration in Early Detection Period of New Pulmonary Tuberculosis (PTB) Patients

Authors: Tasnuva Tamanna, Sanjida Halim Topa

Abstract:

Sputum smear conversion after one month of antituberculosis therapy in new smear positive pulmonary tuberculosis patients (PTB+) is a vital indicator towards treatment success. The objective of this study is to determine the rate of sputum smear conversion in new PTB+ patients after one month under treatment of National Institute of Diseases of the Chest and Hospital (NIDCH). Analysis of sputum smear conversion was done by re-clinical examination with sputum smear microscopic test after one month. Socio-demographic and hematological parameters were evaluated to perceive the correlation with the disease status. Among all enrolled patients only 33.33% were available for follow up diagnosis and of them only 42.86% patients turned to smear negative. Probably this consequence is due to non-coherence to the proper disease management. 66.67% and 78.78% patients reported low haemoglobin and packed cell volume level respectively whereas 80% and 93.33% patients accounted accelerated platelet count and erythrocyte sedimentation rate correspondingly.

Keywords: Followed up patients, PTB+ patients, sputum smear conversion, and sputum smear microscopic test.

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220 A Novel Method for the Characterization of Synchronization and Coupling in Multichannel EEG and ECoG

Authors: Manfred Hartmann, Andreas Graef, Hannes Perko, Christoph Baumgartner, Tilmann Kluge

Abstract:

In this paper we introduce a novel method for the characterization of synchronziation and coupling effects in multivariate time series that can be used for the analysis of EEG or ECoG signals recorded during epileptic seizures. The method allows to visualize the spatio-temporal evolution of synchronization and coupling effects that are characteristic for epileptic seizures. Similar to other methods proposed for this purpose our method is based on a regression analysis. However, a more general definition of the regression together with an effective channel selection procedure allows to use the method even for time series that are highly correlated, which is commonly the case in EEG/ECoG recordings with large numbers of electrodes. The method was experimentally tested on ECoG recordings of epileptic seizures from patients with temporal lobe epilepsies. A comparision with the results from a independent visual inspection by clinical experts showed an excellent agreement with the patterns obtained with the proposed method.

Keywords: EEG, epilepsy, regression analysis, seizurepropagation.

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219 Orthosis and Finite Elements: A Study for Development of New Designs through Additive Manufacturing

Authors: M. Volpini, D. Alves, A. Horta, M. Borges, P. Reis

Abstract:

The gait pattern in people that present motor limitations foment the demand for auxiliary locomotion devices. These artifacts for movement assistance vary according to its shape, size and functional features, following the clinical applications desired. Among the ortheses of lower limbs, the ankle-foot orthesis aims to improve the ability to walk in people with different neuromuscular limitations, although they do not always answer patients' expectations for their aesthetic and functional characteristics. The purpose of this study is to explore the possibility of using new design in additive manufacturer to reproduce the shape and functional features of a ankle-foot orthesis in an efficient and modern way. Therefore, this work presents a study about the performance of the mechanical forces through the analysis of finite elements in an ankle-foot orthesis. It will be demonstrated a study of distribution of the stress on the orthopedic device in orthostatism and during the movement in the course of patient's walk.

Keywords: Additive manufacture, new designs, orthoses, finite elements.

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218 Aflatoxins Aggravate the Incidence of Salmonellosis Outbreak in Fattening Calves: A Case Study

Authors: Abdel-Rahman A., El Okle O. S.

Abstract:

Fever, bloody diarrhea and high mortality rate were the main clinical finding in a group of fattening calves. Analysis of corn silage revealed presence of aflatoxins at level of 370 ppb. This level of aflatoxins in the feed of cattle is somewhat low to be the main cause of reported signs. Leukocytopenia, anemia, decreased lymphocytic activity and lowered phagocytic index are the main hematological and immunological alterations in diseased calves. Bacteriological investigation revealed isolation of pathogenic Salmonella typhimurium from the rectal swabs of diseased calves. Our results suggested that, long duration of exposure to aflatoxins even at small concentrations may considered as predisposing factor for the incidence of natural infectious outbreaks as salmonellosis due to its immunosuppressive effect. We can conclude that the veterinarians and owners must be given an attention to the relation between aflatoxicosis and salmonellosis under field condition. We are recommended that the treatment program during similar outbreaks must be including anti-aflatoxins preparations beside the antimicrobial therapy.

Keywords: Aflatoxins, Calves, Salmonellosis.

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217 Dental Ethics versus Malpractice, as Phenomenon with a Growing Trend

Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

Abstract:

Dealing with emerging cases of dental malpractice with justifications that stem from the clear rules of dental ethics is a phenomenon with an increasing trend in today's dental practice. Dentists should clearly understand how far the limit of malpractice goes, with or without minimal or major consequences, for the affected patient, which can be justified as a complication of dental treatment, in support of the rules of dental ethics in the dental office. Indeed, malpractice can occur in cases of lack of professionalism, but it can also come as a consequence of anatomical and physiological limitations in the implementation of the dental protocols, predetermined and indicated by the patient in the paragraph of the treatment plan in his personal card. Let this article serve as a short communication between readers and interested parties about the problems that dental malpractice can bring to the community. Malpractice should not be seen only as a professional wrong approach, but also as a phenomenon that can occur during dental practice. The aim of this article is presentation of the latest data published in the literature about malpractice. The combination of keywords is done in such a way with the aim to give the necessary space for collecting the right information in the networks of publications about this field, always first from the point of view of the dentist and not from that of the lawyer or jurist. From the findings included in this article, it was noticed that the diversity of approaches towards the phenomenon depends on the different countries based on the legal basis that these countries have. There is a lack of or a small number of articles that touch on this topic, and these articles are presented with a limited amount of data on the same topic. Dental malpractice should not be hidden under the guise of various dental complications that we justify with the strict rules of ethics for patients treated in the dental chair. The individual experience of dental malpractice must be published with the aim of serving as a source of experience for future generations of dentists.

Keywords: Dental ethics, malpractice, professional protocol, random deviation, dental tourism.

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216 Decision Tree for Competing Risks Survival Probability in Breast Cancer Study

Authors: N. A. Ibrahim, A. Kudus, I. Daud, M. R. Abu Bakar

Abstract:

Competing risks survival data that comprises of more than one type of event has been used in many applications, and one of these is in clinical study (e.g. in breast cancer study). The decision tree method can be extended to competing risks survival data by modifying the split function so as to accommodate two or more risks which might be dependent on each other. Recently, researchers have constructed some decision trees for recurrent survival time data using frailty and marginal modelling. We further extended the method for the case of competing risks. In this paper, we developed the decision tree method for competing risks survival time data based on proportional hazards for subdistribution of competing risks. In particular, we grow a tree by using deviance statistic. The application of breast cancer data is presented. Finally, to investigate the performance of the proposed method, simulation studies on identification of true group of observations were executed.

Keywords: Competing risks, Decision tree, Simulation, Subdistribution Proportional Hazard.

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215 Placebo Effect on Psychoemotional Status and Clinical Analyses of Armenian Crohn's Disease Patients

Authors: Elya S. Pepoyan, Astghik Z. Pepoyan

Abstract:

The Zung self-depression scale and Beck Anxiety Inventory were used both to study the depression and anxiety levels of Armenian Crohn’s disease patients, and to reveal the relation between emotional status and placebo effect of these patients. On the other hand, the blood cell analyses and gut bacteria investigations were used to assess the placebo effect on ESR, and haemoglobin-s and leukocyte-s levels as well as gut commensal E. coli quantities of these patients. Despite of registered high levels of depression and anxiety, the high placebo effect on psychoemotional status for investigated patients during the investigations was described. On the other hand, no positive effect of placebo on measurements of ESP and hemoglobin-s levels of Crohn’s disease patients was revealed. The importance of use of psychotherapies for optimal outcomes during treatments of Crohn’s disease is discussed.

Keywords: Crohn's disease, emotional disorders, placebo, gut microflora and blood composition.

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