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

Search results for: clinical presentation.

214 Family Functionality in Mexican Children with Congenital and Non-Congenital Deafness

Authors: D. Estrella, A. Silva, R. Zapata, H. Rubio

Abstract:

A total of 100 primary caregivers (mothers, fathers, grandparents) with at least one child or grandchild with a diagnosis of congenital bilateral profound deafness were assessed in order to evaluate the functionality of families with a deaf member, who was evaluated by specialists in audiology, molecular biology, genetics and psychology. After confirmation of the clinical diagnosis, DNA from the patients and parents were analyzed in search of the 35delG deletion of the GJB2 gene to determine who possessed the mutation. All primary caregivers were provided psychological support, regardless of whether or not they had the mutation, and prior and subsequent, the family APGAR test was applied. All parents, grandparents were informed of the results of the genetic analysis during the psychological intervention. The family APGAR, after psychological and genetic counseling, showed that 14% perceived their families as functional, 62% moderately functional and 24% dysfunctional. This shows the importance of psychological support in family functionality that has a direct impact on the quality of life of these families.

Keywords: Deafness, psychological support, family, adaptation to disability.

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213 Quantitative Indicator of Abdominal Aortic Aneurysm Rupture Risk Based on its Geometric Parameters

Authors: Guillermo Vilalta, Félix Nieto, Carlos Vaquero, José A. Vilalta

Abstract:

Abdominal aortic aneurysms rupture (AAAs) is one of the main causes of death in the world. This is a very complex phenomenon that usually occurs “without previous warning". Currently, criteria to assess the aneurysm rupture risk (peak diameter and growth rate) can not be considered as reliable indicators. In a first approach, the main geometric parameters of aneurysms have been linked into five biomechanical factors. These are combined to obtain a dimensionless rupture risk index, RI(t), which has been validated preliminarily with a clinical case and others from literature. This quantitative indicator is easy to understand, it allows estimating the aneurysms rupture risks and it is expected to be able to identify the one in aneurysm whose peak diameter is less than the threshold value. Based on initial results, a broader study has begun with twelve patients from the Clinic Hospital of Valladolid-Spain, which are submitted to periodic follow-up examinations.

Keywords: AAA, rupture risk prediction, biomechanical factors, AAA geometric characterization.

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212 Neural Network based Texture Analysis of Liver Tumor from Computed Tomography Images

Authors: K.Mala, V.Sadasivam, S.Alagappan

Abstract:

Advances in clinical medical imaging have brought about the routine production of vast numbers of medical images that need to be analyzed. As a result an enormous amount of computer vision research effort has been targeted at achieving automated medical image analysis. Computed Tomography (CT) is highly accurate for diagnosing liver tumors. This study aimed to evaluate the potential role of the wavelet and the neural network in the differential diagnosis of liver tumors in CT images. The tumors considered in this study are hepatocellular carcinoma, cholangio carcinoma, hemangeoma and hepatoadenoma. Each suspicious tumor region was automatically extracted from the CT abdominal images and the textural information obtained was used to train the Probabilistic Neural Network (PNN) to classify the tumors. Results obtained were evaluated with the help of radiologists. The system differentiates the tumor with relatively high accuracy and is therefore clinically useful.

Keywords: Fuzzy c means clustering, texture analysis, probabilistic neural network, LVQ neural network.

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211 Main Puteri Traditional Malay Healing Ceremony

Authors: M. G. Nasuruddin, S. Ishak

Abstract:

This paper deals with the traditional Malay healing ritualistic ceremony known as Main Puteri. This non-invasive intervention uses the vehicle of performance to administer the healing process. It employs the performance elements of Makyung, that is, music, movements/dance and dramatic dialogue to heal psychosomatic maladies. There are two perspectives to this therapeutic healing process, one traditional and the other scientific. From the traditional perspective, the psychosomatic illness is attributed to the infestations/possessions by malevolent spirits. To heal such patients, these spirits must be exorcised through placating them by making offerings. From the scientific perspective, the music (sonic orders), movements (kinetic energy) and smell (olfactory) connect with the brain waves to release the chemicals that would activate the internal healing energy. Currently, in Main Puteri, the therapeutic healing ritual is no longer relevant as modern clinical medicine has proven to be more effective. Thus, Main Puteri is an anachronism in today’s technologically advanced Malaysia.

Keywords: Exorcism, Main Puteri, Shamans, Therapeutic Healing.

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210 Inflammatory Markers in the Blood and Chronic Periodontitis

Authors: Saimir Heta, Ilma Robo, Nevila Alliu, Tea Meta

Abstract:

Background: Plasma levels of inflammatory markers are the expression of the infectious wastes of existing periodontitis, as well as of existing inflammation everywhere in the body. Materials and Methods: The study consists of the clinical part of the measurement of inflammatory markers of 23 patients diagnosed with chronic periodontitis and the recording of parental periodontal parameters of patient periodontal status: hemorrhage index and probe values, before and 7-10 days after non-surgical periodontal treatment. Results: The level of fibrinogen drops according to the categorization of disease progression, active and passive, with the biggest % (18%-30%) at the fluctuation 10-20 mg/d. Fluctuations in fibrinogen level according to the age of patients in the range 0-10 mg/dL under 40 years and over 40 years was 13%-26%, in the range 10-20 mg/dL was 26%-22%, in the 20-40 mg/dL was 9%-4%. Conclusions: Non-surgical periodontal treatment significantly reduces the level of non-inflammatory markers in the blood. Oral health significantly reduces the potential source for periodontal bacteria, with the potential of promoting thromboembolism, through interaction between thrombocytes.

Keywords: Chronic periodontitis, atherosclerosis, risk factor, inflammatory markers.

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209 Segmenting Ultrasound B-Mode Images Using RiIG Distributions and Stochastic Optimization

Authors: N. Mpofu, M. Sears

Abstract:

In this paper, we propose a novel algorithm for delineating the endocardial wall from a human heart ultrasound scan. We assume that the gray levels in the ultrasound images are independent and identically distributed random variables with different Rician Inverse Gaussian (RiIG) distributions. Both synthetic and real clinical data will be used for testing the algorithm. Algorithm performance will be evaluated using the expert radiologist evaluation of a soft copy of an ultrasound scan during the scanning process and secondly, doctor’s conclusion after going through a printed copy of the same scan. Successful implementation of this algorithm should make it possible to differentiate normal from abnormal soft tissue and help disease identification, what stage the disease is in and how best to treat the patient. We hope that an automated system that uses this algorithm will be useful in public hospitals especially in Third World countries where problems such as shortage of skilled radiologists and shortage of ultrasound machines are common. These public hospitals are usually the first and last stop for most patients in these countries.

Keywords: Endorcardial Wall, Rician Inverse Distributions, Segmentation, Ultrasound Images.

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208 A Closed-Loop Design Model for Sustainable Manufacturing by Integrating Forward Design and Reverse Design

Authors: Yuan-Jye Tseng, Yi-Shiuan Chen

Abstract:

In this paper, a new concept of closed-loop design for a product is presented. The closed-loop design model is developed by integrating forward design and reverse design. Based on this new concept, a closed-loop design model for sustainable manufacturing by integrated evaluation of forward design, reverse design, and green manufacturing using a fuzzy analytic network process is developed. In the design stage of a product, with a given product requirement and objective, there can be different ways to design the detailed components and specifications. Therefore, there can be different design cases to achieve the same product requirement and objective. Subsequently, in the design evaluation stage, it is required to analyze and evaluate the different design cases. The purpose of this research is to develop a model for evaluating the design cases by integrated evaluating the criteria in forward design, reverse design, and green manufacturing. A fuzzy analytic network process method is presented for integrated evaluation of the criteria in the three models. The comparison matrices for evaluating the criteria in the three groups are established. The total relational values among the three groups represent the total relational effects. In applications, a super matrix model is created and the total relational values can be used to evaluate the design cases for decision-making to select the final design case. An example product is demonstrated in this presentation. It shows that the model is useful for integrated evaluation of forward design, reverse design, and green manufacturing to achieve a closed-loop design for sustainable manufacturing objective.

Keywords: Design evaluation, forward design, reverse design, closed-loop design, supply chain management, closed-loop supply chain, fuzzy analytic network process.

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207 Design of a Pneumonia Ontology for Diagnosis Decision Support System

Authors: Sabrina Azzi, Michal Iglewski, Véronique Nabelsi

Abstract:

Diagnosis error problem is frequent and one of the most important safety problems today. One of the main objectives of our work is to propose an ontological representation that takes into account the diagnostic criteria in order to improve the diagnostic. We choose pneumonia disease since it is one of the frequent diseases affected by diagnosis errors and have harmful effects on patients. To achieve our aim, we use a semi-automated method to integrate diverse knowledge sources that include publically available pneumonia disease guidelines from international repositories, biomedical ontologies and electronic health records. We follow the principles of the Open Biomedical Ontologies (OBO) Foundry. The resulting ontology covers symptoms and signs, all the types of pneumonia, antecedents, pathogens, and diagnostic testing. The first evaluation results show that most of the terms are covered by the ontology. This work is still in progress and represents a first and major step toward a development of a diagnosis decision support system for pneumonia.

Keywords: Clinical decision support system, diagnostic errors, ontology, pneumonia.

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206 Automatically Driven Vector for Guidewire Segmentation in 2D and Biplane Fluoroscopy

Authors: Simon Lessard, Pascal Bigras, Caroline Lau, Daniel Roy, Gilles Soulez, Jacques A. de Guise

Abstract:

The segmentation of endovascular tools in fluoroscopy images can be accurately performed automatically or by minimum user intervention, using known modern techniques. It has been proven in literature, but no clinical implementation exists so far because the computational time requirements of such technology have not yet been met. A classical segmentation scheme is composed of edge enhancement filtering, line detection, and segmentation. A new method is presented that consists of a vector that propagates in the image to track an edge as it advances. The filtering is performed progressively in the projected path of the vector, whose orientation allows for oriented edge detection, and a minimal image area is globally filtered. Such an algorithm is rapidly computed and can be implemented in real-time applications. It was tested on medical fluoroscopy images from an endovascular cerebral intervention. Ex- periments showed that the 2D tracking was limited to guidewires without intersection crosspoints, while the 3D implementation was able to cope with such planar difficulties.

Keywords: Edge detection, Line Enhancement, Segmentation, Fluoroscopy.

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205 Identification of Promiscuous Epitopes for Cellular Immune Responses in the Major Antigenic Protein Rv3873 Encoded by Region of Difference 1 of Mycobacterium tuberculosis

Authors: Abu Salim Mustafa

Abstract:

Rv3873 is a relatively large size protein (371 amino acids in length) and its gene is located in the immunodominant genomic region of difference (RD)1 that is present in the genome of Mycobacterium tuberculosis but deleted from the genomes of all the vaccine strains of Bacillus Calmette Guerin (BCG) and most other mycobacteria. However, when tested for cellular immune responses using peripheral blood mononuclear cells from tuberculosis patients and BCG-vaccinated healthy subjects, this protein was found to be a major stimulator of cell mediated immune responses in both groups of subjects. In order to further identify the sequence of immunodominant epitopes and explore their Human Leukocyte Antigen (HLA)-restriction for epitope recognition, 24 peptides (25-mers overlapping with the neighboring peptides by 10 residues) covering the sequence of Rv3873 were synthesized chemically using fluorenylmethyloxycarbonyl chemistry and tested in cell mediated immune responses. The results of these experiments helped in the identification of an immunodominant peptide P9 that was recognized by people expressing varying HLA-DR types. Furthermore, it was also predicted to be a promiscuous binder with multiple epitopes for binding to HLA-DR, HLA-DP and HLA-DQ alleles of HLA-class II molecules that present antigens to T helper cells, and to HLA-class I molecules that present antigens to T cytotoxic cells. In addition, the evaluation of peptide P9 using an immunogenicity predictor server yielded a high score (0.94), which indicated a greater probability of this peptide to elicit a protective cellular immune response. In conclusion, P9, a peptide with multiple epitopes and ability to bind several HLA class I and class II molecules for presentation to cells of the cellular immune response, may be useful as a peptide-based vaccine against tuberculosis.

Keywords: Mycobacterium tuberculosis, Rv3873, peptides, vaccine

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204 Performance Evaluation of an Amperometric Biosensor using a Simple Microcontroller based Data Acquisition System

Authors: V. G. Sangam, Balasaheb M. Patre

Abstract:

In this paper we have proposed a methodology to develop an amperometric biosensor for the analysis of glucose concentration using a simple microcontroller based data acquisition system. The work involves the development of Detachable Membrane Unit (enzyme based biomembrane) with immobilized glucose oxidase on the membrane and interfacing the same to the signal conditioning system. The current generated by the biosensor for different glucose concentrations was signal conditioned, then acquired and computed by a simple AT89C51-microcontroller. The optimum operating parameters for the better performance were found and reported. The detailed performance evaluation of the biosensor has been carried out. The proposed microcontroller based biosensor system has the sensitivity of 0.04V/g/dl, with a resolution of 50mg/dl. It has exhibited very good inter day stability observed up to 30 days. Comparing to the reference method such as HPLC, the accuracy of the proposed biosensor system is well within ± 1.5%. The system can be used for real time analysis of glucose concentration in the field such as, food and fermentation and clinical (In-Vitro) applications.

Keywords: Biosensor, DMU, Glucose oxidase andMicrocontroller.

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203 Clinical and Methodological Issues in the Research on the Rape Myth

Authors: Ana Pauna, Zbigniew Pleszewski

Abstract:

The purpose of this study is to revisit the concept of rape as represented by professionals in the literature as well as its perception (beliefs and attitudes) in the population at large and to propose methodological improvements to its measurement tool. Rape is a serious crime threatening its victim-s physical and mental health and integrity; and as such is legally prosecuted in all modern societies. The problem is not in accepting or rejecting rape as a criminal act, but rather in the vagueness of its interpretations and “justifications" maintained in the mentality of modern societies - known in the literature as the phenomenon of "rape-myth". The rapemyth can be studied from different perspectives: criminology, sociology, ethics, medicine and psychology. Its investigation requires rigorous scientific objectivity, free of passion (victims of rape are at risk of emotional bias), free of activism (social activists, even if wellintentioned are also biased), free of any pre-emptive assumptions or prejudices. To apply a rigorous scientific procedure, we need a solid, valid and reliable measurement. Rape is a form of heterosexual or homosexual aggression, violently forcing the victim to give-in in the sexual activity of the aggressor against her/his will. Human beings always try to “understand" or find a reason justifying their acts. Psychological literature provides multiple clinical and experimental examples of it; just to mention the famous studies by Milgram on the level of electroshock delivered by the “teacher" towards the “learner" if “scientifically justifiable" or the studies on the behavior of “prisoners" and the “guards" and many other experiments and field observations. Sigmund Freud presented the phenomenon of unconscious justification and called it rationalization. The multiple justifications, rationalizations and repeated opinions about sexual behavior contribute to a myth maintained in the society. What kind of “rationale" our societies apply to “understand" the non-consensual sexual behavior? There are many, just to mention few: • Sex is a ludistic activity for both participants, therefore – even if not consented – it should bring pleasure to both. • Everybody wants sex, but only men are allowed to manifest it openly while women have to pretend the opposite, thus men have to initiate sexual behavior and women would follow. • A person who strongly needs sex is free to manifest it and struggle to get it; the person who doesn-t want it must not reveal her/his sexual attraction and avoid risky situations; otherwise she/he is perceived as a promiscuous seducer. • A person who doesn-t fight against the sexual initiator unconsciously accepts the rape (does it explain why homosexual rapes are reported less frequently than rapes against women?). • Women who are raped deserve it because their wardrobe is very revealing and seducing and they ''willingly'' go to highly risky places (alleys, dark roads, etc.). • Men need to ventilate their sexual energy and if they are deprived of a partner their urge to have sex is difficult to control. • Men are supposed to initiate and insist even by force to have sex (their testosterone makes them both sexual and aggressive). The paper overviews numerous cultural beliefs about masculine versus feminine behavior and their impact on the “rape myth".

Keywords: Rape Myth components, psycho-social factors, testing, Likert-type scale

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202 Mass Casualty Acute Pepper Spray Inhalation Respiratory Effect Severity

Authors: B. Michelle Sweeting

Abstract:

Pepper spray use has gained momentum since 1992 and although the active ingredient is readily available, it is considered a weapon with restricted use in many regions, including The Bahamas. In light of controversy in the literature regarding the severity of presenting respiration complaints among individuals postacute exposure of pepper spray inhalation, this descriptive case series study was conducted to assess the respiratory status of persons evaluated during a mass casualty in The Bahamas. Parameters noted were patients- demographics and respiration severity determined via clinical examination findings, disposition and follow-up review of the 20 persons. Their most common complaint was difficulty breathing post exposure. Two required admission and stayed for <24 hours uneventfully. All cases remained without residual complaints upon follow-up. Results showed that although respiration difficulty was perceived as the most detrimental of presenting complaints, it was noted to be mostly subjective with benign outcome.

Keywords: Acute Pepper Spray Inhalation, Capsaicinoids, Oleoresin Capsicum, Pepper spray, Respiratory severity severity.

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201 Numerical Investigation of Multiphase Flow in Pipelines

Authors: Gozel Judakova, Markus Bause

Abstract:

We present and analyze reliable numerical techniques for simulating complex flow and transport phenomena related to natural gas transportation in pipelines. Such kind of problems are of high interest in the field of petroleum and environmental engineering. Modeling and understanding natural gas flow and transformation processes during transportation is important for the sake of physical realism and the design and operation of pipeline systems. In our approach a two fluid flow model based on a system of coupled hyperbolic conservation laws is considered for describing natural gas flow undergoing hydratization. The accurate numerical approximation of two-phase gas flow remains subject of strong interest in the scientific community. Such hyperbolic problems are characterized by solutions with steep gradients or discontinuities, and their approximation by standard finite element techniques typically gives rise to spurious oscillations and numerical artefacts. Recently, stabilized and discontinuous Galerkin finite element techniques have attracted researchers’ interest. They are highly adapted to the hyperbolic nature of our two-phase flow model. In the presentation a streamline upwind Petrov-Galerkin approach and a discontinuous Galerkin finite element method for the numerical approximation of our flow model of two coupled systems of Euler equations are presented. Then the efficiency and reliability of stabilized continuous and discontinous finite element methods for the approximation is carefully analyzed and the potential of the either classes of numerical schemes is investigated. In particular, standard benchmark problems of two-phase flow like the shock tube problem are used for the comparative numerical study.

Keywords: Discontinuous Galerkin method, Euler system, inviscid two-fluid model, streamline upwind Petrov-Galerkin method, two-phase flow.

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200 A Face-to-Face Education Support System Capable of Lecture Adaptation and Q&A Assistance Based On Probabilistic Inference

Authors: Yoshitaka Fujiwara, Jun-ichirou Fukushima, Yasunari Maeda

Abstract:

Keys to high-quality face-to-face education are ensuring flexibility in the way lectures are given, and providing care and responsiveness to learners. This paper describes a face-to-face education support system that is designed to raise the satisfaction of learners and reduce the workload on instructors. This system consists of a lecture adaptation assistance part, which assists instructors in adapting teaching content and strategy, and a Q&A assistance part, which provides learners with answers to their questions. The core component of the former part is a “learning achievement map", which is composed of a Bayesian network (BN). From learners- performance in exercises on relevant past lectures, the lecture adaptation assistance part obtains information required to adapt appropriately the presentation of the next lecture. The core component of the Q&A assistance part is a case base, which accumulates cases consisting of questions expected from learners and answers to them. The Q&A assistance part is a case-based search system equipped with a search index which performs probabilistic inference. A prototype face-to-face education support system has been built, which is intended for the teaching of Java programming, and this approach was evaluated using this system. The expected degree of understanding of each learner for a future lecture was derived from his or her performance in exercises on past lectures, and this expected degree of understanding was used to select one of three adaptation levels. A model for determining the adaptation level most suitable for the individual learner has been identified. An experimental case base was built to examine the search performance of the Q&A assistance part, and it was found that the rate of successfully finding an appropriate case was 56%.

Keywords: Bayesian network, face-to-face education, lecture adaptation, Q&A assistance.

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199 Efficient Feature-Based Registration for CT-M R Images Based on NSCT and PSO

Authors: Nemir Al-Azzawi, Harsa A. Mat Sakim, Wan Ahmed K. Wan Abdullah, Yasmin Mohd Yacob

Abstract:

Feature-based registration is an effective technique for clinical use, because it can greatly reduce computational costs. However, this technique, which estimates the transformation by using feature points extracted from two images, may cause misalignments. To handle with this limitation, we propose to extract the salient edges and extracted control points (CP) of medical images by using efficiency of multiresolution representation of data nonsubsampled contourlet transform (NSCT) that finds the best feature points. The MR images were first decomposed using the NSCT, and then Edge and CP were extracted from bandpass directional subband of NSCT coefficients and some proposed rules. After edge and CP extraction, mutual information was adopted for the registration of feature points and translation parameters are calculated by using particle swarm optimization (PSO). The experimental results showed that the proposed method produces totally accurate performance for registration medical CT-MR images.

Keywords: Feature-based registration, mutual information, nonsubsampled contourlet transform, particle swarm optimization.

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198 A Decision Support Tool for Evaluating Mobility Projects

Authors: H. Omrani, P. Gerber

Abstract:

Success is a European project that will implement several clean transport offers in three European cities and evaluate the environmental impacts. The goal of these measures is to improve urban mobility or the displacement of residents inside cities. For e.g. park and ride, electric vehicles, hybrid bus and bike sharing etc. A list of 28 criteria and 60 measures has been established for evaluation of these transport projects. The evaluation criteria can be grouped into: Transport, environment, social, economic and fuel consumption. This article proposes a decision support system based that encapsulates a hybrid approach based on fuzzy logic, multicriteria analysis and belief theory for the evaluation of impacts of urban mobility solutions. A web-based tool called DeSSIA (Decision Support System for Impacts Assessment) has been developed that treats complex data. The tool has several functionalities starting from data integration (import of data), evaluation of projects and finishes by graphical display of results. The tool development is based on the concept of MVC (Model, View, and Controller). The MVC is a conception model adapted to the creation of software's which impose separation between data, their treatment and presentation. Effort is laid on the ergonomic aspects of the application. It has codes compatible with the latest norms (XHTML, CSS) and has been validated by W3C (World Wide Web Consortium). The main ergonomic aspect focuses on the usability of the application, ease of learning and adoption. By the usage of technologies such as AJAX (XML and Java Script asynchrones), the application is more rapid and convivial. The positive points of our approach are that it treats heterogeneous data (qualitative, quantitative) from various information sources (human experts, survey, sensors, model etc.).

Keywords: Decision support tool, hybrid approach, urban mobility.

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197 Voice Disorders Identification Using Hybrid Approach: Wavelet Analysis and Multilayer Neural Networks

Authors: L. Salhi, M. Talbi, A. Cherif

Abstract:

This paper presents a new strategy of identification and classification of pathological voices using the hybrid method based on wavelet transform and neural networks. After speech acquisition from a patient, the speech signal is analysed in order to extract the acoustic parameters such as the pitch, the formants, Jitter, and shimmer. Obtained results will be compared to those normal and standard values thanks to a programmable database. Sounds are collected from normal people and patients, and then classified into two different categories. Speech data base is consists of several pathological and normal voices collected from the national hospital “Rabta-Tunis". Speech processing algorithm is conducted in a supervised mode for discrimination of normal and pathology voices and then for classification between neural and vocal pathologies (Parkinson, Alzheimer, laryngeal, dyslexia...). Several simulation results will be presented in function of the disease and will be compared with the clinical diagnosis in order to have an objective evaluation of the developed tool.

Keywords: Formants, Neural Networks, Pathological Voices, Pitch, Wavelet Transform.

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196 Biomechanical Findings in Patients with Bipartite Medial Cuneiforms

Authors: Aliza Lee, Mark Wilt, John Bonk, Scott Floyd, Bradley Hoffman, Karen Uchmanowicz

Abstract:

Bipartite medial cuneiforms are relatively rare but may play a significant role in biomechanical and gait abnormalities. It is believed that a bipartite medial cuneiform may alter the available range of motion due to its larger morphological variant, thus limiting the metatarsal plantarflexion needed to achieve adequate hallux dorsiflexion for normal gait. Radiographic and clinical assessment were performed on two patients who reported with foot pain along the first ray. Both patients had visible bipartite medial cuneiforms on MRI. Using gait plate and Metascan ™ analysis, both were noted to have four measurements far beyond the expected range. Medial and lateral heel peak pressure, hallux peak pressure, and 1st metatarsal peak pressure were all noted to be increased. These measurements are believed to be increased due to the hindrance placed on the available ROM of the first ray by the increased size of the medial cuneiform. A larger patient population would be needed to fully understand this developmental anomaly.

Keywords: Bipartite medial cuneiforms, cuneiform, developmental anomaly, gait abnormality.

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195 Ultrasonographic Manifestations of Periventricular Leukomalacia in Preterm Neonates at Teaching Hospital Peradeniya, Sri Lanka

Authors: P. P. Chandrasekera, P. B. Hewavithana, S. Rosario, M. H. M. N. Hearth, D. M. R. D. Mirihella

Abstract:

Periventricular Leukomalacia (PVL) is a White Matter Injury (WMI) of preterm neonatal brain. Objectives of the study were to assess the neuro-developmental outcome at one year of age and to determine a good protocol of cranial ultrasonography to detect PVL. Two hundred and sixty four preterm neonates were included in the study. Series of cranial ultrasound scans were done by using a dedicated neonatal head probe 4-10 MHz of Logic e portable ultrasound scanner. Clinical history of seizures, abnormal head growth (hydrocephalus or microcephaly) and developmental milestones were assessed and neurological examinations were done until one year of age. Among live neonates, 57% who had cystic PVL (Grades 2 and 3) manifested as cerebral palsy. In conclusion cystic PVL has permanent neurological disabilities like cerebral palsy. Good protocol of real time cranial ultrasonography to detect PVL is to perform scans at least once a week until one month and at term (40 weeks of gestation).

Keywords: Cerebral palsy, cranial ultrasonography, Periventricular Leukomalacia (PVL), preterm neonates.

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194 Scatterer Density in Nonlinear Diffusion for Speckle Reduction in Ultrasound Imaging: The Isotropic Case

Authors: Ahmed Badawi

Abstract:

This paper proposes a method for speckle reduction in medical ultrasound imaging while preserving the edges with the added advantages of adaptive noise filtering and speed. A nonlinear image diffusion method that incorporates local image parameter, namely, scatterer density in addition to gradient, to weight the nonlinear diffusion process, is proposed. The method was tested for the isotropic case with a contrast detail phantom and varieties of clinical ultrasound images, and then compared to linear and some other diffusion enhancement methods. Different diffusion parameters were tested and tuned to best reduce speckle noise and preserve edges. The method showed superior performance measured both quantitatively and qualitatively when incorporating scatterer density into the diffusivity function. The proposed filter can be used as a preprocessing step for ultrasound image enhancement before applying automatic segmentation, automatic volumetric calculations, or 3D ultrasound volume rendering.

Keywords: Ultrasound imaging, Nonlinear isotropic diffusion, Speckle noise, Scattering.

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193 Poincaré Plot for Heart Rate Variability

Authors: Mazhar B. Tayel, Eslam I. AlSaba

Abstract:

Heart is the most important part in the body of living organisms. It affects and is affected by any factor in the body. Therefore, it is a good detector for all conditions in the body. Heart signal is a non-stationary signal; thus, it is utmost important to study the variability of heart signal. The Heart Rate Variability (HRV) has attracted considerable attention in psychology, medicine and has become important dependent measure in psychophysiology and behavioral medicine. The standards of measurements, physiological interpretation and clinical use for HRV that are most often used were described in many researcher papers, however, remain complex issues are fraught with pitfalls. This paper presents one of the nonlinear techniques to analyze HRV. It discusses many points like, what Poincaré plot is and how Poincaré plot works; also, Poincaré plot's merits especially in HRV. Besides, it discusses the limitation of Poincaré cause of standard deviation SD1, SD2 and how to overcome this limitation by using complex correlation measure (CCM). The CCM is most sensitive to changes in temporal structure of the Poincaré plot as compared toSD1 and SD2.

Keywords: Heart rate variability, chaotic system, Poincaré, variance, standard deviation, complex correlation measure.

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192 Optimal Design of a PV/Diesel Hybrid System for Decentralized Areas through Economic Criteria

Authors: D. Tsuanyo, D. Aussel, Y. Azoumah, P. Neveu

Abstract:

An innovative concept called “Flexy-Energy” is developing at 2iE. This concept aims to produce electricity at lower cost by smartly mix different available energy sources in accordance to the load profile of the region. With a higher solar irradiation and due to the fact that Diesel generator are massively used in sub-Saharan rural areas, PV/Diesel hybrid systems could be a good application of this concept and a good solution to electrify this region, provided they are reliable, cost effective and economically attractive to investors. Presentation of the developed approach is the aims of this paper. The PV/Diesel hybrid system designed consists to produce electricity and/or heat from a coupling between Diesel Diesel generators and PV panels without batteries storage, while ensuring the substitution of gasoil by bio-fuels available in the area where the system will be installed. The optimal design of this system is based on his technical performances; the Life Cycle Cost (LCC) and Levelized Cost of Energy are developed and use as economic criteria. The Net Present Value (NPV), the internal rate of return (IRR) and the discounted payback (DPB) are also evaluated according to dual electricity pricing (in sunny and unsunny hours). The PV/Diesel hybrid system obtained is compared to the standalone Diesel Diesel generators. The approach carried out in this paper has been applied to Siby village in Mali (Latitude 12 ° 23'N 8 ° 20'W) with 295 kWh as daily demand.This approach provides optimal physical characteristics (size of the components, number of component) and dynamical characteristics in real time (number of Diesel generator on, their load rate, fuel specific consumptions, and PV penetration rate) of the system. The system obtained is slightly cost effective; but could be improved with optimized tariffing strategies.

Keywords: Investments criteria, Optimization, PV hybrid, Sizing, Rural electrification.

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191 Identification of Regulatory Mechanism of Orthostatic Response

Authors: E. Hlavacova, J. Chrenova, Z. Rausova, M. Vlcek, A. Penesova, L. Dedik

Abstract:

En bloc assumes modeling all phases of the orthostatic test with the only one mathematical model, which allows the complex parametric view of orthostatic response. The work presents the implementation of a mathematical model for processing of the measurements of systolic, diastolic blood pressure and heart rate performed on volunteers during orthostatic test. The original assumption of model hypothesis that every postural change means only one Stressor, did not complying with the measurements of physiological circulation factor-time profiles. Results of the identification support the hypothesis that second postural change of orthostatic test causes induced Stressors, with the observation of a physiological regulation mechanism. Maximal demonstrations are on the heart rate and diastolic blood pressure-time profile, minimal are for the measurements of the systolic blood pressure. Presented study gives a new view on orthostatic test with impact on clinical practice.

Keywords: En bloc modeling, physiological circulatory factor, postural change, stressor

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190 The Effect of Binahong to Hematoma

Authors: Sri Sumartiningsih

Abstract:

In elevating performance in competetive sports, an athlete must continously train in achieving maximum performance,but needs to pay attention to recovery therapy, that is to recover from fatigue as well as injury.The correct recovery therapy will assist in process of recovery and helps in the training in achieving better performace. Binahong (Anredera cordifolia) was proven empirically by the locals in assisting speedy recovery from an injury.Clinical research with lab animals receiving blunt trauma injury, microscopically shown signs of: 1) redness, 2) heatiness, 3) swelling and, 4) lack of activity. There is also microscopic indication of: 1) infiltration of inflame cells (migration of cells to the trauma area), 2) Cells necrosis, 3) Congestion (as a result of dead red blood cells), 4) uedema. On administration of Binahong for 3 days, there is a significant drop of 5% in cell inflammation, 2% increase of fibroblast (cell membrance) count.Conclutin: Binahong do assist in reducing cell inflammation and increase counts of cells fibroblast. Suggestion: In helping athlete's to recover from force injury, we need study about Binahong's roots to inflammation cell and healing of injuried cell.

Keywords: Binahong, sport injury, hematoma

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189 Feasibility of Risk Assessment for Type 2 Diabetes in Community Pharmacies Using Two Different Approaches: A Pilot Study in Thailand

Authors: Thitaporn Thoopputra, Tipaporn Pongmesa, Shuchuen Li

Abstract:

Aims: To evaluate the application of non-invasive diabetes risk assessment tool in community pharmacy setting. Methods: Thai diabetes risk score was applied to assess individuals at risk of developing type 2 diabetes. Interactive computer-based risk screening (IT) and paper-based risk screening (PT) tools were applied. Participants aged over 25 years with no known diabetes were recruited in six participating pharmacies. Results: A total of 187 clients, mean aged (+SD) was 48.6 (+10.9) years. 35% were at high risk. The mean value of willingness-to-pay for the service fee in IT group was significantly higher than PT group (p=0.013). No significant difference observed for the satisfaction between groups. Conclusions: Non-invasive risk assessment tool, whether paper-based or computerized-based can be applied in community pharmacy to support the enhancing role of pharmacists in chronic disease management. Long term follow up is needed to determine the impact of its application in clinical, humanistic and economic outcomes.

Keywords: Community pharmacy, intervention, prevention, risk assessment, type 2 diabetes.

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188 Understanding ICT Behaviors among Health Workers in Sub-Saharan Africa: A Cross-Sectional Study for Laboratory Persons in Uganda

Authors: M. Kasusse, M. Rosette, E. Burke, C. Mwangi, R. Batamwita, N. Tumwesigye, S. Aisu

Abstract:

A cross-sectional survey to ascertain the capacity of laboratory persons in using ICTs was conducted in 15 Ugandan districts (July-August 2013). A self-administered questionnaire served as data collection tool, interview guide and observation checklist. 69 questionnaires were filled, 12 interviews conducted, 45 HC observed. SPSS statistics 17.0 and SAS 9.2 software were used for entry and analyses. 69.35% of participants find it difficult to access a computer at work. Of the 30.65% who find it easy to access a computer at work, a significant 21.05% spend 0 hours on a computer daily. 60% of the participants cannot access internet at work. Of the 40% who have internet at work, a significant 20% lack email address but 20% weekly read emails weekly and 48% daily. It is viable/feasible to pilot informatics projects as strategies to build bridges develop skills for e-health landscape in laboratory services with a bigger financial muscle.

Keywords: ICT Behavior, Clinical Laboratory persons, Sub-Saharan Africa, Uganda.

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187 Quadratic Pulse Inversion Ultrasonic Imaging(QPI): A Two-Step Procedure for Optimization of Contrast Sensitivity and Specificity

Authors: Mamoun F. Al-Mistarihi

Abstract:

We have previously introduced an ultrasonic imaging approach that combines harmonic-sensitive pulse sequences with a post-beamforming quadratic kernel derived from a second-order Volterra filter (SOVF). This approach is designed to produce images with high sensitivity to nonlinear oscillations from microbubble ultrasound contrast agents (UCA) while maintaining high levels of noise rejection. In this paper, a two-step algorithm for computing the coefficients of the quadratic kernel leading to reduction of tissue component introduced by motion, maximizing the noise rejection and increases the specificity while optimizing the sensitivity to the UCA is presented. In the first step, quadratic kernels from individual singular modes of the PI data matrix are compared in terms of their ability of maximize the contrast to tissue ratio (CTR). In the second step, quadratic kernels resulting in the highest CTR values are convolved. The imaging results indicate that a signal processing approach to this clinical challenge is feasible.

Keywords: Volterra Filter, Pulse Inversion, Ultrasonic Imaging, Contrast Agent.

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186 Changing Patterns of Colorectal Cancer in Hail Region

Authors: Laila Salah Seada, Ashraf Ibrahim, Fawaz Al Rashid, Ihab Abdo, Hassan Kasim, Waleed Al Mansi, Saud Al Shabli

Abstract:

Background and Objectives: Colorectal carcinoma is increasing among both men and women worldwide. It has a multifactorial etiology including genetic factors, environmental factors and inflammatory conditions of the digestive tract. A clinicopathologic assessment of colorectal carcinoma in Hail region is done, considering any changing patterns in two 5-year periods from 2005-2009 (A) and from 2012 to 2017 (B). All data had been retrieved from histopathology files of King Khalid Hospital, Hail. Results: During period (A), 75 cases were diagnosed as colorectal carcinoma. Male patients comprised 56/75 (74.7%) of the study, with a mean age of 58.4 (36-97), while females were 19/75 (25.3%) with a mean age of 50.3(30-85) and the difference was significant (p = 0.05). M:F ratio was 2.9:1. Most common histological type was adenocarcioma in 68/75 (90.7%) patients mostly well differentiated in 44/68 (64.7%). Mucinous neoplasms comprised only 7/75 (9.3%) of cases and tended to have a higher stage (p = 0.04). During period (B), 115 cases were diagnosed with an increase of 53.3% in number of cases than period (A). Male to female ratio also decreased to 1.35:1, females being 44.83% more affected. Adenocarcinoma remained the prevalent type (93.9%), while mucinous type was still rare (5.2%). No distal metastases found at time of presentation. Localization of tumors was rectosigmoid in group (A) in 41.4%, which increased to 56.6% in group (B), with an increase of 15.2%. Iliocecal location also decreased from 8% to 3.5%, being 56.25% less. Other proximal areas of the colon were decreased by 25.75%, from 53.9% in group (A) to 40% in group (B). Conclusion: Colorectal carcinoma in Hail region has increased by 53.3% in the past 5 years, with more females being diagnosed. Localization has also shifted distally by 15.2%. These findings are different from Western world patterns which experienced a decrease in incidence and proximal shift of the colon cancer localization. This might be due to better diagnostic tools, population awareness of the disease, as well as changing of life style and/or food habits in the region.

Keywords: Colorectal cancer, Hail Region, changing pattern, distal shift.

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185 Finite Element Analysis of Full Ceramic Crowns with and without Zirconia Framework

Authors: Porojan S., Sandu L., Topală F.

Abstract:

Simulation of occlusal function during laboratory material-s testing becomes essential in predicting long-term performance before clinical usage. The aim of the study was to assess the influence of chamfer preparation depth on failure risk of heat pressed ceramic crowns with and without zirconia framework by means of finite element analysis. 3D models of maxillary central incisor, prepared for full ceramic crowns with different depths of the chamfer margin (between 0.8 and 1.2 mm) and 6-degree tapered walls together with the overlying crowns were generated using literature data (Fig. 1, 2). The crowns were designed with and without a zirconia framework with a thickness of 0.4 mm. For all preparations and crowns, stresses in the pressed ceramic crown, zirconia framework, pressed ceramic veneer, and dentin were evaluated separately. The highest stresses were registered in the dentin. The depth of the preparations had no significant influence on the stress values of the teeth and pressed ceramics for the studied cases, only for the zirconia framework. The zirconia framework decreases the stress values in the veneer.

Keywords: Finite element analysis, full ceramic crown, zirconia framework, stresses.

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