Search results for: clinical indicator

Authors: N. Mpofu, M. Sears

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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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Authors: Sabrina Azzi, Michal Iglewski, Véronique Nabelsi

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

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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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Authors: Andrea Zielke-Nadkarni

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Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: Pain management, migrants, sociocultural context, palliative care.

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

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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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Authors: Ana Pauna, Zbigniew Pleszewski

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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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Authors: Souad Demigha

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The paper aims to specify and build a system, a learning support in radiology-senology (breast radiology) dedicated to help assist junior radiologists-senologists in their radiologysenology- related activity based on experience of expert radiologistssenologists. This system is named SAFRS (i.e. system supporting the training of radiologists-senologists). It is based on the exploitation of radiologic-senologic images (primarily mammograms but also echographic images or MRI) and their related clinical files. The aim of such a system is to help breast cancer screening in education. In order to acquire this expert radiologist-senologist knowledge, we have used the CBR (case-based reasoning) approach. The SAFRS system will promote the evolution of teaching in radiology-senology by offering the “junior radiologist" trainees an advanced pedagogical product. It will permit a strengthening of knowledge together with a very elaborate presentation of results. At last, the know-how will derive from all these factors.

Keywords: Learning support, radiology-senology, training, education, CBR, accumulated experience.

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Authors: B. Michelle Sweeting

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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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Authors: Noda L. M., Salvador I. C, C. M. L. G. Parada, Fonseca C. R. B.

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In Brazil, neonatal mortality rate is considered incompatible with the country development conditions, and has been a Public Health concern. Reduction in infant mortality rates has also been part of the Millennium Development Goals, a commitment made by countries, members of the Organization of United Nations (OUN), including Brazil. Fetal mortality rate is considered a highly sensitive indicator of health care quality. Suitable actions, such as good quality and access to health services may contribute positively towards reduction in these fetal and neonatal rates. With appropriate antenatal follow-up and health care during gestation and delivery, some death causes could be reduced or even prevented by means of early diagnosis and intervention, as well as changes in risk factors and interventions. Objectives: To study the quality of maternal and infant health care based on fetal and neonatal mortality, as well as the possible actions to prevent those deaths in Botucatu (Brazil). Methods: Classification of prevention according to the International Classification of Diseases and the modified Wigglesworth´s classification. In order to evaluate adequacy, indicators of quality of antenatal and delivery care were established by the authors. Results: Considering fetal deaths, 56.7% of them occurred before delivery, which reveals possible shortcomings in antenatal care, and 38.2% of them were a result of intra- labor changes, which could be prevented or reduced by adequate obstetric management. These findings were different from those in the group of early neonatal deaths which were also studied. Adequacy of health services showed that antenatal and childbirth care was appropriate for 24% and 33.3% of pregnant women, respectively, which corroborates the results of prevention. These results revealed that shortcomings in obstetric and antenatal care could be the causes of deaths in the study. Early and late neonatal deaths have similar characteristics: 76% could be prevented or reduced mainly by adequate newborn care (52.9%) and adequate health care for gestational women (11.7%). When adequacy of care was evaluated, childbirth and newborn care was adequate in 25.8% and antenatal care was adequate in 16.1%. In conclusion, direct relationship was found between adequacy and quality of care rendered to pregnant women and newborns, and fetal and infant mortality. Moreover, our findings highlight that deaths could be prevented by an adequate obstetric and neonatal management.

Keywords: Fetal Mortality, Infant Mortality, Maternal-Child Health Services, Program Evaluation.

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

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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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Authors: Amean A. Yasir, Zainab Kh. A. Al-Mahdi Al-Amean

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In both developed and developing countries, obesity among women is increasing, but in different patterns and at very different speeds. It may have a negative effect on health, leading to reduced life expectancy and/or increased health problems. This research studied the age distribution among obese women, the types of overweight and obesity, and the extent of the problem of overweight/obesity and the obesity etiological factors among women in Hillah city in central Iraq. A total of 322 overweight and obese women were included in the study, those women were randomly selected. The Body Mass Index was used as indicator for overweight/ obesity. The incidence of overweight/obesity among age groups were estimated, the etiology factors included genetic, environmental, genetic/environmental and endocrine disease. The overweight and obese women were screened for incidence of infection and/or diseases. The study found that the prevalence of 322 overweight and obese women in Hillah city in central Iraq was 19.25% and 80.78%, respectively. The obese women types were recorded based on BMI and WHO classification as class-1 obesity (29.81%), class-2 obesity (24.22%) and class-3 obesity (26.70%), the result was discrepancy non-significant, P value < 0.05. The incidence of overweight in women was high among those aged 20-29 years (90.32%), 6.45% aged 30-39 years old and 3.22% among ≥ 60 years old, while the incidence of obesity was 20.38% for those in the age group 20-29 years, 17.30% were 30-39 years, 23.84% were 40-49 years, 16.92% were 50-59 years group and 21.53% were ≥ 60 years age group. These results confirm that the age can be considered as a significant factor for obesity types (P value < 0.0001). The result also showed that the both genetic factors and environmental factors were responsible for incidents of overweight or obesity (84.78%) p value < 0.0001. The results also recorded cases of different repeated infections (skin infection, recurrent UTI and influenza), cancer, gallstones, high blood pressure, type 2 diabetes, and infertility. Weight stigma and bias generally refers to negative attitudes; Obesity can affect quality of life, and the results of this study recorded depression among overweight or obese women. This can lead to sexual problems, shame and guilt, social isolation and reduced work performance. Overweight and Obesity are real problems among women of all age groups and is associated with the risk of diseases and infection and negatively affects quality of life. This result warrants further studies into the prevalence of obesity among women in Hillah City in central Iraq and the immune response of obese women.

Keywords: Obesity, overweight, Iraq, body mass index.

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Authors: Naima Nur, Safa Islam, Saeema Islam, Md. Faridul Alam

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The study addresses the increasing challenge of pediatric presumptive tuberculosis, emphasizing the need to understand the factors associated with it. The research aims to determine the proportion of presumptive TB and factors associated with it among suspected pediatric tuberculosis patients. A cross-sectional study was conducted at ICDDR-Bangladesh, collecting specimens from suspected pediatric patients and using logistic regression for data analysis. The study found a high proportion of presumptive TB (85.7%) but no statistically significant differences between presumptive and non-presumptive TB. Theoretical importance of the study highlights the importance of identifying factors associated with presumptive TB for better control and management strategies. Specimens were collected from 84 suspected pediatric patients diagnosed with TB based on clinical symptoms/radiological findings. Microbiological tests like smear-microscopy, culture, and GeneXpert were used to isolate presumptive TB and confirmed TB. The proportion of presumptive TB was 85.7% among suspected pediatric TB patients. Among various factors that were not found to be associated with the presumptive TB. The study concludes that despite a high proportion of presumptive TB, no significant differences were found between presumptive and non-presumptive TB cases.

Keywords: Presumptive tuberculosis, confirmed tuberculosis, patient's characteristics, diagnosis.

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

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

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

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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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Authors: Ahmed Badawi

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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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Authors: Mazhar B. Tayel, Eslam I. AlSaba

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

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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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Authors: Sri Sumartiningsih

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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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Authors: Thitaporn Thoopputra, Tipaporn Pongmesa, Shuchuen Li

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

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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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Authors: Mamoun F. Al-Mistarihi

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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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Authors: S. Murr, S. Phillips

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One of the biggest challenges entering a market with a carsharing or any other shared mobility (SM) service is sound investment decision-making. To support this process, the authors think that a city index evaluating different criteria is necessary. The goal of such an index is to benchmark cities along a set of external measures to answer the main two challenges: financially viability and the understanding of its specific requirements. The authors have consulted several shared mobility projects and industry experts to create such a Shared Mobility City Index (SMCI). The current proposal of the SMCI consists of 11 individual index measures: general data (demographics, geography, climate and city culture), shared mobility landscape (current SM providers, public transit options, commuting patterns and driving culture) and political vision and goals (vision of the Mayor, sustainability plan, bylaws/tenders supporting SM). To evaluate the suitability of the index, 16 cities on the East Coast of North America were selected and secondary research was conducted. The main sources of this study were census data, organisational records, independent press releases and informational websites. Only non-academic sources where used because the relevant data for the chosen cities is not published in academia. Applying the index measures to the selected cities resulted in three major findings. Firstly, density (city area divided by number of inhabitants) is not an indicator for the number of SM services offered: the city with the lowest density has five bike and carsharing options. Secondly, there is a direct correlation between commuting patterns and how many shared mobility services are offered. New York, Toronto and Washington DC have the highest public transit ridership and the most shared mobility providers. Lastly, except one, all surveyed cities support shared mobility with their sustainability plan. The current version of the shared mobility index is proving a practical tool to evaluate cities, and to understand functional, political, social and environmental considerations. More cities will have to be evaluated to refine the criteria further. However, the current version of the index can be used to assess cities on their suitability for shared mobility services and will assist investors deciding which city is a financially viable market.

Keywords: Carsharing, transportation, urban planning, shared mobility city index.

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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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Authors: I. Abasi, L. Fata, M. Sadeghi, S. Banihashemi, A. Mohammadee

Abstract:

Background: Dimensional and transdiagnostic approaches as a result of high comorbidity among mental disorders have captured researchers and clinicians interests for exploring the latent factors to development and maintenance of some psychological disorders. The goal of present study is comparing some of these common factors between generalized anxiety disorder and unipolar mood disorder. Methods: 27 patients with generalized anxiety disorder, 29 patients with depression disorder were recruited by using SCID-I and 69 non-clinical populations were selected by using GHQ cut off point. MANCOVA was used for analyzing data. Results: The results show that worry, rumination, intolerance of uncertainty, maladaptive metacognitive beliefs, and experiential avoidance were all significantly different between GAD and unipolar mood disorder groups. However, there weren’t any significant differences in difficulties in emotion regulation and neuroticism between GAD and unipolar mood disorder groups. Discussion: Results indicate that although there are some transdiagnostic and common factors in GAD and unipolar mood disorder, there may be some specific vulnerability factors for each disorder. Further study is needed for answering these questions.

Keywords: Depression, emotion regulation, generalized anxiety disorder, transdiagnostic.

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Authors: Roman Major, Klaudia Trembecka-Wojciga, Juergen Markus Lackner, Boguslaw Major

Abstract:

The future and the development of science is therefore seen in interdisciplinary areas such as biomedical engineering. Selfassembled structures, similar to stem cell niches would inhibit fast division process and subsequently capture the stem cells from the blood flow. By means of surface topography and the stiffness as well as microstructure progenitor cells should be differentiated towards the formation of endothelial cells monolayer which effectively will inhibit activation of the coagulation cascade. The idea of the material surface development met the interest of the clinical institutions, which support the development of science in this area and are waiting for scientific solutions that could contribute to the development of heart assist systems. This would improve the efficiency of the treatment of patients with myocardial failure, supported with artificial heart assist systems. Innovative materials would enable the redesign, in the post project activity, construction of ventricular heart assist.

Keywords: Bio-inspired materials, electron microscopy, haemocompatibility, niche-like structures, thin coatings.

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Authors: Panprapa Yongtrakul, Punyaphat Sirithanabadeekul, Pakjira Siriphan

Abstract:

Background: The thread lift technique has become popular because it is less invasive, requires a shorter operation, less downtime, and results in fewer postoperative complications. The advantage of the technique is that the thread can be inserted under the skin without the need for long incisions. Currently, there are a lot of thread lift techniques with respect to the specific types of thread used on specific areas, such as the mid-face, lower face, or neck area. Objective: To review the thread lift technique for specific areas according to type of thread, patient selection, and how to match the most appropriate to the patient. Materials and Methods: A literature review technique was conducted by searching PubMed and MEDLINE, then compiled and summarized. Result: We have divided our protocols into two sections: Protocols for short suture, and protocols for long suture techniques. We also created 3D pictures for each technique to enhance understanding and application in a clinical setting. Conclusion: There are advantages and disadvantages to short suture and long suture techniques. The best outcome for each patient depends on appropriate patient selection and determining the most suitable technique for the defect and area of patient concern.

Keywords: Thread lift, thread lift method, thread lift technique, thread lift procedure, threading.

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Authors: M. Hashemi, R. Madani, N. Razmi

Abstract:

M. paratuberculosis is a slow growing mycobactin dependent mycobacterial species known to be the causative agent of Johne’s disease in all species of domestic ruminants worldwide. JD is characterized by gradual weight loss; decreased milk production. Excretion of the organism may occur for prolonged periods (1 to 2.5 years) before the onset of clinical disease. In recent years researchers focus on identification a specific antigen of MAP to use in diagnosis test and preparation of effective vaccine. In this paper, for production of polyclonal antibody against proteins of Mycobacterium avium paratuberculosis cell well a rabbit immunization at a certain time period with antigen. After immunization of the animal, rabbit was bleeded for producing enriched serum. Antibodies were purification with ion exchange chromatography. For exact measurement of interaction, western blotting test was used that this study demonstrated sharp bands appears in nitrocellulose paper and specific bands were 50 and 150 KD molecular weight. These were indicating immunodominant proteins.

Keywords: Paratuberculosis, Immunodominant, Western blotting, Ion exchange choromatography.

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Authors: Desmond B. Keenan

Abstract:

The clinical usefulness of heart rate variability is limited to the range of Holter monitoring software available. These software algorithms require a normal sinus rhythm to accurately acquire heart rate variability (HRV) measures in the frequency domain. Premature ventricular contractions (PVC) or more commonly referred to as ectopic beats, frequent in heart failure, hinder this analysis and introduce ambiguity. This investigation demonstrates an algorithm to automatically detect ectopic beats by analyzing discrete wavelet transform coefficients. Two techniques for filtering and replacing the ectopic beats from the RR signal are compared. One technique applies wavelet hard thresholding techniques and another applies linear interpolation to replace ectopic cycles. The results demonstrate through simulation, and signals acquired from a 24hr ambulatory recorder, that these techniques can accurately detect PVC-s and remove the noise and leakage effects produced by ectopic cycles retaining smooth spectra with the minimum of error.

Keywords: Heart rate variability, vagal tone, sympathetic, parasympathetic, wavelets, ectopic beats, spectral analysis.

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Authors: Tsair-Fwu Lee , Hui-Min Ting , Pei-Ju Chao, Jing-Chuan Jiang, Min-Yuan Chao, Wen-Cheng Chen, Long-Chang Chen, Jia-Ming Wu

Abstract:

The purpose of this study is to derive parameters estimating for the Lyman–Kutcher–Burman (LKB) normal tissue complication probability (NTCP) model using analysis of scintigraphy assessments and quality of life (QoL) measurement questionnaires for the parotid gland (xerostomia). In total, 31 patients with head-and-neck (HN) cancer were enrolled. Salivary excretion factor (SEF) and EORTC QLQ-H&N35 questionnaires datasets are used for the NTCP modeling to describe the incidence of grade 4 xerostomia. Assuming that n= 1, NTCP fitted parameters are given as TD50= 43.6 Gy, m= 0.18 in SEF analysis, and as TD50= 44.1 Gy, m= 0.11 in QoL measurements, respectively. SEF and QoL datasets can validate the Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC) guidelines well, resulting in NPV-s of 100% for the both datasets and suggests that the QUANTEC 25/20Gy gland-spared guidelines are suitable for clinical used for the HN cohort to effectively avoid xerostomia.

Keywords: HN, NTCP, SEF, QoL, QUANTEC

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