Search results for: medical tourism

Authors: Heshalini Rajagopal, Li Sze Chow, Raveendran Paramesran

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Magnetic Resonance Imaging (MRI) is one of the most important medical imaging modality. Subjective assessment of the image quality is regarded as the gold standard to evaluate MR images. In this study, a database of 210 MR images which contains ten reference images and 200 distorted images is presented. The reference images were distorted with four types of distortions: Rician Noise, Gaussian White Noise, Gaussian Blur and DCT compression. The 210 images were assessed by ten subjects. The subjective scores were presented in Difference Mean Opinion Score (DMOS). The DMOS values were compared with four FR-IQA metrics. We have used Pearson Linear Coefficient (PLCC) and Spearman Rank Order Correlation Coefficient (SROCC) to validate the DMOS values. The high correlation values of PLCC and SROCC shows that the DMOS values are close to the objective FR-IQA metrics.

Keywords: Medical Resonance (MR) images, Difference Mean Opinion Score (DMOS), Full Reference Image Quality Assessment (FR-IQA).

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Authors: Chakkrit Snae, Michael Brueckner

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In this paper the authors present the framework of a system for assisting users through counseling on personal health, the Personal Health Assistance Service Expert System (PHASES). Personal health assistance systems need Personal Health Records (PHR), which support wellness activities, improve the understanding of personal health issues, enable access to data from providers of health services, strengthen health promotion, and in the end improve the health of the population. This is especially important in societies where the health costs increase at a higher rate than the overall economy. The most important elements of a healthy lifestyle are related to food (such as balanced nutrition and diets), activities for body fitness (such as walking, sports, fitness programs), and other medical treatments (such as massage, prescriptions of drugs). The PHASES framework uses an ontology of food, which includes nutritional facts, an expert system keeping track of personal health data that are matched with medical treatments, and a comprehensive data transfer between patients and the system.

Keywords: Personal health assistance service, expert system, ontologies, knowledge management, information technology.

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Authors: Sreejith Jayachandran, Mojtaba Ghodsi, Morteza Mohammadzaheri

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The modern busy world is running behind new embedded technologies based on computers and software meanwhile some people are unable to monitor their health condition and regular medical check-ups. Some of them postpone medical check-ups due to a lack of time and convenience while others skip these regular evaluations and medical examinations due to huge medical bills and hospital expenses. In this research, we present a device in the telemonitoring system capable of monitoring, checking, and evaluating the health status of the human body remotely through the internet for the needs of all kinds of people. The remote health monitoring device is a microcontroller-based embedded unit. The various types of sensors in this device are connected to the human body, and with the help of an Arduino UNO board, the required analogue data are collected from the sensors. The microcontroller on the Arduino board processes the analogue data collected in this way into digital data and transfers that information to the cloud and stores it there; the processed digital data are then instantly displayed through the LCD attached to the machine. By accessing the cloud storage with a username and password, the concerned person’s health care teams/doctors, and other health staff can collect these data for the assessment and follow-up of that patient. Besides that, the family members/guardians can use and evaluate these data for awareness of the patient's current health status. Moreover, the system is connected to a GPS module. In emergencies, the concerned team can be positioning the patient or the person with this device. The setup continuously evaluates and transfers the data to the cloud and also the user can prefix a normal value range for the evaluation. For example, the blood pressure normal value is universally prefixed between 80/120 mmHg. Similarly, the Remote Health Monitoring System (RHMS) is also allowed to fix the range of values referred to as normal coefficients. This IoT-based miniature system 11×10×10 cm3 with a low weight of 500 gr only consumes 10 mW. This smart monitoring system is manufactured for 100 GBP (British Pound Sterling), and can facilitate the communication between patients and health systems, but also it can be employed for numerous other uses including communication sectors in the aerospace and transportation systems.

Keywords: Embedded Technology, Telemonitoring system, Microcontroller, Arduino UNO, Cloud storage, GPS, RHMS, Remote Health Monitoring System, Alert system.

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Authors: K. Jyothi, T. S. Mohamed Saleem, L. Vineela, C. Gopinath, K. B. Yadavender Reddy

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Objective: Acute coronary syndrome is a clinical condition encompassing ST segments elevation myocardial infraction, Non ST segment is elevation myocardial infraction and un stable angina is characterized by ruptured coronary plaque, stress and myocardial injury. Angina pectoris is a pressure like pain in the chest that is induced by exertion or stress and relived with in the minute after cessation of effort or using sublingual nitroglycerin. The present research was undertaken to study the drug utilization pattern of antiplatelet drugs for the ischemic heart disease in a tertiary care hospital. Method: The present study is retrospective drug utilization study and study period is 6months. The data is collected from the discharge case sheet of general medicine department from medical department Rajiv Gandhi institute of medical sciences, Kadapa. The tentative sample size fixed was 250 patients. Out of 250 cases 19 cases was excluded because of unrelated data. Results: A total of 250 prescriptions were collected for the study according to the inclusion criteria 233 prescriptions were diagnosed with ischemic heart disease 17 prescriptions were excluded due to unrelated information. out of 233 prescriptions 128 are male (54.9%) and 105 patients are were female (45%). According to the gender distribution, the prevalence of ischemic heart disease in males are 90 (70.31%) and females are 39 (37.1%). In the same way the prevalence of ischemic heart disease along with cerebrovascular disease in males are 39 (29.6%) and females are 66 (62.6%). Conclusion: We found that 94.8% of drug utilization of antiplatelet drugs was achieved in the Rajiv Gandhi institute of medical sciences, Kadapa from 2011-2012.

Keywords: Angina pectoris, aspirin, clopidogrel, myocardial infarction.

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Authors: J. George, M. Al Mutairi, W. Aljuryyad, A. Alhussanan, A. Alkashan, T. Aldoghiri, Z. Alamari, A. Albakr

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Introduction: Students make plans for their career and are keen in exploring options of employment in those carriers. They make their employment choice based on their desires and preferences. This study aims to identify if students of King Saud Bin Abdulaziz for Health Sciences, College of Applied Medical Sciences after obtaining appropriate education prefer to work as clinicians, university faculty, or full-time researchers. There are limited studies in Saudi Arabia exploring the university student’s employment choices and preferences. This study would help employers to build the required job positions and prevent misleading employers from opening undesired positions in the job market. Methodology: The study included 394 students from third and fourth years both male and female among the eighth programs of college of applied medical sciences, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh campus. A prospective quantitative cross-sectional study was conducted; data were collected by distributing a seven item questionnaire and analyzed using SPSS. Results: Among the participants, 358 (90.9%) of them chose one of the three listed career choices, 263 (66.8%) decided to work as hospital staff after their education, 75 students (19.0%) chose to work as a faculty member in a university after obtaining appropriate degree, 20 students (5.1%) preferred to work as full-time researcher after obtaining appropriate degree, the remaining 36 students (9.1%) had different career goals, such as obtaining a master degree after graduating, to obtain a bachelor of medicine and bachelor in surgery degree, and working in the private sector. The most recurrent reason behind the participants' choice was "career goal", where 276 (70.1%) chose it as a reason. Conclusion: The findings of the study showed that most student’s preferred to work in hospitals as clinicians, followed by choice of working as a faculty in a university, the least choice was to be working as full-time researchers.

Keywords: College of Applied Medical Sciences, employment ambitions, graduating students, King Saud bin Abdulaziz University for Health Sciences.

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Authors: P. C. Kutschera, Elena C. Tesoro, Mary Grace Talamera-Sandico, Jose Maria G. Pelayo III

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Second generation military Filipino Amerasians comprise a formidable contemporary segment of the estimated 250,000-plus biracial Amerasians in the Philippines today. Overall, they are a stigmatized and socioeconomically marginalized diaspora; historically, they were abandoned or estranged by U.S. military personnel fathers assigned during the century-long Colonial, Post- World War II and Cold War Era of permanent military basing (1898- 1992). Indeed, U.S. military personnel are assigned in smaller numbers in the Philippines today. This inquiry is an outgrowth of two recent small sample studies. The first surfaced the impact of the U.S. military prostitution system on formation of the ‘Derivative Amerasian Family Construct’ on first generation Amerasians; a second, qualitative case study suggested the continued effect of the prostitution systems' destructive impetuous on second generation Amerasians. The intent of this current qualitative, multiple-case study was to actively seek out second generation sex industry toilers. The purpose was to focus further on this human phenomenon in the postbasing and post-military prostitution system eras. As background, the former military prostitution apparatus has transformed into a modern dynamic of rampant sex tourism and prostitution nationwide. This is characterized by hotel and resorts offering unrestricted carnal access, urban and provincial brothels (casas), discos, bars and pickup clubs, massage parlors, local barrio karaoke bars and street prostitution. A small case study sample (N = 4) of female and male second generation Amerasians were selected. Sample formation employed a non-probability ‘snowball’ technique drawing respondents from the notorious Angeles, Metro Manila, Olongapo City ‘AMO Amerasian Triangle’ where most former U.S. military installations were sited and modern sex tourism thrives. A six-month study and analysis of in-depth interviews of female and male sex laborers, their families and peers revealed a litany of disturbing, and troublesome experiences. Results showed profiles of debilitating human poverty, history of family disorganization, stigmatization, social marginalization and the ghost of the military prostitution system and its harmful legacy on Amerasian family units. Emerging were testimonials of wayward young people ensnared in a maelstrom of deep economic deprivation, familial dysfunction, psychological desperation and societal indifference. The paper recommends that more study is needed and implications of unstudied psychosocial and socioeconomic experiences of distressed younger generations of military Amerasians require specific research. Heretofore apathetic or disengaged U.S. institutions need to confront the issue and formulate activist and solution-oriented social welfare, human services and immigration easement policies and alternatives. These institutions specifically include academic and social science research agencies, corporate foundations, the U.S. Congress, and Departments of State, Defense and Health and Human Services, and Homeland Security (i.e. Citizen and Immigration Services) It is them who continue to endorse a laissez-faire policy of non-involvement over the entire Filipino Amerasian question. Such apathy, the paper concludes, relegates this consequential but neglected blood progeny to the status of humiliating destitution and exploitation. Amerasians; thus, remain entrapped in their former colonial, and neo-colonial habitat. Ironically, they are unwitting victims of a U.S. American homeland that fancies itself geo-politically as a strong and strategic military treaty ally of the Philippines in the Western Pacific.

Keywords: Asian Americans, Filipino Amerasians, diaspora, military prostitution, stigmatization.

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Authors: Librado A. Santiago, Anna Beatriz R. Mayor

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Alongside with antioxidant, pro-oxidant activity is also observed in phytochemical compounds. In the study, Ficus odorata, an endemic medicinal plant in the Philippines, was screened for the potential medical application of its pro-oxidant activity.

Phytochemical screening revealed the presence of terpenes, glycosides and phenolic acids. The crude extract was found to contain low gallic acid and quercetin equivalence. The TLC chromatogram of the crude extract showed that none of the 11 spots obtained has antioxidant activity nor correspond to gallic acid and quercetin standards. Experiments showed that the crude extract has stimulatory activity towards DPPH radicals, hydrogen peroxide, hydroxyl radicals, superoxide anions and nitric oxide. Moreover, the extract exhibited a low ferric reducing power.

The prooxidant activity was evident in the crude ethanolic leaf extract of F. odorata, which may provide a better understanding of the plant’s pharmacological importance in the prevention of diseases.

Keywords: Ficus odorata Blanco, Free Radicals, Oxidative Stress, Prooxidant, Antioxidant.

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Authors: Shih-Hsu Wang, Yuan-Yuan Cheng, Ming-Tsung Lee, Wei-Chih Wang

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Determining reasonable fees is the main objective of designing the cost estimation and payment systems for consultant contracts. However, project clients utilize different cost estimation and payment systems because of their varying views on the reasonableness of consultant fees. This study reviews the cost estimation and payment systems of consultant contracts for five countries, including the US (Washington State Department of Transportation), Japan (Ministry of Land, Infrastructure, Transport and Tourism), China (Engineering Design Charging Standard) and UK (Her Majesty's Treasure). Specifically, this work investigates the budgeting process, contractor selection method, contractual price negotiation process, cost review, and cost-control concept of the systems used in these countries. The main finding indicates that that project client-s view on whether the fee is high will affect the way he controls it. In the US, the fee is commonly considered to be high. As a result, stringent auditing system (low flexibility given to the consultant) is then applied. In the UK, the fee is viewed to be low by comparing it to the total life-cycle project cost. Thus, a system that has high flexibility in budgeting and cost reviewing is given to the consultant. In terms of the flexibility allowed for the consultant, the systems applied in Japan and China fall between those of the US and UK. Both the US and UK systems are helpful in determining a reasonable fee. However, in the US system, rigid auditing standards must be established and additional cost-audit manpower is required. In the UK system, sufficient historical cost data should be needed to evaluate the reasonableness of the consultant-s proposed fee

Keywords: Consultant Services, Cost Estimation and Payment System, Payment Flexibility, Cost-control Concept

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Authors: Zhalmagambetov Yerlanbek, Assymova Dariya, Tashieva Saltanat, and Aliya Bolatkhan

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The relevance of the study of everyday life in Almaty and Kyzylorda are associated with the emergence of the modern trends in historiography and socializing areas of government reform. The relevance is due to the fact that in the early twentieth century Kyzylorda and Almaty began to develop as a city and this period has a special place in the life of the state. An interesting aspect of the everyday life of the inhabitants of the new city, which was built in the era of Stalin's Five-Year Plans, can be examined through the eyes of the Soviet people living in a specific environment, reflecting the life of the citizens. The study of industrialization of the Soviet Union and the attention paid to new developments in the first five years of everyday aspects as the impact of the modernization of the 1930s was one of the decisive factors in the lives of residents. Among these factors, we would like to highlight the medical field, which is the basis of all human life, specifically focusing on the state of medicine in Alma-Ata in the first 20-30-years of the twentieth century, and analyze the different aspects of human life, determining the quality of medical care to the population during this period.

Keywords: Alma Ata, capital, epidemic diseases, health care, Kyzylorda, the USSR, Vernyj.

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Authors: Seyed Ziya Tabatabaei, Azimi Bin Hj Hamzah, Fatemeh Ebrahimi

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The increase in proportion of older people in Malaysia has led to a significant growth of health care demands. The aim of this study is to explore how perceived health care needs influence on quality of life among elderly Malay residents who reside in a Malaysian residential home. This study employed a method known as ethnographic research from May 2011 to January 2012. Four data collection strategies were selected as the main data-collecting tools including participant observation, field notes, in-depth interviews, and review of related documents. The nine knowledgeable participants for the present study were selected using the purposive sampling method. Two themes were identified: (1) Medical concerns: Feeling secure, lack of information, inadequate medical staff; and (2) Health promotion: Body condition, health education, physiotherapy and rehabilitation. These results could evoke the attention of policy-makers and care providers to better meet elderly residents’ health care needs.

Keywords: Ethnographic study, health care needs, elderly Malay people, Malaysia, quality of life, residential home.

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Authors: Jheng-Long Wu, Pei-Chann Chang, Shih-Ling Chang, Liang-Chih Yu, Jui-Feng Yeh, Chin-Sheng Yang

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The Major Depressive Disorder has been a burden of medical expense in Taiwan as well as the situation around the world. Major Depressive Disorder can be defined into different categories by previous human activities. According to machine learning, we can classify emotion in correct textual language in advance. It can help medical diagnosis to recognize the variance in Major Depressive Disorder automatically. Association language incremental is the characteristic and relationship that can discovery words in sentence. There is an overlapping-category problem for classification. In this paper, we would like to improve the performance in classification in principle of no overlapping-category problems. We present an approach that to discovery words in sentence and it can find in high frequency in the same time and can-t overlap in each category, called Association Language Features by its Category (ALFC). Experimental results show that ALFC distinguish well in Major Depressive Disorder and have better performance. We also compare the approach with baseline and mutual information that use single words alone or correlation measure.

Keywords: Association language features, Emotion Classification, Overlap-Category Feature, Nature Language Processing.

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Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: Data integrity, data integrity challenges, hospital information systems, South Africa.

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Authors: M. P. Sebastian

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Health for all is considered as a sign of well-being and inclusive growth. New healthcare technologies are contributing to the quality of human lives by promoting health education and awareness, leading to the prevention, early diagnosis and treatment of the symptoms of diseases. Healthcare technologies have now migrated from the medical and institutionalized settings to the home and everyday life. This paper explores these new technologies and investigates how they contribute to health education and awareness, promoting the objective of high-value health system for all. The methodology used for the research is literature review. The paper also discusses the opportunities and challenges with futuristic healthcare technologies. The combined advances in genomics medicine, wearables and the IoT with enhanced data collection in electronic health record (EHR) systems, environmental sensors, and mobile device applications can contribute in a big way to high-value health system for all. The promise by these technologies includes reduced total cost of healthcare, reduced incidence of medical diagnosis errors, and reduced treatment variability. The major barriers to adoption include concerns with security, privacy, and integrity of healthcare data, regulation and compliance issues, service reliability, interoperability and portability of data, and user friendliness and convenience of these technologies.

Keywords: Bigdata, education, healthcare, ICT, patients, technologies.

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Authors: J. P. Dubois, O. M. Abdul-Latif

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Support Vector Machine (SVM) is a statistical learning tool that was initially developed by Vapnik in 1979 and later developed to a more complex concept of structural risk minimization (SRM). SVM is playing an increasing role in applications to detection problems in various engineering problems, notably in statistical signal processing, pattern recognition, image analysis, and communication systems. In this paper, SVM was applied to the detection of medical ultrasound images in the presence of partially developed speckle noise. The simulation was done for single look and multi-look speckle models to give a complete overlook and insight to the new proposed model of the SVM-based detector. The structure of the SVM was derived and applied to clinical ultrasound images and its performance in terms of the mean square error (MSE) metric was calculated. We showed that the SVM-detected ultrasound images have a very low MSE and are of good quality. The quality of the processed speckled images improved for the multi-look model. Furthermore, the contrast of the SVM detected images was higher than that of the original non-noisy images, indicating that the SVM approach increased the distance between the pixel reflectivity levels (detection hypotheses) in the original images.

Keywords: LS-SVM, medical ultrasound imaging, partially developed speckle, multi-look model.

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

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

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

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Authors: Shaoyan Sun, Liwei Zhang, Chonghui Guo

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As the use of registration packages spreads, the number of the aligned image pairs in image databases (either by manual or automatic methods) increases dramatically. These image pairs can serve as a set of training data. Correspondingly, the images that are to be registered serve as testing data. In this paper, a novel medical image registration method is proposed which is based on the a priori knowledge of the expected joint intensity distribution estimated from pre-aligned training images. The goal of the registration is to find the optimal transformation such that the distance between the observed joint intensity distribution obtained from the testing image pair and the expected joint intensity distribution obtained from the corresponding training image pair is minimized. The distance is measured using the divergence measure based on Tsallis entropy. Experimental results show that, compared with the widely-used Shannon mutual information as well as Tsallis mutual information, the proposed method is computationally more efficient without sacrificing registration accuracy.

Keywords: Multimodality images, image registration, Shannonentropy, Tsallis entropy, mutual information, Powell optimization.

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Authors: M. E. Abalaka, S. Y. Daniyan, S. O. Adeyemo, D. Damisa

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Gold nanoparticles (AuNPs) have gained increasing interest in recent times. This is greatly due to their special features, which include unusual optical and electronic properties, high stability and biological compatibility, controllable morphology and size dispersion, and easy surface functionalization. In typical synthesis, AuNPs were produced by reduction of gold salt AuCl4 in an appropriate solvent. A stabilizing agent was added to prevent the particles from aggregating. The antibacterial activity of different sizes of gold nanoparticles was investigated against Staphylococcus aureus, Salmonella typhi and Pseudomonas pneumonia using the disk diffusion method in a Müeller–Hinton Agar. The Au-NPs were effective against all bacteria tested. That the Au-NPs were successfully synthesized in suspension and were used to study the antibacterial activity of the two medicinal plants against some bacterial pathogens suggests that Au-NPs can be employed as an effective bacteria inhibitor and may be an effective tool in medical field. The study clearly showed that the Au-NPs exhibiting inhibition towards the tested pathogenic bacteria in vitro could have the same effects in vivo and thus may be useful in the medical field if well researched into.

Keywords: Gold Nanoparticles, Gomphrena celesioides, Prunus amygdalus, Pathogens.

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Authors: Lidon Lashley

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This paper presents how the social model of disability can be used to reshape inclusive education practices in Guyana. Inclusive education in Guyana is metamorphosizing but still firmly held in the tenets of the Medical Model of Disability which influences the experiences of children with Special Education Needs and/or Disabilities (SEN/D). An ethnographic approach to data gathering was employed in this study. Qualitative data were gathered from the voices of children with and without SEN/D as well as their mainstream teachers to present the interplay of discourses and subjectivities in the situation. The data were analyzed using Adele Clarke's situational analysis. The data suggest that it is possible but will be challenging to fully contextualize and adopt Loreman's synthesis and Booths and Ainscow's Index in the two mainstream schools studied. In addition, the data paved the way for the presentation of the 'Southern Inclusive Education Framework for Guyana' and its support tool 'The Inclusive Checker created for Southern mainstream primary classrooms'.

Keywords: Social Model of Disability, Medical Model of Disability, subjectivities, metamorphosis, special education needs, postcolonial Guyana, Quasi-inclusion practices, Guyanese cultural challenges, mainstream primary schools, Loreman's Synthesis, Booths and Ainscow's Index.

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Authors: Siripen Yiamjanya, Kevin Wongleedee

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This research paper aims to identify travel motivation by push and pull factors that affected decision making of international tourists in selecting Thailand as their destination choice. A total of 200 international tourists who traveled to Thailand during January and February, 2014 were used as the sample in this study. A questionnaire was employed as a tool in collecting the data, conducted in Bangkok. The list consisted of 30 attributes representing both psychological factors as “push- based factors” and destination factors as “pull-based factors”. Mean and standard deviation were used in order to find the top ten travel motives that were important determinants in the respondents’ decision making process to select Thailand as their destination choice. The finding revealed the top ten travel motivations influencing international tourists to select Thailand as their destination choice included [i] getting experience in foreign land; [ii] Thai food; [iii] learning new culture; [iv] relaxing in foreign land; [v] wanting to learn new things; [vi] being interested in Thai culture, and traditional markets; [vii] escaping from same daily life; [viii] enjoying activities; [ix] adventure; and [x] good weather. Classification of push- based and pull- based motives suggested that getting experience in foreign land was the most important push motive for international tourists to travel, while Thai food portrayed its highest significance as pull motive. Discussion and suggestions were also made for tourism industry of Thailand.

Keywords: Decision Making, Destination Choice, International Tourist, Pull Factor, Push Factor, Thailand, Travel Motivation.

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Authors: Hritwik Ghosh, Irfan Sadiq Rahat, Sachi Nandan Mohanty, J. V. R. Ravindra, Abdus Sobur

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In the rapidly evolving landscape of medical diagnostics, the early detection and accurate classification of skin cancer remain paramount for effective treatment outcomes. This research delves into the transformative potential of artificial intelligence (AI), specifically deep learning (DL), as a tool for discerning and categorizing various skin conditions. Utilizing a diverse dataset of 3,000 images, representing nine distinct skin conditions, we confront the inherent challenge of class imbalance. This imbalance, where conditions like melanomas are over-represented, is addressed by incorporating class weights during the model training phase, ensuring an equitable representation of all conditions in the learning process. Our approach presents a hybrid model, amalgamating the strengths of two renowned convolutional neural networks (CNNs), VGG16 and ResNet50. These networks, pre-trained on the ImageNet dataset, are adept at extracting intricate features from images. By synergizing these models, our research aims to capture a holistic set of features, thereby bolstering classification performance. Preliminary findings underscore the hybrid model's superiority over individual models, showcasing its prowess in feature extraction and classification. Moreover, the research emphasizes the significance of rigorous data pre-processing, including image resizing, color normalization, and segmentation, in ensuring data quality and model reliability. In essence, this study illuminates the promising role of AI and DL in revolutionizing skin cancer diagnostics, offering insights into its potential applications in broader medical domains.

Keywords: Artificial intelligence, machine learning, deep learning, skin cancer, dermatology, convolutional neural networks, image classification, computer vision, healthcare technology, cancer detection, medical imaging.

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Authors: H. Feza Carlak, N. G. Gencer

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To increase the temperature contrast in thermal images, the characteristics of the electrical conductivity and thermal imaging modalities can be combined. In this experimental study, it is objected to observe whether the temperature contrast created by the tumor tissue can be improved just due to the current application within medical safety limits. Various thermal breast phantoms are developed to simulate the female breast tissue. In vitro experiments are implemented using a thermal infrared camera in a controlled manner. Since experiments are implemented in vitro, there is no metabolic heat generation and blood perfusion. Only the effects and results of the electrical stimulation are investigated. Experimental study is implemented with two-dimensional models. Temperature contrasts due to the tumor tissues are obtained. Cancerous tissue is determined using the difference and ratio of healthy and tumor images. 1 cm diameter single tumor tissue causes almost 40 °mC temperature contrast on the thermal-breast phantom. Electrode artifacts are reduced by taking the difference and ratio of background (healthy) and tumor images. Ratio of healthy and tumor images show that temperature contrast is increased by the current application.

Keywords: Medical diagnostic imaging, breast phantom, active thermography, breast cancer detection.

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Authors: D. Mokhtari

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Any variation in environmental characteristics of geomorphosites would lead to destabilisation of their geotouristic values all around the planet. The Urmia lake, with an area of approximately 5,500 km2 and a catchment area of 51,876 km2, and to which various reasons over time, especially in the last fifty years have seen a sharp decline and have decreased by about 93 % in two recent decades. These variations are not only driving significant changes in the morphology and ecology of the present lake landscape, but at the same time are shaping newly formed morphologies, which vanished some valuable geomorphosites or develop into smaller geomorphosites with significant value from a scientific and cultural point of view. This paper analyses and discusses features and evolution in several representative coastal and island geomorphosites. For this purpose, a total of 23 geomorphosites were studied in two data series (1963 and 2015) and the respective data were compared and analysed. The results showed, the total loss in geomorphosites area in a half century amounted to a loss of more than 90% of the valuable geomorphosites. Moreover, the comparison between the mean yearly value of coastal area lost over the entire period and the yearly average calculated for the shorter period (1998- 2014) clearly indicates a pattern of acceleration. This acceleration in the rate of reduction in lake area was seen in most of the southern half of the lake. In the region as well, the general water-level falling is not only causing the loss of a significant water resource, which is followed by major impact on regional ecosystems, but is also driving the most marked recent (last century) changes in the geotouristic landscapes. In fact, the disappearance of geomorphosites means the loss of tourism phenomenon. In this context attention must be paid to the question of conservation. The action needed to safeguard geomorphosites includes: 1) Preventive action, 2) Corrective action, and 3) Sharing knowledge.

Keywords: Changing lake, environmental changes, geomorphosite, northwest of Iran, Urmia lake.

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

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Despite the existence of different dental specialties, the dentist-patient relationship is unique, in the very fact that the treatment is performed by one doctor and the patient identifies the malpractice presented as part of that doctor's practice; this is in complete contrast to cases of medical treatments where the patient can be presented to a team of doctors, to treat a specific pathology. The rules of dental ethics are almost the same as the rules of medical ethics. The appearance of dental malpractice affects exactly this two-party relationship, created on the basis of professionalism, without deviations in this direction, between the dentist and the patient, but with very narrow individual boundaries, compared to cases of medical malpractice. Malpractice can have different reasons for its appearance, starting from professional negligence, but also from the lack of professional knowledge of the dentist who undertakes the dental treatment. It should always be seen in perspective that we are not talking about the individual - the dentist who goes to work with the intention of harming their patients. Malpractice can also be a consequence of the impossibility, for anatomical or physiological reasons of the tooth under dental treatment, to realize the predetermined dental treatment plan. On the other hand, the dentist himself is an individual who can be affected by health conditions, or have vices that affect the systemic health of the dentist as an individual, which in these conditions can cause malpractice. So, depending on the reason that led to the appearance of malpractice, the method of treatment from a legal point of view also varies, for the dentist who committed the malpractice, evaluating the latter if the malpractice came under the conditions of applying the rules of dental ethics. The deviation from the predetermined dental plan is the minimum sign of malpractice and the latter should not be definitively related only to cases of difficult dental treatments. The identification of the reason for the appearance of malpractice is the initial element, which makes the difference in the way of its treatment, from a legal point of view, and the involvement of the dentist in the assessment of the malpractice committed, must be based on the legislation in force, which must be said to have their specific changes in different states. Malpractice should be referred to, or included in the lectures or in the continuing education of professionals, because it serves as a method of obtaining professional experience in order not to repeat the same thing several times, by different professionals.

Keywords: Dental ethics, malpractice, negligence, legal basis, continuing education, dental treatments.

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Authors: Ashkan Ebadi, Adam Krzyzak

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Recommender systems, also known as recommender engines, have become an important research area and are now being applied in various fields. In addition, the techniques behind the recommender systems have been improved over the time. In general, such systems help users to find their required products or services (e.g. books, music) through analyzing and aggregating other users’ activities and behavior, mainly in form of reviews, and making the best recommendations. The recommendations can facilitate user’s decision making process. Despite the wide literature on the topic, using multiple data sources of different types as the input has not been widely studied. Recommender systems can benefit from the high availability of digital data to collect the input data of different types which implicitly or explicitly help the system to improve its accuracy. Moreover, most of the existing research in this area is based on single rating measures in which a single rating is used to link users to items. This paper proposes a highly accurate hotel recommender system, implemented in various layers. Using multi-aspect rating system and benefitting from large-scale data of different types, the recommender system suggests hotels that are personalized and tailored for the given user. The system employs natural language processing and topic modelling techniques to assess the sentiment of the users’ reviews and extract implicit features. The entire recommender engine contains multiple sub-systems, namely users clustering, matrix factorization module, and hybrid recommender system. Each sub-system contributes to the final composite set of recommendations through covering a specific aspect of the problem. The accuracy of the proposed recommender system has been tested intensively where the results confirm the high performance of the system.

Keywords: Tourism, hotel recommender system, hybrid, implicit features.

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Authors: Lubis A., Setiawati L., Setyoningrum A. R., Suryawan A., Irwanto

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Asthma is a condition that causing chronic health problems in children. In addition to basic therapy against disease, we must try to reduce the impact of chronic health problems and also optimize their medical aspect of growth and development. A boy with mild asthma attack frequent episode did not showed any improvement with medical treatment and his asthma control test was 11. From radiologic examination he got hyperaerated lung and billateral sinusitis maxillaris; skin test results were house dust, food and pet allergy; an overweight body; bad school grades; psychological and environmental problem. We followed and evaluated this boy in 6 months, treated holistically. Even we could not do much on environmental but no more psychological and school problems, his on a good bodyweight and his asthma control test was 22. A case of a child with mild asthma attack frequent episode was reported. Asthma clinical course show no significant improvement when other predisposing factor is not well-controlled and a child’s growth and development may be affected. Improving condition of the patient can be created with the help of loving and caring way of nurturing from the parents and supportive peer group. Therefore, continuous and consistent monitoring is required because prognosis of asthma is generally good when regularly and properly controlled.

Keywords: Asthma, chronic health problems, growth and development.

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Authors: Faith-Michael E. Uzoka, Boluwaji A. Akinnuwesi, Taiwo Amoo, Flora Aladi, Stephen Fashoto, Moses Olaniyan, Joseph Osuji

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The overarching aim of this study is to develop a soft-computing system for the differential diagnosis of tropical diseases. These conditions are of concern to health bodies, physicians, and the community at large because of their mortality rates, and difficulties in early diagnosis due to the fact that they present with symptoms that overlap, and thus become ‘confusable’. We report on the first phase of our study, which focuses on the development of a fuzzy cognitive map model for early differential diagnosis of tropical diseases. We used malaria as a case disease to show the effectiveness of the FCM technology as an aid to the medical practitioner in the diagnosis of tropical diseases. Our model takes cognizance of manifested symptoms and other non-clinical factors that could contribute to symptoms manifestations. Our model showed 85% accuracy in diagnosis, as against the physicians’ initial hypothesis, which stood at 55% accuracy. It is expected that the next stage of our study will provide a multi-disease, multi-symptom model that also improves efficiency by utilizing a decision support filter that works on an algorithm, which mimics the physician’s diagnosis process.

Keywords: Medical diagnosis, tropical diseases, fuzzy cognitive map, decision support filters, malaria differential diagnosis.

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Authors: Salama Meghriche, Amer Draa, Mohammed Boulemden

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Heart failure is the most common reason of death nowadays, but if the medical help is given directly, the patient-s life may be saved in many cases. Numerous heart diseases can be detected by means of analyzing electrocardiograms (ECG). Artificial Neural Networks (ANN) are computer-based expert systems that have proved to be useful in pattern recognition tasks. ANN can be used in different phases of the decision-making process, from classification to diagnostic procedures. This work concentrates on a review followed by a novel method. The purpose of the review is to assess the evidence of healthcare benefits involving the application of artificial neural networks to the clinical functions of diagnosis, prognosis and survival analysis, in ECG signals. The developed method is based on a compound neural network (CNN), to classify ECGs as normal or carrying an AtrioVentricular heart Block (AVB). This method uses three different feed forward multilayer neural networks. A single output unit encodes the probability of AVB occurrences. A value between 0 and 0.1 is the desired output for a normal ECG; a value between 0.1 and 1 would infer an occurrence of an AVB. The results show that this compound network has a good performance in detecting AVBs, with a sensitivity of 90.7% and a specificity of 86.05%. The accuracy value is 87.9%.

Keywords: Artificial neural networks, Electrocardiogram(ECG), Feed forward multilayer neural network, Medical diagnosis, Pattern recognitionm, Signal processing.

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Authors: Christopher C. Anyadubalu

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Biological, psychological and social experiences and perceptions of healthcare services in patients medically diagnosed of coronary heart disease were investigated using a sample of 10 participants whose responses to the in-depth interview questions were analyzed based on inter-and-intra-case analyses. The results obtained revealed that advancing age, single status, divorce and/or death of spouse and the issue of single parenting negatively impacted patients- biopsychosocial experiences. The patients- experiences of physical signs and symptoms, anxiety and depression, past serious medical conditions, use of self-prescribed medications, family history of poor mental/medical or physical health, nutritional problems and insufficient physical activities heightened their risk of coronary attack. Collectivist culture served as a big source of relieve to the patients. Patients- temperament, experience of different chronic life stresses/challenges, mood alteration, regular drinking, smoking/gambling, and family/social impairments compounded their health situation. Patients were satisfied with the biomedical services rendered by the healthcare personnel, whereas their psychological and social needs were not attended to. Effective procedural treatment model, a holistic and multidimensional approach to the treatment of heart disease patients was proposed.

Keywords: Biopsychosocial, Coronary Heart Disease, Experience, Patients, Perception, Perspective.

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Authors: Hussein Alahmer, Amr Ahmed

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Liver cancer is one of the common diseases that cause the death. Early detection is important to diagnose and reduce the incidence of death. Improvements in medical imaging and image processing techniques have significantly enhanced interpretation of medical images. Computer-Aided Diagnosis (CAD) systems based on these techniques play a vital role in the early detection of liver disease and hence reduce liver cancer death rate.  This paper presents an automated CAD system consists of three stages; firstly, automatic liver segmentation and lesion’s detection. Secondly, extracting features. Finally, classifying liver lesions into benign and malignant by using the novel contrasting feature-difference approach. Several types of intensity, texture features are extracted from both; the lesion area and its surrounding normal liver tissue. The difference between the features of both areas is then used as the new lesion descriptors. Machine learning classifiers are then trained on the new descriptors to automatically classify liver lesions into benign or malignant. The experimental results show promising improvements. Moreover, the proposed approach can overcome the problems of varying ranges of intensity and textures between patients, demographics, and imaging devices and settings.

Keywords: CAD system, difference of feature, Fuzzy c means, Liver segmentation.

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Authors: Chutarat Boontho

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The purposes of this study were as follows to evaluate the economic value of Phu Kradueng National Park by the travel cost method (TCM) and the contingent valuation method (CVM) and to estimate the demand for traveling and the willingness to pay. The data for this study were collected by conducting two large scale surveys on users and non-users. A total of 1,016 users and 1,034 non-users were interviewed. The data were analyzed using multiple linear regression analysis, logistic regression model and the consumer surplus (CS) was the integral of demand function for trips. The survey found, were as follows: 1)Using the travel cost method which provides an estimate of direct benefits to park users, we found that visitors- total willingness to pay per visit was 2,284.57 bath, of which 958.29 bath was travel cost, 1,129.82 bath was expenditure for accommodation, food, and services, and 166.66 bath was consumer surplus or the visitors -net gain or satisfaction from the visit (the integral of demand function for trips). 2) Thai visitors to Phu Kradueng National Park were further willing to pay an average of 646.84 bath per head per year to ensure the continued existence of Phu Kradueng National Park and to preserve their option to use it in the future. 3) Thai non-visitors, on the other hand, are willing to pay an average of 212.61 bath per head per year for the option and existence value provided by the Park. 4) The total economic value of Phu Kradueng National Park to Thai visitors and non-visitors taken together stands today at 9,249.55 million bath per year. 5) The users- average willingness to pay for access to Phu Kradueng National Park rises from 40 bath to 84.66 bath per head per trip for improved services such as road improvement, increased cleanliness, and upgraded information. This paper was needed to investigate of the potential market demand for bio prospecting in Phu Kradueng national Park and to investigate how a larger share of the economic benefits of tourism could be distributed income to the local residents.

Keywords: Contingent Valuation Method, Travel Cost Method, Consumer surplus.

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