Search results for: medical tourism

Authors: Ali Akbar Sadat Asl

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Diagnosis and deciding about diseases in medical fields is facing innate uncertainty which can affect the whole process of treatment. This decision is made based on expert knowledge and the way in which an expert interprets the patient's condition, and the interpretation of the various experts from the patient's condition may be different. Fuzzy logic can provide mathematical modeling for many concepts, variables, and systems that are unclear and ambiguous and also it can provide a framework for reasoning, inference, control, and decision making in conditions of uncertainty. In systems with high uncertainty and high complexity, fuzzy logic is a suitable method for modeling. In this paper, we use type-2 fuzzy logic for uncertainty modeling that is in diagnosis of leukemia. The proposed system uses an indirect-direct approach and consists of two stages: In the first stage, the inference of blood test state is determined. In this step, we use an indirect approach where the rules are extracted automatically by implementing a clustering approach. In the second stage, signs of leukemia, duration of disease until its progress and the output of the first stage are combined and the final diagnosis of the system is obtained. In this stage, the system uses a direct approach and final diagnosis is determined by the expert. The obtained results show that the type-2 fuzzy expert system can diagnose leukemia with the average accuracy about 97%.

Keywords: Expert system, leukemia, medical diagnosis, type-2 fuzzy logic.

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Authors: Yanru Wu, Qing Sun

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Sightseeing glass bridges located in steep valley area are being built on a large scale owing to the development of tourism. Consequently, their aerostatic stability is seriously affected by the wind field characteristics created by strong wind and special terrain, such as wind speed and wind attack angle. For instance, a cable-stayed pedestrian bridge without backstays comprised of a 60-m cantilever girder and the glass bridge deck is located in an abrupt valley, acting as a viewing platform. The bridge’s nonlinear aerostatic stability was analyzed by the segmental model test and numerical simulation in this paper. Based on aerostatic coefficients of the main girder measured in wind tunnel tests, nonlinear influences caused by the structure and aerostatic load, inhomogeneous distribution of torsion angle along the bridge axis, and the influence of initial attack angle were analyzed by using the incremental double iteration method. The results show that the aerostatic response varying with speed shows an obvious nonlinearity, and the aerostatic instability mode is of the characteristic of space deformation of bending-twisting coupling mode. The vertical and torsional deformation of the main girder is larger than its lateral deformation, with the wind speed approaching the critical wind speed. The flow of negative attack angle will reduce the bridges’ critical stability wind speed, but the influence of the negative attack angle on the aerostatic stability is more significant than that of the positive attack angle. The critical wind speeds of torsional divergence and lateral buckling are both larger than 200 m/s; namely, the bridge will not occur aerostatic instability under the action of various wind attack angles.

Keywords: Aerostatic nonlinearity, cable-stayed pedestrian bridge, numerical simulation, nonlinear aerostatic stability.

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Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

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Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, antibiotic misuse, Iraq, prescribing.

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Authors: V. P. Mvungi, J. Mcharo, M. E. Mmbuji, L. E. Mgonja, A. Y. Kitua

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This paper is based on a study conducted in 2006 to assess the impact of computer usage on health of National Institute for Medical Research (NIMR) staff. NIMR being a research Institute, most of its staff spend substantial part of their working time on computers. There was notion among NIMR staff on possible prolonged computer usage health hazards. Hence, a study was conducted to establish facts and possible mitigation measures. A total of 144 NIMR staff were involved in the study of whom 63.2% were males and 36.8% females aged between 20 and 59 years. All staff cadres were included in the sample. The functions performed by Institute staff using computers includes; data management, proposal development and report writing, research activities, secretarial duties, accounting and administrative duties, on-line information retrieval and online communication through e-mail services. The interviewed staff had been using computers for 1-8 hours a day and for a period ranging from 1 to 20 years. The study has indicated ergonomic hazards for a significant proportion of interviewees (63%) of various kinds ranging from backache to eyesight related problems. The authors highlighted major issues which are substantially applicable in preventing occurrences of computer related problems and they urged NIMR Management and/or the government of Tanzania opts to adapt their practicability.

Keywords: Computers ergonomic hazards, computer usagehealth hazards.

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Authors: Rujijan Vichivanives

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This research aims to create a knowledge-based system as a database for self-healthcare analysis, diagnosis of simple illnesses, and the use of Thai herbs instead of modern medicine by using principles of Thai traditional medication theory. These were disseminated by website network programs within Suan Sunandha Rajabhat University. The population used in this study was divided into two groups: the first group consisted of four experts of Thai traditional medication and the second group was 300 website users. The methods used for collecting data were paper questionnaires and poll questionnaires on the website. The statistics used for analyzing data was at an average level. The results were divided into three parts: the first part was the development of a knowledge-based system and the second part was applied programs on website. Both parts could be fulfilled and achieved according to the set goal. The third part was the evaluation of the study: The evaluation of the viewpoints of the experts towards website designs were evaluated at a good level of 4.20. The satisfaction evaluation of the users was found at a good level of average satisfactory level at 4.24. It was found that the young population of those under the age of 16 had less cares about their health than the population of other teenagers, working age adults and those of older age. The research findings should be extended in order to encourage the lifestyle modifications to people of all ages by using the self-healthcare principles.

Keywords: Developing, Herbs, Knowledge-based system, Medical treatment.

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Authors: Ntokozo C. Mthembu

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The notion of sustainable chemistry has become significant in the discourse for a global post-colonial era, including South Africa, especially when it comes to access to the general health system and related policies in relation to disease or ease of human life. In view of the stubborn vestiges of coloniality in the daily lives of indigenous African people in general, the fundamentals of present Western medical and traditional medicine systems and related policies in the democratic era were examined in this study. The situation of traditional healers in relation to current policy was also reviewed. The advent of democracy in South Africa brought about a variety of development opportunities and limitations, particularly with respect to indigenous African knowledge systems such as traditional medicine. There were high hopes that the limitations of previous narrow cultural perspectives would be rectified in the democratic era through development interventions, but some sections of society, such as traditional healers, remain marginalised. The Afrocentric perspective was explored in dissecting government interventions related to traditional medicine. This article highlights that multiple medical systems should be adopted and that health policies should be aligned in order to guarantee mutual respect and to address the remnants of colonialism in South Africa, Africa and the broader global community.

Keywords: Traditional healing system, healers, pluralist healthcare system, post-colonial era.

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Authors: Walid MOUDANI

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The healthcare environment is generally perceived as being information rich yet knowledge poor. However, there is a lack of effective analysis tools to discover hidden relationships and trends in data. In fact, valuable knowledge can be discovered from application of data mining techniques in healthcare system. In this study, a proficient methodology for the extraction of significant patterns from the Coronary Heart Disease warehouses for heart attack prediction, which unfortunately continues to be a leading cause of mortality in the whole world, has been presented. For this purpose, we propose to enumerate dynamically the optimal subsets of the reduced features of high interest by using rough sets technique associated to dynamic programming. Therefore, we propose to validate the classification using Random Forest (RF) decision tree to identify the risky heart disease cases. This work is based on a large amount of data collected from several clinical institutions based on the medical profile of patient. Moreover, the experts- knowledge in this field has been taken into consideration in order to define the disease, its risk factors, and to establish significant knowledge relationships among the medical factors. A computer-aided system is developed for this purpose based on a population of 525 adults. The performance of the proposed model is analyzed and evaluated based on set of benchmark techniques applied in this classification problem.

Keywords: Multi-Classifier Decisions Tree, Features Reduction, Dynamic Programming, Rough Sets.

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Authors: Feyzan Tuzkaya, Nihan S. Soylu, Çağlar Solak, Hilal Peker, Mehmet Peker, Kemal Özeralp, Ceren Mete, Ezgi Mehmetoğlu, Mehmet Karasu, Cihan Elçi, Ece Akca, Melek Göregenli

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Perception, evaluation and representation of the environment have been the subject of many disciplines including psychology, geography and architecture. In environmental and social psychology literature there are several evidences which suggest that cognitive representations about a place consisted of not only geographic items but also social and cultural. Mental representations of residence area or a country are influenced and determined by social-demographics, the physical and social context. Thus, all mental representations of a given place are also social representations. Cognitive maps are the main and common instruments that are used to identify spatial images and the difference between physical and subjective environments. The aim of the current study is investigating the mental and social representations of Turkey in university students’ minds. Data was collected from 249 university students from different departments (i.e. psychology, geography, history, tourism departments) of Ege University. Participants were requested to reflect Turkey in their mind onto the paper drawing sketch maps. According to the results, cognitive maps showed geographic aspects of Turkey as well as the context of symbolic, cultural and political reality of Turkey. That is to say, these maps had many symbolic and verbal items related to critics on social and cultural problems, ongoing ethnic and political conflicts, and actual political agenda of Turkey. Additionally, one of main differentiations in these representations appeared in terms of the East and West side of the Turkey, and the representations of the East and West was varied correspondingly participants’ cultural background, their ethnic values, and where they have born. The results of the study were discussed in environmental and social psychological perspective considering cultural and social values of Turkey and current political circumstances of the country.

Keywords: Cognitive maps, East and West, politics, social representations, Turkey.

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Authors: N.E.Galich

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We develop new nonlinear methods of immunofluorescence analysis for a sensitive technology of respiratory burst reaction of DNA fluorescence due to oxidative activity in the peripheral blood neutrophils. Histograms in flow cytometry experiments represent a fluorescence flashes frequency as functions of fluorescence intensity. We used the Shannon-Weaver index for definition of neutrophils- biodiversity and Hurst index for definition of fractal-s correlations in immunofluorescence for different donors, as the basic quantitative criteria for medical diagnostics of health status. We analyze frequencies of flashes, information, Shannon entropies and their fractals in immunofluorescence networks due to reduction of histogram range. We found the number of simplest universal correlations for biodiversity, information and Hurst index in diagnostics and classification of pathologies for wide spectra of diseases. In addition is determined the clear criterion of a common immunity and human health status in a form of yes/no answers type. These answers based on peculiarities of information in immunofluorescence networks and biodiversity of neutrophils. Experimental data analysis has shown the existence of homeostasis for information entropy in oxidative activity of DNA in neutrophil nuclei for all donors.

Keywords: blood and cells fluorescence in diagnostics ofdiseases, cytometric histograms, entropy and information in fractalnetworks of oxidative activity of DNA, long-range chromosomalcorrelations in living cells.

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Authors: Seda Sahin, Emin Akata

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Obturator Foramen is a specific structure in Pelvic bone images and recognition of it is a new concept in medical image processing. Moreover, segmentation of bone structures such as Obturator Foramen plays an essential role for clinical research in orthopedics. In this paper, we present a novel method to analyze the similarity between the substructures of the imaged region and a hand drawn template as a preprocessing step for computation of Pelvic bone rotation on hip radiographs. This method consists of integrated usage of Marker-controlled Watershed segmentation and Zernike moment feature descriptor and it is used to detect Obturator Foramen accurately. Marker-controlled Watershed segmentation is applied to separate Obturator Foramen from the background effectively. Then, Zernike moment feature descriptor is used to provide matching between binary template image and the segmented binary image for final extraction of Obturator Foramens. Finally, Pelvic bone rotation rate calculation for each hip radiograph is performed automatically to select and eliminate hip radiographs for further studies which depend on Pelvic bone angle measurements. The proposed method is tested on randomly selected 100 hip radiographs. The experimental results demonstrated that the proposed method is able to segment Obturator Foramen with 96% accuracy.

Keywords: Medical image analysis, marker-controlled watershed segmentation, segmentation of bone structures on hip radiographs, pelvic bone rotation rate, zernike moment feature descriptor.

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Authors: Ching - Yi Lee, I-Hsiung Tseng, Feng-Chuan Pan

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Environment today is featured with aging population, increasing prevalence of chronic disease and complex of medical treatment. Safe use of pharmaceutics relied very much on the efforts made by both the health- related organizations and as well as the government agencies. As far as the specialization concern in providing health services to the patients, the government actively issued and implemented the divisions of medical treatment and pharmaceutical to improve the quality of care and to reduce medication errors and ensure public health. Pharmaceutical sub-sector policy has been implemented for 13 years. This study attempts to explore the factors that affect the patients- behavior intention of refilling a prescription from a NHIB pharmacy. Samples were those patients refilling their prescriptions with the case NHIB pharmacies. A self-administered questionnaire was used to collect respondents- information while the patients or family members visit the pharmacy for the refilling. 1,200 questionnaires were dispatched in 37 pharmacies that randomly selected from Pingtung City, Dongkang, Chaozhou, Hengchun areas. 732 responses were gained with 604 valid samples for further analyses. Results of data analyses indicated that respondents- attitude, subjective norm, perceived behavior control and behavior intentions toward refilling behavior varied from some demographic variables to another. This research also suggested adding actual behavior, either by a self-report or observed, into the research.

Keywords: Separation of dispensing and prescribing, prescriptions refill slip, NHIB contracted pharmacy, drug safety, theory of planned behavior.

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Authors: S. Zith Dey Babu, S. Kour, S. Verma, C. Verma, V. Pathania, A. Agrawal, V. Chaudhary, A. Manoj Puthur, R. Goyal, A. Pal, T. Danti Dey, A. Kumar, K. Wadhwa, O. Ved

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Background: Skin cancer is now is the buzzing button in the field of medical science. The cyst's pandemic is drastically calibrating the body and well-being of the global village. Methods: The extracted image of the skin tumor cannot be used in one way for diagnosis. The stored image contains anarchies like the center. This approach will locate the forepart of an extracted appearance of skin. Partitioning image models has been presented to sort out the disturbance in the picture. Results: After completing partitioning, feature extraction has been formed by using genetic algorithm and finally, classification can be performed between the trained and test data to evaluate a large scale of an image that helps the doctors for the right prediction. To bring the improvisation of the existing system, we have set our objectives with an analysis. The efficiency of the natural selection process and the enriching histogram is essential in that respect. To reduce the false-positive rate or output, GA is performed with its accuracy. Conclusions: The objective of this task is to bring improvisation of effectiveness. GA is accomplishing its task with perfection to bring down the invalid-positive rate or outcome. The paper's mergeable portion conflicts with the composition of deep learning and medical image processing, which provides superior accuracy. Proportional types of handling create the reusability without any errors.

Keywords: Computer-aided system, detection, image segmentation, morphology.

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Authors: Yuki Irie, Shota Ogawa, Hitomi Kosugi, Hiromitsu Shinozaki

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Dropout rates in higher educational institutions pose significant challenges for both students and institutions, with poor mental health (MH) emerging as a key risk factor. Healthcare college students, including medical students, are particularly vulnerable to MH issues due to the demanding academic schedules they face. Poor mental health (MH) would be considered as a key risk factor for dropout from higher educational institutions that pose significant challenges for both students and institutions. And, inadequate food access (FA) has been related to poor MH. Given that targeted students may experience multiple risk factors for poor MH and vulnerable FA, the study aims to clarify the relationship between MH and FA to enhance student well-being. A cross-sectional design was used to explore the association between MH status and FA among 421 students (147 male, 274 female). Participants completed two questionnaires assessing MH and FA during winter 2022. The mean MH score was 6.7 ± 4.6, with higher scores indicating worse MH (max. score 27). While year-round FA showed no significant association with MH, FA during winter was significantly associated with MH (p = 0.01). Although car ownership did not directly impact MH, it was significantly associated with FA (p < 0.01), thus indirectly influencing MH. Our findings underscore the importance of FA in promoting MH, particularly during winter. Adopting a lifestyle that facilitates easier FA may be beneficial for MH, given its indirect association with MH outcomes. These insights emphasize the significance of addressing FA-related challenges to enhance student’s mental well-being.

Keywords: Mental health, food access, co-medical students, lifestyle.

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Authors: M. A. Askari, M. A. Nazari, P. Perrier, Y. Payan

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Growth and remodeling of biological structures have gained lots of attention over the past decades. Determining the response of living tissues to mechanical loads is necessary for a wide range of developing fields such as prosthetics design or computerassisted surgical interventions. It is a well-known fact that biological structures are never stress-free, even when externally unloaded. The exact origin of these residual stresses is not clear, but theoretically, growth is one of the main sources. Extracting body organ’s shapes from medical imaging does not produce any information regarding the existing residual stresses in that organ. The simplest cause of such stresses is gravity since an organ grows under its influence from birth. Ignoring such residual stresses might cause erroneous results in numerical simulations. Accounting for residual stresses due to tissue growth can improve the accuracy of mechanical analysis results. This paper presents an original computational framework based on gradual growth to determine the residual stresses due to growth. To illustrate the method, we apply it to a finite element model of a healthy human face reconstructed from medical images. The distribution of residual stress in facial tissues is computed, which can overcome the effect of gravity and maintain tissues firmness. Our assumption is that tissue wrinkles caused by aging could be a consequence of decreasing residual stress and thus not counteracting gravity. Taking into account these stresses seems therefore extremely important in maxillofacial surgery. It would indeed help surgeons to estimate tissues changes after surgery.

Keywords: Finite element method, growth, residual stress, soft tissue.

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Authors: Kay-Anne Haykal, Issack Biyong

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The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: Post-Traumatic Stress Disorder, diagnosis, co-morbidities, mental health disorders.

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Authors: Saleh Abduallah Saleh, Mohammad Basir Bin Saud, Mohd Azwardi Md Isa

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It is very important for a developing nation to developing their infrastructure on the prime priority because their infrastructure particularly their roads and transportation functions as a blood in the system. Almost 1.1 billion populations share the travel and transportation industry in India. On the other hand, the Pakistan transportation industry is also extensive and elevating about 170 million users of transportation. Indian and Pakistani specifically within bus industry are well connected within and between the urban and rural areas. The transportation industry is radically helping the economic alleviation of both countries. Due to high economic instability, unemployment and poverty rate both countries governments are very serious and committed to help for boosting their economy. They believe that any form of transportation development would play a vital role in the development of land, infrastructure which could indirectly support many other industries’ developments, such as tourism, freighting and shipping businesses, just to mention a few. However, it seems that their previous transportation planning in the due course has failed to meet the fast growing demand. As with the span of time, both the countries are looking forward to a long-term, and economical solutions, because the demand is from time to time keep appreciating and reacting according to other key economic drivers. Content analysis method and case study approach is used in this paper and secondary data from the bureau of statistic is used for case analysis. The paper focused on the mobility concerns of the lower and middle-income people in India and Pakistan. The paper is aimed to highlight the weaknesses, opportunities and limitations resulting from low priority industry for a government, which is making the either country's public suffer. The paper has concluded that the main issue is identified as the slow, inappropriate, and unfavorable decisions which are not in favor of long-term country’s economic development and public interest. The paper also recommends to future research avenues for public and private transportation, which is continuously failing to meet the public expectations.

Keywords: Bus transportation industries, transportation demand, government parallel initiatives, road and traffic congestions.

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Authors: Molly P. M. Wong

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In this study, a blended and interactive e-learning Courseware that our team developed will be introduced, and our team’s experiences on how the e-learning Courseware and the flipped classroom benefit student learning in bioethics in the medical program will be shared. This study is a continuation of the previously established study, which provides a summary of the well-developed e-learning Courseware in a blended learning approach and an update on its efficiency and efficacy. First, a collection of animated videos capturing selected topics of bioethics and related ethical issues and dilemma will be introduced. Next, a selection of problem-based learning videos (“simulated doctor-patient role play”) with pop-up questions and discussions will be further discussed. Our findings demonstrated that these activities launched by the Courseware strongly engaged students in bioethics education and enhanced students’ critical thinking and creativity. Moreover, the educational benefits of the online art exhibition, art jamming and competition will be discussed, through which students could express bioethics through arts and enrich their learning in medical research in an interactive, fun and entertaining way, strengthening their interests in bioethics. Furthermore, online survey questionnaires and focus group interviews were conducted. Our results indicated that implementing the e-learning Courseware with a flipped classroom in bioethics education enhanced both active learning and student engagement. In conclusion, our Courseware not only reinforces education in art, bioethics and medicine, but also benefits students in understanding and critical thinking in socio-ethical issues, and serves as a valuable learning tool in bioethics teaching and learning.

Keywords: Bioethics, courseware, e-learning, flipped classroom.

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Authors: Şenay Pehli̇van, Gülümser Kublay

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Female inmates placed in a Correctional Institution (CI) have more physical health problems than other women and their male counterparts. Thus, they require more health care services in the CI and nursing services in particular. CI nurses also have the opportunity to teach behaviors which will protect and improve their health to these women who are difficult to reach in the community. The aim of this study was to evaluate effect of nursing services provided in a CI on the physical health levels and health behaviors of female inmates. The study has a quasi-experimental design. The study was done in Female Closed CI in Ankara, Turkey. The study was conducted on 30 female inmates. Before the implementation of nursing interventions in the initial phase of the study, female inmates were evaluated in terms of physical health problems and health behavior using forms, a physical examination, medical history, health files (file containing medical information related to prisons) and the Omaha System (OS). Findings obtained from evaluations were grouped and symptoms-findings were expressed with OS diagnosis codes. Knowledge, behavior and status scores of prisoners in relation to health problems were determined. After the implementation of the nursing interventions, female inmates were evaluated in terms of physical health problems and health behavior using OS. The research data were collected using the Female Evaluation Form developed by the researcher and the OS. It was found that knowledge, behavior and status scores of prisoners significantly increased after the implementation of nursing interventions (p < 0.05).

Keywords: Correctional institution, correctional nursing, prison nursing, female inmates, physical health problems, health behaviors.

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Authors: Rebecca E. Dalli Gonzi, Joseph Falzon

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Background: Islands in the Mediterranean region offer opportunities for various industries to take advantage of the facilitation and use of versatile floating structures in coastal areas. In the context of dense land use, marine structures can contribute to ensure both terrestrial and marine resource sustainability. Objective: The aim of this paper is to present and critically discuss an array of issues that characterize the design process of a floating structure for coastal areas and to present the challenges and opportunities of providing such multifunctional and versatile structures around the Maltese coastline. Research Design: A three-tier research design commenced with a systematic literature review. Semi-structured interviews with stakeholders including a naval architect, a marine engineer and civil designers were conducted. A second stage preceded a focus group with stakeholders in design and construction of marine lightweight structures. The three tier research design ensured triangulation of issues. All phases of the study were governed by research ethics. Findings: Findings were grouped into three main themes: excellence, impact and implementation. These included design considerations, applications and potential impacts on local industry. Literature for the design and construction of marine structures in the Maltese Islands presented multiple gaps in the application of marine structures for local industries. Weather conditions, depth of sea bed and wave actions presented limitations on the design capabilities of the structure. Conclusion: Water structures offer great potential and conclusions demonstrate the applicability of such designs for Maltese waters. There is still no such provision within Maltese coastal areas for multi-purpose use. The introduction of such facilities presents a range of benefits for visiting tourists and locals thereby offering wide range of services to tourism and marine industry. Costs for construction and adverse weather conditions were amongst the main limitations that shaped design capacities of the water structures.

Keywords: Coastal areas, lightweight, marine structure, multipurpose, versatile, floating device.

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Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

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Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: Geocoding, chronic disease management, quality of diabetes care, rate ratio.

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Authors: Sumathi Poobal, G. Ravindran

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Medical imaging uses the advantage of digital technology in imaging and teleradiology. In teleradiology systems large amount of data is acquired, stored and transmitted. A major technology that may help to solve the problems associated with the massive data storage and data transfer capacity is data compression and decompression. There are many methods of image compression available. They are classified as lossless and lossy compression methods. In lossy compression method the decompressed image contains some distortion. Fractal image compression (FIC) is a lossy compression method. In fractal image compression an image is coded as a set of contractive transformations in a complete metric space. The set of contractive transformations is guaranteed to produce an approximation to the original image. In this paper FIC is achieved by PIFS using quadtree partitioning. PIFS is applied on different images like , Ultrasound, CT Scan, Angiogram, X-ray, Mammograms. In each modality approximately twenty images are considered and the average values of compression ratio and PSNR values are arrived. In this method of fractal encoding, the parameter, tolerance factor Tmax, is varied from 1 to 10, keeping the other standard parameters constant. For all modalities of images the compression ratio and Peak Signal to Noise Ratio (PSNR) are computed and studied. The quality of the decompressed image is arrived by PSNR values. From the results it is observed that the compression ratio increases with the tolerance factor and mammogram has the highest compression ratio. The quality of the image is not degraded upto an optimum value of tolerance factor, Tmax, equal to 8, because of the properties of fractal compression.

Keywords: Fractal image compression, IFS, PIFS, PSNR, Quadtree partitioning.

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Authors: Catherine A. Todd, Fazel Naghdy

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In this work a surgical simulator is produced which enables a training otologist to conduct a virtual, real-time prosthetic insertion. The simulator provides the Ear, Nose and Throat surgeon with real-time visual and haptic responses during virtual cochlear implantation into a 3D model of the human Scala Tympani (ST). The parametric model is derived from measured data as published in the literature and accounts for human morphological variance, such as differences in cochlear shape, enabling patient-specific pre- operative assessment. Haptic modeling techniques use real physical data and insertion force measurements, to develop a force model which mimics the physical behavior of an implant as it collides with the ST walls during an insertion. Output force profiles are acquired from the insertion studies conducted in the work, to validate the haptic model. The simulator provides the user with real-time, quantitative insertion force information and associated electrode position as user inserts the virtual implant into the ST model. The information provided by this study may also be of use to implant manufacturers for design enhancements as well as for training specialists in optimal force administration, using the simulator. The paper reports on the methods for anatomical modeling and haptic algorithm development, with focus on simulator design, development, optimization and validation. The techniques may be transferrable to other medical applications that involve prosthetic device insertions where user vision is obstructed.

Keywords: Haptic modeling, medical device insertion, real-time visualization of prosthetic implantation, surgical simulation.

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Authors: Arash Taheri, Meysam Mohammadi-Amin, Seyed Hossein Moosavy

Abstract:

Medical applications are among the most impactful areas of microrobotics. The ultimate goal of medical microrobots is to reach currently inaccessible areas of the human body and carry out a host of complex operations such as minimally invasive surgery (MIS), highly localized drug delivery, and screening for diseases at their very early stages. Miniature, safe and efficient propulsion systems hold the key to maturing this technology but they pose significant challenges. A new type of propulsion developed recently, uses multi-flagella architecture inspired by the motility mechanism of prokaryotic microorganisms. There is a lack of efficient methods for designing this type of propulsion system. The goal of this paper is to overcome the lack and this way, a numerical strategy is proposed to design multi-flagella propulsion systems. The strategy is based on the implementation of the regularized stokeslet and rotlet theory, RFT theory and new approach of “local corrected velocity". The effects of shape parameters and angular velocities of each flagellum on overall flow field and on the robot net forces and moments are considered. Then a multi-layer perceptron artificial neural network is designed and employed to adjust the angular velocities of the motors for propulsion control. The proposed method applied successfully on a sample configuration and useful demonstrative results is obtained.

Keywords: Artificial Neural Network, Biomimetic Microrobots, Flagellar Propulsion, Swimming Robots.

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Authors: S. Hegazy

Abstract:

Culture sustainability, which reflects a deep respect for people and history, is a cause of concern in contemporary architecture. Adopting ultramodern architecture styles was initiated in the 20th century by a plurality of states worldwide. Only a few countries, including Oman, realized that fashionable architectural designs ignore cultural values, identity, the context of its environment, economic perspective, and social performance. Stirring the Sultanate of Oman from being a listless and closed community to a modern country started in the year 1970. Despite unprecedented development in all aspects of Omani people's life, the leadership and the public had the capability to adjust to the changing global challenges without compromising social values and identity. This research provides a close analysis of one of the recent examples of contemporary vernacular architecture in the Sultanate of Oman, as a case study, Oman International Airport. The airport gained an international appreciation for its Omani-themed architecture, distinguished traveler experience, and advanced technology. Accordingly, it was selected by the World Travel Awards as the Best Tourism Development Project in the Middle East only four weeks afterward after starting its operation. This paper aims to transfer this successful design approach of integrating the latest trends in technology, systems, eco-friendly aspects, and materials with the traditional Omani architectural features, which reflects symbiotic harmony of the community, individuals, and environment to other countries, designers, researchers, and students. In addition, the paper aims to encourage architects and teachers to take responsibility for valorizing-built heritage as a source of inspiration for modern architecture, which could be considered as an added value. The work depends on reviewing the relevant literature, a case study, interviews with two architects who were involved in the project’s site work, and one current high-ranking employee in the airport besides data analysis and conclusion.

Keywords: Contemporary vernacular architecture, culture sustainability, Oman international airport, current Omani architecture type.

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Authors: Ahmed Badawi, J. Michael Johnson, Mohamed Mahfouz

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This paper proposes new enhancement models to the methods of nonlinear anisotropic diffusion to greatly reduce speckle and preserve image features in medical ultrasound images. By incorporating local physical characteristics of the image, in this case scatterer density, in addition to the gradient, into existing tensorbased image diffusion methods, we were able to greatly improve the performance of the existing filtering methods, namely edge enhancing (EE) and coherence enhancing (CE) diffusion. The new enhancement methods were tested using various ultrasound images, including phantom and some clinical images, to determine the amount of speckle reduction, edge, and coherence enhancements. Scatterer density weighted nonlinear anisotropic diffusion (SDWNAD) for ultrasound images consistently outperformed its traditional tensor-based counterparts that use gradient only to weight the diffusivity function. SDWNAD is shown to greatly reduce speckle noise while preserving image features as edges, orientation coherence, and scatterer density. SDWNAD superior performances over nonlinear coherent diffusion (NCD), speckle reducing anisotropic diffusion (SRAD), adaptive weighted median filter (AWMF), wavelet shrinkage (WS), and wavelet shrinkage with contrast enhancement (WSCE), make these methods ideal preprocessing steps for automatic segmentation in ultrasound imaging.

Keywords: Nonlinear anisotropic diffusion, ultrasound imaging, speckle reduction, scatterer density estimation, edge based enhancement, coherence enhancement.

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Authors: Luedech Girdwichai, Witthaya Mekhum

Abstract:

This research intended to develop the model of community management for sustainable utilization by investigating on 2 groups of population, the family heads and the community management team. The population of the former group consisted of family heads from 511 families in 12 areas to complete the questionnaires which were returned at 479 sets. The latter group consisted of the community management team of 12 areas with 1 representative from each area to give the interview. The questionnaires for the family heads consisted of 2 main parts; general information such as occupations, etc. in the form of checklist. The second part dealt with the data on self reliance community development based on 4P Framework, i.e., People (human resource) development, Place (area) development, Product (economic and income source) development, and Plan (community plan) development in the form of rating scales. Data in the 1^st part were calculated to find frequency and percentage while those in the 2^nd part were analyzed to find arithmetic mean and SD. Data from the 2^nd group of population or the community management team were derived from focus group to find factors influencing successful management together with the in depth interview which were analyzed by descriptive statistics. The results showed that 479 family heads reported that the aspect on the implementation of community plan to self reliance community activities based on Sufficient Economy Philosophy and the 4P was at the average of 3.28 or moderate level. When considering in details, it was found that the 1^st aspect was on the area development with the mean of 3.71 or high level followed by human resource development with the mean of 3.44 or moderate level, then, economic and source of income development with the mean of 3.09 or moderate level. The last aspect was community plan development with the mean of 2.89. The results from the small group discussion revealed some factors and guidelines for successful community management as follows: 1) on the People (human resource) development aspect, there was a project to support and develop community leaders. 2) On the aspect of Place (area) development, there was a development on conservative tourism areas. 3) On the aspect of Product (economic and source of income) development, the community leaders promoted the setting of occupational group, saving group, and product processing group. 4) On the aspect of Plan (community plan) development, there was a prioritization through public hearing.

Keywords: Model of community management, sustainable utilization.

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Authors: Adam Kurnicki, Bartłomiej Stanczyk, Bartosz Kania

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This paper presents development of the light-weight manipulator with series elastic actuation for medical telediagnostics (USG examination). General structure of realized impedance control algorithm was shown. It was described how to perform force measurements based mainly on elasticity of manipulator links.

Keywords: Telediagnostics, elastic manipulator, impedance control, force measurement.

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Authors: Jihad S. Daba (Jean-Pierre Dubois), Philip Jreije

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Speckled images arise when coherent microwave, optical, and acoustic imaging techniques are used to image an object, surface or scene. Examples of coherent imaging systems include synthetic aperture radar, laser imaging systems, imaging sonar systems, and medical ultrasound systems. Speckle noise is a form of object or target induced noise that results when the surface of the object is Rayleigh rough compared to the wavelength of the illuminating radiation. Detection and estimation in images corrupted by speckle noise is complicated by the nature of the noise and is not as straightforward as detection and estimation in additive noise. In this work, we derive stochastic models for speckle noise, with an emphasis on speckle as it arises in medical ultrasound images. The motivation for this work is the problem of segmentation and tissue classification using ultrasound imaging. Modeling of speckle in this context involves partially developed speckle model where an underlying Poisson point process modulates a Gram-Charlier series of Laguerre weighted exponential functions, resulting in a doubly stochastic filtered Poisson point process. The statistical distribution of partially developed speckle is derived in a closed canonical form. It is observed that as the mean number of scatterers in a resolution cell is increased, the probability density function approaches an exponential distribution. This is consistent with fully developed speckle noise as demonstrated by the Central Limit theorem.

Keywords: Doubly stochastic filtered process, Poisson point process, segmentation, speckle, ultrasound

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Authors: L. B. Naves, L. Almeida

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The development of Drugs Delivery System (DDS) has been widely investigated in the last decades. In this paper, first a general overview of traditional and modern wound dressing is presented. This is followed by a review of what scientists have done in the medical environment, focusing on the possibility to develop a new alternative for DDS through transdermal pathway, aiming to treat melanoma skin cancer.

Keywords: Cancer Therapy, Dressing Polymers, Melanoma, wound healing.

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Authors: Chhaya Gangwal, R. N. Bhaumik, Shishir Kumar

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Some properties of Intuitionistic Fuzzy (IF) rough relational algebraic operators under an IF rough relational data model are investigated and illustrated using diabetes and heart disease databases. These properties are important and desirable for processing queries in an effective and efficient manner.

 

Keywords: IF Set, Rough Set, IF Rough Relational Database, IF rough Relational Operators.

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