Search results for: Sensorineural loss patients
Commenced in January 2007
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Edition: International
Paper Count: 1528

Search results for: Sensorineural loss patients

1498 Angiographic Evaluation of ETT (Treadmill) Positive Patients in a Tertiary Care Hospital of Bangladesh

Authors: Syed Dawood Md. Taimur, Saidur Rahman Khan, Farzana Islam

Abstract:

To evaluate the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) that is treadmill results and coronary artery findings. This descriptive study was conducted at Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from 1st January, 2014 to 31st August, 2014. All patients who had done ETT (treadmill) for chest pain diagnosis were studied. One hundred and four patients underwent coronary angiogram after positive treadmill result. Patients were divided into two groups depending upon the angiographic findings, i.e. true positive and false positive. Positive treadmill test patients who have coronary artery involvement these are called true positive and who have no involvement they are called false positive group. Both groups were compared with each other. Out of 104 patients, 81 (77.9%) patients had true positive ETT and 23 (22.1%) patients had false positive ETT. The mean age of patients in positive ETT was 53.46± 8.06 years and male mean age was 53.63±8.36 years and female was 52.87±7.0 years. Sixty nine (85.19%) male patients and twelve (14.81%) female patients had true positive ETT, whereas 15 (65.21%) males and 8 (34.79%) females had false positive ETT, this was statistically significant (p<0.032) in the two groups (sex) in comparison of true and false positive ETT. The risk factors of these patients like diabetes mellitus, hypertension, dyslipidemia, family history and smoking were seen among these patients. Hypertensive patients having true positive which were statistically significant (p<0.004) and diabetic, dyslipidemic patients having true positive which were statistically significant (p<0.032 & 0.030).True positive patients had family history were 68(83.95%) and smoking were 52 (64.20%), where family history patients had statistically significant (p<0.017) between two groups of patients and smokers were significant (p<0.012). 46 true positive patients achieved THR which was not statistically significant (P<0.138) and 79 true patients had abnormal resting ECG whether it was significant (p<0.036). Amongst the vessels involvement the most common was LAD 55 (67.90 %) followed by LCX 42 (51.85%), RCA 36 (44.44%), and the LMCA was 9 (11.11%). 40 patients (49.38%) had SVD, 26 (30.10%) had DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. It can be concluded that among the female patients who have positive ETT with normal resting ECG, who had achieved target heart rate are likely to have a false positive test result. Conversely male patients, resting abnormal ECG who had not achieved THR, symptom limited ETT, have a hypertension, diabetes, dyslipidemia, family history and smoking are likely to have a true positive treadmill test result.

Keywords: Exercise tolerance test, Coronary artery disease, Coronary angiography, True positive, False positive.

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1497 Dual Band Microstrip Patch Antenna for IEEE802.11b Application

Authors: Biplab Bag

Abstract:

In this paper, the design of a coaxial feed single layer rectangular microstrip patch antenna for IEEE802.11b application is presented. The proposed antenna is designed by using substrate FR4_epoxy having permittivity of about 4.4 and tangent loss of 0.013. The characteristics of the substrate are designed and to evaluate the performance of modeled antenna using HFSS v.11 EM simulator, from Ansoft. The proposed antenna dual resonant frequency has been achieved in the band of 1.57GHz-1.68GHz (with BW 30 MHz) and 2.25 GHz -2.55GHz (with BW 40MHz). The simulation results with frequency response, radiation pattern and return loss, VSWR, Input Impedance are presented with appropriate table and graph.

Keywords: Microstrip, Radiation Pattern, Return Loss, Tangent Loss, VSWR.

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1496 Loss Function Optimization for CNN-Based Fingerprint Anti-Spoofing

Authors: Yehjune Heo

Abstract:

As biometric systems become widely deployed, the security of identification systems can be easily attacked by various spoof materials. This paper contributes to finding a reliable and practical anti-spoofing method using Convolutional Neural Networks (CNNs) based on the types of loss functions and optimizers. The types of CNNs used in this paper include AlexNet, VGGNet, and ResNet. By using various loss functions including Cross-Entropy, Center Loss, Cosine Proximity, and Hinge Loss, and various loss optimizers which include Adam, SGD, RMSProp, Adadelta, Adagrad, and Nadam, we obtained significant performance changes. We realize that choosing the correct loss function for each model is crucial since different loss functions lead to different errors on the same evaluation. By using a subset of the Livdet 2017 database, we validate our approach to compare the generalization power. It is important to note that we use a subset of LiveDet and the database is the same across all training and testing for each model. This way, we can compare the performance, in terms of generalization, for the unseen data across all different models. The best CNN (AlexNet) with the appropriate loss function and optimizers result in more than 3% of performance gain over the other CNN models with the default loss function and optimizer. In addition to the highest generalization performance, this paper also contains the models with high accuracy associated with parameters and mean average error rates to find the model that consumes the least memory and computation time for training and testing. Although AlexNet has less complexity over other CNN models, it is proven to be very efficient. For practical anti-spoofing systems, the deployed version should use a small amount of memory and should run very fast with high anti-spoofing performance. For our deployed version on smartphones, additional processing steps, such as quantization and pruning algorithms, have been applied in our final model.

Keywords: Anti-spoofing, CNN, fingerprint recognition, loss function, optimizer.

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1495 Parkinsons Disease Classification using Neural Network and Feature Selection

Authors: Anchana Khemphila, Veera Boonjing

Abstract:

In this study, the Multi-Layer Perceptron (MLP)with Back-Propagation learning algorithm are used to classify to effective diagnosis Parkinsons disease(PD).It-s a challenging problem for medical community.Typically characterized by tremor, PD occurs due to the loss of dopamine in the brains thalamic region that results in involuntary or oscillatory movement in the body. A feature selection algorithm along with biomedical test values to diagnose Parkinson disease.Clinical diagnosis is done mostly by doctor-s expertise and experience.But still cases are reported of wrong diagnosis and treatment. Patients are asked to take number of tests for diagnosis.In many cases,not all the tests contribute towards effective diagnosis of a disease.Our work is to classify the presence of Parkinson disease with reduced number of attributes.Original,22 attributes are involved in classify.We use Information Gain to determine the attributes which reduced the number of attributes which is need to be taken from patients.The Artificial neural networks is used to classify the diagnosis of patients.Twenty-Two attributes are reduced to sixteen attributes.The accuracy is in training data set is 82.051% and in the validation data set is 83.333%.

Keywords: Data mining, classification, Parkinson disease, artificial neural networks, feature selection, information gain.

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1494 Energy Loss at Drops using Neuro Solutions

Authors: Farzin Salmasi

Abstract:

Energy dissipation in drops has been investigated by physical models. After determination of effective parameters on the phenomenon, three drops with different heights have been constructed from Plexiglas. They have been installed in two existing flumes in the hydraulic laboratory. Several runs of physical models have been undertaken to measured required parameters for determination of the energy dissipation. Results showed that the energy dissipation in drops depend on the drop height and discharge. Predicted relative energy dissipations varied from 10.0% to 94.3%. This work has also indicated that the energy loss at drop is mainly due to the mixing of the jet with the pool behind the jet that causes air bubble entrainment in the flow. Statistical model has been developed to predict the energy dissipation in vertical drops denotes nonlinear correlation between effective parameters. Further an artificial neural networks (ANNs) approach was used in this paper to develop an explicit procedure for calculating energy loss at drops using NeuroSolutions. Trained network was able to predict the response with R2 and RMSE 0.977 and 0.0085 respectively. The performance of ANN was found effective when compared to regression equations in predicting the energy loss.

Keywords: Air bubble, drop, energy loss, hydraulic jump, NeuroSolutions

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1493 Effect on Bandwidth of Using Double Substrates Based Metamaterial Planar Antenna

Authors: Smrity Dwivedi

Abstract:

The present paper has revealed the effect of double substrates over a bandwidth performance for planar antennas. The used material has its own importance to get minimum return loss and improved directivity. The author has taken double substrates to enhance the efficiency in terms of gain of antenna. Metamaterial based antenna has its own specific structure which increased the performance of antenna. Improved return loss is -20 dB, and the voltage standing wave ratio (VSWR) is 1.2, which is better than single substrate having return loss of -15 dB and VSWR of 1.4. Complete results are obtained using commercial software CST microwave studio.

Keywords: Metamaterials, return loss, standing wave ratio, directivity, CST microwave studio.

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1492 A Two-Way Wilkinson Power Divider Realized Using One Eighth Wave Transmission Line for GSM Application

Authors: G. Kalpanadevi, S. Ravimaran, M. Shanmugapriya

Abstract:

In this paper, a modified Wilkinson power divider for GSM application is presented. The quarter–wavelength microstrip lines in the conventional Wilkinson power divider (WPD) are replaced by one-eighth wavelength transmission line. Wilkinson power divider is designed using λ/4 and λ/8 transmission line. It has the operating frequency of 915 MHz which is used in the GSM standard. The proposed Wilkinson Power Divider is designed using the simulation tool Advanced Design System. The results of λ/8 transmission line are very close to the results of λ/4 transmission line. The isolation loss of λ/8 transmission line is improved by introducing a capacitor between the output ports. The proposed Wilkinson power divider has the best return loss of greater than -10 dB and isolation loss of -15.25 dB. The λ/8 transmission line Wilkinson power divider has the reduced size of 53.9 percentages than λ/4 transmission line WPD. The proposed design has simple structure, better isolation loss and good insertion loss.

Keywords: Wilkinson Power Divider, Quarter wave line, one eighth wave transmission line, microstrip line.

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1491 Improving Patients Discharge Process in Hospitals by using Six Sigma Approach

Authors: Mahmoud A. El-Banna

Abstract:

The need to increase the efficiency of health care systems is becoming an obligation, and one of area of improvement is the discharge process. The objective of this work is to minimize the patients discharge time (for insured patients) to be less than 50 minutes by using six sigma approach, this improvement will also: lead to an increase in customer satisfaction, increase the number of admissions and turnover on the rooms, increase hospital profitability.Three different departments were considered in this study: Female, Male, and Paediatrics. Six Sigma approach coupled with simulation has been applied to reduce the patients discharge time for pediatrics, female, and male departments at hospital. Upon applying these recommendations at hospital: 60%, 80%, and 22% of insured female, male, and pediatrics patients respectively will have discharge time less than the upper specification time i.e. 50 min.

Keywords: Discharge Time, Healthcare, Hospitals, Patients, Process Improvement, Six Sigma, Simulation

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1490 An Assessment of the Hip Muscular Imbalance for Patients with Rheumatism

Authors: Anthony Bawa, Konstantinos Banitsas

Abstract:

Rheumatism is a muscular disorder that affects the muscles of the upper and lower limbs. This condition could potentially progress to impair the movement of patients. This study aims to investigate the hip muscular imbalance in patients with chronic rheumatism. A clinical trial involving a total of 15 participants, made up of 10 patients and five control subjects, took place in KATH Hospital between August and September. Participants recruited for the study were of age 54 ± 8 years, weight 65 ± 8 kg, and height 176 ± 8 cm. Muscle signals were recorded from the rectus femoris, and vastus lateralis on the right and left hip of participants. The parameters used in determining the hip muscular imbalances were the maximum voluntary contraction (MVC%), the mean difference, and hip muscle fatigue levels. The mean signals were compared using a t-test, and the metrics for muscle fatigue assessment were based on the root mean square (RMS), mean absolute value (MAV) and mean frequency (MEF), which were computed between the hip muscles of participants. The results indicated that there were significant imbalances in the muscle coactivity between the right and left hip muscles of patients. The patients’ MVC values were observed to be above 10% when compared with control subjects. Furthermore, the mean difference was seen to be higher with p > 0.002 among patients, which indicated clear differences in the hip muscle contraction activities. The findings indicate significant hip muscular imbalances for patients with rheumatism compared with control subjects. Information about the imbalances among patients will be useful for clinicians in designing therapeutic muscle-strengthening exercises.

Keywords: Muscular, imbalances, rheumatism, hip.

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1489 Outcomes of Pregnancy in Women with TPO Positive Status after Appropriate Dose Adjustments of Thyroxin: A Prospective Cohort Study

Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

Abstract:

This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: Antinuclear antibody, Subclinical hypothyroidism, Thyroxin, TPO antibody.

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1488 Determination of Critical Source Areas for Sediment Loss: Sarrath River Basin, Tunisia

Authors: Manel Mosbahi

Abstract:

The risk of water erosion is one of the main environmental concerns in the southern Mediterranean regions. Thus, quantification of soil loss is an important issue for soil and water conservation managers. The objective of this paper is to examine the applicability of the Soil and Water Assessment Tool (SWAT) model in The Sarrath river catchment, North of Tunisia, and to identify the most vulnerable areas in order to help manager implement an effective management program. The spatial analysis of the results shows that 7 % of the catchment experiences very high erosion risk, in need for suitable conservation measures to be adopted on a priority basis. The spatial distribution of erosion risk classes estimated 3% high, 5,4% tolerable, and 84,6% low. Among the 27 delineated subcatchments only 4 sub-catchments are found to be under high and very high soil loss group, two sub-catchments fell under moderate soil loss group, whereas other sub-catchments are under low soil loss group.

Keywords: Critical source areas, Erosion risk, SWAT model.

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1487 Prevalence of Epstein-Barr Virus Latent Membrane Protein-1 in Jordanian Patients with Hodgkin's Lymphoma and Non- Hodgkin's Lymphoma

Authors: Fawzi Irshaid, Adnan Jaran, Fatiha Dilmi, Khaled Tarawneh, Raji Hadeth, Ahad Al-Khatib

Abstract:

The aim of this study was to estimate the frequency of EBV infection in Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL) occurring in Jordanian patients. A total of 55 patients with lymphoma were examined in this study. Of 55 patients, 30 and 25 were diagnosed as HL and NHL, respectively. The four HL subtypes were observed with the majority of the cases exhibited the mixed cellularity (MC) subtype followed by the nodular sclerosis (NS). The high grade was found to be the commonest subtype of NHL in our sample, followed by the low grade. The presence of EBV virus was detected by immunostating for expression of latent membrane protein-1 (LMP-1). The frequency of LMP-1 expression occurred more frequent in patients with HL (60.0%) than in patients with NHL (32.0%). The frequency of LMP-1 expression was also higher in patients with MC subtype (61.11%) than those patients with NS (28.57%). No age or gender difference in occurrence of EBV infection was observed among patient with HL. By contrast, the prevalence of EBV infection in NHL patients aged below 50 was lower (16.66%) than in NHL patients aged 50 or above (46.15%). In addition, EBV infection was more frequent in females with NHL (38.46%) than in male with NHL (25%). In NHL cases, the frequency of EBV infection in intermediate grade (60.0%) was high when compared with frequency of low (25%) or high grades (25%). In conclusion, analysis of LMP-1 expression indicates an important role for this viral oncogene in the pathogenesis of EBV-associated malignant lymphomas. These data also support the previous findings that people with EBV may develop lymphoma and that efforts to maintain low lymphoma should be considered for people with EBV infection.

Keywords: Hodgkin lymphoma, Epstein Barr virus, hematoxylin, infection, LMP-1 expression.

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1486 Improved Rare Species Identification Using Focal Loss Based Deep Learning Models

Authors: Chad Goldsworthy, B. Rajeswari Matam

Abstract:

The use of deep learning for species identification in camera trap images has revolutionised our ability to study, conserve and monitor species in a highly efficient and unobtrusive manner, with state-of-the-art models achieving accuracies surpassing the accuracy of manual human classification. The high imbalance of camera trap datasets, however, results in poor accuracies for minority (rare or endangered) species due to their relative insignificance to the overall model accuracy. This paper investigates the use of Focal Loss, in comparison to the traditional Cross Entropy Loss function, to improve the identification of minority species in the “255 Bird Species” dataset from Kaggle. The results show that, although Focal Loss slightly decreased the accuracy of the majority species, it was able to increase the F1-score by 0.06 and improve the identification of the bottom two, five and ten (minority) species by 37.5%, 15.7% and 10.8%, respectively, as well as resulting in an improved overall accuracy of 2.96%.

Keywords: Convolutional neural networks, data imbalance, deep learning, focal loss, species classification, wildlife conservation.

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1485 CFD Prediction of the Round Elbow Fitting Loss Coefficient

Authors: Ana Paula P. dos Santos, Claudia R. Andrade, Edson L. Zaparoli

Abstract:

Pressure loss in ductworks is an important factor to be considered in design of engineering systems such as power-plants, refineries, HVAC systems to reduce energy costs. Ductwork can be composed by straight ducts and different types of fittings (elbows, transitions, converging and diverging tees and wyes). Duct fittings are significant sources of pressure loss in fluid distribution systems. Fitting losses can be even more significant than equipment components such as coils, filters, and dampers. At the present work, a conventional 90o round elbow under turbulent incompressible airflow is studied. Mass, momentum, and k-e turbulence model equations are solved employing the finite volume method. The SIMPLE algorithm is used for the pressure-velocity coupling. In order to validate the numerical tool, the elbow pressure loss coefficient is determined using the same conditions to compare with ASHRAE database. Furthermore, the effect of Reynolds number variation on the elbow pressure loss coefficient is investigated. These results can be useful to perform better preliminary design of air distribution ductworks in air conditioning systems.

Keywords: Duct fitting, Pressure loss, Elbow.

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1484 Loss Reduction and Reliability Improvement of Industrial Distribution System through Network Reconfiguration

Authors: Ei Ei Phyu, Kyaw Myo Lin, Thin Thin Moe

Abstract:

The paper presents an approach to improve the reliability and reduce line losses of practical distribution system applying network reconfiguration. The change of the topology redirects the power flow within the distribution network to obtain better performance of the system. Practical distribution network (Pyigyitagon Industrial Zone (I)) is used as the case study network. The detailed calculations of the reliability indices are done by using analytical method and power flow calculation is performed by Newton-Rephason solver. The comparison of various network reconfiguration techniques are described with respect to power loss and reliability index levels. Finally, the optimal reconfigured network is selected among difference cases based on the two factors: the most reliable network and the least loss minimization.

Keywords: Distribution system reliability, loss reduction, network reconfiguration, reliability enhancement, reliability indices.

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1483 Experimental Investigation of On-Body Channel Modelling at 2.45 GHz

Authors: Hasliza A. Rahim, Fareq Malek, Nur A. M. Affendi, Azuwa Ali, Norshafinash Saudin, Latifah Mohamed

Abstract:

This paper presents the experimental investigation of on-body channel fading at 2.45 GHz considering two effects of the user body movement; stationary and mobile. A pair of body-worn antennas was utilized in this measurement campaign. A statistical analysis was performed by comparing the measured on-body path loss to five well-known distributions; lognormal, normal, Nakagami, Weibull and Rayleigh. The results showed that the average path loss of moving arm varied higher than the path loss in sitting position for upper-arm-to-left-chest link, up to 3.5 dB. The analysis also concluded that the Nakagami distribution provided the best fit for most of on-body static link path loss in standing still and sitting position, while the arm movement can be best described by log-normal distribution.

Keywords: On-Body channel communications, fading characteristics, statistical model.

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1482 Plasma Properties Effect on Fluorescent Tube Plasma Antenna Performance

Authors: A. N. Dagang, E. I. Ismail, Z. Zakaria

Abstract:

This paper presents the analysis on the performance of monopole antenna with fluorescent tubes. In this research, the simulation and experimental approach is conducted. The fluorescent tube with different length and size is designed using Computer Simulation Technology (CST) software and the characteristics of antenna parameter are simulated throughout the software. CST was used to simulate antenna parameters such as return loss, resonant frequency, gain and directivity. Vector Network Analyzer (VNA) was used to measure the return loss of plasma antenna in order to validate the simulation results. In the simulation and experiment, the supply frequency is set starting from 1 GHz to 10 GHz. The results show that the return loss of plasma antenna changes when size of fluorescent tubes is varied, correspond to the different plasma properties. It shows that different values of plasma properties such as plasma frequency and collision frequency gives difference result of return loss, gain and directivity. For the gain, the values range from 2.14 dB to 2.36 dB. The return loss of plasma antenna offers higher value range from -22.187 dB to -32.903 dB. The higher the values of plasma frequency and collision frequency, the higher return loss can be obtained. The values obtained are comparative to the conventional type of metal antenna.

Keywords: Plasma antenna, fluorescent tube, computer simulation technology, plasma parameters.

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1481 Minimization of Power Loss in Distribution Networks by Different Techniques

Authors: L.Ramesh, S.P.Chowdhury, S.Chowdhury, A.A.Natarajan, C.T.Gaunt

Abstract:

Accurate loss minimization is the critical component for efficient electrical distribution power flow .The contribution of this work presents loss minimization in power distribution system through feeder restructuring, incorporating DG and placement of capacitor. The study of this work was conducted on IEEE distribution network and India Electricity Board benchmark distribution system. The executed experimental result of Indian system is recommended to board and implement practically for regulated stable output.

Keywords: Distribution system, Distributed Generation LossMinimization, Network Restructuring

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1480 Minimizing Fish-feed Loss due to Sea Currents: An Economic Methodology

Authors: V. Vassiliou, M. Charalambides, M. Menicou

Abstract:

Fish-feed is a major cost component of operating expenses for any aquaculture farm. Due to soaring prices of fish-feed ingredients, the need for better feeding schedule management has become imperative. On such factor that influences the utilization rate of fish-feed are sea currents. Up to now, practical monitoring of fishfeed loss due to sea currents is not exercised. This paper gives a description of an economic methodology that aims at quantifying the amount of fish-feed lost due to sea currents and draws on data from a Mediterranean aquaculture farm to formulate the associated model.

Keywords: Aquaculture, economic model, fish-feed loss, sea currents.

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1479 Patients’ Perceptions of Receiving a Diagnosis of a Hematological Malignancy, Following the SPIKES Protocol

Authors: L. Dixon, D. Gavani

Abstract:

Objective: Sharing devastating news with patients is often considered the most difficult task of doctors. This study aimed to explore patients’ perceptions of receiving bad news including which features improve the experience and which areas need refining. Methods: A questionnaire was written based on the steps of the SPIKES model for breaking bad new. 20 patients receiving treatment for a hematological malignancy completed the questionnaire. Results: Overall, the results are promising as most patients praised their consultation. ‘Poor’ was more commonly rated by women and participants aged 45-64. The main differences between the ‘excellent’ and ‘poor’ consultations include the doctor’s sensitivity and checking the patients’ understanding. Only 35% of patients were asked their existing knowledge and 85% of consultations failed to discuss the impact of the diagnosis on daily life. Conclusion: This study agreed with the consensus of existing literature. The commended aspects include consultation set-up and information given. Areas patients felt needed improvement include doctors determining the patient’s existing knowledge and checking new information has been understood. Doctors should also explore how the diagnosis will affect the patient’s life. With a poorer prognosis, doctors should work on conveying appropriate hope. The study was limited by a small sample size and potential recall bias.

Keywords: Communication, diagnosis, hematology, patients.

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1478 Beyond Taguchi’s Concept of the Quality Loss Function

Authors: Atul Dev, Pankaj Jha

Abstract:

Dr. Genichi Taguchi looked at quality in a broader term and gave an excellent definition of quality in terms of loss to society. However the scope of this definition is limited to the losses imparted by a poor quality product to the customer only and are considered during the useful life of the product and further in a certain situation this loss can even be zero. In this paper, it has been proposed that the scope of quality of a product shall be further enhanced by considering the losses imparted by a poor quality product to society at large, due to associated environmental and safety related factors, over the complete life cycle of the product. Moreover, though these losses can be further minimized with the use of techno-safety interventions, the net losses to society however can never be made zero. This paper proposes an entirely new approach towards defining product quality and is based on Taguchi’s definition of quality.

Keywords: Existing concept, goal post philosophy, life cycle, proposed concept, quality loss function.

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1477 The Experiences of Coronary Heart Disease Patients: Biopsychosocial Perspective

Authors: Christopher C. Anyadubalu

Abstract:

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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1476 The Prevalence of Transfusion-Transmitted Virus (TTV) Infection inIranian Patients with Chronic Hepatitis B

Authors: P. Ghasemi Dehkordi, A. Doosti, M. R. Hajimirzaei

Abstract:

TTV is an unenveloped circular single-stranded DNA virus with a diameter of 30-32 nm that first was described in 1997 in Japan. TTV was detected in various populations without proven pathology, including blood donors and in patients with chronic HBV and HCV hepatitis. The aim of this study was to determine the prevalence of TTV DNA in Iranian patients with chronic hepatitis B and C. Viral TTV-DNA was studied in 442 samples (202 with HBV, 138 with HCV and 102 controls) collected from west south of Iran. All extracted serum DNA was amplified by TTV ORF1 gene specific primers using the semi nested PCR technique. TTV DNA was detected in the serum of 8.9% and 10.8% patients with chronic hepatitis B and C, respectively. Prevalence of TTV-DNA in the serum of 102 controls was 2.9%. Results showed significant relation of TTV with HBV and HCV in patients by using T test examination (P<0.01). The prevalence of TTV-DNA in Iranian hepatitis B and C patients is rather high, and compare with other countries. To control and prevention of the distribution of TT-virus, examination of the blood and blood products it seems to be necessary.

Keywords: Transfusion-transmitted virus (TTV), Hepatitis Cvirus (HCV), Hepatitis B virus (HBV), ORF1 gene, Semi nested PCR, Iran.

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1475 Poststreptococcal Reactive Arthritis in Children: A Serial Case

Authors: A. Lubis, S. S. Pasulu, Z. Hikmah, A. Endaryanto, A. Harsono

Abstract:

Infection by group A streptococci (GAS) can trigger an autoantibody that cause a poststreptococcal reactive arthritis (PSRA). Four patients with PSRA aged 10 years to 14 years old with the main complaint of joint pain for five days to 10 days after suffering a fever and sore throat. The joint pain was persistent, additive, and non migratory. All patients revealed an increase in erythrocyte sedimentation rate (ESR) and anti-streptolysin O (ASLO), but the chest x-ray, electrocardiography, and echocardiography were normal. Bone imaging showed no destruction on the affected joint. Jones Criteria were not fulfilled in all patients. Erythromycin and ibuprofen were given in all patients and an improvement was shown. Erythromycin was continued for one year and routine controls were conducted for cardiac evaluation. The prognosis of all the patients was good.

Keywords: Arthritis, group A streptococcus, autoantibody, Jones criteria.

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1474 Operational Risk – Scenario Analysis

Authors: Milan Rippel, Petr Teply

Abstract:

This paper focuses on operational risk measurement techniques and on economic capital estimation methods. A data sample of operational losses provided by an anonymous Central European bank is analyzed using several approaches. Loss Distribution Approach and scenario analysis method are considered. Custom plausible loss events defined in a particular scenario are merged with the original data sample and their impact on capital estimates and on the financial institution is evaluated. Two main questions are assessed – What is the most appropriate statistical method to measure and model operational loss data distribution? and What is the impact of hypothetical plausible events on the financial institution? The g&h distribution was evaluated to be the most suitable one for operational risk modeling. The method based on the combination of historical loss events modeling and scenario analysis provides reasonable capital estimates and allows for the measurement of the impact of extreme events on banking operations.

Keywords: operational risk, scenario analysis, economic capital, loss distribution approach, extreme value theory, stress testing

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1473 Optimal Allocation of DG Units for Power Loss Reduction and Voltage Profile Improvement of Distribution Networks using PSO Algorithm

Authors: K. Varesi

Abstract:

This paper proposes a Particle Swarm Optimization (PSO) based technique for the optimal allocation of Distributed Generation (DG) units in the power systems. In this paper our aim is to decide optimal number, type, size and location of DG units for voltage profile improvement and power loss reduction in distribution network. Two types of DGs are considered and the distribution load flow is used to calculate exact loss. Load flow algorithm is combined appropriately with PSO till access to acceptable results of this operation. The suggested method is programmed under MATLAB software. Test results indicate that PSO method can obtain better results than the simple heuristic search method on the 30-bus and 33- bus radial distribution systems. It can obtain maximum loss reduction for each of two types of optimally placed multi-DGs. Moreover, voltage profile improvement is achieved.

Keywords: Distributed Generation (DG), Optimal Allocation, Particle Swarm Optimization (PSO), Power Loss Minimization, Voltage Profile Improvement.

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1472 Coherence Analysis for Epilepsy Patients: An MEG Study

Authors: S. Ge, T. Wu, HY. Tang, X. Xiao, K. Iramina, W. Wu

Abstract:

It is crucial to quantitatively evaluate the treatment of epilepsy patients. This study was undertaken to test the hypothesis that compared to the healthy control subjects, the epilepsy patients have abnormal resting-state connectivity. In this study, we used the imaginary part of coherency to measure the resting-state connectivity. The analysis results shown that compared to the healthy control subjects, epilepsy patients tend to have abnormal rhythm brain connectivity over their epileptic focus.

Keywords: Coherence, connectivity, resting-state, epilepsy

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1471 Placebo Effect on Psychoemotional Status and Clinical Analyses of Armenian Crohn's Disease Patients

Authors: Elya S. Pepoyan, Astghik Z. Pepoyan

Abstract:

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

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

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1470 Adaptive Few-Shot Deep Metric Learning

Authors: Wentian Shi, Daming Shi, Maysam Orouskhani, Feng Tian

Abstract:

Currently the most prevalent deep learning methods require a large amount of data for training, whereas few-shot learning tries to learn a model from limited data without extensive retraining. In this paper, we present a loss function based on triplet loss for solving few-shot problem using metric based learning. Instead of setting the margin distance in triplet loss as a constant number empirically, we propose an adaptive margin distance strategy to obtain the appropriate margin distance automatically. We implement the strategy in the deep siamese network for deep metric embedding, by utilizing an optimization approach by penalizing the worst case and rewarding the best. Our experiments on image recognition and co-segmentation model demonstrate that using our proposed triplet loss with adaptive margin distance can significantly improve the performance.

Keywords: Few-shot learning, triplet network, adaptive margin, deep learning.

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1469 Rebuilding the Dental Hygiene Habits of the Hospitalized Patients with Schizophrenia

Authors: Chia-Jou Hsieh, Feng-Chuan Pan

Abstract:

Oral health is particular important to the hospitalized patients with chronic schizophrenia for an extreme high potential of the respiratory infections. Due to the degeneration of physical capability, patients of this kind typically fall dependent in the activity of daily living (ADL). A very high percentage of patients had dental problems of which mostly could be easily avoid by easy regular tooth brushing. Purpose of the project is to develop a mechanism in helping the schizophrenia patients in rebuilding a tooth-cleaning habit. The project observed and evaluated the tooth-cleaning behavior of 100 male patients in a psychiatric hospital, and found the majority of them ignored such an activity in a three-month period of time. In the meantime, the primary care-givers were not aware or not convinced the importance of such a need of dental hygiene, and thus few if any tooth cleaning training or knowledge on dental hygiene were given to the patients. The project then developed a program based on the numerous observations and discussions. The improvement program included patients- group education, care-givers- training, and a tool-kit for tooth-brush holding was erected. The project launched with some incentive package. The outcomes were encouraging with 87% of the patients had rebuilt their tooth-brushing habits against previous 22%, and the tooth cleaning kits were 100% kept against 22% in the past. This project had significantly improved the oral health of the patients. The project, included the procedure and the tool-kit holder specific for this purpose, was a good examples for psychiatric hospitals.

Keywords: Schizophrenia, dental hygiene, tool-kit holder, health education

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