Search results for: medical implant

Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: Emergency nurses, nursing care, workload, work sampling.

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Authors: Salma El Hajjami, Jamal Malki, Alain Bouju, Mohammed Berrada

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With the expansion of machine learning and data mining in the context of Big Data analytics, the common problem that affects data is class imbalance. It refers to an imbalanced distribution of instances belonging to each class. This problem is present in many real world applications such as fraud detection, network intrusion detection, medical diagnostics, etc. In these cases, data instances labeled negatively are significantly more numerous than the instances labeled positively. When this difference is too large, the learning system may face difficulty when tackling this problem, since it is initially designed to work in relatively balanced class distribution scenarios. Another important problem, which usually accompanies these imbalanced data, is the overlapping instances between the two classes. It is commonly referred to as noise or overlapping data. In this article, we propose an approach called: One Side Behavioral Noise Reduction (OSBNR). This approach presents a way to deal with the problem of class imbalance in the presence of a high noise level. OSBNR is based on two steps. Firstly, a cluster analysis is applied to groups similar instances from the minority class into several behavior clusters. Secondly, we select and eliminate the instances of the majority class, considered as behavioral noise, which overlap with behavior clusters of the minority class. The results of experiments carried out on a representative public dataset confirm that the proposed approach is efficient for the treatment of class imbalances in the presence of noise.

Keywords: Machine learning, Imbalanced data, Data mining, Big data.

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Authors: Lucy Ampaw-Asiedu, Terri R. Norton

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In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.

Keywords: Disaster management, safe spaces, structural design, tornado, vulnerability.

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Authors: Abdolghani Ebrahimi, Diego Klabjan, Chenxi Ge, Daniela Ladner, Parker Stride

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In this work, we use machine learning and data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. Our work applies modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Keywords: machine learning, liver cirrhosis, subgraph mining, supervised learning

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Authors: Yemisi Rufina Alli Smith, Isaac Gbadura Adanlawo

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Liver disorders are one of the major problems of the world. Despite its frequent occurrence, high morbidity and high mortality, its medical management is currently inadequate. This study was designed to evaluate the hepatoprotective effect of saponin extract of the root of Garcinia kola on the integrity of the liver of paracetamol induced wistar albino rats. Twenty five (25) male adult wistar albino rats were divided into five (5) groups. Group I was the Control group that received distilled water only, group II was the negative control that received 2 g/kg of paracetamol on the 13th day, and group III, IV and V were pre-treated with 100, 200 and 400mg/kg of the saponin extract before inducing the liver damage on the 13th day with 2 g/kg of paracetamol. Twenty four (24) h after administration, the rats were sacrificed and blood samples were collected. The serum Alanine Transaminase (ALT), Aspartate Transaminase (AST), Alkaline Phosphatase (ALP) activities, Bilirubin and conjugated bilirubin, glucose and protein concentrations were evaluated. The liver was fixed immediately in Formalin and was processed and stained in Haematoxylin and Eosin (H&E). Administration of saponin extract from the root of Garcinia kola significantly decreased paracetamol induced elevated enzymes in the test group. Also histological observations showed that saponin extract of the root of Garcinia kola exhibited a significant liver protection against the toxicant as evident by the cells trying to return to normal. Saponin extract from the root of Garcinia kola indicated a protection of structural integrity of the hepatocytic cell membrane and regeneration of the damaged liver.

Keywords: Garcinia kola, Hepatoprotective, paracetamol, Saponin.

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Authors: Chao Yi, Cunyue Lu, Lingwei Quan

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Piezoelectric linear motors have the characteristics of great electromagnetic compatibility, high positioning accuracy, compact structure and no deceleration mechanism, which make it promising to applicate in micro-miniature precision drive systems. However, most piezoelectric motors are employed by flexible clamping, which has insufficient rigidity and is difficult to use in rapid positioning. Another problem is that this clamping method seriously affects the vibration efficiency of the vibrating unit. In order to solve these problems, this paper proposes a piezoelectric stack linear motor based on double-end rigid clamping. First, a piezoelectric linear motor with a length of only 35.5 mm is designed. This motor is mainly composed of a motor stator, a driving foot, a ceramic friction strip, a linear guide, a pre-tightening mechanism and a base. This structure is much simpler and smaller than most similar motors, and it is easy to assemble as well as to realize precise control. In addition, the properties of piezoelectric stack are reviewed and in order to obtain the elliptic motion trajectory of the driving head, a driving scheme of the longitudinal-shear composite stack is innovatively proposed. Finally, impedance analysis and speed performance testing were performed on the piezoelectric linear motor prototype. The motor can measure speed up to 25.5 mm/s under the excitation of signal voltage of 120 V and frequency of 390 Hz. The result shows that the proposed piezoelectric stacked linear motor obtains great performance. It can run smoothly in a large speed range, which is suitable for various precision control in medical images, aerospace, precision machinery and many other fields.

Keywords: Elliptical trajectory, linear motor, piezoelectric stack, rigid clamping.

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Authors: Tahsien Mohamed Okasha, Warda Youssef Mohamed Morsy, Hanan Elsayed Zaghla

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We hypothesized that post cardiac arrest patients with Glasgow Coma Scale (GCS) score of less than 8 and who will be exposed to therapeutic hypothermia protocol will exhibit improvement in their neurological performance. 17 subjects were enrolled in this study all over one year. The study was carried out using Quasi-experimental research design. Four tools were used for data collection of this study: Demographic and medical data sheet, Post cardiac arrest health assessment sheet, Bedside Shivering Assessment Scale (BSAS), and Glasgow Pittsburgh cerebral performance category scale (CPC). The mean age was X̅ ± SD = 53 ± 8.122 years, 47.1% were arrested because of cardiac etiology. 35.3% subjects were initially arrested in form of ventricular tachycardia (VT), 23.5% initially arrested in form of ventricular fibrillation (VF), and 29.4% in form of A-Systole. Favorable neurological outcome was seen among 70.6%. There was significant statistical difference in WBC, Platelets, blood gases value, random blood sugar. Also, initial arrest rhythm, etiology of cardiac arrest, and shivering status were significantly correlated with cerebral performance categories score. Therapeutic hypothermia has positive effects on neurological performance among post cardiac arrest patients with GCS score of less than 8. Replication of the study on larger probability sample, with randomized control trial design is recommended with further study for suggesting nursing protocol for patients undergoing therapeutic hypothermia is recommended.

Keywords: Therapeutic hypothermia, neurological performance, after resuscitation from cardiac arrest, initial arrest rhythm.

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Authors: Sundararajan Sangeetha, Joseph Jesu Christopher, Swaminathan Ramakrishnan

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In this work, the primary compressive strength components of human femur trabecular bone are qualitatively assessed using image processing and wavelet analysis. The Primary Compressive (PC) component in planar radiographic femur trabecular images (N=50) is delineated by semi-automatic image processing procedure. Auto threshold binarization algorithm is employed to recognize the presence of mineralization in the digitized images. The qualitative parameters such as apparent mineralization and total area associated with the PC region are derived for normal and abnormal images.The two-dimensional discrete wavelet transforms are utilized to obtain appropriate features that quantify texture changes in medical images .The normal and abnormal samples of the human femur are comprehensively analyzed using Harr wavelet.The six statistical parameters such as mean, median, mode, standard deviation, mean absolute deviation and median absolute deviation are derived at level 4 decomposition for both approximation and horizontal wavelet coefficients. The correlation coefficient of various wavelet derived parameters with normal and abnormal for both approximated and horizontal coefficients are estimated. It is seen that in almost all cases the abnormal show higher degree of correlation than normals. Further the parameters derived from approximation coefficient show more correlation than those derived from the horizontal coefficients. The parameters mean and median computed at the output of level 4 Harr wavelet channel was found to be a useful predictor to delineate the normal and the abnormal groups.

Keywords: Image processing, planar radiographs, trabecular bone and wavelet analysis.

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Authors: Blessing Ojeme, Frederick Quinn, Russell Karls, Shannon Quinn

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The detection and segmentation of mitochondria from fluorescence microscopy is crucial for understanding the complex structure of the nervous system. However, the constant fission and fusion of mitochondria and image distortion in the background make the task of detection and segmentation challenging. Although there exists a number of open-source software tools and artificial intelligence (AI) methods designed for analyzing mitochondrial images, the availability of only a few combined expertise in the medical field and AI required to utilize these tools poses a challenge to its full adoption and use in clinical settings. Motivated by the advantages of automated methods in terms of good performance, minimum detection time, ease of implementation, and cross-platform compactibility, this study proposes a fully automated framework for the detection and segmentation of mitochondria using both image shape information and descriptive statistics. Using the low-cost, open-source Python and OpenCV library, the algorithms are implemented in three stages: pre-processing; image binarization; and coarse-to-fine segmentation. The proposed model is validated using the fluorescence mitochondrial dataset. Ground truth labels generated using Labkit were also used to evaluate the performance of our detection and segmentation model using precision, recall and rand index. The study produces good detection and segmentation results and reports the challenges encountered during the image analysis of mitochondrial morphology from the fluorescence mitochondrial dataset. A discussion on the methods and future perspectives of fully automated frameworks concludes the paper.

Keywords: 2D, Binarization, CLAHE, detection, fluorescence microscopy, mitochondria, segmentation.

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Authors: Claude Takenga, Rolf-Dietrich Berndt, Erling Si, Markus Diem, Guohui Qiao, Melanie Gau, Michael Brandstoetter, Martin Kampel, Michael Dworzak

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In patients with acute lymphoblastic leukaemia (ALL), treatment response is increasingly evaluated with minimal residual disease (MRD) analyses. Flow Cytometry (FCM) is a fast and sensitive method to detect MRD. However, the interpretation of these multi-parametric data requires intensive operator training and experience. This paper presents a pipeline-software, as a ready-to-use FCM-based MRD-assessment tool for the daily clinical practice for patients with ALL. The new tool increases accuracy in assessment of FCM-MRD in samples which are difficult to analyse by conventional operator-based gating since computer-aided analysis potentially has a superior resolution due to utilization of the whole multi-parametric FCM-data space at once instead of step-wise, two-dimensional plot-based visualization. The system developed as a telemedical network reduces the work-load and lab-costs, staff-time needed for training, continuous quality control, operator-based data interpretation. It allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise for the benefit of an even larger community of diseased children worldwide. We established a telemedical network system for analysis and clinical follow-up and treatment monitoring of Leukaemia. The system is scalable and adapted to link several centres and laboratories worldwide.

Keywords: Data security, flow cytometry, leukaemia, telematics platform, telemedicine.

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Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahbobeh Gholipour

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Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.

Keywords: Hypertension, dietary intake, weight, waist circumference, North of Iran.

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Authors: Frank C. Pan, Che-Long Su, Ching-Hsuen Chen

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Background, measuring an individual-s Health Literacy is gaining attention, yet no appropriate instrument is available in Taiwan. Measurement tools that were developed and used in western countries may not be appropriate for use in Taiwan due to a different language system. Purpose of this research was to develop a Health Literacy measurement instrument specific for Taiwan adults. Methods, several experts of clinic physicians; healthcare administrators and scholars identified 125 common used health related Chinese phrases from major medical knowledge sources that easy accessible to the public. A five-point Likert scale is used to measure the understanding level of the target population. Such measurement is then used to compare with the correctness of their answers to a health knowledge test for validation. Samples, samples under study were purposefully taken from four groups of people in the northern Pingtung, OPD patients, university students, community residents, and casual visitors to the central park. A set of health knowledge index with 10 questions is used to screen those false responses. A sample size of 686 valid cases out of 776 was then included to construct this scale. An independent t-test was used to examine each individual phrase. The phrases with the highest significance are then identified and retained to compose this scale. Result, a Taiwan Health Literacy Scale (THLS) was finalized with 66 health-related phrases under nine divisions. Cronbach-s alpha of each division is at a satisfactory level of 89% and above. Conclusions, factors significantly differentiate the levels of health literacy are education, female gender, age, family members of stroke victims, experience with patient care, and healthcare professionals in the initial application in this study..

Keywords: Health literacy, health knowledge, REALM, THLS.

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Authors: J. Daba, J. Dubois

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In this work, we improve a previously developed segmentation scheme aimed at extracting edge information from speckled images using a maximum likelihood edge detector. The scheme was based on finding a threshold for the probability density function of a new kernel defined as the arithmetic mean-to-geometric mean ratio field over a circular neighborhood set and, in a general context, is founded on a likelihood random field model (LRFM). The segmentation algorithm was applied to discriminated speckle areas obtained using simple elliptic discriminant functions based on measures of the signal-to-noise ratio with fractional order moments. A rigorous stochastic analysis was used to derive an exact expression for the cumulative density function of the probability density function of the random field. Based on this, an accurate probability of error was derived and the performance of the scheme was analysed. The improved segmentation scheme performed well for both simulated and real images and showed superior results to those previously obtained using the original LRFM scheme and standard edge detection methods. In particular, the false alarm probability was markedly lower than that of the original LRFM method with oversegmentation artifacts virtually eliminated. The importance of this work lies in the development of a stochastic-based segmentation, allowing an accurate quantification of the probability of false detection. Non visual quantification and misclassification in medical ultrasound speckled images is relatively new and is of interest to clinicians.

Keywords: Discriminant function, false alarm, segmentation, signal-to-noise ratio, skewness, speckle.

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Authors: Sharan Badiger, Prema T. Akkasaligar, P. Amith Kumar

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Upper gastrointestinal endoscopy is a commonly performed diagnostic and therapeutic procedure and has many adverse effects like cardiopulmonary complications, complications related to sedation, infectious complications, bleeding and perforation. So this study was undertaken to evaluate important variables like patient’s age, gender and stage of the procedure in relation to the cardiopulmonary changes during diagnostic upper gastrointestinal endoscopy by monitoring oxygen saturation, blood pressure, heart rate and electrocardiogram. This is a prospective longitudinal hospital based study involving a total of 140 consecutive patients, at Sri. B. M. Patil Medical College, Hospital and Research Centre. Cardiopulmonary changes during upper gastrointestinal endoscopy are more common in the age groups of 51-60 years, with equal frequency in both male and female. Oxygen saturation levels decreased by about 4% in both sexes during introduction of endoscopy. Mild to moderate hypoxia was found in 32% of the study group. Severe hypoxia was found in 5% of the patients, mostly in those patients who are above 50 years of age. Tachycardia was noted in 88% of the study group patients. Blood pressure increased to hypertension levels in 22 patients (15.7%) which returned to normal within few minutes after the procedure. S-T depression was noticed in 4% of patients and T wave inversion in 8% of patients during upper gastrointestinal endoscopy. All these changes disappeared after 10 minutes after the endoscopy. Cardiopulmonary changes are common during upper gastrointestinal endoscopy. Maximum changes in oxygen saturation, heart rate and blood pressure occurred immediately after the introduction of endoscope. The cardiopulmonary changes did not manifest into any identifiable clinical symptoms. The rate of recovery was faster in younger age groups and women.

Keywords: Blood Pressure, Cardio-Pulmonary, Heart Rate, Oxygen Saturation, Upper Gastrointestinal Endoscopy.

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Authors: Namugenyi Ephrance Eunice, Julianne Sansa Otim, Marco Zennaro, Stephen D. Wolthusen

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The Internet of Things (IoT) is a network of connected data processing devices, mechanical and digital machinery, items, animals, or people that may send data across a network without requiring human-to-human or human-to-computer interaction. Each component has sensors that can pick up on specific phenomena, as well as processing software and other technologies that can link to and communicate with other systems and/or devices over the Internet or other communication networks and exchange data with them. IoT is increasingly being used in fields other than consumer electronics, such as public safety, emergency response, industrial automation, autonomous vehicles, the Internet of Medical Things (IoMT), and general environmental monitoring. Consumer-based IoT applications, like smart home gadgets and wearables, are also becoming more prevalent. This paper presents the main IoT deployment areas for environmental monitoring in developing regions and the backhaul options suitable for them based on a couple of related works. The study includes an overview of existing IoT deployments, the underlying communication architectures, protocols, and technologies that support them. This overview shows that Low Power Wireless Area Networks (LPWANs) are very well suited for monitoring environment architectures designed for remote locations. LoRa technology, particularly the LoRaWAN protocol, has an advantage over other technologies due to its low power consumption, adaptability, and suitable communication range. The current challenges of various architectures are discussed in detail, with the major issue identified as obstruction of communication paths by buildings, trees, hills, etc.

Keywords: Communication technologies, environmental monitoring, Internet of Things, IoT, IoT deployment challenges.

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Authors: Saimir Heta, Kastriot Haxhirexha, Virtut Velmishi, Nevila Alliu, Ilma Robo

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Background: Testicular rotation can occur at any age. The possibility to save the testicle is the fastest possible surgical intervention which is indicated by the presence of acute pain even at rest. The time element is more important to diagnose and proceed further with surgical intervention. Testicular damage is a consequence which mainly depends on the moment of onset of symptoms, at the time when the symptoms are diagnosed, the earliest action to be performed is surgical intervention. Sometimes medical tests are needed to confirm a diagnosis, or to help identify another cause for symptoms; for example, the urine test, that is used to check for infection, associated with the scrotal ultrasound test. Control of blood flow to the longitudinal supply vessels of the testicles is indicated. The sign that indicates testicular rotation is a reduction in blood flow. This is the element which is distinguished from ultrasound examination. Surgery may be needed to determine if the patient’s symptoms are caused by the rotation of the testis or any other condition. Discussion: As a surgical intervention of the emergency, the torsion of the test depends very much on the duration of the torsion, as the success in the life of the testicle depends on the fastest surgical intervention. From the previous clinic, it is noted that in any case presented to the pediatric patient diagnosed with testicular rotation, there is always a link with personal history that the patient refers to the presence of a previous episode of testicular trauma. Literature supports this fact very logically. Conclusions: Salvation without testicular atrophy depends closely on establishing the diagnosis of testicular rotation as soon as possible. Following the logic above, it can be said that the diagnosis for rotation should be performed as soon as possible, to avoid consequences that will not be favorable for the patient.

Keywords: Acute scrotum, testicular torsion, newborns, infants, clinical presentation.

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Authors: Makkia, Ahmad, Al-Falahi, Abdullah Abdelaziz Muharram

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Healthcare workers (HCWs) in Yemen are exposed to a myriad of occupational health hazards, including biological, physical, ergonomic, chemical and psychosocial hazards. HCWs operate in an environment that is considered to be one of the most hazardous occupational settings. The current study aimed to assess sng the prevalence of ‎occupational health hazards among Health care workers and associated ‎risk factors in public hospitals in Sana'a City, Yemen. Descriptive cross-sectional design was utilized; out of 5443 totals of HCWs 396 were selected by multistage sampling technique was carried out in the public hospitals in Sana'a city, Yemen. More the half (60.6%) of HCWs were aged between 20-30 years, 50.8% were males, 56.3% were married, and 45.5% had a diploma qualification, while 65.2% of HCWs had less than 6 years of experience. The results show a high prevalence of occupational hazards (99%); ergonomic hazards (93.4%), biological hazards (87.6%), psychosocial (86.65%), physical hazards (83.3%), and chemical hazards (73.5%). There were no statistically significant differences between demographic characteristics and the prevalence of occupational hazards (p > 0.05). The study revealed that occupational hazards were highly prevalent among the participants. The most common biological hazard was exposure to sharp-related injuries, while the predominant physical hazard was slip, trip, and fall incidents. Ergonomic hazards manifested as back or neck pain during work. Chemical hazards were represented by allergic reactions to medical gloves powder. Psychosocial hazards included experiencing verbal and physical harassment. In conclusion, the study emphasized the importance of raising awareness among HCWs and conducting training courses to prevent occupational hazards.

Keywords: Health workers, occupational hazard, prevalence, risk factors.

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Authors: Chi-Shan Chen, Mao-Chou Hsu, Feng-Chuan Pan

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The incidence of oral cancer in Taiwan increased year by year. It replaced the nasopharyngeal as the top incurrence among head and neck cancers since 1994. Early examination and earlier identification for earlier treatment is the most effective medical treatment for these cancers. Although the government fully subsidized the expenses with tremendous promotion program for oral cancer screening, the citizen-s participation remained low. Purpose of this study is to understand the factors affecting the citizens- behavior intensions of taking an oral cancer screening. Based on the Theory of Planned Behavior, this study adopted four distinctive variables in explaining the captioned behavior intentions.700 questionnaires were dispatched with 500 valid responses or 71.4% returned by the citizens with an age 30 or above from the eastern counties of Taiwan. Test results has shown that attitude toward, subjective norms of, and perceived behavioral control over the oral cancer screening varied from some demographic factors to another. The study proofed that attitude toward, subjective norms of, and perceived behavioral control over the oral cancer screening had positive impacts on the corresponding behavior intention. The test concluded that the theory of planned behavior was appropriate as a theoretical framework in explaining the influencing factors of intentions of taking oral cancer screening. This study suggested the healthcare professional should provide high accessibility of screening services other than just delivering knowledge on oral cancer to promote the citizens- intentions of taking the captioned screening. This research also provided a practical implication to the healthcare professionals when formulating and implementing promotion instruments for lifting the screening rate of oral cancer.

Keywords: Theory of planned behavior, oral cancer, cancer screening

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Authors: U K Chakrabarti, Jigisha Parikh

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Hazardous Material transportation by road is coupled with inherent risk of accidents causing loss of lives, grievous injuries, property losses and environmental damages. The most common type of hazmat road accident happens to be the releases (78%) of hazardous substances, followed by fires (28%), explosions (14%) and vapour/ gas clouds (6 %.). The paper is discussing initially the probable 'Impact Zones' likely to be caused by one flammable (LPG) and one toxic (ethylene oxide) chemicals being transported through a sizable segment of a State Highway connecting three notified Industrial zones in Surat district in Western India housing 26 MAH industrial units. Three 'hotspots' were identified along the highway segment depending on the particular chemical traffic and the population distribution within 500 meters on either sides. The thermal radiation and explosion overpressure have been calculated for LPG / Ethylene Oxide BLEVE scenarios along with toxic release scenario for ethylene oxide. Besides, the dispersion calculations for ethylene oxide toxic release have been made for each 'hotspot' location and the impact zones have been mapped for the LOC concentrations. Subsequently, the maximum Initial Isolation and the protective zones were calculated based on ERPG-3 and ERPG-2 values of ethylene oxide respectively which are estimated taking the worst case scenario under worst weather conditions. The data analysis will be helpful to the local administration in capacity building with respect to rescue / evacuation and medical preparedness and quantitative inputs to augment the District Offsite Emergency Plan document.

Keywords: Hotspot, Ethylene Oxide, LPG, MAH (MajorAccident Hazard).

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Authors: Md. Shafiqul Islam, Abdullah Khan, Sharon Kao-Walter, Li Jian

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Shear testing is one of the most complex testing areas where available methods and specimen geometries are different from each other. Therefore, a modified shear test specimen (MSTS) combining the simple uniaxial test with a zone of interest (ZOI) is tested which gives almost the pure shear. In this study, material parameters of polypropylene (PP) and high density polyethylene (HDPE) are first measured by tensile tests with a dogbone shaped specimen. These parameters are then used as an input for the finite element analysis. Secondly, a specially designed specimen (MSTS) is used to perform the shear stress tests in a tensile testing machine to get the results in terms of forces and extension, crack initiation etc. Scanning Electron Microscopy (SEM) is also performed on the shear fracture surface to find material behavior. These experiments are then simulated by finite element method and compared with the experimental results in order to confirm the simulation model. Shear stress state is inspected to find the usability of the proposed shear specimen. Finally, a geometry correction factor can be established for these two materials in this specific loading and geometry with notch using Linear Elastic Fracture Mechanics (LEFM). By these results, strain energy of shear failure and stress intensity factor (SIF) of shear of these two polymers are discussed in the special application of the screw cap opening of the medical or food packages with a temper evidence safety solution.

Keywords: Shear test specimen, Stress intensity factor, Finite Element simulation, Scanning electron microscopy, Screw cap opening.

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Authors: Gorazd Karer

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When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents is one of the main tasks of the anesthesiologist. That being said, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. This paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a User-Datagram-Protocol-based (UDP-based) communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of medical-device manufacturer and is implemented in MATLAB-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: Closed-loop control, Depth of Anesthesia, DoA, optical signal acquisition, Patient State index, PSi, UDP communication protocol.

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Authors: Elvin Çomo, Edlira Tako, Albana Hasimi, Rrapo Ormeni, Olger Gjuzi, Mirela Ndrita

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In Albania, only low-enthalpy geothermal springs and wells are known, the temperatures of some of them are almost at the upper limits of low enthalpy, reaching over 60 °C. These resources can be used to improve the country's energy balance, as well as for profitable economic purposes. The region of Elbasan has the greatest geothermal energy potential in Albania. This basin is one of the most known and most used thermal springs in our country. This area is a surface with a number of sources, located in the form of a chain, in the sector between Llixha and Hidraj and constitutes a thermo-mineral basin with stable discharge and high temperature. The sources of Elbasan Springs, with the current average flow of thermo mineral water of 12-18 l/s and its temperature 55-65 oC, have specific reserves of 39.6 GJ/m2 and potential power to install 2760 kW potential power. For the assessment of physicochemical parameters and heavy metals, water samples were taken at 5 monitoring stations throughout 2022. The levels of basic parameters were analyzed using ISO, EU and APHA standard methods. This study presents the current state of the physicochemical parameters of this thermal basin, the evaluation of these parameters for curative activities and for industrial processes, as well as the integrated utilization of geothermal energy. Thermomineral waters can be utilized for heating homes in the surrounding area or further, depending on the flow from the source or geothermal well. There is awareness among Albanian investors, medical researchers, and the community about the high economic and therapeutic efficiency of the integrated use of geothermal energy in the region and the development of the tourism sector. An analysis of the negative environmental impact from the use of thermal water is also provided.

Keywords: Geothermal energy, Llixha, physicochemical parameters, thermal water.

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Authors: Marilena Ianculescu, Adriana Alexandru

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Internet of Health Things (IoHT) has already proved to be a persuasive means to support a proper assessment of the living conditions by collecting a huge variety of data. For a customized health management of a senior patient, IoHT provides the capacity to build a dynamic solution for sustaining the shift inside the patient-physician relationship by allowing a real-time and continuous remote monitoring of the health status, well-being, safety and activities of the senior, especially in a non-clinical environment. Thus, is created a win-win solution in which both the patient and the physician enhance their involvement and shared decision-making, with significant outcomes. Health monitoring systems in smart environments are becoming a viable alternative to traditional healthcare solutions. The ongoing “Non-invasive monitoring and health assessment of the elderly in a smart environment (RO-SmartAgeing)” project aims to demonstrate that the existence of complete and accurate information is critical for assessing the health condition of the seniors, improving wellbeing and quality of life in relation to health. The researches performed inside the project aim to highlight how the management of IoHT devices connected to the RO-SmartAgeing platform in a secure way by using a role-based access control system, can allow the physicians to provide health services at a high level of efficiency and accessibility, which were previously only available in hospitals. The project aims to identify deficient aspects in the provision of health services tailored to a senior patient’s specificity and to offer a more comprehensive perspective of proactive and preventive medical acts.

Keywords: Health management, Internet of Health Things, remote monitoring, senior patient.

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Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: Virological non-suppression, HIV-positive, ART, Woliso Town, Ethiopia.

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Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

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This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: Awareness, knowledge, osteoporosis, practices.

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Authors: Abeer Aljohani

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The COVID-19 virus spread has been one of the extreme pandemics across the globe. It is also referred as corona virus which is a contagious disease that continuously mutates into numerous variants. Currently, the B.1.1.529 variant labeled as Omicron is detected in South Africa. The huge spread of COVID-19 disease has affected several lives and has surged exceptional pressure on the healthcare systems worldwide. Also, everyday life and the global economy have been at stake. Numerous COVID-19 cases have produced a huge burden on hospitals as well as health workers. To reduce this burden, this paper predicts COVID-19 disease based on the symptoms and medical history of the patient. As machine learning is a widely accepted area and gives promising results for healthcare, this research presents an architecture for COVID-19 detection using ML techniques integrated with feature dimensionality reduction. This paper uses a standard University of California Irvine (UCI) dataset for predicting COVID-19 disease. This dataset comprises symptoms of 5434 patients. This paper also compares several supervised ML techniques on the presented architecture. The architecture has also utilized 10-fold cross validation process for generalization and Principal Component Analysis (PCA) technique for feature reduction. Standard parameters are used to evaluate the proposed architecture including F1-Score, precision, accuracy, recall, Receiver Operating Characteristic (ROC) and Area under Curve (AUC). The results depict that Decision tree, Random Forest and neural networks outperform all other state-of-the-art ML techniques. This result can be used to effectively identify COVID-19 infection cases.

Keywords: Supervised machine learning, COVID-19 prediction, healthcare analytics, Random Forest, Neural Network.

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Authors: O.B. Ozipek, E. Bozdag, E. Sunbuloglu, A. Abdullahoglu, E. Belen, E. Celikkanat

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In textile industry, besides the conventional textile products, technical textile goods, that have been brought external functional properties into, are being developed for technical textile industry. Especially these products produced with weaving technology are widely preferred in areas such as sports, geology, medical, automotive, construction and marine sectors. These textile products are exposed to various stresses and large deformations under typical conditions of use. At this point, sufficient and reliable data could not be obtained with uniaxial tensile tests for determination of the mechanical properties of such products due to mainly biaxial stress state. Therefore, the most preferred method is a biaxial tensile test method and analysis. These tests and analysis is applied to fabrics with different functional features in order to establish the textile material with several characteristics and mechanical properties of the product. Planar biaxial tensile test, cylindrical inflation and bulge tests are generally required to apply for textile products that are used in automotive, sailing and sports areas and construction industry to minimize accidents as long as their service life. Airbags, seat belts and car tires in the automotive sector are also subject to the same biaxial stress states, and can be characterized by same types of experiments. In this study, in accordance with the research literature related to the various biaxial test methods are compared. Results with discussions are elaborated mainly focusing on the design of a biaxial test apparatus to obtain applicable experimental data for developing a finite element model. Sample experimental results on a prototype system are expressed.

Keywords: Biaxial Stress, Bulge Test, Cylindrical Inflation, Fabric Testing, Planar Tension.

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Authors: Sajed A. Habib

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Problem-based learning (PBL) is a student-centered pedagogy that originated in the medical field and has also been used extensively in other knowledge disciplines with recognized advantages and limitations. PBL has been used in various undergraduate engineering programs with mixed outcomes. The current fourth industrial revolution (digital era or Industry 4.0) has made it essential for many science and engineering students to receive effective training in advanced courses such as industrial automation and robotics. This paper presents a case study at Assumption University of Thailand, where a PBL-like approach was used to teach some aspects of automation and robotics to selected groups of undergraduate engineering students. These students were given some basic level training in automation prior to participating in a subsequent training session in order to solve technical problems with increased complexity. The participating students’ evaluation of the training sessions in terms of learning effectiveness, skills enhancement, and incremental knowledge following the problem-solving session was captured through a follow-up survey consisting of 14 questions and a 5-point scoring system. From the most recent training event, an overall 70% of the respondents indicated that their skill levels were enhanced to a much greater level than they had had before the training, whereas 60.4% of the respondents from the same event indicated that their incremental knowledge following the session was much greater than what they had prior to the training. The instructor-facilitator involved in the training events suggested that this method of learning was more suitable for senior/advanced level students than those at the freshmen level as certain skills to effectively participate in such problem-solving sessions are acquired over a period of time, and not instantly.

Keywords: Automation, industry 4.0, model-based design training, problem-based learning.

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Authors: Abou-Baker Salim, A. A. K. Abou-Arab, Sherif R. Mohamed, T. A. Eldesouky

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Pomegranate (Punica granatum L.) is an ancient fruit of great medical interest and rich source of antioxidants. Pesticides as dimethoate play a crucial role in the occurrence many diseases in plants, animal and human. Therefore the ability of Pomegranate (Punica granatum L.) to alleviate hepatotoxicity induced by organophosphate pesticide dimethoate was investigated. Albino male rats were divided randomly into 4 groups and kept at 7 animals per group in an environmentally controlled condition for 6 weeks. The first group was served as a control group (basal diet), the second group fed on basal diet supplemented with 5% freeze dried pomegranate seeds, the third group fed on 20 ppm dimethoate contaminated diet and the last group fed on dimethoate contaminated diet supplemented with 5% freeze dried pomegranate seeds. The results revealed that administration of dimethoate caused high significant increased in liver functions: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) activities as well as lipid peroxide (malonaldhyde, MDA); on the other hand high significant decreased on glutathione (GSH), glutathione peroxidase (GPx), albumin and total protein were observed. However addition of 5% freeze dried pomegranate seeds significantly improved all previously mentioned parameters. These results indicate the dimethoate induced hepatotoxicity and highlight the protective effect of pomegranate seeds as a potential protective agent against dimethoate induced hepatotoxicity. This may be attributed to the powerful antioxidants (polyphenols, total phenols, and total flavonoids) which present in high levels in pomegranate as well as improving the immunity by activation of antioxidant enzymes GSH and GPx.

Keywords: Pomegranate, organophosphate pesticides, dimethoate, liver toxicity, free radicals, antioxidants.

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Authors: H. Benjamin Fredrick David, R. Balasubramanian, A. Anbarasa Pandian

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Image retrieval is the most interesting technique which is being used today in our digital world. CBIR, commonly expanded as Content Based Image Retrieval is an image processing technique which identifies the relevant images and retrieves them based on the patterns that are extracted from the digital images. In this paper, two research works have been presented using CBIR. The first work provides an automated and interactive approach to the analysis of CBIR techniques. CBIR works on the principle of supervised machine learning which involves feature selection followed by training and testing phase applied on a classifier in order to perform prediction. By using feature extraction, the image transforms such as Contourlet, Ridgelet and Shearlet could be utilized to retrieve the texture features from the images. The features extracted are used to train and build a classifier using the classification algorithms such as Naïve Bayes, K-Nearest Neighbour and Multi-class Support Vector Machine. Further the testing phase involves prediction which predicts the new input image using the trained classifier and label them from one of the four classes namely 1- Normal brain, 2- Benign tumour, 3- Malignant tumour and 4- Severe tumour. The second research work includes developing a tool which is used for tumour stage identification using the best feature extraction and classifier identified from the first work. Finally, the tool will be used to predict tumour stage and provide suggestions based on the stage of tumour identified by the system. This paper presents these two approaches which is a contribution to the medical field for giving better retrieval performance and for tumour stages identification.

Keywords: Brain tumour detection, content based image retrieval, classification of tumours, image retrieval.

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