Search results for: medical ultrasound imaging

Authors: G. Feletti, D. Tedesco, P. Trucco

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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of a first phase of revision of the technical-scientific literature concerning the indicators currently in use for the performance measurement of EMS. It emerges that current studies focus on two distinct areas and independent objectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). Conversely, the perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal covers the end-to-end healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid even to EMS aspects that in current literature tend to be neglected or underestimated. In particular, the integration of the two processes enables to evaluate the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering, besides the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating firstly the ones not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draw us to exclude additional indicators due to unavailability of data required for their computation. The final dashboard, that was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness on EDs accessibility in real time. The association of each KPI to the EMS phase it refers to enabled the design of a well-balanced dashboard, covering both efficiency and effectiveness performance objectives of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient care are covered by traditional KPIs. Future developments could be directed to building a hierarchical dashboard, composed by a high-level minimal set of KPIs for measuring the basic performance of the EMS system, at an aggregate level, and lower levels of KPIs that bring additional and more detailed information on specific performance dimensions or EMS phases.

Keywords: Emergency Medical Services, Key Performance Indicators, Dashboard, Decision Support.

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Authors: E. Shahhaidar

Abstract:

In this paper we present a novel design of a wearable electronic textile. After defining a special application, we used the specifications of some low power, tiny elements including sensors, microcontrollers, transceivers, and a fault tolerant special topology to have the most reliability as well as low power consumption and longer lifetime. We have considered two different conditions as normal and bodily critical conditions and set priorities for using different sensors in various conditions to have a longer effective lifetime.

Keywords: ECG, E-Textile, Fault Tolerance, Powerconsumption.

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Authors: Ganetsou Evanthia, Koutsikos Emmanouil, Austin Anna Maria

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Information technology has long served the needs of individuals for learning and entertainment, but much less for children in sickness. The aim of the proposed online video game is to provide immersive learning opportunities as well as essential social and emotional scenarios for hospital-bound children with long-term illness. Online self-paced courses on chosen school subjects, including specialized software and multisensory assessments, aim at enhancing children’s academic achievement and sense of inclusion, while doctor minigames familiarize and educate young patients on their medical conditions. Online ethical dilemmas will offer children opportunities to contemplate on the importance of medical procedures and following assigned medication, often challenging for young patients; they will therefore reflect on their condition, re-evaluate their perceptions about hospitalization, and assume greater personal responsibility for their progress. Children’s emotional and psychosocial needs are addressed by engaging in social conventions, such as interactive, daily, collaborative mini games with other hospitalized peers, like virtual competitive sports games, weekly group psychodrama sessions, and online birthday parties or sleepovers. Social bonding is also fostered by having a virtual pet to interact with and take care of, as well as a virtual nurse to discuss and reflect on the mood of the day, engage in constructive dialogue and perspective-taking, and offer reminders. Access to the platform will be available throughout the day depending on the patient’s health status. The program is designed to minimize escapism and feelings of exclusion and can flexibly be adapted to offer post-treatment and a support online system at home.

Keywords: Hospitalized children, interactive games, long-term illness, cognitive enhancement, socioemotional development.

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Authors: B. Mendonça, D. Sandwell

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The Metropolitan Region of Sao Paulo (MRSP) has suffered from serious water scarcity. Consequently, the most convenient solution has been building wells to extract groundwater from local aquifers. However, it requires constant vigilance to prevent over extraction and future events that can pose serious threat to the population, such as subsidence. Radar imaging techniques (InSAR) have allowed continuous investigation of such phenomena. The analysis of data in the present study consists of 23 SAR images dated from October 2007 to March 2011, obtained by the ALOS-1 spacecraft. Data processing was made with the software GMTSAR, by using the InSAR technique to create pairs of interferograms with ground displacement during different time spans. First results show a correlation between the location of 102 wells registered in 2009 and signals of ground displacement equal or lower than -90 millimeters (mm) in the region. The longest time span interferogram obtained dates from October 2007 to March 2010. As a result, from that interferogram, it was possible to detect the average velocity of displacement in millimeters per year (mm/y), and which areas strong signals have persisted in the MRSP. Four specific areas with signals of subsidence of 28 mm/y to 40 mm/y were chosen to investigate the phenomenon: Guarulhos (Sao Paulo International Airport), the Greater Sao Paulo, Itaquera and Sao Caetano do Sul. The coverage area of the signals was between 0.6 km and 1.65 km of length. All areas are located above a sedimentary type of aquifer. Itaquera and Sao Caetano do Sul showed signals varying from 28 mm/y to 32 mm/y. On the other hand, the places most likely to be suffering from stronger subsidence are the ones in the Greater Sao Paulo and Guarulhos, right beside the International Airport of Sao Paulo. The rate of displacement observed in both regions goes from 35 mm/y to 40 mm/y. Previous investigations of the water use at the International Airport highlight the risks of excessive water extraction that was being done through 9 deep wells. Therefore, it is affirmed that subsidence events are likely to occur and to cause serious damage in the area. This study could show a situation that has not been explored with proper importance in the city, given its social and economic consequences. Since the data were only available until 2011, the question that remains is if the situation still persists. It could be reaffirmed, however, a scenario of risk at the International Airport of Sao Paulo that needs further investigation.

Keywords: Ground subsidence, interferometric satellite aperture radar (InSAR), metropolitan region of Sao Paulo, water extraction.

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Authors: Cathal Merz, Gareth O’Donnell

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Coil reinforced thin-walled (CRTW) tubes are used in medicine to treat problems affecting blood vessels within the body through minimally invasive procedures. The CRTW tube considered in this research makes up part of such a device and is inserted into the patient via their femoral or brachial arteries and manually navigated to the site in need of treatment. This procedure replaces the requirement to perform open surgery but is limited by reduction of blood vessel lumen diameter and increase in tortuosity of blood vessels deep in the brain. In order to maximize the capability of these procedures, CRTW tube devices are being manufactured with decreasing wall thicknesses in order to deliver treatment deeper into the body and to allow passage of other devices through its inner diameter. This introduces significant stresses to the device materials which have resulted in an observed increase in the breaking of the proximal segment of the device into two separate pieces after it has failed by buckling. As there is currently no international standard for measuring the mechanical properties of these CRTW tube devices, it is difficult to accurately analyze this problem. The aim of the current work is to address this discrepancy in the biomedical device industry by developing a measurement system that can be used to quantify the effect of process and design changes on CRTW tube performance, aiding in the development of better performing, next generation devices. Using materials testing frames, micro-computed tomography (micro-CT) imaging, experiment planning, analysis of variance (ANOVA), T-tests and regression analysis, test methods have been developed for assessing the impact of process and design changes on the device. The major findings of this study have been an insight into the suitability of buckle and three-point bend tests for the measurement of the effect of varying processing factors on the device’s performance, and guidelines for interpreting the output data from the test methods. The findings of this study are of significant interest with respect to verifying and validating key process and design changes associated with the device structure and material condition. Test method integrity evaluation is explored throughout.

Keywords: Buckling, coil reinforced thin-walled tubes, fracture, test method.

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Authors: Somayeh Abedian, Pirhossein Kolivand, Hamid Reza Lornejad, Amin Karampour, Ebrahim Keshavarz Safari

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For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. EMS Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients that seconds are vital in saving their lives. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Keywords: response time, geographic location inquiry service, location-based services, emergency medical services information system

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Authors: Ogunduyile O. Oluwgbenga

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Recent advancements in sensor technologies and Wireless Body Area Networks (WBANs) have led to the development of cost-effective healthcare devices which can be used to monitor and analyse a person-s physiological parameters from remote locations. These advancements provides a unique opportunity to overcome current healthcare challenges of low quality service provisioning, lack of easy accessibility to service varieties, high costs of services and increasing population of the elderly experienced globally. This paper reports on a prototype implementation of an architecture that seamlessly integrates Wireless Body Area Network (WBAN) with Web services (WS) to proactively collect physiological data of remote patients to recommend diagnostic services. Technologies based upon WBAN and WS can provide ubiquitous accessibility to a variety of services by allowing distributed healthcare resources to be massively reused to provide cost-effective services without individuals physically moving to the locations of those resources. In addition, these technologies can reduce costs of healthcare services by allowing individuals to access services to support their healthcare. The prototype uses WBAN body sensors implemented on arduino fio platforms to be worn by the patient and an android smart phone as a personal server. The physiological data are collected and uploaded through GPRS/internet to the Medical Health Server (MHS) to be analysed. The prototype monitors the activities, location and physiological parameters such as SpO2 and Heart Rate of the elderly and patients in rehabilitation. Medical practitioners would have real time access to the uploaded information through a web application.

Keywords: Android Smart phone, Arduino Fio, Web application server, Wireless Body Area Networks.

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Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini

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Background: There is growing evidence that Cerebral Vascular Accident (CVA) can be a consequence of COVID-19 infection. Understanding novel treatment approaches is important in optimizing patient outcomes. Case: This case explores the use of Virtual Reality (VR) in the treatment of a 23-year-old COVID-positive female presenting with left hemiparesis in August 2020. Imaging showed right globus pallidus, thalamus, and internal capsule ischemic stroke. Conventional rehabilitation was started two weeks later, with VR included. This game-based VR technology developed for stroke patients was based on upper extremity exercises and functions for stroke. Physical examination showed left hemiparesis with muscle strength 3/5 in the upper extremity and 4/5 in the lower extremity. The range of motion of the shoulder was 90-100 degrees. The speech exam showed a mild decrease in fluency. Mild lower lip dynamic asymmetry was seen. Babinski was positive on the left. Gait speed was decreased (75 steps per minute). Intervention: Our game-based VR system was developed based on upper extremity physiotherapy exercises for post-stroke patients to increase the active, voluntary movement of the upper extremity joints and improve the function. The conventional program was initiated with active exercises, shoulder sanding for joint ROMs, walking shoulder, shoulder wheel, and combination movements of the shoulder, elbow, and wrist joints, alternative flexion-extension, pronation-supination movements, Pegboard and Purdo pegboard exercises. Also, fine movements included smart gloves, biofeedback, finger ladder, and writing. The difficulty of the game increased at each stage of the practice with progress in patient performances. Outcome: After 6 weeks of treatment, gait and speech were normal and upper extremity strength was improved to near normal status. No adverse effects were noted. Conclusion: This case suggests that VR is a useful tool in the treatment of a patient with COVID-19 related CVA. The safety of developed instruments for such cases provides approaches to improve the therapeutic outcomes and prognosis as well as increased satisfaction rate among patients.

Keywords: COVID-19, stroke, virtual reality, rehabilitation.

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Authors: Luciana Montera

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DNA shuffling is a powerful method used for in vitro evolute molecules with specific functions and has application in areas such as, for example, pharmaceutical, medical and agricultural research. The success of such experiments is dependent on a variety of parameters and conditions that, sometimes, can not be properly pre-established. Here, two computational models predicting DNA shuffling results is presented and their use and results are evaluated against an empirical experiment. The in silico and in vitro results show agreement indicating the importance of these two models and motivating the study and development of new models.

Keywords: Computer simulation, DNA shuffling, in silico andin vitro comparison.

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Authors: M. G. Cattaneo

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The non-effectiveness of certain codified human rights is particularly apparent with reference to the lack of access to essential drugs in developing countries, which represents a breach of the human right to receive adequate health assistance. This paper underlines the conflict and the legal contradictions between human rights, namely health rights, international Intellectual Property Rights, in particular patent law, as well as international trade law. The paper discusses the crucial links between R&D costs for innovation, patents and new medical drugs, with the goal of reformulating the hierarchies of priorities and of interests at stake in the international intellectual property (IP) law system. Different from what happens today, International patent law should be a legal instrument apt at rebalancing an axiological asymmetry between the (conflicting) needs at stake The core argument in the paper is the proposal of an alternative pathway, namely a feasible proposal for a patent law reform. IP laws tend to balance the benefits deriving from innovation with the costs of the provided monopoly, but since developing countries and industrialized countries are in completely different political and economic situations, it is necessary to (re)modulate such exchange according to the different needs. Based on this critical analysis, the paper puts forward a proposal, called Trading Time for Space (TTS), whereby a longer time for patent exclusive life in western countries (Time) is offered to the patent holder company, in exchange for the latter selling the medical drug at cost price in developing countries (Space). Accordingly, pharmaceutical companies should sell drugs in developing countries at the cost price, or alternatively grant a free license for the sale in such countries, without any royalties or fees. However, such social service shall be duly compensated. Therefore, the consideration for such a service shall be an extension of the temporal duration of the patent’s exclusive in the country of origin that will compensate the reduced profits caused by the supply at the price cost in developing countries.

Keywords: Global health, global justice, patent law reform, access to drugs.

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Authors: Samuel P. Prahlow, Anthony Sciuva, Katherine Bombly, Emily Wilson, Shiv Dhiman, Savita Arya

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A prevalence cohort study of atherosclerotic lesions within cadavers was performed to better understand and characterize the prevalence of atherosclerosis among Georgia residents within body donors in the Philadelphia College of Osteopathic Medicine (PCOM) - Georgia body donor program. We procured specimens from cadavers used for medical student, physical therapy student, and biomedical science student cadaveric anatomical dissection at PCOM - South Georgia and PCOM - Georgia. Tissues were prepared using hematoxylin and eosin (H&E) stain as histological slides by Colquitt Regional Medical Center Laboratory Services. One section from each of the following arteries was taken after cadaveric dissection at the site of most calcification palpated grossly (if present): left anterior descending coronary artery, left internal carotid artery, abdominal aorta, splenic artery, and hepatic artery. All specimens were graded and categorized according to the American Heart Association’s Modified and Conventional Standards for Atherosclerotic Lesions using x4, x10, x40 microscopic magnification. Our study cohort included 22 cadavers, with 16 females and 6 males. The average age was 72.54 and median age was 72, with a range of 52 to 90 years old. The cause of death determination listing vascular and/or cardiovascular causes were present on 6 of the 22 death certificates. 19 of 22 (86%) cadavers had at least a single artery grading > 5. Of the cadavers with at least a single artery graded at greater than 5, only 5 of 19 (26%) cadavers had a vascular or cardiovascular cause of death reported. Malignancy was listed as a cause of death on 7 (32%) of death certificates. The average atherosclerosis grading of the common hepatic, splenic and left internal carotid arteries (2.15, 3.05, and 3.36 respectively) were lower than the left anterior descending artery and the abdominal aorta (5.16 and 5.86 respectively). This prevalence study characterizes atherosclerosis found in five medium and large systemic arteries within cadavers from the state of Georgia.

Keywords: Atherosclerosis, cardiovascular, histology, pathology.

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Authors: Nikou Javadi, Uğur Dağlı

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The importance of culture and tourism in the attractiveness and competitiveness of the countries is central, and many regions are evidencing their cultural assets, tangible and intangible, as a means to create comparative advantages in tourism and produce a distinctive place in response to the pressures of globalization. Culture and tourism are interlinked because of their obvious combination and growth potential. Cultural tourism is a crucial global tourism market with fast growing. Regions can develop significant relations between culture and tourism to increase their attractiveness as places to visit, live and invest, increasing their competitiveness. Accordingly, having new and creative approach to historical areas as cultural value-based destinations can improve their conditions to promote tourism. Furthermore, in 21st century, media become the most important factor affecting the development of urban cities, including public places. As a result of the digital revolution, re-imaging and re-linkage public places by media are essential to create more interactions between public spaces and users, interaction media display, and urban screens, one of the most important defined media. This interaction can transform the urban space from being neglected to be more interactive space with users, especially the pedestrians. The paper focuses on The Walled City of Famagusta. As many other historic quarters elsewhere in the world, is in a process, of decay and deterioration, and its functionally distinctive areas are severely threatened by physical, functional, locational, and image obsolescence at varying degrees. So the focus on the future development of this area through tourism promotion can be an appropriate decision for the monument enhancement of the spatial quality in Walled City of Famagusta. In this paper, it is aimed to identify the effects of these new digital factors to transform public spaces especially in historic urban areas to promote creative tourism. Accordingly, two different analysis methods are used as well as a theoretical review. The first is case study on site and the second is Close ended questionnaire, test many concepts raised in this paper. The physical analysis on site carried out in order to evaluate the walled city restoration for touristic purpose. Besides, theoretical review is done in order to provide background to the subject and cleared Factors to attract tourists.

Keywords: Historical areas, Media Facade, Sustainable tourism, Walled city of Famagusta.

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Authors: K. Turhan, B. Kurt, E. Uzun

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This paper describes Clinical Document Architecture Release Two (CDA R2) standard and a client application for messaging with SAĞLIK-NET project developed by The Ministry of Health of Turkey. CDA R2 , developed by Health Level 7 (HL7) organization and approved by American National Standards Institute (ANSI) in 2004, to standardize medical information to be able to share semantically and syntactically. In this study, a client application compatible with HL7 V3 for a project named SAĞLIKNET, aimed to build a National Health Information System by Turkey. Moreover, CDA conformance of this application will also be evaluated.

Keywords: HL7 V3, CDA, Interoperability, Web Service.

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Authors: Yong Jun Choi, Juman Byun, Simon Berkovich

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One of the ubiquitous routines in medical practice is searching through voluminous piles of clinical documents. In this paper we introduce a distributed system to search and exchange clinical documents. Clinical documents are distributed peer-to-peer. Relevant information is found in multiple iterations of cross-searches between the clinical text and its domain encyclopedia.

Keywords: Clinical documents, cross-search, document exchange, information retrieval, peer-to-peer.

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Authors: Shaun Cox, Michael Oakes, Stefan Wermter, Maurice Hawthorne

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We report on the results of a pilot study in which a data-mining tool was developed for mining audiology records. The records were heterogeneous in that they contained numeric, category and textual data. The tools developed are designed to observe associations between any field in the records and any other field. The techniques employed were the statistical chi-squared test, and the use of self-organizing maps, an unsupervised neural learning approach.

Keywords: Audiology, data mining, chi-squared, self-organizing maps

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Authors: J. A. López, J. E. Olguín, C. W. Camargo, G. A. Quijano, R. Martínez

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This paper presents an anthropometric study conducted to 300 employees in a maquiladora industry that belongs to the cluster of medical products as part of a research project to pretend simulate workplace conditions under which operators conduct their activities. This project is relevant because traditionally performed a study to design ergonomic workspaces according to anthropometric profile of users, however, this paper demonstrates the importance of making decisions when the infrastructure cannot be adapted for economic whichever put emphasis on user activity.

Keywords: Anthropometry, Biomechanics, Design, Ergonomics, Productivity.

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Authors: J. Bartnicka, J. A. Piedrabuena, R. Portilla, L. Moyano - Cuevas, J. B. Pagador, P. Augat, J. Tokarczyk, F. M. Sánchez Margallo

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Orthopaedic surgeries are characterized by a high degree of complexity. This is reflected by four main groups of resources: 1) surgical team which is consisted of people with different competencies, educational backgrounds and positions; 2) information and knowledge about medical and technical aspects of surgery; 3) medical equipment including surgical tools and materials; 4) space infrastructure which is important from an operating room layout point of view. These all components must be integrated and build a homogeneous organism for achieving an efficient and ergonomically correct surgical workflow. Taking this as a background, there was formulated a concept of international project, called “Online Vocational Training course on ergonomics for orthopaedic Minimally Invasive” (Train4OrthoMIS), which aim is to develop an e-learning tool available in 4 languages (English, Spanish, Polish and German). In the article, there is presented the first project research outcomes focused on three aspects: 1) ergonomic needs of surgeons who work in hospitals around different European countries, 2) the concept of structure of e-learning course, 3) the definition of tools and methods for knowledge assessment adjusted to users’ expectation.  The methodology was based on the expert panels and two types of surveys: 1) on training needs, 2) on evaluation and self-assessment preferences. The major findings of the study allowed describing the subjects of four training modules and learning sessions. According to peoples’ opinion there were defined most expected test methods which are single choice test and right after quizzes: “True or False” and “Link elements” The first project outcomes confirmed the necessity of creating a universal training tool for orthopaedic surgeons regardless of the country in which they work. Because of limited time that surgeons have, the e-learning course should be strictly adjusted to their expectation in order to be useful.

Keywords: International e-learning, ergonomics, orthopaedic surgery, Train4OrthoMIS.

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Authors: Rohana Mahmud, Hairul Aysa Abdul Halim Sithiq, Haryuna Mohd Taharim

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In this paper, the authors present architecture of a multi agent consultation system for obesity related problems, which hybrid the technology of an expert system (ES) and an intelligent agent (IA). The strength of the ES which is capable of pulling the expert knowledge is consulted and presented to the end user via the autonomous and friendly pushing environment of the intelligent agent.

Keywords: Expert System, Hybrid Technology, Intelligent Agent, Medical Informatics, Multi Agent Consultation System.

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Authors: Claudiu N.Musat

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Due to the constant increase in the volume of information available to applications in fields varying from medical diagnosis to web search engines, accurate support of similarity becomes an important task. This is also the case of spam filtering techniques where the similarities between the known and incoming messages are the fundaments of making the spam/not spam decision. We present a novel approach to filtering based solely on layout, whose goal is not only to correctly identify spam, but also warn about major emerging threats. We propose a mathematical formulation of the email message layout and based on it we elaborate an algorithm to separate different types of emails and find the new, numerically relevant spam types.

Keywords: Clustering, layout, k-means, spam.

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Authors: Luca Indovina, Carmela Coppola, Carlo Altucci, Riccardo Barberi, Rocco Romano

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In this paper a real court case, held in Italy at the Court of Nola, in which a correct physical description, conducted with both a Monte Carlo and biophysical analysis, would have been sufficient to arrive at conclusions confirmed by documentary evidence, is considered. This will be an example of how forensic physics can be useful in confirming documentary evidence in order to reach hardly questionable conclusions. This was a libel trial in which the defendant, Mr. DS (Defendant for Slander), had falsely accused one of his neighbors, Mr. OP (Offended Person), of having caused him some damages. The damages would have been caused by an external plaster piece that would have detached from the neighbor’s property and would have hit Mr DS while he was in his garden, much more than a meter far away from the facade of the building from which the plaster piece would have detached. In the trial, Mr. DS claimed to have suffered a scratch on his forehead, but he never showed the plaster that had hit him, nor was able to tell from where the plaster would have arrived. Furthermore, Mr. DS presented a medical certificate with a diagnosis of contusion of the cerebral cortex. On the contrary, the images of Mr. OP’s security cameras do not show any movement in the garden of Mr. DS in a long interval of time (about 2 hours) around the time of the alleged accident, nor do they show any people entering or coming out from the house of Mr. DS in the same interval of time. Biophysical analysis shows that both the diagnosis of the medical certificate and the wound declared by the defendant, already in conflict with each other, are not compatible with the fall of external plaster pieces too small to be found. The wind was at a level 1 of the Beaufort scale, that is, unable to raise even dust (level 4 of the Beaufort scale). Therefore, the motion of the plaster pieces can be described as a projectile motion, whereas collisions with the building cornice can be treated using Newtons law of coefficients of restitution. Numerous numerical Monte Carlo simulations show that the pieces of plaster would not have been able to reach even the garden of Mr. DS, let alone a distance over 1.30 meters. Results agree with the documentary evidence (images of Mr. OP’s security cameras) that Mr. DS could not have been hit by plaster pieces coming from Mr. OP’s property.

Keywords: Biophysical analysis, Monte Carlo simulations, Newton’s law of restitution, projectile motion.

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Authors: Ntokozo Mthembu

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Access to relevant health indicates people’s likelihood of survival, including craft of indigenous healing and its related practitioners- izinyanga. However, the emergence of a dreaded novel corona virus - COVID-19 that has engulfed almost the whole world has necessitated the need to revisit the state of traditional healers in South Africa. This circumstance tended to expose the reality of social settings in various social structures and related policies including the manner coloniality reveal its ugly head when it comes treatment between western and African based therapeutic practices in this country. In attempting to gain a better understanding of such experiences, primary and secondary sources were consulted when collecting data that perusal of various literature in this instance including face-to-face interviews with traditional healers working on the street of Tshwane Municipality in South Africa. Preliminary findings revealed that the emergence of this deadly virus coincided with the moment when the government agenda was focussed on fulfilment of its promise of addressing the past inequity practices, including the transformation of medical sector. This scenario can be witnessed by the manner in which government and related agencies such as health department keeps on undermining indigenous healing practice irrespective of its historical record in terms of healing profession and fighting various diseases before times of father of medicine, Imhotep. Based on these preliminary findings, it is recommended that the government should hasten the incorporation of African knowledge systems especially medicine to offer alternatives and diverse to assess the underutilised indigenous African therapeutic approach and relevant skills that could be useful in combating ailments such as COVID 19. Perhaps, the plural medical systems should be recognized and related policies are formulated to guarantee mutual respect among citizens and the incorporation of healing practices in South African health sector, Africa and in the broader global community.

Keywords: Indigenous healing practice, inyanga, COVID-19, therapeutic, urban, experience.

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Authors: J. R. Büttler, T. Pham

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Basic understanding of interfacial mechanisms is of importance for the development of polymer composites. For this purpose, we need techniques to analyze the quality of interphases, their chemical and physical interactions and their strength and fracture resistance. In order to investigate the interfacial phenomena in detail, advanced characterization techniques are favorable. Dynamic mechanical thermal analysis (DMTA) using a rheological system is a sensitive tool. T-peel tests were performed with this system, to investigate the temperature-dependent peel behavior of woven textile composites. A model system was made of polyamide (PA) woven fabric laminated with films of polypropylene (PP) or PP modified by grafting with maleic anhydride (PP-g-MAH). Firstly, control measurements were performed with solely PP matrixes. Polymer melt investigations, as well as the extensional stress, extensional viscosity and extensional relaxation modulus at -10°C, 100 °C and 170 °C, demonstrate similar viscoelastic behavior for films made of PP-g-MAH and its non-modified PP-control. Frequency sweeps have shown that PP-g-MAH has a zero phase viscosity of around 1600 Pa·s and PP-control has a similar zero phase viscosity of 1345 Pa·s. Also, the gelation points are similar at 2.42*104 Pa (118 rad/s) and 2.81*104 Pa (161 rad/s) for PP-control and PP-g-MAH, respectively. Secondly, the textile composite was analyzed. The extensional stress of PA66 fabric laminated with either PP-control or PP-g-MAH at -10 °C, 25 °C and 170 °C for strain rates of 0.001 – 1 s^-1 was investigated. The laminates containing the modified PP need more stress for T-peeling. However, the strengthening effect due to the modification decreases by increasing temperature and at 170 °C, just above the melting temperature of the matrix, the difference disappears. Independent of the matrix used in the textile composite, there is a decrease of extensional stress by increasing temperature. It appears that the more viscous is the matrix, the weaker the laminar adhesion. Possibly, the measurement is influenced by the fact that the laminate becomes stiffer at lower temperatures. Adhesive lap-shear testing at room temperature supports the findings obtained with the T-peel test. Additional analysis of the textile composite at the microscopic level ensures that the fibers are well embedded in the matrix. Atomic force microscopy (AFM) imaging of a cross section of the composite shows no gaps between the fibers and matrix. Measurements of the water contact angle show that the MAH grafted PP is more polar than the virgin-PP, and that suggests a more favorable chemical interaction of PP-g-MAH with PA, compared to the non-modified PP. In fact, this study indicates that T-peel testing by DMTA is a technique to achieve more insights into polymeric textile composites.

Keywords: Dynamic mechanical thermal analysis, interphase, polyamide, polypropylene, textile composite, T-peel test.

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Authors: J. S. Kim

Abstract:

This paper presents a 0.13-µm Complementary Metal-Oxide Semiconductor (CMOS) vector modulator for beamforming system. The vector modulator features a 360° phase and gain range of -10 dB to 10 dB with a root mean square phase and amplitude error of only 2.2° and 0.45 dB, respectively. These features make it a suitable for wireless backhaul system in the 5 GHz industrial, scientific, and medical (ISM) bands. It draws a current of 20.4 mA from a 1.2 V supply. The total chip size is 1.87x1.34 mm².

Keywords: CMOS, vector modulator, beamforming, wireless backhaul, ISM.

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

Abstract:

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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Authors: R. Pääkkönen, L. Korpinen, T. Kava, I. Salmi

Abstract:

This study evaluates obstructive sleep apnea treatment through a case study involving a 67-year-old male driver who had a successful continuous positive airway pressure (CPAP) treatment at home but experienced difficulties with traveling and dental care. There are many cheap sleep apnea and snoring devices available, but there is little professional advice on what kind of devices can help. Professional drivers receive yearly specialized medical care follow-up.

Keywords: Sleep, apnea patient, CPAP, professional driver.

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Authors: Daniela Matei, Radu Matei

Abstract:

In this paper a class of analog algorithms based on the concept of Cellular Neural Network (CNN) is applied in some processing operations of some important medical images, namely retina images, for detecting various symptoms connected with diabetic retinopathy. Some specific processing tasks like morphological operations, linear filtering and thresholding are proposed, the corresponding template values are given and simulations on real retina images are provided.

Keywords: Diabetic retinopathy, pathology detection, cellular neural networks, analog algorithms.

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Authors: Paulo S. Caparelli, Eduardo Costa, Alexsandro S. Soares, Hipolito Barbosa

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This paper presents an evolutionary method for designing electronic circuits and numerical methods associated with monitoring systems. The instruments described here have been used in studies of weather and climate changes due to global warming, and also in medical patient supervision. Genetic Programming systems have been used both for designing circuits and sensors, and also for determining sensor parameters. The authors advance the thesis that the software side of such a system should be written in computer languages with a strong mathematical and logic background in order to prevent software obsolescence, and achieve program correctness.

Keywords: Pattern recognition, evolutionary computation, biological signal, functional programming.

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Authors: St. Karagiannis, A. I. Dounis, T. Chalastras, P. Tiropanis, D. Papachristos

Abstract:

This work presents the design of an expert system that aims in the procurement of patient medial background and in the search for suitable skin test selections. Skin testing is the tool used most widely to diagnose allergies. The language of expert systems CLIPS is used as a tool of designing. Finally, we present the evaluation of the proposed expert system which was achieved with the import of certain medical cases and the system produced with suitable successful skin tests.

Keywords: Artificial intelligence, expert system - CLIPS, allergy and skin test.

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Authors: Noraziah Ahmad, Roslina Mohd Sidek, Mohd Affendy Omardin

Abstract:

E-Appointment Scheduling (EAS) has been developed to handle appointment for UMP students, lecturers in Faculty of Computer Systems & Software Engineering (FCSSE) and Student Medical Center. The schedules are based on the timetable and university activities. Constraints Logic Programming (CLP) has been implemented to solve the scheduling problems by giving recommendation to the users in part of determining any available slots from the lecturers and doctors- timetable. By using this system, we can avoid wasting time and cost because this application will set an appointment by auto-generated. In addition, this system can be an alternative to the lecturers and doctors to make decisions whether to approve or reject the appointments.

Keywords: EAS, Constraint Logic Programming, PHP, Apache.

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Authors: L. Korpinen, T. Kava, I. Salmi

Abstract:

This study aimed to describe the operating model of obstructive sleep apnea. Due to the large number of patients, the role of nurses in the diagnosis and treatment of sleep apnea was important. Pulmonary physicians met only a minority of the patients. The sleep apnea study in 2018 included about 800 patients, of which about 28% were normal and 180 patients were classified as severe (apnea-hypopnea index [AHI] over 30). The operating model has proven to be workable and appropriate. The patients understand well that they may not be referred to a pulmonary doctor. However, specialized medical follow-up on professional drivers continues every year.

Keywords: Sleep, apnea patient, operating model, hospital.

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