Search results for: high risk cardiac patients.

Authors: Raad Nari, Maura Moriaty, Maha T. Barakat

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Introduction: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs with a unique mechanism of action. They are used to improve glycaemic control in adults with type 2 diabetes by enhancing urinary glucose excretion. In the UAE, there has been certainly an increased use of these medications. As with any new medication, there are safety considerations related to their use in patients with type two diabetes. A retrospective study was conducted at the three main centres of the Imperial College London Diabetes Centre. Methodology: All patients in electronic database (Diamond) from October 2014 to October 2017 were included with a minimum of six months usage of sodium glucose co-transporter inhibitors that comprise canagliflozin, dapagliflozin and empagliflozin. There were 15 paired sample biochemical and clinical correlations. The analysis was done at the start of the study, three months and six months apart. SPSS version 24 was used for this study. Conclusion: This study of sodium glucose co-transporter-2 inhibitors used showed significant reductions in weight, glycated haemoglobin A1C, systolic and diastolic blood pressures. As the case with systematic reviews, there were similar changes in liver enzymes, raised total cholesterol, low density lipopoptein and high density lipoprotein. There was slight improvement in estimated glomerular filtration rate too. Our analysis also showed that they increased in the incidence of urinary tract symptoms and incidence of urinary tract infections.

Keywords: SGLT2 inhibitors dapagliflozin empagliflozin canagliflozin, adverse effects, amputation diabetic ketoacidosis DKA, urinary tract infection.

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Authors: Weidong Xia, Malgorzata Kolotylo, Xuan Tan

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This study examines the key factors that influence general practitioners’ learning and transfer of specialized arthritis knowledge and self-care techniques to patients during normal patient visits. Drawing on the theory of planed behavior and using matched survey data collected from general practitioners before and after training sessions provided by specialized orthopedic physicians, the study suggests that the general practitioner’s intention to use and transfer learned knowledge was influenced mainly by intrinsic motivation, organizational learning culture and absorptive capacity, but was not influenced by extrinsic motivation. The results provide both theoretical and practical implications.

Keywords: Empirical study, healthcare knowledge management, patient self-care, physician knowledge transfer.

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Authors: Reza Gharehkhani

Abstract:

Sedimentation in reservoirs lowers the quality of consumed water, reduce the volume of reservoir, lowers the controllable amount of flood, increases the risk of water overflow during possible floods and the risk of reversal and reduction of dam's useful life. So in all stages of dam establishment such as cognitive studies, phase-1 studies of design, control, construction and maintenance, the problem of sedimentation in reservoir should be considered. What engineers need to do is examine and develop the methods to keep effective capacity of a reservoir, however engineers should also consider the influences of the methods on the flood disaster, functions of water use facilities and environmental issues.This article first examines the sedimentation in reservoirs and shows how to control it and then discusses the studies about the sedimens in Siazakh Dam.

Keywords: Sedimentation, Reservoir, Sediment Control, Dam

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Authors: Donatien Callon, Ian Lalonde, Mathieu Nadeau, Alexandre Girard

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Patient transfer is a challenging, critical task because it exposes caregivers to injury risks. Available transfer devices, like floor lifts, lead to improvements but are far from perfect. They do not eliminate the caregivers’ risk of musculoskeletal disorders, and they can be burdensome to use due to their poor maneuverability. This paper presents a motorized floor lift with a single central motorized wheel connected to an instrumented handle. Admittance controllers are designed to 1) improve the device maneuverability, 2) reduce the required caregiver effort, and 3) ensure the security and comfort of patients. Two controller designs, one with a linear admittance law and a non-linear admittance law with variable damping, were developed and implemented on a prototype. Tests were performed on seven participants to evaluate the performance of the assistance system and the controllers. The experimental results show that 1) the motorized assistance with the variable damping controller improves maneuverability by 28%, 2) reduces the amount of effort required to push the lift by 66% and 3) provides the same level of patient comfort compared to a standard unassisted floor lift.

Keywords: Floor lift, human robot interaction, admittance controller, variable admittance.

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Authors: Ali Poureslami, Hossein Borhanifar, Seyed Ali Alavian

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In this paper, we implement a modern serial backplane platform for telecommunication inter-rack systems. For combination high reliability and low cost protocol property, we applied high level data link control (HDLC) protocol with low voltage differential signaling (LVDS) bus for card to card communicated over backplane. HDLC protocol is a high performance with several operation modes and is famous in telecommunication systems. LVDS bus is a high reliability with high immunity against electromagnetic interference (EMI) and noise.

Keywords: Backplane, BLVDS, HDLC, EMI, I2C, LCT, OSC, SFP, SNMP.

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Authors: Julinda Keçi

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In many countries, governments have been promoting the involvement of private sector entities to enter into long-term agreements for the development and delivery of large infrastructure projects, with a focus on overcoming the limitations upon public fund of the traditional approach. The involvement of private sector through public private partnerships (PPP) brings in new capital investments, value for money and additional risks to handle. Worldwide research studies have shown that an objective, systematic, reliable and useroriented risk assessment process and an optimal allocation mechanism among different stakeholders is crucial to the successful completion. In this framework, this paper, which is the first stage of a research study, aims to identify the main risks for the delivery of PPP projects. A review of cross-countries research projects and case studies was performed to map the key risks affecting PPP infrastructure delivery. The matrix of mapping offers a summary of the frequency of factors, clustered in eleven categories: construction, design, economic, legal, market, natural, operation, political, project finance, project selection and relationship. Results will highlight the most critical risk factors, and will hopefully assist the project managers in directing the managerial attention in the further stages of risk allocation.

Keywords: Construction, infrastructure, public private partnerships, risks.

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Authors: Bishnupriya Sahoo, Prasad K. Bhaskaran

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Tropical cyclone is one among the worst natural hazards that results in a trail of destruction causing enormous damage to life, property, and coastal infrastructures. In a global perspective, the Indian Ocean is considered as one of the cyclone prone basins in the world. Specifically, the frequency of cyclogenesis in the Bay of Bengal is higher compared to the Arabian Sea. Out of the four maritime states in the East coast of India, Odisha is highly susceptible to tropical cyclone landfall. Historical records clearly decipher the fact that the frequency of cyclones have reduced in this basin. However, in the recent decades, the intensity and size of tropical cyclones have increased. This is a matter of concern as the risk and vulnerability level of Odisha coast exposed to high wind speed and gusts during cyclone landfall have increased. In this context, there is a need to assess and evaluate the severity of coastal risk, area of exposure under risk, and associated vulnerability with a higher dimension in a multi-risk perspective. Changing climate can result in the emergence of a new hazard and vulnerability over a region with differential spatial and socio-economic impact. Hence there is a need to have coastal vulnerability projections in a changing climate scenario. With this motivation, the present study attempts to estimate the destructiveness of tropical cyclones based on Power Dissipation Index (PDI) for those cyclones that made landfall along Odisha coast that exhibits an increasing trend based on historical data. The study also covers the futuristic scenarios of integral coastal vulnerability based on the trends in PDI for the Odisha coast. This study considers 11 essential and important parameters; the cyclone intensity, storm surge, onshore inundation, mean tidal range, continental shelf slope, topo-graphic elevation onshore, rate of shoreline change, maximum wave height, relative sea level rise, rainfall distribution, and coastal geomorphology. The study signifies that over a decadal scale, the coastal vulnerability index (CVI) depends largely on the incremental change in variables such as cyclone intensity, storm surge, and associated inundation. In addition, the study also performs a critical analysis on the modulation of PDI on storm surge and inundation characteristics for the entire coastal belt of Odisha State. Interestingly, the study brings to light that a linear correlation exists between the storm-tide with PDI. The trend analysis of PDI and its projection for coastal Odisha have direct practical applications in effective coastal zone management and vulnerability assessment.

Keywords: Bay of Bengal, coastal vulnerability index, power dissipation index, tropical cyclone.

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Authors: Tanvir Ahmed, Thanh N. Long, Phan T. Huong, Donald E. Stewart

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This paper presents views on condom use and the contexts of safe and unsafe sexual practices with different sexual partners and their relationships among Injecting Drug Users (IDUs) in Hai Phong, Vietnam. Fifteen IDUs participated and two local interviewers conducted qualitative semi-structured face-to-face interviews in September-October, 2012 in Vietnamese language. Data were analyzed thematically. Non-protective condom attitudes include negotiate or convince Female Sex Workers (FSW); not realizing risk, importance or necessity; partner doesn’t like, and having extra money/drug from clients. On the other hand, self-awareness, family-consciousness, suspicion of STI presence, fear of getting HIV, and client negotiation sometimes resulted in a safe-sex practice. A thematic diagram was developed to present the relationship (strong/weak) between condom attitude and sexual practice (safe/unsafe) by partner types. The experiences and views reflected in the qualitative information emphasize the heightened need for safe-sex education especially among young IDUs (male/female) highlighting sexual transmission risk.

Keywords: AIDS, HIV, injecting drug user, risk behaviors, Vietnam.

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Authors: Hossam Shalabi, George Hadjisophocleous

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The Canadian Nuclear Power Plants (NPPs) use some portions of NUREG/CR-6850 in carrying out Fire Probabilistic Risk Assessment (PRA). An assessment for the applicability of NUREG/CR-6850 to CANDU reactors was performed and a CANDU Fire PRA was introduced. There are 19 operating CANDU reactors in Canada at five sites (Bruce A, Bruce B, Darlington, Pickering and Point Lepreau). A fire load density survey was done for all Fire Safe Shutdown Analysis (FSSA) fire zones in all CANDU sites in Canada. National Fire Protection Association (NFPA) Standard 557 proposes that a fire load survey must be conducted by either the weighing method or the inventory method or a combination of both. The combination method results in the most accurate values for fire loads. An updated CANDU Fire PRA model is demonstrated in this paper that includes the fuel survey in all Canadian CANDU stations. A qualitative screening step for the CANDU fire PRA is illustrated in this paper to include any fire events that can damage any part of the emergency power supply in addition to FSSA cables.

Keywords: Fire safety, CANDU, nuclear, fuel densities, FDS, qualitative analysis, fire probabilistic risk assessment.

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Authors: Weerachi Sarakorn, I-Ming Tang

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A mathematical model for the transmission of SARS is developed. In addition to dividing the population into susceptible (high and low risk), exposed, infected, quarantined, diagnosed and recovered classes, we have included a class called untraced. The model simulates the Gompertz curves which are the best representation of the cumulative numbers of probable SARS cases in Hong Kong and Singapore. The values of the parameters in the model which produces the best fit of the observed data for each city are obtained by using a differential evolution algorithm. It is seen that the values for the parameters needed to simulate the observed daily behaviors of the two epidemics are different.

Keywords: SARS, mathematical modelling, differential evolution algorithm.

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Authors: H. Zarei, M. H. Fazel Zarandi, M. Karbasian

Abstract:

A Decision Support System/Expert System for stock portfolio selection presented where at first step, both technical and fundamental data used to estimate technical and fundamental return and risk (1st phase); Then, the estimated values are aggregated with the investor preferences (2nd phase) to produce convenient stock portfolio. In the 1st phase, there are two expert systems, each of which is responsible for technical or fundamental estimation. In the technical expert system, for each stock, twenty seven candidates are identified and with using rough sets-based clustering method (RC) the effective variables have been selected. Next, for each stock two fuzzy rulebases are developed with fuzzy C-Mean method and Takai-Sugeno- Kang (TSK) approach; one for return estimation and the other for risk. Thereafter, the parameters of the rule-bases are tuned with backpropagation method. In parallel, for fundamental expert systems, fuzzy rule-bases have been identified in the form of “IF-THEN" rules through brainstorming with the stock market experts and the input data have been derived from financial statements; as a result two fuzzy rule-bases have been generated for all the stocks, one for return and the other for risk. In the 2nd phase, user preferences represented by four criteria and are obtained by questionnaire. Using an expert system, four estimated values of return and risk have been aggregated with the respective values of user preference. At last, a fuzzy rule base having four rules, treats these values and produce a ranking score for each stock which will lead to a satisfactory portfolio for the user. The stocks of six manufacturing companies and the period of 2003-2006 selected for data gathering.

Keywords: Stock Portfolio Selection, Fuzzy Rule-Base ExpertSystems, Financial Decision Support Systems, Technical Analysis, Fundamental Analysis.

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Authors: M.N. Khan, T. Rehman, Z Iqbal, M.S Sajid, M Ahmad, M Riaz

Abstract:

A cross-sectional study was carried out to determine the prevalence, species characterization and associated risk factors with Eimeria (E.) in sheep of district Toba Tek Singh from April, 2009 to March, 2010. Of the total 486 faecal samples examined for Eimeria, 209 (43%) were found infected with five species of Eimeria. Amongst the identified species of Eimeria, E. ovinoidalis was the commonest one (48.32%), followed in order by E. ahsata, E. intricata, E. parva and E. faurei with prevalence of 45.45, 28.71, 24.40 and 19.14 percent respectively. Peak prevalence was observed in August. Wet season (rainy and post-rainy) was found to be favourable for Eimeria infection. Lambs had significantly higher prevalence (P < 0.05) of Eimeria than adults. Similarly higher prevalence of Eimeria was observed in female as compared to male. Among management and husbandry practices; watering system, housing system, floor type and herd size strongly influenced the prevalence of Eimeria. Coccidiosis was more prevalent in closed housing system, non-cemented floor type, pond watered animals and larger herds (P < 0.05) as compared to open housing system, partially cemented floor type, tap watered animals and smaller herds respectively. Feeding system, breed and body condition of animals were not found as risk factors (P>0.05) influencing prevalence of Eimeria.

Keywords: Eimeria, Pakistan prevalence, sheep.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

A growing list of cancers might be influenced by obesity. Obesity is associated with an increased risk for the occurrence and development of some cancers. Inflammation can lead to cancer. It is one of the characteristic features of cancer and plays a critical role in cancer development. C-reactive protein (CRP) is under evaluation related to the new and simple prognostic factors in patients with metastatic renal cell cancer. Obesity can predict and promote systemic inflammation in healthy adults. BMI is correlated with hs-CRP. In this study, SII index and CRP values were evaluated in children with normal BMI and those within the range of different obesity grades to detect the tendency towards cancer in pediatric obesity. A total of one hundred and ninety-four children; thirty-five children with normal BMI, twenty overweight (OW), forty-seven obese (OB) and ninety-two morbid obese (MO) participated in the study. Age- and sex-matched groups were constituted using BMI-for age percentiles. Informed consent was obtained. Ethical Committee approval was taken. Weight, height, waist circumference (C), hip C, head C and neck C of the children were measured. The complete blood count test was performed. C-reactive protein analysis was performed. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. SII index values were progressively increasing starting from normal weight (NW) to MO children. There is a statistically significant difference between NW and OB as well as MO children. No significant difference was observed between NW and OW children, however, a correlation was observed between NW and OW children. MO constitutes the only group, which exhibited a statistically significant correlation between SII index and CRP. Obesity-related bladder, kidney, cervical, liver, colorectal, endometrial cancers are still being investigated. Obesity, characterized as a chronic low-grade inflammation, is a crucial risk factor for colon cancer. Elevated childhood BMI values may be indicative of processes leading to cancer, initiated early in life. Prevention of childhood adiposity may decrease the cancer incidence in adults. To authors’ best knowledge, this study is the first to introduce SII index values during obesity of varying degrees of severity. It is suggested that this index seems to affect all stages of obesity with an increasing tendency and may point out the concomitant status of obesity and cancer starting from very early periods of life.

Keywords: Children, c- reactive protein, systemic immune-inflammation index, obesity.

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Authors: Mohammad Emran, Colton Wayne, Shannon M Koehler, P. Stephen Almond, Haroon Patel

Abstract:

Purpose: Assessment of anastomotic perfusion in Hirschsprung disease using Indocyanine Green (ICG)-near-infrared (NIR) fluorescence angiography. Introduction: Anastomotic stricture and leak are well-known complications of Hirschsprung pull-through procedures. Complications are due to tension, infection, and/or poor perfusion. While a surgeon can visually determine and control the amount of tension and contamination, assessment of perfusion is subject to surgeon determination. Intraoperative use of ICG-NIR enhances this decision-making process by illustrating perfusion intensity and adequacy in the pulled-through bowel segment. This technique, proven to reduce anastomotic stricture and leak in adults, has not been studied in children to our knowledge. ICG, an FDA approved, nontoxic, non-immunogenic, intravascular (IV) dye, has been used in adults and children for over 60 years, with few side effects. ICG-NIR was used in this report to demonstrate the adequacy of perfusion during transanal pullthrough for Hirschsprung’s disease. Method: 8 patients with Hirschsprung disease were evaluated with ICG-NIR technology. Levels of affected area ranged from sigmoid to total colonic Hirschsprung disease. After leveling, but prior to anastomosis, ICG was administered at 1.25 mg (< 2 mg/kg) and perfusion visualized using an NIR camera, before and during anastomosis. Video and photo imaging was performed and perfusion of the bowel was compared to surrounding tissues. This showed the degree of perfusion and demarcation of perfused and non-perfused bowel. The anastomosis was completed uneventfully and the patients all did well. Results: There were no complications of stricture or leak. 5 of 8 patients (62.5%) had modification of the plan based on ICG-NIR imaging. Conclusion: Technologies that enhance surgeons’ ability to visualize bowel perfusion prior to anastomosis in Hirschsprung’s patients may help reduce post-operative complications. Further studies are needed to assess the potential benefits.

Keywords: Colonic anastomosis, fluorescence angiography, Hirschsprung disease, pediatric surgery, SPY, ICG, NIR.

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Authors: R. A. Isabel, E. Baburaj

Abstract:

Wireless Body Area Networks (WBANs) are essential for real-time health monitoring of patients and in diagnosing of many diseases. WBANs comprise many sensors to monitor a large range of ambient conditions. Quality of Service (QoS) is a key challenge in WBAN, because the different state information of the neighboring nodes has to be monitored in an accurate manner. However, energy consumption gets increased while predicting and maintaining the exact information in highly dynamic environments. In order to reduce energy consumption and end to end delay, Markov Chain Based Quality of Service Support (MC-QoSS) method is designed in the health monitoring services of WBAN communication. The energy consumption gets reduced by forming a Markov chain with high energy nodes in the sensor networks communication path. The low energy level sensor nodes are removed using transitional probability in order to reduce end to end delay. High energy nodes are formed in the chain structure of its corresponding path to enhance communication. After choosing the communication path through high energy nodes, the packets are sent to the sink node from the source node with a higher Packet Delivery Ratio. The simulation result shows that MC-QoSS method improves the packet delivery ratio and reduces energy consumption with minimum end to end delay, compared to existing methods.

Keywords: Wireless body area networks, quality of service, Markov chain, health monitoring services.

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Authors: Gilbert Makanda, Roelf Sypkens

Abstract:

In this study we investigated the relevance of high school mathematics in university education. The paper particularly focused on whether the concepts taught in high school are enough for engineering courses at diploma level. The study identified particular concepts that are required in engineering courses whether they were adequately covered in high school. A questionnaire was used to investigate whether relevant topics were covered in high school. The respondents were 228 first year students at the Central University of Technology in the Faculty of Engineering and Information Technology. The study indicates that there are some topics such as integration, complex numbers and matrices that are not done at high schools and are required in engineering courses at university. It is further observed that some students did not cover the topics that are in the current syllabus. Female students enter the university less prepared than their male counterparts. More than 30% of the respondents in this study felt that high school mathematics was not useful for them to be able to do engineering courses.

Keywords: High school mathematics, university education, SPSS package, students’ perceptions.

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Authors: R .H. Talwekar, S. S Limaye

Abstract:

The designing of charge pump with high gain Op- Amp is a challenging task for getting faithful response .Design of high performance phase locked loop require ,a design of high performance charge pump .We have designed a operational amplifier for reducing the error caused by high speed glitch in a transistor and mismatch currents . A separate Op-Amp has designed in 180 nm CMOS technology by CADENCE VIRTUOSO tool. This paper describes the design of high performance charge pump for GHz CMOS PLL targeting orthogonal frequency division multiplexing (OFDM) application. A high speed low power consumption Op-Amp with more than 500 MHz bandwidth has designed for increasing the speed of charge pump in Phase locked loop.

Keywords: Charge pump (CP) Orthogonal frequency divisionmultiplexing (OFDM), Phase locked loop (PLL), Phase frequencydetector (PFD), Voltage controlled oscillator (VCO),

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Authors: Hekmatpanah, M.

Abstract:

Since the beginning of human history, human activities have caused many changes in the environment. Today, a particular attention should be paid to gaining knowledge about water quality of wetlands which are pristine natural environments rich in genetic reserves. If qualitative conditions of industrial areas (in terms of both physicochemical and biological conditions) are not addressed properly, they could cause disruption in natural ecosystems, especially in rivers. With regards to the quality of water resources, determination of pollutant sources plays a pivotal role in engineering projects as well as designing water quality control systems. Thus, using different methods such as flow duration curves, dischargepollution load model and frequency analysis by HYFA software package, risk of various industrial pollutants in international and ecologically important Gavkhoni wetland is analyzed. In this study, a station located at Varzaneh City is used as the last station on Zayanderud River, from where the river water is discharged into the wetland. Results showed that elements- concentrations often exceeded the allowed level and river water can endanger regional ecosystem. In addition, if the river discharge is managed on Q25 basis, this basis can lower concentrations of elements, keeping them within the normal level.

Keywords: Pollutants Risk, Industry, Flow Discharge, Management, Gavkhoni Wetland

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Authors: A. Taqaddas

Abstract:

Purpose: Planning and dosimetry of different VMAT algorithms (SmartArc, Ergo++, Autobeam) is compared with IMRT for Head and Neck Cancer patients. Modelling was performed to rule out the causes of discrepancies between planned and delivered dose. Methods: Five HNC patients previously treated with IMRT were re-planned with SmartArc (SA), Ergo++ and Autobeam. Plans were compared with each other and against IMRT and evaluated using DVHs for PTVs and OARs, delivery time, monitor units (MU) and dosimetric accuracy. Modelling of control point (CP) spacing, Leaf-end Separation and MLC/Aperture shape was performed to rule out causes of discrepancies between planned and delivered doses. Additionally estimated arc delivery times, overall plan generation times and effect of CP spacing and number of arcs on plan generation times were recorded. Results: Single arc SmartArc plans (SA4d) were generally better than IMRT and double arc plans (SA2Arcs) in terms of homogeneity and target coverage. Double arc plans seemed to have a positive role in achieving improved Conformity Index (CI) and better sparing of some Organs at Risk (OARs) compared to Step and Shoot IMRT (ss-IMRT) and SA4d. Overall Ergo++ plans achieved best CI for both PTVs. Dosimetric validation of all VMAT plans without modelling was found to be lower than ss-IMRT. Total MUs required for delivery were on average 19%, 30%, 10.6% and 6.5% lower than ss-IMRT for SA4d, SA2d (Single arc with 2⁰ Gantry Spacing), SA2Arcs and Autobeam plans respectively. Autobeam was most efficient in terms of actual treatment delivery times whereas Ergo++ plans took longest to deliver. Conclusion: Overall SA single arc plans on average achieved best target coverage and homogeneity for both PTVs. SA2Arc plans showed improved CI and some OARs sparing. Very good dosimetric results were achieved with modelling. Ergo++ plans achieved best CI. Autobeam resulted in fastest treatment delivery times.

Keywords: Dosimetry, Intensity Modulated Radiotherapy, Optimization Algorithms, Volumetric Modulated Arc Therapy.

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Authors: Andrea Zielke-Nadkarni

Abstract:

Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: Pain management, migrants, sociocultural context, palliative care.

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Authors: Dejan Stantic, Jun Jo

Abstract:

ECG contains very important clinical information about the cardiac activities of the heart. Often the ECG signal needs to be captured for a long period of time in order to identify abnormalities in certain situations. Such signal apart of a large volume often is characterised by low quality due to the noise and other influences. In order to extract features in the ECG signal with time-varying characteristics at first need to be preprocessed with the best parameters. Also, it is useful to identify specific parts of the long lasting signal which have certain abnormalities and to direct the practitioner to those parts of the signal. In this work we present a method based on wavelet transform, standard deviation and variable threshold which achieves 100% accuracy in identifying the ECG signal peaks and heartbeat as well as identifying the standard deviation, providing a quick reference to abnormalities.

Keywords: Electrocardiogram-ECG, Arrhythmia, Signal Processing, Wavelet Transform, Standard Deviation

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Authors: Nan-Ying Yu, Shao-Hsia Chang

Abstract:

This study explores the clinical features of neurodegenerative disease patients with tremor. We study the motor impairments in patients with Parkinson’s disease (PD) and essential tremor (ET). Since uncertainty exists on whether Parkinson's disease (PD) and essential tremor (ET) patients have similar degree of impairment during motor tasks, this study based on the self-developed computerized handwriting movement analysis to characterize motor functions of these two impairments. The recruited subjects were diagnosed and confirmed one of neurodegenerative diseases. They were undergone general clinical evaluations by physicians in the first year. We recruited 8 participants with PD and 10 with ET. Additional 12 participants without any neuromuscular dysfunction were recruited as control group. This study used fine motor control of penmanship on digital tablet for sensorimotor function tests. The movement speed in PD/ET group is found significant slower than subjects in normal control group. In movement intensity and speed, the result found subject with ET has similar clinical feature with PD subjects. The ET group shows smaller and slower movements than control group but not to the same extent as PD group. The results of this study contribute to the early screening and detection of diseases and the evaluation of disease progression.

Keywords: Parkinson’s disease, essential tremor, motor function, fine motor movement, computerized handwriting evaluation.

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Authors: Petra Balla, Gabor Manhertz, Akos Antal

Abstract:

Nowadays spinal deformities are very frequent problems among teenagers. Scheuermann disease is a one dimensional deformity of the spine, but it has prevalence over 11% of the children. A traditional technology, the moiré method was used by us for screening and diagnosing this type of spinal deformity. A LabVIEW program has been developed to evaluate the moiré pictures of patients with Scheuermann disease. Two different solutions were tested in this computer program, the extreme and the inflexion point calculation methods. Effects using these methods were compared and according to the results both solutions seemed to be appropriate. Statistical results showed better efficiency in case of the extreme search method where the average difference was only 6,09⁰.

Keywords: Spinal deformity, picture evaluation, moiré method, Scheuermann disease, curve detection, moiré topography.

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Authors: D. Hilton

Abstract:

An analysis of the Australian Diabetes Screening Study estimated undiagnosed diabetes mellitus [DM] prevalence in a high risk general practice based cohort. DM prevalence varied from 9.4% to 18.1% depending upon the diagnostic criteria utilised with age being a highly significant risk factor. Utilising the gold standard oral glucose tolerance test, the prevalence of DM was 22-23% in those aged >= 70 years and <15% in those aged 40-59 years. Opportunistic screening in Australian general practice potentially can identify many persons with undiagnosed type 2 DM. An Australian Bureau of Statistics document published three years ago, reported the highest rate of DM in men aged 65-74 years [19%] whereas the rate for women was highest in those over 75 years [13%]. If you consider that the Australian Bureau of Statistics report in 2007 found that 13% of the population was over 65 years of age and that this will increase to 23-25% by 2056 with a further projected increase to 25-28% by 2101, obviously this information has to be factored into the equation when age related diabetes prevalence predictions are calculated. This 10-15% proportional increase of elderly persons within the population demographics has dramatic implications for the estimated number of elderly persons with DM in these age groupings. Computational methodology showing the age related demographic changes reported in these official statistical documents will be done showing estimates for 2056 and 2101 for different age groups. This has relevance for future diabetes prevalence rates and shows that along with many countries worldwide Australia is facing an increasing pandemic. In contrast Japan is expected to have a decrease in the next twenty years in the number of persons with diabetes.

Keywords: Epidemiological methods, aging, prevalence.

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Authors: Niousha Bagheri Khulenjani, Mohammad Saniee Abadeh

Abstract:

Learning from very big datasets is a significant problem for most present data mining and machine learning algorithms. MicroRNA (miRNA) is one of the important big genomic and non-coding datasets presenting the genome sequences. In this paper, a hybrid method for the classification of the miRNA data is proposed. Due to the variety of cancers and high number of genes, analyzing the miRNA dataset has been a challenging problem for researchers. The number of features corresponding to the number of samples is high and the data suffer from being imbalanced. The feature selection method has been used to select features having more ability to distinguish classes and eliminating obscures features. Afterward, a Convolutional Neural Network (CNN) classifier for classification of cancer types is utilized, which employs a Genetic Algorithm to highlight optimized hyper-parameters of CNN. In order to make the process of classification by CNN faster, Graphics Processing Unit (GPU) is recommended for calculating the mathematic equation in a parallel way. The proposed method is tested on a real-world dataset with 8,129 patients, 29 different types of tumors, and 1,046 miRNA biomarkers, taken from The Cancer Genome Atlas (TCGA) database.

Keywords: Cancer classification, feature selection, deep learning, genetic algorithm.

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Authors: Yunjung Lee, Pil Un Kim, Gyhyoun Lee, Jin Ho Cho, Myoung Nam Kim

Abstract:

Various sounds generated in the chest are included in auscultation sound. Adaptive Noise Canceller (ANC) is one of the useful techniques for biomedical signal. But the ANC is not suitable for auscultation sound. Because the ANC needs two input channels as a primary signal and a reference signals, but a stethoscope can provide just one input sound. Therefore, in this paper, it was proposed the Single Input ANC (SIANC) for suppression of breath sound in a cardiac auscultation sound. For the SIANC, it was proposed that the reference generation system which included Heart Sound Detector, Control and Reference Generator. By experiment and comparison, it was confirmed that the proposed SIANC was efficient for heart sound enhancement and it was independent of variations of a heartbeat.

Keywords: Adaptive noise canceller, Auscultation, Breath soundsuppression, Signal enhancement.

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Authors: Awadhesh Pachauri, Manabendra Bhuyan

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Electrocardiogram (ECG) is considered to be the backbone of cardiology. ECG is composed of P, QRS & T waves and information related to cardiac diseases can be extracted from the intervals and amplitudes of these waves. The first step in extracting ECG features starts from the accurate detection of R peaks in the QRS complex. We have developed a robust R wave detector using wavelets. The wavelets used for detection are Daubechies and Symmetric. The method does not require any preprocessing therefore, only needs the ECG correct recordings while implementing the detection. The database has been collected from MIT-BIH arrhythmia database and the signals from Lead-II have been analyzed. MatLab 7.0 has been used to develop the algorithm. The ECG signal under test has been decomposed to the required level using the selected wavelet and the selection of detail coefficient d4 has been done based on energy, frequency and cross-correlation analysis of decomposition structure of ECG signal. The robustness of the method is apparent from the obtained results.

Keywords: ECG, P-QRS-T waves, Wavelet Transform, Hard Thresholding, R-wave Detection.

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Authors: Mohamed H. Elhsnawi, Mesbah M. Salem, Saleh B. Mohamed

Abstract:

Numerical simulation performed to investigate the behavior of the high pressure hydrogen jetting of air. High pressure hydrogen (30–40 MPa) was injected to air at atmospheric pressure through 2mm orifice. Numerical simulations were performed with Kiva3V code with 2D axisymmetric geometry. Numerical simulations showed that auto ignition of high pressure hydrogen to air are possible due to molecular diffusion. Auto ignition was predicted at hydrogen-air contact surface due to mass and energy exchange between high temperature hydrogen and air heated by shock wave.

Keywords: Spontaneous Ignition, Diffusion Ignition, Hydrogen ignition, Hydrogen Jet.

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Authors: S. Jarernprasert, E. Bazan-Zurita, P. C. Rizzo

Abstract:

Currently, seismic probabilistic risk assessments (SPRA) for nuclear facilities use In-Structure Response Spectra (ISRS) in the calculation of fragilities for systems and components. ISRS are calculated via dynamic analyses of the host building subjected to two orthogonal components of horizontal ground motion. Each component is defined as the median motion in any horizontal direction. Structural engineers applied the components along selected X and Y Cartesian axes. The ISRS at different locations in the building are also calculated in the X and Y directions. The choice of the directions of X and Y are not specified by the ground motion model with respect to geographic coordinates, and are rather arbitrarily selected by the structural engineer. Normally, X and Y coincide with the “principal” axes of the building, in the understanding that this practice is generally conservative. For SPRA purposes, however, it is desirable to remove any conservatism in the estimates of median ISRS. This paper examines the effects of the direction of horizontal seismic motion on the ISRS on typical nuclear structure. We also evaluate the variability of ISRS calculated along different horizontal directions. Our results indicate that some central measures of the ISRS provide robust estimates that are practically independent of the selection of the directions of the horizontal Cartesian axes.

Keywords: Seismic, Directionality, In-Structure Response Spectra, Probabilistic Risk Assessment.

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Authors: Mikhail V. Khachaturyan, Inga A. Koryagina, Eugenia V. Klicheva

Abstract:

In modern conditions, scientific judgment of problems in developing mechanisms of value creation and risk management acquires special relevance. Formation of economic knowledge has resulted in the constant analysis of consumer behavior for all players from national and world markets. Effective mechanisms development of the demand analysis, crucial for consumer's characteristics of future production, and the risks connected with the development of this production are the main objectives of control systems in modern conditions. The modern period of economic development is characterized by a high level of globalization of business and rigidity of competition. At the same time, the considerable share of new products and services costs has a non-material intellectual nature. The most successful in Russia is the contemporary development of small innovative firms. Such firms, through their unique technologies and new approaches to process management, which form the basis of their intellectual capital, can show flexibility and succeed in the market. As a rule, such enterprises should have very variable structure excluding the tough scheme of submission and demanding essentially new incentives for inclusion of personnel in innovative activity. Realization of similar structures, as well as a new approach to management, can be constructed based on value-oriented management which is directed to gradual change of consciousness of personnel and formation from groups of adherents included in the solution of the general innovative tasks. At the same time, valuable changes can gradually capture not only innovative firm staff, but also the structure of its corporate partners. Introduction of new technologies is the significant factor contributing to the development of new valuable imperatives and acceleration of the changing values systems of the organization. It relates to the fact that new technologies change the internal environment of the organization in a way that the old system of values becomes inefficient in new conditions. Introduction of new technologies often demands change in the structure of employee’s interaction and training in their new principles of work. During the introduction of new technologies and the accompanying change in the value system, the structure of the management of the values of the organization is changing. This is due to the need to attract more staff to justify and consolidate the new value system and bring their view into the motivational potential of the new value system of the organization.

Keywords: Value, risk, creation, problems, organization.

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