Search results for: Medical Imaging

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

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

Keywords: Awareness, knowledge, osteoporosis, practices.

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Authors: Abeer Aljohani

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

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

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

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

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

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Authors: Sajed A. Habib

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

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

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

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

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

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

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

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

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Authors: Sharan Badiger, Prema T. Akkasaligar, Sandeep HM, Biradar MS

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Essential hypertension (HTN) usually clusters with other cardiovascular risk factors such as age, overweight, diabetes, insulin resistance and dyslipidemia. The target organ damage (TOD) such as left ventricular hypertrophy, microalbuminuria (MA), acute coronary syndrome (ACS), stroke and cognitive dysfunction takes place early in course of hypertension. Though the prevalence of hypertension is high in India, the relationship between microalbuminuria and target organ damage in hypertension is not well studied. This study aim at detecting MA in essential hypertension and its relation to severity of HTN, duration of HTN, body mass index (BMI), age and TOD such as HTN retinopathy and acute coronary syndrome The present study was done in 100 patients of essential hypertension non diabetics admitted to B.L.D.E.University-s Sri B.M.Patil Medical College, Bijapur, from October 2008 to April 2011. The patients underwent detailed history and clinical examination. Early morning 5 ml of urine sample was collected & MA was estimated by immunoturbidometry method. The relationship of MA with the duration & severity of HTN, BMI, age, sex and TOD's like hypertensive retinopathy, ACS was assessed by univariate analysis. The prevalence of MA in this study was found to be 63 %. In that 42% were male & 21% were female. In this study a significant association between MA and the duration of hypertension (p = 0.036) & (OR =0.438). Longer the duration of hypertension, more possibility of microalbumin in urine. Also there was a significant association between severity of hypertension and MA (p=0.045) and (OR=0.093). MA was positive in 50 (79.4%) patients out of 63, whose blood pressure was >160/100 mm Hg. In this study a significant association between MA and the grades of hypertensive retinopathy (p =0.011) and acute coronary syndrome (p = 0.041) (OR =2.805). Gender and BMI did not pose high risk for MA in this study.The prevalence of MA in essential hypertension is high in this part of the community and MA will increase the risk of developing target organ damage.Early screening of patients with essential hypertension for MA and aggressive management of positive cases might reduce the burden of chronic kidney diseases and cardiovascular diseases in the community.

Keywords: Acute coronary syndrome, Essential hypertension, Microalbuminuria, Target organ damage

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Authors: Muhammad Waqar, Touqir Ahmad Afridi, Quratulain Soomro

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Radiation is a ghost causing unimaginable physical damage, but its harm is not inevitable. The panic created by previously reported worst-case scenarios i.e., Three Mile Island, Fukushima, Chernobyl, has adversely affected the attitude of radiation workers towards the profession. The psychological effect of radiation-related catastrophes creates an invisible barrier that reduces the efficiency of radiation workers. Careful handling and proper monitoring of radiation decreases the hazards of radiation and proves that the psychological impairment of radiation is myriad fold adverse than its physiological damage. Thermoluminescent Dosimeter (TLD) badges with unique identity numbers were provided to 36 radiation workers for a period of one year (2021). TLDs were read quarterly, and doses were recorded for every radiation worker. Annual doses were recorded and compared with national and international standards. Moreover, the period for which an individual worker is expected to reach one year limit of 20 mSv was also calculated. The highest radiation dose for the radiation worker in 2021 was found at 3.2 mSv, which was 16% of the permissible annual dose limit. The average occupational radiation doses ranged from 1.0 mSv to 3.20 mSv. 64% of the employees did not exceed the 10% of the annual limit, receiving less than 2 mSv. The least time for 20 mSv completion was found 6.25 years for the hot-lab technician. As a whole, the 20 mSv completion period ranged from 6.25 to 20 years. We concluded that the annual professional radiation doses were well within the permissible limits of Pakistan Nuclear Regulatory Authority (PNRA) and International Commission on Radiological Protection (ICRP). The fear of radiation is unnecessary and it creates reluctance towards performing their assigned duties and it is also not favorable for the institute. It must be abolished through education and training sessions.

Keywords: TLD, thermoluminescent dosimeter, psychological impact, radiation dose, annual dose limit, PNRA, ICRP, IAEA.

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Authors: Sajjad Seifi Mofarah, S. K. Sadrnezhaad, Shokooh Moghadam, Javad Tavakoli

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In recent years a new method of combination treatment for cancer has been developed and studied that has led to significant advancements in the field of cancer therapy. Hyperthermia is a traditional therapy that, along with a creation of a medically approved level of heat with the help of an alternating magnetic AC current, results in the destruction of cancer cells by heat. This paper gives details regarding the production of the spherical nanocomposite PVA/γ-Fe2O3 in order to be used for medical purposes such as tumor treatment by hyperthermia. To reach a suitable and evenly distributed temperature, the nanocomposite with core-shell morphology and spherical form within a 100 to 200 nanometer size was created using phase separation emulsion, in which the magnetic nano-particles γ- Fe2O3 with an average particle size of 20 nano-meters and with different percentages of 0.2, 0.4, 0.5 and 0.6 were covered by polyvinyl alcohol. The main concern in hyperthermia and heat treatment is achieving desirable specific absorption rate (SAR) and one of the most critical factors in SAR is particle size. In this project all attempts has been done to reach minimal size and consequently maximum SAR. The morphological analysis of the spherical structure of the nanocomposite PVA/γ-Fe2O3 was achieved by SEM analyses and the study of the chemical bonds created was made possible by FTIR analysis. To investigate the manner of magnetic nanocomposite particle size distribution a DLS experiment was conducted. Moreover, to determine the magnetic behavior of the γ- Fe2O3 particle and the nanocomposite PVA/γ-Fe2O3 in different concentrations a VSM test was conducted. To sum up, creating magnetic nanocomposites with a spherical morphology that would be employed for drug loading opens doors to new approaches in developing nanocomposites that provide efficient heat and a controlled release of drug simultaneously inside the magnetic field, which are among their positive characteristics that could significantly improve the recovery process in patients.

Keywords: Nanocomposite, hyperthermia, cancer therapy, drug release.

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Authors: P. Mukhopadhyay, N. C. Dey

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Occupational health hazard is a very common term in every emerging country. Along with the unorganized sector, most organized sectors including government industries are suffering from this affliction. In addition to workload, the seasonal changes also have some impacts on working environment. With this focus in mind, one hundred male industrial workers, who are directly involved to the task of Periodic Overhauling (POH) in a fabricating workshop in the public domain are selected for this research work. They have been studied during work periods throughout different seasons in a year. For each and every season, the participants working heart rate (WHR) is measured and compared with the standards given by different national and internationally recognized agencies i.e., World Health Organization (WHO) and American Conference of Governmental Industrial Hygienists (ACGIH) etc. The different environmental parameters i.e. dry bulb temperature (DBT), wet bulb temperature (WBT), globe temperature (GT), natural wet bulb temperature (NWB), relative humidity (RH), wet bulb globe temperature (WBGT), air velocity (AV), effective temperature (ET) are recorded throughout the seasons to critically observe the effect of seasonal changes on the WHR of the workers. The effect of changes in environment to the WHR of the workers is very much surprising. It is found that the percentages of workers who belong to the ‘very heavy’ workload category are 83.33%, 66.66% and 16.66% in the summer, rainy and winter seasons, respectively. Ongoing undertaking of this type of job profile forces the worker towards occupational disorders causing absenteeism. This occurrence results in lower production rates, and on the other hand, costs due to medical claims also weaken the industry’s economic condition. In this circumstance, the authors are trying to focus on some remedial measures from the ergonomic angle by proposing a new work/ rest regimen and introducing engineering controls along with management controls which may help the worker, and consequently, the management also.

Keywords: Environmental changes, industrial worker, working heart rate, workload, occupational health hazard.

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Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

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Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m²), B – 442 females with obesity (BMI >29.9 kg/m²)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p<0.001). TBS was significantly higher in women with increased body weight compared to obese and metabolic syndrome patients. Analysis showed significant positive correlation between waist circumference, triglycerides level and BMD of lumbar spine and femur. Significant negative association between serum HDL level and BMD of investigated sites was established. The TBS (L1-L4) indexes positively correlated with HDL (high-density lipoprotein) level. Despite the fact that BMD indexes were better in women with metabolic syndrome, the frequency of non-vertebral fractures was significantly higher in this group of patients.

Keywords: Bone mineral density, trabecular bone score, metabolic syndrome, fracture.

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Authors: Nadia H. Mohammed, Anmar Al-Taie, Fadia H. Al-Sultany

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Although breast cancer prevalence continues to increase, mortality has been decreasing as a result of early detection and improvement in adjuvant systemic therapy. Nevertheless, this disease required further efforts to understand and identify the associated potential risk factors that could play a role in the prevalence of this malignancy among Iraqi women. The objective of this study was to assess the perception of certain predictive risk factors on the prevalence of breast cancer types among a sample of Iraqi women diagnosed with breast cancer. This was a retrospective observational study carried out at National Cancer Research Center in College of Medicine, Baghdad University from November 2017 to January 2018. Data of 100 patients with breast cancer whose biopsies examined in the National Cancer Research Center were included in this study. Data were collected to structure a detailed assessment regarding the patients’ demographic, medical and cancer records. The majority of study participants (94%) suffered from ductal breast cancer with mean age 49.57 years. Among those women, 48.9% were obese with body mass index (BMI) 35 kg/m². 68.1% of them had positive family history of breast cancer and 66% had low parity. 40.4% had stage II ductal breast cancer followed by 25.5% with stage III. It was found that 59.6% and 68.1% had positive oestrogen receptor sensitivity and positive human epidermal growth factor (HER2/neu) receptor sensitivity respectively. In regard to the impact of prediction of certain variables on the incidence of ductal breast cancer, positive family history of breast cancer (P < 0.0001), low parity (P< 0.0001), stage I and II breast cancer (P = 0.02) and positive HER2/neu status (P < 0.0001) were significant predictive factors among the study participants. The results from this study provide relevant evidence for a significant positive and potential association between certain risk factors and the prevalence of breast cancer among Iraqi women.

Keywords: Ductal breast cancer, hormone sensitivity, Iraq, risk factors.

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Authors: Ticijana Prijon, Branko Ermenc

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Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall. An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: Aorta, blunt trauma, car accidents, morphology, risk factors.

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Authors: Saule Mussabekova

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Recent advances in genetics have allowed increasing acutely the capacities of the formation of reliable evidence in conducting forensic examinations. Thus, traces of biological origin are important sources of information about a crime. Currently, around the world, sexual offenses have increased, and among them are those in which the criminals use various detergents to remove traces of their crime. A feature of modern synthetic detergents is the presence of biological additives - enzymes. Enzymes purposefully destroy stains of biological origin. To study the nature and extent of the impact of modern washing powders on saliva stains on the physical evidence, specially prepared test specimens of different types of tissues to which saliva was applied have been examined. Materials and Methods: Washing machines of famous manufacturers of household appliances have been used with different production characteristics and advertised brands of washing powder for test washing. Over 3,500 experimental samples were tested. After washing, the traces of saliva were identified using modern research methods of forensic medicine. Results: The influence was tested and the dependence of the use of different washing programs, types of washing machines and washing powders in the process of establishing saliva trace and identify of the stains on the physical evidence while washing was revealed. The results of experimental and practical expert studies have shown that in most cases it is not possible to draw the conclusions in the identification of saliva traces on physical evidence after washing. This is a consequence of the effect of biological additives and other additional factors on traces of saliva during washing. Conclusions: On the basis of the results of the study, the feasibility of saliva traces of the stains on physical evidence after washing is established. The use of modern molecular genetic methods makes it possible to partially solve the problems arising in the study of unlaundered evidence. Additional study of physical evidence after washing facilitates detection and investigation of sexual offenses against women and children.

Keywords: Saliva research, modern synthetic detergents, laundry detergents, forensic medicine.

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Authors: M. Ishak, K. Yamasaki, K. Maekawa

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Magnesium alloys have gained increased attention in recent years in automotive, electronics, and medical industry. This because of magnesium alloys have better properties than aluminum alloys and steels in respects of their low density and high strength to weight ratio. However, the main problems of magnesium alloy welding are the crack formation and the appearance of porosity during the solidification. This paper proposes a unique technique to weld two thin sheets of AZ31B magnesium alloy using a paste containing Ag nanoparticles. The paste containing Ag nanoparticles of 5 nm in average diameter and an organic solvent was used to coat the surface of AZ31B thin sheet. The coated sheet was heated at 100 °C for 60 s to evaporate the solvent. The dried sheet was set as a lower AZ31B sheet on the jig, and then lap fillet welding was carried out by using a pulsed Nd:YAG laser in a closed box filled with argon gas. The characteristics of the microstructure and the corrosion behavior of the joints were analyzed by opticalmicroscopy (OM), energy dispersive spectrometry (EDS), electron probe micro-analyzer (EPMA), scanning electron microscopy (SEM), and immersion corrosion test. The experimental results show that the wrought AZ31B magnesium alloy can be joined successfully using Ag nanoparticles. Ag nanoparticles insert promote grain refinement, narrower the HAZ width and wider bond width compared to weld without and insert. Corrosion rate of welded AZ31B with Ag nanoparticles reduced up to 44 % compared to base metal. The improvement of corrosion resistance of welded AZ31B with Ag nanoparticles due to finer grains and large grain boundaries area which consist of high Al content. β-phase Mg17Al12 could serve as effective barrier and suppressed further propagation of corrosion. Furthermore, Ag distribution in fusion zone provide much more finer grains and may stabilize the magnesium solid solution making it less soluble or less anodic in aqueous

Keywords: Laser welding, magnesium alloys, nanoparticles, mechanical property

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Authors: Farhad H. Mustafa, Mohamad S. Jaafar , Asaad H. Ismail, Ahamad F. Omar, Zahra A. Timimi, Hend A. A. Houssein

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The process of laser absorption in the skin during laser irradiation was a critical point in medical application treatments. Delivery the correct amount of laser light is a critical element in photodynamic therapy (PDT). More amounts of laser light able to affect tissues in the skin and small amount not able to enhance PDT procedure in skin. The knowledge of the skin tone laser dependent distribution of 635 nm radiation and its penetration depth in skin is a very important precondition for the investigation of advantage laser induced effect in (PDT) in epidermis diseases (psoriasis). The aim of this work was to estimate an optimum effect of diode laser (635 nm) on the treatment of epidermis diseases in different color skin. Furthermore, it is to improve safety of laser in PDT in epidermis diseases treatment. Advanced system analytical program (ASAP) which is a new approach in investigating the PDT, dependent on optical properties of different skin color was used in present work. A two layered Realistic Skin Model (RSM); stratum corneum and epidermal with red laser (635 nm, 10 mW) were used for irradiative transfer to study fluence and absorbance in different penetration for various human skin colors. Several skin tones very fair, fair, light, medium and dark are used to irradiative transfer. This investigation involved the principles of laser tissue interaction when the skin optically injected by a red laser diode. The results demonstrated that the power characteristic of a laser diode (635 nm) can affect the treatment of epidermal disease in various color skins. Power absorption of the various human skins were recorded and analyzed in order to find the influence of the melanin in PDT treatment in epidermal disease. A two layered RSM show that the change in penetration depth in epidermal layer of the color skin has a larger effect on the distribution of absorbed laser in the skin; this is due to the variation of the melanin concentration for each color.

Keywords: Photodynamic therapy, Realistic skin model, Laser, Light penetration, simulation, Optical properties of skin, Melanin.

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Authors: Mustafa M. Donma

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Circumference measurements may give meaningful information about the varying stages of obesity. Some formulas may be derived from a number of body circumference measurements to estimate body fat. Waist (WC), hip (HC) and neck (NC) circumferences are currently the most frequently used measurements. The aim of this study was to develop a formula derived from these three anthropometric measurements for the differential diagnosis of morbid obesity with and without metabolic syndrome (MetS), MOMetS+ and MOMetS-, respectively. 187 children were recruited from the pediatrics outpatient clinic of Tekirdag Namik Kemal University, Faculty of Medicine. Signed informed consent forms were taken from the participants. The study was carried out according to the Helsinki Declaration. The study protocol was approved by the institutional non-interventional ethics committee of Tekirdag Namik Kemal University Medical Faculty. The study population was divided into four groups as normal-body mass index (N-BMI) (n = 35), obese (OB) (n = 44), morbid obese (MO) (n = 75) and MetS (n = 33). Age- and gender-adjusted BMI percentile values were used for the classification of groups. The children in MetS group were selected based upon the nature of the MetS components described as MetS criteria. Anthropometric measurements, laboratory analysis and statistical evaluation confined to study population were performed. BMI values were calculated. A circumference index, advanced Donma circumference index (ADCI) was presented as WC*HC/NC. The statistical significance degree was chosen as p < 0.05. BMI values were 17.7 ± 2.8, 24.5 ± 3.3, 28.8 ± 5.7, 31.4 ± 8.0 kg/m2, for N-BMI, OB, MO, MetS groups (p = 0.001), respectively. An increasing trend from N-BMI to MetS was observed. However, the increase in MetS group compared to MO group was not significant. For the new index, significant differences were obtained between N-BMI and OB, MO, MetS groups (p = 0.001). A significant difference between MO and MetS groups was detected (p = 0.043). A significant correlation was found between BMI and ADCI. In conclusion, in spite of the strong correlation between BMI and ADCI values obtained when all groups were considered, ADCI, but not BMI, was the index, which was capable of differentiating cases with morbid obesity from cases with morbid obesity and MetS.

Keywords: Anthropometry, body mass index, childhood obesity, body circumference, metabolic syndrome.

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Authors: Shankar Subramanian Iyer

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The vocational education, enhanced by technology and Recognition of Prior Learning (RPL) is going to be the main ingredient of the future of education. This is coming from the various issues of the current educational system like cost, time, type of course, type of curriculum, unemployment, to name the major reasons. Most millennials like to perform and learn rather than learning how to perform. This is the essence of vocational education be it any field from cooking, painting, plumbing to modern technologies using computers. Even a more theoretical course like entrepreneurship can be taught as to be an entrepreneur and learn about its nuances. The best way to learn accountancy is actually keeping accounts for a small business or grocer and learn the ropes of accountancy and finance. The purpose of this study is to investigate the relationship between vocational skills, RPL and new technologies with future employability. This study implies that individual's knowledge and skills are essential aspects to be emphasized in future education and to give credit for prior experience for future employability. Virtual reality can be used to stimulate workplace situations for vocational learning for fields like hospitality, medical emergencies, healthcare, draughtsman ship, building inspection, quantity surveying, estimation, to name a few. All disruptions in future education, especially vocational education, are going to be technology driven with the advent of AI, ML, IoT, VR, VI etc. Vocational education not only helps institutes cut costs drastically, but allows all students to have hands-on experiences, rather than to be observers. The earlier experiential learning theory and the recent theory of knowledge and skills-based learning modified and applied to the vocational education and development of skills is the proposed contribution of this paper. Apart from secondary research study on major scholarly articles, books, primary research using interviews, questionnaire surveys have been used to validate and test the reliability of the suggested model using Partial Least Square- Structural Equation Method (PLS-SEM), the factors being assimilated using an existing literature review. Major findings have been that there exists high relationship between the vocational skills, RPL, new technology to the future employability through mediation of future employability skills.

Keywords: Vocational education, vocational skills, competencies, modern technologies, Recognition of Prior Learning, RPL.

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Authors: Wan-I Lee, Nelio Mendoza Figueredo

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The impact of COVID-19 has a significant effect on all sectors of society globally. Health information technology (HIT) has become an effective health strategy in this age of distancing. In this regard, Mobile Health (mHealth) plays a critical role in managing patient and provider workflows during the COVID-19 pandemic. Therefore, the users' perception of service quality about mHealth services plays a significant role in shaping confidence and subsequent behaviors regarding the mHealth users' intention of use. This study's objective was to explore levels of user attributes analyzed by a qualitative method of how health practitioners and patients are satisfied or dissatisfied with using mHealth services; and analyzed the users' intention in the context of Taiwan during the COVID-19 pandemic. This research explores the experienced usability of a mHealth services during the Covid-19 pandemic. This study uses qualitative methods that include in-depth and semi-structured interviews that investigate participants' perceptions and experiences and the meanings they attribute to them. The five cases consisted of health practitioners, clinic staff, and patients' experiences using mHealth services. This study encourages participants to discuss issues related to the research question by asking open-ended questions, usually in one-to-one interviews. The findings show the positive and negative attributes of mHealth service quality. Hence, the significant importance of patients' and health practitioners' issues on several dimensions of perceived service quality is system quality, information quality, and interaction quality. A concept map for perceptions regards to emergency uses' intention of mHealth services process is depicted. The findings revealed that users pay more attention to "Medical care", "ease of use" and "utilitarian benefits" and have less importance for "Admissions and Convenience" and "Social influence". To improve mHealth services, the mHealth providers and health practitioners should better manage users' experiences to enhance mHealth services. This research contributes to the understanding of service quality issues in mHealth services during the COVID-19 pandemic.

Keywords: COVID-19, mobile health, mHealth, service quality, use intention.

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Authors: Chun-Lang Chang

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According to the statistics, the prevalence of congenital hearing loss in Taiwan is approximately six thousandths; furthermore, one thousandths of infants have severe hearing impairment. Hearing ability during infancy has significant impact in the development of children-s oral expressions, language maturity, cognitive performance, education ability and social behaviors in the future. Although most children born with hearing impairment have sensorineural hearing loss, almost every child more or less still retains some residual hearing. If provided with a hearing aid or cochlear implant (a bionic ear) timely in addition to hearing speech training, even severely hearing-impaired children can still learn to talk. On the other hand, those who failed to be diagnosed and thus unable to begin hearing and speech rehabilitations on a timely manner might lose an important opportunity to live a complete and healthy life. Eventually, the lack of hearing and speaking ability will affect the development of both mental and physical functions, intelligence, and social adaptability. Not only will this problem result in an irreparable regret to the hearing-impaired child for the life time, but also create a heavy burden for the family and society. Therefore, it is necessary to establish a set of computer-assisted predictive model that can accurately detect and help diagnose newborn hearing loss so that early interventions can be provided timely to eliminate waste of medical resources. This study uses information from the neonatal database of the case hospital as the subjects, adopting two different analysis methods of using support vector machine (SVM) for model predictions and using logistic regression to conduct factor screening prior to model predictions in SVM to examine the results. The results indicate that prediction accuracy is as high as 96.43% when the factors are screened and selected through logistic regression. Hence, the model constructed in this study will have real help in clinical diagnosis for the physicians and actually beneficial to the early interventions of newborn hearing impairment.

Keywords: Data mining, Hearing impairment, Logistic regression analysis, Support vector machines

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Authors: Zahraa Albasry, Hadeel D. Najim, Anmar Al-Taie

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Background: Hypertension is considered as one of the most important causes of cardiovascular complications and one of the leading causes of worldwide mortality. Identifying the potential risk factors associated with this medical health problem plays an important role in minimizing its incidence and related complications. The objective of this study is to explore the prevalence of receptor sensitivity regarding assess and understand the perception of specific predictive confounding factors on the prevalence of hypertension (HT) among a sample of Iraqi population in Baghdad, Iraq. Materials and Methods: A randomized cross sectional study was carried out on 100 adult subjects during their visit to the outpatient clinic at a certain sector of Baghdad Province, Iraq. Demographic, clinical and health records alongside specific screening and laboratory tests of the participants were collected and analyzed to detect the potential of confounding factors on the prevalence of HT. Results: 63% of the study participants suffered from HT, most of them were female patients (P < 0.005). Patients aged between 41-50 years old significantly suffered from HT than other age groups (63.5%, P < 0.001). 88.9% of the participants were obese (P < 0.001) and 47.6% had diabetes with HT. Positive family history and sedentary lifestyle were significantly higher among all hypertensive groups (P < 0.05). High salt and fatty food intake was significantly found among patients suffered from isolated systolic hypertension (ISHT) (P < 0.05). A significant positive correlation between packed cell volume (PCV) and systolic blood pressure (SBP) (r = 0.353, P = 0.048) found among normotensive participants. Among hypertensive patients, a positive significant correlation found between triglycerides (TG) and both SBP (r = 0.484, P = 0.031) and diastolic blood pressure (DBP) (r = 0.463, P = 0.040), while low density lipoprotein-cholesterol (LDL-c) showed a positive significant correlation with DBP (r = 0.443, P = 0.021). Conclusion: The prevalence of HT among Iraqi populations is of major concern. Further consideration is required to detect the impact of potential risk factors and to minimize blood pressure (BP) elevation and reduce the risk of other cardiovascular complications later in life.

Keywords: Correlation, hypertension, Iraq, risk factors.

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Authors: P. V. Pramila, V. Mahesh

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Pulmonary Function Tests are important non-invasive diagnostic tests to assess respiratory impairments and provides quantifiable measures of lung function. Spirometry is the most frequently used measure of lung function and plays an essential role in the diagnosis and management of pulmonary diseases. However, the test requires considerable patient effort and cooperation, markedly related to the age of patients resulting in incomplete data sets. This paper presents, a nonlinear model built using Multivariate adaptive regression splines and Random forest regression model to predict the missing spirometric features. Random forest based feature selection is used to enhance both the generalization capability and the model interpretability. In the present study, flow-volume data are recorded for N= 198 subjects. The ranked order of feature importance index calculated by the random forests model shows that the spirometric features FVC, FEF25, PEF, FEF25-75, FEF50 and the demographic parameter height are the important descriptors. A comparison of performance assessment of both models prove that, the prediction ability of MARS with the `top two ranked features namely the FVC and FEF25 is higher, yielding a model fit of R2= 0.96 and R2= 0.99 for normal and abnormal subjects. The Root Mean Square Error analysis of the RF model and the MARS model also shows that the latter is capable of predicting the missing values of FEV1 with a notably lower error value of 0.0191 (normal subjects) and 0.0106 (abnormal subjects) with the aforementioned input features. It is concluded that combining feature selection with a prediction model provides a minimum subset of predominant features to train the model, as well as yielding better prediction performance. This analysis can assist clinicians with a intelligence support system in the medical diagnosis and improvement of clinical care.

Keywords: FEV1, Multivariate Adaptive Regression Splines Pulmonary Function Test, Random Forest.

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Authors: Hind Bouami, Patrick Millot

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Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.

Keywords: Automated drug delivery systems, hospitals, human-centered automated system, risk management.

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Authors: S. Vijayakumar, M. Sasikala, T. S. Mohammed Saleem, Gurusharan, K. Gauthaman

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The main objective of our study is to collect data about the profile of the asthmatic patients in Assam and thereby have a comprehensive knowledge of the factors influencing the asthmatic patients of the state and their medication pattern. We developed a search strategy to find any publication about the community based survey asthma related and used. These to search the MEDLINE (1996 to current literature) CINAHL DOAJ pubmed databases using the key phrases, Asthma, Respiratory disorders, Drug therapy of Asthma, database decision support system and asthma. The appropriate literature was printed out from the online source and library (Journal) source. The study was conducted through a set of structured and non-structured questionnaires targeted on the asthmatic patients belonging to the rural and urban areas of Assam, during the month of Dec 2006 to July 2007, 138 cases were studied in Gauwathi Medical College & Hospital located in Bhangagarh, Assam in India. The demographic characteristics a factor in 138 patients with asthma with allergic rhinitis (cases) gives the detail profile of asthmatic patient-s distribution of Assam as classified on the basis of age and sex. It is evident from the study that male populations (66%) are more prone to asthma as compared to the females (34%).Another striking features that emerged from this survey is the maximum prevalence of asthma in the age group of 20- 30 years followed by infants belonging to the age group of 7 (0.05%) 0-10years among both male and female populations of Assam. The high incidence of asthma in the age group of 20-30 years may probably be due to the allergy arising out of sudden exposure to dust and pollen which the children face while playing and going to the school. The rural females in the age group of 30-40 years are more prone to asthma than urban females in the same age group may be due to sex differentiation among the tribal population of the state. Pharmacists should educate the asthmatics how to use inhalers considering growing menace of asthma in the state. Safer drugs should be produced in the form of aerosol so that easy administration by the asthmatic patients and physicians of the state is possible for curing asthma. The health centers should be more equipped with the medicines to cure asthma in the state like Assam.

Keywords: Asthma, Respiratory disease, Smoker.

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Authors: Abdullah Faqihi, John Hedley

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Biosensors play a significant role in the healthcare sectors, scientific and technological progress. Developing electrodes that are easy to manufacture and deliver better electrochemical performance is advantageous for diagnostics and biosensing. They can be implemented extensively in various analytical tasks such as drug discovery, food safety, medical diagnostics, process controls, security and defence, in addition to environmental monitoring. Development of biosensors aims to create high-performance electrochemical electrodes for diagnostics and biosensing. A biosensor is a device that inspects the biological and chemical reactions generated by the biological sample. A biosensor carries out biological detection via a linked transducer and transmits the biological response into an electrical signal; stability, selectivity, and sensitivity are the dynamic and static characteristics that affect and dictate the quality and performance of biosensors. In this research, a developed experimental study for laser scribing technique for graphene oxide inside a vacuum chamber for processing of graphene oxide is presented. The processing of graphene oxide (GO) was achieved using the laser scribing technique. The effect of the laser scribing on the reduction of GO was investigated under two conditions: atmosphere and vacuum. GO solvent was coated onto a LightScribe DVD. The laser scribing technique was applied to reduce GO layers to generate rGO. The micro-details for the morphological structures of rGO and GO were visualised using scanning electron microscopy (SEM) and Raman spectroscopy so that they could be examined. The first electrode was a traditional graphene-based electrode model, made under normal atmospheric conditions, whereas the second model was a developed graphene electrode fabricated under a vacuum state using a vacuum chamber. The purpose was to control the vacuum conditions, such as the air pressure and the temperature during the fabrication process. The parameters to be assessed include the layer thickness and the continuous environment. Results presented show high accuracy and repeatability achieving low cost productivity.

Keywords: Laser scribing, LightScribe DVD, graphene oxide, scanning electron microscopy.

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Authors: Shende Suraj Balu, A. B. Deoghare, K. M. Pandey

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The human middle ear (ME) is a delicate and vital organ. It has a complex structure that performs various functions such as receiving sound pressure and producing vibrations of eardrum and propagating it to inner ear. It consists of Tympanic Membrane (TM), three auditory ossicles, various ligament structures and muscles. Incidents such as traumata, infections, ossification of ossicular structures and other pathologies may damage the ME organs. The conditions can be surgically treated by employing prosthesis. However, the suitability of the prosthesis needs to be examined in advance prior to the surgery. Few decades ago, this issue was addressed and analyzed by developing an equivalent representation either in the form of spring mass system, electrical system using R-L-C circuit or developing an approximated CAD model. But, nowadays a three-dimensional ME model can be constructed using micro X-Ray Computed Tomography (μCT) scan data. Moreover, the concern about patient specific integrity pertaining to the disease can be examined well in advance. The current research work emphasizes to develop the ME model from the stacks of μCT images which are used as input file to MIMICS Research 19.0 (Materialise Interactive Medical Image Control System) software. A stack of CT images is converted into geometrical surface model to build accurate morphology of ME. The work is further extended to understand the dynamic behaviour of Harmonic response of the stapes footplate and umbo for different sound pressure levels applied at lateral side of eardrum using finite element approach. The pathological condition Cholesteatoma of ME is investigated to obtain peak to peak displacement of stapes footplate and umbo. Apart from this condition, other pathologies, mainly, changes in the stiffness of stapedial ligament, TM thickness and ossicular chain separation and fixation are also explored. The developed model of ME for pathologies is validated by comparing the results available in the literatures and also with the results of a normal ME to calculate the percentage loss in hearing capability.

Keywords: Computed tomography, human middle ear, harmonic response, pathologies, tympanic membrane.

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Authors: Excellence Favor, Bakari M. M. Mwinyiwiwa

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Access to information holds the key to the empowerment of everybody despite where they are living. This research has been carried out in respect of the people living in developing countries, considering their plight and complex geographical, demographic, social-economic conditions surrounding the areas they live, which hinder access to information and of professionals providing services such as medical workers, which has led to high death rates and development stagnation. Research on Unified Communications and Integrated Collaborations (UCIC) system in the health sector of developing countries aims at creating a possible solution of bridging the digital canyon among the communities. The system is meant to deliver services in a seamless manner to assist health workers situated anywhere to be accessed easily and access information which will enhance service delivery. The proposed UCIC provides the most immersive telepresence experience for one-to-one or many-to-many meetings. Extending to locations anywhere in the world, the transformative platform delivers Ultra-low operating costs through the use of general purpose networks and using special lenses and track systems. The essence of this study is to create a security model for the deployment of the UCIC system in the health sector of developing countries. The model approach used for building the UCIC system security carefully considers the specific requirements for the health sector environment organization such as data centre, national, regional and district hospitals, and health centers IV, III, II and I and then builds the single best possible secure network to meet their needs. The security model demonstrates on how the components of the UCIC system will be protected physically and logically in the health sector environment. The UCIC system once adopted and implemented correctly will bring enhancement to the speed and quality of services offered by health workers. The capacities of UCIC will help health workers shorten decision cycles, accelerate service delivery and save lives by speeding access to information and by making it possible for all health workers and patients to collaborate ubiquitously.

Keywords: Developing Countries, Health Sector Environment, Security, Unified Communications and Integrated Collaborations.

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. However, to the best of our knowledge, their status in children is not clear. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of 68 children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, 35 children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised 33 OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p < 0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r = 0.336 and p = 0.065 in the N-BMI group. On the other hand, they were r = 0.707 and p = 0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p < 0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. TRG are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. TRG are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs. FIB-4 correlations in N-BMI and OB groups (no correlation vs. high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.

Keywords: APRI, FIB-4, obesity, triglycerides.

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Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: Dilator, sexually active, vaginal dilation, vaginal stenosis.

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Authors: Tomio Iwasaki, Yosuke Kawahito

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The adhesion strength and wettability at the interfaces between a polyetheretherketone (PEEK) resin and titanium dioxide (TiO2) have become more important because direct joining of PEEK resin and titanium (Ti), whose surface has usually the oxide (TiO2), is needed not only in vehicles such as airplanes, automobiles, and space vehicles, but also in medical devices such as implants. To realize strong joint between the PEEK resin and TiO2, the dependence of the adhesion strength and wettability on crystal orientations of rutile TiO2 were investigated by using molecular simulations. Molecular dynamics simulations were conducted by combining quantum-mechanics equation of electrons with Newton’s equation of motion of nuclear coordinates (atomic coordinates). By putting a PEEK-resin sphere on a rutile TiO2 surface and by heating the system to 650 K, the contact angles at the interfaces were calculated to evaluate the wettability. After the system is cooled to 300 K from 650 K, to evaluate the adhesin strength, the adhesive fracture energy is calculated as the difference between the energy of the PEEK-TiO2 attached state and that of the PEEK-TiO2 detached state. The results of the contact angles showed that PEEK resin on the TiO2(100) and that on the TiO2(001) surface has low wettability with large contact angles. On the other hand, PEEK resin on the TiO2(110) surface has high wettability with a small contact angle. The results of the adhesive fracture energies showed that the adhesion at the PEEK-resin/TiO2(100) and PEEK-resin/TiO2(001) interfaces are weak. On the other hand, the adhesion at the PEEK-resin/TiO2(110) interface is strong. To clarify the reason that the higher wettability and stronger adhesion are obtained at the PEEK/TiO2(110) interface than at the at the PEEK/TiO2(100) and PEEK/TiO2(001) interfaces, atomic configurations at the interfaces were visualized. The atomic configuration at the PEEK/TiO2(110) interface showed that the lattice-matched coherent interface is realized, and the atomic density is high. On the other hand, the atomic configuration at the PEEK/TiO2(001) interface showed the lattice-unmatched incoherent interface. The atomic configuration at the PEEK/TiO2(100) interface showed that the atomic density is very low although the lattice-matched interface is realized. Therefore, the lattice matching and the high atomic density at the PEEK/TiO2(001) interface are considered to be dominant factors in the high wettability and strong adhesion.

Keywords: Adhesion, direct joining, PEEK, TiO2, wettability.

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