Search results for: clinical trials

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

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

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

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Authors: Cornelia-Eugenia Munteanu

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From a psychological perspective, psychopathology is the area of clinical psychology that has at its core psychological assessment and psychotherapy. In day-to-day clinical practice, psychodiagnosis and psychotherapy are used independently, according to their intended purpose and their specific methods of application. The paper explores how the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Mini Mental State Examination-2 (MMSE-2) psychological tools contribute to enhancing the effectiveness of cognitive behavioral psychotherapy (CBT). This combined approach, psychotherapy in conjunction with assessment of personality and cognitive functions, is illustrated by two cases, a severe depressive episode with psychotic symptoms and a mixed anxiety-depressive disorder. The order in which CBT, MMPI-2, and MMSE-2 were used in the diagnostic and therapeutic process was determined by the particularities of each case. In the first case, the sequence started with psychotherapy, followed by the administration of blue form MMSE-2, MMPI-2, and red form MMSE-2. In the second case, the cognitive screening with blue form MMSE-2 led to a personality assessment using MMPI-2, followed by red form MMSE-2; reapplication of the MMPI-2 due to the invalidation of the first profile, and finally, psychotherapy. The MMPI-2 protocols gathered useful information that directed the steps of therapeutic intervention: a detailed symptom picture of potentially self-destructive thoughts and behaviors otherwise undetected during the interview. The memory loss and poor concentration were confirmed by MMSE-2 cognitive screening. This combined approach, psychotherapy with psychological assessment, aligns with the trend of adaptation of the psychological services to the everyday life of contemporary man and paves the way for deepening and developing the field.

Keywords: Assessment, cognitive behavioral psychotherapy, MMPI-2, MMSE-2, psychopathology.

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Authors: Raymond Xu, Ashley Hua, Andrew Wang, Yuru Lin

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During COVID-19, the depression rate has increased dramatically. Young adults are most vulnerable to the mental health effects of the pandemic. Lower-income families have a higher ratio to be diagnosed with depression than the general population, but less access to clinics. This research aims to achieve early depression detection at low cost, large scale, and high accuracy with an interdisciplinary approach by incorporating clinical practices defined by American Psychiatric Association (APA) as well as multimodal AI framework. The proposed approach detected the nine depression symptoms with Natural Language Processing sentiment analysis and a symptom-based Lexicon uniquely designed for young adults. The experiments were conducted on the multimedia survey results from adolescents and young adults and unbiased Twitter communications. The result was further aggregated with the facial emotional cues analyzed by the Convolutional Neural Network on the multimedia survey videos. Five experiments each conducted on 10k data entries reached consistent results with an average accuracy of 88.31%, higher than the existing natural language analysis models. This approach can reach 300+ million daily active Twitter users and is highly accessible by low-income populations to promote early depression detection to raise awareness in adolescents and young adults and reveal complementary cues to assist clinical depression diagnosis.

Keywords: Artificial intelligence, depression detection, facial emotion recognition, natural language processing, mental disorder.

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Authors: Srinivas Bathini, Duraichelvan Raju, Simona Badilescu, Muthukumaran Packirisamy

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A bio-sensing method, based on the plasmonic property of gold nano-islands, has been developed for detection of exosomes in a clinical setting. The position of the gold plasmon band in the UV-Visible spectrum depends on the size and shape of gold nanoparticles as well as on the surrounding environment. By adsorbing various chemical entities, or binding them, the gold plasmon band will shift toward longer wavelengths and the shift is proportional to the concentration. Exosomes transport cargoes of molecules and genetic materials to proximal and distal cells. Presently, the standard method for their isolation and quantification from body fluids is by ultracentrifugation, not a practical method to be implemented in a clinical setting. Thus, a versatile and cutting-edge platform is required to selectively detect and isolate exosomes for further analysis at clinical level. The new sensing protocol, instead of antibodies, makes use of a specially synthesized polypeptide (Vn96), to capture and quantify the exosomes from different media, by binding the heat shock proteins from exosomes. The protocol has been established and optimized by using a glass substrate, in order to facilitate the next stage, namely the transfer of the protocol to a microfluidic environment. After each step of the protocol, the UV-Vis spectrum was recorded and the position of gold Localized Surface Plasmon Resonance (LSPR) band was measured. The sensing process was modelled, taking into account the characteristics of the nano-island structure, prepared by thermal convection and annealing. The optimal molar ratios of the most important chemical entities, involved in the detection of exosomes were calculated as well. Indeed, it was found that the results of the sensing process depend on the two major steps: the molar ratios of streptavidin to biotin-PEG-Vn96 and, the final step, the capture of exosomes by the biotin-PEG-Vn96 complex. The microfluidic device designed for sensing of exosomes consists of a glass substrate, sealed by a PDMS layer that contains the channel and a collecting chamber. In the device, the solutions of linker, cross-linker, etc., are pumped over the gold nano-islands and an Ocean Optics spectrometer is used to measure the position of the Au plasmon band at each step of the sensing. The experiments have shown that the shift of the Au LSPR band is proportional to the concentration of exosomes and, thereby, exosomes can be accurately quantified. An important advantage of the method is the ability to discriminate between exosomes having different origins.

Keywords: Exosomes, gold nano-islands, microfluidics, plasmonic biosensing.

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Authors: Leandro Marcos Alves Vaz

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The teaching of physics in Brazilian public schools emphasizes strongly the theoretical aspects of this science, showing its philosophical and mathematical basis, but neglecting its experimental character. Perhaps the lack of science laboratories explains this practice. In this work, we present a method of teaching physics using the computer. As alternatives to real experiments, we have the trials through simulators, many of which are free software available on the internet. In order to develop a study on the use of simulators in teaching, knowing the impossibility of simulations on all topics in a given subject, we combined these programs with phenomenological and/or experimental texts in order to mitigate this limitation. This study proposes the use of simulators and the debate using phenomenological/experimental texts on electrostatic theme in groups of the 3rd year of EJA (Adult and Youth Education) in order to verify the advantages of this methodology. Some benefits of the hybridization of the traditional method with the tools used were: Greater motivation of the students in learning, development of experimental notions, proactive socialization to learning, greater easiness to understand some concepts and the creation of collaborative activities that can reduce timidity of part of the students.

Keywords: Physics teaching, simulators, youth and adult education, experimentation, electrostatic.

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Authors: Ayesha Zaman, Tanvir Atahary, Shahida Rafiq

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Functional Magnetic Resonance Imaging(fMRI) is a noninvasive imaging technique that measures the hemodynamic response related to neural activity in the human brain. Event-related functional magnetic resonance imaging (efMRI) is a form of functional Magnetic Resonance Imaging (fMRI) in which a series of fMRI images are time-locked to a stimulus presentation and averaged together over many trials. Again an event related potential (ERP) is a measured brain response that is directly the result of a thought or perception. Here the neuronal response of human visual cortex in normal healthy patients have been studied. The patients were asked to perform a visual three choice reaction task; from the relative response of each patient corresponding neuronal activity in visual cortex was imaged. The average number of neurons in the adult human primary visual cortex, in each hemisphere has been estimated at around 140 million. Statistical analysis of this experiment was done with SPM5(Statistical Parametric Mapping version 5) software. The result shows a robust design of imaging the neuronal activity of human visual cortex.

Keywords: Echo Planner Imaging, Event related Response, General Linear Model, Visual Neuronal Response.

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Authors: Abdulfatah Al-Jaradi, Marzoq Ali Odhah, Abdulnasser A. Haza’a

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Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of Antenatal Care (ANC) include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding ANC. Methodology: A descriptive knowledge, attitude, and practice (KAP) study was conducted in public hospitals in Sana'a City, Yemen. The study population included all pregnant women that intended to the prenatal department and clinical outpatient department; the final sample size was 371 pregnant women. A self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women had correct answers in total knowledge regarding ANC, and about two-thirds (67%) of pregnant women had performance practice regarding ANC and two-third (68%) of pregnant women had a positive attitude. Conclusions: More than three quarter of pregnant women had good knowledge level, most of pregnant women had moderate practice level, and more than two-thirds of pregnant women had a positive attitude regarding antenatal care. There was a statistically significant association between overall knowledge and practice level toward ANC and demographic characteristics of pregnant women, at P-value ≤ 0.05. Recommendations: we recommended more education and training courses, lecturers, and education sessions in clinical facilitators focused on ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

Keywords: Antenatal care, knowledge, practice, attitude, pregnant women.

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Authors: A. El Shahat, A. Keyhani, H. El Shewy

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High Speed PM Generators driven by micro-turbines are widely used in Smart Grid System. So, this paper proposes comparative study among six classical, optimized and genetic analytical design cases for 400 kW output power at tip speed 200 m/s. These six design trials of High Speed Permanent Magnet Synchronous Generators (HSPMSGs) are: Classical Sizing; Unconstrained optimization for total losses and its minimization; Constrained optimized total mass with bounded constraints are introduced in the problem formulation. Then a genetic algorithm is formulated for obtaining maximum efficiency and minimizing machine size. In the second genetic problem formulation, we attempt to obtain minimum mass, the machine sizing that is constrained by the non-linear constraint function of machine losses. Finally, an optimum torque per ampere genetic sizing is predicted. All results are simulated with MATLAB, Optimization Toolbox and its Genetic Algorithm. Finally, six analytical design examples comparisons are introduced with study of machines waveforms, THD and rotor losses.

Keywords: High Speed, Micro - Turbines, Optimization, PM Generators, Smart Grid, MATLAB.

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Authors: Y. Duvarci, A. K. Kutluca

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Design and land use are closely linked to the energy efficiency levels for an urban area. The current city planning practice does not involve an effective land useenergy evaluation in its 'blueprint' urban plans. The study proposed an appraisal method that can be embedded in GIS programs using five planning criteria as how far a planner can give away from the planning principles (criteria) for the most energy output s/he can obtain. The case of Balcova, a district in the Izmir Metropolitan area, is used conformingly for evaluating the proposed master plan and the geothermal energy (heating only) use for the concern district. If the land use design were proposed accordingly at-most energy efficiency (a 30% obtained), mainly increasing the density around the geothermal wells and also proposing more mixed use zones, we could have 17% distortion (infidelity to the main planning principles) from the original plan. The proposed method can be an effective tool for planners as simulation media, of which calculations can be made by GIS ready tools, to evaluate efficiency levels for different plan proposals, letting to know how much energy saving causes how much deviation from the other planning ideals. Lower energy uses can be possible for different land use proposals for various policy trials.

Keywords: Sustainable Urban Planning, Energy Efficiency, Geothermal Energy, District Heating Systems (DHS), EnergyPlanning

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Authors: Gorazd Karer

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

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

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Authors: Saeed Safari Dolatabad, Rajab Choukan

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Selection of maize (Zea mays) hybrids with wide adaptability across diverse farming environments is important, prior to recommending them to achieve a high rate of hybrid adoption. Grain yield of 14 maize hybrids, tested in a randomized completeblock design with four replicates across 22 environments in Iran, was analyzed using site regression (SREG) stability model. The biplot technique facilitates a visual evaluation of superior genotypes, which is useful for cultivar recommendation and mega-environment identification. The objectives of this study were (i) identification of suitable hybrids with both high mean performance and high stability (ii) to determine mega-environments for maize production in Iran. Biplot analysis identifies two mega-environments in this study. The first mega-environments included KRM, KSH, MGN, DZF A, KRJ, DRB, DZF B, SHZ B, and KHM, where G10 hybrid was the best performing hybrid. The second mega-environment included ESF B, ESF A, and SHZ A, where G4 hybrid was the best hybrid. According to the ideal-hybrid biplot, G10 hybrid was better than all other hybrids, followed by the G1 and G3 hybrids. These hybrids were identified as best hybrids that have high grain yield and high yield stability. GGE biplot analysis provided a framework for identifying the target testing locations that discriminates genotypes that are high yielding and stable.

Keywords: Zea mays L, GGE biplot, Multi-environment trials, Yield stability.

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Authors: K. Afsahi, M. Soheilifar, S. H. Hosseini, O. S. Esmaeili, R. Kezemi, N. Mehrbod, N. Vahed, T. Hajiahmad, N. N. Ansari

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Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of virtual reality (VR) beside conventional rehabilitation versus conventional rehabilitation alone on the spasticity and motor function in stroke patients. Materials and methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were Modified Ashworth scale, Recovery Stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in combination group (P = 0.003). Only wrist extension was varied between groups and was better in combination group. The variables generally had statistically significant difference (P < 0.05). Conclusion: VR plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: Stroke, virtual therapy, efficacy, rehabilitation.

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Authors: H. El Omari, A. Fall, T. Krochni

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This present work mainly concerns the improvement of citrus water productivity in the Souss Massa region. The objective is to evaluate the effect of deficit irrigation applied during the fruit growth stage on fruit size, quality and yield of the Orogrande variety grafted on Citrus macrophylla and Citrus volkameriana. Three irrigation regimes were adopted, a control D0 of 3.6 l/h and two doses D1 (58% D0 = 2.1 l/h) and D2 (236% D0 = 8.5 l/h). The experimental design was a randomized complete block while keeping the same spacing between drippers, the same duration of irrigation and the beginning of trials (fruit growth stage). Results showed that at the end of the cycle from October 1, 2020, to September 30, 2021, a total water supply of 732 mm and 785 mm using the D1 dose was provided to trees of Orogrande variety, respectively grafted on Citrus macrophylla and Citrus volkameriana rootstocks. Citrus macrophylla presented largest fruit size of 38 mm compared to Citrus volkameriana (33 mm) with a significant difference (p = 0.007). Total soluble sugar (8°Brix) and juice content level (40%) were higher with the application of the D1 dose on both rootstocks. Yield of 36 Tons was not affected by the deficit irrigation. Reduction of water supply by 18% increases agronomic productivity (6 MAD/m³) and economic productivity (3 MAD/m³).

Keywords: Water productivity, Citrus, irrigation, fruit size, fruit quality, yield.

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Authors: Soofiyan Atar, Adil Shaikh, Sahil Rajpurkar, Pragnesh Bhalala, Aniket Desai, Irfan Siddavatam

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Deep reinforcement learning (deep RL) algorithms leverage the symbolic power of complex controllers by automating it by mapping sensory inputs to low-level actions. Deep RL eliminates the complex robot dynamics with minimal engineering. Deep RL provides high-risk involvement by directly implementing it in real-world scenarios and also high sensitivity towards hyperparameters. Tuning of hyperparameters on a pneumatic quadruped robot becomes very expensive through trial-and-error learning. This paper presents an automated learning control for a pneumatic quadruped robot using sample efficient deep Q learning, enabling minimal tuning and very few trials to learn the neural network. Long training hours may degrade the pneumatic cylinder due to jerk actions originated through stochastic weights. We applied this method to the pneumatic quadruped robot, which resulted in a hopping gait. In our process, we eliminated the use of a simulator and acquired a stable gait. This approach evolves so that the resultant gait matures more sturdy towards any stochastic changes in the environment. We further show that our algorithm performed very well as compared to programmed gait using robot dynamics.

Keywords: model-based reinforcement learning, gait stability, supervised learning, pneumatic quadruped

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Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

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The Ramon preparation is received from a plant; it is destined for external treatment of inflammations in post-surgery period. The Ramon is a biogenic immune stimulator accelerating metabolism, contributing to improvement of blood indexes, having general tonic, anti-inflammatory and bactericidal effect.

Keywords: Anti-inflammatory, anthraquinones, bactericidal activity, Ramon.

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Authors: Mustafa M. Donma, Sule G. Kacmaz, Ahsen Yilmaz, Savas Guzel, Orkide Donma

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Obesity, as excessive fat accumulation in the body, is a global health problem. The prevalence of obesity and its complications increase due to easy access to high-energy food and decreased physical activity. Cardiovascular diseases (CVDs) constitute a significant part of obesity-related morbidity and mortality. Since the effects of obesity on cardiovascular system may start during childhood without clinical findings, elucidating the mechanisms of cardiovascular changes associated with childhood obesity became more important. In this study, we aimed to investigate some biochemical parameters which may be involved in obesity-related pathologic processes of CVDs. One hundred and seventy-seven children were included in the study, and they were divided into four groups based upon WHO criteria and presence of the metabolic syndrome (MetS): children with normal-BMI, obesity, morbid obesity, and MetS. High-sensitive cardiac troponin T (hs-cTnT), cardiac myosin binding protein C (cMyBP-C), trimethylamine N-oxide (TMAO), soluble tumor necrosis factor-like weak inducer (sTWEAK), chromogranin A (CgA), multimerin-2 levels, and other biochemical parameters were measured in serum samples. Anthropometric measurements and clinical findings of the children were recorded. Statistical analyses were performed. Children with normal-BMI had significantly higher CgA levels than children with obesity, morbid obesity, and MetS (p < 0.05). Cardiac MyBP-C levels of children with MetS were significantly higher than of children with normal-BMI and OB children (p < 0.05). There was no significant difference in hs-cTnT, sTWEAK, TMAO and multimerin-2 between the groups (p>0.05). These results suggested that cMyBP-C and CgA molecules may be involved in the pathogenesis of obesity-related CVDs.

Keywords: biomarker, cardiovascular diseases, children, obesity

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Authors: Yasuyuki Takahashi, Hayato Ishimura, Masao Miyagawa, Teruhito Mochizuki

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Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of ^99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of ^99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the ^99mTc-tetorofosmin myocardial SPECT image is considerably improved.

Keywords: 99mTc-tetrofosmin, dynamic SPECT, time subtraction, semiconductor detector.

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Authors: Cameron Hamilton, Walter Potter, Gerrit Hoogenboom, Ronald McClendon, Will Hobbs

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A model was constructed to predict the amount of solar radiation that will make contact with the surface of the earth in a given location an hour into the future. This project was supported by the Southern Company to determine at what specific times during a given day of the year solar panels could be relied upon to produce energy in sufficient quantities. Due to their ability as universal function approximators, an artificial neural network was used to estimate the nonlinear pattern of solar radiation, which utilized measurements of weather conditions collected at the Griffin, Georgia weather station as inputs. A number of network configurations and training strategies were utilized, though a multilayer perceptron with a variety of hidden nodes trained with the resilient propagation algorithm consistently yielded the most accurate predictions. In addition, a modeled direct normal irradiance field and adjacent weather station data were used to bolster prediction accuracy. In later trials, the solar radiation field was preprocessed with a discrete wavelet transform with the aim of removing noise from the measurements. The current model provides predictions of solar radiation with a mean square error of 0.0042, though ongoing efforts are being made to further improve the model’s accuracy.

Keywords: Artificial Neural Networks, Resilient Propagation, Solar Radiation, Time Series Forecasting.

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Authors: Eisa Noveiri, Adel Taheri Nia

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The Non-Rotating Adjustable Stabilizer / Directional Solution (NAS/DS) is the imitation of a mechanical process or an object by a directional drilling operation that causes a respond mathematically and graphically to data and decision to choose the best conditions compared to the previous mode. The NAS/DS Auto Guide rotary steerable tool is undergoing final field trials. The point-the-bit tool can use any bit, work at any rotating speed, work with any MWD/LWD system, and there is no pressure drop through the tool. It is a fully closed-loop system that automatically maintains a specified curvature rate. The Non–Rotating Adjustable stabilizer (NAS) can be controls curvature rate by exactly positioning and run with the optimum bit, use the most effective weight (WOB) and rotary speed (RPM) and apply all of the available hydraulic energy to the bit. The directional simulator allowed to specify the size of the curvature rate performance errors of the NAS tool and the magnitude of the random errors in the survey measurements called the Directional Solution (DS). The combination of these technologies (NAS/DS) will provide smoother bore holes, reduced drilling time, reduced drilling cost and incredible targeting precision. This simulator controls curvature rate by precisely adjusting the radial extension of stabilizer blades on a near bit Non-Rotating Stabilizer and control process corrects for the secondary effects caused by formation characteristics, bit and tool wear, and manufacturing tolerances.

Keywords: non-rotating, Adjustable stabilizer, simulator, Directional Drilling, optimization, Oil Well Drilling

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Authors: M. Tsirintani

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The article is proposing a base plan for the future Patient Care Information Systems in a changing health care environment where it is necessary to assure quality patient care services and reducing cost and where new technology trends give the opportunities to develop clinical applications and services patient focused according to new business objectives.

Keywords: Health care management, planning patient care information system.

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Authors: S. Onder, Z. Kocbeker

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The impact of noise upon live quality has become an important aspect to make both urban and environmental policythroughout Europe and in Turkey. Concern over the quality of urban environments, including noise levels and declining quality of green space, is over the past decade with increasing emphasis on designing livable and sustainable communities. According to the World Health Organization, noise pollution is the third most hazardous environmental type of pollution which proceeded by only air (gas emission) and water pollution. The research carried out in two phases, the first stage of the research noise and plant types providing the suction of noise was evaluated through literature study and at the second stage, definite types (Juniperus horizontalis L., Spirea vanhouetti Briot., Cotoneaster dammerii C.K., Berberis thunbergii D.C., Pyracantha coccinea M. etc.) were selected for the city of Konya. Trials were conducted on the highway of Konya. The biggest value of noise reduction was 6.3 dB(A), 4.9 dB(A), 6.2 dB(A) value with compared to the control which includes the group that formed by the bushes at the distance of 7m, 11m, 20m from the source and 5m, 9m, 20m of plant width, respectively. In this paper, definitions regarding to noise and its sources were made and the precautions were taken against to noise that mentioned earlier with the adverse effects of noise. Plantation design approaches and suggestions concerning to the diversity to be used, which are peculiar to roadside, were developed to discuss the role and the function of plant material to reduce the noise of the traffic.

Keywords: Bushes, noise, road, Konya

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Authors: M. E. Silva, I. Brás

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To study the influence of different organic amendments on the quality of poultry manure compost, three pilot composting trials were carried out with different mixes: poultry manure/carcasse meal/ashes/grape pomace (Pile 1), poultry manure/ cellulosic sludge (Pile 2) and poultry manure (Pile 3). For all piles, wood chips were applied as bulking agent. The process was monitored, over time, by evaluating standard physical and chemical parameters, such as, pH, electric conductivity, moisture, organic matter and ash content, total carbon and total nitrogen content, carbon/nitrogen ratio (C/N) and content in mineral elements. Piles 1 and 2 reached a thermophilic phase, however having different trends. Pile 1 reached this phase earlier than Pile 2. For both, the pH showed a slight alkaline character and the electric conductivity was lower than 2 mS/cm. Also, the initial C/N value was 22 and reached values lower than 15 at the end of composting process. The total N content of the Pile 1 increased slightly during composting, in contrast with the others piles. At the end of composting process, the phosphorus content ranged between 54 and 236 mg/kg dry matter, for Pile 2 and 3, respectively. Generally, the Piles 1 and 3 exhibited similar heavy metals content. This study showed that organic amendments can be used as carbon source, given that the final composts presented parameters within the range of those recommended in the 2^nd Draft of EU regulation proposal (DG Env.A.2 2001) for compost quality.

Keywords: Co-composting, compost quality, organic amendments, poultry manure.

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Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

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A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: Critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team.

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Authors: Morten Stigaard Laursen, Rasmus Nyholm Jørgensen, Henrik Skov Midtiby, Anders Krogh Mortensen, Sanmohan Baby

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This work contributes a statistical model and simulation framework yielding the best estimate possible for the potential herbicide reduction when using the MoDiCoVi algorithm all the while requiring a efficacy comparable to conventional spraying. In June 2013 a maize field located in Denmark were seeded. The field was divided into parcels which was assigned to one of two main groups: 1) Control, consisting of subgroups of no spray and full dose spraty; 2) MoDiCoVi algorithm subdivided into five different leaf cover thresholds for spray activation. In addition approximately 25% of the parcels were seeded with additional weeds perpendicular to the maize rows. In total 299 parcels were randomly assigned with the 28 different treatment combinations. In the statistical analysis, bootstrapping was used for balancing the number of replicates. The achieved potential herbicide savings was found to be 70% to 95% depending on the initial weed coverage. However additional field trials covering more seasons and locations are needed to verify the generalisation of these results. There is a potential for further herbicide savings as the time interval between the first and second spraying session was not long enough for the weeds to turn yellow, instead they only stagnated in growth.

Keywords: Weed crop discrimination, macrosprayer, herbicide reduction, site-specific, sprayer-boom.

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Authors: Abu Salim Mustafa

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Polymerase chain reaction (PCR) assays targeting genomic DNA segments have been established for the detection of Helicobacter pylori in clinical specimens. However, the data on comparative evaluations of various targets in detection of H. pylori are limited. Furthermore, the frequencies of vacA (s1 and s2) and cagA genotypes, which are suggested to be involved in the pathogenesis of H. pylori in other parts of the world, are not well studied in Kuwait. The aim of this study was to evaluate PCR assays for the detection and genotyping of H. pylori by targeting the amplification of DNA targets from four genomic segments. The genomic DNA were isolated from 72 clinical isolates of H. pylori and tested in PCR with four pairs of oligonucleotides primers, i.e. ECH-U/ECH-L, ET-5U/ET-5L, CagAF/CagAR and Vac1F/Vac1XR, which were expected to amplify targets of various sizes (471 bp, 230 bp, 183 bp and 176/203 bp, respectively) from the genomic DNA of H. pylori. The PCR-amplified DNA were analyzed by agarose gel electrophoresis. PCR products of expected size were obtained with all primer pairs by using genomic DNA isolated from H. pylori. DNA dilution experiments showed that the most sensitive PCR target was 471 bp DNA amplified by the primers ECH-U/ECH-L, followed by the targets of Vac1F/Vac1XR (176 bp/203 DNA), CagAF/CagAR (183 bp DNA) and ET-5U/ET-5L (230 bp DNA). However, when tested with undiluted genomic DNA isolated from single colonies of all isolates, the Vac1F/Vac1XR target provided the maximum positive results (71/72 (99% positives)), followed by ECH-U/ECH-L (69/72 (93% positives)), ET-5U/ET-5L (51/72 (71% positives)) and CagAF/CagAR (26/72 (46% positives)). The results of genotyping experiments showed that vacA s1 (46% positive) and vacA s2 (54% positive) genotypes were almost equally associated with VaCA+/CagA- isolates (P > 0.05), but with VacA+/CagA+ isolates, S1 genotype (92% positive) was more frequently detected than S2 genotype (8% positive) (P< 0.0001). In conclusion, among the primer pairs tested, Vac1F/Vac1XR provided the best results for detection of H. pylori. The genotyping experiments showed that vacA s1 and vacA s2 genotypes were almost equally associated with vaCA⁺/cagA^- isolates, but vacA s1 genotype had a significantly increased association with vacA⁺/cagA⁺ isolates.

Keywords: H. pylori, detection, genotyping, Kuwait.

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Authors: Md Rashadul Islam, Umme Amina Mannan, Rafiqul A. Tarefder

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Stiffness of Hot Mix Asphalt (HMA) in flexible pavement is largely dependent of temperature, mode of testing and age of pavement. Accurate measurement of HMA stiffness is thus quite challenging. This study determines HMA stiffness based on Finite Element Model (FEM) and validates the results using field data. As a first step, stiffnesses of different layers of a pavement section on Interstate 40 (I-40) in New Mexico were determined by Falling Weight Deflectometer (FWD) test. Pavement temperature was not measured at that time due to lack of temperature probe. Secondly, a FE model is developed in ABAQUS. Stiffness of the base, subbase and subgrade were taken from the FWD test output obtained from the first step. As HMA stiffness largely varies with temperature it was assigned trial and error approach. Thirdly, horizontal strain and vertical stress at the bottom of the HMA and temperature at different depths of the pavement were measured with installed sensors on the whole day on December 25th, 2012. Fourthly, outputs of FEM were correlated with measured stress-strain responses. After a number of trials a relationship was developed between the trial stiffness of HMA and measured mid-depth HMA temperature. At last, the obtained relationship between stiffness and temperature is verified by further FWD test when pavement temperature was recorded. A promising agreement between them is observed. Therefore, conclusion can be drawn that linear elastic FEM can accurately predict the stiffness and the structural response of flexible pavement.

Keywords: Asphalt pavement, falling weight deflectometer test, field instrumentation, finite element model, horizontal strain, temperature probes.

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Authors: M. Saravanan

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Antimicrobial resistant is becoming a major factor in virtually all hospital acquired infection may soon untreatable is a serious public health problem. These concerns have led to major research effort to discover alternative strategies for the treatment of bacterial infection. Nanobiotehnology is an upcoming and fast developing field with potential application for human welfare. An important area of nanotechnology for development of reliable and environmental friendly process for synthesis of nanoscale particles through biological systems In the present studies are reported on the use of fungal strain Aspergillus species for the extracellular synthesis of bionanoparticles from 1 mM silver nitrate (AgNO3) solution. The report would be focused on the synthesis of metallic bionanoparticles of silver using a reduction of aqueous Ag+ ion with the culture supernatants of Microorganisms. The bio-reduction of the Ag+ ions in the solution would be monitored in the aqueous component and the spectrum of the solution would measure through UV-visible spectrophotometer The bionanoscale particles were further characterized by Atomic Force Microscopy (AFM), Fourier Transform Infrared Spectroscopy (FTIR) and Thin layer chromatography. The synthesized bionanoscale particle showed a maximum absorption at 385 nm in the visible region. Atomic Force Microscopy investigation of silver bionanoparticles identified that they ranged in the size of 250 nm - 680 nm; the work analyzed the antimicrobial efficacy of the silver bionanoparticles against various multi drug resistant clinical isolates. The present Study would be emphasizing on the applicability to synthesize the metallic nanostructures and to understand the biochemical and molecular mechanism of nanoparticles formation by the cell filtrate in order to achieve better control over size and polydispersity of the nanoparticles. This would help to develop nanomedicine against various multi drug resistant human pathogens.

Keywords: Bionanoparticles, UV-visible spectroscopy, AtomicForce Microscopy, Extracellular synthesis, Multi drug resistant, antimicrobial activity, Nanomedicine

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Authors: Alok Madan, Arshad K. Hashmi

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Performance based design (PBD) is an iterative exercise in which a preliminary trial design of the building structure is selected and if the selected trial design of the building structure does not conform to the desired performance objective, the trial design is revised. In this context, development of a fundamental approach for performance based seismic design of masonry infilled frames with minimum number of trials is an important objective. The paper presents a plastic design procedure based on the energy balance concept for PBD of multi-story multi-bay masonry infilled reinforced concrete (R/C) frames subjected to near-field earthquakes. The proposed energy based plastic design procedure was implemented for trial performance based seismic design of representative masonry infilled reinforced concrete frames with various practically relevant distributions of masonry infill panels over the frame elevation. Non-linear dynamic analyses of the trial PBD of masonry infilled R/C frames was performed under the action of near-field earthquake ground motions. The results of non-linear dynamic analyses demonstrate that the proposed energy method is effective for performance based design of masonry infilled R/C frames under near-field as well as far-field earthquakes.

Keywords: Masonry Infilled Frame, Energy Methods, Near-fault Ground Motions, Pushover Analysis, Nonlinear Dynamic Analysis, Seismic Demand.

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Authors: Syed Dawood Md. Taimur, Md. Hasanur Rahman, Syeda Fahmida Afrin, Farzana Islam

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The concept of myocardial injury, although first recognized from animal studies, is now recognized as a clinical phenomenon that may result in microvascular damage, no-reflow phenomenon, myocardial stunning, myocardial hibernation and ischemic preconditioning. The final consequence of this event is left ventricular (LV) systolic dysfunction leading to increased morbidity and mortality. The typical clinical case of reperfusion injury occurs in acute myocardial infarction (MI) with ST segment elevation in which an occlusion of a major epicardial coronary artery is followed by recanalization of the artery. This may occur spontaneously or by means of thrombolysis and/or by primary percutaneous coronary intervention (PCI) with efficient platelet inhibition by aspirin (acetylsalicylic acid), clopidogrel and glycoprotein IIb/IIIa inhibitors. In recent years, percutaneous coronary intervention (PCI) has become a well-established technique for the treatment of coronary artery disease. PCI improves symptoms in patients with coronary artery disease and it has been increasing safety of procedures. However, peri- and post-procedural myocardial injury, including angiographical slow coronary flow, microvascular embolization, and elevated levels of cardiac enzyme, such as creatine kinase and troponin-T and -I, has also been reported even in elective cases. Furthermore, myocardial reperfusion injury at the beginning of myocardial reperfusion, which causes tissue damage and cardiac dysfunction, may occur in cases of acute coronary syndrome. Because patients with myocardial injury is related to larger myocardial infarction and have a worse long-term prognosis than those without myocardial injury, it is important to prevent myocardial injury during and/or after PCI in patients with coronary artery disease. To date, many studies have demonstrated that adjunctive pharmacological treatment suppresses myocardial injury and increases coronary blood flow during PCI procedures. In this review, we highlight the usefulness of pharmacological treatment in combination with PCI in attenuating myocardial injury in patients with coronary artery disease.

Keywords: Coronary artery disease, Percutaneous coronary intervention, Myocardial injury, Pharmacology.

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Authors: Tony Austin, Shanghua Sun, Nathan Lea, Steve Iliffe, Dipak Kalra, David Ingram, David Patterson

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Computer-based decision support (CDSS) systems can deliver real patient care and increase chances of long-term survival in areas of chronic disease management prone to poor control. One such CDSS, for the management of warfarin, is described in this paper and the outcomes shown. Data is derived from the running system and show a performance consistently around 20% better than the applicable guidelines.

Keywords: "Decision Support", "Anticoagulant Control"

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