Search results for: intelligent systems patient monitoring

Authors: Rafael Jorge Menezes Santos, Ginalber Luiz de Oliveira Serra, Carlos César Teixeira Ferreira

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This paper proposes a methodology for analysis of the dynamic behavior of a robotic manipulator in continuous time. Initially this system (nonlinear system) will be decomposed into linear submodels and analyzed in the context of the Linear and Parameter Varying (LPV) Systems. The obtained linear submodels, which represent the local dynamic behavior of the robotic manipulator in some operating points were grouped in a Takagi-Sugeno fuzzy structure. The obtained fuzzy model was analyzed and validated through analog simulation, as universal approximator of the robotic manipulator.

Keywords: modeling of nonlinear dynamic systems, Takagi- Sugeno fuzzy model, Linear and Parameter Varying (LPV) System.

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Authors: Ma-Wubin, Deng-Su, Huang Hongbin, Chen-Jian, Wu-Yahun, Li-zhuo

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Cyber physical system (CPS) for target tracking, military surveillance, human health monitoring, and vehicle detection all require maximizing the utility and saving the energy. Sensor selection is one of the most important parts of CPS. Sensor selection problem (SSP) is concentrating to balance the tradeoff between the number of sensors which we used and the utility which we will get. In this paper, we propose a performance constrained slide windows (PCSW) based algorithm for SSP in CPS. we present results of extensive simulations that we have carried out to test and validate the PCSW algorithms when we track a target, Experiment shows that the PCSW based algorithm improved the performance including selecting time and communication times for selecting.

Keywords: Cyber physical system, sensor selection problem, PCSW based algorithm.

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Authors: A. Buruzs, M. F. Hatwágner, A. Torma, L. T. Kóczy

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Recently, an increasing number of researchers have been focusing on working out realistic solutions to sustainability problems. As sustainability issues gain higher importance for organisations, the management of such decisions becomes critical. Knowledge representation is a fundamental issue of complex knowledge based systems. Many types of sustainability problems would benefit from models based on experts’ knowledge. Cognitive maps have been used for analyzing and aiding decision making. A cognitive map can be made of almost any system or problem. A fuzzy cognitive map (FCM) can successfully represent knowledge and human experience, introducing concepts to represent the essential elements and the cause and effect relationships among the concepts to model the behaviour of any system. Integrated waste management systems (IWMS) are complex systems that can be decomposed to non-related and related subsystems and elements, where many factors have to be taken into consideration that may be complementary, contradictory, and competitive; these factors influence each other and determine the overall decision process of the system. The goal of the present paper is to construct an efficient IWMS which considers various factors. The authors’ intention is to propose an expert based system design approach for implementing expert decision support in the area of IWMSs and introduces an appropriate methodology for the development and analysis of group FCM. A framework for such a methodology consisting of the development and application phases is presented.

Keywords: Factors, fuzzy cognitive map, group decision, integrated waste management system.

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Authors: Ruth Lijtmaer, Roy Moodley, Shafik Sunderani

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The argument that self-disclosure will change the psychoanalytic process into a socio-cultural niche distorting the therapeutic alliance and compromise therapeutic effectiveness is still the widely held belief amongst many psychotherapists. This paper considers the issues surrounding culture, disclosure and concealment since they remain largely untheorized and clinically problematic. The first part of the paper will critically examine the theory and practice of psychoanalysis across cultures, and explore the reasons for culturally diverse patients to conceal rather than disclose their feelings and thoughts in the transference. This is followed by a discussion on how immigrant analysts- anonymity is difficult to maintain since diverse nationalities, language and accents provide clues to the therapist-s and patient-s origins. Through personal clinical examples of one the author-s (who is an immigrant) the paper analyses the transference-countertransference paradigm and how it reflects in the analyst-s self-revelation.

Keywords: Self-disclosure, cross-cultural, transferencecountertransference, immigrant therapist.

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Authors: Khalid M. Albarkoly, Kenneth S. Park

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The substantial development of the construction industry has forced the cement industry, its major support, to focus on achieving maximum productivity to meet the growing demand for this material. This means that the reliability of a cement production system needs to be at the highest level that can be achieved by good maintenance. This paper studies the extent to which the implementation of RCM is needed as a strategy for increasing the reliability of the production systems component can be increased, thus ensuring continuous productivity. In a case study of four Libyan cement factories, 80 employees were surveyed and 12 top and middle managers interviewed. It is evident that these factories usually breakdown more often than once per month which has led to a decline in productivity. In many times they cannot achieve the minimum level of production amount. This has resulted from the poor reliability of their production systems as a result of poor or insufficient maintenance. It has been found that most of the factories’ employees misunderstand maintenance and its importance. The main cause of this problem is the lack of qualified and trained staff, but in addition it has been found that most employees are not found to be motivated as a result of a lack of management support and interest. In response to these findings, it has been suggested that the RCM strategy should be implemented in the four factories. The results show the importance of the development of maintenance strategies through the implementation of RCM in these factories. The purpose of it would be to overcome the problems that could secure the reliability of the production systems. This study could be a useful source of information for academic researchers and the industrial organizations which are still experiencing problems in maintenance practices.

Keywords: Libyan cement industry, maintenance, production, reliability centered maintenance, reliability.

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Authors: Bin Su

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Auckland has a temperate climate with comfortable warm, dry summers and mild, wet winters. Auckland house design not only focus on winter thermal performance and indoor thermal condition, but also indoor moisture control, which is closely related to indirect health effects such as dust mites, fungi, etc. Most Auckland houses are designed to use temporary heating for winter indoor thermal comfort. Based on field study data of indoor microclimate conditions of two Auckland townhouses with a whole home mechanical ventilation system or a passive wind directional skylight vent, this study is to evaluate and compare indoor moisture conditions of two insulated townhouses only using temporary heating with different ventilation systems.

Keywords: House ventilation, house thermal design, indoor health condition, indoor moisture control.

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Authors: Mamoun F. Al-Mistarihi, Rami Mohaisen

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Cooperative diversity (CD) has been adopted in many communication systems because it helps in improving performance of the wireless communication systems with the help of the relays that emulate the multiple antenna terminals. This work aims to provide the derivation of the performance analysis expressions of the multiuser diversity (MUD) in the two-hop cooperative multi-relay wireless networks (TCMRNs). Considering the work analysis, we provide analytically the derivation of a closed form expression of the two most commonly used performance metrics namely, the outage probability and the symbol error probability (SEP) for the fixed decode-and-forward (FDF) protocol with MUD.

Keywords: Cooperative diversity (CD), fixed decode-andforward(FDF), multiuser diversity (MUD) , two - hop cooperative multi-relay wireless networks (TCMRN).

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Authors: H. Ostad-Ahmad-Ghorabi, T. Rahmani, D. Gerhard

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Product Data Management (PDM) systems for Computer Aided Design (CAD) file management are widely established in design processes. This management system is indispensable for design collaboration or when design task distribution is present. It is thus surprising that engineering design curricula has not paid much attention in the education of PDM systems. This is also the case for eduction of ecodesign and environmental evaluation of products. With the rise of sustainability as a strategic aspect in companies, environmental concerns are becoming a key issue in design. This paper discusses the establishment of a PDM platform to be used among technical and vocational schools in Austria. The PDM system facilitates design collaboration among these schools. Further, it will be discussed how the PDM system has been prepared in order to facilitate environmental evaluation of parts, components and subassemblies of a product. By integrating a Business Intelligence solution, environmental Life Cycle Assessment and communication of results is enabled.

Keywords: CAD, Engineering Design, Design Education, ProductLife Cycle, Sustainability

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Authors: Badr M. Alshammari, Mohamed A. El-Kady

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The paper presents new results of a recent industry supported research and development study in which an efficient framework for evaluating practical and meaningful power system reliability and quality indices was applied. The system-wide integrated performance indices are capable of addressing and revealing areas of deficiencies and bottlenecks as well as redundancies in the composite generation-transmission-demand structure of large-scale power grids. The technique utilizes a linear programming formulation, which simulates practical operating actions and offers a general and comprehensive framework to assess the harmony and compatibility of generation, transmission and demand in a power system. Practical applications to a reduced system model as well as a portion of the Saudi power grid are also presented in the paper for demonstration purposes.

Keywords: Power systems, Linear programming, Quality assessment, Reliability.

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Authors: C. S. Paglia, E. Pesenti, A. Krattiger

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Commercially available methacrylate and acrylamide-based acrylic resins for injection in concrete systems have been tested with respect to the sealing performance and the rebar corrosion. Among the different resins, a methacrylate-based type of acrylic resin significantly inhibited the rebar corrosion. This was mainly caused by the relatively high pH of the resin and the resin aqueous solution. This resin also exhibited a relatively high sealing performance, in particular after exposing the resin to durability tests. The corrosion inhibition behaviour and the sealing properties after the exposition to durability tests were maintained up to one year. The other resins either promoted the corrosion of the rebar and/or exhibited relatively low sealing properties.

Keywords: Acrylic resin, sealing performance, rebar corrosion, concrete injection.

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Authors: Igor Astrov, Andrus Pedai

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This paper focuses on a critical component of the situational awareness (SA), the neural control of depth flight of an autonomous underwater vehicle (AUV). Constant depth flight is a challenging but important task for AUVs to achieve high level of autonomy under adverse conditions. With the SA strategy, we proposed a multirate neural control of an AUV trajectory for a nontrivial mid-small size AUV “r2D4" stochastic model. This control system has been demonstrated and evaluated by simulation of diving maneuvers using software package Simulink. From the simulation results it can be seen that the chosen AUV model is stable in the presence of noises, and also can be concluded that the proposed research technique will be useful for fast SA of similar AUV systems in real-time search-and-rescue operations.

Keywords: Autonomous underwater vehicles, multirate systems, neurocontrollers, situational awareness.

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Authors: J. Kellner, A. Bumbová, D. Pluskal, A. Langerová, Z. Večeřa, P. Mikuška

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The paper deals with the development of portable aerosol concentrator and its application for the determination of nitrites and nitrates. The device enables the continuous trapping of pollutants in the air. An extensive literature search has been elaborated which aims at the development of samplers and the possibilities of their application in the continuous determination of volatile organic compounds. The practical part of the paper is focused on the development of the portable aerosol concentrator. The device using the Aerosol Enrichment Unit has been experimentally verified and subsequently realized. It operates on the principle of equilibrium accumulation of pollutants from the gaseous phase using absorption liquid polydisperse aerosol. The device has been applied for monitoring nitrites and nitrates in the air. The chemiluminescence detector was used for detection; the achieved detection limit for nitrites was 28 ng/m3 and for nitrates 78 ng/m3.

Keywords: aerosol enrichment unit, air pollution, NO2, portableaerosol concentrator

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Authors: Tomohiro Hachino, Hitoshi Takata, Shigeru Nakayama, Ichiro Iimura, Seiji Fukushima, Yasutaka Igarashi

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This paper presents a nonparametric identification of continuous-time nonlinear systems by using a Gaussian process (GP) model. The GP prior model is trained by artificial bee colony algorithm. The nonlinear function of the objective system is estimated as the predictive mean function of the GP, and the confidence measure of the estimated nonlinear function is given by the predictive covariance of the GP. The proposed identification method is applied to modeling of a simplified electric power system. Simulation results are shown to demonstrate the effectiveness of the proposed method.

Keywords: Artificial bee colony algorithm, Gaussian process model, identification, nonlinear system, electric power system.

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Authors: Theerawut Jinayim, Somchai Arunrungrasmi, Tanes Tanitteerapan, Narong Mungkung

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Although White LED lighting systems powered by solar cells have presented for many years, they are not widely used in today application because of their cost and low energy conversion efficiency. The proposed system use the dc power generated by fixed solar cells module to energize White LED light sources that are operated by directly connected White LED with current limitation resistors, resulting in much more power consumption. This paper presents the use of white LED as a general lighting application powered by tracking solar cells module and using pulse to apply the electrical power to the White LED. These systems resulted in high efficiency power conversion, low power consumption, and long light of the white LED.

Keywords: Efficiency, lighting, light-emitting diode, pulse, Solar, white LED.

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Authors: Shahin Dezdar

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Over the past few years, companies in developing countries have implemented enterprise resource planning (ERP) systems. Regardless of the various benefits of the ERP system, its adoption and implementation have not been without problems. Many companies have assigned considerable organizational resources to their ERP projects, but have encountered unexpected challenges. Neglecting a number of important factors in ERP projects might lead to failure instead of success. User satisfaction is among those factors that has a major influence on ERP implementation success. So, this paper intends to investigate the key factors that create ERP users- satisfaction and to discover whether ERP users- satisfaction varies among different users- profiles. The study was conducted using a survey questionnaire which was distributed to ERP users in Iranian organizations. A total of 384 responses were collected and analyzed. The findings indicated that younger ERP users tend to be more satisfied with ERP systems. Furthermore, ERP users with more experiences in IT and also more educated users have more satisfaction with ERP softwares. However, the study found no satisfaction differences between men and women users.

Keywords: ERP, Enterprise resource planning, User satisfaction, Iran, Developing country

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Authors: C. Angel, S. Asha

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Despite the advances made in various new technologies, application of these technologies for agriculture still remains a formidable task, as it involves integration of diverse domains for monitoring the different process involved in agricultural management. Advances in ambient intelligence technology represents one of the most powerful technology for increasing the yield of agricultural crops and to mitigate the impact of water scarcity, climatic change and methods for managing pests, weeds and diseases. This paper proposes a GPS-assisted, machine to machine solutions that combine information collected by multiple sensors for the automated management of paddy crops. To maintain the economic viability of paddy cultivation, the various techniques used in agriculture are discussed and a novel system which uses ambient intelligence technique is proposed in this paper. The ambient intelligence based agricultural system gives a great scope.

Keywords: Ambient Intelligence, Agricultural technology, smart agriculture, precise farming.

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Authors: Leo Laine, Morgan Johansson

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To meet the civilizations future needs for safe living and low environmental footprint, the engineers designing the complex systems of tomorrow will need efficient ways to model and optimize these systems for their intended purpose. For example, a civil defence shelter and its subsystem components needs to withstand, e.g. airblast and ground shock from decided design level explosion which detonates with a certain distance from the structure. In addition, the complex civil defence shelter needs to have functioning air filter systems to protect from toxic gases and provide clean air, clean water, heat, and electricity needs to also be available through shock and vibration safe fixtures and connections. Similar complex building systems can be found in any concentrated living or office area. In this paper, the authors use a multidomain modelling language called Modelica to model a concrete wall as a single degree of freedom (SDOF) system with elastoplastic properties with the implemented option of plastic hardening. The elastoplastic model was developed and implemented in the open source tool OpenModelica. The simulation model was tested on the case with a transient equivalent reflected pressure time history representing an airblast from 100 kg TNT detonating 15 meters from the wall. The concrete wall is approximately regarded as a concrete strip of 1.0 m width. This load represents a realistic threat on any building in a city like area. The OpenModelica model results were compared with an Excel implementation of a SDOF model with an elastic-plastic spring using simple fixed timestep central difference solver. The structural displacement results agreed very well with each other when it comes to plastic displacement magnitude, elastic oscillation displacement, and response times.

Keywords: Airblast from explosives, elastoplastic spring model, Modelica modelling language, SDOF, structural response of concrete structure.

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Authors: A. Eui Koog Ahn, B. Gi-Nam Wang, C. Sang C. Park

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Higher productivity and less cost in the ship manufacturing process are required to maintain the international competitiveness of morden manufacturing industries. In shipbuilding, however, the Engineering To Order (ETO) production method and production process is very difficult. Thus, designs change frequently. In accordance with production, planning should be set up according to scene changes. Therefore, fixed production planning is very difficult. Thus, a scheduler must first make sketchy plans, then change the plans based on the work progress and modifications. Thus, data sharing in a shipbuilding block assembly shop is very important. In this paper, we proposed to scheduling method applicable to the shipbuilding industry and decision making support system through web based visualization system.

Keywords: Shipbuilding, Monitoring, Block assembly shop, Visualization

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Authors: J. K. Alhassan, B. Attah, S. Misra

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Human beings have the ability to make logical decisions. Although human decision - making is often optimal, it is insufficient when huge amount of data is to be classified. Medical dataset is a vital ingredient used in predicting patient’s health condition. In other to have the best prediction, there calls for most suitable machine learning algorithms. This work compared the performance of Artificial Neural Network (ANN) and Decision Tree Algorithms (DTA) as regards to some performance metrics using diabetes data. WEKA software was used for the implementation of the algorithms. Multilayer Perceptron (MLP) and Radial Basis Function (RBF) were the two algorithms used for ANN, while RegTree and LADTree algorithms were the DTA models used. From the results obtained, DTA performed better than ANN. The Root Mean Squared Error (RMSE) of MLP is 0.3913 that of RBF is 0.3625, that of RepTree is 0.3174 and that of LADTree is 0.3206 respectively.

Keywords: Artificial neural network, classification, decision tree, diabetes mellitus.

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Authors: Parvinder S. Sandhu, Jagdeep Singh, Vikas Gupta, Mandeep Kaur, Sonia Manhas, Ramandeep Sidhu

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Prediction of fault-prone modules provides one way to support software quality engineering. Clustering is used to determine the intrinsic grouping in a set of unlabeled data. Among various clustering techniques available in literature K-Means clustering approach is most widely being used. This paper introduces K-Means based Clustering approach for software finding the fault proneness of the Object-Oriented systems. The contribution of this paper is that it has used Metric values of JEdit open source software for generation of the rules for the categorization of software modules in the categories of Faulty and non faulty modules and thereafter empirically validation is performed. The results are measured in terms of accuracy of prediction, probability of Detection and Probability of False Alarms.

Keywords: K-Means, Software Fault, Classification, ObjectOriented Metrics.

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Authors: R. Bansal, A. Jain, M. Kumar, R. S. Meena

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Present wireless communication demands compact and intelligent devices with multitasking capabilities at affordable cost. The focus in the presented paper is on a dual band antenna for wireless communication with the capability of operating at two frequency bands with same structure. Two resonance frequencies are observed with the second operation band at 4.2GHz approximately three times the first resonance frequency at 1.5GHz. Structure is simple loop of microstrip line with characteristic impedance 50 ohms. The proposed antenna is designed using defective ground structure (DGS) and shows the nearly one third reductions in size as compared to without DGS. This antenna was simulated on electromagnetic (EM) simulation software and fabricated using microwave integrated circuit technique on RT-Duroid dielectric substrate (ε_r= 2.22) of thickness (H=15 mils). The designed antenna was tested on automatic network analyzer and shows the good agreement with simulated results. The proposed structure is modeled into an equivalent electrical circuit and simulated on circuit simulator. Subsequently, theoretical analysis was carried out and simulated. The simulated, measured, equivalent circuit response, and theoretical results shows good resemblance. The bands of operation draw many potential applications in today’s wireless communication.

Keywords: Defective Ground plane, Dual band, Loop Antenna, Microstrip antenna, Resonance frequency.

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Authors: Ciprian Dobre

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The scale, complexity and worldwide geographical spread of the LHC computing and data analysis problems are unprecedented in scientific research. The complexity of processing and accessing this data is increased substantially by the size and global span of the major experiments, combined with the limited wide area network bandwidth available. We present the latest generation of the MONARC (MOdels of Networked Analysis at Regional Centers) simulation framework, as a design and modeling tool for large scale distributed systems applied to HEP experiments. We present simulation experiments designed to evaluate the capabilities of the current real-world distributed infrastructure to support existing physics analysis processes and the means by which the experiments bands together to meet the technical challenges posed by the storage, access and computing requirements of LHC data analysis within the CMS experiment.

Keywords: Modeling and simulation, evaluation, large scale distributed systems, LHC experiments, CMS.

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Authors: Nina Robson, Kenneth John Faller II, Vishalkumar Ahir, Arthur Ricardo Deps Miguel Ferreira, John Buchanan, Amarnath Banerjee

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This paper describes the development of a virtual-reality system ARWED, which will be used in physical rehabilitation of patients with reduced upper extremity mobility to increase limb Active Range of Motion (AROM). The ARWED system performs a symmetric reflection and real-time mapping of the patient’s healthy limb on to their most affected limb, tapping into the mirror neuron system and facilitating the initial learning phase. Using the ARWED, future experiments will test the extension of the action-observation priming effect linked to the mirror-neuron system on healthy subjects and then stroke patients.

Keywords: Physical rehabilitation, mirror neuron, virtual reality, stroke therapy.

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Authors: Abolhassan Razminia, Mohammad-Ali Sadrnia

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Chua’s circuit is one of the most important electronic devices that are used for Chaos and Bifurcation studies. A central role of secure communication is devoted to it. Since the adaptive control is used vastly in the linear systems control, here we introduce a new trend of application of adaptive method in the chaos controlling field. In this paper, we try to derive a new adaptive control scheme for Chua’s circuit controlling because control of chaos is often very important in practical operations. The novelty of this approach is for sake of its robustness against the external perturbations which is simulated as an additive noise in all measured states and can be generalized to other chaotic systems. Our approach is based on Lyapunov analysis and the adaptation law is considered for the feedback gain. Because of this, we have named it NAFT (Nonlinear Adaptive Feedback Technique). At last, simulations show the capability of the presented technique for Chua’s circuit.

Keywords: Chaos, adaptive control, nonlinear control, Chua's circuit.

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Authors: A.V.Naresh Babu, S.Sivanagaraju

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A considerable progress has been achieved in transient stability analysis (TSA) with various FACTS controllers. But, all these controllers are associated with single transmission line. This paper is intended to discuss a new approach i.e. a multi-line FACTS controller which is interline power flow controller (IPFC) for TSA of a multi-machine power system network. A mathematical model of IPFC, termed as power injection model (PIM) presented and this model is incorporated in Newton-Raphson (NR) power flow algorithm. Then, the reduced admittance matrix of a multi-machine power system network for a three phase fault without and with IPFC is obtained which is required to draw the machine swing curves. A general approach based on L-index has also been discussed to find the best location of IPFC to reduce the proximity to instability of a power system. Numerical results are carried out on two test systems namely, 6-bus and 11-bus systems. A program in MATLAB has been written to plot the variation of generator rotor angle and speed difference curves without and with IPFC for TSA and also a simple approach has been presented to evaluate critical clearing time for test systems. The results obtained without and with IPFC are compared and discussed.

Keywords: Flexible alternating current transmission system (FACTS), first swing stability, interline power flow controller (IPFC), power injection model (PIM).

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Authors: D. R. Ambika, K. R. Radhika, D. Seshachalam

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Unconstrained authentication is an important component for personal automated systems and human-computer interfaces. Existing solutions mostly use face as the primary object of analysis. The performance of face-based systems is largely determined by the extent of deformation caused in the facial region and amount of useful information available in occluded face images. Periocular region is a useful portion of face with discriminative ability coupled with resistance to deformation. A reliable portion of periocular area is available for occluded images. The present work demonstrates that joint representation of periocular texture and periocular structure provides an effective expression and poses invariant representation. The proposed methodology provides an effective and compact description of periocular texture and shape. The method is tested over four benchmark datasets exhibiting varied acquisition conditions.

Keywords: Periocular authentication, Zernike moments, LBPV, shape and texture fusion.

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Authors: T. Kero, R. Söderberg, M. Andersson, L. Lindkvist

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Within dental-guided surgery, there has been a lack of analytical methods for optimizing the treatment of the rehabilitation concepts regarding geometrical variation. The purpose of this study is to find the source of the greatest geometrical variation contributor and sensitivity contributor with the help of virtual variation simulation of a dental drill- and implant-guided surgery process using a methodical approach. It is believed that lower geometrical variation will lead to better patient security and higher quality of dental drill- and implant-guided surgeries. It was found that the origin of the greatest contributor to the most variation, and hence where the foci should be set, in order to minimize geometrical variation was in the assembly category (surgery). This was also the category that was the most sensitive for geometrical variation.

Keywords: Variation Simulation, Process Optimization, Guided Surgeries, Dental Prosthesis.

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Authors: Ramin Khamedi, Isa Ahmadi

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In this study acoustic emission (AE) signals obtained during deformation and fracture of two types of ferrite-martensite dual phase steels (DPS) specimens have been analyzed in frequency domain. For this reason two low carbon steels with various amounts of carbon were chosen, and intercritically heat treated. In the introduced method, identifying the mechanisms of failure in the various phases of DPS is done. For this aim, AE monitoring has been used during tensile test of several DPS with various volume fraction of the martensite (VM) and attempted to relate the AE signals and failure mechanisms in these steels. Different signals, which referred to 2-3 micro-mechanisms of failure due to amount of carbon and also VM have been seen. By Fast Fourier Transformation (FFT) of signals in distinct locations, an excellent relationship between peak frequencies in these areas and micro-mechanisms of failure were seen. The results were verified by microscopic observations (SEM).

Keywords: Dual Phase Steel, Deformation, Acoustic Emission.

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Authors: Surajit Debnath, Soma Addya

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Human genome is not only the evolutionary summation of all advantageous events, but also houses lesions of deleterious foot prints. A single gene mutation sometimes may express multiple consequences in numerous tissues and a linear relationship of the genotype and the phenotype may often be obscure. ß Thalassemia minor, a transfusion independent mild anaemia, coupled with environment among other factors may articulate into phenotypic pleotropy with Hypocholesterolemia, Vitamin D deficiency, Tissue hypoxia, Hyper-parathyroidism and Psychological alterations. Occurrence of Pancreatic insufficiency, resultant steatorrhoea, Vitamin-D (25-OH) deficiency (13.86 ngm/ml) with Hypocholesterolemia (85mg/dl) in a 30 years old male ß Thal-minor patient (Hemoglobin 11mg/dl with Fetal Hemoglobin 2.10%, Hb A2 4.60% and Hb Adult 84.80% and altered Hemogram) with increased Para thyroid hormone (62 pg/ml) & moderate Serum Ca+2 (9.5mg/ml) indicate towards a cascade of phenotypic pleotropy where the ß Thalassemia mutation ,be it in the 5’ cap site of the mRNA , differential splicing etc in heterozygous state is effecting several metabolic pathways. Compensatory extramedulary hematopoiesis may not coped up well with the stressful life style of the young individual and increased erythropoietic stress with high demand for cholesterol for RBC membrane synthesis may have resulted in Hypocholesterolemia.Oxidative stress and tissue hypoxia may have caused the pancreatic insufficiency, leading to Vitamin D deficiency. This may in turn have caused the secondary hyperparathyroidism to sustain serum Calcium level. Irritability and stress intolerance of the patient was a cumulative effect of the vicious cycle of metabolic compromises. From these findings we propose that the metabolic deficiencies in the ß Thalassemia mutations may be considered as the phenotypic display of the pleotropy to explain the genetic epidemiology. According to the recommendations from the NIH Workshop on Gene-Environment Interplay in Common Complex Diseases: Forging an Integrative Model, study design of observations should be informed by gene-environment hypotheses and results of a study (genetic diseases) should be published to inform future hypotheses. Variety of approaches is needed to capture data on all possible aspects, each of which is likely to contribute to the etiology of disease. Speakers also agreed that there is a need for development of new statistical methods and measurement tools to appraise information that may be missed out by conventional method where large sample size is needed to segregate considerable effect. A meta analytic cohort study in future may bring about significant insight on to the title comment.

Keywords: Genetic disease, Genetic epidemiology, Heterozygous, Phenotype, Pleotropy, ß Thalassemia minor, Metabolic compromises.

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Authors: Yu-Yu Wang, Shih-Hua Hsieh, Ru-Shian Hsieh

Abstract:

Wishes and choices being respected, and the right to be supported rather than coerced, have been internationally recognized as the human rights of persons with mental illness. In Taiwan, ‘coerced hospitalization’ has become difficult since the revision of the mental health legislation in 2007. Despite trend towards human rights, the real problem families face when their family members are in mental health crisis is the lack of alternative services. This study aims to explore: 1) When is hospitalization seen as the only solution by family members? 2) What are the barriers for arranging hospitalization, and how are they managed? 3) What have family carers learned, in their experiences of caring for their family members with mental illness? To answer these questions, qualitative approach was adopted, and focus group interviews were taken to collect data. This study includes 24 family carers. The main findings of this research include: First, hospital is the last resort for carers in helplessness. Family carers tend to do everything they could to provide care at home for their family members with mental illness. Carers seek hospitalization only when a patient’s behavior is too violent, weird, and/or abnormal, and beyond their ability to manage. Hospitalization, nevertheless, is never an easy choice. Obstacles emanate from the attitudes of the medical doctors, the restricted areas of ambulance service, and insufficient information from the carers’ part. On the other hand, with some professionals’ proactive assistance, access to medical care while in crisis becomes possible. Some family carers obtained help from the medical doctor, nurse, therapist and social workers. Some experienced good help from policemen, taxi drivers, and security guards at the hospital. The difficulty in accessing medical care prompts carers to work harder on assisting their family members with mental illness to stay in stable states. Carers found different ways of helping the ‘person’ to get along with the ‘illness’ and have better quality of life. Taking back ‘the right to control’ in utilizing medication, from passiveness to negotiating with medical doctors and seeking alternative therapies, are seen in many carers’ efforts. Besides, trying to maintain regular activities in daily life and play normal family roles are also experienced as important. Furthermore, talking with the patient as a person is also important. The authors conclude that in order to protect the human rights of persons with mental illness, it is crucial to make the medical care system more flexible and to make the services more humane: sufficient information should be provided and communicated, and efforts should be made to maintain the person’s social roles and to support the family.

Keywords: Family carers, coercive treatment, independent living, mental health crisis, persons with mental illness.

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