Search results for: clinical sociology
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 416

Search results for: clinical sociology

206 A Novel Method for the Characterization of Synchronization and Coupling in Multichannel EEG and ECoG

Authors: Manfred Hartmann, Andreas Graef, Hannes Perko, Christoph Baumgartner, Tilmann Kluge

Abstract:

In this paper we introduce a novel method for the characterization of synchronziation and coupling effects in multivariate time series that can be used for the analysis of EEG or ECoG signals recorded during epileptic seizures. The method allows to visualize the spatio-temporal evolution of synchronization and coupling effects that are characteristic for epileptic seizures. Similar to other methods proposed for this purpose our method is based on a regression analysis. However, a more general definition of the regression together with an effective channel selection procedure allows to use the method even for time series that are highly correlated, which is commonly the case in EEG/ECoG recordings with large numbers of electrodes. The method was experimentally tested on ECoG recordings of epileptic seizures from patients with temporal lobe epilepsies. A comparision with the results from a independent visual inspection by clinical experts showed an excellent agreement with the patterns obtained with the proposed method.

Keywords: EEG, epilepsy, regression analysis, seizurepropagation.

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205 Orthosis and Finite Elements: A Study for Development of New Designs through Additive Manufacturing

Authors: M. Volpini, D. Alves, A. Horta, M. Borges, P. Reis

Abstract:

The gait pattern in people that present motor limitations foment the demand for auxiliary locomotion devices. These artifacts for movement assistance vary according to its shape, size and functional features, following the clinical applications desired. Among the ortheses of lower limbs, the ankle-foot orthesis aims to improve the ability to walk in people with different neuromuscular limitations, although they do not always answer patients' expectations for their aesthetic and functional characteristics. The purpose of this study is to explore the possibility of using new design in additive manufacturer to reproduce the shape and functional features of a ankle-foot orthesis in an efficient and modern way. Therefore, this work presents a study about the performance of the mechanical forces through the analysis of finite elements in an ankle-foot orthesis. It will be demonstrated a study of distribution of the stress on the orthopedic device in orthostatism and during the movement in the course of patient's walk.

Keywords: Additive manufacture, new designs, orthoses, finite elements.

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204 Aflatoxins Aggravate the Incidence of Salmonellosis Outbreak in Fattening Calves: A Case Study

Authors: Abdel-Rahman A., El Okle O. S.

Abstract:

Fever, bloody diarrhea and high mortality rate were the main clinical finding in a group of fattening calves. Analysis of corn silage revealed presence of aflatoxins at level of 370 ppb. This level of aflatoxins in the feed of cattle is somewhat low to be the main cause of reported signs. Leukocytopenia, anemia, decreased lymphocytic activity and lowered phagocytic index are the main hematological and immunological alterations in diseased calves. Bacteriological investigation revealed isolation of pathogenic Salmonella typhimurium from the rectal swabs of diseased calves. Our results suggested that, long duration of exposure to aflatoxins even at small concentrations may considered as predisposing factor for the incidence of natural infectious outbreaks as salmonellosis due to its immunosuppressive effect. We can conclude that the veterinarians and owners must be given an attention to the relation between aflatoxicosis and salmonellosis under field condition. We are recommended that the treatment program during similar outbreaks must be including anti-aflatoxins preparations beside the antimicrobial therapy.

Keywords: Aflatoxins, Calves, Salmonellosis.

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203 Decision Tree for Competing Risks Survival Probability in Breast Cancer Study

Authors: N. A. Ibrahim, A. Kudus, I. Daud, M. R. Abu Bakar

Abstract:

Competing risks survival data that comprises of more than one type of event has been used in many applications, and one of these is in clinical study (e.g. in breast cancer study). The decision tree method can be extended to competing risks survival data by modifying the split function so as to accommodate two or more risks which might be dependent on each other. Recently, researchers have constructed some decision trees for recurrent survival time data using frailty and marginal modelling. We further extended the method for the case of competing risks. In this paper, we developed the decision tree method for competing risks survival time data based on proportional hazards for subdistribution of competing risks. In particular, we grow a tree by using deviance statistic. The application of breast cancer data is presented. Finally, to investigate the performance of the proposed method, simulation studies on identification of true group of observations were executed.

Keywords: Competing risks, Decision tree, Simulation, Subdistribution Proportional Hazard.

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202 Placebo Effect on Psychoemotional Status and Clinical Analyses of Armenian Crohn's Disease Patients

Authors: Elya S. Pepoyan, Astghik Z. Pepoyan

Abstract:

The Zung self-depression scale and Beck Anxiety Inventory were used both to study the depression and anxiety levels of Armenian Crohn’s disease patients, and to reveal the relation between emotional status and placebo effect of these patients. On the other hand, the blood cell analyses and gut bacteria investigations were used to assess the placebo effect on ESR, and haemoglobin-s and leukocyte-s levels as well as gut commensal E. coli quantities of these patients. Despite of registered high levels of depression and anxiety, the high placebo effect on psychoemotional status for investigated patients during the investigations was described. On the other hand, no positive effect of placebo on measurements of ESP and hemoglobin-s levels of Crohn’s disease patients was revealed. The importance of use of psychotherapies for optimal outcomes during treatments of Crohn’s disease is discussed.

Keywords: Crohn's disease, emotional disorders, placebo, gut microflora and blood composition.

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201 Family Functionality in Mexican Children with Congenital and Non-Congenital Deafness

Authors: D. Estrella, A. Silva, R. Zapata, H. Rubio

Abstract:

A total of 100 primary caregivers (mothers, fathers, grandparents) with at least one child or grandchild with a diagnosis of congenital bilateral profound deafness were assessed in order to evaluate the functionality of families with a deaf member, who was evaluated by specialists in audiology, molecular biology, genetics and psychology. After confirmation of the clinical diagnosis, DNA from the patients and parents were analyzed in search of the 35delG deletion of the GJB2 gene to determine who possessed the mutation. All primary caregivers were provided psychological support, regardless of whether or not they had the mutation, and prior and subsequent, the family APGAR test was applied. All parents, grandparents were informed of the results of the genetic analysis during the psychological intervention. The family APGAR, after psychological and genetic counseling, showed that 14% perceived their families as functional, 62% moderately functional and 24% dysfunctional. This shows the importance of psychological support in family functionality that has a direct impact on the quality of life of these families.

Keywords: Deafness, psychological support, family, adaptation to disability.

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200 Quantitative Indicator of Abdominal Aortic Aneurysm Rupture Risk Based on its Geometric Parameters

Authors: Guillermo Vilalta, Félix Nieto, Carlos Vaquero, José A. Vilalta

Abstract:

Abdominal aortic aneurysms rupture (AAAs) is one of the main causes of death in the world. This is a very complex phenomenon that usually occurs “without previous warning". Currently, criteria to assess the aneurysm rupture risk (peak diameter and growth rate) can not be considered as reliable indicators. In a first approach, the main geometric parameters of aneurysms have been linked into five biomechanical factors. These are combined to obtain a dimensionless rupture risk index, RI(t), which has been validated preliminarily with a clinical case and others from literature. This quantitative indicator is easy to understand, it allows estimating the aneurysms rupture risks and it is expected to be able to identify the one in aneurysm whose peak diameter is less than the threshold value. Based on initial results, a broader study has begun with twelve patients from the Clinic Hospital of Valladolid-Spain, which are submitted to periodic follow-up examinations.

Keywords: AAA, rupture risk prediction, biomechanical factors, AAA geometric characterization.

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199 Neural Network based Texture Analysis of Liver Tumor from Computed Tomography Images

Authors: K.Mala, V.Sadasivam, S.Alagappan

Abstract:

Advances in clinical medical imaging have brought about the routine production of vast numbers of medical images that need to be analyzed. As a result an enormous amount of computer vision research effort has been targeted at achieving automated medical image analysis. Computed Tomography (CT) is highly accurate for diagnosing liver tumors. This study aimed to evaluate the potential role of the wavelet and the neural network in the differential diagnosis of liver tumors in CT images. The tumors considered in this study are hepatocellular carcinoma, cholangio carcinoma, hemangeoma and hepatoadenoma. Each suspicious tumor region was automatically extracted from the CT abdominal images and the textural information obtained was used to train the Probabilistic Neural Network (PNN) to classify the tumors. Results obtained were evaluated with the help of radiologists. The system differentiates the tumor with relatively high accuracy and is therefore clinically useful.

Keywords: Fuzzy c means clustering, texture analysis, probabilistic neural network, LVQ neural network.

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198 Main Puteri Traditional Malay Healing Ceremony

Authors: M. G. Nasuruddin, S. Ishak

Abstract:

This paper deals with the traditional Malay healing ritualistic ceremony known as Main Puteri. This non-invasive intervention uses the vehicle of performance to administer the healing process. It employs the performance elements of Makyung, that is, music, movements/dance and dramatic dialogue to heal psychosomatic maladies. There are two perspectives to this therapeutic healing process, one traditional and the other scientific. From the traditional perspective, the psychosomatic illness is attributed to the infestations/possessions by malevolent spirits. To heal such patients, these spirits must be exorcised through placating them by making offerings. From the scientific perspective, the music (sonic orders), movements (kinetic energy) and smell (olfactory) connect with the brain waves to release the chemicals that would activate the internal healing energy. Currently, in Main Puteri, the therapeutic healing ritual is no longer relevant as modern clinical medicine has proven to be more effective. Thus, Main Puteri is an anachronism in today’s technologically advanced Malaysia.

Keywords: Exorcism, Main Puteri, Shamans, Therapeutic Healing.

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197 Inflammatory Markers in the Blood and Chronic Periodontitis

Authors: Saimir Heta, Ilma Robo, Nevila Alliu, Tea Meta

Abstract:

Background: Plasma levels of inflammatory markers are the expression of the infectious wastes of existing periodontitis, as well as of existing inflammation everywhere in the body. Materials and Methods: The study consists of the clinical part of the measurement of inflammatory markers of 23 patients diagnosed with chronic periodontitis and the recording of parental periodontal parameters of patient periodontal status: hemorrhage index and probe values, before and 7-10 days after non-surgical periodontal treatment. Results: The level of fibrinogen drops according to the categorization of disease progression, active and passive, with the biggest % (18%-30%) at the fluctuation 10-20 mg/d. Fluctuations in fibrinogen level according to the age of patients in the range 0-10 mg/dL under 40 years and over 40 years was 13%-26%, in the range 10-20 mg/dL was 26%-22%, in the 20-40 mg/dL was 9%-4%. Conclusions: Non-surgical periodontal treatment significantly reduces the level of non-inflammatory markers in the blood. Oral health significantly reduces the potential source for periodontal bacteria, with the potential of promoting thromboembolism, through interaction between thrombocytes.

Keywords: Chronic periodontitis, atherosclerosis, risk factor, inflammatory markers.

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196 Segmenting Ultrasound B-Mode Images Using RiIG Distributions and Stochastic Optimization

Authors: N. Mpofu, M. Sears

Abstract:

In this paper, we propose a novel algorithm for delineating the endocardial wall from a human heart ultrasound scan. We assume that the gray levels in the ultrasound images are independent and identically distributed random variables with different Rician Inverse Gaussian (RiIG) distributions. Both synthetic and real clinical data will be used for testing the algorithm. Algorithm performance will be evaluated using the expert radiologist evaluation of a soft copy of an ultrasound scan during the scanning process and secondly, doctor’s conclusion after going through a printed copy of the same scan. Successful implementation of this algorithm should make it possible to differentiate normal from abnormal soft tissue and help disease identification, what stage the disease is in and how best to treat the patient. We hope that an automated system that uses this algorithm will be useful in public hospitals especially in Third World countries where problems such as shortage of skilled radiologists and shortage of ultrasound machines are common. These public hospitals are usually the first and last stop for most patients in these countries.

Keywords: Endorcardial Wall, Rician Inverse Distributions, Segmentation, Ultrasound Images.

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195 Design of a Pneumonia Ontology for Diagnosis Decision Support System

Authors: Sabrina Azzi, Michal Iglewski, Véronique Nabelsi

Abstract:

Diagnosis error problem is frequent and one of the most important safety problems today. One of the main objectives of our work is to propose an ontological representation that takes into account the diagnostic criteria in order to improve the diagnostic. We choose pneumonia disease since it is one of the frequent diseases affected by diagnosis errors and have harmful effects on patients. To achieve our aim, we use a semi-automated method to integrate diverse knowledge sources that include publically available pneumonia disease guidelines from international repositories, biomedical ontologies and electronic health records. We follow the principles of the Open Biomedical Ontologies (OBO) Foundry. The resulting ontology covers symptoms and signs, all the types of pneumonia, antecedents, pathogens, and diagnostic testing. The first evaluation results show that most of the terms are covered by the ontology. This work is still in progress and represents a first and major step toward a development of a diagnosis decision support system for pneumonia.

Keywords: Clinical decision support system, diagnostic errors, ontology, pneumonia.

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194 Automatically Driven Vector for Guidewire Segmentation in 2D and Biplane Fluoroscopy

Authors: Simon Lessard, Pascal Bigras, Caroline Lau, Daniel Roy, Gilles Soulez, Jacques A. de Guise

Abstract:

The segmentation of endovascular tools in fluoroscopy images can be accurately performed automatically or by minimum user intervention, using known modern techniques. It has been proven in literature, but no clinical implementation exists so far because the computational time requirements of such technology have not yet been met. A classical segmentation scheme is composed of edge enhancement filtering, line detection, and segmentation. A new method is presented that consists of a vector that propagates in the image to track an edge as it advances. The filtering is performed progressively in the projected path of the vector, whose orientation allows for oriented edge detection, and a minimal image area is globally filtered. Such an algorithm is rapidly computed and can be implemented in real-time applications. It was tested on medical fluoroscopy images from an endovascular cerebral intervention. Ex- periments showed that the 2D tracking was limited to guidewires without intersection crosspoints, while the 3D implementation was able to cope with such planar difficulties.

Keywords: Edge detection, Line Enhancement, Segmentation, Fluoroscopy.

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193 Performance Evaluation of an Amperometric Biosensor using a Simple Microcontroller based Data Acquisition System

Authors: V. G. Sangam, Balasaheb M. Patre

Abstract:

In this paper we have proposed a methodology to develop an amperometric biosensor for the analysis of glucose concentration using a simple microcontroller based data acquisition system. The work involves the development of Detachable Membrane Unit (enzyme based biomembrane) with immobilized glucose oxidase on the membrane and interfacing the same to the signal conditioning system. The current generated by the biosensor for different glucose concentrations was signal conditioned, then acquired and computed by a simple AT89C51-microcontroller. The optimum operating parameters for the better performance were found and reported. The detailed performance evaluation of the biosensor has been carried out. The proposed microcontroller based biosensor system has the sensitivity of 0.04V/g/dl, with a resolution of 50mg/dl. It has exhibited very good inter day stability observed up to 30 days. Comparing to the reference method such as HPLC, the accuracy of the proposed biosensor system is well within ± 1.5%. The system can be used for real time analysis of glucose concentration in the field such as, food and fermentation and clinical (In-Vitro) applications.

Keywords: Biosensor, DMU, Glucose oxidase andMicrocontroller.

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192 The SAFRS System : A Case-Based Reasoning Training Tool for Capturing and Re-Using Knowledge

Authors: Souad Demigha

Abstract:

The paper aims to specify and build a system, a learning support in radiology-senology (breast radiology) dedicated to help assist junior radiologists-senologists in their radiologysenology- related activity based on experience of expert radiologistssenologists. This system is named SAFRS (i.e. system supporting the training of radiologists-senologists). It is based on the exploitation of radiologic-senologic images (primarily mammograms but also echographic images or MRI) and their related clinical files. The aim of such a system is to help breast cancer screening in education. In order to acquire this expert radiologist-senologist knowledge, we have used the CBR (case-based reasoning) approach. The SAFRS system will promote the evolution of teaching in radiology-senology by offering the “junior radiologist" trainees an advanced pedagogical product. It will permit a strengthening of knowledge together with a very elaborate presentation of results. At last, the know-how will derive from all these factors.

Keywords: Learning support, radiology-senology, training, education, CBR, accumulated experience.

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191 Mass Casualty Acute Pepper Spray Inhalation Respiratory Effect Severity

Authors: B. Michelle Sweeting

Abstract:

Pepper spray use has gained momentum since 1992 and although the active ingredient is readily available, it is considered a weapon with restricted use in many regions, including The Bahamas. In light of controversy in the literature regarding the severity of presenting respiration complaints among individuals postacute exposure of pepper spray inhalation, this descriptive case series study was conducted to assess the respiratory status of persons evaluated during a mass casualty in The Bahamas. Parameters noted were patients- demographics and respiration severity determined via clinical examination findings, disposition and follow-up review of the 20 persons. Their most common complaint was difficulty breathing post exposure. Two required admission and stayed for <24 hours uneventfully. All cases remained without residual complaints upon follow-up. Results showed that although respiration difficulty was perceived as the most detrimental of presenting complaints, it was noted to be mostly subjective with benign outcome.

Keywords: Acute Pepper Spray Inhalation, Capsaicinoids, Oleoresin Capsicum, Pepper spray, Respiratory severity severity.

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190 Efficient Feature-Based Registration for CT-M R Images Based on NSCT and PSO

Authors: Nemir Al-Azzawi, Harsa A. Mat Sakim, Wan Ahmed K. Wan Abdullah, Yasmin Mohd Yacob

Abstract:

Feature-based registration is an effective technique for clinical use, because it can greatly reduce computational costs. However, this technique, which estimates the transformation by using feature points extracted from two images, may cause misalignments. To handle with this limitation, we propose to extract the salient edges and extracted control points (CP) of medical images by using efficiency of multiresolution representation of data nonsubsampled contourlet transform (NSCT) that finds the best feature points. The MR images were first decomposed using the NSCT, and then Edge and CP were extracted from bandpass directional subband of NSCT coefficients and some proposed rules. After edge and CP extraction, mutual information was adopted for the registration of feature points and translation parameters are calculated by using particle swarm optimization (PSO). The experimental results showed that the proposed method produces totally accurate performance for registration medical CT-MR images.

Keywords: Feature-based registration, mutual information, nonsubsampled contourlet transform, particle swarm optimization.

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189 Proportion and Factors Associated with Presumptive Tuberculosis among Suspected Pediatric TB Patients

Authors: Naima Nur, Safa Islam, Saeema Islam, Md. Faridul Alam

Abstract:

The study addresses the increasing challenge of pediatric presumptive tuberculosis, emphasizing the need to understand the factors associated with it. The research aims to determine the proportion of presumptive TB and factors associated with it among suspected pediatric tuberculosis patients. A cross-sectional study was conducted at ICDDR-Bangladesh, collecting specimens from suspected pediatric patients and using logistic regression for data analysis. The study found a high proportion of presumptive TB (85.7%) but no statistically significant differences between presumptive and non-presumptive TB. Theoretical importance of the study highlights the importance of identifying factors associated with presumptive TB for better control and management strategies. Specimens were collected from 84 suspected pediatric patients diagnosed with TB based on clinical symptoms/radiological findings. Microbiological tests like smear-microscopy, culture, and GeneXpert were used to isolate presumptive TB and confirmed TB. The proportion of presumptive TB was 85.7% among suspected pediatric TB patients. Among various factors that were not found to be associated with the presumptive TB. The study concludes that despite a high proportion of presumptive TB, no significant differences were found between presumptive and non-presumptive TB cases.

Keywords: Presumptive tuberculosis, confirmed tuberculosis, patient's characteristics, diagnosis.

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188 Voice Disorders Identification Using Hybrid Approach: Wavelet Analysis and Multilayer Neural Networks

Authors: L. Salhi, M. Talbi, A. Cherif

Abstract:

This paper presents a new strategy of identification and classification of pathological voices using the hybrid method based on wavelet transform and neural networks. After speech acquisition from a patient, the speech signal is analysed in order to extract the acoustic parameters such as the pitch, the formants, Jitter, and shimmer. Obtained results will be compared to those normal and standard values thanks to a programmable database. Sounds are collected from normal people and patients, and then classified into two different categories. Speech data base is consists of several pathological and normal voices collected from the national hospital “Rabta-Tunis". Speech processing algorithm is conducted in a supervised mode for discrimination of normal and pathology voices and then for classification between neural and vocal pathologies (Parkinson, Alzheimer, laryngeal, dyslexia...). Several simulation results will be presented in function of the disease and will be compared with the clinical diagnosis in order to have an objective evaluation of the developed tool.

Keywords: Formants, Neural Networks, Pathological Voices, Pitch, Wavelet Transform.

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187 Biomechanical Findings in Patients with Bipartite Medial Cuneiforms

Authors: Aliza Lee, Mark Wilt, John Bonk, Scott Floyd, Bradley Hoffman, Karen Uchmanowicz

Abstract:

Bipartite medial cuneiforms are relatively rare but may play a significant role in biomechanical and gait abnormalities. It is believed that a bipartite medial cuneiform may alter the available range of motion due to its larger morphological variant, thus limiting the metatarsal plantarflexion needed to achieve adequate hallux dorsiflexion for normal gait. Radiographic and clinical assessment were performed on two patients who reported with foot pain along the first ray. Both patients had visible bipartite medial cuneiforms on MRI. Using gait plate and Metascan ™ analysis, both were noted to have four measurements far beyond the expected range. Medial and lateral heel peak pressure, hallux peak pressure, and 1st metatarsal peak pressure were all noted to be increased. These measurements are believed to be increased due to the hindrance placed on the available ROM of the first ray by the increased size of the medial cuneiform. A larger patient population would be needed to fully understand this developmental anomaly.

Keywords: Bipartite medial cuneiforms, cuneiform, developmental anomaly, gait abnormality.

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186 Ultrasonographic Manifestations of Periventricular Leukomalacia in Preterm Neonates at Teaching Hospital Peradeniya, Sri Lanka

Authors: P. P. Chandrasekera, P. B. Hewavithana, S. Rosario, M. H. M. N. Hearth, D. M. R. D. Mirihella

Abstract:

Periventricular Leukomalacia (PVL) is a White Matter Injury (WMI) of preterm neonatal brain. Objectives of the study were to assess the neuro-developmental outcome at one year of age and to determine a good protocol of cranial ultrasonography to detect PVL. Two hundred and sixty four preterm neonates were included in the study. Series of cranial ultrasound scans were done by using a dedicated neonatal head probe 4-10 MHz of Logic e portable ultrasound scanner. Clinical history of seizures, abnormal head growth (hydrocephalus or microcephaly) and developmental milestones were assessed and neurological examinations were done until one year of age. Among live neonates, 57% who had cystic PVL (Grades 2 and 3) manifested as cerebral palsy. In conclusion cystic PVL has permanent neurological disabilities like cerebral palsy. Good protocol of real time cranial ultrasonography to detect PVL is to perform scans at least once a week until one month and at term (40 weeks of gestation).

Keywords: Cerebral palsy, cranial ultrasonography, Periventricular Leukomalacia (PVL), preterm neonates.

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185 Scatterer Density in Nonlinear Diffusion for Speckle Reduction in Ultrasound Imaging: The Isotropic Case

Authors: Ahmed Badawi

Abstract:

This paper proposes a method for speckle reduction in medical ultrasound imaging while preserving the edges with the added advantages of adaptive noise filtering and speed. A nonlinear image diffusion method that incorporates local image parameter, namely, scatterer density in addition to gradient, to weight the nonlinear diffusion process, is proposed. The method was tested for the isotropic case with a contrast detail phantom and varieties of clinical ultrasound images, and then compared to linear and some other diffusion enhancement methods. Different diffusion parameters were tested and tuned to best reduce speckle noise and preserve edges. The method showed superior performance measured both quantitatively and qualitatively when incorporating scatterer density into the diffusivity function. The proposed filter can be used as a preprocessing step for ultrasound image enhancement before applying automatic segmentation, automatic volumetric calculations, or 3D ultrasound volume rendering.

Keywords: Ultrasound imaging, Nonlinear isotropic diffusion, Speckle noise, Scattering.

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184 Poincaré Plot for Heart Rate Variability

Authors: Mazhar B. Tayel, Eslam I. AlSaba

Abstract:

Heart is the most important part in the body of living organisms. It affects and is affected by any factor in the body. Therefore, it is a good detector for all conditions in the body. Heart signal is a non-stationary signal; thus, it is utmost important to study the variability of heart signal. The Heart Rate Variability (HRV) has attracted considerable attention in psychology, medicine and has become important dependent measure in psychophysiology and behavioral medicine. The standards of measurements, physiological interpretation and clinical use for HRV that are most often used were described in many researcher papers, however, remain complex issues are fraught with pitfalls. This paper presents one of the nonlinear techniques to analyze HRV. It discusses many points like, what Poincaré plot is and how Poincaré plot works; also, Poincaré plot's merits especially in HRV. Besides, it discusses the limitation of Poincaré cause of standard deviation SD1, SD2 and how to overcome this limitation by using complex correlation measure (CCM). The CCM is most sensitive to changes in temporal structure of the Poincaré plot as compared toSD1 and SD2.

Keywords: Heart rate variability, chaotic system, Poincaré, variance, standard deviation, complex correlation measure.

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183 Identification of Regulatory Mechanism of Orthostatic Response

Authors: E. Hlavacova, J. Chrenova, Z. Rausova, M. Vlcek, A. Penesova, L. Dedik

Abstract:

En bloc assumes modeling all phases of the orthostatic test with the only one mathematical model, which allows the complex parametric view of orthostatic response. The work presents the implementation of a mathematical model for processing of the measurements of systolic, diastolic blood pressure and heart rate performed on volunteers during orthostatic test. The original assumption of model hypothesis that every postural change means only one Stressor, did not complying with the measurements of physiological circulation factor-time profiles. Results of the identification support the hypothesis that second postural change of orthostatic test causes induced Stressors, with the observation of a physiological regulation mechanism. Maximal demonstrations are on the heart rate and diastolic blood pressure-time profile, minimal are for the measurements of the systolic blood pressure. Presented study gives a new view on orthostatic test with impact on clinical practice.

Keywords: En bloc modeling, physiological circulatory factor, postural change, stressor

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182 The Effect of Binahong to Hematoma

Authors: Sri Sumartiningsih

Abstract:

In elevating performance in competetive sports, an athlete must continously train in achieving maximum performance,but needs to pay attention to recovery therapy, that is to recover from fatigue as well as injury.The correct recovery therapy will assist in process of recovery and helps in the training in achieving better performace. Binahong (Anredera cordifolia) was proven empirically by the locals in assisting speedy recovery from an injury.Clinical research with lab animals receiving blunt trauma injury, microscopically shown signs of: 1) redness, 2) heatiness, 3) swelling and, 4) lack of activity. There is also microscopic indication of: 1) infiltration of inflame cells (migration of cells to the trauma area), 2) Cells necrosis, 3) Congestion (as a result of dead red blood cells), 4) uedema. On administration of Binahong for 3 days, there is a significant drop of 5% in cell inflammation, 2% increase of fibroblast (cell membrance) count.Conclutin: Binahong do assist in reducing cell inflammation and increase counts of cells fibroblast. Suggestion: In helping athlete's to recover from force injury, we need study about Binahong's roots to inflammation cell and healing of injuried cell.

Keywords: Binahong, sport injury, hematoma

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181 Feasibility of Risk Assessment for Type 2 Diabetes in Community Pharmacies Using Two Different Approaches: A Pilot Study in Thailand

Authors: Thitaporn Thoopputra, Tipaporn Pongmesa, Shuchuen Li

Abstract:

Aims: To evaluate the application of non-invasive diabetes risk assessment tool in community pharmacy setting. Methods: Thai diabetes risk score was applied to assess individuals at risk of developing type 2 diabetes. Interactive computer-based risk screening (IT) and paper-based risk screening (PT) tools were applied. Participants aged over 25 years with no known diabetes were recruited in six participating pharmacies. Results: A total of 187 clients, mean aged (+SD) was 48.6 (+10.9) years. 35% were at high risk. The mean value of willingness-to-pay for the service fee in IT group was significantly higher than PT group (p=0.013). No significant difference observed for the satisfaction between groups. Conclusions: Non-invasive risk assessment tool, whether paper-based or computerized-based can be applied in community pharmacy to support the enhancing role of pharmacists in chronic disease management. Long term follow up is needed to determine the impact of its application in clinical, humanistic and economic outcomes.

Keywords: Community pharmacy, intervention, prevention, risk assessment, type 2 diabetes.

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180 Understanding ICT Behaviors among Health Workers in Sub-Saharan Africa: A Cross-Sectional Study for Laboratory Persons in Uganda

Authors: M. Kasusse, M. Rosette, E. Burke, C. Mwangi, R. Batamwita, N. Tumwesigye, S. Aisu

Abstract:

A cross-sectional survey to ascertain the capacity of laboratory persons in using ICTs was conducted in 15 Ugandan districts (July-August 2013). A self-administered questionnaire served as data collection tool, interview guide and observation checklist. 69 questionnaires were filled, 12 interviews conducted, 45 HC observed. SPSS statistics 17.0 and SAS 9.2 software were used for entry and analyses. 69.35% of participants find it difficult to access a computer at work. Of the 30.65% who find it easy to access a computer at work, a significant 21.05% spend 0 hours on a computer daily. 60% of the participants cannot access internet at work. Of the 40% who have internet at work, a significant 20% lack email address but 20% weekly read emails weekly and 48% daily. It is viable/feasible to pilot informatics projects as strategies to build bridges develop skills for e-health landscape in laboratory services with a bigger financial muscle.

Keywords: ICT Behavior, Clinical Laboratory persons, Sub-Saharan Africa, Uganda.

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179 Quadratic Pulse Inversion Ultrasonic Imaging(QPI): A Two-Step Procedure for Optimization of Contrast Sensitivity and Specificity

Authors: Mamoun F. Al-Mistarihi

Abstract:

We have previously introduced an ultrasonic imaging approach that combines harmonic-sensitive pulse sequences with a post-beamforming quadratic kernel derived from a second-order Volterra filter (SOVF). This approach is designed to produce images with high sensitivity to nonlinear oscillations from microbubble ultrasound contrast agents (UCA) while maintaining high levels of noise rejection. In this paper, a two-step algorithm for computing the coefficients of the quadratic kernel leading to reduction of tissue component introduced by motion, maximizing the noise rejection and increases the specificity while optimizing the sensitivity to the UCA is presented. In the first step, quadratic kernels from individual singular modes of the PI data matrix are compared in terms of their ability of maximize the contrast to tissue ratio (CTR). In the second step, quadratic kernels resulting in the highest CTR values are convolved. The imaging results indicate that a signal processing approach to this clinical challenge is feasible.

Keywords: Volterra Filter, Pulse Inversion, Ultrasonic Imaging, Contrast Agent.

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178 Finite Element Analysis of Full Ceramic Crowns with and without Zirconia Framework

Authors: Porojan S., Sandu L., Topală F.

Abstract:

Simulation of occlusal function during laboratory material-s testing becomes essential in predicting long-term performance before clinical usage. The aim of the study was to assess the influence of chamfer preparation depth on failure risk of heat pressed ceramic crowns with and without zirconia framework by means of finite element analysis. 3D models of maxillary central incisor, prepared for full ceramic crowns with different depths of the chamfer margin (between 0.8 and 1.2 mm) and 6-degree tapered walls together with the overlying crowns were generated using literature data (Fig. 1, 2). The crowns were designed with and without a zirconia framework with a thickness of 0.4 mm. For all preparations and crowns, stresses in the pressed ceramic crown, zirconia framework, pressed ceramic veneer, and dentin were evaluated separately. The highest stresses were registered in the dentin. The depth of the preparations had no significant influence on the stress values of the teeth and pressed ceramics for the studied cases, only for the zirconia framework. The zirconia framework decreases the stress values in the veneer.

Keywords: Finite element analysis, full ceramic crown, zirconia framework, stresses.

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177 A Comparison of Transdiagnostic Components in Generalized Anxiety Disorder, Unipolar Mood Disorder and Nonclinical Population

Authors: I. Abasi, L. Fata, M. Sadeghi, S. Banihashemi, A. Mohammadee

Abstract:

Background: Dimensional and transdiagnostic approaches as a result of high comorbidity among mental disorders have captured researchers and clinicians interests for exploring the latent factors to development and maintenance of some psychological disorders. The goal of present study is comparing some of these common factors between generalized anxiety disorder and unipolar mood disorder. Methods: 27 patients with generalized anxiety disorder, 29 patients with depression disorder were recruited by using SCID-I and 69 non-clinical populations were selected by using GHQ cut off point. MANCOVA was used for analyzing data. Results: The results show that worry, rumination, intolerance of uncertainty, maladaptive metacognitive beliefs, and experiential avoidance were all significantly different between GAD and unipolar mood disorder groups. However, there weren’t any significant differences in difficulties in emotion regulation and neuroticism between GAD and unipolar mood disorder groups. Discussion: Results indicate that although there are some transdiagnostic and common factors in GAD and unipolar mood disorder, there may be some specific vulnerability factors for each disorder. Further study is needed for answering these questions.

Keywords: Depression, emotion regulation, generalized anxiety disorder, transdiagnostic.

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