Search results for: Medical Imaging

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

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

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

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

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

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

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Authors: Ticijana Prijon, Branko Ermenc

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

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

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Authors: Saule Mussabekova

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

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

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

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

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

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

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

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

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Authors: Shankar Subramanian Iyer

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

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

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Authors: Wan-I Lee, Nelio Mendoza Figueredo

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

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

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Authors: Chun-Lang Chang

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

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

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

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

Keywords: Correlation, hypertension, Iraq, risk factors.

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Authors: P. V. Pramila, V. Mahesh

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

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

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Authors: Hind Bouami, Patrick Millot

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

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

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

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

Keywords: Asthma, Respiratory disease, Smoker.

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Authors: Abdullah Faqihi, John Hedley

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

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

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

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

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

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Authors: Excellence Favor, Bakari M. M. Mwinyiwiwa

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

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

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Authors: Mustafa M. Donma, Orkide Donma

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

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

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

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

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

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Authors: Tomio Iwasaki, Yosuke Kawahito

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

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

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Authors: Ibrahim Abubakar Alkali, Abubakar Sarkile Kawuwa, Ibrahim Sani Khalil

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The concept of space and function forms the bedrock for spatial configuration in architectural design. Thus, the effectiveness and functionality of an architectural product depends their cordial relationship. This applies to all buildings especially to a hospital ward setting designed to accommodate various complex and diverse functions. Health care facilities design, especially an inpatient setting, is governed by many regulations and technical requirements. It is also affected by many less defined needs, particularly, response to culture and the need to provide for patient families’ presence and participation. The spatial configuration of the hospital ward setting in developing countries has no consideration for the patient’s families despite the significant role they play in promoting recovery. Attempts to integrate facilities for patients’ families have always been challenging, especially in developing countries like Nigeria, where accommodation for inpatients is predominantly in an open ward system. In addition, the situation is compounded by culture, which significantly dictates healthcare practices in Africa. Therefore, achieving such a hospital ward setting that is patient and family-centered requires careful assessment of family care actions and transaction spaces so as to arrive at an evidence based solution. Therefore, the aim of this study is to identify how hospital ward spaces can be reconfigured to provide for sustainable family integration. In achieving this aim, a qualitative approach using the principles of behavioral mapping was employed in male and female medical wards of the Federal Teaching Hospital (FTH) Gombe, Nigeria. The data obtained was analysed using classical and comparative content analysis. Patients’ families have been found to be a critical component of hospital ward design that cannot be undermined. Accordingly, bedsides, open yards, corridors and foyers have been identified as patient families’ transaction spaces that require design attention. Arriving at sustainable family integration can be achieved by revisiting the design requirements of the family transaction spaces based on the findings in order to avoid the rowdiness of the wards and uncoordinated sprawl.

Keywords: Caregiving, design basics, family integration, hospital ward, sustainability.

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Authors: Naoto Suzuki

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A decline in visual sensitivity at arbitrary points on the retina can be measured using a precise perimetry apparatus along with a fundus camera. However, the retinal layer associated with this decline cannot be identified accurately with current medical technology. To investigate cryptogenic diseases, such as macular dystrophy, acute zonal occult outer retinopathy (AZOOR), and multiple evanescent white dot syndrome (MEWDS), we evaluated an electroretinogram (ERG) function that allows moving the center of the multifocal hexagonal stimulus array to a chosen position. Macular dystrophy is a generalized term used for a variety of functional disorders of the macula lutea, and the ERG shows a diminution of the b-wave in these disorders. AZOOR causes an acute functional disorder to an outer layer of the retina, and the ERG shows a-wave and b-wave amplitude reduction as well as delayed 30 Hz flicker responses. MEWDS causes acute visual loss and the ERG shows a decrease in a-wave amplitude. We combined an electroretinographic optical system and a perimetric optical system into an experimental apparatus that has the same optical system as that of a fundus camera. We also deployed an EO-50231 Edmund infrared camera, a 45-degree cold mirror, a lens with a 25-mm focal length, a halogen lamp, and an 8-inch monitor. Then, we also employed a differential amplifier with gain 10, a 50 Hz notch filter, a high-pass filter with a 21.2 Hz cut-off frequency, and two non-inverting amplifiers with gains 1001 and 11. In addition, we used a USB-6216 National Instruments I/O device, a NE-113A Nihon Kohden plate electrode, a SCB-68A shielded connector block, and LabVIEW 2017 software for data retrieval. The software was used to generate the multifocal hexagonal stimulus array on the computer monitor with C++Builder 10.2 and to move the center of the array toward the left and right and up and down. Cone and bright flash ERG results were observed using the moving ERG function. The a-wave, b-wave, c-wave, and the photopic negative response were identified with cone ERG. The moving ERG function allowed the identification of the retinal layer causing visual alterations.

Keywords: Moving ERG, multifocal ERG, precise perimetry, retinal layers, visual sensitivity

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Authors: Lei Zhao, Yi Song, Tim Dunne, Jiaxiang (Jason) Ren, Wenhan Yue, Lei Yang, Li Wen, Yu Liu

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Fasting dissolving magnesium (DM) alloy technology has contributed significantly to the “Shale Revolution” in oil and gas industry. This application requires DM downhole tools dissolving initially at a slow rate, rapidly accelerating to a high rate after certain period of operation time (typically 8 h to 2 days), a contradicting requirement that can hardly be addressed by traditional Mg alloying or processing itself. Premature disintegration has been broadly reported in downhole DM tool from field trials. To address this issue, “temporary” thin polymers of various formulations are currently coated onto DM surface to delay its initial dissolving. Due to conveying parts, harsh downhole condition, and high dissolving rate of the base material, the current delay coatings relying on pure polymers are found to perform well only at low temperature (typical < 100 ℃) and parts without sharp edges or corners, as severe geometries prevent high quality thin film coatings from forming effectively. In this study, a coating technology combining Plasma Electrolytic Oxide (PEO) coatings with advanced thin film deposition has been developed, which can delay DM complex parts (with sharp corners) in corrosive fluid at 150 ℃ for over 2 days. Synergistic effects between porous hard PEO coating and chemical inert elastic-polymer sealing leads to its delaying dissolution improvement, and strong chemical/physical bonding between these two layers has been found to play essential role. Microstructure of this advanced coating and compatibility between PEO and various polymer selections has been thoroughly investigated and a model is also proposed to explain its delaying performance. This study could not only benefit oil and gas industry to unplug their High Temperature High Pressure (HTHP) unconventional resources inaccessible before, but also potentially provides a technical route for other industries (e.g., bio-medical, automobile, aerospace) where primer anti-corrosive protection on light Mg alloy is highly demanded.

Keywords: Dissolvable magnesium, coating, plasma electrolytic oxide, sealer.

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Authors: Ayelet Gur

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Background: In recent years we are witnessing a welcome trend in which more children/persons with disabilities are living at home with their families and within their communities. This trend is related to various policy innovations as the UN Convention on the Rights of People with Disabilities that reflect a shift from the medical-institutional model to a human rights approach. We also witness the emergence of family centered approaches that perceive the family and not just the individual with the disability as a worthy target of policy planning, implementation and evaluation efforts. The current investigation aims to explore economic, psychological and social factors among households of families of children or adults with intellectual disabilities in Israel and to present policy recommendation. Methods: A national sample of 301 households was recruited through the education and employment settings of persons with intellectual disability. The main caregiver of the person with the disability (a parent) was interviewed. Measurements included the income and expense surveys; assets and debts questionnaire; the questionnaire on resources and stress; the social involvement questionnaire and Personal Wellbeing Index. Results: Findings indicate significant gaps in financial circumstances between households of families of children with intellectual disabilities and households of the general Israeli society. Households of families of children with intellectual disabilities report lower income and higher expenditures and loans than the general society. They experience difficulties in saving and coping with unexpected expenses. Caregivers (the parents) experience high stress, low social participation, low financial support from family, friend and non-governmental organizations and decreased well-being. They are highly dependent on social security allowances which constituted 40% of the household's income. Conclusions: Households' dependency on social security allowances may seem contradictory to the encouragement of persons with intellectual disabilities to favor independent living in light of the human rights approach to disability. New policy should aim at reducing caregivers' stress and enhance their social participation and support, with special emphasis on families of lower socio-economic status. Finally, there is a need to continue monitoring the economic and psycho-social needs of households of families of children with intellectual disabilities and other developmental disabilities.

Keywords: Disability policy, family policy, intellectual and developmental disabilities, Israel, households study, parents of children with disabilities.

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Authors: W. Kritsarikan, T. Patcharawit, T. Yingnakorn, S. Khumkoa

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Neodymium-iron-boron (NdFeB) magnets classified as high-power magnets are widely used in various applications such as automotive, electrical and medical devices. Because significant amounts of rare earth metals will be subjected to shortages in the future, therefore domestic NdFeB magnet waste recycling should therefore be developed in order to reduce social and environmental impacts towards a circular economy. Each type of wastes has different characteristics and compositions. As a result, these directly affect recycling efficiency as well as types and purity of the recyclable products. This research, therefore, focused on the recycling of manufacturing NdFeB magnet waste obtained from the sintering stage of magnet production and the waste contained 23.6% Nd, 60.3% Fe and 0.261% B in order to recover high purity neodymium oxide (Nd2O3) using hybrid metallurgical process via oxidative roasting and selective leaching techniques. The sintered NdFeB waste was first ground to under 70 mesh prior to oxidative roasting at 550–800 oC to enable selective leaching of neodymium in the subsequent leaching step using H2SO4 at 2.5 M over 24 h. The leachate was then subjected to drying and roasting at 700–800 oC prior to precipitation by oxalic acid and calcination to obtain Nd2O3 as the recycling product. According to XRD analyses, it was found that increasing oxidative roasting temperature led to an increasing amount of hematite (Fe2O3) as the main composition with a smaller amount of magnetite (Fe3O4) found. Peaks of Nd2O3 were also observed in a lesser amount. Furthermore, neodymium iron oxide (NdFeO3) was present and its XRD peaks were pronounced at higher oxidative roasting temperatures. When proceeded to acid leaching and drying, iron sulfate and neodymium sulfate were mainly obtained. After the roasting step prior to water leaching, iron sulfate was converted to form Fe2O3 as the main compound, while neodymium sulfate remained in the ingredient. However, a small amount of Fe3O4 was still detected by XRD. The higher roasting temperature at 800 oC resulted in a greater Fe2O3 to Nd2(SO4)3 ratio, indicating a more effective roasting temperature. Iron oxides were subsequently water leached and filtered out while the solution contained mainly neodymium sulfate. Therefore, low oxidative roasting temperature not exceeding 600 oC followed by acid leaching and roasting at 800 oC gave the optimum condition for further steps of precipitation and calcination to finally achieve Nd2O3.

Keywords: NdFeB magnet waste, oxidative roasting, recycling, selective leaching

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Authors: Anupam Bhatia

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Upon reviewing the literature and the pragmatic work done in the field of E- textiles, it is observed that the applications of wearable technologies have found a steady growth in the field of military, medical, industrial, sports; whereas fashion is at a loss to know how to treat this technology and bring it to market. The purpose of this paper is to understand the practical issues of integration of electronics in garments; cutting patterns for mass production, maintaining the basic properties of textiles and daily maintenance of garments that hinder the wide adoption of interactive fabric technology within Fashion and leisure wear. To understand the practical hindrances an experimental and laboratory approach is taken. “Techno Meets Fashion” has been an interactive fashion project where sensor technologies have been embedded with textiles that result in set of ensembles that are light emitting garments, sound sensing garments, proximity garments, shape memory garments etc. Smart textiles, especially in the form of textile interfaces, are drastically underused in fashion and other lifestyle product design. Clothing and some other textile products must be washable, which subjects to the interactive elements to water and chemical immersion, physical stress, and extreme temperature. The current state of the art tends to be too fragile for this treatment. The process for mass producing traditional textiles becomes difficult in interactive textiles. As cutting patterns from larger rolls of cloth and sewing them together to make garments breaks and reforms electronic connections in an uncontrolled manner. Because of this, interactive fabric elements are integrated by hand into textiles produced by standard methods. The Arduino has surely made embedding electronics into textiles much easier than before; even then electronics are not integral to the daily wear garments. Soft and flexible interfaces of MEMS (micro sensors and Micro actuators) can be an option to make this possible by blending electronics within E-textiles in a way that’s seamless and still retains functions of the circuits as well as the garment. Smart clothes, which offer simultaneously a challenging design and utility value, can be only mass produced if the demands of the body are taken care of i.e. protection, anthropometry, ergonomics of human movement, thermo- physiological regulation.

Keywords: Ambient Intelligence, Proximity Sensors, Shape Memory Materials, Sound sensing garments, Wearable Technology.

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Authors: M. Garcia-Alsina, J. Cobarsí

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The role of controlled vocabularies in information retrieval is broadly recognized as a relevant feature. Besides, there is a standing demand that editors and databases should consider the effective introduction of controlled vocabularies in their procedures to index scientific literature. That is especially important because information retrieval is pointed out as a significant point to drive systematic literature review. Hence, a first question emerges: Are the controlled vocabularies at this moment considered? On the other hand, subject searching in the catalogs is complex mainly due to the dichotomy between keywords from authors versus keywords based on controlled vocabularies. Finally, there is some demand to unify the terminology related to health to make easier the medical history exploitation and research. Considering these features, this paper focuses on controlled vocabularies related to the health field and their role for storing, classifying, and retrieving relevant literature. The objective is knowing which role plays the controlled vocabularies related to the health field to index and retrieve research literature in data bases such as Web of Science (WoS) and Scopus. So, this exploratory research is grounded over two research questions: 1) Which are the terms considered in specific controlled vocabularies of the health field; and 2) How papers are indexed in relevant databases to be easily retrieved, considering keywords vs specific health’ controlled vocabularies? This research takes as fieldwork the controlled vocabularies related to health and the scientific interest for 1918 flu pandemic, also known equivocally as ‘Spanish flu’. This interest has been fostered by the emergence in the early 21st of epidemics of pneumonic diseases caused by virus. Searches about and with controlled vocabularies on WoS and Scopus databases are conducted. First results of this work in progress are surprising. There are different controlled vocabularies for the health field, into which the terms collected and preferred related to ‘1918 pandemic’ are identified. To summarize, ‘Spanish influenza epidemic’ or ‘Spanish flu’ are collected as not preferred terms. The preferred terms are: ‘influenza’ or ‘influenza pandemic, 1918-1919’. Although the controlled vocabularies are clear in their election, most of the literature about ‘1918 pandemic’ is retrievable either by ‘Spanish’ or by ‘1918’ disjunct, and the dominant word to retrieve literature is ‘Spanish’ rather than ‘1918’. This is surprising considering the existence of suitable controlled vocabularies related to health topics, and the modern guidelines of World Health Organization concerning naming of diseases that point out to other preferred terms. A first conclusion is the failure of using controlled vocabularies for a field such as health, and in consequence for WoS and Scopus. This research opens further research questions about which is the role that controlled vocabularies play in the instructions to authors that journals deliver to documents’ authors.

Keywords: Controlled vocabularies, indexing, 1918 influenza, information retrieval, keywords, 1918 pandemic, scientific databases.

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Authors: Zsolt János Viharos, Krisztián Balázs Kis, Imre Paniti, Gábor Belső, Péter Németh, János Farkas

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The paper presents the results and industrial applications in the production setup period estimation based on industrial data inherited from the field of polymer cutting. The literature of polymer cutting is very limited considering the number of publications. The first polymer cutting machine is known since the second half of the 20th century; however, the production of polymer parts with this kind of technology is still a challenging research topic. The products of the applying industrial partner must met high technical requirements, as they are used in medical, measurement instrumentation and painting industry branches. Typically, 20% of these parts are new work, which means every five years almost the entire product portfolio is replaced in their low series manufacturing environment. Consequently, it requires a flexible production system, where the estimation of the frequent setup periods' lengths is one of the key success factors. In the investigation, several (input) parameters have been studied and grouped to create an adequate training information set for an artificial neural network as a base for the estimation of the individual setup periods. In the first group, product information is collected such as the product name and number of items. The second group contains material data like material type and colour. In the third group, surface quality and tolerance information are collected including the finest surface and tightest (or narrowest) tolerance. The fourth group contains the setup data like machine type and work shift. One source of these parameters is the Manufacturing Execution System (MES) but some data were also collected from Computer Aided Design (CAD) drawings. The number of the applied tools is one of the key factors on which the industrial partners’ estimations were based previously. The artificial neural network model was trained on several thousands of real industrial data. The mean estimation accuracy of the setup periods' lengths was improved by 30%, and in the same time the deviation of the prognosis was also improved by 50%. Furthermore, an investigation on the mentioned parameter groups considering the manufacturing order was also researched. The paper also highlights the manufacturing introduction experiences and further improvements of the proposed methods, both on the shop floor and on the quotation preparation fields. Every week more than 100 real industrial setup events are given and the related data are collected.

Keywords: Artificial neural network, low series manufacturing, polymer cutting, setup period estimation.

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Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires were returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age ranges from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge; however, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non- significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: Gene Profiling, Knowledge, Malaysia, Physician.

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: Home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis.

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

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Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: Advanced palliative aquatics care, magnetic field therapy, medical device, research design.

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