Search results for: forensic medicine.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 238

Search results for: forensic medicine.

58 Basic Science Medical Students’ Perception of a Formative Peer Assessment Model for Reinforcing the Learning of Physical Examination Skills During the COVID-19 Pandemic Online Learning Period

Authors: Neilal A. Isaac, Madison Edwards, Kirthana Sugunathevan, Mohan Kumar

Abstract:

The COVID-19 pandemic challenged the education system and forced medical schools to transition to online learning. With this transition, one of the major concerns for students and educators was to ensure that Physical Examination (PE) skills were still being mastered. Thus, the formative peer assessment model was designed to enhance the learning of PE skills during the COVID-19 pandemic in the online learning landscape. Year 1 and year 2 students enrolled in clinical skills courses at the University of Medicine and Health Sciences, St. Kitts were asked to record themselves demonstrating PE skills with a healthy patient volunteer after every skills class. Each student was assigned to exchange feedback with one peer in the course. At the end of the first two semesters of this learning activity, a cross-sectional survey was conducted for the two cohorts of year-1 and year-2 students. The year-1 cohorts most frequently rated the peer assessment exercise as 4 on a 5-point Likert scale, with a mean score of 3.317 [2.759, 3.875]. The year-2 cohorts most frequently rated the peer assessment exercise as 4 on a 5-point Likert scale, with a mean score of 3.597 [2.978, 4.180]. Students indicated that guidance from faculty, flexible deadlines, and detailed and timely feedback from peers were areas for improvement in this process.

Keywords: COVID-19 pandemic, distant learning, online medical education, peer assessment, physical examination.

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57 Examining the Perceived Usefulness of ICTs for Learning about Indigenous Foods

Authors: K. M. Ngcobo, S. D. Eyono Obono

Abstract:

Science and technology has a major impact on many societal domains such as communication, medicine, food, transportation, etc. However, this dominance of modern technology can have a negative unintended impact on indigenous systems, and in particular on indigenous foods. This problem serves as a motivation to this study whose aim is to examine the perceptions of learners on the usefulness of Information and Communication Technologies (ICTs) for learning about indigenous foods. This aim will be subdivided into two types of research objectives. The design and identification of theories and models will be achieved using literature content analysis. The objective on the empirical testing of such theories and models will be achieved through the survey of Hospitality studies learners from different schools in the iLembe and Umgungundlovu Districts of the South African Kwazulu-Natal province. SPSS is used to quantitatively analyze the data collected by the questionnaire of this survey using descriptive statistics and Pearson correlations after the assessment of the validity and the reliability of the data. The main hypothesis behind this study is that there is a connection between the demographics of learners, their perceptions on the usefulness of ICTs for learning about indigenous foods, and the following personality and eLearning related theories constructs: Computer self-efficacy, Trust in ICT systems, and Conscientiousness; as suggested by existing studies on learning theories. This hypothesis was fully confirmed by the survey conducted by this study except for the demographic factors where gender and age were not found to be determinant factors of learners’ perceptions on the usefulness of ICTs for learning about indigenous foods.

Keywords: E-learning, Indigenous Foods, Information and Communication Technologies, Learning Theories, Personality.

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56 The Efficacy of Andrographis paniculata and Chromolaena odorata Plant Extract against Malaria Parasite

Authors: Funmilola O. Omoya, Abdul O. Momoh

Abstract:

Malaria constitutes one of the major health problems in Nigeria. One of the reasons attributed for the upsurge was the development of resistance of Plasmodium falciparum and the emergence of multi-resistant strains of the parasite to anti-malaria drugs. A continued search for other effective, safe and cheap plantbased anti-malaria agents thus becomes imperative in the face of these difficulties. The objective of this study is therefore to evaluate the in vivo anti-malarial efficacy of ethanolic extracts of Chromolaena odorata and Androgaphis paniculata leaves. The two plants were evaluated for their anti-malaria efficacy in vivo in a 4-day curative test assay against Plasmodium berghei strain in mice. The group treated with 500mg/ml dose of ethanolic extract of A. paniculata plant showed parasite suppression with increase in Packed Cell Volume (PCV) value except day 3 which showed a slight decrease in PCV value. During the 4-day curative test, an increase in the PCV values, weight measurement and zero count of Plasmodium berghei parasite values was recorded after day 3 of drug administration. These results obtained in group treated with A. paniculata extract showed anti-malarial efficacy with higher mortality rate in parasitaemia count when compared with Chromolaena odorata group. These results justify the use of ethanolic extracts of A. paniculata plant as medicinal herb used in folklore medicine in the treatment of malaria.

Keywords: Anti-malaria, Curative, Plant-based anti-malaria agents.

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55 Estimated Human Absorbed Dose of 111In-BPAMD as a New Bone-Seeking SPECT-Imaging Agent

Authors: H. Yousefnia, S. Zolghadri

Abstract:

An early diagnosis of bone metastasis is very important for making a right decision on a subsequent therapy. One of the most important steps to be taken initially, for developing a new radiopharmaceutical is the measurement of organ radiation exposure dose. In this study, the dosimetric studies of a novel agent for SPECT-imaging of the bone metastasis, 111In-(4- {[(bis(phosphonomethyl))carbamoyl]methyl}7,10bis(carboxymethyl) -1,4,7,10-tetraazacyclododec-1-yl) acetic acid (111In-BPAMD) complex, have been carried out to estimate the dose in human organs based on the data derived from mice. The radiolabeled complex was prepared with high radiochemical purity in the optimal conditions. Biodistribution studies of the complex was investigated in the male Syrian mice at the selected times after injection (2, 4, 24 and 48 h). The human absorbed dose estimation of the complex was made based on data derived from the mice by the radiation absorbed dose assessment resource (RADAR) method. 111In-BPAMD complex was prepared with high radiochemical purity >95% (ITLC) and specific activities of 2.85 TBq/mmol. Total body effective absorbed dose for 111In-BPAMD was 0.205 mSv/MBq. This value is comparable to the other 111In clinically used complexes. The results show that the dose with respect to the critical organs is satisfactory within the acceptable range for diagnostic nuclear medicine procedures. Generally, 111In-BPAMD has interesting characteristics and it can be considered as a viable agent for SPECT-imaging of the bone metastasis in the near future.

Keywords: In-111, BPAMD, absorbed dose, RADAR.

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54 The Applications of Four Fingers Theory: The Proof of 66 Acupoints under the Human Elbow and Knee

Authors: Chih-I. Tsai, Yu-Chien. Lin

Abstract:

Through experiences of clinical practices, it is discovered that locations on the body at a level of four fingerbreadth above and below the joints are the points at which muscles connect to tendons, and since the muscles and tendons possess opposite characteristics, muscles are full of blood but lack qi, while tendons are full of qi but lack blood, these points on our body become easily blocked. It is proposed that through doing acupuncture or creating localized pressure to the areas four fingerbreadths above and below our joints, with an elastic bandage, we could help the energy, also known as qi, to flow smoothly in our body and further improve our health. Based on the Four Fingers Theory, we understand that human height is 22 four fingerbreadths. In addition, qi and blood travel through 24 meridians, 50 times each day, and they flow through 6 cun with every human breath. We can also understand the average number of human heartbeats is 75 times per minute. And the function of qi-blood circulation system in Traditional Chinese Medicine is the same as the blood circulation in Western Medical Science. Informed by Four Fingers Theory, this study further examined its applications in acupuncture practices. The research question is how Four Fingers Theory proves what has been mentioned in Nei Jing that there are 66 acupoints under a human’s elbow and knee. In responding to the research question, there are 66 acupoints under a human’s elbow and knee. Four Fingers Theory facilitated the creation of the acupuncture naming and teaching system. It is expected to serve as an approachable and effective way to deliver knowledge of acupuncture to the public worldwide.

Keywords: Four Fingers theory, Meridians circulation, 66 Acupoints under a human’s elbow and knee, acupuncture.

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53 Patient Support Program in Pharmacovigilance: Foster Patient Confidence and Compliance

Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

Abstract:

The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: Drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance.

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52 Tele-Diagnosis System for Rural Thailand

Authors: C. Snae Namahoot, M. Brueckner

Abstract:

Thailand-s health system is challenged by the rising number of patients and decreasing ratio of medical practitioners/patients, especially in rural areas. This may tempt inexperienced GPs to rush through the process of anamnesis with the risk of incorrect diagnosis. Patients have to travel far to the hospital and wait for a long time presenting their case. Many patients try to cure themselves with traditional Thai medicine. Many countries are making use of the Internet for medical information gathering, distribution and storage. Telemedicine applications are a relatively new field of study in Thailand; the infrastructure of ICT had hampered widespread use of the Internet for using medical information. With recent improvements made health and technology professionals can work out novel applications and systems to help advance telemedicine for the benefit of the people. Here we explore the use of telemedicine for people with health problems in rural areas in Thailand and present a Telemedicine Diagnosis System for Rural Thailand (TEDIST) for diagnosing certain conditions that people with Internet access can use to establish contact with Community Health Centers, e.g. by mobile phone. The system uses a Web-based input method for individual patients- symptoms, which are taken by an expert system for the analysis of conditions and appropriate diseases. The analysis harnesses a knowledge base and a backward chaining component to find out, which health professionals should be presented with the case. Doctors have the opportunity to exchange emails or chat with the patients they are responsible for or other specialists. Patients- data are then stored in a Personal Health Record.

Keywords: Biomedical engineering, data acquisition, expert system, information management system, and information retrieval.

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51 Assessing Psycho-Social Stressors for Chronically Infected Hepatitis C Virus Patients in Egypt

Authors: Ammal M. Metwally, Dalia M. Elmosalami, Walaa A. Fouad, Abla G. Khalifa, Lobna A. El Etreby, Mohamed AbdelRahman

Abstract:

People with hepatitis C are likely to experience psychological distress related to adjustment issues following diagnosis. Objective: The study was conducted to determine the psycho-social stressors accompanying Hepatitis C virus (HCV) chronic infection. The study focused on immediate and later on reactions to being diagnosed as infected HCV patients. Effect of HCV on disruption of patients’ relationships in term of family relationship and friendship, employment and financial status was assessed. The magnitude and causes of the social stigma and its relation to awareness about illness, level of education were also assessed. Methods: During this study the subjective experiences of people having HCV was explored through a designed questionnaire targeted 540 cases; 359 males and 181 females from ten out of 21 National Treatment Reference Centers of National Hepatology and Tropical Medicine Research Institutes of Ministry of Health (MOH) hospitals. The study was conducted along a period of six months from September 2011 to March 2012. Results: The study revealed that the financial problems are the commonest problems faced by 75.5% of the cases. More than 70% of the cases suffered from immediate sadness versus 67.4% suffered from worry. Social stigma was reported by 13 % of HCV +patients, the majority of which were females. Conclusions: Exploring the psychosocial consequences of HCV infection can act as pressing motivators for behavior change needed for limiting HCV endemicity in Egypt.

Keywords: Egypt, HCV infection, psychosocial adjustment, stigma.

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50 Post-Traumatic Stress Disorder: Management at the Montfort Hospital

Authors: Kay-Anne Haykal, Issack Biyong

Abstract:

The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: Post-Traumatic Stress Disorder, diagnosis, co-morbidities, mental health disorders.

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49 Engineering of E-Learning Content Creation: Case Study for African Countries

Authors: María-Dolores Afonso-Suárez, Nayra Pumar-Carreras, Juan Ruiz-Alzola

Abstract:

This research addresses the use of an e-Learning creation methodology for learning objects. Throughout the process, indicators are being gathered, to determine if it responds to the main objectives of an engineering discipline. These parameters will also indicate if it is necessary to review the creation cycle and readjust any phase. Within the project developed for this study, apart from the use of structured methods, there has been a central objective: the establishment of a learning atmosphere. A place where all the professionals involved are able to collaborate, plan, solve problems and determine guides to follow in order to develop creative and innovative solutions. It has been outlined as a blended learning program with an assessment plan that proposes face to face lessons, coaching, collaboration, multimedia and web based learning objects as well as support resources. The project has been drawn as a long term task, the pilot teaching actions designed provide the preliminary results object of study. This methodology is been used in the creation of learning content for the African countries of Senegal, Mauritania and Cape Verde. It has been developed within the framework of the MACbioIDi, an Interreg European project for the International cooperation and development. The educational area of this project is focused in the training and advice of professionals of the medicine as well as engineers in the use of applications of medical imaging technology, specifically the 3DSlicer application and the Open Anatomy Browser.

Keywords: Teaching contents engineering, e-learning, blended learning, international cooperation, 3DSlicer, open anatomy browser.

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48 Flipped Classroom in Bioethics Education: A Blended and Interactive Online Learning Courseware that Enhances Active Learning and Student Engagement

Authors: Molly P. M. Wong

Abstract:

In this study, a blended and interactive e-learning Courseware that our team developed will be introduced, and our team’s experiences on how the e-learning Courseware and the flipped classroom benefit student learning in bioethics in the medical program will be shared. This study is a continuation of the previously established study, which provides a summary of the well-developed e-learning Courseware in a blended learning approach and an update on its efficiency and efficacy. First, a collection of animated videos capturing selected topics of bioethics and related ethical issues and dilemma will be introduced. Next, a selection of problem-based learning videos (“simulated doctor-patient role play”) with pop-up questions and discussions will be further discussed. Our findings demonstrated that these activities launched by the Courseware strongly engaged students in bioethics education and enhanced students’ critical thinking and creativity. Moreover, the educational benefits of the online art exhibition, art jamming and competition will be discussed, through which students could express bioethics through arts and enrich their learning in medical research in an interactive, fun and entertaining way, strengthening their interests in bioethics. Furthermore, online survey questionnaires and focus group interviews were conducted. Our results indicated that implementing the e-learning Courseware with a flipped classroom in bioethics education enhanced both active learning and student engagement. In conclusion, our Courseware not only reinforces education in art, bioethics and medicine, but also benefits students in understanding and critical thinking in socio-ethical issues, and serves as a valuable learning tool in bioethics teaching and learning.

Keywords: Bioethics, courseware, e-learning, flipped classroom.

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47 Unsupervised Segmentation Technique for Acute Leukemia Cells Using Clustering Algorithms

Authors: N. H. Harun, A. S. Abdul Nasir, M. Y. Mashor, R. Hassan

Abstract:

Leukaemia is a blood cancer disease that contributes to the increment of mortality rate in Malaysia each year. There are two main categories for leukaemia, which are acute and chronic leukaemia. The production and development of acute leukaemia cells occurs rapidly and uncontrollable. Therefore, if the identification of acute leukaemia cells could be done fast and effectively, proper treatment and medicine could be delivered. Due to the requirement of prompt and accurate diagnosis of leukaemia, the current study has proposed unsupervised pixel segmentation based on clustering algorithm in order to obtain a fully segmented abnormal white blood cell (blast) in acute leukaemia image. In order to obtain the segmented blast, the current study proposed three clustering algorithms which are k-means, fuzzy c-means and moving k-means algorithms have been applied on the saturation component image. Then, median filter and seeded region growing area extraction algorithms have been applied, to smooth the region of segmented blast and to remove the large unwanted regions from the image, respectively. Comparisons among the three clustering algorithms are made in order to measure the performance of each clustering algorithm on segmenting the blast area. Based on the good sensitivity value that has been obtained, the results indicate that moving kmeans clustering algorithm has successfully produced the fully segmented blast region in acute leukaemia image. Hence, indicating that the resultant images could be helpful to haematologists for further analysis of acute leukaemia.

Keywords: Acute Leukaemia Images, Clustering Algorithms, Image Segmentation, Moving k-Means.

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46 Potentials of Raphia hookeri Wine in Livelihood Sustenance among Rural and Urban Populations in Nigeria

Authors: A. A. Aiyeloja, A.T. Oladele, O. Tumulo

Abstract:

Raphia wine is an important forest product with cultural significance besides its use as medicine and food in southern Nigeria. This work aims to evaluate the profitability of Raphia wine production and marketing in Sapele Local Government Area, Nigeria. Four communities (Sapele, Ogiede, Okuoke and Elume) were randomly selected for data collection via questionnaires among producers and marketers. A total of 50 producers and 34 marketers were randomly selected for interview. Data was analyzed using descriptive statistics, profit margin, multiple regression and rate of returns on investment (RORI). Annual average profit was highest in Okuoke (Producers – N90, 000.00, Marketers - N70, 000.00) and least in Sapele (Producers N50, 000.00, Marketers – N45, 000.00). Calculated RORI for marketers were Elume (40.0%), Okuoke (25.0%), Ogiede (33.3%) and Sapele (50.0%). Regression results showed that location has significant effects (0.000, ρ ≤ 0.05) on profit margins. Male (58.8%) and female (41.2%) invest in Raphia wine marketing, while males (100.0%) dominate production. Results showed that Raphia wine has potentials to generate household income, enhance food security and improve quality of life in rural, semi-urban and urban communities. Improved marketing channels, storage facilities and credit facilities via cooperative groups are recommended for producers and marketers by concerned agencies.

Keywords: Raphia wine, Profit margin, RORI, Livelihood, Nigeria.

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45 Q-Map: Clinical Concept Mining from Clinical Documents

Authors: Sheikh Shams Azam, Manoj Raju, Venkatesh Pagidimarri, Vamsi Kasivajjala

Abstract:

Over the past decade, there has been a steep rise in the data-driven analysis in major areas of medicine, such as clinical decision support system, survival analysis, patient similarity analysis, image analytics etc. Most of the data in the field are well-structured and available in numerical or categorical formats which can be used for experiments directly. But on the opposite end of the spectrum, there exists a wide expanse of data that is intractable for direct analysis owing to its unstructured nature which can be found in the form of discharge summaries, clinical notes, procedural notes which are in human written narrative format and neither have any relational model nor any standard grammatical structure. An important step in the utilization of these texts for such studies is to transform and process the data to retrieve structured information from the haystack of irrelevant data using information retrieval and data mining techniques. To address this problem, the authors present Q-Map in this paper, which is a simple yet robust system that can sift through massive datasets with unregulated formats to retrieve structured information aggressively and efficiently. It is backed by an effective mining technique which is based on a string matching algorithm that is indexed on curated knowledge sources, that is both fast and configurable. The authors also briefly examine its comparative performance with MetaMap, one of the most reputed tools for medical concepts retrieval and present the advantages the former displays over the latter.

Keywords: Information retrieval (IR), unified medical language system (UMLS), Syntax Based Analysis, natural language processing (NLP), medical informatics.

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44 Opportunities for Precision Feed in Apiculture for Managing the Efficacy of Feed and Medicine

Authors: John Michael Russo

Abstract:

Honeybees are important to our food system and continue to suffer from high rates of colony loss. Precision feed has brought many benefits to livestock cultivation and these should transfer to apiculture. However, apiculture has unique challenges. The objective of this research is to understand how principles of precision agriculture, applied to apiculture and feed specifically, might effectively improve state-of-the-art cultivation. The methodology surveys apicultural practice to build a model for assessment. First, a review of apicultural motivators is made. Feed method is then evaluated. Finally, precision feed methods are examined as accelerants with potential to advance the effectiveness of feed practice. Six important motivators emerge: colony loss, disease, climate change, site variance, operational costs, and competition. Feed practice itself is used to compensate for environmental variables. The research finds that the current state-of-the-art in apiculture feed focuses on critical challenges in the management of feed schedules which satisfy requirements of the bees, preserve potency, optimize environmental variables, and manage costs. Many of the challenges are most acute when feed is used to dispense medication. Technology such as RNA treatments have even more rigorous demands. Precision feed solutions focus on strategies which accommodate specific needs of individual livestock. A major component is data; they integrate precise data with methods that respond to individual needs. There is enormous opportunity for precision feed to improve apiculture through the integration of precision data with policies to translate data into optimized action in the apiary, particularly through automation.

Keywords: Apiculture, precision apiculture, RNA varroa treatment, honeybee feed applications.

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43 Some Physiological Effects of Momordica charantia and Trigonella foenum-graecum Extracts in Diabetic Rats as Compared with Cidophage®

Authors: Wehash, F. E., Ismail I. Abo-Ghanema, Rasha Mohamed Saleh

Abstract:

This study was conducted to evaluate the anti-diabetic properties of ethanolic extract of two plants commonly used in folk medicine, Mormodica charantia (bitter melon) and Trigonella foenum-graecum (fenugreek). The study was performed on STZinduced diabetic rats (DM type-I). Plant extracts of these two plants were given to STZ diabetic rats at the concentration of 500 mg/kg body weight ,50 mg/kg body weight respectively. Cidophage® (metformin HCl) were administered to another group to support the results at a dose of 500 mg/kg body weight, the ethanolic extracts and Cidophage administered orally once a day for four weeks using a stomach tube and; serum samples were obtained for biochemical analysis. The extracts caused significant decreases in glucose levels compared with diabetic control rats. Insulin secretions were increased after 4 weeks of treatment with Cidophage® compared with the control non-diabetic rats. Levels of AST and ALT liver enzymes were normalized by all treatments. Decreases in liver cholesterol, triglycerides, and LDL in diabetic rats were observed with all treatments. HDL levels were increased by the treatments in the following order: bitter melon, Cidophage®, and fenugreek. Creatinine levels were reduced by all treatments. Serum nitric oxide and malonaldehyde levels were reduced by all extracts. GSH levels were increased by all extracts. Extravasation as measured by the Evans Blue test increased significantly in STZ-induced diabetic animals. This effect was reversed by ethanolic extracts of bitter melon or fenugreek.

Keywords: Cidophage®, Diabetic rats, Mormodica charantia, Trigonella foenum-graecum

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42 A Challenge to Acquire Serious Victims’ Locations during Acute Period of Giant Disasters

Authors: Keiko Shimazu, Yasuhiro Maida, Tetsuya Sugata, Daisuke Tamakoshi, Kenji Makabe, Haruki Suzuki

Abstract:

In this paper, we report how to acquire serious victims’ locations in the Acute Stage of Large-scale Disasters, in an Emergency Information Network System designed by us. The background of our concept is based on the Great East Japan Earthquake occurred on March 11th, 2011. Through many experiences of national crises caused by earthquakes and tsunamis, we have established advanced communication systems and advanced disaster medical response systems. However, Japan was devastated by huge tsunamis swept a vast area of Tohoku causing a complete breakdown of all the infrastructures including telecommunications. Therefore, we noticed that we need interdisciplinary collaboration between science of disaster medicine, regional administrative sociology, satellite communication technology and systems engineering experts. Communication of emergency information was limited causing a serious delay in the initial rescue and medical operation. For the emergency rescue and medical operations, the most important thing is to identify the number of casualties, their locations and status and to dispatch doctors and rescue workers from multiple organizations. In the case of the Tohoku earthquake, the dispatching mechanism and/or decision support system did not exist to allocate the appropriate number of doctors and locate disaster victims. Even though the doctors and rescue workers from multiple government organizations have their own dedicated communication system, the systems are not interoperable.

Keywords: Crisis management, disaster mitigation, messing, MGRS, Satellite communication system.

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41 An Overview of Technology Availability to Support Remote Decentralized Clinical Trials

Authors: S. Huber, B. Schnalzer, B. Alcalde, S. Hanke, L. Mpaltadoros, T. G. Stavropoulos, S. Nikolopoulos, I. Kompatsiaris, L. Pérez-Breva, V. Rodrigo-Casares, J. Fons-Martínez, J. de Bruin

Abstract:

Developing new medicine and health solutions and improving patient health currently rely on the successful execution of clinical trials, which generate relevant safety and efficacy data. For their success, recruitment and retention of participants are some of the most challenging aspects of protocol adherence. Main barriers include: i) lack of awareness of clinical trials; ii) long distance from the clinical site; iii) the burden on participants, including the duration and number of clinical visits, and iv) high dropout rate. Most of these aspects could be addressed with a new paradigm, namely the Remote Decentralized Clinical Trials (RDCTs). Furthermore, the COVID-19 pandemic has highlighted additional advantages and challenges for RDCTs in practice, allowing participants to join trials from home and not depending on site visits, etc. Nevertheless, RDCTs should follow the process and the quality assurance of conventional clinical trials, which involve several processes. For each part of the trial, the Building Blocks, existing software and technologies were assessed through a systematic search. The technology needed to perform RDCTs is widely available and validated but is yet segmented and developed in silos, as different software solutions address different parts of the trial and at various levels. The current paper is analyzing the availability of technology to perform RDCTs, identifying gaps and providing an overview of Basic Building Blocks and functionalities that need to be covered to support the described processes.

Keywords: architectures and frameworks for health informatics systems, clinical trials, information and communications technology, remote decentralized clinical trials, technology availability

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40 A Corporate Social Responsibility Project to Improve the Democratization of Scientific Education in Brazil

Authors: Denise Levy

Abstract:

Nuclear technology is part of our everyday life and its beneficial applications help to improve the quality of our lives. Nevertheless, in Brazil, most often the media and social networks tend to associate radiation to nuclear weapons and major accidents, and there is still great misunderstanding about the peaceful applications of nuclear science. The Educational Portal Radioatividades (Radioactivities) is a corporate social responsibility initiative that takes advantage of the growing impact of Internet to offer high quality scientific information for teachers and students throughout Brazil. This web-based initiative focusses on the positive applications of nuclear technology, presenting the several contributions of ionizing radiation in different contexts, such as nuclear medicine, agriculture techniques, food safety and electric power generation, proving nuclear technology as part of modern life and a must to improve the quality of our lifestyle. This educational project aims to contribute for democratization of scientific education and social inclusion, approaching society to scientific knowledge, promoting critical thinking and inspiring further reflections. The website offers a wide variety of ludic activities such as curiosities, interactive exercises and short courses. Moreover, teachers are offered free web-based material with full instructions to be developed in class. Since year 2013, the project has been developed and improved according to a comprehensive study about the realistic scenario of ICTs infrastructure in Brazilian schools and in full compliance with the best e-learning national and international recommendations.

Keywords: Information and communication technologies, nuclear technology, science communication, society and education.

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39 Response of Diaphragmatic Excursion to Inspiratory Muscle Trainer Post Thoracotomy

Authors: H. M. Haytham, E. A. Azza, E.S. Mohamed, E. G. Nesreen

Abstract:

Thoracotomy is a great surgery that has serious pulmonary complications, so purpose of this study was to determine the response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy. Thirty patients of both sexes (16 men and 14 women) with age ranged from 20 to 40 years old had done thoracotomy participated in this study. The practical work was done in cardiothoracic department, Kasr-El-Aini hospital at faculty of medicine for individuals 3 days Post operatively. Patients were assigned into two groups: group A (study group) included 15 patients (8 men and 7 women) who received inspiratory muscle training by using inspiratory muscle trainer for 20 minutes and routine chest physiotherapy (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Group B (control group) included 15 patients (8 men and 7 women) who received the routine chest physiotherapy only (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Ultrasonography was used to evaluate the changes in diaphragmatic excursion before and after training program. Statistical analysis revealed a significant increase in diaphragmatic excursion in the study group (59.52%) more than control group (18.66%) after using inspiratory muscle trainer post operatively in patients post thoracotomy. It was concluded that the inspiratory muscle training device increases diaphragmatic excursion in patients post thoracotomy through improving inspiratory muscle strength and improving mechanics of breathing and using of inspiratory muscle trainer as a method of physical therapy rehabilitation to reduce post-operative pulmonary complications post thoracotomy.

Keywords: Diaphragmatic excursion, inspiratory muscle trainer, ultrasonography, thoracotomy.

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38 Performance Analysis of Search Medical Imaging Service on Cloud Storage Using Decision Trees

Authors: González A. Julio, Ramírez L. Leonardo, Puerta A. Gabriel

Abstract:

Telemedicine services use a large amount of data, most of which are diagnostic images in Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7) formats. Metadata is generated from each related image to support their identification. This study presents the use of decision trees for the optimization of information search processes for diagnostic images, hosted on the cloud server. To analyze the performance in the server, the following quality of service (QoS) metrics are evaluated: delay, bandwidth, jitter, latency and throughput in five test scenarios for a total of 26 experiments during the loading and downloading of DICOM images, hosted by the telemedicine group server of the Universidad Militar Nueva Granada, Bogotá, Colombia. By applying decision trees as a data mining technique and comparing it with the sequential search, it was possible to evaluate the search times of diagnostic images in the server. The results show that by using the metadata in decision trees, the search times are substantially improved, the computational resources are optimized and the request management of the telemedicine image service is improved. Based on the experiments carried out, search efficiency increased by 45% in relation to the sequential search, given that, when downloading a diagnostic image, false positives are avoided in management and acquisition processes of said information. It is concluded that, for the diagnostic images services in telemedicine, the technique of decision trees guarantees the accessibility and robustness in the acquisition and manipulation of medical images, in improvement of the diagnoses and medical procedures in patients.

Keywords: Cloud storage, decision trees, diagnostic image, search, telemedicine.

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37 Influence of Internal Topologies on Components Produced by Selective Laser Melting: Numerical Analysis

Authors: C. Malça, P. Gonçalves, N. Alves, A. Mateus

Abstract:

Regardless of the manufacturing process used, subtractive or additive, material, purpose and application, produced components are conventionally solid mass with more or less complex shape depending on the production technology selected. Aspects such as reducing the weight of components, associated with the low volume of material required and the almost non-existent material waste, speed and flexibility of production and, primarily, a high mechanical strength combined with high structural performance, are competitive advantages in any industrial sector, from automotive, molds, aviation, aerospace, construction, pharmaceuticals, medicine and more recently in human tissue engineering. Such features, properties and functionalities are attained in metal components produced using the additive technique of Rapid Prototyping from metal powders commonly known as Selective Laser Melting (SLM), with optimized internal topologies and varying densities. In order to produce components with high strength and high structural and functional performance, regardless of the type of application, three different internal topologies were developed and analyzed using numerical computational tools. The developed topologies were numerically submitted to mechanical compression and four point bending testing. Finite Element Analysis results demonstrate how different internal topologies can contribute to improve mechanical properties, even with a high degree of porosity relatively to fully dense components. Results are very promising not only from the point of view of mechanical resistance, but especially through the achievement of considerable variation in density without loss of structural and functional high performance.

Keywords: Additive Manufacturing, Internal topologies, Porosity, Rapid Prototyping, Selective Laser Melting.

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36 Making Waves: Preparing the Next Generation of Bilingual Medical Doctors

Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

Abstract:

Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: Bilingual, English, medicine, doctor.

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35 Non-Destructive Testing of Carbon Fiber Reinforced Plastic by Infrared Thermography Methods

Authors: W. Swiderski

Abstract:

Composite materials are one answer to the growing demand for materials with better parameters of construction and exploitation. Composite materials also permit conscious shaping of desirable properties to increase the extent of reach in the case of metals, ceramics or polymers. In recent years, composite materials have been used widely in aerospace, energy, transportation, medicine, etc. Fiber-reinforced composites including carbon fiber, glass fiber and aramid fiber have become a major structural material. The typical defect during manufacture and operation is delamination damage of layered composites. When delamination damage of the composites spreads, it may lead to a composite fracture. One of the many methods used in non-destructive testing of composites is active infrared thermography. In active thermography, it is necessary to deliver energy to the examined sample in order to obtain significant temperature differences indicating the presence of subsurface anomalies. To detect possible defects in composite materials, different methods of thermal stimulation can be applied to the tested material, these include heating lamps, lasers, eddy currents, microwaves or ultrasounds. The use of a suitable source of thermal stimulation on the test material can have a decisive influence on the detection or failure to detect defects. Samples of multilayer structure carbon composites were prepared with deliberately introduced defects for comparative purposes. Very thin defects of different sizes and shapes made of Teflon or copper having a thickness of 0.1 mm were screened. Non-destructive testing was carried out using the following sources of thermal stimulation, heating lamp, flash lamp, ultrasound and eddy currents. The results are reported in the paper.

Keywords: Non-destructive testing, IR thermography, composite material, thermal stimulation.

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34 Synthesis of Highly Sensitive Molecular Imprinted Sensor for Selective Determination of Doxycycline in Honey Samples

Authors: Nadia El Alami El Hassani, Soukaina Motia, Benachir Bouchikhi, Nezha El Bari

Abstract:

Doxycycline (DXy) is a cycline antibiotic, most frequently prescribed to treat bacterial infections in veterinary medicine. However, its broad antimicrobial activity and low cost, lead to an intensive use, which can seriously affect human health. Therefore, its spread in the food products has to be monitored. The scope of this work was to synthetize a sensitive and very selective molecularly imprinted polymer (MIP) for DXy detection in honey samples. Firstly, the synthesis of this biosensor was performed by casting a layer of carboxylate polyvinyl chloride (PVC-COOH) on the working surface of a gold screen-printed electrode (Au-SPE) in order to bind covalently the analyte under mild conditions. Secondly, DXy as a template molecule was bounded to the activated carboxylic groups, and the formation of MIP was performed by a biocompatible polymer by the mean of polyacrylamide matrix. Then, DXy was detected by measurements of differential pulse voltammetry (DPV). A non-imprinted polymer (NIP) prepared in the same conditions and without the use of template molecule was also performed. We have noticed that the elaborated biosensor exhibits a high sensitivity and a linear behavior between the regenerated current and the logarithmic concentrations of DXy from 0.1 pg.mL−1 to 1000 pg.mL−1. This technic was successfully applied to determine DXy residues in honey samples with a limit of detection (LOD) of 0.1 pg.mL−1 and an excellent selectivity when compared to the results of oxytetracycline (OXy) as analogous interfering compound. The proposed method is cheap, sensitive, selective, simple, and is applied successfully to detect DXy in honey with the recoveries of 87% and 95%. Considering these advantages, this system provides a further perspective for food quality control in industrial fields.

Keywords: Electrochemical sensor, molecular imprinted polymer, doxycycline, food control.

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33 Ozone Therapy and Pulsed Electromagnetic Fields Interplay in Controlling Tumor Growth, Symptom and Pain Management: A Case Report

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

Abstract:

Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: Cancer, complementary and alternative medicine, ozone therapy, palliative care, PEMF Therapy.

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32 A Retrospective Drug Utilization Study of Antiplatelet Drugs in Patients with Ischemic Heart Disease

Authors: K. Jyothi, T. S. Mohamed Saleem, L. Vineela, C. Gopinath, K. B. Yadavender Reddy

Abstract:

Objective: Acute coronary syndrome is a clinical condition encompassing ST segments elevation myocardial infraction, Non ST segment is elevation myocardial infraction and un stable angina is characterized by ruptured coronary plaque, stress and myocardial injury. Angina pectoris is a pressure like pain in the chest that is induced by exertion or stress and relived with in the minute after cessation of effort or using sublingual nitroglycerin. The present research was undertaken to study the drug utilization pattern of antiplatelet drugs for the ischemic heart disease in a tertiary care hospital. Method: The present study is retrospective drug utilization study and study period is 6months. The data is collected from the discharge case sheet of general medicine department from medical department Rajiv Gandhi institute of medical sciences, Kadapa. The tentative sample size fixed was 250 patients. Out of 250 cases 19 cases was excluded because of unrelated data. Results: A total of 250 prescriptions were collected for the study according to the inclusion criteria 233 prescriptions were diagnosed with ischemic heart disease 17 prescriptions were excluded due to unrelated information. out of 233 prescriptions 128 are male (54.9%) and 105 patients are were female (45%). According to the gender distribution, the prevalence of ischemic heart disease in males are 90 (70.31%) and females are 39 (37.1%). In the same way the prevalence of ischemic heart disease along with cerebrovascular disease in males are 39 (29.6%) and females are 66 (62.6%). Conclusion: We found that 94.8% of drug utilization of antiplatelet drugs was achieved in the Rajiv Gandhi institute of medical sciences, Kadapa from 2011-2012.

Keywords: Angina pectoris, aspirin, clopidogrel, myocardial infarction.

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31 The Nuclear Energy Museum in Brazil: Creative Solutions to Transform Science Education into Meaningful Learning

Authors: Denise Levy, Helen J. Khoury

Abstract:

Nuclear technology is a controversial issue among a great share of the Brazilian population. Misinformation and common wrong beliefs confuse public’s perceptions and the scientific community is expected to offer a wider perspective on the benefits and risks resulting from ionizing radiation in everyday life. Attentive to the need of new approaches between science and society, the Nuclear Energy Museum, in northeast Brazil, is an initiative created to communicate the growing impact of the beneficial applications of nuclear technology in medicine, industry, agriculture and electric power generation. Providing accessible scientific information, the museum offers a rich learning environment, making use of different educational strategies, such as films, interactive panels and multimedia learning tools, which not only increase the enjoyment of visitors, but also maximize their learning potential. Developed according to modern active learning instructional strategies, multimedia materials are designed to present the increasingly role of nuclear science in modern life, transforming science education into a meaningful learning experience. In year 2016, nine different interactive computer-based activities were developed, presenting curiosities about ionizing radiation in different landmarks around the world, such as radiocarbon dating works in Egypt, nuclear power generation in France and X-radiography of famous paintings in Italy. Feedback surveys have reported a high level of visitors’ satisfaction, proving the high quality experience in learning nuclear science at the museum. The Nuclear Energy Museum is the first and, up to the present time, the only permanent museum in Brazil devoted entirely to nuclear science.

Keywords: Nuclear technology, multimedia learning tools, science museum, society and education.

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30 A Continuous Real-Time Analytic for Predicting Instability in Acute Care Rapid Response Team Activations

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

Abstract:

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

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

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29 Assessment of Predictive Confounders for the Prevalence of Breast Cancer among Iraqi Population: A Retrospective Study from Baghdad, Iraq

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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