Search results for: hospital.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 241

Search results for: hospital.

121 Using Discrete Event Simulation Approach to Reduce Waiting Times in Computed Tomography Radiology Department

Authors: Mwafak Shakoor

Abstract:

The purpose of this study was to reduce patient waiting times, improve system throughput and improve resources utilization in radiology department. A discrete event simulation model was developed using Arena simulation software to investigate different alternatives to improve the overall system delivery based on adding resource scenarios due to the linkage between patient waiting times and resource availability. The study revealed that there is no addition investment need to procure additional scanner but hospital management deploy managerial tactics to enhance machine utilization and reduce the long waiting time in the department.

Keywords: Arena, Computed Tomography (CT), Discrete event simulation, Healthcare modeling, Radiology department, Waiting time.

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120 Using Knowledge Management and Visualisation Concepts to Improve Patients and Hospitals Staff Workflow

Authors: A. A. AlRasheed, A. Atkins, R. Campion

Abstract:

This paper focuses on using knowledge management and visualisation concepts to improve the patients and hospitals employee’s workflow. Hospitals workflow is a complex and complicated process and poor patient flow can put both patients and a hospital’s reputation at risk, and can threaten the facility’s financial sustainability. Healthcare leaders are under increased pressure to reduce costs while maintaining or increasing patient care standards. In this paper, a framework is proposed to help improving patient experience, staff satisfaction, and operational efficiency across hospitals by using knowledge management based visualisation concepts. This framework is using real-time visibility to track and monitor location and status of patients, staff, rooms, and medical equipment.

Keywords: Knowledge management, visualisation, patients, hospitals, healthcare workers, workflow, improvements.

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119 Hospitals Disaster Preparedness during Arab Spring in Yemen

Authors: Saleem Ahmed Aladhrai, Pier Luigi Ingrassia, Nahid K. El- Bakri

Abstract:

Objective: The objective of this paper is to assess the hospitals preparedness for emergency using WHO standards. Method: This is a cross-sectional study, consisted of site visit, questionnaire survey, 16 health facilities were included. The WHO standard for emergency preparedness of health facilities was used to evaluate and assess the hospitals preparedness of health facilities. Result: 13 hospitals were responded. They scored below average in all measure >75%), while above average score was in 7 out 9 nine measure with a range of 8%-25%. Un acceptable below average was noted in two measures only. Discussion: The biggest challenge facing the hospitals in their emergency intervention is the lack of pre-emergency and emergency preparedness plans as well as the coordination of the hospitals response mechanisms. Conclusion: The studied hospitals presently are far from international disasters preparedness protocols. That necessitates improvements in emergency preparedness, as well as in physician skills for injury management.

Keywords: Arab Spring, Yemen, Hospital Preparedness, Disaster.

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118 Comparative Study of Filter Characteristics as Statistical Vocal Correlates of Clinical Psychiatric State in Human

Authors: Thaweesak Yingthawornsuk, Chusak Thanawattano

Abstract:

Acoustical properties of speech have been shown to be related to mental states of speaker with symptoms: depression and remission. This paper describes way to address the issue of distinguishing depressed patients from remitted subjects based on measureable acoustics change of their spoken sound. The vocal-tract related frequency characteristics of speech samples from female remitted and depressed patients were analyzed via speech processing techniques and consequently, evaluated statistically by cross-validation with Support Vector Machine. Our results comparatively show the classifier's performance with effectively correct separation of 93% determined from testing with the subjectbased feature model and 88% from the frame-based model based on the same speech samples collected from hospital visiting interview sessions between patients and psychiatrists.

Keywords: Depression, SVM, Vocal Extract, Vocal Tract

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117 A Study on Websites of Public and Private Hospitals in Konya

Authors: H. Nur Gorkemli, Mehmet Fidan

Abstract:

After the first acquaintance with internet in April 1993, number of internet users increased rapidly in Turkey. Almost half of the population between 16-74 age group use internet in the country. Hospitals are one of the areas where the internet is intensively being used like many other businesses. As a part of public relations application, websites are important tools for hospitals to reach a wide range of target audience within and outside the organization. With their websites, hospitals have opportunities to give information about their organization, strengthen their image, compete with their rivals, interact with shareholders, reflect their transparency and meet with new audiences. This study examines web sites of totally 34 hospitals which are located in Konya. Institutions are categorized as public and private hospitals and then three main research categories are determined: content, visual and technical. Main and sub categories are examined by using content analysis method. Results are interpreted in scope of public and private institutions and as a whole.

Keywords: Health Communication, Hospital, Internet, Webpages, Websites

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116 Scattering Operator and Spectral Clustering for Ultrasound Images: Application on Deep Venous Thrombi

Authors: Thibaud Berthomier, Ali Mansour, Luc Bressollette, Frédéric Le Roy, Dominique Mottier, Léo Fréchier, Barthélémy Hermenault

Abstract:

Deep Venous Thrombosis (DVT) occurs when a thrombus is formed within a deep vein (most often in the legs). This disease can be deadly if a part or the whole thrombus reaches the lung and causes a Pulmonary Embolism (PE). This disorder, often asymptomatic, has multifactorial causes: immobilization, surgery, pregnancy, age, cancers, and genetic variations. Our project aims to relate the thrombus epidemiology (origins, patient predispositions, PE) to its structure using ultrasound images. Ultrasonography and elastography were collected using Toshiba Aplio 500 at Brest Hospital. This manuscript compares two classification approaches: spectral clustering and scattering operator. The former is based on the graph and matrix theories while the latter cascades wavelet convolutions with nonlinear modulus and averaging operators.

Keywords: Deep venous thrombosis, ultrasonography, elastography, scattering operator, wavelet, spectral clustering.

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115 Machine Learning for Aiding Meningitis Diagnosis in Pediatric Patients

Authors: Karina Zaccari, Ernesto Cordeiro Marujo

Abstract:

This paper presents a Machine Learning (ML) approach to support Meningitis diagnosis in patients at a children’s hospital in Sao Paulo, Brazil. The aim is to use ML techniques to reduce the use of invasive procedures, such as cerebrospinal fluid (CSF) collection, as much as possible. In this study, we focus on predicting the probability of Meningitis given the results of a blood and urine laboratory tests, together with the analysis of pain or other complaints from the patient. We tested a number of different ML algorithms, including: Adaptative Boosting (AdaBoost), Decision Tree, Gradient Boosting, K-Nearest Neighbors (KNN), Logistic Regression, Random Forest and Support Vector Machines (SVM). Decision Tree algorithm performed best, with 94.56% and 96.18% accuracy for training and testing data, respectively. These results represent a significant aid to doctors in diagnosing Meningitis as early as possible and in preventing expensive and painful procedures on some children.

Keywords: Machine learning, medical diagnosis, meningitis detection, gradient boosting.

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114 Target Tracking in Sensor Networks: A Distributed Constraint Satisfaction Approach

Authors: R.Mostafaei, A.Habiboghli, M.R.Meybodi

Abstract:

In distributed resource allocation a set of agents must assign their resources to a set of tasks. This problem arises in many real-world domains such as distributed sensor networks, disaster rescue, hospital scheduling and others. Despite the variety of approaches proposed for distributed resource allocation, a systematic formalization of the problem, explaining the different sources of difficulties, and a formal explanation of the strengths and limitations of key approaches is missing. We take a step towards this goal by using a formalization of distributed resource allocation that represents both dynamic and distributed aspects of the problem. In this paper we present a new idea for target tracking in sensor networks and compare it with previous approaches. The central contribution of the paper is a generalized mapping from distributed resource allocation to DDCSP. This mapping is proven to correctly perform resource allocation problems of specific difficulty. This theoretical result is verified in practice by a simulation on a realworld distributed sensor network.

Keywords: Distributed CSP, Target Tracking, Sensor Network

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113 An Evaluation of Sputum Smear Conversion and Haematological Parameter Alteration in Early Detection Period of New Pulmonary Tuberculosis (PTB) Patients

Authors: Tasnuva Tamanna, Sanjida Halim Topa

Abstract:

Sputum smear conversion after one month of antituberculosis therapy in new smear positive pulmonary tuberculosis patients (PTB+) is a vital indicator towards treatment success. The objective of this study is to determine the rate of sputum smear conversion in new PTB+ patients after one month under treatment of National Institute of Diseases of the Chest and Hospital (NIDCH). Analysis of sputum smear conversion was done by re-clinical examination with sputum smear microscopic test after one month. Socio-demographic and hematological parameters were evaluated to perceive the correlation with the disease status. Among all enrolled patients only 33.33% were available for follow up diagnosis and of them only 42.86% patients turned to smear negative. Probably this consequence is due to non-coherence to the proper disease management. 66.67% and 78.78% patients reported low haemoglobin and packed cell volume level respectively whereas 80% and 93.33% patients accounted accelerated platelet count and erythrocyte sedimentation rate correspondingly.

Keywords: Followed up patients, PTB+ patients, sputum smear conversion, and sputum smear microscopic test.

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112 A Study of Lean Principles Implementation in the Libyan Healthcare and Industry Sectors

Authors: Nasser M. Amaitik, Ngwan F. Elsagzli

Abstract:

Lean technique is very important in the service and industrial fields. It is defined as an effective tool to eliminate the wastes. In lean the wastes are defined as anything which does not add value to the end product. There are wastes that can be avoided, but some are unavoidable for many reasons.    

The present study aims to apply the principles of lean in two different sectors, healthcare and industry. Two case studies have been selected to apply the experimental work. The first case was Al-Jalaa Hospital, while the second case study was the Technical Company of Aluminum Sections in Benghazi, LIBYA. In both case studies the Value Stream Map (VSM) of the current state has been constructed. The proposed plans have been implemented by merging or eliminating procedures or processes.

The results obtained from both case studies showed improvement in Capacity, Idle time and Utilized time.

Keywords: Healthcare service delivery, Idle time, Lean principles, Utilized time, Value stream mapping, Wastes.

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111 Development of the Structure of the Knowledgebase for Countermeasures in the Knowledge Acquisition Process for Trouble Prediction in Healthcare Processes

Authors: Shogo Kato, Daisuke Okamoto, Satoko Tsuru, Yoshinori Iizuka, Ryoko Shimono

Abstract:

Healthcare safety has been perceived important. It is essential to prevent troubles in healthcare processes for healthcare safety. Trouble prevention is based on trouble prediction using accumulated knowledge on processes, troubles, and countermeasures. However, information on troubles has not been accumulated in hospitals in the appropriate structure, and it has not been utilized effectively to prevent troubles. In the previous study, however a detailed knowledge acquisition process for trouble prediction was proposed, the knowledgebase for countermeasures was not involved. In this paper, we aim to propose the structure of the knowledgebase for countermeasures, in the knowledge acquisition process for trouble prediction in healthcare process. We first design the structure of countermeasures and propose the knowledge representation form on countermeasures. Then, we evaluate the validity of the proposal, by applying it into an actual hospital.

Keywords: Trouble prevention, knowledge structure, structured knowledge, reusable knowledge.

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110 Low-Cost Robotic-Assisted Laparoscope

Authors: Ege Can Onal, Enver Ersen, Meltem Elitas

Abstract:

Laparoscopy is a surgical operation, well known as keyhole surgery. The operation is performed through small holes, hence, scars of a patient become much smaller, patients can recover in a short time and the hospital stay becomes shorter in comparison to an open surgery. Several tools are used at laparoscopic operations; among them, the laparoscope has a crucial role. It provides the vision during the operation, which will be the main focus in here. Since the operation area is very small, motion of the surgical tools might be limited in laparoscopic operations compared to traditional surgeries. To overcome this limitation, most of the laparoscopic tools have become more precise, dexterous, multi-functional or automated. Here, we present a robotic-assisted laparoscope that is controlled with pedals directly by a surgeon. Thus, the movement of the laparoscope might be controlled better, so there will not be a need to calibrate the camera during the operation. The need for an assistant that controls the movement of the laparoscope will be eliminated. The duration of the laparoscopic operation might be shorter since the surgeon will directly operate the camera.

Keywords: Laparoscope, laparoscopy, low-cost, minimally invasive surgery, robotic-assisted surgery.

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109 Brain Drain of Doctors; Causes and Consequences in Pakistan

Authors: Muhammad Wajid Tahir, Rubina Kauser, Majid Ali Tahir

Abstract:

Pakistani doctors (MBBS) are emigrating towards developed countries for professional adjustments. This study aims to highlight causes and consequences of doctors- brain drain from Pakistan. Primary data was collected from Mayo Hospital, Lahore by interviewing doctors (n=100) through systematic random sampling technique. It found that various socio-economic and political conditions are working as push and pull factors for brain drain of doctors in Pakistan. Majority of doctors (83%) declared poor remunerations and professional infrastructure of health department as push factor of doctors- brain drain. 81% claimed that continuous instability in political situation and threats of terrorism are responsible for emigration of doctors. 84% respondents considered fewer opportunities of further studies responsible for their emigration. Brain drain of doctors is affecting health sector-s policies / programs, standard doctor-patient ratios and quality of health services badly.

Keywords: Brain Drain, Emigration, Remuneration, Politicalinstability, MBBS doctors

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108 Characteristics and Outcomes of COVID-19 Related Stroke: A Cohort Study

Authors: Kasra Afsahi, Maryam Soheilifar

Abstract:

Cerebrovascular accident (CVA) is a neurological side effect of COVID-19 disease wit high rate in pandemics. Effect of COVID-19 disease on disorder is unclear. In this cohort, patients with COVID-19 disease were assessed. 60 CVA cases were assessed in a referral hospital in 2020. The major factor was mortality and the cases were those with and without death. The groups were compared for all features about mortality in the patients with COVID-19 and CVA. Totally 23 out of 60 cases (38.3%) were expired. In univariate analysis there was significant association for death by ischemic heart disease (P = 0.015), high-severity stroke (P = 0.012), high C-reactive protein (CRP) (P = 0.001), high ESR (P = 0.009), pleural effusion (P = 0.005), pericardial effusion (P = 0.027), cardiomegaly (P = 0.005), ground glass opacity (P = 0.001), and consolidation (P = 0.001). Among these factors, there was significant association only for CRP (P = 0.001) and consolidation (P = 0.003) in multivariate analysis. Mortality in the cases with COVID-19-related CVA is one-third and it has relationship to elevated CRP and finding the consolidation in the computerized tomography scan of the lungs.

Keywords: COVID-19, stroke, prognosis, C-reactive protein, CRP.

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107 Machine Learning Framework: Competitive Intelligence and Key Drivers Identification of Market Share Trends among Healthcare Facilities

Authors: A. Appe, B. Poluparthi, L. Kasivajjula, U. Mv, S. Bagadi, P. Modi, A. Singh, H. Gunupudi, S. Troiano, J. Paul, J. Stovall, J. Yamamoto

Abstract:

The necessity of data-driven decisions in healthcare strategy formulation is rapidly increasing. A reliable framework which helps identify factors impacting a healthcare provider facility or a hospital (from here on termed as facility) market share is of key importance. This pilot study aims at developing a data-driven machine learning-regression framework which aids strategists in formulating key decisions to improve the facility’s market share which in turn impacts in improving the quality of healthcare services. The US (United States) healthcare business is chosen for the study, and the data spanning 60 key facilities in Washington State and about 3 years of historical data are considered. In the current analysis, market share is termed as the ratio of the facility’s encounters to the total encounters among the group of potential competitor facilities. The current study proposes a two-pronged approach of competitor identification and regression approach to evaluate and predict market share, respectively. Leveraged model agnostic technique, SHAP (SHapley Additive exPlanations), to quantify the relative importance of features impacting the market share. Typical techniques in literature to quantify the degree of competitiveness among facilities use an empirical method to calculate a competitive factor to interpret the severity of competition. The proposed method identifies a pool of competitors, develops Directed Acyclic Graphs (DAGs) and feature level word vectors, and evaluates the key connected components at the facility level. This technique is robust since it is data-driven, which minimizes the bias from empirical techniques. The DAGs factor in partial correlations at various segregations and key demographics of facilities along with a placeholder to factor in various business rules (for e.g., quantifying the patient exchanges, provider references, and sister facilities). Identified are the multiple groups of competitors among facilities. Leveraging the competitors' identified developed and fine-tuned Random Forest Regression model to predict the market share. To identify key drivers of market share at an overall level, permutation feature importance of the attributes was calculated. For relative quantification of features at a facility level, incorporated SHAP, a model agnostic explainer. This helped to identify and rank the attributes at each facility which impacts the market share. This approach proposes an amalgamation of the two popular and efficient modeling practices, viz., machine learning with graphs and tree-based regression techniques to reduce the bias. With these, we helped to drive strategic business decisions.

Keywords: Competition, DAGs, hospital, healthcare, machine learning, market share, random forest, SHAP.

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106 Mechanical Simulation with Electrical and Dimensional Tests for AISHa Containment Chamber

Authors: F. Noto, G. Costa, L. Celona, F. Chines, G. Ciavola, G. Cuttone, S. Gammino, O. Leonardi, S. Marletta, G. Torrisi

Abstract:

At Istituto Nazionale di Fisica Nucleare – Laboratorio Nazionale del Sud (INFN-LNS), a broad experience in the design, construction and commissioning of ECR and microwave ion sources is available. The AISHa ion source has been designed by taking into account the typical requirements of hospital-based facilities, where the minimization of the mean time between failures (MTBF) is a key point together with the maintenance operations, which should be fast and easy. It is intended to be a multipurpose device, operating at 18 GHz, in order to achieve higher plasma densities. It should provide enough versatility for future needs of the hadron therapy, including the ability to run at larger microwave power to produce different species and highly charged ion beams. The source is potentially interesting for any hadron therapy facility using heavy ions. In this paper, we analyzed the dimensional test and electrical test about an innovative solution for the containment chamber that allows us to solve our isolation and structural problems.

Keywords: FEM Analysis, ECR ion source, dielectrical measurement.

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105 ROI Based Embedded Watermarking of Medical Images for Secured Communication in Telemedicine

Authors: Baisa L. Gunjal, Suresh N. Mali

Abstract:

Medical images require special safety and confidentiality because critical judgment is done on the information provided by medical images. Transmission of medical image via internet or mobile phones demands strong security and copyright protection in telemedicine applications. Here, highly secured and robust watermarking technique is proposed for transmission of image data via internet and mobile phones. The Region of Interest (ROI) and Non Region of Interest (RONI) of medical image are separated. Only RONI is used for watermark embedding. This technique results in exact recovery of watermark with standard medical database images of size 512x512, giving 'correlation factor' equals to 1. The correlation factor for different attacks like noise addition, filtering, rotation and compression ranges from 0.90 to 0.95. The PSNR with weighting factor 0.02 is up to 48.53 dBs. The presented scheme is non blind and embeds hospital logo of 64x64 size.

Keywords: Compression, DWT, ROI, Scrambling, Vertices

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104 The Corporate Integration of Highly Skilled Professionals - A Social Capital Perspective

Authors: K. Zigan

Abstract:

Not with standing the importance of foreign highly skilled professionals for host economies, there is a paucity of research studies investigating the role of the corporate social context during the integration process. This research aims to address this paucity by exploring the role of social capital in the integration of foreign health professionals. It does so by using a qualitative research approach. In this pilot study the hospital sector forms this study-s sample and interviews were conducted with HR managers, foreign health professionals and external HR consultants. It was found that most of the participating hospitals had not established specific HR practices and had only partly linked the development of organisational social capital with a successful integration process. This research contributes, for example, to the HR literature on the integration of self-initiated expatriates by analysing the role of HRM in generating organisational social capital needed for a successful integration process.

Keywords: Corporate integration, hospitals, self-initiated expatriates, organisational social capital.

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

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

Abstract:

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

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

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102 Tabu Search to Draw Evacuation Plans in Emergency Situations

Authors: S. Nasri, H. Bouziri

Abstract:

Disasters are quite experienced in our days. They are caused by floods, landslides, and building fires that is the main objective of this study. To cope with these unexpected events, precautions must be taken to protect human lives. The emphasis on disposal work focuses on the resolution of the evacuation problem in case of no-notice disaster. The problem of evacuation is listed as a dynamic network flow problem. Particularly, we model the evacuation problem as an earliest arrival flow problem with load dependent transit time. This problem is classified as NP-Hard. Our challenge here is to propose a metaheuristic solution for solving the evacuation problem. We define our objective as the maximization of evacuees during earliest periods of a time horizon T. The objective provides the evacuation of persons as soon as possible. We performed an experimental study on emergency evacuation from the tunisian children’s hospital. This work prompts us to look for evacuation plans corresponding to several situations where the network dynamically changes.

Keywords: Dynamic network flow, Load dependent transit time, Evacuation strategy, Earliest arrival flow problem.

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101 Use of Opti-Jet Cs Md1mr Device for Biocide Aerosolisation in 3t Magnetic Resonance

Authors: Robert Pintaric, Joze Matela, Stefan Pintaric, Stanka Vadnjal

Abstract:

Introduction: This work is aimed to represent the use of the OPTI-JET CS MD1 MR prototype for application of neutral electrolyzed oxidizing water (NEOW) in magnetic resonance rooms. Material and Methods: We produced and used OPTI-JET CS MD1 MR aerosolisator whereby was performed aerosolization. The presence of microorganisms before and after the aerosolisation was recorded with the help of cyclone air sampling. Colony formed units (CFU) was counted. Results: The number of microorganisms in magnetic resonance 3T room was low as expected. Nevertheless, a possible CFU reduction of 87% was recorded. Conclusions: The research has shown that the use of EOW for the air and hard surface disinfection can considerably reduce the presence of microorganisms and consequently the possibility of hospital infections. It has also demonstrated that the use of OPTI-JET CS MD1 MR is very good. With this research, we started new guidelines for aerosolization in magnetic resonance rooms. Future work: We predict that presented technique works very good but we must focus also on time capacity sensors, and new appropriate toxicological studies.

Keywords: Biocide, electrolyzed oxidizing water (EOW), disinfection, microorganisms, OPTI-JET CS MD1MR.

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100 Predicting Dietary Practice Behavior among Type 2 Diabetics Using the Theory of Planned Behavior and Mixed Methods Design

Authors: D.O. Omondi, M.K. Walingo, G.M. Mbagaya, L.O.A. Othuon

Abstract:

This study applied the Theory of Planned Behavior model in predicting dietary behavior among Type 2 diabetics in a Kenyan environment. The study was conducted for three months within the diabetic clinic at Kisii Hospital in Nyanza Province in Kenya and adopted sequential mixed methods design combing both qualitative and quantitative phases. Qualitative data was analyzed using grounded theory analysis method. Structural equation modeling using maximum likelihood was used to analyze quantitative data. The results based on the common fit indices revealed that the theory of planned behavior fitted the data acceptably well among the Type 2 diabetes and within dietary behavior {χ2 = 223.3, df = 77, p = .02, χ2/df = 2.9, n=237; TLI = .93; CFI =.91; RMSEA (90CI) = .090(.039, .146)}. This implies that the Theory of Planned Behavior holds and forms a framework for promoting dietary practice among Type 2 diabetics.

Keywords: Dietary practice, Kenya, Theory of PlannedBehavior, Type 2 diabetes, Mixed Methods Design.

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99 Relations of Progression in Cognitive Decline with Initial EEG Resting-State Functional Network in Mild Cognitive Impairment

Authors: Chia-Feng Lu, Yuh-Jen Wang, Yu-Te Wu, Sui-Hing Yan

Abstract:

This study aimed at investigating whether the functional brain networks constructed using the initial EEG (obtained when patients first visited hospital) can be correlated with the progression of cognitive decline calculated as the changes of mini-mental state examination (MMSE) scores between the latest and initial examinations. We integrated the time–frequency cross mutual information (TFCMI) method to estimate the EEG functional connectivity between cortical regions, and the network analysis based on graph theory to investigate the organization of functional networks in aMCI. Our finding suggested that higher integrated functional network with sufficient connection strengths, dense connection between local regions, and high network efficiency in processing information at the initial stage may result in a better prognosis of the subsequent cognitive functions for aMCI. In conclusion, the functional connectivity can be a useful biomarker to assist in prediction of cognitive declines in aMCI.

Keywords: Cognitive decline, functional connectivity, MCI, MMSE.

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98 Dengue Death Review: A Tool to Adjudge the Cause of Dengue Mortality and Use of the Tool for Prevention of Dengue Deaths

Authors: Gagandeep Singh Grover, Vini Mahajan, Bhagmal, Priti Thaware, Jaspreet Takkar

Abstract:

Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The state of Punjab in India shows cyclical and seasonal variation in dengue cases. The Case Fatality Rate of Dengue has ranged from 0.6 to 1.0 in the past years. The department has initiated review of the cases that have died due to dengue in order to know the exact cause of the death in a case of dengue. The study has been undertaken to know the other associated co-morbidities and factors causing death in a case of dengue. The study used the predesigned proforma on which the records (medical and Lab) were recorded and reviewed by the expert committee of the doctors. This study has revealed that cases of dengue having co-morbidities have longer stay in hospital. Fluid overload and co-morbidities have been found as major factors leading to death, however, in a confirmed case of dengue hepatorenal shutdown was found to be major cause of mortality. The data obtained will help in sensitizing the treating physicians in order to decrease the mortality due to dengue in future.

Keywords: Dengue, death, morbidities, DHF, DSS.

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97 The Resource Description Framework (RDF) as a Modern Structure for Medical Data

Authors: Gabriela Lindemann, Danilo Schmidt, Thomas Schrader, Dietmar Keune

Abstract:

The amount and heterogeneity of data in biomedical research, notably in interdisciplinary fields, requires new methods for the collection, presentation and analysis of information. Important data from laboratory experiments as well as patient trials are available but come out of distributed resources. The Charité - University Hospital Berlin has established together with the German Research Foundation (DFG) a new information service centre for kidney diseases and transplantation (Open European Nephrology Science Centre - OpEN.SC). Beside a collaborative aspect to create new research groups every single partner or institution of this science information centre making his own data available is allowed to search the whole data pool of the various involved centres. A core task is the implementation of a non-restricting open data structure for the various different data sources. We decided to use a modern RDF model and in a first phase transformed original data coming from the web-based Electronic Patient Record database TBase©.

Keywords: Medical databases, Resource Description Framework (RDF), metadata repository.

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96 A 3-Year Evaluation Study on Fine Needle Aspiration Cytology and Corresponding Histology

Authors: Amjad Al Shammari, Ashraf Ibrahim, Laila Seada

Abstract:

Background and Objectives: Incidence of thyroid carcinoma has been increasing world-wide. In the present study, we evaluated diagnostic accuracy of Fine needle aspiration (FNA) and its efficiency in early detecting neoplastic lesions of thyroid gland over a 3-year period. Methods: Data have been retrieved from pathology files in King Khalid Hospital. For each patient, age, gender, FNA, site & size of nodule and final histopathologic diagnosis were recorded. Results: Study included 490 cases where 419 of them were female and 71 male. Male to female ratio was 1:6. Mean age was 43 years for males and 38 for females. Cases with confirmed histopathology were 131. In 101/131 (77.1%), concordance was found between FNA and histology. In 30/131 (22.9%), there was discrepancy in diagnosis. Total malignant cases were 43, out of which 14 (32.5%) were true positive and 29 (67.44%) were false negative. No false positive cases could be found in our series. Conclusion: FNA could diagnose benign nodules in all cases, however, in malignant cases, ultrasound findings have to be taken into consideration to avoid missing of a microcarcinoma in the contralateral lobe.

Keywords: FNA, hail, histopathology, thyroid.

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

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

Abstract:

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

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

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

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

Abstract:

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

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

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93 Resilience in Patients with Chronic Kidney Disease in Hemodialysis

Authors: Gomes C. C. Izabel, Lanzotti B. Rafaela, Orlandi S. Fabiana

Abstract:

Chronic Kidney Disease is considered a serious public health problem. The exploitation of resilience has been guided by studies conducted in various contexts, especially in hemodialysis, since the impact of diagnosis and restrictions produced during the treatment process because, despite advances in treatment, remains the stigma of the disease and the feeling of pain, hopelessness, low self-esteem and disability. The objective was to evaluate the level of resilience of patients in chronic renal dialysis. This is a descriptive, correlational, cross and quantitative research. The sample consisted of 100 patients from a Renal Replacement Therapy Unit in the countryside of São Paulo. For data collection were used the characterization instrument of Participants and the Resilience Scale. There was a predominance of males (70.0%) were Caucasian (45.0%) and had completed elementary education (34.0%). The average score obtained through the Resilience Scale was 131.3 (± 20.06) points. The resiliency level submitted may be considered satisfactory. It is expected that this study will assist in the preparation of programs and actions in order to avoid possible situations of crises faced by chronic renal patients.

Keywords: Hemodialysis units, hospital, renal dialysis, renal insufficiency chronic, resilience psychological.

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92 Decision Trees for Predicting Risk of Mortality using Routinely Collected Data

Authors: Tessy Badriyah, Jim S. Briggs, Dave R. Prytherch

Abstract:

It is well known that Logistic Regression is the gold standard method for predicting clinical outcome, especially predicting risk of mortality. In this paper, the Decision Tree method has been proposed to solve specific problems that commonly use Logistic Regression as a solution. The Biochemistry and Haematology Outcome Model (BHOM) dataset obtained from Portsmouth NHS Hospital from 1 January to 31 December 2001 was divided into four subsets. One subset of training data was used to generate a model, and the model obtained was then applied to three testing datasets. The performance of each model from both methods was then compared using calibration (the χ2 test or chi-test) and discrimination (area under ROC curve or c-index). The experiment presented that both methods have reasonable results in the case of the c-index. However, in some cases the calibration value (χ2) obtained quite a high result. After conducting experiments and investigating the advantages and disadvantages of each method, we can conclude that Decision Trees can be seen as a worthy alternative to Logistic Regression in the area of Data Mining.

Keywords: Decision Trees, Logistic Regression, clinical outcome, risk of mortality.

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