Interactive simulated patient—an advanced tool for student-activated learning in medicine and healthcare

An advanced learning system for interactive simulation of patient cases (ISP) is described. The system was designed to meet specific pedagogical needs where student activation and problem orientation were two of the key issues. The system includes features such as video based illness history-taking function using free text input, highly interactive physiological examination procedures, extensive laboratory tests and detailed user feedback. The system was constructed mainly in Authorware Professional, starting more than 10 years ago, and it is now available in refined versions in different languages. Twelve pedagogical and three technical features were initially defined for the project. All of these aims were fulfilled. The ISP system has been successfully used in education, and in international collaboration, including three applicability field tests. The system is also a powerful research tool for studying for instance medical decision-making.     

Scatter search technique for exam timetabling

At universities where students enjoy flexibility in selecting courses, the Registrar’s office aims to generate an appropriate exam timetable for numerous courses and large number of students. An appropriate, real-world exam timetable should show fairness towards all students, respecting the following constraints: (a) eliminating or minimizing the number of simultaneous exams; (b) minimizing the number of consecutive exams; (c) minimizing the number of students with two or three exams per day (d) eliminating the possibility of more than three exams per day (e) exams should fit in rooms with predefined capacity; and (f) the number of exam periods is limited. These constraints are conflicting, which makes exam timetabling intractable. Hence, solving this problem in realistic time requires the use of heuristic approaches. In this work, we develop an evolutionary heuristic technique based on the scatter search approach for finding good suboptimal solutions for exam timetabling. This approach is based on maintaining and evolving a population of solutions. We evaluate our suggested technique on real-world university data and compare our results with the registrar’s manual timetable in addition to the timetables of other heuristic optimization algorithms. The experimental results show that our adapted scatter search technique generates better timetables than those produced by the registrar, manually, and by other meta-heuristics.     

A computer simulation model for studying the performance of coordinate measuring machines

The increasing trend toward computer-integrated manufacturing (CIM) in today's industry created a need for an effective process control. The objective of the inspection process is not only preventing shipment of defective parts but also providing a feedback to keep the manufacturing process in control. Through data processing capability, speed, and flexibility of operation, coordinate measuring machines (CMMs) play an important role for computer-integrated manufacturing (CIM). This paper introduces coordinate measuring machines and studies their performance. A computer simulation method for studying the performance of such machines working in a production line is developed. In this paper, CMM performance is measured by its speed and flexibility in performing measurements. In flexible manufacturing systems (FMS), CMMs serve as the inspection work station where arrival time of parts to be measured vary according to the flow of operations. The developed simulation model provides information about the machine, scheduled time for parts to be measured, and delay time for the measuring process.     

Anaesthesia record system on handheld computers--pilot experience and uses for quality control and clinical guidelines

This paper describes a mobile information system to collect patient information for anesthesia quality control. In this system, a mobile database program was designed for use on handheld computers (Pocket PC). This program is used to collect patient data at the bedside on the handhelds, with a daily synchronization of the data between the anaesthesiologists' handhelds with the anaesthesia database. All collected data are later used for quality control analysis. Furthermore, clinical guidelines will be included on these same handhelds. During the pilot phase, data from a sample set of about 300 patients were incorporated. The processes and interfaces of the system are presented in the paper. The current mobile database system has been designed to replace the original paper-based data collection system. The individual anaesthesiologist's handheld synchronizes patient data daily with anaesthesia database center. This information database is analyzed and used not only to give feedback to the individual doctor or center, but also to review the use of the guidelines provided and the results of their utilization.     

Selection of wild lactic acid bacteria isolated from traditional Egyptian dairy products according to production and technological criteria

A total of 755 wild lactic acid bacteria (LAB), belonging to Lactococcus, Lactobacillus, Enterococcus, Streptcoccus, Leuconostoc and Pediococcus isolated from Egyptian raw milk and its products were screened and selected according to their production and technological properties. Many strains showed high yield of biomass in fermentation and some strains were resistant to lyophilization conditions. Most strains showed a good separation after centrifugation, 2% of Lactococcus, 13% of Lactobacillus and 1% of Enterococcus were fast acidifying strains. Aminopeptidase and autolytic activity were generally higher for most lactobacilli compared to other strains. In milk cultures many strains were able to produce pleasant flavours. Antimicrobial activity was detected in 47% of Lactococcus, 21% of Lactobacillus and 41% of Enterococcus strains and some strains produced exopolysaccharides (slime and capsule). Several strains were able to maintain a high activity of two or three technological characteristics together. Detailed information about the characteristics of each strain is available in the culture collection of Faculty of Agriculture Alexandria University (FAAU). A wide variety of LAB from traditional Egyptian dairy products that showed potentially important properties are not only valuable for practical application but they may also provide an expanded gene pool for designing genetic modified strains with improved traits.     

Metaheuristic Algorithm for State-Based Software Testing

This article presents a metaheuristic algorithm for testing software, especially web applications, which can be modeled as a state transition diagram. We formulate the testing problem as an optimization problem and use a simulated annealing (SA) metaheuristic algorithm to generate test cases as sequences of events while keeping the test suite size reasonable. SA evolves a solution by minimizing an energy function that is based on testing objectives such as coverage, diversity, and continuity of events. The suggested method includes a “significance weight” assigned to events, which leads to important web pages and ensures coverage of relevant features by test cases. The experimental results demonstrate the effectiveness of simulated annealing and show that SA yields good results for testing web applications in comparison with other heuristics.     

Clinical and genetic characteristics of type 2 diabetes with and without GAD antibodies

The aim of the study was 1) to establish the prevalence of GAD antibodies (GADab) in a population-based study of type 2 diabetes in western Finland, 2) to genetically and phenotypically characterize this subgroup, and 3) to provide a definition for latent autoimmune diabetes in adults (LADA). The prevalence of GADab was 9.3% among 1,122 type 2 diabetic patients, 3.6% among 558 impaired glucose tolerance (IGT) subjects, and 4.4% among 383 nondiabetic control subjects. Islet antigen 2 antibodies (IA2ab) or islet cell antibodies were detected in only 0.5% of the GADab- patients. The GADab+ patients had lower fasting C-peptide concentrations (median [interquartile range]: 0.46 [0.45] vs. 0.62 [0.44] nmol/l, P = 0.0002) and lower insulin response to oral glucose compared with GADab- patients. With respect to features of the metabolic syndrome, the GADab+ patients had lower systolic (140 [29.1] vs. 148 [26.0] mmHg, P = 0.009) and diastolic (79.2 [17.6] vs. 81.0 [13.1] mmHg, P = 0.030) blood pressure values, as well as lower triglyceride concentrations (1.40 [1.18] vs. 1.75 [1.25] mmol/l, P = 0.003). GADab+ men had a lower waist-to-hip ratio compared with GADab- patients. Compared with GADab- patients and control subjects, the GADab+ patients had an increased frequency HLA-DQB1*0201/0302 (13 vs. 4%; P = 0.002) and other genotypes containing the *0302 allele (22 vs. 12%; P = 0.010). However, the frequency of these high-risk genotypes was significantly lower in GADab+ type 2 patients than in type 1 diabetes of young or adult onset (0201/0302 or 0302/X: 36 vs. 66 vs. 64%, P < 0.001). The GADab+ type 2 group did not differ from control subjects with respect to genotypes containing the protective DQB1-alleles *0602 or *0603, nor with respect to the type 1 high-risk genotype in the IDDM1 (Hph1 +/+). We conclude that GADab+ patients differ from both GADab- type 2 diabetic patients and type 1 diabetic patients with respect to beta-cell function, features of the metabolic syndrome, and type 1 diabetes susceptibility genes. Further, we propose that LADA be defined as GADab positivity (>5 relative units) in patients older than 35 years at onset of type 2 diabetes.     

New oxygen evolution anodes for metal electrowinning: MnO<Subscript>2</Subscript> composite electrodes

Several modifications of manganese dioxide (MnO₂) were investigated for use in composite electrode materials for oxygen evolution, the target application being anodes for the industrial electrowinning of metals. It is demonstrated that the performance of this material depends strongly on the modifications of MnO₂. All modifications investigated were found to be more active than the usual anode of lead alloyed with silver (PbAg) used in zinc electrowinning. A composite sample containing chemical manganese dioxide (CMD) was found to give an oxygen evolution overpotential 0.25 V lower than the standard PbAg anode material. In the second part of the article, we investigate the effect of varying several parameters of the composite electrode assembly, including the size of the catalyst particles and percentage of the catalyst material used. A model is proposed where the performance of the material is proportional to the total length of the boundaries between the lead matrix material and the MnO₂ catalyst particles. Physicochemical processes contributing to the observed data are discussed.     

Corrosion of irradiated MOX fuel in presence of dissolved H2

The corrosion behaviour of irradiated MOX fuel (47 GWd/tHM) has been studied in an autoclave experiment simulating repository conditions. Fuel fragments were corroded at room temperature in a 10 mM NaCl/2 mM NaHCO₃ solution in presence of dissolved H₂ for 2100 days. The results show that dissolved H₂ in concentration 1 mM and higher inhibits oxidation and dissolution of the fragments. Stable U and Pu concentrations were measured at 7 × 10⁻¹⁰ and 5 × 10⁻¹¹ M, respectively. Caesium was only released during the first two years of the experiment. The results indicate that the UO₂ matrix of a spent MOX fuel is the main contributor to the measured dissolution, while the corrosion of the high burn-up Pu-rich islands appears negligible.