Search results for: biomechanics and clinical applications
9601 Improving Decision Support for Organ Transplant
Authors: Ian McCulloh, Andrew Placona, Darren Stewart, Daniel Gause, Kevin Kiernan, Morgan Stuart, Christopher Zinner, Laura Cartwright
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An estimated 22-25% of viable deceased donor kidneys are discarded every year in the US, while waitlisted candidates are dying every day. As many as 85% of transplanted organs are refused at least once for a patient that scored higher on the match list. There are hundreds of clinical variables involved in making a clinical transplant decision and there is rarely an ideal match. Decision makers exhibit an optimism bias where they may refuse an organ offer assuming a better match is imminent. We propose a semi-parametric Cox proportional hazard model, augmented by an accelerated failure time model based on patient specific suitable organ supply and demand to estimate a time-to-next-offer. Performance is assessed with Cox-Snell residuals and decision curve analysis, demonstrating improved decision support for up to a 5-year outlook. Providing clinical decision makers with quantitative evidence of likely patient outcomes (e.g., time to next offer and the mortality associated with waiting) may improve decisions and reduce optimism bias, thus reducing discarded organs and matching more patients on the waitlist.Keywords: decision science, KDPI, optimism bias, organ transplant
Procedia PDF Downloads 1059600 A Parasitic Resonator-Based Diamond Shape Microstrip Antenna for Ultra-Wide-Band Applications
Authors: M. Zulfiker Mahmud, M. Naimur Rahman, Farhad Bin Ashraf, Norbahiah Misran, Mohammad Tariqul Islam
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This study proposes a diamond-shaped microstrip patch antenna for ultra-wideband applications. The antenna is made up of a diamond shape radiating patch, partial ground plane, and three asterisk-shaped parasitic elements. The parasitic elements are positioned above the ground plane to enhance the bandwidth and gain. The proposed antenna has a compact dimension of 30 x 25 x 1.6 mm3 and achieves an overall bandwidth (S11<-10dB) is 5.8 GHz from 2.7 GHz to 8.5 GHz. The antenna attains more than 4 dBi realized the gain and 80% efficiency over the bandwidth with omnidirectional radiation pattern. The design and simulation of the proposed antenna are performed in Computer Simulation Technology (CST) Microwave Studio. The observation during the analysis of the simulated data reveals that the proposed antenna is suitable for Ultra wide-band (UWB) applications where high gain is required.Keywords: diamond-shaped antenna, microstrip antenna, parasitic resonator, UWB applications
Procedia PDF Downloads 2239599 Carbon Monoxide Poisoning in Children
Authors: Atitallah Sofien, Bouyahia Olfa, Hadj Salah Ibrahim, Ben Saleh Foued, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir
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Introduction: Carbon monoxide (CO) poisoning is a common pathology responsible for high morbidity and mortality worldwide. Aim: The purpose of this study was to determine the epidemiological profile of CO poisoning as well as its clinical, paraclinical, therapeutic, and evolutionary aspects. Methods: Our study included observations of CO poisoning in children hospitalized in the pediatric department C of the Children's Hospital in Tunis over a period of 3 years. Results: We have collected 199 cases of CO poisoning in children. The average age was 5.43 years, with a sex ratio of 0.98. The source of CO was inside the home in 73.2% of cases, and it was the gas bath heater in 68.8% of cases. The intoxication was collective in 93.5% of the cases, and it occurred during the month of January in 35.8% of the cases. The clinical manifestations were headaches in 69.5% of cases. The rate of carboxyhemoglobin was pathological in 73.9% of cases. All patients received normobaric oxygen therapy, and only 3.6% of patients had a hyperbaric oxygen therapy session. We did not deplore any case of death in our study. Conclusion: CO poisoning remains a public health problem in Tunisia with high morbidity. The risk of secondary complications, particularly neuropsychiatric, requires clinical and possibly neuroradiological monitoring of these victims.Keywords: poisoning, carbon monoxide, children, hyperbaric oxygenation
Procedia PDF Downloads 719598 HLA-DPB1 Matching on the Outcome of Unrelated Donor Hematopoietic Stem Cell Transplantation
Authors: Shi-xia Xu, Zai-wen Zhang, Ru-xue Chen, Shan Zhou, Xiang-feng Tang
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Objective: The clinical influence of HLA-DPB1 mismatches on clinical outcome of HSCT is less clear. This is the first meta-analysis to study the HLA-DPB1 matching statues on clinical outcomes after unrelated donor HSCT. Methods: We searched the CIBMTR, Cochrane Central Register of Controlled Trials (CENTRAL) and related databases (1995.01–2017.06) for all relevant articles. Comparative studies were used to investigate the HLA-DPB1 loci mismatches on clinical outcomes after unrelated donor HSCT, such as the disease-free survival (DFS), overall survival, GVHD, relapse, and transplant-related mortality (TRM). We performed meta-analysis using Review Manager 5.2 software and funnel plot to assess the bias. Results: At first, 1246 articles were retrieved, and 18 studies totaling 26368 patients analyzed. Pooled comparisons of studies found that the HLA-DPB1 mismatched group had a lower rate of DFS than the DPB1-matched group, and lower OS in non-T cell depleted transplantation. The DPB1 mismatched group has a higher incidence of aGVHD and more severe ( ≥ III degree) aGvHD, lower rate of relapse and higher TRM. Moreover, compared with 1-antigen mismatch, 2-antigen mismatched led to a higher risk of TRM and lower relapse rate. Conclusions: This meta-analysis indicated HLA-DPB1 has important influence on survival and transplant-related complications during unrelated donor HSCT and HLA-DPB1 donor selection strategies have been proposed based on a personalized algorithm.Keywords: human leukocyte antigen, DPB1, transplant, meta-analysis, outcome
Procedia PDF Downloads 2989597 In vivo Mechanical Characterization of Facial Skin Combining Digital Image Correlation and Finite Element
Authors: Huixin Wei, Shibin Wang, Linan Li, Lei Zhou, Xinhao Tu
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Facial skin is a biomedical material with complex mechanical properties of anisotropy, viscoelasticity, and hyperelasticity. The mechanical properties of facial skin are crucial for a number of applications including facial plastic surgery, animation, dermatology, cosmetic industry, and impact biomechanics. Skin is a complex multi-layered material which can be broadly divided into three main layers, the epidermis, the dermis, and the hypodermis. Collagen fibers account for 75% of the dry weight of dermal tissue, and it is these fibers which are responsible for the mechanical properties of skin. Many research on the anisotropic mechanical properties are mainly concentrated on in vitro, but there is a great difference between in vivo and in vitro for mechanical properties of the skin. In this study, we presented a method to measure the mechanical properties of facial skin in vivo. Digital image correlation (DIC) and indentation tests were used to obtain the experiment data, including the deformation of facial surface and indentation force-displacement curve. Then, the experiment was simulated using a finite element (FE) model. Application of Computed Tomography (CT) and reconstruction techniques obtained the real tissue geometry. A three-dimensional FE model of facial skin, including a bi-layer system, was obtained. As the epidermis is relatively thin, the epidermis and dermis were regarded as one layer and below it was hypodermis in this study. The upper layer was modeled as a Gasser-Ogden-Holzapfel (GOH) model to describe hyperelastic and anisotropic behaviors of the dermis. The under layer was modeled as a linear elastic model. In conclusion, the material properties of two-layer were determined by minimizing the error between the FE data and experimental data.Keywords: facial skin, indentation test, finite element, digital image correlation, computed tomography
Procedia PDF Downloads 1129596 Development of Innovative Islamic Web Applications
Authors: Farrukh Shahzad
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The rich Islamic resources related to religious text, Islamic sciences, and history are widely available in print and in electronic format online. However, most of these works are only available in Arabic language. In this research, an attempt is made to utilize these resources to create interactive web applications in Arabic, English and other languages. The system utilizes the Pattern Recognition, Knowledge Management, Data Mining, Information Retrieval and Management, Indexing, storage and data-analysis techniques to parse, store, convert and manage the information from authentic Arabic resources. These interactive web Apps provide smart multi-lingual search, tree based search, on-demand information matching and linking. In this paper, we provide details of application architecture, design, implementation and technologies employed. We also presented the summary of web applications already developed. We have also included some screen shots from the corresponding web sites. These web applications provide an Innovative On-line Learning Systems (eLearning and computer based education).Keywords: Islamic resources, Muslim scholars, hadith, narrators, history, fiqh
Procedia PDF Downloads 2839595 Radiation Dose and Associated Exposure Parameters in Selected MDCT Scanners in Multiphase Scan of Abdomen-Pelvic Region: A Clinical Study
Authors: P. Sathyathas, H. M. I. S. W. Herath, T. Amalraj, U. J. M. A. L. Jayasinghe
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Over two thirds of medical radiation can now be attributed to Computed Tomography (CT). There is little information on amount of radiation received from multiphase CT scan of abdomen- pelvic region in clinical practice. We sought to estimate the radiation dose and associated exposure parameters in the multiphase abdomen - pelvic scan of Multideteror Computed Tomography (MDCT) studies in clinical practice. This was a retrospective cross sectional studies describing radiation dose associated with main exposure parameters in diagnostic multiphase abdomen - pelvic scans performed on 152 consecutive patients by two different sixteen slice CT scanners. Patient information, exposure parameters of CTDI (volume), DLP, kVp, mAs and pitch were recorded for every phases of abdomen- a pelvic study from dose report of MDCT scanners (MDCTs). Age of patients range from 14 years to 87 years in both MDCT scanners. Overall CTDI (volume) median was 63.8 (±10.4) mGy for a multiphase abdominal-pelvic scan with scanner A while it was 35.4 (±15.6) mGy for scanner B. Patients' effective dose for multiphase abdomen - pelvic CT scan range from 8.2 mSv to 58 mSv. Median effective dose for patients, who underwent multiphase abdomen- pelvis scan with scanner A and B were 38.5 (± 8.2) mSv and 21.3 (± 8.6) mSv respectively. Median value of exposure parameters of mAs, kVp and pitch, were 150 (±29.7), 130 (±15.3) and 1.3 (±0.1) respectively in scanner A. In scanner B; they were 60 (±14.5), 120 and 1. The median effective dose for patients between multiphase abdomen-pelvic scan of both MDCT, a significant different (P<0.05) was observed. Multiphase abdomen – pelvic scan of clinical study shows significant different of effective dose with reference level of phantom studies (8-14mSv) and it depends on the type of vendors.Keywords: abdomen-pelvic region, computed tomography, exposure parameters, radiation dose
Procedia PDF Downloads 3279594 Use of Mobile Phone Applications in Teaching Precalculus
Authors: Jay-R. Hosana Leonidas, Jayson A. Lucilo
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The K-12 Curriculum in the Philippines shed light to mathematics education as it recognizes the use of smartphones/mobile phones as appropriate tools necessary in teaching mathematics. However, there were limited pieces of evidence on the use of these devices in teaching and learning process. This descriptive study developed lessons integrating the use of mobile phone applications with basis on low-level competencies of students in Precalculus and determined its effects on students’ conceptual understanding, procedural skills, and attitudes towards Precalculus. Employing Bring Your Own Device (BYOD) scheme in the study, lessons developed were conducted among Grade 11 Science, Technology, Engineering, and Mathematics (STEM) students at Central Bicol State University of Agriculture for the academic year 2018-2019. This study found that there is a significant difference between the competency levels of students along conceptual understanding and procedural skills prior to and after the conduct of lessons developed. Also, it disclosed that the use of mobile phone applications had positive effects on students’ attitudes towards Precalculus. Thus, the use of mobile phone applications in teaching Precalculus can enrich students’ understanding of concepts and procedural skills (solving and graphing skills) and can increase students’ motivation, self-confidence, and enjoyment in dealing with Precalculus.Keywords: bring your own device, mathematics education, mobile phone applications, senior high school
Procedia PDF Downloads 1639593 Advancement of Oscillating Water Column Wave Energy Technologies through Integrated Applications and Alternative Systems
Authors: S. Doyle, G. A. Aggidis
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Wave energy converter technologies continue to show good progress in worldwide research. One of the most researched technologies, the Oscillating Water Column (OWC), is arguably one of the most popular categories within the converter technologies due to its robustness, simplicity and versatility. However, the versatility of the OWC is still largely untapped with most deployments following similar trends with respect to applications and operating systems. As the competitiveness of the energy market continues to increase, the demand for wave energy technologies to be innovative also increases. For existing wave energy technologies, this requires identifying areas to diversify for lower costs of energy with respect to applications and synergies or integrated systems. This paper provides a review of all OWCs systems integrated into alternative applications in the past and present. The aspects and variation in their design, deployment and system operation are discussed. Particular focus is given to the Multi-OWCs (M-OWCs) and their great potential to increase capture on a larger scale, especially in synergy applications. It is made clear that these steps need to be taken in order to make wave energy a competitive and viable option in the renewable energy mix as progression to date shows that stand alone single function devices are not economical. Findings reveal that the trend of development is moving toward these integrated applications in order to reduce the Levelised Cost of Energy (LCOE) and will ultimately continue in this direction in efforts to make wave energy a competitive option in the renewable energy mix.Keywords: wave energy converter, oscillating water column, ocean energy, renewable energy
Procedia PDF Downloads 1349592 Epidemiological, Clinical, Histopathological Profile and Management of Breast Cancer at Kinshasa University Clinics
Authors: Eddy K. Mukadi
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This work is a documentary and descriptive study devoted to the epidemiological, clinical, histopathological and therapeutic profile of breast cancer deals with the department of gynecology and obstetrics of the university clinics of Kinshasa during the period from 1 January 2014 to 31 December 2014. We have identified 56 cases of breast cancer. These cancers accounted for 45.2% of gynecological mammary cancers. The youngest in our series was 18 years old while the oldest was 74 years old; And the mean age of these patients was 43.4 years and mostly multiparous (35.7%). Brides (60.7%) and bachelors (26.8%) were the most affected by breast cancer. The reasons for consultation were dominated by nodules in the breast (48.2%) followed by pain (35.7%) and nipple discharge (14.3%). In 89.2% of the cases, it was the advanced clinical stage (stage 3 and 4) and the infiltrating ductal carcinoma was the most frequent histological type (75%) The malignant tumor was mainly in the left breast (55.3%), and chemotherapy with hormone therapy and patey was the most convenient treatment (42.8%), while patey mastectomy was performed in 12.5% of patients. Because of the high incidence of breast cancer identified in our study, some preventive measures must be taken into account to address this public health problem, including breast autopalpation once a month, Early detection system development of a national breast cancer policy and the implementation of a national breast cancer control program.Keywords: breast cancer, histopathological profile, epidemiological profile, Kinshasa
Procedia PDF Downloads 2169591 The Role of Molecular Subtypes in Pathological Response to Neoadjuvant Chemotherapy and Clinical Outcomes in Patients with Locally Advanced Breast Cancer
Authors: Aliakbar Hafezi, Jalal Taherian, Mahsa Elahi, Jamshid Abedi
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Background: Patients with breast cancer with different molecular subtypes may have different pathological responses to neoadjuvant chemotherapy (NAC). The aim of this study was to evaluate the pathological response to NAC in patients with locally advanced breast cancer based on molecular subtypes. Method: In this retrospective cohort study, 210 female patients with breast cancer candidate for NAC referred to the radiation oncology departments in southern Iran between August 2019 and September 2024 were evaluated in terms of pathologic complete response (pCR) based on immunohistochemical molecular markers (estrogen and progesterone receptors, Her-2/neu and Ki-67), overall survival (OS) and disease-free survival (DFS). Results: The mean age of the patients was 38.22 ± 10.34 years, and 68 patients (32.4%) had a positive family history of breast cancer. The pCR rate was 17.6% (37 patients), which in the subtypes of luminal A, luminal B, Her-2/neu positive and triple negative was 7.7%, 16.9%, 26.5% and 21.05%, respectively. Patients with pCR had significantly better OS (78.4% vs. 49.1%, P = 0.014) and DFS (83.8% vs. 51.4%, P = 0.020) than patients with partial/no pathological response. Conclusion: It seems that the molecular subtype plays a decisive role in the clinical outcome and the pathological response to NAC in patients with locally advanced breast cancer.Keywords: locally advanced breast cancer, neoadjuvant chemotherapy, pathologic complete response, clinical outcomes
Procedia PDF Downloads 79590 Understanding the Heterogeneity of Polycystic Ovarian Syndrome: The Influence of Ethnicity and Body Mass
Authors: Hamza Ikhlaq, Stephen Franks
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Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. The aetiology behind PCOS is poorly understood but influencing ethnic, environmental, and genetic factors have been recognised. However, literature examining the impact of ethnicity is scarce. We hypothesised Body Mass Index (BMI) and ethnicity influence the clinical, metabolic, and biochemical presentations of PCOS, with an interaction between these factors. Methods: A database of 1081 women with PCOS and a control group of 72 women were analysed. BMIs were grouped using the World Health Organisation classification into normal weight, overweight and obese groups. Ethnicities were classified into European, South Asian, and Afro-Caribbean groups. Biochemical and clinical presentations were compared amongst these groups, and statistical analyses were performed to assess significance. Results: This study revealed ethnicity significantly influences biochemical and clinical presentations of PCOS. A greater proportion of South Asian women are impacted by menstrual cycle disturbances and hirsutism than European and Afro-Caribbean women. South Asian and Afro-Caribbean women show greater measures of insulin resistance and weight gain when compared to their European peers. Women with increased BMI are shown to have an increased prevalence of PCOS phenotypes alongside increased levels of insulin resistance and testosterone. Furthermore, significantly different relationships between the waist-hip ratio and measures of insulin and glucose control for Afro-Caribbean women were identified compared to other ethnic groups. Conclusions: The findings of this study show ethnicity significantly influence the phenotypic and biochemical presentations of PCOS, with an interaction between body habitus and ethnicity found. Furthermore, we provide further data on the influences of BMI on the manifestations of PCOS. Therefore, we highlight the need to consider these factors when reviewing diagnostic criteria and delivering clinical care for these groups.Keywords: PCOS, ethnicity, BMI, clinical
Procedia PDF Downloads 1139589 Isolation Preserving Medical Conclusion Hold Structure via C5 Algorithm
Authors: Swati Kishor Zode, Rahul Ambekar
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Data mining is the extraction of fascinating examples on the other hand information from enormous measure of information and choice is made as indicated by the applicable information extracted. As of late, with the dangerous advancement in internet, stockpiling of information and handling procedures, privacy preservation has been one of the major (higher) concerns in data mining. Various techniques and methods have been produced for protection saving data mining. In the situation of Clinical Decision Support System, the choice is to be made on the premise of the data separated from the remote servers by means of Internet to diagnose the patient. In this paper, the fundamental thought is to build the precision of Decision Support System for multiple diseases for different maladies and in addition protect persistent information while correspondence between Clinician side (Client side) also, the Server side. A privacy preserving protocol for clinical decision support network is proposed so that patients information dependably stay scrambled amid diagnose prepare by looking after the accuracy. To enhance the precision of Decision Support System for various malady C5.0 classifiers and to save security, a Homomorphism encryption algorithm Paillier cryptosystem is being utilized.Keywords: classification, homomorphic encryption, clinical decision support, privacy
Procedia PDF Downloads 3309588 3 Dimensional (3D) Assesment of Hippocampus in Alzheimer’s Disease
Authors: Mehmet Bulent Ozdemir, Sultan Çagirici, Sahika Pinar Akyer, Fikri Turk
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Neuroanatomical appearance can be correlated with clinical or other characteristics of illness. With the introduction of diagnostic imaging machines, producing 3D images of anatomic structures, calculating the correlation between subjects and pattern of the structures have become possible. The aim of this study is to examine the 3D structure of hippocampus in cases with Alzheimer disease in different dementia severity. For this purpose, 62 female and 38 male- 68 patients’s (age range between 52 and 88) MR scanning were imported to the computer. 3D model of each right and left hippocampus were developed by a computer aided propramme-Surf Driver 3.5. Every reconstruction was taken by the same investigator. There were different apperance of hippocampus from normal to abnormal. In conclusion, These results might improve the understanding of the correlation between the morphological changes in hippocampus and clinical staging in Alzheimer disease.Keywords: Alzheimer disease, hippocampus, computer-assisted anatomy, 3D
Procedia PDF Downloads 4819587 Development of a Novel Clinical Screening Tool, Using the BSGE Pain Questionnaire, Clinical Examination and Ultrasound to Predict the Severity of Endometriosis Prior to Laparoscopic Surgery
Authors: Marlin Mubarak
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Background: Endometriosis is a complex disabling disease affecting young females in the reproductive period mainly. The aim of this project is to generate a diagnostic model to predict severity and stage of endometriosis prior to Laparoscopic surgery. This will help to improve the pre-operative diagnostic accuracy of stage 3 & 4 endometriosis and as a result, refer relevant women to a specialist centre for complex Laparoscopic surgery. The model is based on the British Society of Gynaecological Endoscopy (BSGE) pain questionnaire, clinical examination and ultrasound scan. Design: This is a prospective, observational, study, in which women completed the BSGE pain questionnaire, a BSGE requirement. Also, as part of the routine preoperative assessment patient had a routine ultrasound scan and when recto-vaginal and deep infiltrating endometriosis was suspected an MRI was performed. Setting: Luton & Dunstable University Hospital. Patients: Symptomatic women (n = 56) scheduled for laparoscopy due to pelvic pain. The age ranged between 17 – 52 years of age (mean 33.8 years, SD 8.7 years). Interventions: None outside the recognised and established endometriosis centre protocol set up by BSGE. Main Outcome Measure(s): Sensitivity and specificity of endometriosis diagnosis predicted by symptoms based on BSGE pain questionnaire, clinical examinations and imaging. Findings: The prevalence of diagnosed endometriosis was calculated to be 76.8% and the prevalence of advanced stage was 55.4%. Deep infiltrating endometriosis in various locations was diagnosed in 32/56 women (57.1%) and some had DIE involving several locations. Logistic regression analysis was performed on 36 clinical variables to create a simple clinical prediction model. After creating the scoring system using variables with P < 0.05, the model was applied to the whole dataset. The sensitivity was 83.87% and specificity 96%. The positive likelihood ratio was 20.97 and the negative likelihood ratio was 0.17, indicating that the model has a good predictive value and could be useful in predicting advanced stage endometriosis. Conclusions: This is a hypothesis-generating project with one operator, but future proposed research would provide validation of the model and establish its usefulness in the general setting. Predictive tools based on such model could help organise the appropriate investigation in clinical practice, reduce risks associated with surgery and improve outcome. It could be of value for future research to standardise the assessment of women presenting with pelvic pain. The model needs further testing in a general setting to assess if the initial results are reproducible.Keywords: deep endometriosis, endometriosis, minimally invasive, MRI, ultrasound.
Procedia PDF Downloads 3539586 System Dietadhoc® - A Fusion of Human-Centred Design and Agile Development for the Explainability of AI Techniques Based on Nutritional and Clinical Data
Authors: Michelangelo Sofo, Giuseppe Labianca
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In recent years, the scientific community's interest in the exploratory analysis of biomedical data has increased exponentially. Considering the field of research of nutritional biologists, the curative process, based on the analysis of clinical data, is a very delicate operation due to the fact that there are multiple solutions for the management of pathologies in the food sector (for example can recall intolerances and allergies, management of cholesterol metabolism, diabetic pathologies, arterial hypertension, up to obesity and breathing and sleep problems). In this regard, in this research work a system was created capable of evaluating various dietary regimes for specific patient pathologies. The system is founded on a mathematical-numerical model and has been created tailored for the real working needs of an expert in human nutrition using the human-centered design (ISO 9241-210), therefore it is in step with continuous scientific progress in the field and evolves through the experience of managed clinical cases (machine learning process). DietAdhoc® is a decision support system nutrition specialists for patients of both sexes (from 18 years of age) developed with an agile methodology. Its task consists in drawing up the biomedical and clinical profile of the specific patient by applying two algorithmic optimization approaches on nutritional data and a symbolic solution, obtained by transforming the relational database underlying the system into a deductive database. For all three solution approaches, particular emphasis has been given to the explainability of the suggested clinical decisions through flexible and customizable user interfaces. Furthermore, the system has multiple software modules based on time series and visual analytics techniques that allow to evaluate the complete picture of the situation and the evolution of the diet assigned for specific pathologies.Keywords: medical decision support, physiological data extraction, data driven diagnosis, human centered AI, symbiotic AI paradigm
Procedia PDF Downloads 239585 Evaluation of Anti-Pruritus Effect of Melatonin on Hemodialysis Patients with Uremic Pruritus: A Randomized Clinical Trial
Authors: Paria Baharvand, Mohammad Reza Abbasi, Soha Namazi
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Introduction: Uremic pruritus (UP) is one of the major complaints in hemodialysis patients. The aim of this randomized clinical trial study was the evaluation of the anti-pruritus effect of Melatonin on hemodialysis patients with UP. Methods: This multi-centered double, blinded randomized clinical trial study was conducted on hemodialysis patients with UP that referred to the dialysis department of Imam Khomeini Hospital, Labbafinezhad Hospital and Ghiasi Hospital in Tehran, Iran, in 2018. Forty participants were enrolled and block randomization was performed by using a randomized list and divided into 2 groups of twenty patients. Evaluation of the 12-Item Pruritus Severity Scale (12-PSS), Visual analog scale (VAS), and Calculation of the affected body surface area for pruritus extent (BSA %) was performed every week. The Melatonin group received a 10 mg soft gel capsule, and the placebo group received a soft gel capsule placebo after dinner. For statistical analysis used by SPSS version 21(IRCT20180714040462N1). Results: 38 hemodialysis patients enrolled in this study. The mean age in the placebo group and in the Melatonin group was 55.88 ± 11.70 and 54.52 ± 13.00 years (p> 0.05). Also, 46% of all participants were female. Aspartate transaminase, alanine transaminase and C-reactive protein have significant differences between the two groups (p< 0.05). VAS score reduction in the two groups had a statistically significant (CI 95% = -1.71, P= 0.015(.The results of BSA% showed Melatonin had a significant effect on the decrease of the pruritus extent compared to placebo (CI 95% = -22.82, P= 0.001(. Conclusion: According to the results of this study and the preliminary effects of Melatonin on uremic pruritus, we suggest performing advanced clinical trials studies.Keywords: Melatonin, Uremic Pruritus, hemodialysis, anti-pruritus
Procedia PDF Downloads 809584 Analytics Model in a Telehealth Center Based on Cloud Computing and Local Storage
Authors: L. Ramirez, E. Guillén, J. Sánchez
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Some of the main goals about telecare such as monitoring, treatment, telediagnostic are deployed with the integration of applications with specific appliances. In order to achieve a coherent model to integrate software, hardware, and healthcare systems, different telehealth models with Internet of Things (IoT), cloud computing, artificial intelligence, etc. have been implemented, and their advantages are still under analysis. In this paper, we propose an integrated model based on IoT architecture and cloud computing telehealth center. Analytics module is presented as a solution to control an ideal diagnostic about some diseases. Specific features are then compared with the recently deployed conventional models in telemedicine. The main advantage of this model is the availability of controlling the security and privacy about patient information and the optimization on processing and acquiring clinical parameters according to technical characteristics.Keywords: analytics, telemedicine, internet of things, cloud computing
Procedia PDF Downloads 3259583 Embedded Hw-Sw Reconfigurable Techniques For Wireless Sensor Network Applications
Authors: B. Kirubakaran, C. Rajasekaran
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Reconfigurable techniques are used in many engineering and industrial applications for the efficient data transmissions through the wireless sensor networks. Nowadays most of the industrial applications are work for try to minimize the size and cost. During runtime the reconfigurable technique avoid the unwanted hang and delay in the system performance. In recent world Field Programmable Gate Array (FPGA) as one of the most efficient reconfigurable device and widely used for most of the hardware and software reconfiguration applications. In this paper, the work deals with whatever going to make changes in the hardware and software during runtime it’s should not affect the current running process that’s the main objective of the paper our changes be done in a parallel manner at the same time concentrating the cost and power transmission problems during data trans-receiving. Analog sensor (Temperature) as an input for the controller (PIC) through that control the FPGA digital sensors in generalized manner.Keywords: field programmable gate array, peripheral interrupt controller, runtime reconfigurable techniques, wireless sensor networks
Procedia PDF Downloads 4079582 Skin Manifestations in Children With Inborn Errors of Immunity in a Tertiary Care Hospital in Iran
Authors: Zahra Salehi Shahrbabaki, Zahra Chavoshzadeh, Fahimeh Abdollahimajd, Samin Sharafian, Tolue Mahdavi, Mahnaz Jamee
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Background: Inborn errors of immunity (IEIs) are monogenic diseases of the immune the system with broad clinical manifestations. Despite the increasing genetic advancements, the diagnosis of IEIs still leans on clinical diagnosis. Dermatologic manifestations are observed in a large number of IEI patients and can lead to proper approach, prompt intervention and improved prognosis. Methods: This cross-sectional study was carried out between 2018 and 2020 on IEIs at a Children's tertiary care center in Tehran, Iran. Demographic details (including age, sex, and parental consanguinity), age at onset of symptoms and family history of IEI with were recorded. Results :212 patients were included. Cutaneous findings were reported in (95 ,44.8%) patients. and 61 of 95 (64.2%) reported skin lesions as the first clinical presentation. Skin infection (69, 72.6%) was the most frequent cutaneous manifestation, followed by an eczematous rash (24, 25 %). Conclusions: Skin manifestations are common feature in IEI patients and can be readily recognizable by healthcare providers. This study tried to provide information on prognostic consequences.Keywords: primary immuno deficiency, inborn errror of metabolism, skin manifestation, skin infection
Procedia PDF Downloads 969581 Graphene Based Electronic Device
Authors: Ali Safari, Pejman Hosseiniun, Iman Rahbari, MohamadReza Kalhor
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The semiconductor industry is placing an increased emphasis on emerging materials and devices that may provide improved performance, or provide novel functionality for devices. Recently, graphene, as a true two-dimensional carbon material, has shown fascinating applications in electronics. In this paper detailed discussions are introduced for possible applications of grapheme Transistor in RF and digital devices.Keywords: graphene, GFET, RF, digital
Procedia PDF Downloads 3619580 The Power of the Proper Orthogonal Decomposition Method
Authors: Charles Lee
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The Principal Orthogonal Decomposition (POD) technique has been used as a model reduction tool for many applications in engineering and science. In principle, one begins with an ensemble of data, called snapshots, collected from an experiment or laboratory results. The beauty of the POD technique is that when applied, the entire data set can be represented by the smallest number of orthogonal basis elements. It is the such capability that allows us to reduce the complexity and dimensions of many physical applications. Mathematical formulations and numerical schemes for the POD method will be discussed along with applications in NASA’s Deep Space Large Antenna Arrays, Satellite Image Reconstruction, Cancer Detection with DNA Microarray Data, Maximizing Stock Return, and Medical Imaging.Keywords: reduced-order methods, principal component analysis, cancer detection, image reconstruction, stock portfolios
Procedia PDF Downloads 849579 A Review on Aluminium Metal Matric Composites
Authors: V. Singh, S. Singh, S. S. Garewal
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Metal matrix composites with aluminum as the matrix material have been heralded as the next great development in advanced engineering materials. Aluminum metal matrix composites (AMMC) refer to the class of light weight high performance material systems. Properties of AMMCs can be tailored to the demands of different industrial applications by suitable combinations of matrix, reinforcement and processing route. AMMC finds its application in automotive, aerospace, defense, sports and structural areas. This paper presents an overview of AMMC material systems on aspects relating to processing, types and applications with case studies.Keywords: aluminum metal matrix composites, applications of aluminum metal matrix composites, lighting material processing of aluminum metal matrix composites
Procedia PDF Downloads 4659578 Sensitivity and Specificity of Clinical Testing for Digital Nerve Injury
Authors: Guy Rubin, Ravit Shay, Nimrod Rozen
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The accuracy of a diagnostic test used to classify a patient as having disease or being disease-free is a valuable piece of information to be used by the physician when making treatment decisions. Finger laceration, suspected to have nerve injury is a challenging decision for the treating surgeon. The purpose of this study was to evaluate the sensitivity, specificity and predictive values of six clinical tests in the diagnosis of digital nerve injury. The six clinical tests included light touch, pin prick, static and dynamic 2-point discrimination, Semmes Weinstein monofilament and wrinkle test. Data comparing pre-surgery examination with post-surgery results of 42 patients with 52 digital nerve injury was evaluated. The subjective examinations, light touch, pin prick, static and dynamic 2-point discrimination and Semmes-Weinstein monofilament were not sensitive (57.6, 69.7, 42.4, 40 and 66.8% respectively) and specific (36.8, 36.8, 47.4, 42.1 and 31.6% respectively). Wrinkle test, the only objective examination, was the most sensitive (78.1%) and specific (55.6%). This result gives no pre-operative examination the ability to predict the result of explorative surgery.Keywords: digital nerve, injury, nerve examination, Semmes-Weinstein monofilamen, sensitivity, specificity, two point discrimination, wrinkle test
Procedia PDF Downloads 3449577 Improving the Emergency Medicine Teaching from the Perspective of Faculty Training
Authors: Qin-Min Ge, Shu-Ming Pan
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Emergency clinicians usually get teaching qualification after graduating from medical universities without special faculty training in China mainland. Emergency departments are overcrowded places, with large numbers of patients suffering undifferentiated illness. In the field of emergency medicine (EM), improving the faculty competencies and developing the teaching skills are important for medical education, they could enhance learners outcomes and hence affect the patients prognosis indirectly. This article highlights the necessities of faculty training in EM, illustrates the qualities a good clinical educator should qualify, advances the skills as educators in an academic setting and discusses the ways to be good clinical teachers.Keywords: emergency education, competence, faculty training, teaching, emergency medicine
Procedia PDF Downloads 5969576 Does Clinical Guidelines Affect Healthcare Quality and Populational Health: Quebec Colorectal Cancer Screening Program
Authors: Nizar Ghali, Bernard Fortin, Guy Lacroix
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In Quebec, colonoscopies volumes have continued to rise in recent years in the absence of effective monitoring mechanism for the appropriateness and the quality of these exams. In 2010, November, Quebec Government introduced the colorectal cancer-screening program in the objective to control for volume and cost imperfection. This program is based on clinical standards and was initiated for first group of institutions. One year later, Government adds financial incentives for participants institutions. In this analysis, we want to assess for the causal effect of the two components of this program: clinical pathways and financial incentives. Especially we assess for the reform effect on healthcare quality and population health in the context that medical remuneration is not directly dependent on this additional funding offered by the program. We have data on admissions episodes and deaths for 8 years. We use multistate model analog to difference in difference approach to estimate reform effect on the transition probability between different states for each patient. Our results show that the reform reduced length of stay without deterioration in hospital mortality or readmission rate. In the other hand, the program contributed to decrease the hospitalization rate and a less invasive treatment approach for colorectal surgeries. This is a sign of healthcare quality and population health improvement. We demonstrate in this analysis that physicians’ behavior can be affected by both clinical standards and financial incentives even if offered to facilities.Keywords: multi-state and multi-episode transition model, healthcare quality, length of stay, transition probability, difference in difference
Procedia PDF Downloads 2149575 Oral Examination: An Important Adjunct to the Diagnosis of Dermatological Disorders
Authors: Sanjay Saraf
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The oral cavity can be the site for early manifestations of mucocutaneous disorders (MD) or the only site for occurrence of these disorders. It can also exhibit oral lesions with simultaneous associated skin lesions. The MD involving the oral mucosa commonly presents with signs such as ulcers, vesicles and bullae. The unique environment of the oral cavity may modify these signs of the disease, thereby making the clinical diagnosis an arduous task. In addition to the unique environment of oral cavity, the overlapping of the signs of various mucocutaneous disorders, also makes the clinical diagnosis more intricate. The aim of this review is to present the oral signs of dermatological disorders having common oral involvement and emphasize their importance in early detection of the systemic disorders. The aim is also to highlight the necessity of oral examination by a dermatologist while examining the skin lesions. Prior to the oral examination, it must be imperative for the dermatologists and the dental clinicians to have the knowledge of oral anatomy. It is also important to know the impact of various diseases on oral mucosa, and the characteristic features of various oral mucocutaneous lesions. An initial clinical oral examination is may help in the early diagnosis of the MD. Failure to identify the oral manifestations may reduce the likelihood of early treatment and lead to more serious problems. This paper reviews the oral manifestations of immune mediated dermatological disorders with common oral manifestations.Keywords: dermatological investigations, genodermatosis, histological features, oral examination
Procedia PDF Downloads 3579574 Correlation Study between Clinical and Radiological Findings in Knee Osteoarthritis
Authors: Nabil A. A. Mohamed, Alaa A. A. Balbaa, Khaled E. Ayad
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Osteoarthritis (OA) of the knee is the most common form of arthritis and leads to more activity limitations (e.g., disability in walking and stair climbing) than any other disease, especially in the elderly. Recently, impaired proprioceptive accuracy of the knee has been proposed as a local factor in the onset and progression of radiographic knee OA (ROA). Purpose: To compare the clinical and radiological findings in healthy with that of knee OA. Also, to determine if there is a correlation between the clinical and radiological findings in patients with knee OA. Subjects: Fifty one patients diagnosed as unilateral or bilateral knee OA with age ranged between 35-70 years, from both gender without any previous history of knee trauma or surgery, and twenty one normal subjects with age ranged from 35 - 68 years. METHODS: peak torque/body weight (PT/BW) was recorded from knee extensors at isokinetic isometric mode at angle of 45 degree. Also, the Absolute Angular Error was recorded at 45O and 30O to measure joint position sense (JPS). They made anteroposterior (AP) plain X-rays from standing semiflexed knee position and their average score of Timed Up and Go test(TUG) and WOMAC were recorded as a measure of knee pain, stiffness and function. Comparison between the mean values of different variables in the two groups was performed using unpaired student t test. The P value less or equal to 0.05 was considered significant. Results: There were significant differences between the studied variables between the experimental and control groups except the values of AAE at 30O. Also, there were no significant correlation between the clinical findings (pain, function, muscle strength and proprioception) and the severity of arthritic changes in X-rays. CONCLUSION: From the finding of the current study we can conclude that there were a significant difference between the both groups in all studied parameters (the WOMAC, functional level, quadriceps muscle strength and the joint proprioception). Also this study did not support the dependency on radiological findings in management of knee OA as the radiological features did not necessarily indicate the level of structural damage of patients with knee OA and we should consider the clinical features in our treatment plan.Keywords: joint position sense, peak torque, proprioception, radiological knee osteoarthritis
Procedia PDF Downloads 3029573 Physics Informed Deep Residual Networks Based Type-A Aortic Dissection Prediction
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Purpose: Acute Type A aortic dissection is a well-known cause of extremely high mortality rate. A highly accurate and cost-effective non-invasive predictor is critically needed so that the patient can be treated at earlier stage. Although various CFD approaches have been tried to establish some prediction frameworks, they are sensitive to uncertainty in both image segmentation and boundary conditions. Tedious pre-processing and demanding calibration procedures requirement further compound the issue, thus hampering their clinical applicability. Using the latest physics informed deep learning methods to establish an accurate and cost-effective predictor framework are amongst the main goals for a better Type A aortic dissection treatment. Methods: Via training a novel physics-informed deep residual network, with non-invasive 4D MRI displacement vectors as inputs, the trained model can cost-effectively calculate all these biomarkers: aortic blood pressure, WSS, and OSI, which are used to predict potential type A aortic dissection to avoid the high mortality events down the road. Results: The proposed deep learning method has been successfully trained and tested with both synthetic 3D aneurysm dataset and a clinical dataset in the aortic dissection context using Google colab environment. In both cases, the model has generated aortic blood pressure, WSS, and OSI results matching the expected patient’s health status. Conclusion: The proposed novel physics-informed deep residual network shows great potential to create a cost-effective, non-invasive predictor framework. Additional physics-based de-noising algorithm will be added to make the model more robust to clinical data noises. Further studies will be conducted in collaboration with big institutions such as Cleveland Clinic with more clinical samples to further improve the model’s clinical applicability.Keywords: type-a aortic dissection, deep residual networks, blood flow modeling, data-driven modeling, non-invasive diagnostics, deep learning, artificial intelligence.
Procedia PDF Downloads 899572 Self-Stigma Regarding Mental Illness: An Empirical Study
Authors: Linta Koka
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Aim: The way people with severe mental disorders deal with self-stigma and how it affects their self-esteem is a problem that has gained much attention in recent years. The primary aim of this study was to empirically explore the link between self-stigma and self-esteem of individuals with the presence of a mental illness, offering a novel perspective by exploring the same variables amongst a sample without a mental illness. Methods: This study utilized a cross-sectional study. Participants with (N=85) and without (N=75) a mental health issue were included from Darlingdon's Mind organization. Participants completed two scales, one of Self-Stigma of Mental Illness Scale and one of Self-Esteem, following some demographics questions. Results: According to the primary hypothesis, self-stigma significantly correlates with self-esteem in the clinical population. Furthermore, gender and ethnicity, above all the demographics, positively correlates to the relationship of self-stigma with self-esteem in people who endure a mental health issue. Limitations: A significant limitation is that of the size of the sample of participants conducted in this study. The clinical population was limited to 85 participants, and the control group consisted of 76 participants. Since the sample was not representative. The small size used did not allow any comparisons between the group with mental illness and the control group. There was a restricted time to approach the participants since the online survey was released by the end of May. Conclusions: Individuals suffering from mental illnesses may internalize stigmatizing stereotypes on an explicit level. Efforts should be made to lessen the harmful impact stigma may have on mentally ill people, such as worsening symptoms or delays in receiving care. Further study is needed within this small research topic to improve awareness and regulate mental health among the general population. Undoubtedly, people with mental disorders are stigmatized; therefore, more research is required to explore all factors contributing to mentally ill patients' devaluation.Keywords: self-stigma, mental illness, self-esteem, clinical population, non-clinical population
Procedia PDF Downloads 63