Search results for: Acute heart attacks
2279 Assessment of Psychomotor Development of Preschool Children: A Review of Eight Psychomotor Developmental Tools
Authors: Viola Hubačová Pirová
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The assessment of psychomotor development allows us to identify children with motor delays, helps us to monitor progress in time and prepare suitable intervention programs. The foundation of psychomotor development lies in pre-school age and is crucial for child´s further cognitive and social development. Many assessment tools of psychomotor development have been developed over the years. Some of them are easy screening tools; others are more complex and sophisticated. The purpose of this review is to describe the history of psychomotor assessment, specify preschool children´s psychomotor evaluation and review eight psychomotor development assessment tools for preschool children (Denver II., DEMOST-PRE, TGMD -2/3, BOT-2, MABC-2, PDMS-2, KTK, MOT 4-6). The selection of test depends on purpose and context in which is the assessment planned.Keywords: assessment of psychomotor development, preschool children, psychomotor development, review of assessment tools
Procedia PDF Downloads 1672278 Resisting Adversarial Assaults: A Model-Agnostic Autoencoder Solution
Authors: Massimo Miccoli, Luca Marangoni, Alberto Aniello Scaringi, Alessandro Marceddu, Alessandro Amicone
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The susceptibility of deep neural networks (DNNs) to adversarial manipulations is a recognized challenge within the computer vision domain. Adversarial examples, crafted by adding subtle yet malicious alterations to benign images, exploit this vulnerability. Various defense strategies have been proposed to safeguard DNNs against such attacks, stemming from diverse research hypotheses. Building upon prior work, our approach involves the utilization of autoencoder models. Autoencoders, a type of neural network, are trained to learn representations of training data and reconstruct inputs from these representations, typically minimizing reconstruction errors like mean squared error (MSE). Our autoencoder was trained on a dataset of benign examples; learning features specific to them. Consequently, when presented with significantly perturbed adversarial examples, the autoencoder exhibited high reconstruction errors. The architecture of the autoencoder was tailored to the dimensions of the images under evaluation. We considered various image sizes, constructing models differently for 256x256 and 512x512 images. Moreover, the choice of the computer vision model is crucial, as most adversarial attacks are designed with specific AI structures in mind. To mitigate this, we proposed a method to replace image-specific dimensions with a structure independent of both dimensions and neural network models, thereby enhancing robustness. Our multi-modal autoencoder reconstructs the spectral representation of images across the red-green-blue (RGB) color channels. To validate our approach, we conducted experiments using diverse datasets and subjected them to adversarial attacks using models such as ResNet50 and ViT_L_16 from the torch vision library. The autoencoder extracted features used in a classification model, resulting in an MSE (RGB) of 0.014, a classification accuracy of 97.33%, and a precision of 99%.Keywords: adversarial attacks, malicious images detector, binary classifier, multimodal transformer autoencoder
Procedia PDF Downloads 1122277 Implementation of the Interlock Protocol to Enhance Security in Unmanned Aerial Vehicles
Authors: Vikram Prabhu, Mohammad Shikh Bahaei
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This paper depicts the implementation of a new infallible technique to protect an Unmanned Aerial Vehicle from cyber-attacks. An Unmanned Aerial Vehicle (UAV) could be vulnerable to cyber-attacks because of jammers or eavesdroppers over the network which pose as a threat to the security of the UAV. In the field of network security, there are quite a few protocols which can be used to establish a secure connection between UAVs and their Operators. In this paper, we discuss how the Interlock Protocol could be implemented to foil the Man-in-the-Middle Attack. In this case, Wireshark has been used as the sniffer (man-in-the-middle). This paper also shows a comparison between the Interlock Protocol and the TCP Protocols using cryptcat and netcat and at the same time highlights why the Interlock Protocol is the most efficient security protocol to prevent eavesdropping over the communication channel.Keywords: interlock protocol, Diffie-Hellman algorithm, unmanned aerial vehicles, control station, man-in-the-middle attack, Wireshark
Procedia PDF Downloads 3012276 Acute Cartilage Defects of the Knee Treated With Chondral Restoration Procedures and Patellofemoral Stabilisation
Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil
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Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.Keywords: patella dislocation, chondral restoration, knee, patella stabilisation
Procedia PDF Downloads 1282275 Optimal ECG Sampling Frequency for Multiscale Entropy-Based HRV
Authors: Manjit Singh
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Multiscale entropy (MSE) is an extensively used index to provide a general understanding of multiple complexity of physiologic mechanism of heart rate variability (HRV) that operates on a wide range of time scales. Accurate selection of electrocardiogram (ECG) sampling frequency is an essential concern for clinically significant HRV quantification; high ECG sampling rate increase memory requirements and processing time, whereas low sampling rate degrade signal quality and results in clinically misinterpreted HRV. In this work, the impact of ECG sampling frequency on MSE based HRV have been quantified. MSE measures are found to be sensitive to ECG sampling frequency and effect of sampling frequency will be a function of time scale.Keywords: ECG (electrocardiogram), heart rate variability (HRV), multiscale entropy, sampling frequency
Procedia PDF Downloads 2712274 Carvacrol Attenuates Lung Injury in Rats with Severe Acute Pancreatitis
Authors: Salim Cerig, Fatime Geyikoglu, Pınar Akpulat, Suat Colak, Hasan Turkez, Murat Bakir, Mirkhalil Hosseinigouzdagani, Kubra Koc
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This study was designed to evaluate whether carvacrol (CAR) could provide protection against lung injury by acute pancreatitis development. The rats were randomized into groups to receive (I) no therapy; (II) 50 μg/kg cerulein at 1h intervals by four intraperitoneal injections (i.p.); (III) 50, 100 and 200 mg/kg CAR by one i.p.; and (IV) cerulein+CAR after 2h of cerulein injection. 12h later, serum samples were obtained to assess pancreatic function the lipase and amylase values. The animals were euthanized and lung samples were excised. The specimens were stained with hematoxylin-eosin (H&E), periodic acid–Schif (PAS), Mallory's trichrome and amyloid. Additionally, oxidative DNA damage was determined by measuring as increases in 8-hydroxy-deoxyguanosine (8-OH-dG) adducts. The results showed that the serum activity of lipase and amylase in AP rats were significantly reduced after the therapy (p<0.05). We also found that the 100 mg/kg dose of CAR significantly decreased 8-OH-dG levels. Moreover, the severe pathological findings in the lung such as necrosis, inflammation, congestion, fibrosis, and thickened alveolar septum were attenuated in the AP+CAR groups when compared with AP group. Finally, the magnitude of the protective effect on lung is certain, and CAR is an effective therapy for lung injury caused by AP.Keywords: antioxidant activity, acute pancreatitis, carvacrol, experimental, lung injury, oxidative DNA damage
Procedia PDF Downloads 3692273 Detection, Isolation, and Raman Spectroscopic Characterization of Acute and Chronic Staphylococcus aureus Infection in an Endothelial Cell Culture Model
Authors: Astrid Tannert, Anuradha Ramoji, Christina Ebert, Frederike Gladigau, Lorena Tuchscherr, Jürgen Popp, Ute Neugebauer
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Staphylococcus aureus is a facultative intracellular pathogen, which by entering host cells may evade immunologic host response as well as antimicrobial treatment. In that way, S. aureus can cause persistent intracellular infections which are difficult to treat. Depending on the strain, S. aureus may persist at different intracellular locations like the phagolysosome. The first barrier invading pathogens from the blood stream that they have to cross are the endothelial cells lining the inner surface of blood and lymphatic vessels. Upon proceeding from an acute to a chronic infection, intracellular pathogens undergo certain biochemical and structural changes including a deceleration of metabolic processes to adopt for long-term intracellular survival and the development of a special phenotype designated as small colony variant. In this study, the endothelial cell line Ea.hy 926 was used as a model for acute and chronic S. aureus infection. To this end, Ea.hy 926 cells were cultured on QIAscout™ Microraft Arrays, a special graded cell culture substrate that contains around 12,000 microrafts of 200 µm edge length. After attachment to the substrate, the endothelial cells were infected with GFP-expressing S. aureus for 3 weeks. The acute infection and the development of persistent bacteria was followed by confocal laser scanning microscopy, scanning the whole Microraft Array for the presence and for detailed determination of the intracellular location of fluorescent intracellular bacteria every second day. After three weeks of infection representative microrafts containing infected cells, cells with protruded infections and cells that did never show any infection were isolated and fixed for Raman micro-spectroscopic investigation. For comparison, also microrafts with acute infection were isolated. The acquired Raman spectra are correlated with the fluorescence microscopic images to give hints about a) the molecular alterations in endothelial cells during acute and chronic infection compared to non-infected cells, and b) metabolic and structural changes within the pathogen when entering a mode of persistence within host cells. We thank Dr. Ruth Kläver from QIAGEN GmbH for her support regarding QIAscout technology. Financial support by the BMBF via the CSCC (FKZ 01EO1502) and from the DFG via the Jena Biophotonic and Imaging Laboratory (JBIL, FKZ PO 633/29-1, BA 1601/10-1) is highly acknowledged.Keywords: correlative image analysis, intracellular infection, pathogen-host adaption, Raman micro-spectroscopy
Procedia PDF Downloads 1812272 Factors Associated with Commencement of Non-Invasive Ventilation
Authors: Manoj Kumar Reddy Pulim, Lakshmi Muthukrishnan, Geetha Jayapathy, Radhika Raman
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Introduction: In the past two decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure in children. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions, decrease airway injury, and prevent respiratory tract infections. There is a need to determine the clinical profile and parameters which point towards the need for NIV in the pediatric emergency setting. Objectives: i) To study the clinical profile of children who required non invasive ventilation and invasive ventilation, ii) To study the clinical parameters common to children who required non invasive ventilation. Methods: All children between one month to 18 years, who were intubated in the pediatric emergency department and those for whom decision to commence Non Invasive Ventilation was made in Emergency Room were included in the study. Children were transferred to the Paediatric Intensive Care Unit and started on Non Invasive Ventilation as per our hospital policy and followed up in the Paediatric Intensive Care Unit. Clinical profile of all children which included age, gender, diagnosis and indication for intubation were documented. Clinical parameters such as respiratory rate, heart rate, saturation, grunting were documented. Parameters obtained were subject to statistical analysis. Observations: Airway disease (Bronchiolitis 25%, Viral induced wheeze 22%) was a common diagnosis in 32 children who required Non Invasive Ventilation. Neuromuscular disorder was the common diagnosis in 27 children (78%) who were Intubated. 17 children commenced on Non Invasive Ventilation who later needed invasive ventilation had Neuromuscular disease. High frequency nasal cannula was used in 32, and mask ventilation in 17 children. Clinical parameters common to the Non Invasive Ventilation group were age < 1 year (17), tachycardia n = 7 (22%), tachypnea n = 23 (72%) and severe respiratory distress n = 9 (28%), grunt n = 7 (22%), SPO2 (80% to 90%) n = 16. Children in the Non Invasive Ventilation + INTUBATION group were > 3 years (9), had tachycardia 7 (41%), tachypnea 9(53%) with a male predominance n = 9. In statistical comparison among 3 groups,'p' value was significant for pH, saturation, and use of Ionotrope. Conclusion: Invasive ventilation can be avoided in the paediatric Emergency Department in children with airway disease, by commencing Non Invasive Ventilation early. Intubation in the pediatric emergency department has a higher association with neuromuscular disorders.Keywords: clinical parameters, indications, non invasive ventilation, paediatric emergency room
Procedia PDF Downloads 3362271 Acute Respiratory Distress Syndrome (ARDS) Developed Clinical Pathway: Suggested Protocol
Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah
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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome
Procedia PDF Downloads 5342270 Secure Optimized Ingress Filtering in Future Internet Communication
Authors: Bander Alzahrani, Mohammed Alreshoodi
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Information-centric networking (ICN) using architectures such as the Publish-Subscribe Internet Technology (PURSUIT) has been proposed as a new networking model that aims at replacing the current used end-centric networking model of the Internet. This emerged model focuses on what is being exchanged rather than which network entities are exchanging information, which gives the control plane functions such as routing and host location the ability to be specified according to the content items. The forwarding plane of the PURSUIT ICN architecture uses a simple and light mechanism based on Bloom filter technologies to forward the packets. Although this forwarding scheme solve many problems of the today’s Internet such as the growth of the routing table and the scalability issues, it is vulnerable to brute force attacks which are starting point to distributed- denial-of-service (DDoS) attacks. In this work, we design and analyze a novel source-routing and information delivery technique that keeps the simplicity of using Bloom filter-based forwarding while being able to deter different attacks such as denial of service attacks at the ingress of the network. To achieve this, special forwarding nodes called Edge-FW are directly attached to end user nodes and used to perform a security test for malicious injected random packets at the ingress of the path to prevent any possible attack brute force attacks at early stage. In this technique, a core entity of the PURSUIT ICN architecture called topology manager, that is responsible for finding shortest path and creating a forwarding identifiers (FId), uses a cryptographically secure hash function to create a 64-bit hash, h, over the formed FId for authentication purpose to be included in the packet. Our proposal restricts the attacker from injecting packets carrying random FIds with a high amount of filling factor ρ, by optimizing and reducing the maximum allowed filling factor ρm in the network. We optimize the FId to the minimum possible filling factor where ρ ≤ ρm, while it supports longer delivery trees, so the network scalability is not affected by the chosen ρm. With this scheme, the filling factor of any legitimate FId never exceeds the ρm while the filling factor of illegitimate FIds cannot exceed the chosen small value of ρm. Therefore, injecting a packet containing an FId with a large value of filling factor, to achieve higher attack probability, is not possible anymore. The preliminary analysis of this proposal indicates that with the designed scheme, the forwarding function can detect and prevent malicious activities such DDoS attacks at early stage and with very high probability.Keywords: forwarding identifier, filling factor, information centric network, topology manager
Procedia PDF Downloads 1542269 Prevalence of Methylenetetrahydrofolate Reductase A1298C Variant in Tunisian Childhood Acute Lymphoblastic Leukemia
Authors: Rim Frikha, Maha Ben Jema, Moez Elloumi, Tarek Rebai
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Background: Acute lymphoblastic leukemia (ALL); a common blood cancer characterized by the interaction between genetic and environmental factors. Methylenetetrahydrofolate reductase (MTHFR) is an essential folate metabolic enzyme in the processes of DNA synthesis and methylation. A common functional variant of the MTHFR gene, the A1298C, which induces disturbances in folate metabolism, may affect susceptibility to ALL. Objective: The present study aimed to assess the prevalence of MTHFR polymorphism A1298 > C in Tunisian children with ALL. Materials and Methods: A total of 28 Tunisian ALL children were enrolled in this study. Genomic DNA was extracted from whole venous blood collected in ethylenediaminetetraacetic acid (EDTA). Genotyping was carried out with restriction fragment length polymorphism (RFLP) using MboII restriction enzyme. Genotype distribution and allele frequency of MTHFR A1298C was calculated in ALL patients. Results: The A1298C variant of MTHFR was found in 11(19.6%) heterozygous and one homozygous patient (3.5%). Conclusions: This result highlights that A1298C polymorphism of MTHFR is common in Tunisian childhood ALL and suggests that this variant may have a potential role in leukemogenesis. Genotyping of large samples and different ethnicities are required to validate these findings.Keywords: methylenetetrahydrofolate reductase, acute lymphoblastic leukemia, A1298C variant, prevalence
Procedia PDF Downloads 1352268 Possible Protective Role of Angiotensin II Antagonist on Bacterial Endotoxin Induced Acute Lung Injury: Morphological Study on Adult Male Albino Rat
Authors: Mohamed Bakry Mohamed Ali, Mohamed Ehab El-Din Mustafa, Joseph Naiem Sabet Aziz, Sarah Mahmoud Ali Kaooh
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Background: Acute lung injury (ALI) is one of the major challenges in intensive care medicine. The most common extrapulmonary cause of ALI is sepsis, accounting more than 30% of the cases in humans. Lipopolysaccharide (LPS) has gained wide acceptance as a clinically relevant model of ALI. Lipopolysaccharide is a glycoprotein forming the major constituent of bacterial endotoxin. Losartan is angiotensin II type 1 (AT1) receptor antagonists. It is widely used for management of hypertension. It was recently suggested that losartan protects against septic ALI. It would thereby prevent LPS-induced ALI. Aim of the work and design of the experiment: This work investigated the injurious effect of lipopolysaccharide (LPS) and ALI on adult male albino rat at 24 hours and 14 days of LPS administration and the possible protective role of losartan pretreatment. LPS has deteriorated animal survival and behavior. It increased lung weight and induced lung histological damage. These changes could be much reduced by the losartan pretreatment. Conclusion: Administration of losartan before LPS could largely reduce these LPS/ ALI induced short and long term alterations. It could be recommended that patients susceptible to developing ALI, as in ICU, should receive a protective dose of angitensin II type 1 (AT1) receptor blocker as losartan.Keywords: acute lung injury (ALI), lipopolysaccharide (LPS), losartan
Procedia PDF Downloads 6072267 Altered TP53 Mutations in de Novo Acute Myeloid Leukemia Patients in Iran
Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani
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Background: The TP53 mutation is frequently detected in acute myeloid leukemia (AML) patients with complex karyotype (CK), but the stability of this mutation during the clinical course remains unclear. Material and Methods: In this study, TP53 mutations were identified in 7% of 500 patients with de novo AML and 58.8% of patients with CK in Tabriz, Iran. TP53 mutations were closely associated with older age, lower white blood cell (WBC) and platelet counts, FAB M6 subtype, unfavorable-risk cytogenetics, and CK, but negatively associated with NPM1 mutation, FLT3/ITD and DNMT3A mutation. Result: Multivariate analysis demonstrated that TP53 mutation was an independent poor prognostic factor for overall survival and disease-free survival among the total cohort and the subgroup of patients with CK. A scoring system incorporating TP53 mutation and nine other prognostic factors, including age, WBC counts, cytogenetics, and gene mutations, into survival analysis proved to be very useful to stratify AML patients. Sequential study of 420 samples showed that TP53 mutations were stable during AML evolution, whereas the mutation was acquired only in 1 of the 126 TP53 wild-type patients when therapy-related AML originated from different clone emerged. Conclusion: In conclusion, TP53 mutations are associated with distinct clinic-biological features and poor prognosis in de novo AML patients and are rather stable during disease progression.Keywords: acute myloblastic leukemia, TP53, FLT3/ITD, Iran
Procedia PDF Downloads 1052266 Real-time Rate and Rhythms Feedback Control System in Patients with Atrial Fibrillation
Authors: Mohammad A. Obeidat, Ayman M. Mansour
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Capturing the dynamic behavior of the heart to improve control performance, enhance robustness, and support diagnosis is very important in establishing real time models for the heart. Control Techniques and strategies have been utilized to improve system costs, reliability, and estimation accuracy for different types of systems such as biomedical, industrial, and other systems that required tuning input/output relation and/or monitoring. Simulations are performed to illustrate potential applications of the technology. In this research, a new control technology scheme is used to enhance the performance of the Af system and meet the design specifications.Keywords: atrial fibrillation, dynamic behavior, closed loop, signal, filter
Procedia PDF Downloads 4202265 DWT-SATS Based Detection of Image Region Cloning
Authors: Michael Zimba
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A duplicated image region may be subjected to a number of attacks such as noise addition, compression, reflection, rotation, and scaling with the intention of either merely mating it to its targeted neighborhood or preventing its detection. In this paper, we present an effective and robust method of detecting duplicated regions inclusive of those affected by the various attacks. In order to reduce the dimension of the image, the proposed algorithm firstly performs discrete wavelet transform, DWT, of a suspicious image. However, unlike most existing copy move image forgery (CMIF) detection algorithms operating in the DWT domain which extract only the low frequency sub-band of the DWT of the suspicious image thereby leaving valuable information in the other three sub-bands, the proposed algorithm simultaneously extracts features from all the four sub-bands. The extracted features are not only more accurate representation of image regions but also robust to additive noise, JPEG compression, and affine transformation. Furthermore, principal component analysis-eigenvalue decomposition, PCA-EVD, is applied to reduce the dimension of the features. The extracted features are then sorted using the more computationally efficient Radix Sort algorithm. Finally, same affine transformation selection, SATS, a duplication verification method, is applied to detect duplicated regions. The proposed algorithm is not only fast but also more robust to attacks compared to the related CMIF detection algorithms. The experimental results show high detection rates.Keywords: affine transformation, discrete wavelet transform, radix sort, SATS
Procedia PDF Downloads 2302264 Security Design of Root of Trust Based on RISC-V
Authors: Kang Huang, Wanting Zhou, Shiwei Yuan, Lei Li
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Since information technology develops rapidly, the security issue has become an increasingly critical for computer system. In particular, as cloud computing and the Internet of Things (IoT) continue to gain widespread adoption, computer systems need to new security threats and attacks. The Root of Trust (RoT) is the foundation for providing basic trusted computing, which is used to verify the security and trustworthiness of other components. Design a reliable Root of Trust and guarantee its own security are essential for improving the overall security and credibility of computer systems. In this paper, we discuss the implementation of self-security technology based on the RISC-V Root of Trust at the hardware level. To effectively safeguard the security of the Root of Trust, researches on security safeguard technology on the Root of Trust have been studied. At first, a lightweight and secure boot framework is proposed as a secure mechanism. Secondly, two kinds of memory protection mechanism are built to against memory attacks. Moreover, hardware implementation of proposed method has been also investigated. A series of experiments and tests have been carried on to verify to effectiveness of the proposed method. The experimental results demonstrated that the proposed approach is effective in verifying the integrity of the Root of Trust’s own boot rom, user instructions, and data, ensuring authenticity and enabling the secure boot of the Root of Trust’s own system. Additionally, our approach provides memory protection against certain types of memory attacks, such as cache leaks and tampering, and ensures the security of root-of-trust sensitive information, including keys.Keywords: root of trust, secure boot, memory protection, hardware security
Procedia PDF Downloads 2152263 Characterization of Chest Pain in Patients Consulting to the Emergency Department of a Health Institution High Level of Complexity during 2014-2015, Medellin, Colombia
Authors: Jorge Iván Bañol-Betancur, Lina María Martínez-Sánchez, María de los Ángeles Rodríguez-Gázquez, Estefanía Bahamonde-Olaya, Ana María Gutiérrez-Tamayo, Laura Isabel Jaramillo-Jaramillo, Camilo Ruiz-Mejía, Natalia Morales-Quintero
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Acute chest pain is a distressing sensation between the diaphragm and the base of the neck and it represents a diagnostic challenge for any physician in the emergency department. Objective: To establish the main clinical and epidemiological characteristics of patients who present with chest pain to the emergency department in a private clinic from the city of Medellin, during 2014-2015. Methods: Cross-sectional retrospective observational study. Population and sample were patients who consulted for chest pain in the emergency department who met the eligibility criteria. The information was analyzed in SPSS program vr.21; qualitative variables were described through relative frequencies, and the quantitative through mean and standard deviation or medians according to their distribution in the study population. Results: A total of 231 patients were evaluated, the mean age was 49.5 ± 19.9 years, 56.7% were females. The most frequent pathological antecedents were hypertension 35.5%, diabetes 10,8%, dyslipidemia 10.4% and coronary disease 5.2%. Regarding pain features, in 40.3% of the patients the pain began abruptly, in 38.2% it had a precordial location, for 20% of the cases physical activity acted as a trigger, and 60.6% was oppressive. Costochondritis was the most common cause of chest pain among patients with an established etiologic diagnosis, representing the 18.2%. Conclusions: Although the clinical features of pain reported coincide with the clinical presentation of an acute coronary syndrome, the most common cause of chest pain in study population was costochondritis instead, indicating that it is a differential diagnostic in the approach of patients with pain acute chest.Keywords: acute coronary syndrome, chest pain, epidemiology, osteochondritis
Procedia PDF Downloads 3432262 Antibacterial Activities, Chemical Constitutes and Acute Toxicity of Peganum Harmala L. Essential Oil
Authors: Samy Selim
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Natural products are still major sources of innovative therapeutic agents for various conditions, including infectious diseases. Peganum harmala L. oil had wide range uses as traditional medicinal plants. The current study was designed to evaluate the antibacterial activity of P. harmala essential oil. The chemical constitutes and toxicity of these oils was also determined to obtain further information on the correlation between the chemical contents and antibacterial activity. The antibacterial effect of the essential oils of P. harmala oil was studied against some foodborne pathogenic bacteria species. The oil of plant was subjected to gas chromatography-mass spectrometry (GC/MS). The impact of oils administration on the change in rate of weight gain and complete blood picture in hamsters were investigated. P. harmala oil had strong antibacterial effect against bacterial species especially at minimum inhibitory concentration (MIC) less than 75.0 μg/ml. From the oil of P. harmala, forty one compounds were identified, and the major constituent was 1-hexyl-2-nitrocyclohexane (9.07%). Acute toxicity test was performed on hamsters and showed complete survival after 14 days, and there were no toxicity symptoms occurred. This study demonstrated that these essential oils seemed to be destitute of toxic effect which could compromise the medicinal use of these plants in folk medicine.Keywords: analysis mass spectrometry, antibacterial activities, acute toxicity, chemical constitutes, gas chromatography, weight gain, Peganum harmala
Procedia PDF Downloads 4832261 Factors Associated with Acute Kidney Injury in Multiple Trauma Patients with Rhabdomyolysis
Authors: Yong Hwang, Kang Yeol Suh, Yundeok Jang, Tae Hoon Kim
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Introduction: Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Acute kidney injury is a potential complication of severe rhabdomyolysis and the prognosis is substantially worse if renal failure develops. We try to identify the factors that were predictive of AKI in severe trauma patients with rhabdomyolysis. Methods: This retrospective study was conducted at the emergency department of a level Ⅰ trauma center. Patients enrolled that initial creatine phosphokinase (CPK) levels were higher than 1000 IU with acute multiple trauma, and more than 18 years older from Oct. 2012 to June 2016. We collected demographic data (age, gender, length of hospital day, and patients’ outcome), laboratory data (ABGA, lactate, hemoglobin. hematocrit, platelet, LDH, myoglobin, liver enzyme, and BUN/Cr), and clinical data (Injury Mechanism, RTS, ISS, AIS, and TRISS). The data were compared and analyzed between AKI and Non-AKI group. Statistical analyses were performed using IMB SPSS 20.0 statistics for Window. Results: Three hundred sixty-four patients were enrolled that AKI group were ninety-six and non-AKI group were two hundred sixty-eight. The base excess (HCO3), AST/ALT, LDH, and myoglobin in AKI group were significantly higher than non-AKI group from laboratory data (p ≤ 0.05). The injury severity score (ISS), revised Trauma Score (RTS), Abbreviated Injury Scale 3 and 4 (AIS 3 and 4) were showed significant results in clinical data. The patterns of CPK level were increased from first and second day, but slightly decreased from third day in both group. Seven patients had received hemodialysis treatment despite the bleeding risk and were survived in AKI group. Conclusion: We recommend that HCO3, CPK, LDH, and myoglobin should be checked and be concerned about ISS, RTS, AIS with injury mechanism at the early stage of treatment in the emergency department.Keywords: acute kidney injury, emergencies, multiple trauma, rhabdomyolysis
Procedia PDF Downloads 3392260 Assisted Prediction of Hypertension Based on Heart Rate Variability and Improved Residual Networks
Authors: Yong Zhao, Jian He, Cheng Zhang
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Cardiovascular diseases caused by hypertension are extremely threatening to human health, and early diagnosis of hypertension can save a large number of lives. Traditional hypertension detection methods require special equipment and are difficult to detect continuous blood pressure changes. In this regard, this paper first analyzes the principle of heart rate variability (HRV) and introduces sliding window and power spectral density (PSD) to analyze the time domain features and frequency domain features of HRV, and secondly, designs an HRV-based hypertension prediction network by combining Resnet, attention mechanism, and multilayer perceptron, which extracts the frequency domain through the improved ResNet18 features through a modified ResNet18, its fusion with time-domain features through an attention mechanism, and the auxiliary prediction of hypertension through a multilayer perceptron. Finally, the network was trained and tested using the publicly available SHAREE dataset on PhysioNet, and the test results showed that this network achieved 92.06% prediction accuracy for hypertension and outperformed K Near Neighbor(KNN), Bayes, Logistic, and traditional Convolutional Neural Network(CNN) models in prediction performance.Keywords: feature extraction, heart rate variability, hypertension, residual networks
Procedia PDF Downloads 1052259 Two-Level Graph Causality to Detect and Predict Random Cyber-Attacks
Authors: Van Trieu, Shouhuai Xu, Yusheng Feng
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Tracking attack trajectories can be difficult, with limited information about the nature of the attack. Even more difficult as attack information is collected by Intrusion Detection Systems (IDSs) due to the current IDSs having some limitations in identifying malicious and anomalous traffic. Moreover, IDSs only point out the suspicious events but do not show how the events relate to each other or which event possibly cause the other event to happen. Because of this, it is important to investigate new methods capable of performing the tracking of attack trajectories task quickly with less attack information and dependency on IDSs, in order to prioritize actions during incident responses. This paper proposes a two-level graph causality framework for tracking attack trajectories in internet networks by leveraging observable malicious behaviors to detect what is the most probable attack events that can cause another event to occur in the system. Technically, given the time series of malicious events, the framework extracts events with useful features, such as attack time and port number, to apply to the conditional independent tests to detect the relationship between attack events. Using the academic datasets collected by IDSs, experimental results show that the framework can quickly detect the causal pairs that offer meaningful insights into the nature of the internet network, given only reasonable restrictions on network size and structure. Without the framework’s guidance, these insights would not be able to discover by the existing tools, such as IDSs. It would cost expert human analysts a significant time if possible. The computational results from the proposed two-level graph network model reveal the obvious pattern and trends. In fact, more than 85% of causal pairs have the average time difference between the causal and effect events in both computed and observed data within 5 minutes. This result can be used as a preventive measure against future attacks. Although the forecast may be short, from 0.24 seconds to 5 minutes, it is long enough to be used to design a prevention protocol to block those attacks.Keywords: causality, multilevel graph, cyber-attacks, prediction
Procedia PDF Downloads 1562258 The Role of QX-314 and Capsaicin in Producing Long-Lasting Local Anesthesia in the Animal Model of Trigeminal Neuralgia
Authors: Ezzati Givi M., Ezzatigivi N., Eimani H.
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Trigeminal Neuralgia (TN) consists of painful attacks often triggered with general activities, which cause impairment and disability. The first line of treatment consists of pharmacotherapy. However, the occurrence of many side-effects limits its application. Acute pain relief is crucial for titrating oral drugs and making time for neurosurgical intervention. This study aimed to examine the long-term anesthetic effect of QX-314 and capsaicin in trigeminal neuralgia using an animal model. TN was stimulated by surgical constriction of the infraorbital nerve in rats. After seven days, anesthesia infiltration was done, and the duration of mechanical allodynia was compared. Thirty-five male Wistar rats were randomly divided into seven groups as follows: control (normal saline); lidocaine (2%); QX314 (30 mM); lidocaine (2%)+QX314 (15 mM); lidocaine (2%)+QX314 (22 mM); lidocaine (2%)+QX314 (30 mM); and lidocaine (2%)+QX314 (30 mM) +capsaicin (1μg). QX314 in combination with lidocaine significantly increased the duration of anesthesia, which was dose-dependent. The combination of lidocaine+QX314+capsaicin could significantly increase the duration of anesthesia in trigeminal neuralgia. In the present study, we demonstrated that the combination of QX-314 with lidocaine and capsaicin produced a long-lasting, reversible local anesthesia and was superior to lidocaine alone in the fields of the duration of trigeminal neuropathic pain blockage.Keywords: trigeminal neuralgia, capsaicin, lidocaine, long-lasting
Procedia PDF Downloads 1142257 Nebulized Magnesium Sulfate in Acute Moderate to Severe Asthma in Pediatric Patients
Authors: Lubna M. Zakaryia Mahmoud, Mohammed A. Dawood, Doaa A. Heiba
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A prospective double-blind placebo controlled trial carried out on 60 children known to be asthmatic who presented to the emergency department at Alexandria University of Children’s Hospital at El-Shatby with acute asthma exacerbations to assess the efficacy of adding inhaled magnesium sulfate to β-agonist, compared with β-agonist in saline, in the management of acute asthma exacerbations in children. The participants in the study were divided in two groups; Group A (study group) received inhaled salbutamol solution (0.15 ml/kg) plus isotonic magnesium sulfate 2 ml in a nebulizer chamber. Group B (control group): received nebulized salbutamol solution (0.15 ml/kg) diluted with placebo (2 ml normal saline). Both groups received inhaled solution every 20 minutes that was repeated for three doses. They were evaluated using the Pediatric Asthma Severity Score (PASS), oxygen saturation using portable pulse oximetry and peak expiratory flow rate using a portable peak expiratory flow meter at initially recorded as zero-minute assessment and every 20 minutes from the end of each nebulization (nebulization lasts 5-10 minutes) recorded as 20, 40 and 60-minute assessments. Regarding PASS, comparison showed non-significant difference with p-value 0.463, 0.472, 0.0766 at 20, 40 and 60 minutes. Regarding oxygen saturation, improvement was more significant towards group A starting from 40 min with significant p-value=0.000. At 60 min p-value=0.000. Although mean PEFR significantly improved from zero-min in both groups; however, improvement was more significant in group A with significant p-value = 0.015, 0.001, 0.001 at 20 min, 40 min and 60 min, respectively. The conclusion this study suggests is that inhaled magnesium sulfate is an efficient add on drug to standard β- agonist inhalation used in the treatment of moderate to severe asthma exacerbations.Keywords: nebulized, magnesium sulfate, acute asthma , pediatric
Procedia PDF Downloads 1832256 Efficient and Timely Mutual Authentication Scheme for RFID Systems
Authors: Hesham A. El Zouka, Mustafa M. Hosni ka
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The Radio Frequency Identification (RFID) technology has a diverse base of applications, but it is also prone to security threats. There are different types of security attacks that limit the range of the RFID applications. For example, deploying the RFID networks in insecure environments could make the RFID system vulnerable to many types of attacks such as spoofing attack, location traceability attack, physical attack and many more. Therefore, security is often an important requirement for RFID systems. In this paper, RFID mutual authentication protocol is implemented based on mobile agent technology and timestamp, which are used to provide strong authentication and integrity assurances to both the RFID readers and their corresponding RFID tags. The integration of mobile agent technology and timestamp provides promising results towards achieving this goal and towards reducing the security threats in RFID systems.Keywords: RFID, security, authentication protocols, privacy, agent-based architecture, time-stamp, digital signature
Procedia PDF Downloads 2692255 Variance-Aware Routing and Authentication Scheme for Harvesting Data in Cloud-Centric Wireless Sensor Networks
Authors: Olakanmi Oladayo Olufemi, Bamifewe Olusegun James, Badmus Yaya Opeyemi, Adegoke Kayode
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The wireless sensor network (WSN) has made a significant contribution to the emergence of various intelligent services or cloud-based applications. Most of the time, these data are stored on a cloud platform for efficient management and sharing among different services or users. However, the sensitivity of the data makes them prone to various confidentiality and performance-related attacks during and after harvesting. Various security schemes have been developed to ensure the integrity and confidentiality of the WSNs' data. However, their specificity towards particular attacks and the resource constraint and heterogeneity of WSNs make most of these schemes imperfect. In this paper, we propose a secure variance-aware routing and authentication scheme with two-tier verification to collect, share, and manage WSN data. The scheme is capable of classifying WSN into different subnets, detecting any attempt of wormhole and black hole attack during harvesting, and enforcing access control on the harvested data stored in the cloud. The results of the analysis showed that the proposed scheme has more security functionalities than other related schemes, solves most of the WSNs and cloud security issues, prevents wormhole and black hole attacks, identifies the attackers during data harvesting, and enforces access control on the harvested data stored in the cloud at low computational, storage, and communication overheads.Keywords: data block, heterogeneous IoT network, data harvesting, wormhole attack, blackhole attack access control
Procedia PDF Downloads 842254 Enhancing Email Security: A Multi-Layered Defense Strategy Approach and an AI-Powered Model for Identifying and Mitigating Phishing Attacks
Authors: Anastasios Papathanasiou, George Liontos, Athanasios Katsouras, Vasiliki Liagkou, Euripides Glavas
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Email remains a crucial communication tool due to its efficiency, accessibility and cost-effectiveness, enabling rapid information exchange across global networks. However, the global adoption of email has also made it a prime target for cyber threats, including phishing, malware and Business Email Compromise (BEC) attacks, which exploit its integral role in personal and professional realms in order to perform fraud and data breaches. To combat these threats, this research advocates for a multi-layered defense strategy incorporating advanced technological tools such as anti-spam and anti-malware software, machine learning algorithms and authentication protocols. Moreover, we developed an artificial intelligence model specifically designed to analyze email headers and assess their security status. This AI-driven model examines various components of email headers, such as "From" addresses, ‘Received’ paths and the integrity of SPF, DKIM and DMARC records. Upon analysis, it generates comprehensive reports that indicate whether an email is likely to be malicious or benign. This capability empowers users to identify potentially dangerous emails promptly, enhancing their ability to avoid phishing attacks, malware infections and other cyber threats.Keywords: email security, artificial intelligence, header analysis, threat detection, phishing, DMARC, DKIM, SPF, ai model
Procedia PDF Downloads 582253 TMBCoI-SIOT: Trust Management System Based on the Community of Interest for the Social Internet of Things
Authors: Oumaima Ben Abderrahim, Mohamed Houcine Elhedhili, Leila Saidane
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In this paper, we propose a trust management system based on clustering architecture for the social internet of things called TMBCO-SIOT. The proposed model integrates numerous factors such as direct and indirect trust; transaction factor; precaution factor; and social modeling of trust. The novelty of our approach can be summed up in two aspects. The first aspect concerns the architecture based on the community of interest (CoT) where each community is headed by an administrator (admin). However, the second aspect is the trust management system that tries to prevent On-Off attacks and mitigates dishonest recommendations using the k-means algorithm and guarantor things. The effectiveness of the proposed system is proved by simulation against malicious nodes.Keywords: IoT, trust management system, attacks, trust, dishonest recommendations, K-means algorithm
Procedia PDF Downloads 2122252 Automated Classification of Hypoxia from Fetal Heart Rate Using Advanced Data Models of Intrapartum Cardiotocography
Authors: Malarvizhi Selvaraj, Paul Fergus, Andy Shaw
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Uterine contractions produced during labour have the potential to damage the foetus by diminishing the maternal blood flow to the placenta. In order to observe this phenomenon labour and delivery are routinely monitored using cardiotocography monitors. An obstetrician usually makes the diagnosis of foetus hypoxia by interpreting cardiotocography recordings. However, cardiotocography capture and interpretation is time-consuming and subjective, often lead to misclassification that causes damage to the foetus and unnecessary caesarean section. Both of these have a high impact on the foetus and the cost to the national healthcare services. Automatic detection of foetal heart rate may be an objective solution to help to reduce unnecessary medical interventions, as reported in several studies. This paper aim is to provide a system for better identification and interpretation of abnormalities of the fetal heart rate using RStudio. An open dataset of 552 Intrapartum recordings has been filtered with 0.034 Hz filters in an attempt to remove noise while keeping as much of the discriminative data as possible. Features were chosen following an extensive literature review, which concluded with FIGO features such as acceleration, deceleration, mean, variance and standard derivation. The five features were extracted from 552 recordings. Using these features, recordings will be classified either normal or abnormal. If the recording is abnormal, it has got more chances of hypoxia.Keywords: cardiotocography, foetus, intrapartum, hypoxia
Procedia PDF Downloads 2162251 An Earth Mover’s Distance Algorithm Based DDoS Detection Mechanism in SDN
Authors: Yang Zhou, Kangfeng Zheng, Wei Ni, Ren Ping Liu
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Software-defined networking (SDN) provides a solution for scalable network framework with decoupled control and data plane. However, this architecture also induces a particular distributed denial-of-service (DDoS) attack that can affect or even overwhelm the SDN network. DDoS attack detection problem has to date been mostly researched as entropy comparison problem. However, this problem lacks the utilization of SDN, and the results are not accurate. In this paper, we propose a DDoS attack detection method, which interprets DDoS detection as a signature matching problem and is formulated as Earth Mover’s Distance (EMD) model. Considering the feasibility and accuracy, we further propose to define the cost function of EMD to be a generalized Kullback-Leibler divergence. Simulation results show that our proposed method can detect DDoS attacks by comparing EMD values with the ones computed in the case without attacks. Moreover, our method can significantly increase the true positive rate of detection.Keywords: DDoS detection, EMD, relative entropy, SDN
Procedia PDF Downloads 3372250 Finite Element Modeling of Aortic Intramural Haematoma Shows Size Matters
Authors: Aihong Zhao, Priya Sastry, Mark L Field, Mohamad Bashir, Arvind Singh, David Richens
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Objectives: Intramural haematoma (IMH) is one of the pathologies, along with acute aortic dissection, that present as Acute Aortic Syndrome (AAS). Evidence suggests that unlike aortic dissection, some intramural haematomas may regress with medical management. However, intramural haematomas have been traditionally managed like acute aortic dissections. Given that some of these pathologies may regress with conservative management, it would be useful to be able to identify which of these may not need high risk emergency intervention. A computational aortic model was used in this study to try and identify intramural haematomas with risk of progression to aortic dissection. Methods: We created a computational model of the aorta with luminal blood flow. Reports in the literature have identified 11 mm as the radial clot thickness that is associated with heightened risk of progression of intramural haematoma. Accordingly, haematomas of varying sizes were implanted in the modeled aortic wall to test this hypothesis. The model was exposed to physiological blood flows and the stresses and strains in each layer of the aortic wall were recorded. Results: Size and shape of clot were seen to affect the magnitude of aortic stresses. The greatest stresses and strains were recorded in the intima of the model. When the haematoma exceeded 10 mm in all dimensions, the stress on the intima reached breaking point. Conclusion: Intramural clot size appears to be a contributory factor affecting aortic wall stress. Our computer simulation corroborates clinical evidence in the literature proposing that IMH diameter greater than 11 mm may be predictive of progression. This preliminary report suggests finite element modelling of the aortic wall may be a useful process by which to examine putative variables important in predicting progression or regression of intramural haematoma.Keywords: intramural haematoma, acute aortic syndrome, finite element analysis,
Procedia PDF Downloads 431