Search results for: musculoskeletal diseases

Authors: Vahid Khadjeh Anvary, Hamideh Karimi Yazdi

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Generally, the tool of comparison between performance of each stage in the life of a project, is the number of project progress during that period, which in most cases is only determined as one-dimensional with referring to one of three factors (physical, time, and financial). In many projects in developing countries there are controversies on accuracy and the way of analyzing progress report of projects that hinders getting definitive and engineering conclusions on the status of project.Identifying weakness points of this kind of one-dimensional look on project and determining a reliable and engineering approach for multi-dimensional decoding information receivable from project is of great importance in project management.This can be a tool to help identification of hidden diseases of project before appearing irreversible symptoms that are usually delays or increased costs of execution. The method used in this paper is defining and evaluating a hypothetical project as an example analyzing different scenarios and numerical comparison of them along with related graphs and tables. Finally, by analyzing different possible scenarios in the project, possibility or impossibility of predicting their occurrence is examine through the evidence.

Keywords: physical progress, time progress, financial progress, delays, critical path

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Authors: Atefeh Ahmadi, Mohamed Sharif Mustaffa

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Mental health problems that children introspect them are hardly identified. The internalizing nature of Anxiety Disorders as the most prevalent psychological diseases, make them been under recognized by parents and teachers and so become under attended by school counsellors and subsequently under referred to clinicians. The aim of this study is to investigate the level of Anxiety Disorders to clarify if it is necessary to run screening programs in rural educational settings. Spence children anxiety scale-malay-child for the first time in Malaysia distributed among 640 Malay rural primary school students aged from 9-11 years old. Cut-off score was considered one standard deviation more than the mean of all students’ scores. The results of descriptive analyses revealed the mean for scores of SCAS was 32.84 and 15.6% of students had high level of anxiety. In addition, the level and prevalence of six types of anxiety disorders based on SCAS were described. In regards to the study outcomes, screening for anxiety disorders in academic settings could prevent and reduce their side effects by early identification.

Keywords: anxiety disorders, primary schools, SCAS, screening

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Authors: Rita Hairani, Warinthorn Chavasiri

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Naphthoquinones are secondary metabolites widespread in nature and can be produced by plants, fungi and actinomycetes. The interest of naphthoquinones is not only limited as organic dyes, but also their wide variety of biological activities such as antitumor, antibacterial, and cytotoxic activities. Typical 1,2-naphthoquinones such as mansonones can be found in Mansonia gagei Drumm. (“chan-cha-mod”), Sterculaceae family. This plant has been used traditionally to treat some diseases such as antiemetic and antidepressant. In this study, some natural mansonones isolated from the CH2Cl2 extract of M. gagei heartwood have been assessed for their antibacterial activities using agar well diffusion method. According to the antibacterial activity results of four natural mansonones (mansonones C, E, G and H), mansonones E and G showed higher activities than the others against Staphylococcus aureus, Propionibacterium acnes and Salmonella typhi, respectively. Since mansonone G exhibited good antibacterial activity and was obtained in the highest yield, we decided to derivertize mansonone G into five ether analogues. Based on the antibacterial activities of these synthesized compounds, four ether analogues (compounds 1-4) revealed higher antibacterial activities than its natural mansonone G against S. aureus and S. typhi.

Keywords: Mansonia gagei Drumm., antibacterial activities, mansonone G, ether analogues

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Authors: Abdolreza Esmaeilzadeh, Mehri Mirzaei

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Objective: Rheumatic disease is a chronic disease that causes pain, stiffness, swelling and limited motion and function of many joints. RA is the most common form of autoimmune arthritis, affecting more than 1.3 million Americans. Of these, about 75% are women. Materials and Methods: This study was formed due to the misconception about ANA test, which is frequently performed with methods based upon solid phase as ELISA. This experiment was conducted on 430 patients, with clinical symptoms that are likely affected with rheumatic diseases, simultaneously by means of ANA and FANA. Results: 36 cases (8.37%) of patients, despite positive ANA, have demonstrated negative results via Indirect Immunofluorescence Assay (IIFA), (false positive). 116 cases (27%) have demonstrated negative ANA results, by means of the ELISA technique, although they had positive IIFA results. Conclusion: Other advantages of IIFA are antibody titration and specific pattern detection that have the capability of distinguishing positive dsDNA results. According to the restrictions and false negative cases, in patients, IIFA test is highly recommended for these disease's diagnosis.

Keywords: autoimmune disease, IIFA, EIA, rheumatic disease

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Authors: Bharti Chogtu Magazine, Dhanya Soodana Mohan, Shruti Nair, Tanwi Trushna

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The study was undertaken to analyse the cardiovascular drugs being prescribed in patients with concomitant reactive airway disease and hypertension or ischemic heart diseases (IHD). Also, the effect of beta-blockers on respiratory symptoms in these patients was recorded. Data was collected from medical records of patients with reactive airway disease and concomitant hypertension and IHD. It included demographic details of the patients, diagnosis, drugs prescribed and the patient outcome regarding the exacerbation of asthma symptoms with intake of beta blockers. Medical records of 250 patients were analysed.13% of patients were prescribed beta-blockers. 12% of hypertensive patients, 16.6% of IHD patients and 20% of patients with concomitant hypertension and IHD were prescribed beta blockers. Of the 33 (13%) patients who were on beta-blockers, only 3 patients had an exacerbation of bronchial asthma symptoms. Cardioselective beta-blockers under supervision appear to be safe in patients with reactive airway disease and concomitant hypertension and IHD.

Keywords: beta blockers, hypertension, ischemic heart disease, asthma

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Authors: Ilona Mewes, Helena Jenzer, Farshideh Einsele

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Objective: The objective of the study was to integrate two big databases from Swiss nutrition national survey (menuCH) and Swiss health national survey 2012 for data mining purposes. Each database has a demographic base data. An integrated Swiss database is built to later discover critical food consumption patterns linked with lifestyle diseases known to be strongly tied with food consumption. Design: Swiss nutrition national survey (menuCH) with approx. 2000 respondents from two different surveys, one by Phone and the other by questionnaire along with Swiss health national survey 2012 with 21500 respondents were pre-processed, cleaned and finally integrated to a unique relational database. Results: The result of this study is an integrated relational database from the Swiss nutritional and health databases.

Keywords: health informatics, data mining, nutritional and health databases, nutritional and chronical databases

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Authors: Karolina Wieczorek, Zofia Przypaśniak

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Climate change is a rapidly growing threat to global health, and part of the responsibility to combat it lies within the healthcare sector itself, including adequate education of future medical professionals. To mitigate the consequences, the General Medical Council (GMC) has equipped medical schools with a list of outcomes regarding sustainability teaching. Students are expected to analyze the impact of the healthcare sector’s emissions on climate change. The delivery of the related teaching content is, however, often inadequate and insufficient time is devoted for exploration of the topics. Teaching curricula lack in-depth exploration of the learning objectives. This study aims to assess the extent and characteristics of climate change and sustainability subjects teaching in the curriculum of a chosen UK medical school (Barts and The London School of Medicine and Dentistry). It compares the data to the national average scores from the Climate Change and Sustainability Teaching (C.A.S.T.) in Medical Education Audit to draw conclusions about teaching on a regional level. This is a single-center audit of the timetabled sessions of teaching in the medical course. The study looked at the academic year 2020/2021 which included a review of all non-elective, core curriculum teaching materials including tutorials, lectures, written resources, and assignments in all five years of the undergraduate and graduate degrees, focusing only on mandatory teaching attended by all students (excluding elective modules). The topics covered were crosschecked with GMC Outcomes for graduates: “Educating for Sustainable Healthcare – Priority Learning Outcomes” as gold standard to look for coverage of the outcomes and gaps in teaching. Quantitative data was collected in form of time allocated for teaching as proxy of time spent per individual outcomes. The data was collected independently by two students (KW and ZP) who have received prior training and assessed two separate data sets to increase interrater reliability. In terms of coverage of learning outcomes, 12 out of 13 were taught (with the national average being 9.7). The school ranked sixth in the UK for time spent per topic and second in terms of overall coverage, meaning the school has a broad range of topics taught with some being explored in more detail than others. For the first outcome 4 out of 4 objectives covered (average 3.5) with 47 minutes spent per outcome (average 84 min), for the second objective 5 out of 5 covered (average 3.5) with 46 minutes spent (average 20), for the third 3 out of 4 (average 2.5) with 10 mins pent (average 19 min). A disproportionately large amount of time is spent delivering teaching regarding air pollution (respiratory illnesses), which resulted in the topic of sustainability in other specialties being excluded from teaching (musculoskeletal, ophthalmology, pediatrics, renal). Conclusions: Currently, there is no coherent strategy on national teaching of climate change topics and as a result an unstandardized amount of time spent on teaching and coverage of objectives can be observed.

Keywords: audit, climate change, sustainability, education

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Authors: Baso Hamdani, Arniati Massinai, Jamaluddin Jompa

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Coral diseases are one of the factors affect reef degradation. This research had analysed the progression rate, incidence, and prevalence of Black Band Disease (BBD) on stony coral (Pachyseris sp.) in relation to the environmental parameters (pH, nitrate, phospate, Dissolved Organic Matter (DOM), and turbidity). The incidence of coral disease was measured weekly for 6 weeks using Belt Transect Method. The progression rate of BBD was measured manually. Furthermore, the prevalence and incidence of BBD were calculated each colonies infected. The relationship between environmental parameters and the progression rate, prevalence and incidence of BBD was analysed by Principal Component Analysis (PCA). The results showed the average of progression rate is 0,07 ± 0,02 cm/ hari. The prevalence of BBD increased from 0,92% - 19,73% in 7 weeks observation with the average incidence of new infected colonies coral 0,2 - 0,65 colony/day The environment factors which important were pH, Nitrate, Phospate, DOM, and Turbidity.

Keywords: progression rate, incidence, prevalence, Black Band Disease, Barranglompo

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Authors: Huamin Xu, Wenting Jia, Hong Jiang, Junxia Xie

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Rosmarinic acid (RA) is a natural acid that is found in a variety of herbs, such as rosemary and has multiple biological activities such as antioxidative, anti-inflammatory and antiviral activities. In this study, we investigated the neuroprotective effects of RA on dopaminergic system in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) induced mouse model of Parkinson’s disease (PD). The mice received oral administration of RA before MPTP injection. Results showed that the tyrosine hydroxylase expression in SN reduced and the levels of dopamine and its metabolites in the striatum decreased in MPTP intoxicated PD mice. Pretreatment with RA significantly inhibited these changes. Further studies demonstrated that MPTP treatment increased the iron content, which was counteracted by pre-treatment with RA. In addition, RA could restore the decrease of superoxide dismutase (SOD) induced by MPTP. This study provides evidence that RA could suppress MPTP-induced degeneration of the nigrostriatal dopaminergic system by regulating iron content and the expression of SOD. Thus, RA might be clinically evaluated for the prevention of neurodegenerative diseases.

Keywords: rosmarinic acid, Parkinson's disease, MPTP, dopaminergic system

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Authors: Haoqi Gao, Koichi Ogawara

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Retinal vascular segmentation of color fundus is the basis of ophthalmic computer-aided diagnosis and large-scale disease screening systems. Early screening of fundus diseases has great value for clinical medical diagnosis. The traditional methods depend on the experience of the doctor, which is time-consuming, labor-intensive, and inefficient. Furthermore, medical images are scarce and fraught with legal concerns regarding patient privacy. In this paper, we propose a new Generative Adversarial Network based on CycleGAN for retinal fundus images. This method can generate not only synthetic fundus images but also generate corresponding segmentation masks, which has certain application value and challenge in computer vision and computer graphics. In the results, we evaluate our proposed method from both quantitative and qualitative. For generated segmented images, our method achieves dice coefficient of 0.81 and PR of 0.89 on DRIVE dataset. For generated synthetic fundus images, we use ”Toy Experiment” to verify the state-of-the-art performance of our method.

Keywords: retinal vascular segmentations, generative ad-versarial network, cyclegan, fundus images

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Authors: Ali Chitgar

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Respiratory infections including diseases in camels are important not only because of the threat of animal health but also to reduce their production. Since that deal with respiratory problems and their treatment requires adequate knowledge of the existing respiratory problems, unfortunately, there is limited information about the species of camels. This study aimed to identify lung lesions camels slaughtered in a slaughterhouse more important was performed using histopathology. Respiratory camels (n = 477) was examined after the killing fully and tissue samples were placed in 10% formalin. The samples and histological sections using hematoxylin and eosin staining and color were evaluated. In this study 79.6 % (236 of 477 samples) of the samples was at least a lung lesion. Rate acute interstitial pneumonia, chronic interstitial pneumonia, bronchopneumonia, bronchiolitis, an inflammation of the pleura and 52.8 % respectively atelectasis (236 of 477 samples), 5.4 % (24 of 477 samples), 7.8 % (35 of 477 samples), 6.7 % (30 of 477 samples), 3.4 % (15 of 477 samples) and 15.2% (68 of 477 samples). The lung lesions, acute interstitial pneumonia and bronchopneumonia in autumn winter rather than spring and summer (p <0/05) and as a result, this study showed that high rates of lung lesions in the camel population. Waste higher results in cold seasons (fall and winter) shows.

Keywords: camel, surgery, histopathology, breathing organ

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Authors: Elham Rezaee, Sayyed Abbas Tabatabai

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Dual inhibition of COX-2 and sEH enzymes represents one of the distinct pharmaceutical approaches for the treatment of inflammation, pain, cancers, and other diseases. The discovery of these inhibitors for treatment is a great deal of attention because of some advantages such as increased efficacy, a promising safety profile, ease of formulation, and better target engagement. In this research, based on the structure-activity relationship of COX-2 and sEH inhibitors, some amide derivatives with oxadiazole and dihydropyrimidinone rings against sEH and COX-2 enzymes were developed. The designed compounds showed high affinity to the active site of both enzymes in docking studies and were synthesized in good yield and characterized by IR, Mass, 1HNMR, and 13CNMR. All of the novel compounds exhibited considerable in-vitro sEH and COX-2 inhibitory activities in comparison with 12-(3-Adamantan-1-yl-ureido)- dodecanoic acid and celecoxib (a potent urea-based sEH inhibitor and selective nonsteroidal anti-inflammatory drug, respectively). Ethyl 6-methyl-4-(4-(4-(methylsulfonyl)benzamido)phenyl)-2-oxo-1,2,3,4-tetrahydropyrimidine-5-carboxylate was found to be the most selective COX-2 inhibitor (COX-2/COX-1 ratio: 683) with IC50 value of 2.1 nM targeting sEH enzyme.

Keywords: COX-2, dual inhibitors, sEH, synthesis

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Authors: Pawinee Innark, Hudsaya Punyanitikul, Chanuluk Khanobdee, Chatchawan Jantasuriyarat, Sompid Samipak

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One of the most devastating diseases in cucumber is downy mildew caused by the fungus Pseudoperonospora cubensis. To enable the use of marker-assisted breeding for resistance cultivars, sixty six microsatellite markers were used to map (quantitative trait loci) QTLs for DM resistance. Total of 315 F2 population from the cross between DM-resistant inbred line CSL0067 and susceptible CSL0139 were evaluated for downy mildew resistance in cotyledon, first and second true leaf at 7, 10, and 14 day after inoculation. The QTL analysis revealed that the downy mildew resistant genes were controlled by multiple recessive genes. From eight linkage groups (LG 1.1, 1.2, 2, 3, 4, 5.1, 5.2 and 6), fourteen QTL positions were detected on 4 linkage groups (LG 1.1, 2, 5.1 and 6) with the log of odd scores ranged from 3.538 to 9.165. Among them, Cot7_5.1_2 and Cot10_5.1 had major-effect QTL with the R2 values of 10.9 and 12.5%, respectively. The flanking markers for Cot7_5.1_2 were SSR19172 - SSR07531 markers and for Cot10_5.1 were SSR03943 - SSR00772. Besides QTLs on chromosome 1, 5 and 6 that were previously reported, this study also revealed a QTL for DM resistance on chromosome 2 that can be used as a new source in cucumber breeding program.

Keywords: cucumber, DNA marker, downy mildew, QTL

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Authors: K. M. G. T. R. Waidyarathna, S. M. Vidanagamachchi

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Public Health System exists in Sri Lanka has a satisfactory complete information flow when compared to other systems in developing countries. The availability of a good health information system contributed immensely to achieve health indices that are in line with the developed countries like US and UK. The health information flow at the moment is completely paper based. In Sri Lanka, the fields like banking, accounting and engineering have incorporated information and communication technology to the same extent that can be observed in any other country. The field of medicine has behind those fields throughout the world mainly due to its complexity, issues like privacy, confidentially and lack of people with knowledge in both fields of Information Technology (IT) and Medicine. Sri Lanka’s situation is much worse and the gap is rapidly increasing with huge IT initiatives by private-public partnerships in all other countries. The major goal of the framework is to support minimizing the spreading diseases. To achieve that a web based framework should be implemented for this application domain with web mapping. The aim of this GIS based public health system is a secure, flexible, easy to maintain environment for creating and maintaining public health records and easy to interact with relevant parties.

Keywords: DHIS2, GIS, public health, Sri Lanka

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Authors: Lorena G. Calvo, Marta Lores, Trinidad de Miguel

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Natural extracts containing high polyphenolic concentration possess antibacterial and antifungal activity. The present research characterizes a hydro-organic extract with a high polyphenolic content as an antimicrobial candidate. As a result of this composition, the extract showed pronounced bioactivities with potential uses in agricultural, veterinary, pharmaceutical, and cosmetic industries. Polyphenol compounds were extracted by using hydro-organic solvent mixtures from the shrub Cytisus scoparius. The in vitro antimicrobial activity of this extract was evaluated on Gram-positive and Gram-negative bacteria and the fungus Candida albicans. Microbial species investigated, Bacillus cereus, Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa, are causing agents of several human and animal diseases. The extract showed activity against all tested species. So, it could be used for the development of biocides to control a wide range of pathogenic agents and contribute to the creation of economic and eco-friendly alternatives to antibiotics.

Keywords: antimicrobial properties, antioxidant properties, Cytisus scoparius, polyphenolic extract

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Authors: Anna Słupik, Krzysztof Jaworski, Anna Mosiołek, Dariusz Białoszewski

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Background: Maintaining the correct body balance is essential in the prevention of falls in the elderly, which is especially important for women because of postmenopausal osteoporosis and the serious consequences of falls. One of the exercise methods which is very popular among adults, and which may affect body balance in a positive way is the pilates method. The aim of the study was to evaluate the effect of regular pilates exercises on the ability to maintain body balance in static conditions in adult healthy women. Material and methods: The study group consisted of 20 healthy women attending pilates twice a week for at least 1 year. The control group consisted of 20 healthy women physically inactive. Women in the age range from 35 to 50 years old without pain in musculoskeletal system or other pain were only qualified to the groups. Body balance was assessed using MatScan VersaTek platform with Sway Analysis Module based on Matscan Clinical 6.7 software. The balance was evaluated under the following conditions: standing on both feet with eyes open, standing on both feet with eyes closed, one-leg standing (separately on the right and left foot) with eyes open. Each test lasted 30 seconds. The following parameters were calculated: estimated size of the ellipse of 95% confidence, the distance covered by the Center of Gravity (COG), the size of the maximum shift in the sagittal and frontal planes and load distribution between the left and right foot, as well as between rear- and forefoot. Results: It was found that there is significant difference between the groups in favor of the study group in the size of the confidence ellipse and maximum shifts of COG in the sagittal plane during standing on both feet, both with the eyes open and closed (p < 0.05). While standing on one leg both on the right and left leg, with eyes opened there was a significant difference in favor of the study group, in terms of the size of confidence ellipse, the size of the maximum shifts in the sagittal and in the frontal plane (p < 0.05). There were no differences between the distribution of load between the right and left foot (standing with both feet), nor between fore- and rear foot (in standing with both feet or one-leg). Conclusions: 1. Static balance in women exercising regularly by pilates method is better than in inactive women, which may in the future prevent falls and their consequences. 2. The observed differences in maintaining balance in frontal plane in one-leg standing may indicate a positive impact of pilates exercises on the ability to maintain global balance in terms of the reduced support surface. 3. Pilates method can be used as a form preventive therapy for all people who are expected to have problems with body balance in the future, for example in chronic neurological disorders or vestibular problems. 4. The results have shown that further prospective randomized research on a larger and more representative group is needed.

Keywords: balance exercises, body balance, pilates, pressure distribution, women

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Authors: Camilla Trevor, Matthew K. Higgins, Andrea Gonzalez-Munoz, Mark Carrington

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Trypanosomiasis is a devastating disease affecting both humans and livestock in sub-Saharan Africa. The diseases are caused by infection with African trypanosomes, protozoa transmitted by tsetse flies. Treatment currently relies on the use of chemotherapeutics with ghastly side effects. Here, we describe the development of effective antibody-drug conjugates that target the T. brucei transferrin receptor. The receptor is essential for trypanosome growth in a mammalian host but there are approximately 12 variants of the transferrin receptor in the genome. Two of the most divergent variants were used to generate recombinant monoclonal immunoglobulin G using phage display and we identified cross-reactive antibodies that bind both variants using phage ELISA, fluorescence resonance energy transfer assays and surface plasmon resonance. Fluorescent antibodies were used to demonstrate uptake into trypanosomes in culture. Toxin-conjugated antibodies were effective at killing trypanosomes at sub-nanomolar concentrations. The approach of using antibody-drug conjugates has proven highly effective.

Keywords: antibody-drug conjugates, phage display, transferrin receptor, trypanosomes

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Authors: Michal Christina Steven, Mohd. Yusof Hj Ibrahim, Haryati Abdul Karim, Prabakaran Dhanaraj, Kelly Alexius Mansin

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After 27 years, Malaysia reported polio cases in 2019 involving the children of the undocumented migrants living in Sabah. These undocumented migrants present a significant challenge in achieving the elimination of vaccine-preventable diseases (VPD). Due to the recent polio outbreak among the undocumented migrant children in Sabah, an in-depth interview was conducted among the caregivers of undocumented migrant children to identify the barriers and drivers towards vaccinating their children. Financial barriers, legal citizenship status, language barrier, the COVID-19 pandemic, and physical barriers have been the barriers to access vaccination services by undocumented migrants. Five significant drivers for undocumented migrants to vaccinate their children are social influence, fear of disease, parental trust in healthcare providers, good support, and vaccine availability. Necessary action should be taken immediately to address the problems of vaccinating the children of undocumented migrants to prevent the re-emergence of VPD.

Keywords: Malaysia, polio, Sabah, undocumented migrants

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Authors: Monica Puri Sikka, Subrato Ghosh Arunangshu Mukhopadhyay

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Appropriate compression bandaging is important for compression therapeutic medical diseases. The high compression approach employed for treating venous leg ulcers should be used correctly so that sufficient (but not excessive) pressure is applied. Bandages used to treat venous disease by compression should achieve and sustain effective levels and gradients of pressure and minimise the risk of pressure trauma. To maintain graduated compression on the limb the bandage needs to be applied at same tension for each layer from ankle to the knee. In this paper the geometry for various bandaging procedures is used to wrap each layer of bandage by marking the relaxed length of the bandage. The relaxed length is calculated depending on the stretch, average circumference of the limb on which it is to be applied and the bandaging technique to be used. This paper aims at developing a scientific approach while applying the bandage to reduce the inter operator variability in applying same tension on each successive layer of bandage.

Keywords: bandaging, compression, inter operator variability, graduated, relaxed length, stretch

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Authors: Subramaniam Iyer

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The most common disease that is pertaining to all human beings is heart-related. The reasons for coronary artery disease are due to lifestyle and eating habits. Due to this, many people mentally become sick, feeling that soon they will die due to their heart problems. This results in stress and anxiety, which has become common amongst all the Indians. Medicines are the commonest curative remedy in India, but it is proposed through this article some remedies through yoga. This article does not guarantee a 100% result, but it is a preventive remedy for coronary artery disease. Yoga is giving a new lease of life to many, so to tackle chronic diseases, it provides remedies that will be lifelong. It is brought to many people by Patanjali. Yoga will provide support to patients having coronary artery disease through its various relevant postures (asanas), which can be done very easily. Yoga does not send a message that if you do it regularly, you will be relieved from a particular disease. If it is performed every day, it will add vital energy for a smooth life, even if you are suffering from any chronic disease. In this article, we will be providing 6 postures (asanas), which can be performed at any time in the day, but the early morning will always be preferred (empty stomach) to get a good result. Secondly, these postures must be implemented after due consultation with your physician. If your physician disapproves, don’t do these postures as it will be harmful to your body.

Keywords: coronary artery, yoga, disease, remedy, medicine

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Authors: Yuguang Gao, Mingtao Deng

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The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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Authors: Rijnbout-St.James Willem, Lindner Volkhard, Scholand Mary Beth, Ashton M. Tillett, Di Gennaro Michael Jude, Smith Silvia Enrica

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Introduction: Fibrosing lung diseases are characterized by changes in the lung interstitium and are classified based on etiology: 1) environmental/exposure-related, 2) autoimmune-related, 3) sarcoidosis, 4) interstitial pneumonia, and 4) idiopathic. Among interstitial lung diseases (ILD) idiopathic forms, idiopathic pulmonary fibrosis (IPF) is the most severe. Pathogenesis of IPF is characterized by an increased presence of proinflammatory mediators, resulting in alveolar injury, where injury to alveolar epithelium precipitates an increase in collagen deposition, subsequently thickening the alveolar septum and decreasing gas exchange. Identifying biomarkers implicated in the pathogenesis of lung fibrosis is key to developing new therapies and improving the efficacy of existing therapies. The transforming growth factor-beta (TGF-B1), a mediator of tissue repair associated with WNT5A signaling, is partially responsible for fibroblast proliferation in ILD and is the target of Pirfenidone, one of the antifibrotic therapies used for patients with IPF. Canonical TGF-B signaling is mediated by the proteins SMAD 2/3, which are, in turn, indirectly regulated by Collagen Triple Helix Repeat Containing 1 (CTHRC1). In this study, we tested the following hypotheses: 1) CTHRC1 is more elevated in the ILD cohort compared to unaffected controls, and 2) CTHRC1 is differently expressed among ILD types. Material and Methods: CTHRC1 levels were measured by ELISA in 171 plasma samples from the deidentified University of Utah ILD cohort. Data represent a cohort of 131 ILD-affected participants and 40 unaffected controls. CTHRC1 samples were categorized by a pulmonologist based on affectation status and disease subtypes: IPF (n = 45), sarcoidosis (4), nonspecific interstitial pneumonia (16), hypersensitivity pneumonitis (n = 7), interstitial pneumonia (n=13), autoimmune (n = 15), other ILD - a category that includes undifferentiated ILD diagnoses (n = 31), and unaffected controls (n = 40). We conducted a single-factor ANOVA of plasma CTHRC1 levels to test whether CTHRC1 variance among affected and non-affected participants is statistically significantly different. In-silico analysis was performed with Ingenuity Pathway Analysis® to characterize the role of CTHRC1 in the pathway of lung fibrosis. Results: Statistical analyses of CTHRC1 in plasma samples indicate that the average CTHRC1 level is significantly higher in ILD-affected participants than controls, with the autoimmune ILD being higher than other ILD types, thus supporting our hypotheses. In-silico analyses show that CTHRC1 indirectly activates and phosphorylates SMAD3, which in turn cross-regulates TGF-B1. CTHRC1 also may regulate the expression and transcription of TGFB-1 via WNT5A and its regulatory relationship with CTNNB1. Conclusion: In-silico pathway analyses demonstrate that CTHRC1 may be an important biomarker in ILD. Analysis of plasma samples indicates that CTHRC1 expression is positively associated with ILD affectation, with autoimmune ILD having the highest average CTHRC1 values. While characterizing CTHRC1 levels in plasma can help to differentiate among ILD types and predict response to Pirfenidone, the extent to which plasma CTHRC1 level is a function of ILD severity or chronicity is unknown.

Keywords: interstitial lung disease, CTHRC1, idiopathic pulmonary fibrosis, pathway analyses

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Authors: Ferruh Taspinar, Gulce K. Seyyar, Gamze Kurt, Eda O. Okur, Emrah Afsar, Ismail Saracoglu, Betul Taspinar

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Alterations of physical activity can effect body composition (especially body fat ratio); however body mass index may not sufficient to indicate these minimal differences. The aim of this study was to evaluate the relationship between body composition and physical activity in university students. In this study, 132 university students (mean age; 21.21±1.51) were included. Tanita BC-418 and International Physical Activity Questionnaire (IPAQ) were used to evaluate participants. The correlation between the parameters was analysed via Spearman correlation analysis. Significance level in statistical analyses was accepted is 0.05. The results showed that there was no correlation between body mass index and physical activity (p>0.05). There was a positive correlation between body muscle ratio and physical activity, whereas a negative correlation between body fat ratio and physical activity (p<0.05). This study showed that body fat and muscle ratio affects the level of physical activity in healthy university students. Therefore, we thought that physical activity might reduce effects of the diseases caused by disturbed body composition. Further studies are required to support this idea.

Keywords: body composition, body mass index, physical activity, university student

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Authors: Maria Zulema Morquecho Vega, Fabiola CarolinaMiranda Castro, Rafael Verdugo Miranda, Ignacio Yocupicio Villegas, Ana lidia Barron Raygoza, Martin enrique MArquez Cordova, Jose Alberto Duarte Moller

Abstract:

Background: Anemopsis californica, also called (tame grass) belongs to the Saururaceae family small, green plant. The blade is long and wide. Gives a white flower. The plant population is only found in humid, swampy habitats, it grows where there is water, along the banks of streams and water holes. In the winter, it dries up. The leaves, rhizomes, or roots of this plant have been used to treat a range of diseases. Some of its healing properties are used to treat wounds, cold and flu symptoms, spasmodic cough, infection, pain and inflammation, burns, swollen feet, as well as lung ailments, asthma, circulatory problems (varicose veins), rheumatoid arthritis, purifies blood, helps in urinary and digestive tract diseases, sores and healing, for headache, sore throat, diarrhea, kidney pain. The tea made from the leaves and roots is used to treat uterine cancer, womb cancer, relieves menstrual pain and stops excessive bleeding after childbirth. It is also used as a gynecological treatment for infections, hemorrhoids, candidiasis and vaginitis. Objective: To study the cytotoxicity of gels prepared with silver nanoparticles in AC extract combined with chitosan, collagen and hyaluronic acid as an alternative therapy for skin conditions. Methods: The Ag NPs were synthesized according to the following method. A 0.3 mg/mL solution is prepared in 10 ml of deionized water, adjust to pH 12 with NaOH, stirring is maintained constant magnetic and a temperature of 80 °C. Subsequently, 100 ul of a 0.1 M AgNO3 solution and kept stirring constantly for 15 min. Once the reaction is complete, measurements are performed by UV-Vis. A gel was prepared in a 5% solution of acetic acid with the respective nanoparticles and AC extract of silver in the extract of AC. Chitosan is added until the process begins to occur gel. At that time, collagen will be added in a ratio of 3 to 5 drops, and later, hyaluronic acid in 2% of the total compound formed. Finally, after resting for 24 hours, the cytotoxic effect of the gels was studied. in the presence of highly positive bacteria Staphylococcus aureus and highly negative for Escherichia coli. Cultures will be incubated for 24 hours in the presence of the compound and compared with the reference. Results: Silver nanoparticles obtained had a spherical shape and sizes among 20 and 30 nm. UV-Vis spectra confirm the presence of silver nanoparticles showing a surface plasmon around 420 nm. Finally, the test in presence of bacteria yield a good antibacterial property of this nanocompound and tests in people were successful. Conclusion: Gel prepared by biogenic synthesis shown beneficious effects in severe acne, acne vulgaris and wound healing with diabetic patients.

Keywords: anemopsis californica, nanomedicina, biotechnology, biomedicine

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Authors: S. M. Abdullah Al Mamun

Abstract:

Human Computer Interaction (HCI) is an excellent area for the researchers to make daily life more simple and fast. Necessary hardware equipments for any BCI are generally expensive and not affordable for most of the people. Emotiv is one of the solutions for this problem, which can provide electroencephalograph (EEG) signal and explain the brain activities. BCI virtual speller was one of the important applications for the people who have lost their hand or speaking ability because of diseases or unexpected accident. In this paper, a matrix speller has been designed for the first time for Bengali speaking people around the world. Bengali is one of the most commonly spoken languages. Among them, a lot of disabled person will be able to express their desire in their mother tongue. This application is also usable for the social networks and daily life communications. For this virtual keyboard, the well-known matrix speller method with column flashing is applied and controlled by single Emokey only. Emokey is a great feature which translates emotional state for application inputs. In this paper, it is presented that the ITR (Information Transfer Rate) were 29.4 bits/min and typing speed achieved up to 7.43 char/per min.

Keywords: brain computer interface, Emotiv EPOC, EEG, virtual keyboard, matrix speller

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Authors: Ghulam Haider Haidaree, Nsenda Lukumwena

Abstract:

Most developing nations face energy production and supply problems. This is also the case of Afghanistan whose generating capacity does not meet its energy demand. This is due in part to high security and risk caused by war which deters foreign investments and insufficient internal revenue. To address the issue above, this paper would like to suggest an alternative and affordable way to deal with the energy problem. That is by converting Solid Waste to energy. As a result, this approach tackles the municipal solid waste issue (potential cause of several diseases), contributes to the improvement of the quality of life, local economy, and so on. While addressing the solid waste problem in general, this paper samples specifically one municipality which is District-12, one of the 22 districts of Kabul city. Using geographic information system (GIS) technology, District-12 is divided into nine different zones whose municipal solid waste is respectively collected, processed, and converted into electricity and distributed to the closest area. It is important to mention that GIS has been used to estimate the amount of electricity to be distributed and to optimally position the production plant.

Keywords: energy problem, estimation of electricity, GIS zones, solid waste management system

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Authors: Michaela Chovancova, Pavel Niedoba

Abstract:

For the treatment of acute and chronic lung diseases it is preferred to deliver medicaments by inhalation. The drug is delivered directly to tracheobronchial tree. This way allows the given medicament to get directly into the place of action and it makes rapid onset of action and maximum efficiency. The transport of aerosol particles in the particular part of the lung is influenced by their size, anatomy of the lungs, breathing pattern and airway resistance. This article deals with calculation of airway resistance in the lung model of Horsfield. It solves the problem of determination of the pressure losses in bifurcation and thus defines the pressure drop at a given location in the bronchial tree. The obtained data will be used as boundary conditions for transport of aerosol particles in a central part of bronchial tree realized by Computational Fluid Dynamics (CFD) approach. The results obtained from CFD simulation will allow us to provide information on the required particle size and optimal inhalation technique for particle transport into particular part of the lung.

Keywords: human lungs, bronchial tree, pressure losses, airways resistance, flow, breathing

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Authors: Laila Montaser, Hala Gabr, Maha El-Bassuony, Gehan Tawfeek

Abstract:

Orthotropic liver transplantation (OLT) is the final procedure of both end stage and metabolic liver diseases. Hepatocyte transplantation is an alternative for OLT, but the sources of hepatocytes are limited. Bone marrow mesenchymal stem cells (BM-MSCs) can differentiate into hepatocyte-like cells and are a potential alternative source for hepatocytes. The MSCs from bone marrow are a promising target population as they are capable of differentiating along multiple lineages and, at least in vitro, have significant expansion capability. MSCs from bone marrow may have the potential to differentiate in vitro and in vivo into hepatocytes. Our study examined whether mesenchymal stem cells (MSCs), which are stem cells originated from human bone marrow, are able to differentiate into functional hepatocyte-like cells in vitro. Our aim was to investigate the differentiation potential of BM-MSCs into hepatocyte-like cells. Adult stem cell therapy could solve the problem of degenerative disorders, including liver disease.

Keywords: bone marrow, differentiation, hepatocyte, stem cells

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Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos

Abstract:

Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.

Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment

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Authors: Shu-Min Tsao, Chung-Ming Lo, Shao-Chun Chen

Abstract:

Most diabetes patients tend to suffer from its complication of retina diseases. Therefore, early detection and early treatment are important. In clinical examinations, using color fundus image was the most convenient and available examination method. According to the exudates appeared in the retinal image, the status of retina can be confirmed. However, the routine screening of diabetic retinopathy by color fundus images would bring time-consuming tasks to physicians. This study thus proposed a computer-aided exudate diagnosis for the screening of diabetic retinopathy. After removing vessels and optic disc in the retinal image, six quantitative features including region number, region area, and gray-scale values etc… were extracted from the remaining regions for classification. As results, all six features were evaluated to be statistically significant (p-value < 0.001). The accuracy of classifying the retinal images into normal and diabetic retinopathy achieved 82%. Based on this system, the clinical workload could be reduced. The examination procedure may also be improved to be more efficient.

Keywords: computer-aided diagnosis, diabetic retinopathy, exudate, image processing

Procedia PDF Downloads 251