Search results for: disease cluster
3074 A Computational Study of N–H…O Hydrogen Bonding to Investigate Cooperative Effects
Authors: Setareh Shekarsaraei, Marjan Moridi, Nasser L. Hadipour
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In this study, nuclear magnetic resonance spectroscopy and nuclear quadrupole resonance spectroscopy parameters of 14N (Nitrogen in imidazole ring) in N–H…O hydrogen bonding for Histidine hydrochloride monohydrate were calculated via density functional theory. We considered a five-molecule model system of Histidine hydrochloride monohydrate. Also, we examined the trends of environmental effect on hydrogen bonds as well as cooperativity. The functional used in this research is M06-2X which is a good functional and the obtained results have shown good agreement with experimental data. This functional was applied to calculate the NMR and NQR parameters. Some correlations among NBO parameters, NMR, and NQR parameters have been studied which have shown the existence of strong correlations among them. Furthermore, the geometry optimization has been performed using M062X/6-31++G(d,p) method. In addition, in order to study cooperativity and changes in structural parameters, along with increase in cluster size, natural bond orbitals have been employed.Keywords: hydrogen bonding, density functional theory (DFT), natural bond orbitals (NBO), cooperativity effect
Procedia PDF Downloads 4563073 An Audit on the Role of Sentinel Node Biopsy in High-Risk Ductal Carcinoma in Situ and Intracystic Papillary Carcinoma
Authors: M. Sulieman, H. Arabiyat, H. Ali, K. Potiszil, I. Abbas, R. English, P. King, I. Brown, P. Drew
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Introduction: The incidence of breast ductal Carcinoma in Situ (DCIS) has been increasing; it currently represents up 20-25% of all breast carcinomas. Some aspects of DCIS management are still controversial, mainly due to the heterogeneity of its clinical presentation and of its biological and pathological characteristics. In DCIS, histological diagnosis obtained preoperatively, carries the risk of sampling error if the presence of invasive cancer is subsequently diagnosed. The mammographic extent over than 4–5 cm and the presence of architectural distortion, focal asymmetric density or mass on mammography are proven important risk factors of preoperative histological under staging. Intracystic papillary cancer (IPC) is a rare form of breast carcinoma. Despite being previously compared to DCIS it has been shown to present histologically with invasion of the basement membrane and even metastasis. SLNB – Carries the risk of associated comorbidity that should be considered when planning surgery for DCIS and IPC. Objectives: The aim of this Audit was to better define a ‘high risk’ group of patients with pre-op diagnosis of non-invasive cancer undergoing breast conserving surgery, who would benefit from sentinel node biopsy. Method: Retrospective data collection of all patients with ductal carcinoma in situ over 5 years. 636 patients identified, and after exclusion criteria applied: 394 patients were included. High risk defined as: Extensive micro-calcification >40mm OR any mass forming DCIS. IPC: Winpath search from for the term ‘papillary carcinoma’ in any breast specimen for 5 years duration;.29 patients were included in this group. Results: DCIS: 188 deemed high risk due to >40mm calcification or a mass forming (radiological or palpable) 61% of those had a mastectomy and 32% BCS. Overall, in that high-risk group - the number with invasive disease was 38%. Of those high-risk DCIS pts 85% had a SLN - 80% at the time of surgery and 5% at a second operation. For the BCS patients - 42% had SLN at time of surgery and 13% (8 patients) at a second operation. 15 (7.9%) pts in the high-risk group had a positive SLNB, 11 having a mastectomy and 4 having BCS. IPC: The provisional diagnosis of encysted papillary carcinoma is upgraded to an invasive carcinoma on final histology in around a third of cases. This has may have implications when deciding whether to offer sentinel node removal at the time of therapeutic surgery. Conclusions: We have defined a ‘high risk’ group of pts with pre-op diagnosis of non-invasive cancer undergoing BCS, who would benefit from SLNB at the time of the surgery. In patients with high-risk features; the risk of invasive disease is up to 40% but the risk of nodal involvement is approximately 8%. The risk of morbidity from SLN is up to about 5% especially the risk of lymphedema.Keywords: breast ductal carcinoma in Situ (DCIS), intracystic papillary carcinoma (IPC), sentinel node biopsy (SLNB), high-risk, non-invasive, cancer disease
Procedia PDF Downloads 1113072 Physical-Chemical Parameters of Latvian Apple Juices and Their Suitability for Cider Production
Authors: Rita Riekstina-Dolge, Zanda Kruma, Daina Karklina, Fredijs Dimins
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Apple juice is the main raw material for cider production. In this study apple juices obtained from 14 dessert and crab variety apples grown in Latvia were investigated. For all samples soluble solids, titratable acidity, pH and sugar content were determined. Crab apples produce more dry matter, total sugar and acid content compared to the dessert apples but it depends on the apple variety. Total sugar content of crab apple juices was 1.3 to 1.8 times larger than in dessert apple juices. Titratable acidity of dessert apple juices is in the range of 4.1g L-1 to 10.83g L-1 and in crab apple juices titratable acidity is from 7.87g L-1 to 19.6g L-1. Fructose was detected as the main sugar whereas glucose level varied depending on the variety. The highest titratable acidity and content of sugars was detected in ‘Cornelia’ apples juice.Keywords: apple juice, hierarchical cluster analysis, sugars, titratable acidity
Procedia PDF Downloads 2423071 A Survey of Skin Cancer Detection and Classification from Skin Lesion Images Using Deep Learning
Authors: Joseph George, Anne Kotteswara Roa
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Skin disease is one of the most common and popular kinds of health issues faced by people nowadays. Skin cancer (SC) is one among them, and its detection relies on the skin biopsy outputs and the expertise of the doctors, but it consumes more time and some inaccurate results. At the early stage, skin cancer detection is a challenging task, and it easily spreads to the whole body and leads to an increase in the mortality rate. Skin cancer is curable when it is detected at an early stage. In order to classify correct and accurate skin cancer, the critical task is skin cancer identification and classification, and it is more based on the cancer disease features such as shape, size, color, symmetry and etc. More similar characteristics are present in many skin diseases; hence it makes it a challenging issue to select important features from a skin cancer dataset images. Hence, the skin cancer diagnostic accuracy is improved by requiring an automated skin cancer detection and classification framework; thereby, the human expert’s scarcity is handled. Recently, the deep learning techniques like Convolutional neural network (CNN), Deep belief neural network (DBN), Artificial neural network (ANN), Recurrent neural network (RNN), and Long and short term memory (LSTM) have been widely used for the identification and classification of skin cancers. This survey reviews different DL techniques for skin cancer identification and classification. The performance metrics such as precision, recall, accuracy, sensitivity, specificity, and F-measures are used to evaluate the effectiveness of SC identification using DL techniques. By using these DL techniques, the classification accuracy increases along with the mitigation of computational complexities and time consumption.Keywords: skin cancer, deep learning, performance measures, accuracy, datasets
Procedia PDF Downloads 1293070 Fabrication of Drug-Loaded Halloysite Nanotubes Containing Sodium Alginate/Gelatin Composite Scaffolds
Authors: Masoumeh Haghbin Nazarpak, Hamidreza Tolabi, Aryan Ekhlasi
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Bone defects are mentioned as one of the most challenging clinical conditions, affecting millions of people each year. A fracture, osteoporosis, tumor, or infection usually causes these defects. At present, autologous and allogeneic grafts are used to correct bone defects, but these grafts have some difficulties, such as limited access, infection, disease transmission, and immune rejection. Bone tissue engineering is considered a new strategy for repairing bone defects. However, problems with scaffolds’ design with unique structures limit their clinical applications. In addition, numerous in-vitro studies have been performed on the behavior of bone cells in two-dimensional environments. Still, cells grow in physiological situations in the human body in a three-dimensional environment. As a result, the controlled design of porous structures with high structural complexity and providing the necessary flexibility to meet specific needs in bone tissue repair is beneficial. For this purpose, a three-dimensional composite scaffold based on gelatin and sodium alginate hydrogels is used in this research. In addition, the antibacterial drug-loaded halloysite nanotubes were introduced into the hydrogel scaffold structure to provide a suitable substrate for controlled drug release. The presence of halloysite nanotubes improved hydrogel’s properties, while the drug eliminated infection and disease transmission. Finally, it can be acknowledged that the composite scaffold prepared in this study for bone tissue engineering seems promising.Keywords: halloysite nanotubes, bone tissue engineering, composite scaffold, controlled drug release
Procedia PDF Downloads 743069 The Population Death Model and Influencing Factors from the Data of The "Sixth Census": Zhangwan District Case Study
Authors: Zhou Shangcheng, Yi Sicen
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Objective: To understand the mortality patterns of Zhangwan District in 2010 and provide the basis for the development of scientific and rational health policy. Methods: Data are collected from the Sixth Census of Zhangwan District and disease surveillance system. The statistical analysis include death difference between age, gender, region and time and the related factors. Methods developed for the Global Burden of Disease (GBD) Study by the World Bank and World Health Organization (WHO) were adapted and applied to Zhangwan District population health data. DALY rate per 1,000 was calculated for varied causes of death. SPSS 16 is used by statistic analysis. Results: From the data of death population of Zhangwan District we know the crude mortality rate was 6.03 ‰. There are significant differences of mortality rate in male and female population which was respectively 7.37 ‰ and 4.68 ‰. 0 age group population life expectancy in Zhangwan District in 2010 was 78.40 years old(Male 75.93, Female 81.03). The five leading causes of YLL in descending order were: cardiovascular diseases(42.63DALY/1000), malignant neoplasm (23.73DALY/1000), unintentional injuries (5.84DALY/1000), Respiratory diseases(5.43 DALY/1000), Respiratory infections (2.44DALY/1000). In addition, there are strong relation between the marital status , educational level and mortality in some to a certain extend. Conclusion Zhangwan District, as city level, is at lower mortality levels. The mortality of the total population of Zhangwan District has a downward trend and life expectancy is rising.Keywords: sixth census, Zhangwan district, death level differences, influencing factors, cause of death
Procedia PDF Downloads 2703068 Text Mining of Veterinary Forums for Epidemiological Surveillance Supplementation
Authors: Samuel Munaf, Kevin Swingler, Franz Brülisauer, Anthony O’Hare, George Gunn, Aaron Reeves
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Web scraping and text mining are popular computer science methods deployed by public health researchers to augment traditional epidemiological surveillance. However, within veterinary disease surveillance, such techniques are still in the early stages of development and have not yet been fully utilised. This study presents an exploration into the utility of incorporating internet-based data to better understand the smallholder farming communities within Scotland by using online text extraction and the subsequent mining of this data. Web scraping of the livestock fora was conducted in conjunction with text mining of the data in search of common themes, words, and topics found within the text. Results from bi-grams and topic modelling uncover four main topics of interest within the data pertaining to aspects of livestock husbandry: feeding, breeding, slaughter, and disposal. These topics were found amongst both the poultry and pig sub-forums. Topic modeling appears to be a useful method of unsupervised classification regarding this form of data, as it has produced clusters that relate to biosecurity and animal welfare. Internet data can be a very effective tool in aiding traditional veterinary surveillance methods, but the requirement for human validation of said data is crucial. This opens avenues of research via the incorporation of other dynamic social media data, namely Twitter and Facebook/Meta, in addition to time series analysis to highlight temporal patterns.Keywords: veterinary epidemiology, disease surveillance, infodemiology, infoveillance, smallholding, social media, web scraping, sentiment analysis, geolocation, text mining, NLP
Procedia PDF Downloads 993067 A Scalable Media Job Framework for an Open Source Search Engine
Authors: Pooja Mishra, Chris Pollett
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This paper explores efficient ways to implement various media-updating features like news aggregation, video conversion, and bulk email handling. All of these jobs share the property that they are periodic in nature, and they all benefit from being handled in a distributed fashion. The data for these jobs also often comes from a social or collaborative source. We isolate the class of periodic, one round map reduce jobs as a useful setting to describe and handle media updating tasks. As such tasks are simpler than general map reduce jobs, programming them in a general map reduce platform could easily become tedious. This paper presents a MediaUpdater module of the Yioop Open Source Search Engine Web Portal designed to handle such jobs via an extension of a PHP class. We describe how to implement various media-updating tasks in our system as well as experiments carried out using these implementations on an Amazon Web Services cluster.Keywords: distributed jobs framework, news aggregation, video conversion, email
Procedia PDF Downloads 2983066 Knowledge Representation Based on Interval Type-2 CFCM Clustering
Authors: Lee Myung-Won, Kwak Keun-Chang
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This paper is concerned with knowledge representation and extraction of fuzzy if-then rules using Interval Type-2 Context-based Fuzzy C-Means clustering (IT2-CFCM) with the aid of fuzzy granulation. This proposed clustering algorithm is based on information granulation in the form of IT2 based Fuzzy C-Means (IT2-FCM) clustering and estimates the cluster centers by preserving the homogeneity between the clustered patterns from the IT2 contexts produced in the output space. Furthermore, we can obtain the automatic knowledge representation in the design of Radial Basis Function Networks (RBFN), Linguistic Model (LM), and Adaptive Neuro-Fuzzy Networks (ANFN) from the numerical input-output data pairs. We shall focus on a design of ANFN in this paper. The experimental results on an estimation problem of energy performance reveal that the proposed method showed a good knowledge representation and performance in comparison with the previous works.Keywords: IT2-FCM, IT2-CFCM, context-based fuzzy clustering, adaptive neuro-fuzzy network, knowledge representation
Procedia PDF Downloads 3223065 Mesenchymal Stem Cells (MSC)-Derived Exosomes Could Alleviate Neuronal Damage and Neuroinflammation in Alzheimer’s Disease (AD) as Potential Therapy-Carrier Dual Roles
Authors: Huan Peng, Chenye Zeng, Zhao Wang
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Alzheimer’s disease (AD) is an age-related neurodegenerative disease that is a leading cause of dementia syndromes and has become a huge burden on society and families. The main pathological features of AD involve excessive deposition of β-amyloid (Aβ) and Tau proteins in the brain, resulting in loss of neurons, expansion of neuroinflammation, and cognitive dysfunction in patients. Researchers have found effective drugs to clear the brain of error-accumulating proteins or to slow the loss of neurons, but their direct administration has key bottlenecks such as single-drug limitation, rapid blood clearance rate, impenetrable blood-brain barrier (BBB), and poor ability to target tissues and cells. Therefore, we are committed to seeking a suitable and efficient delivery system. Inspired by the possibility that exosomes may be involved in the secretion and transport mechanism of many signaling molecules or proteins in the brain, exosomes have attracted extensive attention as natural nanoscale drug carriers. We selected exosomes derived from bone marrow mesenchymal stem cells (MSC-EXO) with low immunogenicity and exosomes derived from hippocampal neurons (HT22-EXO) that may have excellent homing ability to overcome the deficiencies of oral or injectable pathways and bypass the BBB through nasal administration and evaluated their delivery ability and effect on AD. First, MSC-EXO and HT22 cells were isolated and cultured, and MSCs were identified by microimaging and flow cytometry. Then MSC-EXO and HT22-EXO were obtained by gradient centrifugation and qEV SEC separation column, and a series of physicochemical characterization were performed by transmission electron microscope, western blot, nanoparticle tracking analysis and dynamic light scattering. Next, exosomes labeled with lipophilic fluorescent dye were administered to WT mice and APP/PS1 mice to obtain fluorescence images of various organs at different times. Finally, APP/PS1 mice were administered intranasally with two exosomes 20 times over 40 days and 20 μL each time. Behavioral analysis and pathological section analysis of the hippocampus were performed after the experiment. The results showed that MSC-EXO and HT22-EXO were successfully isolated and characterized, and they had good biocompatibility. MSC-EXO showed excellent brain enrichment in APP/PS1 mice after intranasal administration, could improve the neuronal damage and reduce inflammation levels in the hippocampus of APP/PS1 mice, and the improvement effect was significantly better than HT22-EXO. However, intranasal administration of the two exosomes did not cause depression and anxious-like phenotypes in APP/PS1 mice, nor significantly improved the short-term or spatial learning and memory ability of APP/PS1 mice, and had no significant effect on the content of Aβ plaques in the hippocampus, which also meant that MSC-EXO could use their own advantages in combination with other drugs to clear Aβ plaques. The possibility of realizing highly effective non-invasive synergistic treatment for AD provides new strategies and ideas for clinical research.Keywords: Alzheimer’s disease, exosomes derived from mesenchymal stem cell, intranasal administration, therapy-carrier dual roles
Procedia PDF Downloads 623064 Assessment of Dietary Intake of Pregnant Women
Authors: Tuleshova Gulnara, Abduldayeva Aigul
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The goal is based on the studying the prevalence of micronutrient deficiencies among children and women of reproductive age to develop evidence-based recommendations aimed at improving the effectiveness of programs to prevent micronutrient deficiency. Subject: In our study we used a representative, random sample, carried out with the cluster method in the precinct of the principle areas of medical care for children 5 years of old. If the site has at least 60 children under 5 years of old, each second child was sampled, and if more than 60 children - each third child (first child selected by random sampling). The total number of investigated persons was within 80-86 women of reproductive age and children - within 80-92 people. Results: The studies found that the average prevalence of anemia among children aged 6-59 months was 35.2%, with the most susceptible to iron deficiency anemia in infants aged 6-23 months (53.3%). The prevalence of anemia among non-pregnant women was 39.0% among pregnant women - 43.8%. In children, the prevalence of folate deficiency was the highest (27.6%). Among non-pregnant women, frequent prevalence of folic acid deficiency was 37.0%. The prevalence of vitamin A deficiency was higher among children living in Astana (37.4%) compared with the medium-republican level (23.2%).Keywords: nutrition, pregnant women, micronutrients, macronutrients
Procedia PDF Downloads 6163063 An Audit of Restaging Transurethral Resection of Bladder Tumor (Re-TURBT) Quality in a District General Hospital
Authors: Rizwan Iqbal
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Introduction: Re-TURBT has been recommended by international guidelines for patients with non-muscle invasive bladder cancer (NMIBC) who are deemed high-risk. Indications for re-TURBTs remain controversial and studies show mixed outcomes. It should be performed when the initial TURBT specimen lacks detrusor muscle, has tumor stage pT1 or G3/high-grade, or where resection is deemed incomplete. This ensures complete resection of tumors that have a high risk of recurrence as well as accurately identifying any tumors which have been upstaged. The aim of this audit was to evaluate the quality of re-TURBTs in a district general hospital. Method: Data were retrospectively collected from 31 patients who had re-TURBTs between April 2021 and September 2022. Data included baseline demographics, time from initial to re-TURBT, quality of operation note, presence of residual tumor, complications, and administration of chemotherapy within 24 hours of the initial TURBT. Data collection remains ongoing at the time of writing. Results: The mean age was 76 years old and 71.0% of patients were male. 32.3% of patients had their re-TURBT within six weeks and 32.3% had intravesical chemotherapy administered within 24 hours of the initial TURBT. 74.2% of initial TURBTs had detrusor muscle present in the specimen. 48.4% of patients had residual disease following re-TURBT. Just one patient had their pathology upstaged at re-TURBT. The use of the TURBT proforma on the operation note was variable, with 51.6% and 38.7% of surgeons using the proforma after the initial and re-TURBT. Conclusion: Re-TURBT improves bladder cancer staging and is necessary in patients who are deemed high-risk in order to identify any upstaging or recurrence of the disease.Keywords: urology, bladder cancer, turbt, cancer
Procedia PDF Downloads 623062 Factors Affecting Sense of Community in Residential Communities Case Study: Residential Communities in Tehran, Iran
Authors: Parvin Foroughifar
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The concept of sense of community refers to residents’ sense of attachment and commitment to the other residents in a residential community. It is implicitly indicative of the mental image of a physical environment in which the residents enjoy strong social ties. Sense of community, a crucial factor in improving quality of life and social welfare, leads to life satisfaction in a residential community. Despite the important functions of such a notion, few empirical studies, to the best of the authors' knowledge, have been so far carried out in Iran to investigate the effective factors in sharpening the sense of community in residential communities. This survey research examined sense of community in 360 above 20-year old residents of three residential communities in Tehran, Iran using cluster sampling and questionnaire. The study yielded the result that variables of local social ties, social control and trust, sense of security, length of residence, use of public spaces, and mixed land use have a significant relationship with sense of community.Keywords: sense of community, local social ties, sense of security, public space, residential community, Tehran
Procedia PDF Downloads 1883061 Markov Switching of Conditional Variance
Authors: Josip Arneric, Blanka Skrabic Peric
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Forecasting of volatility, i.e. returns fluctuations, has been a topic of interest to portfolio managers, option traders and market makers in order to get higher profits or less risky positions. Based on the fact that volatility is time varying in high frequency data and that periods of high volatility tend to cluster, the most common used models are GARCH type models. As standard GARCH models show high volatility persistence, i.e. integrated behaviour of the conditional variance, it is difficult the predict volatility using standard GARCH models. Due to practical limitations of these models different approaches have been proposed in the literature, based on Markov switching models. In such situations models in which the parameters are allowed to change over time are more appropriate because they allow some part of the model to depend on the state of the economy. The empirical analysis demonstrates that Markov switching GARCH model resolves the problem of excessive persistence and outperforms uni-regime GARCH models in forecasting volatility for selected emerging markets.Keywords: emerging markets, Markov switching, GARCH model, transition probabilities
Procedia PDF Downloads 4553060 Evaluation of Gene Expression after in Vitro Differentiation of Human Bone Marrow-Derived Stem Cells to Insulin-Producing Cells
Authors: Mahmoud M. Zakaria, Omnia F. Elmoursi, Mahmoud M. Gabr, Camelia A. AbdelMalak, Mohamed A. Ghoneim
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Many protocols were publicized for differentiation of human mesenchymal stem cells (MSCS) into insulin-producing cells (IPCs) in order to excrete insulin hormone ingoing to treat diabetes disease. Our aim is to evaluate relative gene expression for each independent protocol. Human bone marrow cells were derived from three volunteers that suffer diabetes disease. After expansion of mesenchymal stem cells, differentiation of these cells was done by three different protocols (the one-step protocol was used conophylline protein, the two steps protocol was depending on trichostatin-A, and the three-step protocol was started by beta-mercaptoethanol). Evaluation of gene expression was carried out by real-time PCR: Pancreatic endocrine genes, transcription factors, glucose transporter, precursor markers, pancreatic enzymes, proteolytic cleavage, extracellular matrix and cell surface protein. Quantitation of insulin secretion was detected by immunofluorescence technique in 24-well plate. Most of the genes studied were up-regulated in the in vitro differentiated cells, and also insulin production was observed in the three independent protocols. There were some slight increases in expression of endocrine mRNA of two-step protocol and its insulin production. So, the two-step protocol was showed a more efficient in expressing of pancreatic endocrine genes and its insulin production than the other two protocols.Keywords: mesenchymal stem cells, insulin producing cells, conophylline protein, trichostatin-A, beta-mercaptoethanol, gene expression, immunofluorescence technique
Procedia PDF Downloads 2153059 Patterns of Self-Reported Overweight, Obesity, and Other Chronic Diseases Among University Students in the United Arab Emirates: A Cross-Sectional Study
Authors: Maryam M. Bashir, Luai A. Ahmed, Meera R. Alshamsi, Sara Almahrooqi, Taif Alyammahi, Shooq A. Alshehhi, Waad I. Alhammadi, Fatima H. Alhammadi, Hind A. Alhosani, Rami H. Al-Rifai, Fatma Al-Maskari
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Obesity in the Middle East and North Africa (MENA) region has exponentially increased over the past five decades due to rapid urbanization and unhealthy lifestyle changes. It has been well established that overweight and obesity increase the risk of non-communicable diseases (NCDs) and are the leading cause of mortality and economic burden locally, and globally. In the United Arab Emirates (UAE), there is a growing epidemic of obesity and other chronic diseases like type 2 diabetes mellitus and cardiovascular diseases. Prevalence of overweight and obesity in UAE range up to 70% depending on the group being studied. Hence, there is a need to explore their patterns in the country for more targeted and responsive interventions. Our study aimed to explore the patterns of overweight and obesity and some self-reported chronic diseases among university students in Abu Dhabi, the capital city of UAE. A validated online self-administered questionnaire was used to collect data from UAE University (UAEU) students, 18years and above, from August to September 2021. Students’ characteristics were summarized using appropriate descriptive statistics. Overweight, obesity and self-reported chronic diseases were described and compared between male and female students using chi-square and t tests. Other associated factors were also explored in relation to overweight and obesity. All analyses were conducted using STATA statistical software version 16.1 (StataCorp LLC, College Station, TX, USA). 902 students participated in the study. 79.8% were females and mean age was 21.90 ± 5.19 years. Majority of the respondents were undergraduate students (80.71%). The prevalence of self-reported chronic diseases was 22.95%. Obesity (BMI≥30kg/m2), Diabetes Mellitus, and Asthma/Allergies were the commonest diseases (12.48%, 4.21% & 3.22%, respectively). Approximately 5% of the students reported more than one chronic disease. Out of the 833 participating students who had complete weight and height data, prevalence of overweight and obesity was 34.81% (22.33% and 12.48%, respectively). More than half of the male students (54.36%) were overweight or obese. This is significantly higher than in female students (30.56%, p=0.001). Overweight/obesity when compared to normal weight is associated with increasing mean age [23.40 vs 21.01, respectively (p=0.001)]. In addition to gender and age, being married [57.63% vs 31.05% (p=0.001)], being a postgraduate student [51.59% vs 30.92% (p=0.001)] and having two or more chronic diseases [65.85% vs 33.21% (p=0.001)] were also significantly associated with overweight/obesity. Our study showed that almost a quarter of the participating university students reported at least one chronic disease. Obesity was the commonest and more than 1 in 3 students were either overweight or obese. This shows the need for intensive health promotion and screening programs on obesity and other chronic diseases to meet the health needs of these students. This study is also a basis for further research, especially qualitative, to explore the relevant risk factors and risk groups for more targeted interventions.Keywords: chronic disease, obesity, overweight, students, United Arab Emirates
Procedia PDF Downloads 1223058 Serum Potassium Before, During and After Exercise at 70% Maximal Heart Rate: The Safe Exercise Dosage Across Different Parameters of Health and Fitness Level
Authors: Omar bin Mihat
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The number of sudden deaths is increasing over the past years. These deaths occur not during physical activities but upon cessation. Post-mortem confirms these deaths as cardiac arrest non-specifically. Congenital heart disease is a condition undiagnosed whereby only surface upon physical exertion leading to sudden death is unavoidable. Channelopathy, a condition that refers to any disease from the defect in iron-channel function, particularly the sodium-potassium pump, during the cessation of the exercise can be controlled. The derivation of heart rate return (HRrtn) is a procedure of a control cooling down process according to the heart rate (HR). Empirically, potassium rises linearly with intensity and falls sharply upon abrupt cessation of exertion, resulting in fatal arrhythmia due to hypokalaemia. It is vital that the flux of potassium should be maintained within the normal range during physical activities. To achieve this, the dosage of physical exertion (exercise) should be identified. Various percentages of the intensity of maximum heart rate (MHR) will precipitate different adaptations and remodeling of various organs. 70% of MHR will surface physiological adaptations, including enhancement of endurance, fitness level, and general health, and there was no significant rise of serum potassium (K+) during the entire phase of the treadmill brisk walk at a different rate of perceived exertion (RPE) from the subject of various fitness background. There was also no significant rise in blood pressure (BP) during the entire phase of the treadmill brisk walk, substantiating 70% MHR is the safe dosage across different parameters of health and fitness level.Keywords: potassium, maximal heart rate, exercise dosage, fitness level
Procedia PDF Downloads 663057 Nutritional Status of People Living with Human Immuno Virus/Acquired Immune Deficiency Syndrome Attending Anti-Retro Viral Treatment Clinic of BP Koirala Institute of Health Sciences, Nepal
Authors: Ghimire K., Mehta R. S., Parajuli P., Chettri R.
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Background: Malnutrition is a common hallmark of Human Immuno Virus (HIV) disease. It plays a synergistic role in immunosuppression which is initiated by Human Immuno Virus itself, and malnutrition forms an independent risk factor for disease progression. Objectives: The objective of the study is to assess the nutritional status of the people living with Human Immuno Virus/Acquired Immune Deficiency Syndrome attending the Anti-Retro viral Treatment Clinic and find the association of nutritional status with different socio-demographic variables. Methods: A total of 101 people living with HIV/AIDS (PLWHA) were selected by convenient sampling technique. The study was conducted at the ART clinic of BPKIHS. A subjective global assessment tool was used for data collection. Descriptive and inferential statistics were used for data analysis. Results: The study demonstrated that the mean age of the respondents was 40.97+8.650 years. 65.3% were well-nourished, and 34.7% of the participants were mildly/moderately malnourished, whereas none of them were severely malnourished. BMI was statistically significant with education status, family income, and duration of illness of the participants, and nutritional status was statistically significant with gender, marital status, education status, and family history of HIV. Conclusion: On the basis of the result, it can be concluded that more than half of the respondents were well nourished. Gender, marital status, and education are associated with nutritional status.Keywords: nutritional status, people living with HIV/AIDS, ART treatment, Nepal
Procedia PDF Downloads 863056 Altered Expression of Ubiquitin Editing Complex in Ulcerative Colitis
Authors: Ishani Majumdar, Jaishree Paul
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Introduction: Ulcerative Colitis (UC) is an inflammatory disease of the colon resulting from an autoimmune response towards individual’s own microbiota. Excessive inflammation is characterized by hyper-activation of NFkB, a transcription factor regulating expression of various pro-inflammatory genes. The ubiquitin editing complex consisting of TNFAIP3, ITCH, RNF11 and TAX1BP1 maintains homeostatic levels of active NFkB through feedback inhibition and assembles in response to various stimuli that activate NFkB. TNFAIP3 deubiquitinates key signaling molecules involved in NFkB activation pathway. ITCH, RNF11 and TAX1BP1 provide substrate specificity, acting as adaptors for TNFAIP3 function. Aim: This study aimed to find expression of members of the ubiquitin editing complex at the transcript level in inflamed colon tissues of UC patients. Materials and Methods: Colonic biopsy samples were collected from 30 UC patients recruited at Department of Gastroenterology, AIIMS (New Delhi). Control group (n= 10) consisted of individuals undergoing examination for functional disorders. Real Time PCR was used to determine relative expression with GAPDH as housekeeping gene. Results: Expression of members of the ubiquitin editing complex was significantly altered during active disease. Expression of TNFAIP3 was upregulated while concomitant decrease in expression of ITCH, RNF11, TAX1BP1 was seen in UC patients. Discussion: This study reveals that increase in expression of TNFAIP3 was unable to control inflammation during active UC. Further, insufficient upregulation of ITCH, RNF11, TAX1BP1 may limit the formation of the ubiquitin complex and contribute to pathogenesis of UC.Keywords: altered expression, inflammation, ubiquitin editing complex, ulcerative colitis
Procedia PDF Downloads 2623055 STAT6 Mediates Local and Systemic Fibrosis and Type Ii Immune Response via Macrophage Polarization during Acute and Chronic Pancreatitis in Murine Model
Authors: Hager Elsheikh, Matthias Sendler, Juliana Glaubnitz
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In pancreatitis, an inflammatory reaction occurs in the pancreatic secretory cells due to premature activation of proteases, leading to pancreatic self-digestion and necrotic cell death of acinar cells. Acute pancreatitis in patients is characterized by a severe immune reaction that could lead to serious complications, such as organ failure or septic shock, if left untreated. Chronic pancreatitis is a recurrence of episodes of acute pancreatitis resulting in a fibro-inflammatory immune response, in which the type 2 immune response is primarily driven by AAMs in the pancreas. One of the most important signaling pathways for M2 macrophage activation is the IL-4/STAT6 pathway. Pancreatic fibrosis is induced by the hyperactivation of pancreatic stellate cells by dysregulation in the inflammatory response, leading to further damage, autodigestion and possibly necrosis of pancreatic acinar cells. The aim of this research is to investigate the effect of STAT6 knockout in disease severity and development of fibrosis wound healing in the presence of different macrophage populations, regulated by the type 2 immune response, after inducing chronic and/or acute pancreatitis in mice models via cerulean injection. We further investigate the influence of the JAK/STAT6 signaling pathway on the balance of fibrosis and regeneration in STAT6 deficient and wild-type mice. The characterization of resident and recruited macrophages will provide insight into the influence of the JAK/STAT6 signaling pathway on infiltrating cells and, ultimately, tissue fibrosis and disease severity.Keywords: acute and chronic pancreatitis, tissue regeneration, macrophage polarization, Gastroenterology
Procedia PDF Downloads 683054 Monitoring Prolong Use of Intravenous Antibiotics: Antimicrobial Stewardship
Authors: Komal Fizza
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Irrational and non-judicious use of antibiotics pave the way for an upsurge in antibiotic resistance, diminished effectiveness of different therapeutic regimens and as well as impounding effect on disease management leading to further morbidities. In the backdrop of this the current research is aimed to assess whether antimicrobial prescribing is in accordance with the Infectious Disease Society of America Guidelines in hospitalized patients at Shifa International Hospital, Islamabad, Pakistan. Shifa International Hospital, Islamabad is a 500 bed hospital. With the help of MIS team a form wad developed that gave the information about medical records number, name of the patient, day of start of antibiotic, the day antibiotic is supposed to be stopped and as well as the diagnosis of the patient. A ward pharmacist was employed to generate this report on a daily basis. The therapeutic regiment was reviewed by the pharmacist by monitoring the clinical progress, laboratory report and diagnosis. On the basis of this information, pharmacist made suggestions and forwarded to the hospital doctors responsible for prescribing antibiotics. If desired, changes were made regularly. In the current research our main focus was to implement this action and therefore, started monitoring patients who were on antibiotic regimens for more than 10-15 days. We took this initiative since November, 2013. At the start of the program a maximum 19 patients/day were reported to be on antibiotic regimen for more than 10-15 days. After the implementation of the initiative, the number of patients was decreased to fifteen patients per day in December, further decreased to 7 in the month of January and 9 and 6 in February and March respectively. The average patient census was 350. The current pilot study highlighted the role of pharmacist in initiating antibiotic stewardship programs in hospital settings.Keywords: stewardship, antibiotics, resistance, clinical process
Procedia PDF Downloads 3533053 Comparing of Hypogonadism Frequency between Metabolic Syndrome Men with Normal Men
Authors: Armaghan Moravej Aleali, Seyed Bahman Ghaderian, Homeira Rashidi, Mahmoud Mapar
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Background and Objective The metabolic syndrome (MetS) is considered the most important public health threat of the 21st century. This syndrome is characterized by a cluster of cardiovascular risk factors including increased central abdominal obesity, elevated triglycerides, reduced high-density lipoprotein, high blood pressure, increased fasting glucose, and hyperinsulinemia. MetS has been associated with hypogonadism and erectile dysfunction (ED), and MetS may be considered a risk factor for ED. The aim of this study was finding an association between metabolic syndrome and hypogonadism in Khouzestan, Iran. Subjects and Methods: In this study, 60 patients divided into two groups consisted of 30 cases (with metabolic syndrome) and 30 controls. Total and free Serum Testosterone and FBS in all of them were measured. Data was analyzed with SPSS20 program. Results: There was a significant difference between two groups about free Testosterone (P=0.01), FBS (P=0.002) and LH (P=0.03). Conclusion: According to this finding, it is thought the prevalence of hypogonadism in men with metabolic syndrome is more than the general population.Keywords: metabolic syndrome, fasting blood sugar, hypogonadism, testosterone
Procedia PDF Downloads 3963052 Anthelminthic Effect of Clitoria Ternatea on Paramphistomum Cervi in Buffalo (Bubalus Bubalis) of Udaipur, Rajasthan, India
Authors: Bhanupriya Sanger, Kiran Roat, Gayatri Swarnakar
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Helminths including Paramphistomum Cervi (P. cervi) are a major cause of reduced production in livestock or domestic ruminant. Rajasthan is the largest state of India having a maximum number of livestock. The economy of rural people largely depends on livestock such as cow, buffalo, goat and sheep. The prevalence of P. cervi helminth parasite is extremely high in buffalo (Bubalus bubalis) of Udaipur, which causes the disease paramphistomiasis. This disease mainly affects milk, meat, wool production and loss of life of buffalo. Chemotherapy is the only efficient and effective tool to cure and control the helminth P. cervi infection, as efficacious vaccines against helminth have not been developed so far. Various veterinary drugs like Albendazole have been used as the standard drug for eliminating P. cervi from buffalo, but these drugs are unaffordable and inaccessible for poor livestock farmers. The fruits, leaves and seeds of Clitoria ternatea Linn. are known for their ethno-medicinal value and commonly known as “Aprajita” in India. Seed extract of Clitoria ternatea found to have a significant anthelmintic action against Paramphistomum cervi at the dose of 35 mg/ml. The tegument of treated P. cervi was compared with controlled parasites by light microscopy. Treated P. cervi showed extensive distortion and destruction of the tegument including ruptured parenchymal cells, disruption of musculature cells, swelling and vacuolization in tegumental and sub tegumental cells. As a result, it can be concluded that the seeds of Clitoria ternatea can be used as the anthelmintic agent. Key words: Paramphistomiasis, Buffalo, Alcoholic extract, Paramphistomum cervi, Clitoria ternatea.Keywords: buffalo, Clitoria ternatea, Paramphistomiasis, Paramphistomum cervi
Procedia PDF Downloads 2293051 Dissection of Genomic Loci for Yellow Vein Mosaic Virus Resistance in Okra (Abelmoschus esculentas)
Authors: Rakesh Kumar Meena, Tanushree Chatterjee
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Okra (Abelmoschus esculentas L. Moench) or lady’s finger is an important vegetable crop belonging to the Malvaceae family. Unfortunately, production and productivity of Okra are majorly affected by Yellow Vein mosaic virus (YVMV). The AO: 189 (resistant parent) X AO: 191(susceptible parent) used for the development of mapping population. The mapping population has 143 individuals (F₂:F₃). Population was characterized by physiological and pathological observations. Screening of 360 DNA markers was performed to survey for parental polymorphism between the contrasting parents’, i.e., AO: 189 and AO: 191. Out of 360; 84 polymorphic markers were used for genotyping of the mapping population. Total markers were distributed into four linkage groups (LG1, LG2, LG3, and LG4). LG3 covered the longest span (106.8cM) with maximum number of markers (27) while LG1 represented the smallest linkage group in terms of length (71.2cM). QTL identification using the composite interval mapping approach detected two prominent QTLs, QTL1 and QTL2 for resistance against YVMV disease. These QTLs were placed between the marker intervals of NBS-LRR72-Path02 and NBS-LRR06- NBS-LRR65 on linkage group 02 and linkage group 04 respectively. The LOD values of QTL1 and QTL2 were 5.7 and 6.8 which accounted for 19% and 27% of the total phenotypic variation, respectively. The findings of this study provide two linked markers which can be used as efficient diagnostic tools to distinguish between YVMV resistant and susceptible Okra cultivars/genotypes. Lines identified as highly resistant against YVMV infection can be used as donor lines for this trait. This will be instrumental in accelerating the trait improvement program in Okra and will substantially reduce the yield losses due to this viral disease.Keywords: Okra, yellow vein mosaic virus, resistant, linkage map, QTLs
Procedia PDF Downloads 2153050 The Effect of Eight-Week Medium Intensity Interval Training and Curcumin Intake on ICMA-1 and VCAM-1 Levels in Menopausal Fat Rats
Authors: Abdolrasoul Daneshjoo, Fatemeh Akbari Ghara
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Background and Purpose: Obesity is an increasing factor in cardiovascular disease and serum levels of cellular adhesion molecule. It plays an important role in predicting risk for coronary artery disease. The purpose of this research was to study the effect of eight weeks moderate intensity interval training and curcumin intake on ICAM-1 & VCAM-1 levels of menopausal fat rats. Materials and methods: in this study, 28 Wistar Menopausal fat rats aged 6-8 weeks with an average weight of 250-300 (gr) were randomly divided into four groups: control, curcumin supplement, moderate intensity interval training and moderate intensity interval training + curcumin supplement. (7 rats each group). The training program was planned as 8 weeks and 3 sessions per week. Each session consisted of 10 one-min sets with 50 percent intensity and the 2-minutes interval between sets in the first week. Subjects started with 14 meters per minute, and 2 (m/min) was added to increase their speed weekly until the speed of 28 (m/min) in the 8th week. Blood samples were taken 48 hours after the last training session, and ICAM-1 A and VCAM-1 levels were measured. SPSS software, one-way analysis of variance (ANOVA) and Pearson correlation coefficient were used to assess the results. Results: The results showed that eight weeks of training and taking curcumin had significant effects on ICAM-1 levels of the rats (p ≤ 0.05). However, it had no significant effect on VCAM-1 levels in menopausal obese rates (p ≥ 0.05). There was no significant correlation between the levels of ICAM-1 and VCAM-1 in eight weeks training and taking curcumin. Conclusion: Implementation of moderate intensity interval training and the use of curcumin decreased ICAM-1 significantly.Keywords: curcumin, interval training , ICMA, VCAM
Procedia PDF Downloads 1923049 Double-Spear 1-H2-1 Oncolytic-Immunotherapy for Refractory and Relapsing High-Risk Human Neuroblastoma and Glioma
Authors: Lian Zeng
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Double-Spear 1-H2-1 (DS1-H2-1) is an oncolytic virus and an innovative biological drug candidate. The chemical composition of the drug product is a live attenuated West Nile virus (WNV) containing the human T cell costimulator (CD86) gene. After intratumoral injection, the virus can rapidly self-replicate in the injected site and lyse/kill the tumor by repeated infection among tumor cells. We also established xenograft tumor models in mice to evaluate the drug candidate's efficacy on those tumors. The results from preclinical studies on transplanted tumors in immunodeficient mice showed that DS1-H2-1 had significant oncolytic effects on human-origin cancers: it completely (100%) shrieked human glioma; limited human neuroblastoma growth reached as high as 95% growth inhibition rate (%TGITW). The safety data of preclinical animal experiments confirmed that DS1-H2-1 is safe as a biological drug for clinical use. In the preclinical drug efficacy experiment, virus-drug administration with different doses did not show abnormal signs and disease symptoms in more than 300 tested mice, and no side effects or death occurred through various administration routes. Intravenous administration did not cause acute infectious disease or other side effects. However, the replication capacity of the virus in tumor tissue via intravenous administration is only 1% of that of direct intratumoral administration. The direct intratumoral administration of DS1-H2-1 had a higher rate of viral replication. Therefore, choosing direct intratumoral injection can ensure both efficacy and safety.Keywords: oncolytic virus, WNV-CD86, immunotherapy drugs, glioma, neuroblastoma
Procedia PDF Downloads 1323048 Obtaining Norms for Arabic Translated Version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Neuropsychological Battery in Normal Elderly Omanis Attending a Tertiary Hospital in Oman
Authors: Ammar Alobaidy, Lamees Alsawafi, Malak Almawali, Balqees Alabri, Hajer Alhamrashdi
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Background: There is scarce data in the literature concerning the use of Arabic version neuron psychological cognitive tests in the geriatric age group of the Omani population. Objectives: Our aim is to obtain norms for normal elderly Omanis assessed by The Consortium to Establish a Registry for Alzheimer's disease (CERAD) neuro psychological battery and to compare these norms with other studies in the literature. Methods: 84 attendants and visitors of in-patients at Sultan Qaboos University Hospital, elder than 55 years, were interviewed. All participants were assessed by Dementia Rating Scale & Geriatric Depression Scale to ensure the integrity of their activities of daily living and the absence of depression, respectively. The performance of all participants in the CERAD battery was rated by a single rater to optimize the inter-rater reliability. Results: The cut-point for average performance in CERAD battery is dependent on the age, sex, and level of education and cannot be set as a single cut-point for all elderly Omanis. Conclusion: This study has shown the effect of age, sex, and level of education on the cognitive performance of normal elderly Omanis. The normative data obtained from this study can be utilized to differentiate between the cognitive decline of normal aging and the cognitive impairment due to various neuro cognitive disorders in the elderly Omanis, and probably culturally similar Arabic speaking communities.Keywords: CERAD, neuropsychological battery, normal aging, elderly Omanis
Procedia PDF Downloads 3713047 Building a Framework for Digital Emergency Response System for Aged, Long Term Care and Chronic Disease Patients in Asia Pacific Region
Authors: Nadeem Yousuf Khan
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This paper proposes the formation of a digital emergency response system (dERS) in the aged, long-term care, and chronic disease setups in the post-COVID healthcare ecosystem, focusing on the Asia Pacific market where the aging population is increasing significantly. It focuses on the use of digital technologies such as wearables, a global positioning system (GPS), and mobile applications to build an integrated care system for old folks with co-morbidities and other chronic diseases. The paper presents a conceptual framework of a connected digital health ecosystem that not only provides proactive care to registered patients but also prevents the damages due to sudden conditions such as strokes by alerting and treating the patients in a digitally connected and coordinated manner. A detailed review of existing digital health technologies such as wearables, GPS, and mobile apps was conducted in context with the new post-COVID healthcare paradigm, along with a detailed literature review on the digital health policies and usability. A good amount of research papers is available in the application of digital health, but very few of them discuss the formation of a new framework for a connected digital ecosystem for the aged care population, which is increasing around the globe. A connected digital emergency response system has been proposed by the author whereby all registered patients (chronic disease and aged/long term care) will be connected to the proposed digital emergency response system (dERS). In the proposed ecosystem, patients will be provided with a tracking wrist band and a mobile app through which the control room will be monitoring the mobility and vitals such as atrial fibrillation (AF), blood sugar, blood pressure, and other vital signs. In addition to that, an alert in case if the patient falls down will add value to this system. In case of any variation in the vitals, an alert is sent to the dERS 24/7, and dERS clinical staff immediately trigger that alert which goes to the connected hospital and the adulatory service providers, and the patient is escorted to the nearest connected tertiary care hospital. By the time, the patient reaches the hospital, dERS team is ready to take appropriate clinical action to save the life of the patient. Strokes or myocardial infarction patients can be prevented from disaster if they are accessible to engagement healthcare. This dERS will play an effective role in saving the lives of aged patients or patients with chronic co-morbidities.Keywords: aged care, atrial fibrillation, digital health, digital emergency response system, digital technology
Procedia PDF Downloads 1223046 Investigation of Genetic Diversity of Tilia tomentosa Moench. (Silver Lime) in Duzce-Turkey
Authors: Ibrahim Ilker Ozyigit, Ertugrul Filiz, Seda Birbilener, Semsettin Kulac, Zeki Severoglu
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In this study, we have performed genetic diversity analysis of Tilia tomentosa genotypes by using randomly amplified polymorphic DNA (RAPD) primers. A total of 28 genotypes, including 25 members from the urban ecosystem and 3 genotypes from forest ecosystem as outgroup were used. 8 RAPD primers produced a total of 53 bands, of which 48 (90.6 %) were polymorphic. Percentage of polymorphic loci (P), observed number of alleles (Na), effective number of alleles (Ne), Nei's (1973) gene diversity (h), and Shannon's information index (I) were found as 94.29 %, 1.94, 1.60, 0.34, and 0.50, respectively. The unweighted pair-group method with arithmetic average (UPGMA) cluster analysis revealed that two major groups were observed. The genotypes of urban and forest ecosystems showed a high genetic similarity between 28% and 92% and these genotypes did not separate from each other in UPGMA tree. Also, urban and forest genotypes clustered together in principal component analysis (PCA).Keywords: Tilia tomentosa, genetic diversity, urban ecosystem, RAPD, UPGMA
Procedia PDF Downloads 5103045 The Lopsided Burden of Non-Communicable Diseases in India: Evidences from the Decade 2004-2014
Authors: Kajori Banerjee, Laxmi Kant Dwivedi
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India is a part of the ongoing globalization, contemporary convergence, industrialization and technical advancement that is taking place world-wide. Some of the manifestations of this evolution is rapid demographic, socio-economic, epidemiological and health transition. There has been a considerable increase in non-communicable diseases due to change in lifestyle. This study aims to assess the direction of burden of disease and compare the pressure of infectious diseases against cardio-vascular, endocrine, metabolic and nutritional diseases. The change in prevalence in a ten-year period (2004-2014) is further decomposed to determine the net contribution of various socio-economic and demographic covariates. The present study uses the recent 71st (2014) and 60th (2004) rounds of National Sample Survey. The pressure of infectious diseases against cardio-vascular (CVD), endocrine, metabolic and nutritional (EMN) diseases during 2004-2014 is calculated by Prevalence Rates (PR), Hospitalization Rates (HR) and Case Fatality Rates (CFR). The prevalence of non-communicable diseases are further used as a dependent variable in a logit regression to find the effect of various social, economic and demographic factors on the chances of suffering from the particular disease. Multivariate decomposition technique further assists in determining the net contribution of socio-economic and demographic covariates. This paper upholds evidences of stagnation of the burden of communicable diseases (CD) and rapid increase in the burden of non-communicable diseases (NCD) uniformly for all population sub-groups in India. CFR for CVD has increased drastically in 2004-2014. Logit regression indicates the chances of suffering from CVD and EMN is significantly higher among the urban residents, older ages, females, widowed/ divorced and separated individuals. Decomposition displays ample proof that improvement in quality of life markers like education, urbanization, longevity of life has positively contributed in increasing the NCD prevalence rate. In India’s current epidemiological phase, compression theory of morbidity is in action as a significant rise in the probability of contracting the NCDs over the time period among older ages is observed. Age is found to play a vital contributor in increasing the probability of having CVD and EMN over the study decade 2004-2014 in the nationally representative sample of National Sample Survey.Keywords: cardio-vascular disease, case-fatality rate, communicable diseases, hospitalization rate, multivariate decomposition, non-communicable diseases, prevalence rate
Procedia PDF Downloads 313