Search results for: breast cancer detection
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5325

Search results for: breast cancer detection

3525 Evaluation of Ensemble Classifiers for Intrusion Detection

Authors: M. Govindarajan

Abstract:

One of the major developments in machine learning in the past decade is the ensemble method, which finds highly accurate classifier by combining many moderately accurate component classifiers. In this research work, new ensemble classification methods are proposed with homogeneous ensemble classifier using bagging and heterogeneous ensemble classifier using arcing and their performances are analyzed in terms of accuracy. A Classifier ensemble is designed using Radial Basis Function (RBF) and Support Vector Machine (SVM) as base classifiers. The feasibility and the benefits of the proposed approaches are demonstrated by the means of standard datasets of intrusion detection. The main originality of the proposed approach is based on three main parts: preprocessing phase, classification phase, and combining phase. A wide range of comparative experiments is conducted for standard datasets of intrusion detection. The performance of the proposed homogeneous and heterogeneous ensemble classifiers are compared to the performance of other standard homogeneous and heterogeneous ensemble methods. The standard homogeneous ensemble methods include Error correcting output codes, Dagging and heterogeneous ensemble methods include majority voting, stacking. The proposed ensemble methods provide significant improvement of accuracy compared to individual classifiers and the proposed bagged RBF and SVM performs significantly better than ECOC and Dagging and the proposed hybrid RBF-SVM performs significantly better than voting and stacking. Also heterogeneous models exhibit better results than homogeneous models for standard datasets of intrusion detection. 

Keywords: data mining, ensemble, radial basis function, support vector machine, accuracy

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3524 Supervised/Unsupervised Mahalanobis Algorithm for Improving Performance for Cyberattack Detection over Communications Networks

Authors: Radhika Ranjan Roy

Abstract:

Deployment of machine learning (ML)/deep learning (DL) algorithms for cyberattack detection in operational communications networks (wireless and/or wire-line) is being delayed because of low-performance parameters (e.g., recall, precision, and f₁-score). If datasets become imbalanced, which is the usual case for communications networks, the performance tends to become worse. Complexities in handling reducing dimensions of the feature sets for increasing performance are also a huge problem. Mahalanobis algorithms have been widely applied in scientific research because Mahalanobis distance metric learning is a successful framework. In this paper, we have investigated the Mahalanobis binary classifier algorithm for increasing cyberattack detection performance over communications networks as a proof of concept. We have also found that high-dimensional information in intermediate features that are not utilized as much for classification tasks in ML/DL algorithms are the main contributor to the state-of-the-art of improved performance of the Mahalanobis method, even for imbalanced and sparse datasets. With no feature reduction, MD offers uniform results for precision, recall, and f₁-score for unbalanced and sparse NSL-KDD datasets.

Keywords: Mahalanobis distance, machine learning, deep learning, NS-KDD, local intrinsic dimensionality, chi-square, positive semi-definite, area under the curve

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3523 Fam111b Gene Dysregulation Contributes to the Malignancy in Fibrosarcoma, Poor Clinical Outcomes in Poiktmp and a Low-cost Method for Its Mutation Screening

Authors: Cenza Rhoda, Falone Sunda, Elvis Kidzeru, Nonhlanhla P. Khumalo, Afolake Arowolo

Abstract:

Introduction: The human FAM111B gene mutations are associated with POIKTMP, a rare multi-organ fibrosing disease. Recent studies also reported the overexpression of FAM111B in specific cancers. However, the role of FAM111B in these pathologies, particularly fibrosarcoma, remains unknown. Materials and Methods: FAM111B RNA expression in some cancer cell lines was assessed in silico and validated in vitro in these cell lines and skin fibroblasts derived from the South African family member affected by POIKTMP with the heterozygous FAM111B gene mutation: NM_198947.4: c.1861T>G (p. Tyr621Asp or Y621D) by qPCR and western blot. The cellular function of FAM111B was also studied in HT1080 using various cell-based functional assays and a simple and cost-effective PCR-RFLP method for genotyping/screening FAM111B gene mutations described. Results: Expression studies showed upregulated FAM111B mRNA and protein in the cancer cells. High FAM111B expression with robust nuclear localization occurred in HT1080. Additionally, expression data and cell-based assays indicated that FAM111B led to the upregulation of cell migration and decreased cell apoptosis and cell proliferation modulation. FAM111B Y621D mutation showed similar effects on cell migration but minimal impact on cell apoptosis. FAM111B mRNA and protein expression were markedly downregulated (p ≤ 0.05) in the patient's skin-derived fibroblasts. Lastly, the PCR-RFLP method successfully genotyped FAM111B Y621D gene mutation. Discussion: FAM111B is a cancer-associated nuclear protein: Its modulation by mutations may enhance cell migration and proliferation and decrease apoptosis, as seen in cancers and POIKTMP/fibrosis, thus representing a viable therapeutic target in these disorders. Furthermore, the PCR-RFLP method could prove a valuable tool for FAM111B mutation validation or screening in resource-constrained laboratories.

Keywords: FAM111B, POIKTMP, cancer, fibrosis, PCR-RFLP

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3522 Epileptic Seizure Onset Detection via Energy and Neural Synchronization Decision Fusion

Authors: Marwa Qaraqe, Muhammad Ismail, Erchin Serpedin

Abstract:

This paper presents a novel architecture for a patient-specific epileptic seizure onset detector using scalp electroencephalography (EEG). The proposed architecture is based on the decision fusion calculated from energy and neural synchronization related features. Specifically, one level of the detector calculates the condition number (CN) of an EEG matrix to evaluate the amount of neural synchronization present within the EEG channels. On a parallel level, the detector evaluates the energy contained in four EEG frequency subbands. The information is then fed into two independent (parallel) classification units based on support vector machines to determine the onset of a seizure event. The decisions from the two classifiers are then combined together according to two fusion techniques to determine a global decision. Experimental results demonstrate that the detector based on the AND fusion technique outperforms existing detectors with a sensitivity of 100%, detection latency of 3 seconds, while it achieves a 2:76 false alarm rate per hour. The OR fusion technique achieves a sensitivity of 100%, and significantly improves delay latency (0:17 seconds), yet it achieves 12 false alarms per hour.

Keywords: epilepsy, EEG, seizure onset, electroencephalography, neuron, detection

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3521 Investigation of Several New Ionic Liquids’ Behaviour during ²¹⁰PB/²¹⁰BI Cherenkov Counting in Waters

Authors: Nataša Todorović, Jovana Nikolov, Ivana Stojković, Milan Vraneš, Jovana Panić, Slobodan Gadžurić

Abstract:

The detection of ²¹⁰Pb levels in aquatic environments evokes interest in various scientific studies. Its precise determination is important not only for the radiological assessment of drinking waters but also ²¹⁰Pb, and ²¹⁰Po distribution in the marine environment are significant for the assessment of the removal rates of particles from the ocean and particle fluxes during transport along the coast, as well as particulate organic carbon export in the upper ocean. Measurement techniques for ²¹⁰Pb determination, gamma spectrometry, alpha spectrometry, or liquid scintillation counting (LSC) are either time-consuming or demand expensive equipment or complicated chemical pre-treatments. However, one other possibility is to measure ²¹⁰Pb on an LS counter if it is in equilibrium with its progeny ²¹⁰Bi - through the Cherenkov counting method. It is unaffected by the chemical quenching and assumes easy sample preparation but has the drawback of lower counting efficiencies than standard LSC methods, typically from 10% up to 20%. The aim of the presented research in this paper is to investigate the possible increment of detection efficiency of Cherenkov counting during ²¹⁰Pb/²¹⁰Bi detection on an LS counter Quantulus 1220. Considering naturally low levels of ²¹⁰Pb in aqueous samples, the addition of ionic liquids to the counting vials with the analysed samples has the benefit of detection limit’s decrement during ²¹⁰Pb quantification. Our results demonstrated that ionic liquid, 1-butyl-3-methylimidazolium salicylate, is more efficient in Cherenkov counting efficiency increment than the previously explored 2-hydroxypropan-1-amminium salicylate. Consequently, the impact of a few other ionic liquids that were synthesized with the same cation group (1-butyl-3-methylimidazolium benzoate, 1-butyl-3-methylimidazolium 3-hydroxybenzoate, and 1-butyl-3-methylimidazolium 4-hydroxybenzoate) was explored in order to test their potential influence on Cherenkov counting efficiency. It was confirmed that, among the explored ones, only ionic liquids in the form of salicylates exhibit a wavelength shifting effect. Namely, the addition of small amounts (around 0.8 g) of 1-butyl-3-methylimidazolium salicylate increases the detection efficiency from 16% to >70%, consequently reducing the detection threshold by more than four times. Moreover, the addition of ionic liquids could find application in the quantification of other radionuclides besides ²¹⁰Pb/²¹⁰Bi via Cherenkov counting method.

Keywords: liquid scintillation counting, ionic liquids, Cherenkov counting, ²¹⁰PB/²¹⁰BI in water

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3520 CSRFDtool: Automated Detection and Prevention of a Reflected Cross-Site Request Forgery

Authors: Alaa A. Almarzuki, Nora A. Farraj, Aisha M. Alshiky, Omar A. Batarfi

Abstract:

The number of internet users is dramatically increased every year. Most of these users are exposed to the dangers of attackers in one way or another. The reason for this lies in the presence of many weaknesses that are not known for native users. In addition, the lack of user awareness is considered as the main reason for falling into the attackers’ snares. Cross Site Request Forgery (CSRF) has placed in the list of the most dangerous threats to security in OWASP Top Ten for 2013. CSRF is an attack that forces the user’s browser to send or perform unwanted request or action without user awareness by exploiting a valid session between the browser and the server. When CSRF attack successes, it leads to many bad consequences. An attacker may reach private and personal information and modify it. This paper aims to detect and prevent a specific type of CSRF, called reflected CSRF. In a reflected CSRF, a malicious code could be injected by the attackers. This paper explores how CSRF Detection Extension prevents the reflected CSRF by checking browser specific information. Our evaluation shows that the proposed solution succeeds in preventing this type of attack.

Keywords: CSRF, CSRF detection extension, attackers, attacks

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3519 Intelligent Platform for Photovoltaic Park Operation and Maintenance

Authors: Andreas Livera, Spyros Theocharides, Michalis Florides, Charalambos Anastassiou

Abstract:

A main challenge in the quest for ensuring quality of operation, especially for photovoltaic (PV) systems, is to safeguard the reliability and optimal performance by detecting and diagnosing potential failures and performance losses at early stages or before the occurrence through real-time monitoring, supervision, fault detection, and predictive maintenance. The purpose of this work is to present the functionalities and results related to the development and validation of a software platform for PV assets diagnosis and maintenance. The platform brings together proprietary hardware sensors and software algorithms to enable the early detection and prediction of the most common and critical faults in PV systems. It was validated using field measurements from operating PV systems. The results showed the effectiveness of the platform for detecting faults and losses (e.g., inverter failures, string disconnections, and potential induced degradation) at early stages, forecasting PV power production while also providing recommendations for maintenance actions. Increased PV energy yield production and revenue can be thus achieved while also minimizing operation and maintenance (O&M) costs.

Keywords: failure detection and prediction, operation and maintenance, performance monitoring, photovoltaic, platform, recommendations, predictive maintenance

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3518 Outlier Detection in Stock Market Data using Tukey Method and Wavelet Transform

Authors: Sadam Alwadi

Abstract:

Outlier values become a problem that frequently occurs in the data observation or recording process. Thus, the need for data imputation has become an essential matter. In this work, it will make use of the methods described in the prior work to detect the outlier values based on a collection of stock market data. In order to implement the detection and find some solutions that maybe helpful for investors, real closed price data were obtained from the Amman Stock Exchange (ASE). Tukey and Maximum Overlapping Discrete Wavelet Transform (MODWT) methods will be used to impute the detect the outlier values.

Keywords: outlier values, imputation, stock market data, detecting, estimation

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3517 Analysis and Design Modeling for Next Generation Network Intrusion Detection and Prevention System

Authors: Nareshkumar Harale, B. B. Meshram

Abstract:

The continued exponential growth of successful cyber intrusions against today’s businesses has made it abundantly clear that traditional perimeter security measures are no longer adequate and effective. We evolved the network trust architecture from trust-untrust to Zero-Trust, With Zero Trust, essential security capabilities are deployed in a way that provides policy enforcement and protection for all users, devices, applications, data resources, and the communications traffic between them, regardless of their location. Information exchange over the Internet, in spite of inclusion of advanced security controls, is always under innovative, inventive and prone to cyberattacks. TCP/IP protocol stack, the adapted standard for communication over network, suffers from inherent design vulnerabilities such as communication and session management protocols, routing protocols and security protocols are the major cause of major attacks. With the explosion of cyber security threats, such as viruses, worms, rootkits, malwares, Denial of Service attacks, accomplishing efficient and effective intrusion detection and prevention is become crucial and challenging too. In this paper, we propose a design and analysis model for next generation network intrusion detection and protection system as part of layered security strategy. The proposed system design provides intrusion detection for wide range of attacks with layered architecture and framework. The proposed network intrusion classification framework deals with cyberattacks on standard TCP/IP protocol, routing protocols and security protocols. It thereby forms the basis for detection of attack classes and applies signature based matching for known cyberattacks and data mining based machine learning approaches for unknown cyberattacks. Our proposed implemented software can effectively detect attacks even when malicious connections are hidden within normal events. The unsupervised learning algorithm applied to network audit data trails results in unknown intrusion detection. Association rule mining algorithms generate new rules from collected audit trail data resulting in increased intrusion prevention though integrated firewall systems. Intrusion response mechanisms can be initiated in real-time thereby minimizing the impact of network intrusions. Finally, we have shown that our approach can be validated and how the analysis results can be used for detecting and protection from the new network anomalies.

Keywords: network intrusion detection, network intrusion prevention, association rule mining, system analysis and design

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3516 Microfluidic Impedimetric Biochip and Related Methods for Measurement Chip Manufacture and Counting Cells

Authors: Amina Farooq, Nauman Zafar Butt

Abstract:

This paper is about methods and tools for counting particles of interest, such as cells. A microfluidic system with interconnected electronics on a flexible substrate, inlet-outlet ports and interface schemes, sensitive and selective detection of cells specificity, and processing of cell counting at polymer interfaces in a microscale biosensor for use in the detection of target biological and non-biological cells. The development of fluidic channels, planar fluidic contact ports, integrated metal electrodes on a flexible substrate for impedance measurements, and a surface modification plasma treatment as an intermediate bonding layer are all part of the fabrication process. Magnetron DC sputtering is used to deposit a double metal layer (Ti/Pt) over the polypropylene film. Using a photoresist layer, specified and etched zones are established. Small fluid volumes, a reduced detection region, and electrical impedance measurements over a range of frequencies for cell counts improve detection sensitivity and specificity. The procedure involves continuous flow of fluid samples that contain particles of interest through the microfluidic channels, counting all types of particles in a portion of the sample using the electrical differential counter to generate a bipolar pulse for each passing cell—calculating the total number of particles of interest originally in the fluid sample by using MATLAB program and signal processing. It's indeed potential to develop a robust and economical kit for cell counting in whole-blood samples using these methods and similar devices.

Keywords: impedance, biochip, cell counting, microfluidics

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3515 Indenyl and Allyl Palladates: Synthesis, Bonding, and Anticancer Activity

Authors: T. Scattolin, E. Cavarzerani, F. Visentin, F. Rizzolio

Abstract:

Organopalladium compounds have recently attracted attention for their high stability even under physiological conditions and, above all, for their remarkable in vitro cytotoxicity towards cisplatin-resistant cell lines. Among the organopalladium derivatives, those bearing at least one N-heterocyclic carbene ligand (NHC) and the Pd(II)-η³-allyl fragment have exhibited IC₅₀ values in the micro and sub-micromolar range towards several cancer cell lines in vitro and in some cases selectivity towards cancerous vs. non-tumorigenic cells. Herein, a selection of allyl and indenyl palladates were synthesized using a solvent-free method consisting of grinding the corresponding palladium precursors with different saturated and unsaturated azolium salts. All compounds have been fully characterized by NMR, XRD and elemental analyses. The intramolecular H, Cl interaction has been elucidated and quantified using the Voronoi Deformation Density scheme. Most of the complexes showed excellent cytotoxicity towards ovarian cancer cell lines, with I₅₀ values comparable to or even lower than cisplatin. Interestingly, the potent anticancer activity was also confirmed in a high-serous ovarian cancer (HGSOC) patient-derived tumoroid, with a clear superiority of this class of compounds over classical platinum-based agents. Finally, preliminary enzyme inhibition studies of the synthesized palladate complexes against the model TrxR show that the compounds have high activity comparable to or even higher than auranofin and classical Au(I) NHC complexes. Based on such promising data, further in vitro and in vivo experiments and in-depth mechanistic studies are ongoing in our laboratories.

Keywords: anticancer activity, palladium complexes, organoids, indenyl and allyl ligands

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3514 Infrared Lightbox and iPhone App for Improving Detection Limit of Phosphate Detecting Dip Strips

Authors: H. Heidari-Bafroui, B. Ribeiro, A. Charbaji, C. Anagnostopoulos, M. Faghri

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In this paper, we report the development of a portable and inexpensive infrared lightbox for improving the detection limits of paper-based phosphate devices. Commercial paper-based devices utilize the molybdenum blue protocol to detect phosphate in the environment. Although these devices are easy to use and have a long shelf life, their main deficiency is their low sensitivity based on the qualitative results obtained via a color chart. To improve the results, we constructed a compact infrared lightbox that communicates wirelessly with a smartphone. The system measures the absorbance of radiation for the molybdenum blue reaction in the infrared region of the spectrum. It consists of a lightbox illuminated by four infrared light-emitting diodes, an infrared digital camera, a Raspberry Pi microcontroller, a mini-router, and an iPhone to control the microcontroller. An iPhone application was also developed to analyze images captured by the infrared camera in order to quantify phosphate concentrations. Additionally, the app connects to an online data center to present a highly scalable worldwide system for tracking and analyzing field measurements. In this study, the detection limits for two popular commercial devices were improved by a factor of 4 for the Quantofix devices (from 1.3 ppm using visible light to 300 ppb using infrared illumination) and a factor of 6 for the Indigo units (from 9.2 ppm to 1.4 ppm) with repeatability of less than or equal to 1.2% relative standard deviation (RSD). The system also provides more granular concentration information compared to the discrete color chart used by commercial devices and it can be easily adapted for use in other applications.

Keywords: infrared lightbox, paper-based device, phosphate detection, smartphone colorimetric analyzer

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3513 An Epidemiological Study on Cutaneous Melanoma, Basocellular and Epidermoid Carcinomas Diagnosed in a Sunny City in Southeast Brazil in a Five-Year Period

Authors: Carolina L. Cerdeira, Julia V. F. Cortes, Maria E. V. Amarante, Gersika B. Santos

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Skin cancer is the most common cancer in several parts of the world; in a tropical country like Brazil, the situation isn’t different. The Brazilian population is exposed to high levels of solar radiation, increasing the risk of developing cutaneous carcinoma. Aimed at encouraging prevention measures and the early diagnosis of these tumors, a study was carried out that analyzed data on cutaneous melanomas, basal cell, and epidermoid carcinomas, using as primary data source the medical records of 161 patients registered in one pathology service, which performs skin biopsies in a city of Minas Gerais, Brazil. All patients diagnosed with skin cancer at this service from January 2015 to December 2019 were included. The incidence of skin carcinoma cases was correlated with the identification of histological type, sex, age group, and topographic location. Correlation between variables was verified by Fisher's exact test at a nominal significance level of 5%, with statistical analysis performed by R® software. A significant association was observed between age group and type of cancer (p=0.0085); age group and sex (0.0298); and type of cancer and body region affected (p < 0.01). Those 161 cases analyzed comprised 93 basal cell carcinomas, 66 epidermoid carcinomas, and only two cutaneous melanomas. In the group aged 19 to 30 years, the epidermoid form was most prevalent; from 31 to 45 and from 46 to 59 years, the basal cell prevailed; in 60-year-olds or over, both types had higher frequencies. Associating age group and sex, in groups aged 18 to 30 and 46 to 59 years, women were most affected. In the 31-to 45-year-old group, men predominated. There was a gender balance in the age group 60-year-olds or over. As for topography, there was a high prevalence in the head and neck, followed by upper limbs. Relating histological type and topography, there was a prevalence of basal cell and epidermoid carcinomas in the head and neck. In the chest, the basal cell form was most prevalent; in upper limbs, the epidermoid form prevailed. Cutaneous melanoma affected only the chest and upper limbs. About 82% of patients 60-year-olds or over had head and neck cancer; from 46 to 59 and 60-year-olds or over, the head and neck region and upper limbs were predominantly affected; the distribution was balanced in the 31-to 45-year-old group. In conclusion, basal cell carcinoma was predominant, whereas cutaneous melanoma was the rarest among the types analyzed. Patients 60-year-olds or over were most affected, showing gender balance. In young adults, there was a prevalence of the epidermoid form; in middle-aged patients, basal cell carcinoma was predominant; in the elderly, both forms presented with higher frequencies. There was a higher incidence of head and neck cancers, followed by malignancies affecting the upper limbs. The epidermoid type manifested significantly in the upper limbs. Body regions such as the thorax and lower limbs were less affected, which is justified by the lower exposure of these areas to incident solar radiation.

Keywords: basal cell carcinoma, cutaneous melanoma, skin cancer, squamous cell carcinoma, topographic location

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3512 Low Probability of Intercept (LPI) Signal Detection and Analysis Using Choi-Williams Distribution

Authors: V. S. S. Kumar, V. Ramya

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In the modern electronic warfare, the signal scenario is changing at a rapid pace with the introduction of Low Probability of Intercept (LPI) radars. In the modern battlefield, radar system faces serious threats from passive intercept receivers such as Electronic Attack (EA) and Anti-Radiation Missiles (ARMs). To perform necessary target detection and tracking and simultaneously hide themselves from enemy attack, radar systems should be LPI. These LPI radars use a variety of complex signal modulation schemes together with pulse compression with the aid of advancement in signal processing capabilities of the radar such that the radar performs target detection and tracking while simultaneously hiding enemy from attack such as EA etc., thus posing a major challenge to the ES/ELINT receivers. Today an increasing number of LPI radars are being introduced into the modern platforms and weapon systems so these LPI radars created a requirement for the armed forces to develop new techniques, strategies and equipment to counter them. This paper presents various modulation techniques used in generation of LPI signals and development of Time Frequency Algorithms to analyse those signals.

Keywords: anti-radiation missiles, cross terms, electronic attack, electronic intelligence, electronic warfare, intercept receiver, low probability of intercept

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3511 Quality of Life Assessment across the Cancer Continuum: Understanding the Role of an Exercise Rehabilitation Programme

Authors: Bernat-Carles Serdà Ferrer, Arantza Del Valle Gómez

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The Quality of Life (QoL) paradigm is multidimensional, dynamic and modular and its definition differs across the cancer continuum. The challenge in the interpretation of QoL data in clinical research is that QoL is influenced by psychological phenomena such as adaptation to illness. This research aims to obtain a valid and sensitive assessment of QoL change over the continuum disease, and to evaluate a rehabilitation programme aimed at inverting the observed decrease in QoL when patients return to daily living activities. The sample comprised 66 men. Patients were first assessed to establish a baseline (P1-diagnosis). This was followed by a post-test (P2-discharge) and a then-test measurement (P3-retrospective evaluation) and after returning home patients were randomized in experimental and control groups. The experimental group attended a rehabilitation programme over 24 weeks (P4). Results show that from baseline to post-test, QoL decreased significantly. The recalibration then-test confirmed a low QoL in all periods evaluated. Significant differences between the experimental and control groups prove the positive effect of the Exercise Rehabilitation Programme (ERP) on QoL. Understanding the real dynamic of QoL over time would help to adapt rehabilitation programmes by improving sensitivity and efficacy and provide professionals with a more accurate perception of the impact of treatment and side effects on patients’ QoL. Our results underline the importance of changing the approach adopted by health professionals towards one of watchful waiting on patients’ QoL until their complete recovery in daily life.

Keywords: exercise, prostate cancer, quality of life, rehabilitation programme, response shift

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3510 Breastfeeding Knowledge, Attitudes and Practice: A Cross-Sectional Study among a Sample of Tunisian Mothers

Authors: Arfaoui Emna, Nouira Mariem

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Background and aims: Breastfeeding is the reference feeding for a child, especially during the first months of life. It is not widespread in many countries due to many factors. There has been a decline in exclusive breastfeeding (EB) practice, particularly in the middle- and low-income countries, i.e., Tunisia. The aim of our study was to describe the knowledge, attitudes, and practice of a sample of Tunisian mothers toward breastfeeding. Methods: It was a descriptive cross-sectional study conducted during the year 2022 over a period of two months in three health structures in the north of Tunisia among mothers of infants aged 2 to 18 months. Levels of mothers’ knowledge (low/moderate/high) were determined using a score ranging from 0 to 11 points. EB was defined as the proportion of infants who were exclusively breastfed during the first six months of life. Results: A total of 180 women with a mean age of 33±4.9 years were included. The average knowledge score was equal to 6.4 ±1.5 points, with extremes ranging from 3 to 11 points. Most of the respondents had a moderate knowledge level (44.4%). More than half of surveyed mothers (66.1%) thought that breastfeeding deforms breasts, and 16.7% thought that breastfeeding is specific to women who do not work. Breastfeeding experience during the first week of life was considered difficult in 70% of cases. The prevalence of EB up to 6 months of age was equal to 16.4% [10.8-23.2]. The main reported obstacles during breastfeeding practice were having an insufficient quantity of breast milk (18.3%) and child difficulties with sucking (12.8%), and having pain in the breast while breastfeeding (12.80%). Conclusion: Our results highlighted the insufficient level of knowledge and a low prevalence of EB in our study population. Improving mothers’ knowledge and promoting EB practice is needed. Implementing health education strategies involving healthcare workers, who represent a main actor in education and breastfeeding promotion, is very important to reach a satisfactory frequency for EB.

Keywords: breastfeeding, practices, knowledge, Tunisia

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3509 Simultaneous Detection of Dopamine and Uric Acid in the Presence of Ascorbic Acid at Physiological Level Using Anodized Multiwalled Carbon Nanotube–Poldimethylsiloxane Paste Electrode

Authors: Angelo Gabriel Buenaventura, Allan Christopher Yago

Abstract:

A carbon paste electrode (CPE) composed of Multiwalled Carbon Nanotube (MWCNT) conducting particle and Polydimethylsiloxane (PDMS) binder was used for simultaneous detection of Dopamine (DA) and Uric Acid (UA) in the presence of Ascorbic Acid (AA) at physiological level. The MWCNT-PDMS CPE was initially activated via potentiodynamic cycling in a basic (NaOH) solution, which resulted in enhanced electrochemical properties. Electrochemical Impedance Spectroscopy measurements revealed a significantly lower charge transfer resistance (Rct) for the OH--activated MWCNT-PDMS CPE (Rct = 5.08kΩ) as compared to buffer (pH 7)-activated MWCNT-PDMS CPE (Rct = 25.9kΩ). Reversibility analysis of Fe(CN)63-/4- redox couple of both Buffer-Activated CPE and OH--Activated CPE showed that the OH—Activated CPE have peak current ratio (Ia/Ic) of 1.11 at 100mV/s while 2.12 for the Buffer-Activated CPE; this showed an electrochemically reversible behavior for Fe(CN)63-/4- redox couple even at relatively fast scan rate using the OH--activated CPE. Enhanced voltammetric signal for DA and significant peak separation between DA and UA was obtained using the OH--activated MWCNT-PDMS CPE in the presence of 50 μM AA via Differential Pulse Voltammetry technique. The anodic peak currents which appeared at 0.263V and 0.414 V were linearly increasing with increasing concentrations of DA and UA, respectively. The linear ranges were obtained at 25 μM – 100 μM for both DA and UA. The detection limit was determined to be 3.86 μM for DA and 5.61 μM for UA. These results indicate a practical approach in the simultaneous detection of important bio-organic molecules using a simple CPE composed of MWCNT and PDMS with base anodization as activation technique.

Keywords: anodization, ascorbic acid, carbon paste electrodes, dopamine, uric acid

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3508 Application of Zeolite Nanoparticles in Biomedical Optics

Authors: Vladimir Hovhannisyan, Chen Yuan Dong

Abstract:

Recently nanoparticles (NPs) have been introduced in biomedicine as effective agents for cancer-targeted drug delivery and noninvasive tissue imaging. The most important requirements to these agents are their non-toxicity, biocompatibility and stability. In view of these criteria, the zeolite (ZL) nanoparticles (NPs) may be considered as perfect candidates for biomedical applications. ZLs are crystalline aluminosilicates consisting of oxygen-sharing SiO4 and AlO4 tetrahedral groups united by common vertices in three-dimensional framework and containing pores with diameters from 0.3 to 1.2 nm. Generally, the behavior and physical properties of ZLs are studied by SEM, X-ray spectroscopy, and AFM, whereas optical spectroscopic and microscopic approaches are not effective enough, because of strong scattering in common ZL bulk materials and powders. The light scattering can be reduced by using of ZL NPs. ZL NPs have large external surface area, high dispersibility in both aqueous and organic solutions, high photo- and thermal stability, and exceptional ability to adsorb various molecules and atoms in their nanopores. In this report, using multiphoton microscopy and nonlinear spectroscopy, we investigate nonlinear optical properties of clinoptilolite type of ZL micro- and nanoparticles with average diameters of 2200 nm and 240 nm, correspondingly. Multiphoton imaging is achieved using a laser scanning microscope system (LSM 510 META, Zeiss, Germany) coupled to a femtosecond titanium:sapphire laser (repetition rate- 80 MHz, pulse duration-120 fs, radiation wavelength- 720-820 nm) (Tsunami, Spectra-Physics, CA). Two Zeiss, Plan-Neofluar objectives (air immersion 20×∕NA 0.5 and water immersion 40×∕NA 1.2) are used for imaging. For the detection of the nonlinear response, we use two detection channels with 380-400 nm and 435-700 nm spectral bandwidths. We demonstrate that ZL micro- and nanoparticles can produce nonlinear optical response under the near-infrared femtosecond laser excitation. The interaction of hypericine, chlorin e6 and other dyes with ZL NPs and their photodynamic activity is investigated. Particularly, multiphoton imaging shows that individual ZL NPs particles adsorb Zn-tetraporphyrin molecules, but do not adsorb fluorescein molecules. In addition, nonlinear spectral properties of ZL NPs in native biotissues are studied. Nonlinear microscopy and spectroscopy may open new perspectives in the research and application of ZL NP in biomedicine, and the results may help to introduce novel approaches into the clinical environment.

Keywords: multiphoton microscopy, nanoparticles, nonlinear optics, zeolite

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3507 Promoter Methylation of RASSF1A and MGMT Genes in Head and Neck Squamous Cell Carcinoma

Authors: Vitor Rafael Regiani, Carlos Henrique Viesi Do Nascimento Filho, Patricia Matos Biselli-Chicote, Claudia Aparecida Rainho, Luiz Sergio Raposo, José Victor Maniglia, Eny Maria Goloni-Bertollo, Erika Cristina Pavarino

Abstract:

Promoter hypermethylation of tumor-related genes has been associated with prognosis in early-stage head-and-neck cancers, providing strong evidence that these hypermethylated genes are valuable biomarkers for prognostic evaluation. Hence, we selected the MGMT and RASSF1A genes to examine the methylation status in head and neck squamous cell carcinomas (HNSCC) samples matched with non-tumor tissues (tumor-surrounding tissues or peripheral blood samples). DNA methylation analysis was based on Methylation-Sensitive High Resolution Melting, and the methylation status was correlated with clinic-pathological characteristics of the patients. RASSF1A and MGMT promoter methylation was detected in 43.24% (16/37) and in 44.44% (16/36) of the tumors, respectively. RASSF1A and MGMT methylation was significantly more frequent in tumor tissue than non-tumor tissues, as well as, simultaneous methylation of RASSF1A and MGMT also was higher in tumor tissue than non-tumor tissues. In relation to anatomic site, larynx cancer presented significant methylation of MGMT gene compared to tumor-surrounding tissue. The frequency of RASSF1A and MGMT promoter methylated was higher in tumor tissues in relation to peripheral blood from the same patient. No association was found between methylation and the variables analyzed, including gender, age, smoking or alcohol drinking habits. Clinic-pathological characteristics also showed no association in the presence of methylation. The Kaplan–Meier's method showed no association of methylation and both disease-free and overall survival. In conclusion, the presence of epigenetic abnormalities in normal-appearing tissue corroborates the hypothesis of the ‘field cancerization', or it can reflect preneoplastic and/or preinvasive. Moreover, MGMT methylation may serve as an important laryngeal cancer biomarker because it showed significant difference between laryngeal cancer and surrounding tumor tissues.

Keywords: head and neck cancer, DNA methylation, MGMT promoter methylation, RASSF1A promoter methylation

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3506 Development of a Sensitive Electrochemical Sensor Based on Carbon Dots and Graphitic Carbon Nitride for the Detection of 2-Chlorophenol and Arsenic

Authors: Theo H. G. Moundzounga

Abstract:

Arsenic and 2-chlorophenol are priority pollutants that pose serious health threats to humans and ecology. An electrochemical sensor, based on graphitic carbon nitride (g-C₃N₄) and carbon dots (CDs), was fabricated and used for the determination of arsenic and 2-chlorophenol. The g-C₃N₄/CDs nanocomposite was prepared via microwave irradiation heating method and was dropped-dried on the surface of the glassy carbon electrode (GCE). Transmission electron microscopy (TEM), X-ray diffraction (XRD), photoluminescence (PL), Fourier transform infrared spectroscopy (FTIR), UV-Vis diffuse reflectance spectroscopy (UV-Vis DRS) were used for the characterization of structure and morphology of the nanocomposite. Electrochemical characterization was done by electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV). The electrochemical behaviors of arsenic and 2-chlorophenol on different electrodes (GCE, CDs/GCE, and g-C₃N₄/CDs/GCE) was investigated by differential pulse voltammetry (DPV). The results demonstrated that the g-C₃N₄/CDs/GCE significantly enhanced the oxidation peak current of both analytes. The analytes detection sensitivity was greatly improved, suggesting that this new modified electrode has great potential in the determination of trace level of arsenic and 2-chlorophenol. Experimental conditions which affect the electrochemical response of arsenic and 2-chlorophenol were studied, the oxidation peak currents displayed a good linear relationship to concentration for 2-chlorophenol (R²=0.948, n=5) and arsenic (R²=0.9524, n=5), with a linear range from 0.5 to 2.5μM for 2-CP and arsenic and a detection limit of 2.15μM and 0.39μM respectively. The modified electrode was used to determine arsenic and 2-chlorophenol in spiked tap and effluent water samples by the standard addition method, and the results were satisfying. According to the measurement, the new modified electrode is a good alternative as chemical sensor for determination of other phenols.

Keywords: electrochemistry, electrode, limit of detection, sensor

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3505 A Vehicle Detection and Speed Measurement Algorithm Based on Magnetic Sensors

Authors: Panagiotis Gkekas, Christos Sougles, Dionysios Kehagias, Dimitrios Tzovaras

Abstract:

Cooperative intelligent transport systems (C-ITS) can greatly improve safety and efficiency in road transport by enabling communication, not only between vehicles themselves but also between vehicles and infrastructure. For that reason, traffic surveillance systems on the road are of great importance. This paper focuses on the development of an on-road unit comprising several magnetic sensors for real-time vehicle detection, movement direction, and speed measurement calculations. Magnetic sensors can feel and measure changes in the earth’s magnetic field. Vehicles are composed of many parts with ferromagnetic properties. Depending on sensors’ sensitivity, changes in the earth’s magnetic field caused by passing vehicles can be detected and analyzed in order to extract information on the properties of moving vehicles. In this paper, we present a prototype algorithm for real-time, high-accuracy, vehicle detection, and speed measurement, which can be implemented as a portable, low-cost, and non-invasive to existing infrastructure solution with the potential to replace existing high-cost implementations. The paper describes the algorithm and presents results from its preliminary lab testing in a close to real condition environment. Acknowledgments: Work presented in this paper was co-financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship, and Innovation (call RESEARCH–CREATE–INNOVATE) under contract no. Τ1EDK-03081 (project ODOS2020).

Keywords: magnetic sensors, vehicle detection, speed measurement, traffic surveillance system

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3504 Detection and Tracking Approach Using an Automotive Radar to Increase Active Pedestrian Safety

Authors: Michael Heuer, Ayoub Al-Hamadi, Alexander Rain, Marc-Michael Meinecke

Abstract:

Vulnerable road users, e.g. pedestrians, have a high impact on fatal accident numbers. To reduce these statistics, car manufactures are intensively developing suitable safety systems. Hereby, fast and reliable environment recognition is a major challenge. In this paper we describe a tracking approach that is only based on a 24 GHz radar sensor. While common radar signal processing loses much information, we make use of a track-before-detect filter to incorporate raw measurements. It is explained how the Range-Doppler spectrum can help to indicated pedestrians and stabilize tracking even in occultation scenarios compared to sensors in series.

Keywords: radar, pedestrian detection, active safety, sensor

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3503 Immobilization of Cobalt Ions on F-Multi-Wall Carbon Nanotubes-Chitosan Thin Film: Preparation and Application for Paracetamol Detection

Authors: Shamima Akhter, Samira Bagheri, M. Shalauddin, Wan Jefrey Basirun

Abstract:

In the present study, a nanocomposite of f-MWCNTs-Chitosan was prepared by the immobilization of Co(II) transition metal through self-assembly method and used for the simultaneous voltammetric determination of paracetamol (PA). The composite material was characterized by field emission scanning electron microscopy (FESEM) and energy dispersive X-Ray analysis (EDX). The electroactivity of cobalt immobilized f-MWCNTs with excellent adsorptive polymer chitosan was assessed during the electro-oxidation of paracetamol. The resulting GCE modified f-MWCNTs/CTS-Co showed electrocatalytic activity towards the oxidation of PA. The electrochemical performances were investigated using cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS) and differential pulse voltammetry (DPV) methods. Under favorable experimental conditions, differential pulse voltammetry showed a linear dynamic range for paracetamol solution in the range of 0.1 to 400µmol L⁻¹ with a detection limit of 0.01 µmol L⁻¹. The proposed sensor exhibited significant selectivity for the paracetamol detection. The proposed method was successfully applied for the determination of paracetamol in commercial tablets and human serum sample.

Keywords: nanomaterials, paracetamol, electrochemical technique, multi-wall carbon nanotube

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3502 EEG Diagnosis Based on Phase Space with Wavelet Transforms for Epilepsy Detection

Authors: Mohmmad A. Obeidat, Amjed Al Fahoum, Ayman M. Mansour

Abstract:

The recognition of an abnormal activity of the brain functionality is a vital issue. To determine the type of the abnormal activity either a brain image or brain signal are usually considered. Imaging localizes the defect within the brain area and relates this area with somebody functionalities. However, some functions may be disturbed without affecting the brain as in epilepsy. In this case, imaging may not provide the symptoms of the problem. A cheaper yet efficient approach that can be utilized to detect abnormal activity is the measurement and analysis of the electroencephalogram (EEG) signals. The main goal of this work is to come up with a new method to facilitate the classification of the abnormal and disorder activities within the brain directly using EEG signal processing, which makes it possible to be applied in an on-line monitoring system.

Keywords: EEG, wavelet, epilepsy, detection

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3501 A Survey on Various Technique of Modified TORA over MANET

Authors: Shreyansh Adesara, Sneha Pandiya

Abstract:

The mobile ad-hoc network (MANET) is an important and open area research for the examination and determination of the performance evolution. Temporary ordered routing algorithm (TORA) is adaptable and distributed MANET routing algorithm which is totally dependent on internet MANET Encapsulation protocol (IMEP) for the detection of the link and sensing of the link. If IMEP detect the wrong link failure then the network suffer from congestion and unnecessary route maintenance. Thus, the improvement in link detection method of TORA is introduced by various methods on IMEP by different perspective from different person. There are also different reactive routing protocols like AODV, TORA and DSR has been compared for the knowledge of the routing scenario for different parameter and using different model.

Keywords: IMEP, mobile ad-hoc network, protocol, TORA

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3500 Role of Dedicated Medical Social Worker in Fund Mobilisation and Economic Evaluation in Ovarian Cancer: Experience from a Tertiary Referral Centre in Eastern India

Authors: Aparajita Bhattacharya, Mousumi Dutta, Zakir Husain, Dionne Sequeira, Asima Mukhopadhyay

Abstract:

Background: Tata Medical Centre (TMC), Kolkata is a major cancer referral centre in Eastern India and neighbouring countries providing state of the art facilities; however, it is a non-profit organisation with patients requiring to pay at subsidised rates. Although a system for social assessment and applying for governmental/ non-governmental (NGO) funds is in place, access is challenging. Amongst gynaecological cancers (GC), ovarian cancer (OC) is associated with the highest treatment cost; majority of which is required at the beginning when complex surgery is performed and funding arrangements cannot be made in time. We therefore appointed a dedicated Medical Social Worker (MSW) in 2016, supported by NGO for GC patients in order to assist patients/family members to access/avail these funds more readily and assist in economic evaluation for both direct and opportunity costs. Objectives: To reflect on our experience and challenges in collecting data on economic evaluation of cancer patients and compare success rates in achieving fund mobilization after introduction of MSW. Methods: A Retrospective survey. Patients with OC and their relatives were seen by the MSW during the initial outpatients department visit and followed though till discharge from the hospital and during follow-up visits. Assistance was provided in preparing the essential documents/paperwork/contacts for the funding agencies including both governmental (Chief-Minister/Prime-Minister/President) and NGO sources. In addition, a detailed questionnaire was filled up for economic assessment of direct/opportunity costs during the entire treatment and 12 months follow up period which forms a part of the study called HEPTROC (Health economic evaluation of primary treatment for ovarian cancer) developed in collaboration with economics departments of Universities. Results: In 2015, 102 patients were operated for OC; only 16 patients (15.68 %) had availed funding of a total sum of INR 1640000 through the hospital system for social assessment. Following challenges were faced by majority of the relatives: 1. Gathering important documents/proper contact details for governmental funding bodies and difficulty in following up the current status 3. Late arrival of funds. In contrast in 2016, 104 OC patients underwent surgery; the direct cost of treatment was significantly higher (median, INR 300000- 400000) compared to other GCs (n=274). 98/104 (94.23%) OC patients could be helped to apply for funds and 90/104(86.56%) patients received funding amounting to a total of INR 10897000. There has been a tenfold increase in funds mobilized in 2016 after the introduction of dedicated MSW in GC. So far, in 2017 (till June), 46/54(85.18%) OC patients applied for funds and 37/54(68.51%) patients have received funding. In a qualitative survey, all patients appreciated the role of the MSW who subsequently became the key worker for patient follow up and the chief portal for patient reported outcome monitoring. Data collection quality for the HEPTROC study was improved when questionnaires were administered by the MSW compared to researchers. Conclusion: Introduction of cancer specific MSW can expedite the availability of funds required for cancer patients and it can positively impact on patient satisfaction and outcome reporting. The economic assessment will influence fund allocation and decision for policymaking in ovarian cancer. Acknowledgement: Jivdaya Foundation Dallas, Texas.

Keywords: economic evaluation, funding, medical social worker, ovarian cancer

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3499 Incidence of Lymphoma and Gonorrhea Infection: A Retrospective Study

Authors: Diya Kohli, Amalia Ardeljan, Lexi Frankel, Jose Garcia, Lokesh Manjani, Omar Rashid

Abstract:

Gonorrhea is the second most common sexually transmitted disease (STDs) in the United States of America. Gonorrhea affects the urethra, rectum, or throat and the cervix in females. Lymphoma is a cancer of the immune network called the lymphatic system that includes the lymph nodes/glands, spleen, thymus gland, and bone marrow. Lymphoma can affect many organs in the body. When a lymphocyte develops a genetic mutation, it signals other cells into rapid proliferation that causes many mutated lymphocytes. Multiple studies have explored the incidence of cancer in people infected with STDs such as Gonorrhea. For instance, the studies conducted by Wang Y-C and Co., as well as Caini, S and Co. established a direct co-relationship between Gonorrhea infection and incidence of prostate cancer. We hypothesize that Gonorrhea infection also increases the incidence of Lymphoma in patients. This research study aimed to evaluate the correlation between Gonorrhea infection and the incidence of Lymphoma. The data for the research was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database. This database was utilized to evaluate patients infected with Gonorrhea versus the ones who were not infected to establish a correlation with the prevalence of Lymphoma using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale for academic research. Standard statistical methods were applied throughout. Between January 2010 and December 2019, the query was analyzed and resulted in 254 and 808 patients in both the infected and control group, respectively. The two groups were matched by Age Range and CCI score. The incidence of Lymphoma was 0.998% (254 patients out of 25455) in the Gonorrhea group (patients infected with Gonorrhea that was Lymphoma Positive) compared to 3.174% and 808 patients in the control group (Patients negative for Gonorrhea but with Lymphoma). This was statistically significant by a p-value < 2.210-16 with an OR= 0.431 (95% CI 0.381-0.487). The patients were then matched by antibiotic treatment to avoid treatment bias. The incidence of Lymphoma was 1.215% (82 patients out of 6,748) in the Gonorrhea group compared to 2.949% (199 patients out of 6748) in the control group. This was statistically significant by a p-value <5.410-10 with an OR= 0.468 (95% CI 0.367-0.596). The study shows a statistically significant correlation between Gonorrhea and a reduced incidence of Lymphoma. Further evaluation is recommended to assess the potential of Gonorrhea in reducing Lymphoma.

Keywords: gonorrhea, lymphoma, STDs, cancer, ICD

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3498 Molecular Detection of Acute Virus Infection in Children Hospitalized with Diarrhea in North India during 2014-2016

Authors: Ali Ilter Akdag, Pratima Ray

Abstract:

Background:This acute gastroenteritis viruses such as rotavirus, astrovirus, and adenovirus are mainly responsible for diarrhea in children below < 5 years old. Molecular detection of these viruses is crucially important to the understand development of the effective cure. This study aimed to determine the prevalence of common these viruses in children < 5 years old presented with diarrhea from Lala Lajpat Rai Memorial Medical College (LLRM) centre (Meerut) North India, India Methods: Total 312 fecal samples were collected from diarrheal children duration 3 years: in year 2014 (n = 118), 2015 (n = 128) and 2016 (n = 66) ,< 5 years of age who presented with acute diarrhea at the Lala Lajpat Rai Memorial Medical College (LLRM) centre(Meerut) North India, India. All samples were the first detection by EIA/RT-PCR for rotaviruses, adenovirus and astrovirus. Results: In 312 samples from children with acute diarrhea in sample viral agent was found, rotavirus A was the most frequent virus identified (57 cases; 18.2%), followed by Astrovirus in 28 cases (8.9%), adenovirus in 21 cases (6.7%). Mixed infections were found in 14 cases, all of which presented with acute diarrhea (14/312; 4.48%). Conclusions: These viruses are a major cause of diarrhea in children <5 years old in North India. Rotavirus A is the most common etiological agent, follow by astrovirus. This surveillance is important to vaccine development of the entire population. There is variation detection of virus year wise due to differences in the season of sampling, method of sampling, hygiene condition, socioeconomic level of the entire people, enrolment criteria, and virus detection methods. It was found Astrovirus higher then Rotavirus in 2015, but overall three years study Rotavirus A is mainly responsible for causing severe diarrhea in children <5 years old in North India. It emphasizes the required for cost-effective diagnostic assays for Rotaviruses which would help to determine the disease burden.

Keywords: adenovirus, Astrovirus, hospitalized children, Rotavirus

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3497 Heavy Metal Contamination in Soils: Detection and Assessment Using Machine Learning Algorithms Based on Hyperspectral Images

Authors: Reem El Chakik

Abstract:

The levels of heavy metals in agricultural lands in Lebanon have been witnessing a noticeable increase in the past few years, due to increased anthropogenic pollution sources. Heavy metals pose a serious threat to the environment for being non-biodegradable and persistent, accumulating thus to dangerous levels in the soil. Besides the traditional laboratory and chemical analysis methods, Hyperspectral Imaging (HSI) has proven its efficiency in the rapid detection of HMs contamination. In Lebanon, a continuous environmental monitoring, including the monitoring of levels of HMs in agricultural soils, is lacking. This is due in part to the high cost of analysis. Hence, this proposed research aims at defining the current national status of HMs contamination in agricultural soil, and to evaluate the effectiveness of using HSI in the detection of HM in contaminated agricultural fields. To achieve the two main objectives of this study, soil samples were collected from different areas throughout the country and were analyzed for HMs using Atomic Absorption Spectrophotometry (AAS). The results were compared to those obtained from the HSI technique that was applied using Hyspex SWIR-384 camera. The results showed that the Lebanese agricultural soils contain high contamination levels of Zn, and that the more clayey the soil is, the lower reflectance it has.

Keywords: agricultural soils in Lebanon, atomic absorption spectrophotometer, hyperspectral imaging., heavy metals contamination

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3496 Early Detection of Neuropathy in Leprosy-Comparing Clinical Tests with Nerve Conduction Study

Authors: Suchana Marahatta, Sabina Bhattarai, Bishnu Hari Paudel, Dilip Thakur

Abstract:

Background: Every year thousands of patients develop nerve damage and disabilities as a result of leprosy which can be prevented by early detection and treatment. So, early detection and treatment of nerve function impairment is of paramount importance in leprosy. Objectives: To assess the electrophysiological pattern of the peripheral nerves in leprosy patients and to compare it with clinical assessment tools. Materials and Methods: In this comparative cross-sectional study, 74 newly diagnosed leprosy patients without reaction were enrolled. They underwent thorough evaluation for peripheral nerve function impairment using clinical tests [i.e. nerve palpation (NP), monofilament (MF) testing, voluntary muscle testing (VMT)] and nerve conduction study (NCS). Clinical findings were compared with that of NCS using SPSS version 11.5. Results: NCS was impaired in 43.24% of leprosy patient at the baseline. Among them, sensory NCS was impaired in more patients (32.4%) in comparison to motor NCS (20.3%). NP, MF, and VMT were impaired in 58.1%, 25.7%, and 9.4% of the patients, respectively. Maximum concordance of monofilament testing and sensory NCS was found for sural nerve (14.7%). Likewise, the concordance of motor NP and motor NCS was the maximum for ulnar nerve (14.9%). When individual parameters of the NCS were considered, amplitude was found to be the most frequently affected parameter for both sensory and motor NCS. It was impaired in 100% of cases with abnormal NCS findings. Conclusion: Since there was no acceptable concordance between NCS findings and clinical findings, we should consider NCS whenever feasible for early detection of neuropathy in leprosy. The amplitude of both sensory nerve action potential (SNAP) and compound nerve action potential (CAMP) could be important determinants of the abnormal NCS if supported by further studies.

Keywords: leprosy, nerve function impairment, neuropathy, nerve conduction study

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