Search results for: ischaemic heart disease
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4626

Search results for: ischaemic heart disease

2316 Learning from Long COVID: How Healthcare Needs to Change for Contested Illnesses

Authors: David Tennison

Abstract:

In the wake of the Covid-19 pandemic, a new chronic illness emerged onto the global stage: Long Covid. Long Covid presents with several symptoms commonly seen in other poorly-understood illnesses, such as fibromyalgia (FM) and myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). However, while Long Covid has swiftly become a recognised illness, FM and ME/CFS are still seen as contested, which impacts patient care and healthcare experiences. This study aims to examine what the differences are between Long Covid and FM; and if the Long Covid case can provide guidance for how to address the healthcare challenge of contested illnesses. To address this question, this study performed comprehensive research into the history of FM; our current biomedical understanding of it; and available healthcare interventions (within the context of the UK NHS). Analysis was undertaken of the stigma and stereotypes around FM, and a comparison made between FM and the emerging Long Covid literature, along with the healthcare response to Long Covid. This study finds that healthcare for chronic contested illnesses in the UK is vastly insufficient - in terms of pharmaceutical and holistic interventions, and the provision of secondary care options. Interestingly, for Long Covid, many of the treatment suggestions are pulled directly from those used for contested illnesses. The key difference is in terms of funding and momentum – Long Covid has generated exponentially more interest and research in a short time than there has been in the last few decades of contested illness research. This stands to help people with FM and ME/CFS – for example, research has recently been funded into “brain fog”, a previously elusive and misunderstood symptom. FM is culturally regarded as a “women’s disease” and FM stigma stems from notions of “hysteria”. A key finding is that the idea of FM affecting women disproportionally is not reflected in modern population studies. Emerging data on Long Covid also suggests a slight leaning towards more female patients, however it is less feminised, potentially due to it emerging in the global historical moment of the pandemic. Another key difference is that FM is rated as an extremely low-prestige illness by healthcare professionals, while it was in large part due to the advocacy of affected healthcare professionals that Long Covid was so quickly recognised by science and medicine. In conclusion, Long Covid (and the risk of future pandemics and post-viral illnesses) highlight a crucial need for implementing new, and reinforcing existing, care networks for chronic illnesses. The difference in how contested illnesses like FM, and new ones like Long Covid are treated have a lot to do with the historical moment in which they emerge – but cultural stereotypes, from within and without medicine, need updating. Particularly as they contribute to disease stigma that causes genuine harm to patients. However, widespread understanding and acceptance of Long Covid could help fight contested illness stigma, and the attention, funding and research into Long Covid may actually help raise the profile of contested illnesses and uncover answers about their symptomatology.

Keywords: long COVID, fibromyalgia, myalgic encephalomyelitis, chronic fatigue syndrome, NHS, healthcare, contested illnesses, chronic illnesses, COVID-19 pandemic

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2315 The Influence of Islamic Epistemology on Mosque Architecture

Authors: Sheba Akhtar

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The profound importance that Islam places on knowledge has directly influenced the architectural development of the mosque throughout the Muslim world. The masjid is the most important religious building type in Islamic society because, as a place of worship and social interaction, it is the center of both spiritual knowledge and secular guidance. The Quran begins with the emphatic injunction, “Iqra”, establishing the central importance of the pursuit of the sacred ilm that is offered to man by Allah. Similarly, numerous hadiths of the Prophet Muhammad emphasize the profound importance of the acquisition and dissemination of knowledge, both spiritual and temporal. The Muslim worshipper must enter the sacred space of the masjid to receive spiritual knowledge, but the transition from the profane realm outside the mosque to that of spirituality within is not merely physical; it is also deeply psychological and emotional. To this end, the architecture of the masjid, from the plan and geometry to the design elements and intricate ornamental details, plays a vital role in creating the environment within which the ritual acts of wudu and salat are enacted to foster the transformative journey, from the mundane reality of this world to the realm of spirituality beyond, in the heart, mind, and soul of the worshipper. It is expected that the paper will provide a better understanding of the ways in which sacred Islamic knowledge has influenced the architectural design of the mosque. The research will draw upon Islamic epistemology, Islamic architecture history, and compositional analysis to demonstrate this philosophical, historical, and formal relationship. In this way, the paper will provide a meaningful bridge between the existing knowledge related to mosque design and the expanding academic discourse about the religious architecture of Islam.

Keywords: Islamic architecture, mosque architecture, religious architecture, sacred architecture

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2314 The Effects of Passive and Active Recoveries on Responses of Platelet Indices and Hemodynamic Variables to Resistance Exercise

Authors: Mohammad Soltani, Sajad Ahmadizad, Fatemeh Hoseinzadeh, Atefe Sarvestan

Abstract:

The exercise recovery is an important variable in designing resistance exercise training. This study determined the effects of passive and active recoveries on responses of platelet indices and hemodynamic variables to resistance exercise. Twelve healthy subjects (six men and six women, age, 25.4 ±2.5 yrs) performed two types of resistance exercise protocols (six exercises including upper- and lower-body parts) at two separate sessions with one-week intervening. First resistance protocol included three sets of six repetitions at 80% of 1RM with 2 min passive rest between sets and exercises; while, the second protocol included three sets of six repetitions at 60% of 1RM followed by active recovery included six repetitions of the same exercise at 20% of 1RM. The exercise volume was equalized. Three blood samples were taken before exercise, immediately after exercise and after 1-hour recovery, and analyzed for fibrinogen and platelet indices. Blood pressure (BP), heart rate (HR) and rate pressure product (RPP), were measured before, immediately after exercise and every 5 minutes during recovery. Data analyzes showed a significant increase in SBP (systolic blood pressure), HR, rate of pressure product (RPP) and PLT in response to resistance exercise (P<0.05) and that changes for HR and RPP were significantly different between two protocols (P<0.05). Furthermore, MPV and P_LCR did not change in response to resistance exercise, though significant reductions were observed after 1h recovery compared to before and after exercise (P<0.05). No significant changes in fibrinogen and PDW following two types of resistance exercise protocols were observed (P>0.05). On the other hand, no significant differences in platelet indices were found between the two protocols (P>0.05). Resistance exercise induces changes in platelet indices and hemodynamic variables, and that these changes are not related to the type of recovery and returned to normal levels after 1h recovery.

Keywords: hemodynamic variables, platelet indices, resistance exercise, recovery intensity

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2313 Detection of Alzheimer's Protein on Nano Designed Polymer Surfaces in Water and Artificial Saliva

Authors: Sevde Altuntas, Fatih Buyukserin

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Alzheimer’s disease is responsible for irreversible neural damage of brain parts. One of the disease markers is Amyloid-β 1-42 protein that accumulates in the brain in the form plaques. The basic problem for detection of the protein is the low amount of protein that cannot be detected properly in body liquids such as blood, saliva or urine. To solve this problem, tests like ELISA or PCR are proposed which are expensive, require specialized personnel and can contain complex protocols. Therefore, Surface-enhanced Raman Spectroscopy (SERS) a good candidate for detection of Amyloid-β 1-42 protein. Because the spectroscopic technique can potentially allow even single molecule detection from liquid and solid surfaces. Besides SERS signal can be improved by using nanopattern surface and also is specific to molecules. In this context, our study proposes to fabricate diagnostic test models that utilize Au-coated nanopatterned polycarbonate (PC) surfaces modified with Thioflavin - T to detect low concentrations of Amyloid-β 1-42 protein in water and artificial saliva medium by the enhancement of protein SERS signal. The nanopatterned PC surface that was used to enhance SERS signal was fabricated by using Anodic Alumina Membranes (AAM) as a template. It is possible to produce AAMs with different column structures and varying thicknesses depending on voltage and anodization time. After fabrication process, the pore diameter of AAMs can be arranged with dilute acid solution treatment. In this study, two different columns structures were prepared. After a surface modification to decrease their surface energy, AAMs were treated with PC solution. Following the solvent evaporation, nanopatterned PC films with tunable pillared structures were peeled off from the membrane surface. The PC film was then modified with Au and Thioflavin-T for the detection of Amyloid-β 1-42 protein. The protein detection studies were conducted first in water via this biosensor platform. Same measurements were conducted in artificial saliva to detect the presence of Amyloid Amyloid-β 1-42 protein. SEM, SERS and contact angle measurements were carried out for the characterization of different surfaces and further demonstration of the protein attachment. SERS enhancement factor calculations were also completed via experimental results. As a result, our research group fabricated diagnostic test models that utilize Au-coated nanopatterned polycarbonate (PC) surfaces modified with Thioflavin-T to detect low concentrations of Alzheimer’s Amiloid – β protein in water and artificial saliva medium. This work was supported by The Scientific and Technological Research Council of Turkey (TUBITAK) Grant No: 214Z167.

Keywords: alzheimer, anodic aluminum oxide, nanotopography, surface enhanced Raman spectroscopy

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2312 Cognition in Crisis: Unravelling the Link Between COVID-19 and Cognitive-Linguistic Impairments

Authors: Celine Davis

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The novel coronavirus 2019 (COVID-19) is an infectious disease caused by the virus SARS-CoV-2, which has detrimental respiratory, cardiovascular, and neurological effects impacting over one million lives in the United States. New researches has emerged indicating long-term neurologic consequences in those who survive COVID-19 infections, including more than seven million Americans and another 27 million people worldwide. These consequences include attentional deficits, memory impairments, executive function deficits and aphasia-like symptoms which fall within the purview of speech-language pathology. The National Health Interview Survey (NHIS) is a comprehensive annual survey conducted by the National Center for Health Statistics (NCHS), a branch of the Centers for Disease Control and Prevention (CDC) in the United States. The NHIS is one of the most significant sources of health-related data in the country and has been conducted since 1957. The longitudinal nature of the study allows for analysis of trends in various variables over the years, which can be essential for understanding societal changes and making treatment recommendations. This current study will utilize NHIS data from 2020-2022 which contained interview questions specifically related to COVID-19. Adult cases of individuals between the ages of 18-50 diagnosed with COVID-19 in the United States during 2020-2022 will be identified using the National Health Interview Survey (NHIS). Multiple regression analysis of self-reported data confirming COVID-19 infection status and challenges with concentration, communication, and memory will be performed. Latent class analysis will be utilized to identify subgroups in the population to indicate whether certain demographic groups have higher susceptibility to cognitive-linguistic deficits associated with COVID-19. Completion of this study will reveal whether there is an association between confirmed COVID-19 diagnosis and heightened incidence of cognitive deficits and subsequent implications, if any, on activities of daily living. This study is distinct in its aim to utilize national survey data to explore the relationship between confirmed COVID-19 diagnosis and the prevalence of cognitive-communication deficits with a secondary focus on resulting activity limitations. To the best of the author’s knowledge, this will be the first large-scale epidemiological study investigating the associations between cognitive-linguistic deficits, COVID-19 and implications on activities of daily living in the United States population. These findings will highlight the need for targeted interventions and support services to address the cognitive-communication needs of individuals recovering from COVID-19, thereby enhancing their overall well-being and functional outcomes.

Keywords: cognition, COVID-19, language, limitations, memory, NHIS

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2311 Impact of Adolescent Smoking on the Behaviour, Academic and Health Aspects in Qatar

Authors: Abdelsalam Gomaa, Mahjabeen Ramzan, Tooba Ali Akbar, Huma Nadeem

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The use of tobacco and the health risks linked to it are well known in this day and age due to the presence of easily available information through the internet. The media is a powerful platform that is used by many anti-smoking awareness campaigns to reach their target audience; yet, it has been found that adolescents are taking up smoking every passing day. Half of this smoking population of youngsters resides in Asia alone, which includes Qatar, the focus country of this study. As smoking happens to be one of the largest avoidable causes of serious diseases like cancers and heart problems, children are taking up smoking at an alarming rate everywhere including Qatar. Importance of the health of the citizens of Qatar is one of the pillars of the Qatar vision 2030, which is to ensure a healthy population, both physically and mentally. Since the youth makes up a significant percentage of the population and in order to achieve the health objectives of the Qatar vision 2030, it is essential to ensure the health and well-being of this part of the population of the country as they are the future of Qatar. Children, especially boys who tend to be more aggressive by nature, are highly likely to develop behavioral and health issues due to smoking at an early age. Research conducted around the world has also emphasized on this association between the smokers developing a bad behaviour as well as poor social communication skills. However, due to lack of research into this association, very little is known about the extent to which smoking impacts the children’s academics, health and behaviour. Moreover, a study of this nature has not yet been conducted in Qatar previously as most of the studies focus on adult smokers and ways to minimize the number of smoking habits in universities and workplaces. This study solely focuses on identifying a relationship between smoking and its impacts on the adolescents by conducting a research on different schools across Qatar.

Keywords: adolescents, modelling techniques, Qatar, smoking

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2310 Noise Detection Algorithm for Skin Disease Image Identification

Authors: Minakshi Mainaji Sonawane, Bharti W. Gawali, Sudhir Mendhekar, Ramesh R. Manza

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People's lives and health are severely impacted by skin diseases. A new study proposes an effective method for identifying the different forms of skin diseases. Image denoising is a technique for improving image quality after it has been harmed by noise. The proposed technique is based on the usage of the wavelet transform. Wavelet transform is the best method for analyzing the image due to the ability to split the image into the sub-band, which has been used to estimate the noise ratio at the noisy image. According to experimental results, the proposed method presents the best values for MSE, PSNR, and Entropy for denoised images. we can found in Also, by using different types of wavelet transform filters is make the proposed approach can obtain the best results 23.13, 20.08, 50.7 for the image denoising process

Keywords: MSE, PSNR, entropy, Gaussian filter, DWT

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2309 The Effects of Traditional Thai Massage Technique Delivered by Parents on Stereotypical Behaviors in Children with Autism: A Pilot Study

Authors: Chanada Aonsri, Wichai Eungpinichpong

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Stereotypical behavior is one of the learning and social skills development problems that affect children with autism. Previous studies found that traditional Thai massage (TTM) could reduce stereotypical behaviors in autistic children. However, the effects of TTM delivered by the parents of autistic children have not been explored. This pilot study investigated the effects of TTM by parents on stereotypical behaviors in children with autism. A one-group pretest-posttest design was applied for 15 children, aged 4-16 years, with their parents' permissions. They participated in the study at the Special Education program of the Special Education Center of Khon Kaen University, Thailand. After being trained in a specialized TTM for children, the parents delivered 50-minute TTM to children once a day, twice a week for eight weeks. The severity of autism and autistic behaviors were measured using the Childhood Autism Rating Scale (CARS), and the Autism Treatment Evaluation Checklist (ATEC), respectively. The functions of autonomic nervous systems were measured using Heart Rate Variability (HRV) to indicated physical and mental disorders such as stress. The data at baseline and the 8th week were analyzed using either an independent t-test or Wilcoxon signed-rank test. The study found that 16 sessions of TTM significantly improved measured data for autism in all children including the CARS (p<0.001), ATEC, speech/language/communication (p<0.001), sociability (p<0.001), sensory/cognitive awareness (p<0.001), health/physical/behavior (p < 0.001), and HRV (p<0.001). The results indicated that TTM performed by parents could be useful as an adjunct therapy for autistic children as it can reduce stereotypical behaviors and stress.

Keywords: traditional Thai massage, stereotypical behaviors, Autistic children, parent

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2308 Protective Effects of Urtica dioica Seed Extract in Aflatoxicosis: Histopathological and Biochemical Findings

Authors: Ahmet Uyar, Zabit Yener, Abdulahad Dogan

Abstract:

(1). The ameliorative potential and antioxidant capacity of an extract of Urtica dioica seeds (UDS) were investigated using histopathological changes in liver and kidney of broiler, measuring serum marker enzymes, antioxidant defence systems and lipid peroxidation (malondialdehyde (MDA)) content in various tissues of broilers exposed to aflatoxin (AF). (2). A total of 32 broilers were divided randomly into 4 groups: control, UDS extract-treated, AF-treated and AF+UDS extract-treated. Broilers in control and UDS extract-treated groups were fed on a diet without AF. The AF-treated group and AF+UDS extract-treated groups were treated with an estimated 1 mg total AF/kg feed. The AF+UDS extract groups received in addition 30 ml UDS extract/kg diet for 21 days. (3). The AF-treated group had significantly decreased body weight gain when compared to the other groups. (4). Biochemical analysis showed a small increase in the concentrations of serum aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transpeptidase and lactate dehydrogenase in the AF-treated group compared to that of the control group, whereas concentrations of these enzymes were decreased in the AF+UDS group compared to that of the AF-treated group. (5). Administration of supplementary UDS extract helped restore the AF-induced increase in MDA and reduced the antioxidant system towards normality, particularly in the liver, brain, kidney and heart. Hepatorenal protection by UDS extracts was further supported by the almost normal histology in AF +UDS extract-treated group as compared to the degenerative changes in the AF-treated broilers. (6). It was concluded that UDS extract has a protective hepatorenal effect in broilers affected by aflatoxicosis, probably acting by promoting the antioxidative defence systems.

Keywords: aflatoxicosis, biochemistry, broiler, histopathology, Urtica dioica seed extract

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2307 The Effects of Grape Waste Bioactive Compounds on the Immune Response and Oxidative Stress in Pig Kidney

Authors: Mihai Palade, Gina Cecilia Pistol, Mariana Stancu, Veronica Chedea, Ionelia Taranu

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Nutrition is an important determinant of general health status, with especially focus on prevention and/or attenuation of the inflammatory-associated pathologies. People with chronic kidney disease can experience chronic inflammation that can lead to cardiovascular disease and even an increased rate of death. There are important links between chronic kidney diseases, inflammation and nutritional strategies that may prevent or protect against undesirable inflammation and oxidative stress. The grape by-products either seeds or pomace are rich in polyphenols which may be beneficial in prevention of inflammatory, antioxidant and antimicrobial processes. As a model for studying the impact of grape seeds on renal inflammation and oxidative stress, we used in this study weaned piglets. After a feeding trial of 30 days with a control diet and an experimental diet containing 5% grape seed (GS), kidney samples were collected. In renal tissues were determined the expression and activity of important markers of immune respose and oxidative stress: pro-inflammatory cytokines (TNF-alpha, IL-1 beta, IL-6, IL-8, IFN-gamma), anti-inflammatory cytokines (IL-4, IL-10), anti-oxidant enzymes (catalase CAT, superoxide dismutase SOD, glutathione peroxidise GPx) and important mediators belonging to nuclear receptors (NF-kB1, Nrf-2 and PPAR-gamma). Gene expression was evaluated by qPCR, whereas protein concentration was determined using proteomic techniques (ELISA). The activity of anti-oxidant enzymes was determined using specific kits. Our results showed that GS enriched in polyphenols does not have effect on TNF-alpha, IL-6 and IL-1 beta gene expression and protein concentration in kidney. By contrast, the gene expression and protein level of IL-8 and IFN-gamma were decreased in GS kidney. Anti-inflammatory cytokines IL-4 and IL-10 gene levels were increased in kidneys collected from GS piglets in comparison with controls, with no modification of protein levels between the two groups. The activities of anti-oxidant enzymes CAT and GPx were increased in kidney by GS, whereas SOD activity was unmodified in comparison with control samples. Also, the GS diet was associated with no modulation of mRNAs for nuclear receptors NF-kB1, Nrf-2 and PPAR-gamma gene expressions in kidneys. In conclusion, our results demonstrated that GS enriched in bioactive compounds such polyphenols could modulate inflammation and oxidative stress markers in kidney tissues. Further studies are necessary to elucidate the mechanism of action of GS compounds in case kidney inflammation associated with oxidative stress, and signalling molecules involved in these mechanisms.

Keywords: animal model, kidney inflammation, oxidative stress, grape seed

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2306 Biosignal Recognition for Personal Identification

Authors: Hadri Hussain, M.Nasir Ibrahim, Chee-Ming Ting, Mariani Idroas, Fuad Numan, Alias Mohd Noor

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A biometric security system has become an important application in client identification and verification system. A conventional biometric system is normally based on unimodal biometric that depends on either behavioural or physiological information for authentication purposes. The behavioural biometric depends on human body biometric signal (such as speech) and biosignal biometric (such as electrocardiogram (ECG) and phonocardiogram or heart sound (HS)). The speech signal is commonly used in a recognition system in biometric, while the ECG and the HS have been used to identify a person’s diseases uniquely related to its cluster. However, the conventional biometric system is liable to spoof attack that will affect the performance of the system. Therefore, a multimodal biometric security system is developed, which is based on biometric signal of ECG, HS, and speech. The biosignal data involved in the biometric system is initially segmented, with each segment Mel Frequency Cepstral Coefficients (MFCC) method is exploited for extracting the feature. The Hidden Markov Model (HMM) is used to model the client and to classify the unknown input with respect to the modal. The recognition system involved training and testing session that is known as client identification (CID). In this project, twenty clients are tested with the developed system. The best overall performance at 44 kHz was 93.92% for ECG and the worst overall performance was ECG at 88.47%. The results were compared to the best overall performance at 44 kHz for (20clients) to increment of clients, which was 90.00% for HS and the worst overall performance falls at ECG at 79.91%. It can be concluded that the difference multimodal biometric has a substantial effect on performance of the biometric system and with the increment of data, even with higher frequency sampling, the performance still decreased slightly as predicted.

Keywords: electrocardiogram, phonocardiogram, hidden markov model, mel frequency cepstral coeffiecients, client identification

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2305 Human Rights to Environment: The Constitutional and Judicial Perspective in India

Authors: Varinder Singh

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The primitive man had not known anything like human rights. In the later centuries of human progress with the development of scientific and technological knowledge, the growth of population and the tremendous changes in the human environment, the laws of nature that maintained the Eco-balance crumbled. The race for better and comfortable life landed mankind in a vicious circle. It created environmental imbalance, unplanned and uneven development, breakdown of self-sustaining village economy, mushrooming of shanty towns and slums, widening the chasm between the rich and the poor, over-exploitation of natural resources, desertification of arable lands, pollution of different kinds, heating up of earth and depletion of ozone layer. Modem International Life has been deeply marked and transformed by current endeavors to meet the needs and fulfill the requirements of protection of human person and of the environment. Such endeavors have been encouraged by the widespread recognition that protection of human being and the environment reflects common superior values and constitutes a common concern of mankind. The parallel evolutions of human rights protection and environmental protection disclose some close affinities. There was the occurrence of process of internationalization of both human rights protection and environmental protection, the former beginning with the 1948 Universal Declaration of Human Rights, the latter with the 1972 Stockholm Declaration on the Human Environment.It is now well established that it is the basic human right of every individual to live in a pollution free environment with full human dignity. The judiciary has so far pronounced a number of judgments in this regard. The Supreme Court in view of various laws relating to environment protection and the constitutional provision has held that right to pollution free environment. Article-21 is the heart of the fundamental rights and has received expanded meanings from time to time.

Keywords: human rights, law, environment, polluter

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2304 Crustal Deformation Study across the Chite Fault Using GPS Measurements in North East India along the Indo Burmese Arc

Authors: Malsawmtluanga, J. Malsawma, R. P. Tiwari, V. K. Gahalaut

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North East India is seismically one of the six most active regions of the world. It is placed in Zone V, the highest zone in the seismic zonation of India. It lies at the junction of Himalayan arc to the north and the Burmese arc to the east. The region has witnessed at least 18 large earthquakes including two great earthquakes Shillong (1987, M=8.7) and the Assam Tibet border (1950, M=8.7).The prominent Chite fault lies at the heart of Aizawl, the capital of Mizoram state and this hilly city is the home to about 2 million people. Geologically the area is a part of the Indo-Burmese Wedge and is prone to natural and man-made disasters. Unplanned constructions and urban dwellings on a rapid scale have lead to numerous unsafe structures adversely affecting the ongoing development and welfare projects of the government and they pose a huge threat for earthquakes. Crustal deformation measurements using campaign mode GPS were undertaken across this fault. Campaign mode GPS data were acquired and were processed with GAMIT-GLOBK software. The study presents the current velocity estimates at all the sites in ITRF 2008 and also in the fixed Indian reference frame. The site motion showed that there appears to be no differential motion anywhere across the fault area, thus confirming presently the fault is neither accumulating strain nor slipping aseismically. From the geological and geomorphological evidence, supported by geodetic measurements, lack of historic earthquakes, the Chite fault favours aseismic behaviour in this part of the Indo Burmese Arc (IBA).

Keywords: Chite fault, crustal deformation, geodesy, GPS, IBA

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2303 A Case of Survival with Self-Draining Haemopericardium Secondary to Stabbing

Authors: Balakrishna Valluru, Ruth Suckling

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A 16 year old male was found collapsed on the road following stab injuries to the chest and abdomen and was transported to the emergency department by ambulance. On arrival in the emergency department the patient was breathless and appeared pale. He was maintaining his airway with spontaneous breathing and had a heart rate of 122 beats per minute with a blood pressure of 83/63 mmHg. He was resuscitated initially with three units of packed red cells. Clinical examination identified three incisional wounds each measuring 2 cm. These were in the left para-sternal region, right infra-scapular region and left upper quadrant of the abdomen. The chest wound over the left parasternal area at the level of 4tth intercostal space was bleeding intermittently on leaning forwards and was relieving his breathlessness intermittently. CT imaging was performed to characterize his injuries and determine his management. CT scan of chest and abdomen showed moderate size haemopericardium with left sided haemopneumothorax. The patient underwent urgent surgical repair of the left ventricle and left anterior descending artery. He recovered without complications and was discharged from the hospital. This case highlights the fact that the potential to develop a life threatening cardiac tamponade was mitigated by the left parasternal stab wound. This injury fortuitously provided a pericardial window through which the bleeding from the injured left ventricle and left anterior descending artery could drain into the left hemithorax providing an opportunity for timely surgical intervention to repair the cardiac injuries.

Keywords: stab, incisional, haemo-pericardium, haemo-pneumothorax

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2302 Usy-Cui Zeolite: An Efficient and Reusable Catalyst for Derivatives Indole Synthesis

Authors: Hassina Harkat, Samiha Taybe, Salima Loucif, Valérie Beneteau, Patrick Pale

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Indole and its derivatives have attracted great interest because of their importance in the synthetic organic and medicinal chemistry. They are widely used as anti hypertension, anti tubercular, anticancer activity, antiviral, Alzheimer's disease, antioxidant properties, and free radical induced lipid peroxidation. Many drugs and natural products contain indole moiety, such as the vinca alkaloids, fungal metabolites and marine natural products. Generally applicable synthetic methods for indole moiety involve ring closure to form the pyrrole. Indole derivatives can also be accessed by further functionalization of the indole nucleus. Therefore we report a mild and efficient protocol for the synthesis of analogues of indole catalyzed via zeolithe USY doped with CuI under solvent-free conditions.

Keywords: indole, zeolithe, USY-CuI, heterogeneous catalysis

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2301 Unsupervised Echocardiogram View Detection via Autoencoder-Based Representation Learning

Authors: Andrea Treviño Gavito, Diego Klabjan, Sanjiv J. Shah

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Echocardiograms serve as pivotal resources for clinicians in diagnosing cardiac conditions, offering non-invasive insights into a heart’s structure and function. When echocardiographic studies are conducted, no standardized labeling of the acquired views is performed. Employing machine learning algorithms for automated echocardiogram view detection has emerged as a promising solution to enhance efficiency in echocardiogram use for diagnosis. However, existing approaches predominantly rely on supervised learning, necessitating labor-intensive expert labeling. In this paper, we introduce a fully unsupervised echocardiographic view detection framework that leverages convolutional autoencoders to obtain lower dimensional representations and the K-means algorithm for clustering them into view-related groups. Our approach focuses on discriminative patches from echocardiographic frames. Additionally, we propose a trainable inverse average layer to optimize decoding of average operations. By integrating both public and proprietary datasets, we obtain a marked improvement in model performance when compared to utilizing a proprietary dataset alone. Our experiments show boosts of 15.5% in accuracy and 9.0% in the F-1 score for frame-based clustering, and 25.9% in accuracy and 19.8% in the F-1 score for view-based clustering. Our research highlights the potential of unsupervised learning methodologies and the utilization of open-sourced data in addressing the complexities of echocardiogram interpretation, paving the way for more accurate and efficient cardiac diagnoses.

Keywords: artificial intelligence, echocardiographic view detection, echocardiography, machine learning, self-supervised representation learning, unsupervised learning

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2300 Health Care Delivery Services at Subdistrict Health Promoting Hospitals on The Islands in Thailand

Authors: Tassana Boontong, Vilaivan Thongcharoen, Orapan Thosingha, Suphamon Chansakul, Anorut Jenwitheesuk, Chanin Chakkrapopyodhin, Isara Phiwchai, Mattika Chaichan, Rungnapha Khiewchaum

Abstract:

According to Thailand health policy, subdistrict health promoting hospitals (SHPHs) serve as forefront facilities for inclusive health care service. Those services include health promotion, disease prevention, primary medical care and rehabilitation. However, SHPHs residing in some distant area, such as SHPHs residing on the islands, would deliver different services relevant to health needs of the local people and the tourists. This research aimed to study health care delivery services at SHPHs on the islands in Thailand. Data were collected using questionnaires. The result revealed that in Thailand, there are 58 SHPHs on the islands. During data collection process, the researchers were not allowed to collect data in 5 SHPHs in the southern part due to Covid-19 pandemic. The report is based on 53 SHPHs on the islands. Numbers of health care personnel were 201, 72.14 % were female, with the ages ranged from 22 to 60 years (mean = 35.56 years). About 53% were community health personnel, while 26.08% were professional nurses. In regard to work experiences, the range of year varied from less than 1 year to 30 years, with the mean of 8.36 years. The majority of their responsibilities focused on providing primary medical care (86.34%), caring of people with chronic illnesses (85.30%) and providing medical care procedures for patients with chronic illnesses at home (84.36%). Nurses were main health care personnel in performing primary medical care. Due to difficulty transportation from the islands to the mainland, nurses had to provide prompt emergency medical care while the patients arrived with emergency and critical illnesses such as severe head trauma, stroke or coronary artery disease. Although some medical procedures were complex and not covered by nursing and midwifery license, they decided to protect patients from life- threatening conditions and make them stable before transportation. In SHPHs, the workload exceeded manpower, health care personnel had to work overtime almost every day. In the famous tourist islands, health care personnel had to carry 3-4 folds of their workload during the holidays because of the large crowds of foreign and Thai tourists. It is recommended that SHPHs on the islands should scale up the level of services to cover advanced medical care. Health care personnel, in particular, professional nurses, should be equipped with emergency and critical care skills. The expected outcomes of the services should emphasize on rescuing patients with emergency and life-threatening illnesses and providing comprehensive care for people living on or visiting the islands.

Keywords: distant area, islands, sub district health promoting hospital, heath care services, Thailand

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2299 A Study of Body Weight and Type Traits Recorded on Hairy Goat in Punjab, Pakistan

Authors: A. Qayyum, G. Bilal, H. M. Waheed

Abstract:

The objectives of the study were to determine phenotypic variations in Hairy goats for quantitative and qualitative traits and to analyze the relationship between different body measurements and body weight in Hairy goats. Data were collected from the Barani Livestock Production Research Institute (BLPRI) at Kherimurat, Attock and potential farmers who were raising hairy goats in the Potohar region. Twelve (12) phenotypic parameters were measured on 99 adult Hairy goat (18 male and 81 female). Four qualitative and 8 quantitative traits were investigated. Qualitative traits were visually observed and expressed as percentages. Descriptive analysis was done on quantitative variables. All hairy goats had predominately black body coat color (72%), whereas white (11%) and brown (11%) body coat color were also observed. Both the pigmented (45.5%) and non-pigmented (54.5%) type of body skin were observed in the goat breed. Horns were present in the majority (91%) of animals. Most of the animals (83%) had straight facial head profiles. Analysis was performed in SAS On-Demand for Academics using PROC mixed model procedure. Overall means ± SD of body weight (BW), body length (BL), height at wither (HAW), ear length (EL), head length (HL), heart girth (HG), tail length (TL) and MC (muzzle circumference) were 41.44 ± 12.21 kg, 66.40 ± 7.87 cm, 75.17 ± 7.83 cm, 22.99 ± 6.75 cm, 15.07 ± 3.44 cm, 76.54 ± 8.80 cm, 18.28 ± 4.18 cm, and 26.24 ± 5.192 cm, respectively. Sex had a significant effect on BL and HG (P < 0.05), whereas BW, HAW, EL, HL, TL, and MC were not significantly affected (P > 0.05). The herd had a significant effect on BW, BL, HAW, HL, HG, and TL (P < 0.05) except EL and MC (P > 0.05). Hairy goats appear to have the potential for selection as mutton breeds in the Potohar region of Punjab. The findings of the present study would help in the characterization and conservation of hairy goats using genetic and genomic tools in the future.

Keywords: body weight, Hairy goat, type traits Punjab, Pakistan

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2298 Contractors Perspective on Causes of Delays in Power Transmission Projects

Authors: Goutom K. Pall

Abstract:

At the very heart of the power system, power transmission (PT) acts as an essential link between power generation and distribution. Timely completion of PT infrastructures is therefore crucial to support the development of power system as a whole. Yet despite the importance, studies on PT infrastructure development projects are embryonic and, hence, PT projects undergoing widespread delays worldwide. These delay factors are idiosyncratic and identifying the critical delay factors is essential if the PT industry professionals are to complete their projects efficiently and within the expected timeframes. This study identifies and categorizes 46 causes of PT project delay under ten major groups using six sector expert’s recommendations studied by a preliminary questionnaire survey. Based on the experts’ strong recommendations, two new groups are introduced in the final questionnaire survey: sector specific factors (SSF) and general factors (GF). SSF pertain to delay factors applicable only to the PT projects, while GF represents less biased samples with shared responsibilities of all project parties involved in a project. The study then uses 112 data samples from the contractors to rank the delay factors using relative importance index (RII). The results reveal that SSF, GF and external factors are the most critical groups, while the highest ranked delay factors include the right of way (RoW) problems of transmission lines (TL), delay in payments, frequent changes in TL routes, poor communication and coordination among the project parties and accessibility to TL tower locations. Finally, recommendations are made to minimize the identified delay. The findings are expected to be of substantial benefit to professionals in minimizing time overrun in PT projects implementation, as well as power generation, power distribution, and non-power linear construction projects worldwide.

Keywords: delay, project delay, power transmission projects, time-overruns

Procedia PDF Downloads 178
2297 The Importance of Electronic Medical Record Systems in Health Care Economics

Authors: Mutaz Shurahabeel Ahmed Ombada

Abstract:

This paper investigates potential health and financial settlement of health information technology, this paper evaluates health care with the use of IT and other associated industries. It assesses prospective savings and costs of extensive acceptance of Electronic Medical Record Systems (EMRS), models significant to health as well as safety remuneration, and conclude that efficient EMRS execution and networking could ultimately save more than US $55 billion annually through recuperating health care effectiveness and that Health Information Technology -enabled prevention and administration of chronic disease could eventually double those savings while rising health and other social remuneration. On the contrary, this is improbable to be realized without related to significant modifications to the health care system.

Keywords: electronic medical record systems, health care economics, EMRS

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2296 Real-world Characterization of Treatment Intensified (Add-on to Metformin) Adults with Type 2 Diabetes in Pakistan: A Multi-center Retrospective Study (Converge)

Authors: Muhammad Qamar Masood, Syed Abbas Raza, Umar Yousaf Raja, Imran Hassan, Bilal Afzal, Muhammad Aleem Zahir, Atika Shaheer

Abstract:

Background: Cardiovascular disease (CVD) is a major burden among people with type 2 diabetes (T2D) with 1 in 3 reported to have CVD. Therefore, understanding real-world clinical characteristics and prescribing patterns could help in better care. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real world with GLP-1RAs) study characterized demographics and medication usage patterns in T2D intensified (add-on to metformin) overall population. The data were further divided into subgroups {dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), insulins, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is)}, according to the latest prescribed antidiabetic agent (ADA) in India/Pakistan/Thailand. Here, we report findings from Pakistan. Methods: A multi-center retrospective study utilized data from medical records between 13-Sep-2008 (post-market approval of GLP-1RAs) and 31-Dec-2017 in adults (≥18-year-old). The data for this study were collected from 05 centers / institutes located in major cities of Pakistan, including Karachi, Lahore, Islamabad, and Multan. These centers included National Hospital, Aga Khan University Hospital, Diabetes Endocrine Clinic Lahore, Shifa International Hospital, Mukhtar A Sheikh Hospital Multan. Data were collected at start of medical record and at 6 or 12-months prior to baseline based on variable type; analyzed descriptively. Results: Overall, 1,010 patients were eligible. At baseline, overall mean age (SD) was 51.6 (11.3) years, T2D duration was 2.4 (2.6) years, HbA1c was 8.3% (1.9) and 35% received ≥1CVD medications in the past 1-year (before baseline). Most frequently prescribed ADAs post-metformin were DPP-4is and SUs (~63%). Only 6.5% received GLP-1RAs and SGLT-2is were not available in Pakistan during the study period. Overall, it took a mean of 4.4 years and 5 years to initiate GLP-1RAs and SGLT-2is, respectively. In comparison to other subgroups, more patients from GLP-1RAs received ≥3 types of ADA (58%), ≥1 CVD medication (64%) and had higher body mass index (37kg/m2). Conclusions: Utilization of GLP-1RAs and SGLT-2is was low, took longer time to initiate and not before trying multiple ADAs. This may be due to lack of evidence for CV benefits for these agents during the study period. The planned phase 2 of the CONVERGE study can provide more insights into utilization and barriers to prescribe GLP-1RAs and SGLT-2is post 2018 in Pakistan.

Keywords: type 2 diabetes, GLP-1RA, treatment intensification, cardiovascular disease

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2295 Synthesis and Molecular Docking of Isonicotinohydrazide Derivatives as Anti-Tuberculosis Candidates

Authors: Ruswanto Ruswanto, Richa Mardianingrum, Tita Nofianti, Nur Rahayuningsih

Abstract:

Tuberculosis (TB) is a chronic disease as a result of Mycobacterium tuberculosis. It can affect all age groups, and hence, is a global health problem that causes the death of millions of people every year. One of the drugs used in tuberculosis treatment is isonicotinohydrazide. In this study, N'-benzoylisonicotinohydrazide derivative compounds (a-l) were prepared using acylation reactions between isonicotinohydrazide and benzoyl chloride derivatives, through the reflux method. Molecular docking studies suggested that all of the compounds had better interaction with Mycobacterium tuberculosis enoyl-acyl carrier protein reductase (InhA) than isonicotinohydrazide. It can be concluded that N'-benzoylisonicotinohydrazide derivatives (a-l) could be used as anti-tuberculosis candidates. From the docking results revealed that all of the compounds interact well with InhA, with compound g (N'-(3-nitrobenzoyl)isonicotinohydrazide) exhibiting the best interaction.

Keywords: anti-tuberculosis , docking, InhA, N'-benzoylisonicotinohydrazide, synthesis

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2294 Acute Effects of Local Vibration on Muscle Activation, Metabolic and Hormone Responses

Authors: Zong Yan Cai, Wen-Chyuan Chen, Chih-Min Wu

Abstract:

The purpose of this study was to investigate the acute effects of local vibration on muscle activation, metabolic and hormone responses. Totally 12 healthy, physically inactive, male adults participated in this study and completed LV exercise session. During LV exercise session, four custom-made vibrations (diameter: 20 mm; thickness: 8 mm; weight: 0.022 g) were locally placed over the belly of the thigh of each subject’s non-dominant leg in supine lying position, and subjects received 10 sets for 1 min at the frequency of 35-40Hz, with 1–2 min of rest between sets. The surface electromyography (EMG) were obtained from the vastus medialis and rectus femoris, and the subjects’ rating of perceived exertion (RPE) and heart rate (HR) were measured. EMG data, RPE values as well as HR were obtained by averaging the results of 10 sets of each exercise session. Blood samples were drawn before exercise, immediately after exercise, and 15min and 30min after exercise in each session for analysis of lactic acid (LA), growth hormone (GH), testosterone (T) and cortisol (C). The results indicated that the HR did not increase after LV (63.18±3.5 to 63.25±2.58 beat/min, p > 0.05). The average RPE values during the LV exposure were at 2.86±0.39. The root mean square % EMG values from the vastus medialis and rectus femoris were 19.02±2.19 and 8.25±2.20 respectively. There were no significant differences after acute LV exercise among LA, GH and T values as compared with baseline values (LA: 0.68±0.11 to 0.7±0.1 mmol/L; GH: 0.06±0.05 to 0.57±0.27 ng/mL; T: 551.33±46.62 to 520.42±43.78 ng/dL, p>0.05). However, the LV treatment caused a significant decrease in C values after exercise (16.56±1.05 to 11.64±1.85 nmol/L, p<0.05). In conclusion, acute LV exercise only slightly increase muscle activation which may not cause effective exercise response. However, acute LV exercise reduces C level, which may reduce the catabolic response. The probable reason might partly due to the vibration rhythmically which massage on muscles.

Keywords: cortisol, growth hormone, lactic acid, testosterone

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2293 Histopathological and Biochemical Investigations of Protective Role of Honey in Rats with Experimental Aflatoxicosis

Authors: Turan Yaman, Zabit Yener, Ismail Celik

Abstract:

The aim of this study was to investigate the antioxidant properties and protective role of honey, considered a part of traditional medicine, against carcinogen chemical aflatoxin (AF) exposure in rats, which were evaluated by histopathological changes in liver and kidney, measuring level of serum marker enzymes [aspartate aminotransferase (AST), alanin aminotransferase (ALT), gamma glutamil transpeptidase (GGT)], antioxidant defense systems [Reduced glutathione (GSH), glutathione reductase (GR), superoxide dismutase (SOD), glutathione-S-transferase (GST) and catalase (CAT)], and lipid peroxidation content in liver, erythrocyte, brain, kidney, heart and lungs. For this purpose, a total of eighteen healthy Sprague-Dawley rats were randomly allocated into three experimental groups: A (Control), B (AF-treated) and C (AF+honey-treated). While rats in group A were fed with a diet without AF, B, and C groups received 25 µg of AF/rat/day, where C group additionally received 1 mL/kg of honey by gavage for 90 days. At the end of the 90-day experimental period, we found that the honey supplementation decreased the lipid peroxidation and the levels of enzyme associated with liver damage, increased enzymatic and non-enzymatic antioxidants in the AF+honey-treated rats. Hepatoprotective and nephroprotective effects of honey is further substantiated by showing almost normal histological architecture in AF+honey-treated group, compared to degenerative changes in the liver and kidney of AF-treated rats. Additionally, honey supplementation ameliorated antioxidant defense systems and lipid peroxidation content in other tissues of AF+honey-treated rats. In conclusion, the present study indicates that honey has a hepatoprotective and nephroprotective effect in rats with experimental aflatoxicosis due to its antioxidant activity.

Keywords: aflatoxicosis, honey, histopathology, malondialdehyde, antioxidant, rat

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2292 Multidisciplinary Approach to Diagnosis of Primary Progressive Aphasia in a Younger Middle Aged Patient

Authors: Robert Krause

Abstract:

Primary progressive aphasia (PPA) is a neurodegenerative disease similar to frontotemporal and semantic dementia, while having a different clinical image and anatomic pathology topography. Nonetheless, they are often included under an umbrella term: frontotemporal lobar degeneration (FTLD). In the study, examples of diagnosing PPA are presented through the multidisciplinary lens of specialists from different fields (neurologists, psychiatrists, clinical speech therapists, clinical neuropsychologists and others) using a variety of diagnostic tools such as MR, PET/CT, genetic screening and neuropsychological and logopedic methods. Thanks to that, specialists can get a better and clearer understanding of PPA diagnosis. The study summarizes the concrete procedures and results of different specialists while diagnosing PPA in a patient of younger middle age and illustrates the importance of multidisciplinary approach to differential diagnosis of PPA.

Keywords: primary progressive aphasia, etiology, diagnosis, younger middle age

Procedia PDF Downloads 195
2291 Experimental and Numerical Performance Analysis for Steam Jet Ejectors

Authors: Abdellah Hanafi, G. M. Mostafa, Mohamed Mortada, Ahmed Hamed

Abstract:

The steam ejectors are the heart of most of the desalination systems that employ vacuum. The systems that employ low grade thermal energy sources like solar energy and geothermal energy use the ejector to drive the system instead of high grade electric energy. The jet-ejector is used to create vacuum employing the flow of steam or air and using the severe pressure drop at the outlet of the main nozzle. The present work involves developing a one dimensional mathematical model for designing jet-ejectors and transform it into computer code using Engineering Equation solver (EES) software. The model receives the required operating conditions at the inlets and outlet of the ejector as inputs and produces the corresponding dimensions required to reach these conditions. The one-dimensional model has been validated using an existed model working on Abu-Qir power station. A prototype has been designed according to the one-dimensional model and attached to a special test bench to be tested before using it in the solar desalination pilot plant. The tested ejector will be responsible for the startup evacuation of the system and adjusting the vacuum of the evaporating effects. The tested prototype has shown a good agreement with the results of the code. In addition a numerical analysis has been applied on one of the designed geometry to give an image of the pressure and velocity distribution inside the ejector from a side, and from other side, to show the difference in results between the two-dimensional ideal gas model and real prototype. The commercial edition of ANSYS Fluent v.14 software is used to solve the two-dimensional axisymmetric case.

Keywords: solar energy, jet ejector, vacuum, evaporating effects

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2290 The Cooperation among Insulin, Cortisol and Thyroid Hormones in Morbid Obese Children and Metabolic Syndrome

Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Obesity, a disease associated with a low-grade inflammation, is a risk factor for the development of metabolic syndrome (MetS). So far, MetS risk factors such as parameters related to glucose and lipid metabolisms as well as blood pressure were considered for the evaluation of this disease. There are still some ambiguities related to the characteristic features of MetS observed particularly in pediatric population. Hormonal imbalance is also important, and quite a lot information exists about the behaviour of some hormones in adults. However, the hormonal profiles in pediatric metabolism have not been cleared yet. The aim of this study is to investigate the profiles of cortisol, insulin, and thyroid hormones in children with MetS. The study population was composed of morbid obese (MO) children without (Group 1) and with (Group 2) MetS components. WHO BMI-for age and sex percentiles were used for the classification of obesity. The values above 99 percentile were defined as morbid obesity. Components of MetS (central obesity, glucose intolerance, high blood pressure, high triacylglycerol levels, low levels of high density lipoprotein cholesterol) were determined. Anthropometric measurements were performed. Ratios as well as obesity indices were calculated. Insulin, cortisol, thyroid stimulating hormone (TSH), free T3 and free T4 analyses were performed by electrochemiluminescence immunoassay. Data were evaluated by statistical package for social sciences program. p<0.05 was accepted as the degree for statistical significance. The mean ages±SD values of Group 1 and Group 2 were 9.9±3.1 years and 10.8±3.2 years, respectively. Body mass index (BMI) values were calculated as 27.4±5.9 kg/m2 and 30.6±8.1 kg/m2, successively. There were no statistically significant differences between the ages and BMI values of the groups. Insulin levels were statistically significantly increased in MetS in comparison with the levels measured in MO children. There was not any difference between MO children and those with MetS in terms of cortisol, T3, T4 and TSH. However, T4 levels were positively correlated with cortisol and negatively correlated with insulin. None of these correlations were observed in MO children. Cortisol levels in both MO as well as MetS group were significantly correlated. Cortisol, insulin, and thyroid hormones are essential for life. Cortisol, called the control system for hormones, orchestrates the performance of other key hormones. It seems to establish a connection between hormone imbalance and inflammation. During an inflammatory state, more cortisol is produced to fight inflammation. High cortisol levels prevent the conversion of the inactive form of the thyroid hormone T4 into active form T3. Insulin is reduced due to low thyroid hormone. T3, which is essential for blood sugar control- requires cortisol levels within the normal range. Positive association of T4 with cortisol and negative association of it with insulin are the indicators of such a delicate balance among these hormones also in children with MetS.

Keywords: children, cortisol, insulin, metabolic syndrome, thyroid hormones

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2289 Evaluation of Hepatic Antioxidant Changes in Ovine Dicrocoeliosis

Authors: Arash Jafari, Somaye Bahrami, Mohammad Hossein Razi Jalali

Abstract:

Dicrocoeliosis, caused by Dicrocoelium dendriticum is a hepatic parasitic disease of clinical and financial significance in ruminant breeding, which causes direct losses due to condemnation of parasitized livers. The purpose of our study was to assess the effects of natural dicrocoeliosis on the antioxidant defense capability of the liver in sheep. For this purpose, livers of 40 infected sheep with D. dendriticumalong with livers of 20 healthy (control) sheep were collected from animals slaughtered in Khuzestan province, Iran. An increase in malondialdehyde concentrations accompanied by decreased activities of SOD and GPX of infected liver was noticed when com-pared with control values. Our data indicate that through dicrocoeliosis insufficient scavenging of reactive oxygen species takes place and caused oxidative liver damage.

Keywords: Dicrocoelium dendriticum, lipid peroxidation, antioxidant enzyme, liver

Procedia PDF Downloads 665
2288 A Deep Learning Approach to Calculate Cardiothoracic Ratio From Chest Radiographs

Authors: Pranav Ajmera, Amit Kharat, Tanveer Gupte, Richa Pant, Viraj Kulkarni, Vinay Duddalwar, Purnachandra Lamghare

Abstract:

The cardiothoracic ratio (CTR) is the ratio of the diameter of the heart to the diameter of the thorax. An abnormal CTR, that is, a value greater than 0.55, is often an indicator of an underlying pathological condition. The accurate prediction of an abnormal CTR from chest X-rays (CXRs) aids in the early diagnosis of clinical conditions. We propose a deep learning-based model for automatic CTR calculation that can assist the radiologist with the diagnosis of cardiomegaly and optimize the radiology flow. The study population included 1012 posteroanterior (PA) CXRs from a single institution. The Attention U-Net deep learning (DL) architecture was used for the automatic calculation of CTR. A CTR of 0.55 was used as a cut-off to categorize the condition as cardiomegaly present or absent. An observer performance test was conducted to assess the radiologist's performance in diagnosing cardiomegaly with and without artificial intelligence (AI) assistance. The Attention U-Net model was highly specific in calculating the CTR. The model exhibited a sensitivity of 0.80 [95% CI: 0.75, 0.85], precision of 0.99 [95% CI: 0.98, 1], and a F1 score of 0.88 [95% CI: 0.85, 0.91]. During the analysis, we observed that 51 out of 1012 samples were misclassified by the model when compared to annotations made by the expert radiologist. We further observed that the sensitivity of the reviewing radiologist in identifying cardiomegaly increased from 40.50% to 88.4% when aided by the AI-generated CTR. Our segmentation-based AI model demonstrated high specificity and sensitivity for CTR calculation. The performance of the radiologist on the observer performance test improved significantly with AI assistance. A DL-based segmentation model for rapid quantification of CTR can therefore have significant potential to be used in clinical workflows.

Keywords: cardiomegaly, deep learning, chest radiograph, artificial intelligence, cardiothoracic ratio

Procedia PDF Downloads 98
2287 Evolutionary Advantages of Loneliness with an Agent-Based Model

Authors: David Gottlieb, Jason Yoder

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The feeling of loneliness is not uncommon in modern society, and yet, there is a fundamental lack of understanding in its origins and purpose in nature. One interpretation of loneliness is that it is a subjective experience that punishes a lack of social behavior, and thus its emergence in human evolution is seemingly tied to the survival of early human tribes. Still, a common counterintuitive response to loneliness is a state of hypervigilance, resulting in social withdrawal, which may appear maladaptive to modern society. So far, no computational model of loneliness’ effect during evolution yet exists; however, agent-based models (ABM) can be used to investigate social behavior, and applying evolution to agents’ behaviors can demonstrate selective advantages for particular behaviors. We propose an ABM where each agent contains four social behaviors, and one goal-seeking behavior, letting evolution select the best behavioral patterns for resource allocation. In our paper, we use an algorithm similar to the boid model to guide the behavior of agents, but expand the set of rules that govern their behavior. While we use cohesion, separation, and alignment for simple social movement, our expanded model adds goal-oriented behavior, which is inspired by particle swarm optimization, such that agents move relative to their personal best position. Since agents are given the ability to form connections by interacting with each other, our final behavior guides agent movement toward its social connections. Finally, we introduce a mechanism to represent a state of loneliness, which engages when an agent's perceived social involvement does not meet its expected social involvement. This enables us to investigate a minimal model of loneliness, and using evolution we attempt to elucidate its value in human survival. Agents are placed in an environment in which they must acquire resources, as their fitness is based on the total resource collected. With these rules in place, we are able to run evolution under various conditions, including resource-rich environments, and when disease is present. Our simulations indicate that there is strong selection pressure for social behavior under circumstances where there is a clear discrepancy between initial resource locations, and against social behavior when disease is present, mirroring hypervigilance. This not only provides an explanation for the emergence of loneliness, but also reflects the diversity of response to loneliness in the real world. In addition, there is evidence of a richness of social behavior when loneliness was present. By introducing just two resource locations, we observed a divergence in social motivation after agents became lonely, where one agent learned to move to the other, who was in a better resource position. The results and ongoing work from this project show that it is possible to glean insight into the evolutionary advantages of even simple mechanisms of loneliness. The model we developed has produced unexpected results and has led to more questions, such as the impact loneliness would have at a larger scale, or the effect of creating a set of rules governing interaction beyond adjacency.

Keywords: agent-based, behavior, evolution, loneliness, social

Procedia PDF Downloads 97