Search results for: diagnostic biomarker
1076 Investigating the Relationship and Interaction between Auditory Processing Disorder and Auditory Attention
Authors: Amirreza Razzaghipour Sorkhab
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The exploration of the connection between cognition and Auditory Processing Disorder (APD) holds significant value. Individuals with APD experience challenges in processing auditory information through the central auditory nervous system's varied pathways. Understanding the importance of auditory attention in individuals with APD, as well as the primary diagnostic tools such as language and auditory attention tests, highlights the critical need for assessing their auditory attention abilities. While not all children with Auditory Processing Disorder (APD) show deficits in auditory attention, there are often deficiencies in cognitive and attentional performance. The link between various types of attention deficits and APD suggests impairments in sustained and divided auditory attention. Research into the origins of APD should also encompass higher-level processes, such as auditory attention. It is evident that investigating the interaction between APD and auditory and cognitive functions holds significant value. Furthermore, it was demonstrated that APD tests may be influenced by cognitive factors, but despite signs of auditory attention interaction with auditory processing skills and the influence of cognitive factors on tests for this disorder, auditory attention measures are not typically included in APD diagnostic protocols. Therefore, incorporating attention assessment tests into the battery of tests for individuals with auditory processing disorder will be beneficial for obtaining useful insights into their attentional abilities.Keywords: auditory processing disorder, auditory attention, central auditory processing disorder, top-down pathway
Procedia PDF Downloads 661075 Rapid Inventory of Terrestrial Ferns and Lycopods in Center for Ecological Development and Recreation (Cedar), Impalutao, Impasug-Ong Bukidnon, Philippines
Authors: Diobein Flores, Venus Buagas, Virgie Darunday
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The study inventoried the species composition of terrestrial ferns and lycopods in Center for Ecological Development and Recreation (CEDAR) Impalutao, Impasug-ong, Bukidnon. Specifically, it aimed to determine and describe the species composition, and diagnostic characters of the ferns and lycopods in the study site. Transect walk method was employed in the inventory of the species. Each species were classified, identified and described according to its diagnostic characters. Results of the study revealed a total of 20 species of ferns and lycopods. Of these, 18 species were ferns and 2 species were lycopods. Eleven (11) families and fifteen (15) genera for ferns and one (1) family and one (1) genera for lycopods. Psomiocarpa apifolia is Philippine endemic and said to be vulnerable or threatened. Taxonomic characters based on habit, rhizome, leaf arrangement and orientation, stem structure and circinate vernation were used to identify the terrestrial pteridophtyes into families, genera and species. The species collected and assessment in CEDAR should be further investigated and monitor their conservation status.Keywords: alpha taxonomy, conservation, habit, taxonomic characters
Procedia PDF Downloads 2221074 Integrating AI into Breast Cancer Diagnosis: Aligning Perspectives for Effective Clinical Practice
Authors: Mehrnaz Mostafavi, Mahtab Shabani, Alireza Azani, Fatemeh Ghafari
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Artificial intelligence (AI) can transform breast cancer diagnosis and therapy by providing sophisticated solutions for screening, imaging interpretation, histopathological analysis, and treatment planning. This literature review digs into the many uses of AI in breast cancer treatment, highlighting the need for collaboration between AI scientists and healthcare practitioners. It emphasizes advances in AI-driven breast imaging interpretation, such as computer-aided detection and diagnosis (CADe/CADx) systems and deep learning algorithms. These have shown significant potential for improving diagnostic accuracy and lowering radiologists' workloads. Furthermore, AI approaches such as deep learning have been used in histopathological research to accurately predict hormone receptor status and categorize tumor-associated stroma from regular H&E stains. These AI-powered approaches simplify diagnostic procedures while providing insights into tumor biology and prognosis. As AI becomes more embedded in breast cancer care, it is crucial to ensure its ethical, efficient, and patient-focused implementation to improve outcomes for breast cancer patients ultimately.Keywords: breast cancer, artificial intelligence, cancer diagnosis, clinical practice
Procedia PDF Downloads 681073 Dielectric Response Analysis Measurement for Diagnostic Oil-Paper Insulation System on Aged Inter Bus Transformer 3x10 MVA
Authors: Eki Farlen, Akas
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Condition assessment of oil-paper-insulated power transformers, particularly of water content, is becoming increasingly important for aged transformers. As insulation ages, it can produce water, which reduces its dielectric strength, accelerates the cellulose ageing process, and causes gas bubbles to form at high temperatures. This paper mainly assesses the life condition of oil-paper insulation system of Inter Bus Transformer (IBT) 30 MVA, 150/30 kV in PT PLN-Substation Jelok that has been operating for 41 years, since 1974. Valuable information about the condition of high voltage insulation may be obtained by measuring its dielectric response. This paper describes in detail the interpretation of Dielectric Response Analysis (DIRANA) measurements and the test result compared to other insulation tests to get deep information for diagnostic, such as Tan delta test, oil characteristic test and Dissolve Gas Analysis (DGA) test. This paper mainly discusses the parameter relationship between moisture content, water content, acidity, oil conductivity and dissipation factor. The result and analysis show that IBT 30 MVA Jelok phase U and W had just been ageing due to high acidity level (>0.2 mgKOH/g) which cause high moisture in cellulose/paper (%) are in wet category about 4.7% and 5% and water content in oil (ppm) about 3.13 ppm and 3.33 ppm at temperature 20°C. High acidity level can make oxidation process and produce water in paper and particle which can decrease the value of Interfacial Tension (IFT) below 22 mN/m (poor category) for both phase U and W. Even if paper insulation of transformer are in wet condition, dissipation factor and capacitance at the same frequency (50 Hz) from both measurement DIRANA test and Tangent delta test give the same result (almost), the results are 0.69% and 0.71% (<1%), it may be acceptable and should not be investigated. The DGA results show that TDCG are in level one (1) condition and there are no found a Key Gases, it means that transformers had no failure during operation like arching, partial discharge and thermal in oil or cellulose.Keywords: diagnostic, inter-bus transformer, oil-paper insulation, moisture, dissipation factor
Procedia PDF Downloads 2791072 Retrospective Analysis Demonstrates No Difference in Percutaneous Native Renal Biopsy Adequacy Between Nephrologists and Radiologists in University Hospital Crosshouse
Authors: Nicole Harley, Mahmoud Eid, Abdurahman Tarmal, Vishal Dey
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Histological sampling plays an integral role in the diagnostic process of renal diseases. Percutaneous native renal biopsy is typically performed under ultrasound guidance, with this service usually being provided by nephrologists. In some centers, there is a role for radiologists in performing renal biopsies. Previous comparative studies have demonstrated non-inferiority between outcomes of percutaneous native renal biopsies performed by nephrologists compared with radiologists. We sought to compare biopsy adequacy between nephrologists and radiologists in University Hospital Crosshouse. The online system SERPR (Scottish Electronic Renal Patient Record) contains information pertaining to patients who have undergone renal biopsies. An online search was performed to acquire a list of all patients who underwent renal biopsy between 2013 and 2020 in University Hospital Crosshouse. 355 native renal biopsies were performed in total across this 7-year period. A retrospective analysis was performed on these cases, with records and reports being assessed for: the total number of glomeruli obtained per biopsy, whether the number of glomeruli obtained was adequate for diagnosis, as per an internationally agreed standard, and whether a histological diagnosis was achieved. Nephrologists performed 43.9% of native renal biopsies (n=156) and radiologists performed 56.1% (n=199). The mean number of glomeruli obtained by nephrologists was 17.16+/-10.31. The mean number of glomeruli obtained by radiologists was 18.38+/-10.55. T-test demonstrated no statistically significant difference between specialties comparatively (p-value 0.277). Native renal biopsies are required to obtain at least 8 glomeruli to be diagnostic as per internationally agreed criteria. Nephrologists met these criteria in 88.5% of native renal biopsies (n=138) and radiologists met this criteria in 89.5% (n=178). T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.663 and 0.922, respectively). Biopsies performed by nephrologists yielded tissue that was diagnostic in 91.0% (n=142) of sampling. Biopsies performed by radiologists yielded tissue that was diagnostic in 92.4% (n=184) of sampling. T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.625 and 0.889, respectively). This project demonstrates that at University Hospital Crosshouse, there is no statistical difference between radiologists and nephrologists in terms of glomeruli acquisition or samples achieving a histological diagnosis. Given the non-inferiority between specialties demonstrated by previous studies and this project, this evidence could support the restructuring of services to allow more renal biopsies to be performed by renal services and allow reallocation of radiology department resources.Keywords: biopsy, medical imaging, nephrology, radiology
Procedia PDF Downloads 811071 Endoscopic Depiction and Treatment Evaluation of Spirocerca lupi in Dogs
Authors: ELdessouky Sheta, Sayed Elzomor, Haithem Farghali, Kawkab A. Ahmed, Naglaa A. Abd Elkader
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The present investigation has been dealt with Spirocerca (S.) lupi infested mongrel dogs. This parasitic disease is highly infective to human beings and carnivores. The diagnosis march has been comprised the lateral contrast thoracic radiographs, fecal examination, blood profile, endoscopic examination and histopathological sections of deep seated pinch biopsies. These infested dogs have been put under an adopted treatment with Ivermectin injection combined with oral prednisolone. The obtained results reveal an absence of the pessimistic recognitions particularly after 3 weeks from the onset of treatment. Endoscopically the presented esophageal nodules are marked out in the distal third of infested dogs' esophagus as masses assigned into the esophageal lumen and fundus of stomach. The endoscopic outlook of Spirocerca lupi lesions has been considered an integral procedure of the diagnostic march and for evaluation of treatment follow up. The diagnostic procedures and the recommended treatment are the vet's guidance to care for Spirocerca lupi in dogs, hoping in future to prevent this disease from being spread among human beings and other carnivores.Keywords: endoscopy, esophagus, stomach spirocercosis, dogs
Procedia PDF Downloads 3941070 Cardiothoracic Ratio in Postmortem Computed Tomography: A Tool for the Diagnosis of Cardiomegaly
Authors: Alex Eldo Simon, Abhishek Yadav
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This study aimed to evaluate the utility of postmortem computed tomography (CT) and heart weight measurements in the assessment of cardiomegaly in cases of sudden death due to cardiac origin by comparing the results of these two diagnostic methods. The study retrospectively analyzed postmortem computed tomography (PMCT) data from 54 cases of sudden natural death and compared the findings with those of the autopsy. The study involved measuring the cardiothoracic ratio (CTR) from coronal computed tomography (CT) images and determining the actual cardiac weight by weighing the heart during the autopsy. The inclusion criteria for the study were cases of sudden death suspected to be caused by cardiac pathology, while exclusion criteria included death due to unnatural causes such as trauma or poisoning, diagnosed natural causes of death related to organs other than the heart, and cases of decomposition. Sensitivity, specificity, and diagnostic accuracy were calculated, and to evaluate the accuracy of using the cardiothoracic ratio (CTR) to detect an enlarged heart, the study generated receiver operating characteristic (ROC) curves. The cardiothoracic ratio (CTR) is a radiological tool used to assess cardiomegaly by measuring the maximum cardiac diameter in relation to the maximum transverse diameter of the chest wall. The clinically used criteria for CTR have been modified from 0.50 to 0.57 for use in postmortem settings, where abnormalities can be detected by comparing CTR values to this threshold. A CTR value of 0.57 or higher is suggestive of hypertrophy but not conclusive. Similarly, heart weight is measured during the traditional autopsy, and a cardiac weight greater than 450 grams is defined as hypertrophy. Of the 54 cases evaluated, 22 (40.7%) had a cardiothoracic ratio (CTR) ranging from > 0.50 to equal 0.57, and 12 cases (22.2%) had a CTR greater than 0.57, which was defined as hypertrophy. The mean CTR was calculated as 0.52 ± 0.06. Among the 54 cases evaluated, the weight of the heart was measured, and the mean was calculated as 369.4 ± 99.9 grams. Out of the 54 cases evaluated, 12 were found to have hypertrophy as defined by PMCT, while only 9 cases were identified with hypertrophy in traditional autopsy. The sensitivity and specificity of the test were calculated as 55.56% and 84.44%, respectively. The sensitivity of the hypertrophy test was found to be 55.56% (95% CI: 26.66, 81.12¹), the specificity was 84.44% (95% CI: 71.22, 92.25¹), and the diagnostic accuracy was 79.63% (95% CI: 67.1, 88.23¹). The limitation of the study was a low sample size of only 54 cases, which may limit the generalizability of the findings. The comparison of the cardiothoracic ratio with heart weight in this study suggests that PMCT may serve as a screening tool for medico-legal autopsies when performed by forensic pathologists. However, it should be noted that the low sensitivity of the test (55.5%) may limit its diagnostic accuracy, and therefore, further studies with larger sample sizes and more diverse populations are needed to validate these findings.Keywords: PMCT, virtopsy, CTR, cardiothoracic ratio
Procedia PDF Downloads 811069 Investigation of Suspected Viral Hepatitis Outbreaks in North India
Authors: Mini P. Singh, Manasi Majumdar, Kapil Goyal, Pvm Lakshmi, Deepak Bhatia, Radha Kanta Ratho
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India is endemic for Hepatitis E virus and frequent water borne outbreaks are reported. The conventional diagnosis rests on the detection of serum anti-HEV IgM antibodies which may take 7-10 days to develop. Early diagnosis in such a situation is desirable for the initiation of prompt control measures. The present study compared three diagnostic methods in 60 samples collected during two suspected HEV outbreaks in the vicinity of Chandigarh, India. The anti-HEV IgM, HEV antigen and HEV-RNA could be detected in serum samples of 52 (86.66%), 16 (26.66%) and 18 (30%) patients respectively. The suitability of saliva samples for antibody detection was also evaluated in 21 paired serum- saliva samples. A total of 15 serum samples showed the presence of anti HEV IgM antibodies, out of which 10 (10/15; 66.6%) were also positive for these antibodies in saliva samples (χ2 = 7.636, p < 0.0057), thus showing a concordance of 76.91%. The positivity of reverse transcriptase PCR and HEV antigen detection was 100% within one week of illness which declined to 5-10% thereafter. The outbreak was attributed to HEV Genotype 1, Subtype 1a and the clinical and environmental strains clustered together. HEV antigen and RNA were found to be an early diagnostic marker with 96.66% concordance. The results indicate that the saliva samples can be used as an alternative to serum samples in an outbreak situation.Keywords: HEV-antigen, outbreak, phylogenetic analysis, saliva
Procedia PDF Downloads 4201068 Audit of Urgent and Non-Urgent Patient Visits to the Emergency: A Case-Control Study
Authors: Peri Harish Kumar, Rafique Umer Harvitkar
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Background: The emergency department mandates maximum efficacy in the utilization of the available resources. Non-urgent patient visits pose a serious concern to the treatment, patient triage, and resources available. Aims and Objectives: We conducted a retrospective case-control study of the emergency department patient list from October 2019 to November 2022. A total of 839 patients formed part of the study. Somatic complaints, vital signs, diagnostic test results, admission to the hospital, etc., were some of the criteria used for the categorization of patients. Results: The proportion of non-urgent visits varied from 7.2% to 43%, with a median of 21%. Somatic complaints were the least associated with further hospital admissions (n=28%), while diagnostic test results were the most significant indicator of further hospital admissions (n=74%). Effective triage helped minimize emergency department admissions by 36%. Conclusion: Our study shows that effective triaging, patient counselling, and round-the-clock consumable monitoring helped in the effective management of patients admitted and also significantly helped provide treatment to the patients most in need.Keywords: urgent visits, non-urgent visits, traiging, emergency department admissions
Procedia PDF Downloads 1121067 Humeral Head and Scapula Detection in Proton Density Weighted Magnetic Resonance Images Using YOLOv8
Authors: Aysun Sezer
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Magnetic Resonance Imaging (MRI) is one of the advanced diagnostic tools for evaluating shoulder pathologies. Proton Density (PD)-weighted MRI sequences prove highly effective in detecting edema. However, they are deficient in the anatomical identification of bones due to a trauma-induced decrease in signal-to-noise ratio and blur in the traumatized cortices. Computer-based diagnostic systems require precise segmentation, identification, and localization of anatomical regions in medical imagery. Deep learning-based object detection algorithms exhibit remarkable proficiency in real-time object identification and localization. In this study, the YOLOv8 model was employed to detect humeral head and scapular regions in 665 axial PD-weighted MR images. The YOLOv8 configuration achieved an overall success rate of 99.60% and 89.90% for detecting the humeral head and scapula, respectively, with an intersection over union (IoU) of 0.5. Our findings indicate a significant promise of employing YOLOv8-based detection for the humerus and scapula regions, particularly in the context of PD-weighted images affected by both noise and intensity inhomogeneity.Keywords: YOLOv8, object detection, humerus, scapula, IRM
Procedia PDF Downloads 661066 Glyco-Biosensing as a Novel Tool for Prostate Cancer Early-Stage Diagnosis
Authors: Pavel Damborsky, Martina Zamorova, Jaroslav Katrlik
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Prostate cancer is annually the most common newly diagnosed cancer among men. An extensive number of evidence suggests that traditional serum Prostate-specific antigen (PSA) assay still suffers from a lack of sufficient specificity and sensitivity resulting in vast over-diagnosis and overtreatment. Thus, the early-stage detection of prostate cancer (PCa) plays undisputedly a critical role for successful treatment and improved quality of life. Over the last decade, particular altered glycans have been described that are associated with a range of chronic diseases, including cancer and inflammation. These glycans differences enable a distinction to be made between physiological and pathological state and suggest a valuable biosensing tool for diagnosis and follow-up purposes. Aberrant glycosylation is one of the major characteristics of disease progression. Consequently, the aim of this study was to develop a more reliable tool for early-stage PCa diagnosis employing lectins as glyco-recognition elements. Biosensor and biochip technology putting to use lectin-based glyco-profiling is one of the most promising strategies aimed at providing fast and efficient analysis of glycoproteins. The proof-of-concept experiments based on sandwich assay employing anti-PSA antibody and an aptamer as a capture molecules followed by lectin glycoprofiling were performed. We present a lectin-based biosensing assay for glycoprofiling of serum biomarker PSA using different biosensor and biochip platforms such as label-free surface plasmon resonance (SPR) and microarray with fluorescent label. The results suggest significant differences in interaction of particular lectins with PSA. The antibody-based assay is frequently associated with the sensitivity, reproducibility, and cross-reactivity issues. Aptamers provide remarkable advantages over antibodies due to the nucleic acid origin, stability and no glycosylation. All these data are further step for construction of highly selective, sensitive and reliable sensors for early-stage diagnosis. The experimental set-up also holds promise for the development of comparable assays with other glycosylated disease biomarkers.Keywords: biomarker, glycosylation, lectin, prostate cancer
Procedia PDF Downloads 4061065 Rapid and Cheap Test for Detection of Streptococcus pyogenes and Streptococcus pneumoniae with Antibiotic Resistance Identification
Authors: Marta Skwarecka, Patrycja Bloch, Rafal Walkusz, Oliwia Urbanowicz, Grzegorz Zielinski, Sabina Zoledowska, Dawid Nidzworski
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Upper respiratory tract infections are one of the most common reasons for visiting a general doctor. Streptococci are the most common bacterial etiological factors in these infections. There are many different types of Streptococci and infections vary in severity from mild throat infections to pneumonia. For example, S. pyogenes mainly contributes to acute pharyngitis, palatine tonsils and scarlet fever, whereas S. Streptococcus pneumoniae is responsible for several invasive diseases like sepsis, meningitis or pneumonia with high mortality and dangerous complications. There are only a few diagnostic tests designed for detection Streptococci from the infected throat of patients. However, they are mostly based on lateral flow techniques, and they are not used as a standard due to their low sensitivity. The diagnostic standard is to culture patients throat swab on semi selective media in order to multiply pure etiological agent of infection and subsequently to perform antibiogram, which takes several days from the patients visit in the clinic. Therefore, the aim of our studies is to develop and implement to the market a Point of Care device for the rapid identification of Streptococcus pyogenes and Streptococcus pneumoniae with simultaneous identification of antibiotic resistance genes. In the course of our research, we successfully selected genes for to-species identification of Streptococci and genes encoding antibiotic resistance proteins. We have developed a reaction to amplify these genes, which allows detecting the presence of S. pyogenes or S. pneumoniae followed by testing their resistance to erythromycin, chloramphenicol and tetracycline. What is more, the detection of β-lactamase-encoding genes that could protect Streptococci against antibiotics from the ampicillin group, which are widely used in the treatment of this type of infection is also developed. The test is carried out directly from the patients' swab, and the results are available after 20 to 30 minutes after sample subjection, which could be performed during the medical visit.Keywords: antibiotic resistance, Streptococci, respiratory infections, diagnostic test
Procedia PDF Downloads 1291064 Diabetes Diagnosis Model Using Rough Set and K- Nearest Neighbor Classifier
Authors: Usiobaifo Agharese Rosemary, Osaseri Roseline Oghogho
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Diabetes is a complex group of disease with a variety of causes; it is a disorder of the body metabolism in the digestion of carbohydrates food. The application of machine learning in the field of medical diagnosis has been the focus of many researchers and the use of recognition and classification model as a decision support tools has help the medical expert in diagnosis of diseases. Considering the large volume of medical data which require special techniques, experience, and high diagnostic skill in the diagnosis of diseases, the application of an artificial intelligent system to assist medical personnel in order to enhance their efficiency and accuracy in diagnosis will be an invaluable tool. In this study will propose a diabetes diagnosis model using rough set and K-nearest Neighbor classifier algorithm. The system consists of two modules: the feature extraction module and predictor module, rough data set is used to preprocess the attributes while K-nearest neighbor classifier is used to classify the given data. The dataset used for this model was taken for University of Benin Teaching Hospital (UBTH) database. Half of the data was used in the training while the other half was used in testing the system. The proposed model was able to achieve over 80% accuracy.Keywords: classifier algorithm, diabetes, diagnostic model, machine learning
Procedia PDF Downloads 3361063 Advances in Health Risk Assessment of Mycotoxins in Africa
Authors: Wilfred A. Abiaa, Chibundu N. Ezekiel, Benedikt Warth, Michael Sulyok, Paul C. Turner, Rudolf Krska, Paul F. Moundipa
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Mycotoxins are a wide range of toxic secondary metabolites of fungi that contaminate various food commodities worldwide especially in sub-Saharan Africa (SSA). Such contamination seriously compromises food safety and quality posing a serious problem for human health as well as to trade and the economy. Their concentrations depend on various factors, such as the commodity itself, climatic conditions, storage conditions, seasonal variances, and processing methods. When humans consume foods contaminated by mycotoxins, they exert toxic effects to their health through various modes of actions. Rural populations in sub-Saharan Africa, are exposed to dietary mycotoxins, but it is supposed that exposure levels and health risks associated with mycotoxins between SSA countries may vary. Dietary exposures and health risk assessment studies have been limited by lack of equipment for the proper assessment of the associated health implications on consumer populations when they eat contaminated agricultural products. As such, mycotoxin research is premature in several SSA nations with product evaluation for mycotoxin loads below/above legislative limits being inadequate. Few nations have health risk assessment reports mainly based on direct quantification of the toxins in foods ('external exposure') and linking food levels with data from food frequency questionnaires. Nonetheless, the assessment of the exposure and health risk to mycotoxins requires more than the traditional approaches. Only a fraction of the mycotoxins in contaminated foods reaches the blood stream and exert toxicity ('internal exposure'). Also, internal exposure is usually smaller than external exposure thus dependence on external exposure alone may induce confounders in risk assessment. Some studies from SSA earlier focused on biomarker analysis mainly on aflatoxins while a few recent studies have concentrated on the multi-biomarker analysis of exposures in urine providing probable associations between observed disease occurrences and dietary mycotoxins levels. As a result, new techniques that could assess the levels of exposures directly in body tissue or fluid, and possibly link them to the disease state of individuals became urgent.Keywords: mycotoxins, biomarkers, exposure assessment, health risk assessment, sub-Saharan Africa
Procedia PDF Downloads 5741062 Encoded Nanospheres for the Fast Ratiometric Detection of Cystic Fibrosis
Authors: Iván Castelló, Georgiana Stoica, Emilio Palomares, Fernando Bravo
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We present herein two colour encoded silica nanospheres (2nanoSi) for the fluorescence quantitative ratiometric determination of trypsin in humans. The system proved to be a faster (minutes) method, with two times higher sensitivity than the state-of-the-art biomarkers based sensors for cystic fibrosis (CF), allowing the quantification of trypsin concentrations in a wide range (0-350 mg/L). Furthermore, as trypsin is directly related to the development of cystic fibrosis, different human genotypes, i.e. healthy homozygotic (> 80 mg/L), CF homozygotic (< 50 mg/L), and heterozygotic (> 50 mg/L), respectively, can be determined using our 2nanoSi nanospheres.Keywords: cystic fibrosis, trypsin, quantum dots, biomarker, homozygote, heterozygote
Procedia PDF Downloads 4831061 Diagnosis of Alzheimer Diseases in Early Step Using Support Vector Machine (SVM)
Authors: Amira Ben Rabeh, Faouzi Benzarti, Hamid Amiri, Mouna Bouaziz
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Alzheimer is a disease that affects the brain. It causes degeneration of nerve cells (neurons) and in particular cells involved in memory and intellectual functions. Early diagnosis of Alzheimer Diseases (AD) raises ethical questions, since there is, at present, no cure to offer to patients and medicines from therapeutic trials appear to slow the progression of the disease as moderate, accompanying side effects sometimes severe. In this context, analysis of medical images became, for clinical applications, an essential tool because it provides effective assistance both at diagnosis therapeutic follow-up. Computer Assisted Diagnostic systems (CAD) is one of the possible solutions to efficiently manage these images. In our work; we proposed an application to detect Alzheimer’s diseases. For detecting the disease in early stage we used the three sections: frontal to extract the Hippocampus (H), Sagittal to analysis the Corpus Callosum (CC) and axial to work with the variation features of the Cortex(C). Our method of classification is based on Support Vector Machine (SVM). The proposed system yields a 90.66% accuracy in the early diagnosis of the AD.Keywords: Alzheimer Diseases (AD), Computer Assisted Diagnostic(CAD), hippocampus, Corpus Callosum (CC), cortex, Support Vector Machine (SVM)
Procedia PDF Downloads 3841060 Comparison of Receiver Operating Characteristic Curve Smoothing Methods
Authors: D. Sigirli
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The Receiver Operating Characteristic (ROC) curve is a commonly used statistical tool for evaluating the diagnostic performance of screening and diagnostic test with continuous or ordinal scale results which aims to predict the presence or absence probability of a condition, usually a disease. When the test results were measured as numeric values, sensitivity and specificity can be computed across all possible threshold values which discriminate the subjects as diseased and non-diseased. There are infinite numbers of possible decision thresholds along the continuum of the test results. The ROC curve presents the trade-off between sensitivity and the 1-specificity as the threshold changes. The empirical ROC curve which is a non-parametric estimator of the ROC curve is robust and it represents data accurately. However, especially for small sample sizes, it has a problem of variability and as it is a step function there can be different false positive rates for a true positive rate value and vice versa. Besides, the estimated ROC curve being in a jagged form, since the true ROC curve is a smooth curve, it underestimates the true ROC curve. Since the true ROC curve is assumed to be smooth, several smoothing methods have been explored to smooth a ROC curve. These include using kernel estimates, using log-concave densities, to fit parameters for the specified density function to the data with the maximum-likelihood fitting of univariate distributions or to create a probability distribution by fitting the specified distribution to the data nd using smooth versions of the empirical distribution functions. In the present paper, we aimed to propose a smooth ROC curve estimation based on the boundary corrected kernel function and to compare the performances of ROC curve smoothing methods for the diagnostic test results coming from different distributions in different sample sizes. We performed simulation study to compare the performances of different methods for different scenarios with 1000 repetitions. It is seen that the performance of the proposed method was typically better than that of the empirical ROC curve and only slightly worse compared to the binormal model when in fact the underlying samples were generated from the normal distribution.Keywords: empirical estimator, kernel function, smoothing, receiver operating characteristic curve
Procedia PDF Downloads 1521059 A Study on the Annual Doses Received by the Workers of Some Medical Practices
Authors: Eltayeb Hamad Elneel Yousif
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This paper describes occupational radiation doses of workers in non-destructive testing (NDT) and some medical practices during the year 2007. The annual doses received by the workers of a public hospital are presented in this report. The Department is facilitated with HARSHAW Reader model 6600 and assigned the rule of personal monitoring to contribute in controlling and reducing the doses received by radiation workers. TLD cards with two TLD chips type LiF: Mg, Ti (TLD-100) were calibrated to measure the personal dose equivalent Hp(10). Around 150 medical radiation workers were monitored throughout the year. Each worker received a single TLD card worn on the chest above lead apron and returned for laboratory reading every two months. The average annual doses received by the workers of radiotherapy, nuclear medicine and diagnostic radiology were evaluated. The annual doses for individual radiation workers ranged between 0.55-4.42 mSv, 0.48-1.86 mSv, and 0.48-0.91 mSv for the workers of radiotherapy, nuclear medicine and diagnostic radiology, respectively. The mean dose per worker was 1.29±1, 1.03±0.4, and 0.69±0.2 mSv, respectively. The results showed compliance with international dose limits. Our results reconfirm the importance of personal dosimetry service in assuring the radiation protection of medical staff in developing countries.Keywords: radiation medicine, non-destructive testing, TLD, public hospital
Procedia PDF Downloads 3791058 Theta-Phase Gamma-Amplitude Coupling as a Neurophysiological Marker in Neuroleptic-Naive Schizophrenia
Authors: Jun Won Kim
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Objective: Theta-phase gamma-amplitude coupling (TGC) was used as a novel evidence-based tool to reflect the dysfunctional cortico-thalamic interaction in patients with schizophrenia. However, to our best knowledge, no studies have reported the diagnostic utility of the TGC in the resting-state electroencephalographic (EEG) of neuroleptic-naive patients with schizophrenia compared to healthy controls. Thus, the purpose of this EEG study was to understand the underlying mechanisms in patients with schizophrenia by comparing the TGC at rest between two groups and to evaluate the diagnostic utility of TGC. Method: The subjects included 90 patients with schizophrenia and 90 healthy controls. All patients were diagnosed with schizophrenia according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) by two independent psychiatrists using semi-structured clinical interviews. Because patients were either drug-naïve (first episode) or had not been taking psychoactive drugs for one month before the study, we could exclude the influence of medications. Five frequency bands were defined for spectral analyses: delta (1–4 Hz), theta (4–8 Hz), slow alpha (8–10 Hz), fast alpha (10–13.5 Hz), beta (13.5–30 Hz), and gamma (30-80 Hz). The spectral power of the EEG data was calculated with fast Fourier Transformation using the 'spectrogram.m' function of the signal processing toolbox in Matlab. An analysis of covariance (ANCOVA) was performed to compare the TGC results between the groups, which were adjusted using a Bonferroni correction (P < 0.05/19 = 0.0026). Receiver operator characteristic (ROC) analysis was conducted to examine the discriminating ability of the TGC data for schizophrenia diagnosis. Results: The patients with schizophrenia showed a significant increase in the resting-state TGC at all electrodes. The delta, theta, slow alpha, fast alpha, and beta powers showed low accuracies of 62.2%, 58.4%, 56.9%, 60.9%, and 59.0%, respectively, in discriminating the patients with schizophrenia from the healthy controls. The ROC analysis performed on the TGC data generated the most accurate result among the EEG measures, displaying an overall classification accuracy of 92.5%. Conclusion: As TGC includes phase, which contains information about neuronal interactions from the EEG recording, TGC is expected to be useful for understanding the mechanisms the dysfunctional cortico-thalamic interaction in patients with schizophrenia. The resting-state TGC value was increased in the patients with schizophrenia compared to that in the healthy controls and had a higher discriminating ability than the other parameters. These findings may be related to the compensatory hyper-arousal patterns of the dysfunctional default-mode network (DMN) in schizophrenia. Further research exploring the association between TGC and medical or psychiatric conditions that may confound EEG signals will help clarify the potential utility of TGC.Keywords: quantitative electroencephalography (QEEG), theta-phase gamma-amplitude coupling (TGC), schizophrenia, diagnostic utility
Procedia PDF Downloads 1431057 A Risk Management Approach to the Diagnosis of Attention Deficit-Hyperactivity Disorder
Authors: Lloyd A. Taylor
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An increase in the prevalence of Attention Deficit-Hyperactivity Disorder (ADHD) highlights the need to consider factors that may be exacerbating symptom presentation. Traditional diagnostic criteria provide a little framework for healthcare providers to consider as they attempt to diagnose and treat children with behavioral problems. In fact, aside from exclusion criteria, limited alternative considerations are available, and approaches fail to consider the impact of outside factors that could increase or decrease the likelihood of appropriate diagnosis and success of interventions. This paper will consider specific systems-based factors that influence behavior and intervention successes that, when not considered, could account for the upsurge of diagnoses. These include understanding (1) challenges in the healthcare system, (2) the influence and impact of educators and the educational system, (3) technology use, and (4) patient and parental attitudes about the diagnosis of ADHD. These factors must be considered both individually and as a whole when considering both the increase in diagnoses and the subsequent increases in prescriptions for psychostimulant medication. A theoretical model based on a risk management approach will be presented. Finally, data will be presented that demonstrates pediatric provider satisfaction with this approach to diagnoses and treatment of ADHD as it relates to practice trends.Keywords: ADHD, diagnostic criteria, risk management model, pediatricians
Procedia PDF Downloads 941056 Geochemical Study of the Bound Hydrocarbon in the Asphaltene of Biodegraded Oils of Cambay Basin
Authors: Sayani Chatterjee, Kusum Lata Pangtey, Sarita Singh, Harvir Singh
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Biodegradation leads to a systematic alteration of the chemical and physical properties of crude oil showing sequential depletion of n-alkane, cycloalkanes, aromatic which increases its specific gravity, viscosity and the abundance of heteroatom-containing compounds. The biodegradation leads to a change in the molecular fingerprints and geochemical parameters of degraded oils, thus make source and maturity identification inconclusive or ambiguous. Asphaltene is equivalent to the most labile part of the respective kerogen and generally has high molecular weight. Its complex chemical structure with substantial microporous units makes it suitable to occlude the hydrocarbon expelled from the source. The occluded molecules are well preserved by the macromolecular structure and thus prevented from secondary alterations. They retain primary organic geochemical information over the geological time. The present study involves the extraction of this occluded hydrocarbon from the asphaltene cage through mild oxidative degradation using mild oxidative reagents like Hydrogen Peroxide (H₂O₂) and Acetic Acid (CH₃COOH) on purified asphaltene of the biodegraded oils of Mansa, Lanwa and Santhal fields in Cambay Basin. The study of these extracted occluded hydrocarbons was carried out for establishing oil to oil and oil to source correlation in the Mehsana block of Cambay Basin. The n-alkane and biomarker analysis through GC and GC-MS of these occluded hydrocarbons show similar biomarker imprint as the normal oil in the area and hence correlatable with them. The abundance of C29 steranes, presence of Oleanane, Gammacerane and 4-Methyl sterane depicts that the oils are derived from terrestrial organic matter deposited in the stratified saline water column in the marine environment with moderate maturity (VRc 0.6-0.8). The oil source correlation study suggests that the oils are derived from Jotana-Warosan Low area. The developed geochemical technique to extract the occluded hydrocarbon has effectively resolved the ambiguity that resulted from the inconclusive fingerprint of the biodegraded oil and the method can be also applied in other biodegraded oils as well.Keywords: asphaltene, biomarkers, correlation, mild oxidation, occluded hydrocarbon
Procedia PDF Downloads 1581055 Description and Evaluation of the Epidemiological Surveillance System for Meningitis in the Province of Taza Between 2016 and 2020
Authors: Bennasser Samira
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Meningitis, especially the meningococcal one, is a serious problem of public health. A system of vigilanceand surveillance is in place to allow effective actions to be taken on actual or potential health problems caused by all forms of meningitis. Objectives: 1. Describe the epidemiological surveillance system for meningitis in the province of Taza. 2. Evaluate the quality and responsiveness of the epidemiological surveillance system for meningitis in the province of Taza. 3. Propose measures to improve this system at the provincial level. Methods: This was a descriptive study with a purely quantitative approach by evaluating the quality and responsiveness of the system during 5 years between January 2016 and December 2020. We usedfor that the investigation files of meningitis cases and the provincial database of meningitis. We calculated some quality indicators of surveillance system already defined by the National Program for the Prevention and Control of Meningitis. Results: The notification is passive, the completeness of the data is quite good (94%), and the timeliness don’t exceed 71%. The quality of the data is acceptable (91% agreement). The systematic and rapid performance of lumbar punctures increases the diagnostic capabilities of the system. The local response actions are effected in 100%. Conclusion: The improvement of this surveillance system depends on strengthening the staff skills in diagnostic, reviewing surveillance tools, and encouraging judicious use of the data.Keywords: evaluation, meningitis, system, taza, morocco
Procedia PDF Downloads 1601054 Development of a Device for Detecting Fluids in the Esophagus
Authors: F. J. Puertas, M. Castro, A. Tebar, P. J. Fito, R. Gadea, J. M. Monzó, R. J. Colom
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There is a great diversity of diseases that affect the integrity of the walls of the esophagus, generally of a digestive nature. Among them, gastroesophageal reflux is a common disease in the general population, affecting the patient's quality of life; however, there are still unmet diagnostic and therapeutic issues. The consequences of untreated or asymptomatic acid reflux on the esophageal mucosa are not only pain, heartburn, and acid regurgitation but also an increased risk of esophageal cancer. Currently, the diagnostic methods to detect problems in the esophageal tract are invasive and annoying, as 24-hour impedance-pH monitoring forces the patient to be uncomfortable for hours to be able to make a correct diagnosis. In this work, the development of a sensor able to measure in depth is proposed, allowing the detection of liquids circulating in the esophageal tract. The multisensor detection system is based on radiofrequency photospectrometry. At an experimental level, consumers representative of the population in terms of sex and age have been used, placing the sensors between the trachea and the diaphragm analyzing the measurements in vacuum, water, orange juice and saline medium. The results obtained have allowed us to detect the appearance of different liquid media in the esophagus, segregating them based on their ionic content.Keywords: bioimpedance, dielectric spectroscopy, gastroesophageal reflux, GERD
Procedia PDF Downloads 1011053 Inflammatory Cytokine (Interleukin-8): A Diagnostic Marker in Leukemia
Authors: Sandeep Pandey, Nimra Habib, Ranjana Singh, Abbas Ali Mahdi
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Leukemia is a malignancy of blood that mainly affects children and young adults; while advancement in the early diagnosis will have the potential to improve the outcome of diseases. A wide range of disease including leukemia shows inflammatory signals in their pathogenesis. In a pilot study conducted in our laboratory, 52 people were screened, of which 26 had leukemia and 26 were free from any kind of malignancy. We performed the estimation of the inflammatory cytokine Interleukin-8 and it was found significantly raised in all the leukemia patients concerning healthy volunteers who participated in the study. Flow cytometry had been performed for the confirmation of leukemia and further genomic, and proteomic, analyses of the sample revealed that IL-8 levels showed a positive correlation in patients with leukemia. The results had shown constitutive secretion of interleukin-8 by leukemia cells. So, our finding demonstrated that IL-8 is considered to have a role in the pathogenesis of leukemia, and quantification of IL-8 levels in leukemia conditions might be more useful and feasible in the clinical setting for the prediction of drug responses where it may represent a putative target for innovative diagnostic toward effective therapeutic approaches. However, further research explorations in this area are needed that include a greater number of patients with all different forms of leukemia, and estimating their IL-8 levels may hold the key for the additional predictive values on the recurrence of leukemia and its prognosis.Keywords: T-ALL, IL-8, leukemia pathogenesis, cancer therapeutics
Procedia PDF Downloads 721052 Positive Psychology and the Social Emotional Ability Instrument (SEAI)
Authors: Victor William Harris
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This research is a validation study of the Social Emotional Ability Inventory (SEAI), a multi-dimensional self-report instrument informed by positive psychology, emotional intelligence, social intelligence, and sociocultural learning theory. Designed for use in tandem with the Social Emotional Development (SEAD) theoretical model, the SEAI provides diagnostic-level guidance for professionals and individuals interested in investigating, identifying, and understanding social, emotional strengths, as well as remediating specific social competency deficiencies. The SEAI was shown to be psychometrically sound, exhibited strong internal reliability, and supported the a priori hypotheses of the SEAD. Additionally, confirmatory factor analysis provided evidence of goodness of fit, convergent and divergent validity, and supported a theoretical model that reflected SEAD expectations. The SEAI and SEAD hold potentially far-reaching and important practical implications for theoretical guidance and diagnostic-level measurement of social, emotional competency across a wide range of domains. Strategies researchers, practitioners, educators, and individuals might use to deploy SEAI in order to improve quality of life outcomes are discussed.Keywords: emotion, emotional ability, positive psychology-social emotional ability, social emotional ability, social emotional ability instrument
Procedia PDF Downloads 2551051 Marzuq Basin Palaeozoic Petroleum System
Authors: M. Dieb, T. Hodairi
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In the Southwest Libya area, the Palaeozoic deposits are an important petroleum system, with Silurian shale considered a hydrocarbon source rock and Cambro-Ordovician recognized as a good reservoir. The Palaeozoic petroleum system has the greatest potential for conventional and is thought to represent the significant prospect of unconventional petroleum resources in Southwest Libya. Until now, the lateral and vertical heterogeneity of the source rock was not well evaluated, and oil-source correlation is still a matter of debate. One source rock, which is considered the main source potential in Marzuq Basin, was investigated for its uranium contents using gamma-ray logs, rock-eval pyrolysis, and organic petrography for their bulk kinetic characteristics to determine the petroleum potential qualitatively and quantitatively. Thirty source rock samples and fifteen oil samples from the Tannezzuft source rock were analyzed by Rock-Eval Pyrolysis, microscopely investigation, GC, and GC-MS to detect acyclic isoprenoids and aliphatic, aromatic, and NSO biomarkers. Geochemistry tools were applied to screen source and age-significant biomarkers to high-spot genetic relationships. A grating heterogeneity exists among source rock zones from different levels of depth with varying uranium contents according to gamma-ray logs, rock-eval pyrolysis results, and kinetic features. The uranium-rich Tannezzuft Formations (Hot Shales) produce oils and oil-to-gas hydrocarbons based on their richness, kerogen type, and thermal maturity. Biomarker results such as C₂₇, C₂₈, and C₂₉ steranes concentrations and C₂₄ tetracyclic terpane/C₂₉ tricyclic terpane ratios, with sterane and hopane ratios, are considered the most promising biomarker information in differentiating within the Silurian Shale Tannezzuft Formation and in correlating with its expelled oils. The Tannezzuft Hot Shale is considered the main source rock for oil and gas accumulations in the Cambro-Ordovician reservoirs within the Marzuq Basin. Migration of the generated and expelled oil and gas from the Tannezzuft source rock to the reservoirs of the Cambro-Ordovician petroleum system was interpreted to have occurred along vertical and lateral pathways along the faults in the Palaeozoic Strata. The Upper Tannezzuft Formation (cold shale) is considered the primary seal in the Marzuq Basin.Keywords: heterogeneity, hot shale, kerogen, Silurian, uranium
Procedia PDF Downloads 611050 Computer Aided Analysis of Breast Based Diagnostic Problems from Mammograms Using Image Processing and Deep Learning Methods
Authors: Ali Berkan Ural
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This paper presents the analysis, evaluation, and pre-diagnosis of early stage breast based diagnostic problems (breast cancer, nodulesorlumps) by Computer Aided Diagnosing (CAD) system from mammogram radiological images. According to the statistics, the time factor is crucial to discover the disease in the patient (especially in women) as possible as early and fast. In the study, a new algorithm is developed using advanced image processing and deep learning method to detect and classify the problem at earlystagewithmoreaccuracy. This system first works with image processing methods (Image acquisition, Noiseremoval, Region Growing Segmentation, Morphological Operations, Breast BorderExtraction, Advanced Segmentation, ObtainingRegion Of Interests (ROIs), etc.) and segments the area of interest of the breast and then analyzes these partly obtained area for cancer detection/lumps in order to diagnosis the disease. After segmentation, with using the Spectrogramimages, 5 different deep learning based methods (specified Convolutional Neural Network (CNN) basedAlexNet, ResNet50, VGG16, DenseNet, Xception) are applied to classify the breast based problems.Keywords: computer aided diagnosis, breast cancer, region growing, segmentation, deep learning
Procedia PDF Downloads 951049 Capacity Building of Extension Agents for Sustainable Dissemination of Agricultural Information and Technologies in Developing Countries
Authors: Michael T. Ajayi, Oluwakemi E. Fapojuwo
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Farmers are in need of regular and relevant information relating to new technologies. Production of extension materials has been found to be useful in facilitating the process. Extension materials help to provide information to reach large numbers of farmers quickly and economically. However, as good as extension materials are, previous materials produced are not used by farmers. The reasons for this include lack of involvement of farmers in the production of the extension materials, most of the extension materials are not relevant to the farmers’ environments, the agricultural extension agents lack capacity to prepare the materials, and many extension agents lack commitment. These problems led to this innovative capacity building of extension agents. This innovative approach involves five stages. The first stage is the diagnostic survey of farmers’ environment to collect useful information. The second stage is the development and production of draft extension materials. The third stage is the field testing and evaluation of draft materials by the same farmers that were involved at the diagnostic stage. The fourth stage is the revision of the draft extension materials by incorporating suggestions from farmers. The fifth stage is the action plans. This process improves the capacity of agricultural extension agents in the preparation of extension materials and also promotes engagement of farmers and beneficiaries in the process. The process also makes farmers assume some level of ownership of the exercise and the extension materials.Keywords: capacity building, extension agents, dissemination, information/technologies
Procedia PDF Downloads 3601048 Management of Acute Appendicitis with Preference on Delayed Primary Suturing of Surgical Incision
Authors: N. A. D. P. Niwunhella, W. G. R. C. K. Sirisena
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Appendicitis is one of the most encountered abdominal emergencies worldwide. Proper clinical diagnosis and appendicectomy with minimal post operative complications are therefore priorities. Aim of this study was to ascertain the overall management of acute appendicitis in Sri Lanka in special preference to delayed primary suturing of the surgical site, comparing other local and international treatment outcomes. Data were collected prospectively from 155 patients who underwent appendicectomy following clinical and radiological diagnosis with ultrasonography. Histological assessment was done for all the specimens. All perforated appendices were managed with delayed primary closure. Patients were followed up for 28 days to assess complications. Mean age of patient presentation was 27 years; mean pre-operative waiting time following admission was 24 hours; average hospital stay was 72 hours; accuracy of clinical diagnosis of appendicitis as confirmed by histology was 87.1%; post operative wound infection rate was 8.3%, and among them 5% had perforated appendices; 4 patients had post operative complications managed without re-opening. There was no fistula formation or mortality reported. Current study was compared with previously published data: a comparison on management of acute appendicitis in Sri Lanka vs. United Kingdom (UK). The diagnosis of current study was equally accurate, but post operative complications were significantly reduced - (current study-9.6%, compared Sri Lankan study-16.4%; compared UK study-14.1%). During the recent years, there has been an exponential rise in the use of Computerised Tomography (CT) imaging in the assessment of patients with acute appendicitis. Even though, the diagnostic accuracy without using CT, and treatment outcome of acute appendicitis in this study match other local studies as well as with data compared to UK. Therefore CT usage has not increased the diagnostic accuracy of acute appendicitis significantly. Especially, delayed primary closure may have reduced post operative wound infection rate for ruptured appendices, therefore suggest this approach for further evaluation as a safer and an effective practice in other hospitals worldwide as well.Keywords: acute appendicitis, computerised tomography, diagnostic accuracy, delayed primary closure
Procedia PDF Downloads 1661047 Comparison of the Effectiveness of Neisseria gonorrhea Crude Protein Injections with Intravenous, Intracutaneous, and Subcutaneous
Authors: Annisa Amalina, Lintang Sekar Sari, Khairunnisa Salsabila, Astya Gema Ramadhan, M. Fatkhi, Andani Eka Putra
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Gonorrhea is one of the sexually transmitted diseases by genito-genital, oro-genital and anogenital. Gonorrhea disease will cause complications if not treated properly. The diagnostic tool that has been used nowadays is microscopic. Thus a rapid diagnostic tool for gonorrhea is required, using polyclonal antibodies. The purpose of this study was to determine the effectiveness of injections of intravenous, subcutaneous and intracutaneous crude protein gonorrhea. The research method used in this research is experimental explorative. This research was conducted in Molecular Microbiology Laboratory of Faculty of Medicine, Andalas University for 3 months from April to June 2017. This study used 3 groups of rabbit with intravenous, subcutaneous, and intracutaneous injections. Each group was treated on days 1, 7, 21, and 28 with crude protein injection. After that, the examination of antibody levels held by using ELISA, followed by the antibody comparative tests contained in all three groups. The results examined by One Way ANOVA test on SPSS 21 and showed that there is no significant difference between intravenous, subcutaneous, and intracutaneous use p=0.69 (p < 0.05). However, there is an increased level (0.047 to 1.171) in antibodies from day 1 to day 14. In addition, subcutaneous use is preferred because it has minimal side effects compared to intravenous and intracutaneous use.Keywords: crude protein, Neisseria gonorrhea, polyclonal antibodies, subcutaneous
Procedia PDF Downloads 160