Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 719

World Academy of Science, Engineering and Technology

[Biomedical and Biological Engineering]

Online ISSN : 1307-6892

719 An Auxiliary Technique for Coronary Heart Disease Prediction by Analyzing ECG Based on ResNet and Bi-LSTM

Authors: Yang Zhang, Jian He

Abstract:

Heart disease is one of the leading causes of death in the world, and coronary heart disease (CHD) is one of the major heart diseases. Electrocardiogram (ECG) is widely used in the detection of heart diseases, but the traditional manual method for CHD prediction by analyzing ECG requires lots of professional knowledge for doctors. This paper presents sliding window and continuous wavelet transform (CWT) to transform ECG signals into images, and then ResNet and Bi-LSTM are introduced to build the ECG feature extraction network (namely ECGNet). At last, an auxiliary system for CHD prediction was developed based on modified ResNet18 and Bi-LSTM, and the public ECG dataset of CHD from MIMIC-3 was used to train and test the system. The experimental results show that the accuracy of the method is 83%, and the F1-score is 83%. Compared with the available methods for CHD prediction based on ECG, such as kNN, decision tree, VGGNet, etc., this method not only improves the prediction accuracy but also could avoid the degradation phenomenon of the deep learning network.

Keywords: Bi-LSTM, CHD, coronary heart disease, ECG, electrocardiogram, ResNet, sliding window.

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718 ECG-Based Heartbeat Classification Using Convolutional Neural Networks

Authors: Jacqueline R. T. Alipo-on, Francesca I. F. Escobar, Myles J. T. Tan, Hezerul Abdul Karim, Nouar AlDahoul

Abstract:

Electrocardiogram (ECG) signal analysis and processing are crucial in the diagnosis of cardiovascular diseases which are considered as one of the leading causes of mortality worldwide. However, the traditional rule-based analysis of large volumes of ECG data is time-consuming, labor-intensive, and prone to human errors. With the advancement of the programming paradigm, algorithms such as machine learning have been increasingly used to perform an analysis on the ECG signals. In this paper, various deep learning algorithms were adapted to classify five classes of heart beat types. The dataset used in this work is the synthetic MIT-Beth Israel Hospital (MIT-BIH) Arrhythmia dataset produced from generative adversarial networks (GANs). Various deep learning models such as ResNet-50 convolutional neural network (CNN), 1-D CNN, and long short-term memory (LSTM) were evaluated and compared. ResNet-50 was found to outperform other models in terms of recall and F1 score using a five-fold average score of 98.88% and 98.87%, respectively. 1-D CNN, on the other hand, was found to have the highest average precision of 98.93%.

Keywords: Heartbeat classification, convolutional neural network, electrocardiogram signals, ECG signals, generative adversarial networks, long short-term memory, LSTM, ResNet-50.

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717 An Assessment of the Hip Muscular Imbalance for Patients with Rheumatism

Authors: Anthony Bawa, Konstantinos Banitsas

Abstract:

Rheumatism is a muscular disorder that affects the muscles of the upper and lower limbs. This condition could potentially progress to impair the movement of patients. This study aims to investigate the hip muscular imbalance in patients with chronic rheumatism. A clinical trial involving a total of 15 participants, made up of 10 patients and five control subjects, took place in KATH Hospital between August and September. Participants recruited for the study were of age 54 ± 8 years, weight 65 ± 8 kg, and height 176 ± 8 cm. Muscle signals were recorded from the rectus femoris, and vastus lateralis on the right and left hip of participants. The parameters used in determining the hip muscular imbalances were the maximum voluntary contraction (MVC%), the mean difference, and hip muscle fatigue levels. The mean signals were compared using a t-test, and the metrics for muscle fatigue assessment were based on the root mean square (RMS), mean absolute value (MAV) and mean frequency (MEF), which were computed between the hip muscles of participants. The results indicated that there were significant imbalances in the muscle coactivity between the right and left hip muscles of patients. The patients’ MVC values were observed to be above 10% when compared with control subjects. Furthermore, the mean difference was seen to be higher with p > 0.002 among patients, which indicated clear differences in the hip muscle contraction activities. The findings indicate significant hip muscular imbalances for patients with rheumatism compared with control subjects. Information about the imbalances among patients will be useful for clinicians in designing therapeutic muscle-strengthening exercises.

Keywords: Muscular, imbalances, rheumatism, hip.

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716 Using Speech Emotion Recognition as a Longitudinal Biomarker for Alzheimer’s Disease

Authors: Yishu Gong, Liangliang Yang, Jianyu Zhang, Zhengyu Chen, Sihong He, Xusheng Zhang, Wei Zhang

Abstract:

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that affects millions of people worldwide and is characterized by cognitive decline and behavioral changes. People living with Alzheimer’s disease often find it hard to complete routine tasks. However, there are limited objective assessments that aim to quantify the difficulty of certain tasks for AD patients compared to non-AD people. In this study, we propose to use speech emotion recognition (SER), especially the frustration level as a potential biomarker for quantifying the difficulty patients experience when describing a picture. We build an SER model using data from the IEMOCAP dataset and apply the model to the DementiaBank data to detect the AD/non-AD group difference and perform longitudinal analysis to track the AD disease progression. Our results show that the frustration level detected from the SER model can possibly be used as a cost-effective tool for objective tracking of AD progression in addition to the Mini-Mental State Examination (MMSE) score.

Keywords: Alzheimer’s disease, Speech Emotion Recognition, longitudinal biomarker, machine learning.

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715 Development of a Miniature and Low-Cost IoT-Based Remote Health Monitoring Device

Authors: Sreejith Jayachandran, Mojtaba Ghodsi, Morteza Mohammadzaheri

Abstract:

The modern busy world is running behind new embedded technologies based on computers and software meanwhile some people are unable to monitor their health condition and regular medical check-ups. Some of them postpone medical check-ups due to a lack of time and convenience while others skip these regular evaluations and medical examinations due to huge medical bills and hospital expenses. In this research, we present a device in the telemonitoring system capable of monitoring, checking, and evaluating the health status of the human body remotely through the internet for the needs of all kinds of people. The remote health monitoring device is a microcontroller-based embedded unit. The various types of sensors in this device are connected to the human body, and with the help of an Arduino UNO board, the required analogue data are collected from the sensors. The microcontroller on the Arduino board processes the analogue data collected in this way into digital data and transfers that information to the cloud and stores it there; the processed digital data are then instantly displayed through the LCD attached to the machine. By accessing the cloud storage with a username and password, the concerned person’s health care teams/doctors, and other health staff can collect these data for the assessment and follow-up of that patient. Besides that, the family members/guardians can use and evaluate these data for awareness of the patient's current health status. Moreover, the system is connected to a GPS module. In emergencies, the concerned team can be positioning the patient or the person with this device. The setup continuously evaluates and transfers the data to the cloud and also the user can prefix a normal value range for the evaluation. For example, the blood pressure normal value is universally prefixed between 80/120 mmHg. Similarly, the Remote Health Monitoring System (RHMS) is also allowed to fix the range of values referred to as normal coefficients. This IoT-based miniature system 11×10×10 cm3 with a low weight of 500 gr only consumes 10 mW. This smart monitoring system is manufactured for 100 GBP (British Pound Sterling), and can facilitate the communication between patients and health systems, but also it can be employed for numerous other uses including communication sectors in the aerospace and transportation systems.

Keywords: Embedded Technology, Telemonitoring system, Microcontroller, Arduino UNO, Cloud storage, GPS, RHMS, Remote Health Monitoring System, Alert system.

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714 Robust Heart Sounds Segmentation Based on the Variation of the Phonocardiogram Curve Length

Authors: Mecheri Zeid Belmecheri, Maamar Ahfir, Izzet Kale

Abstract:

Automatic cardiac auscultation is still a subject of research in order to establish an objective diagnosis. Recorded heart sounds as Phonocardiogram (PCG) signals can be used for automatic segmentation into components that have clinical meanings. These are the first sound, S1, the second sound, S2, and the systolic and diastolic components, respectively. In this paper, an automatic method is proposed for the robust segmentation of heart sounds. This method is based on calculating an intermediate sawtooth-shaped signal from the length variation of the recorded PCG signal in the time domain and, using its positive derivative function that is a binary signal in training a Recurrent Neural Network (RNN). Results obtained in the context of a large database of recorded PCGs with their simultaneously recorded Electrocardiograms (ECGs) from different patients in clinical settings, including normal and abnormal subjects, show on average a segmentation testing performance average of 76% sensitivity and 94% specificity.

Keywords: Heart sounds, PCG segmentation, event detection, Recurrent Neural Networks, PCG curve length.

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713 Heterogenous Dimensional Super Resolution of 3D CT Scans Using Transformers

Authors: Helen Zhang

Abstract:

Accurate segmentation of the airways from CT scans is crucial for early diagnosis of lung cancer. However, the existing airway segmentation algorithms often rely on thin-slice CT scans, which can be inconvenient and costly. This paper presents a set of machine learning-based 3D super-resolution algorithms along heterogenous dimensions to improve the resolution of thicker CT scans to reduce the reliance on thin-slice scans. To evaluate the efficacy of the super-resolution algorithms, quantitative assessments using PSNR (Peak Signal to Noise Ratio) and SSIM (Structural SIMilarity index) were performed. The impact of super-resolution on airway segmentation accuracy is also studied. The proposed approach has the potential to make airway segmentation more accessible and affordable, thereby facilitating early diagnosis and treatment of lung cancer.

Keywords: 3D super-resolution, airway segmentation, thin-slice CT scans, machine learning.

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712 Resting-State Functional Connectivity Analysis Using an Independent Component Approach

Authors: Eric Jacob Bacon, Chaoyang Jin, Dianning He, Shuaishuai Hu, Lanbo Wang, Han Li, Shouliang Qi

Abstract:

Refractory epilepsy is a complicated type of epilepsy that can be difficult to diagnose. Recent technological advancements have made resting-state functional magnetic resonance (rsfMRI) a vital technique for studying brain activity. However, there is still much to learn about rsfMRI. Investigating rsfMRI connectivity may aid in the detection of abnormal activities. In this paper, we propose studying the functional connectivity of rsfMRI candidates to diagnose epilepsy. 45 rsfMRI candidates, comprising 26 with refractory epilepsy and 19 healthy controls, were enrolled in this study. A data-driven approach known as Independent Component Analysis (ICA) was used to achieve our goal. First, rsfMRI data from both patients and healthy controls were analyzed using group ICA. The components that were obtained were then spatially sorted to find and select meaningful ones. A two-sample t-test was also used to identify abnormal networks in patients and healthy controls. Finally, based on the fractional amplitude of low-frequency fluctuations (fALFF), a chi-square statistic test was used to distinguish the network properties of the patient and healthy control groups. The two-sample t-test analysis yielded abnormal in the default mode network, including the left superior temporal lobe and the left supramarginal. The right precuneus was found to be abnormal in the dorsal attention network. In addition, the frontal cortex showed an abnormal cluster in the medial temporal gyrus. In contrast, the temporal cortex showed an abnormal cluster in the right middle temporal gyrus and the right fronto-operculum gyrus. Finally, the chi-square statistic test was significant, producing a p-value of 0.001 for the analysis. This study offers evidence that investigating rsfMRI connectivity provides an excellent diagnosis option for refractory epilepsy.

Keywords: Independent Component Analysis, Resting State Network, refractory epilepsy, rsfMRI.

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711 Basic Study of Mammographic Image Magnification System with Eye-Detector and Simple EEG Scanner

Authors: A. Umemuro, M. Sato, M. Narita, S. Hori, S. Sakurai, T. Nakayama, A. Nakazawa, T. Ogura

Abstract:

Mammography requires the detection of very small calcifications, and physicians search for microcalcifications by magnifying the images as they read them. The mouse is necessary to zoom in on the images, but this can be tiring and distracting when many images are read in a single day. Therefore, an image magnification system combining an eye-detector and a simple electroencephalograph (EEG) scanner was devised, and its operability was evaluated. Two experiments were conducted in this study: the measurement of eye-detection error using an eye-detector and the measurement of the time required for image magnification using a simple EEG scanner. Eye-detector validation showed that the mean distance of eye-detection error ranged from 0.64 cm to 2.17 cm, with an overall mean of 1.24 ± 0.81 cm for the observers. The results showed that the eye detection error was small enough for the magnified area of the mammographic image. The average time required for point magnification in the verification of the simple EEG scanner ranged from 5.85 to 16.73 seconds, and individual differences were observed. The reason for this may be that the size of the simple EEG scanner used was not adjustable, so it did not fit well for some subjects. The use of a simple EEG scanner with size adjustment would solve this problem. Therefore, the image magnification system using the eye-detector and the simple EEG scanner is useful.

Keywords: EEG scanner, eye-detector, mammography, observers.

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710 Arginase Enzyme Activity in Human Serum as a Marker of Cognitive Function: The Role of Inositol in Combination with Arginine Silicate

Authors: Katie Emerson, Sara Perez-Ojalvo, Jim Komorowski, Danielle Greenberg

Abstract:

The purpose of this study was to evaluate arginase activity levels in response to combinations of an inositol-stabilized arginine silicate (ASI; Nitrosigine®), L-arginine, and Inositol. Arginine acts as a vasodilator that promotes increased blood flow resulting in enhanced delivery of oxygen and nutrients to the brain and other tissues. Arginase, found in human serum, catalyzes the conversion of arginine to ornithine and urea, completing the last step in the urea cycle. Decreasing arginase levels maintains arginine and results in increased nitric oxide production. This study aimed to determine the most effective combination of ASI, L-arginine and inositol for minimizing arginase levels and therefore maximize ASI’s effect on cognition. Serum was taken from untreated healthy donors by separation from clotted factors. Arginase activity of serum in the presence or absence of test products was determined (QuantiChrom™, DARG-100, Bioassay Systems, Hayward CA). The remaining ultra-filtrated serum units were harvested and used as the source for the arginase enzyme. ASI alone or combined with varied levels of Inositol were tested as follows: ASI + inositol at 0.25 g, 0.5 g, 0.75 g, or 1.00 g. L-arginine was also tested as a positive control. All tests elicited changes in arginase activity demonstrating the efficacy of the method used. Adding L-arginine to serum from untreated subjects, with or without inositol only had a mild effect. Adding inositol at all levels reduced arginase activity. Adding 0.5 g to the standardized amount of ASI led to the lowest amount of arginase activity as compared to the 0.25 g, 0.75 g or 1.00g doses of inositol or to L-arginine alone. The outcome of this study demonstrates an interaction of the pairing of inositol with ASI on the activity of the enzyme arginase. We found that neither the maximum nor minimum amount of inositol tested in this study led to maximal arginase inhibition. Since the inhibition of arginase activity is desirable for product formulations looking to maintain arginine levels, the most effective amount of inositol was deemed preferred. Subsequent studies suggest this moderate level of inositol in combination with ASI leads to cognitive improvements including reaction time, executive function, and concentration.

Keywords: Arginine, blood flow, colorimetry, urea cycle.

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709 Optimal Rest Interval between Sets in Robot-Based Upper-Arm Rehabilitation

Authors: Virgil Miranda, Gissele Mosqueda, Pablo Delgado, Yimesker Yihun

Abstract:

Muscular fatigue affects the muscle activation that is needed for producing the desired clinical outcome. Integrating optimal muscle relaxation periods into a variety of health care rehabilitation protocols is important to maximize the efficiency of the therapy. In this study, four muscle relaxation periods (30, 60, 90 and 120 seconds) and their effectiveness in producing consistent muscle activation of the muscle biceps brachii between sets of an elbow flexion and extension task were investigated among a sample of 10 subjects with no disabilities. The same resting periods were then utilized in a controlled exoskeleton-based exercise for a sample size of 5 subjects and have shown similar results. On average, the muscle activity of the biceps brachii decreased by 0.3% when rested for 30 seconds, and it increased by 1.25%, 0.76% and 0.82% when using muscle relaxation periods of 60, 90 and 120 seconds, respectively. The preliminary results suggest that a muscle relaxation period of about 60 seconds is needed for optimal continuous muscle activation within rehabilitation regimens. Robot-based rehabilitation is good to produce repetitive tasks with the right intensity and knowing the optimal resting period will make the automation more effective.

Keywords: Rest intervals, muscle biceps brachii, robot rehabilitation, muscle fatigue.

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708 Optical Verification of an Ophthalmological Examination Apparatus Employing the Electroretinogram Function on Fundus-Related Perimetry

Authors: Naoto Suzuki

Abstract:

Japanese are affected by the most common causes of eyesight loss such as glaucoma, diabetic retinopathy, pigmentary retinal degeneration, and age-related macular degeneration. We developed an ophthalmological examination apparatus with a fundus camera, precisely fundus-related perimetry (microperimetry), and electroretinogram (ERG) functions to diagnose a variety of diseases that cause eyesight loss. The experimental apparatus was constructed with the same optical system as a fundus camera. The microperimetry optical system was calculated and added to the experimental apparatus using the German company Optenso's optical engineering software (OpTaliX-LT 10.8). We also added an Edmund infrared camera (EO-0413), a lens with a 25 mm focal length, a 45° cold mirror, a 12 V/50 W halogen lamp, and an 8-inch monitor. We made the artificial eye of a plane-convex lens, a black spacer, and a hemispherical cup. The hemispherical cup had a small section of the paper at the bottom. The artificial eye was photographed five times using the experimental apparatus. The software was created to display the examination target on the monitor and save examination data using C++Builder 10.2. The retinal fundus was displayed on the monitor at a length and width of 1 mm and a resolution of 70.4 ± 4.1 and 74.7 ± 6.8 pixels, respectively. The microperimetry and ERG functions were successfully added to the experimental ophthalmological apparatus. A moving machine was developed to measure the artificial eye's movement. The artificial eye's rear part was painted black and white in the central area. It was rotated 10 degrees from one side to the other. The movement was captured five times as motion videos. Three static images were extracted from one of the motion videos captured. The images display the artificial eye facing the center, right, and left directions. The three images were processed using Scilab 6.1.0 and Image Processing and Computer Vision Toolbox 4.1.2, including trimming, binarization, making a window, deleting peripheral area, and morphological operations. To calculate the artificial eye's fundus center, we added a gravity method to the program to calculate the gravity position of connected components. From the three images, the image processing could calculate the center position.

Keywords: Ophthalmological examination apparatus, microperimetry, electroretinogram, eye movement.

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707 Remote Vital Signs Monitoring in Neonatal Intensive Care Unit Using a Digital Camera

Authors: Fatema-Tuz-Zohra Khanam, Ali Al-Naji, Asanka G. Perera, Kim Gibson, Javaan Chahl

Abstract:

Conventional contact-based vital signs monitoring sensors such as pulse oximeters or electrocardiogram (ECG) may cause discomfort, skin damage, and infections, particularly in neonates with fragile, sensitive skin. Therefore, remote monitoring of the vital sign is desired in both clinical and non-clinical settings to overcome these issues. Camera-based vital signs monitoring is a recent technology for these applications with many positive attributes. However, there are still limited camera-based studies on neonates in a clinical setting. In this study, the heart rate (HR) and respiratory rate (RR) of eight infants at the Neonatal Intensive Care Unit (NICU) in Flinders Medical Centre were remotely monitored using a digital camera applying color and motion-based computational methods. The region-of-interest (ROI) was efficiently selected by incorporating an image decomposition method. Furthermore, spatial averaging, spectral analysis, band-pass filtering, and peak detection were also used to extract both HR and RR. The experimental results were validated with the ground truth data obtained from an ECG monitor and showed a strong correlation using the Pearson correlation coefficient (PCC) 0.9794 and 0.9412 for HR and RR, respectively. The root mean square errors (RMSE) between camera-based data and ECG data for HR and RR were 2.84 beats/min and 2.91 breaths/min, respectively. A Bland Altman analysis of the data also showed a close correlation between both data sets with a mean bias of 0.60 beats/min and 1 breath/min, and the lower and upper limit of agreement -4.9 to + 6.1 beats/min and -4.4 to +6.4 breaths/min for both HR and RR, respectively. Therefore, video camera imaging may replace conventional contact-based monitoring in NICU and has potential applications in other contexts such as home health monitoring.

Keywords: Neonates, NICU, digital camera, heart rate, respiratory rate, image decomposition.

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706 ECG Based Reliable User Identification Using Deep Learning

Authors: R. N. Begum, Ambalika Sharma, G. K. Singh

Abstract:

Identity theft has serious ramifications beyond data and personal information loss. This necessitates the implementation of robust and efficient user identification systems. Therefore, automatic biometric recognition systems are the need of the hour, and electrocardiogram (ECG)-based systems are unquestionably the best choice due to their appealing inherent characteristics. The Convolutional Neural Networks (CNNs) are the recent state-of-the-art techniques for ECG-based user identification systems. However, the results obtained are significantly below standards, and the situation worsens as the number of users and types of heartbeats in the dataset grows. As a result, this study proposes a highly accurate and resilient ECG-based person identification system using CNN's dense learning framework. The proposed research explores explicitly the caliber of dense CNNs in the field of ECG-based human recognition. The study tests four different configurations of dense CNN which are trained on a dataset of recordings collected from eight popular ECG databases. With the highest False Acceptance Rate (FAR)  of 0.04% and the highest False Rejection Rate (FRR)  of 5%, the best performing network achieved an identification accuracy of 99.94%. The best network is also tested with various train/test split ratios. The findings show that DenseNets are not only extremely reliable, but also highly efficient. Thus, they might also be implemented in real-time ECG-based human recognition systems.

Keywords: Biometrics, dense networks, identification rate, train/test split ratio.

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705 Technical Aspects of Closing the Loop in Depth-of-Anesthesia Control

Authors: Gorazd Karer

Abstract:

When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents is one of the main tasks of the anesthesiologist. That being said, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. This paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a User-Datagram-Protocol-based (UDP-based) communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of medical-device manufacturer and is implemented in MATLAB-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: Closed-loop control, Depth of Anesthesia, DoA, optical signal acquisition, Patient State index, PSi, UDP communication protocol.

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704 Finite Element Analysis of Different Architectures for Bone Scaffold

Authors: Nimisha R. Shirbhate, Sanjay Bokade

Abstract:

Bone Scaffolds are fundamental architecture or a support structure that allows the regeneration of lost or damaged tissues and they are developed as a crucial tool in biomedical engineering. The structure of bone scaffolds plays an important role in treating bone defects. The shape of the bone scaffold performs a vital role, specifically pore size and shape, which help understand the behavior and strength of the scaffold. In this article, first, fundamental aspects of bone scaffold design are established. Second, the behavior of each architecture of the bone scaffold with biomaterials is discussed. Finally, for each structure, the stress analysis was carried out. This study aimed to design a porous and mechanically strong bone regeneration scaffold that can be successfully manufactured. Four porous architectures of the bone scaffold were designed using Rhinoceros solid modelling software. The structure model consisted of repeatable unit cells arranged in layers to fill the chosen scaffold volume. The mechanical behavior of used biocompatible material is studied with the help of ANSYS 19.2 software. It is also playing significant role to predict the strength of defined structures or 3 dimensional models.

Keywords: Bone scaffold, stress analysis, porous structure, static loading.

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703 Virtual Reality for PostCOVID-19 Stroke: A Case Report

Authors: Kasra Afsahi, Maryam Soheilifar, Noureddin Nakhostin Ansari

Abstract:

COVID-19 has been associated with stroke and neurological complications. The patient was a 59-year-old male presented with sudden left hemiparesis and diplopia due to cavernous sinus thrombosis (CST) on 28/03/2020. The COVID-19 test was positive. Multislice computerized tomography (MSCT) showed ischemic infarction. He underwent surgical sinectomy 9 days after admission. Physiotherapy began for him on August 2020. Our game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and function for stroke. After 6 weeks of VR therapy plus conventional physiotherapy exercises (18 sessions, three times per week, 60 minutes each session), there were significant improvements in Brunnstrom Motor Recovery Stage (from “4” to “5”), Fugl-Meyer Scale score of upper extremity section (from 49 to 54), and Modified Barthel Index (from 15 to 18). There were no adverse effects. This case with stroke post COVID-19 due to the CST showed the usefulness of VR therapy used as an adjunct to conventional physiotherapy in improving affected upper extremity.

Keywords: COVID-19, stroke, virtual reality, rehabilitation.

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702 Effects of Virtual Reality on the Upper Extremity Spasticity and Motor Function in Patients with Stroke: A Single Blinded Randomized Controlled Trial

Authors: K. Afsahi, M. Soheilifar, S. H. Hosseini, O. S. Esmaeili, R. Kezemi, N. Mehrbod, N. Vahed, T. Hajiahmad, N. N. Ansari

Abstract:

Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of virtual reality (VR) beside conventional rehabilitation versus conventional rehabilitation alone on the spasticity and motor function in stroke patients. Materials and methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were Modified Ashworth scale, Recovery Stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in combination group (P = 0.003). Only wrist extension was varied between groups and was better in combination group. The variables generally had statistically significant difference (P < 0.05). Conclusion: VR plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: Stroke, virtual therapy, efficacy, rehabilitation.

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701 Static Balance in the Elderly: Comparison between Elderly Performing Physical Activity and Fine Motor Coordination Activity

Authors: Andreia Guimarães Farnese, Mateus Fernandes Réu Urban, Leandro Procópio, Renato Zângaro, Regiane Albertini

Abstract:

Senescence changes include postural balance, inferring the risk of falls, and can lead to fractures, bedridden, and the risk of death. Physical activity, e.g., cardiovascular exercises, is notable for improving balance due to brain cell stimulations, but fine coordination exercises also elevate cell brain metabolism. This study aimed to verify whether the elderly person who performs fine motor activity has a balance similar to that of those who practice physical activity. The subjects were divided into three groups according to the activity practice: control group (CG) with seven participants for the sedentary individuals, motor coordination group (MCG) with six participants, and physical activity group (PAG) with eight participants. Data comparisons were from the Berg balance scale, Time up and Go test, and stabilometric analysis. Descriptive statistical and ANOVA analyses were performed for data analysis. The results reveal that including fine motor activities can improve the balance of the elderly and indirectly decrease the risk of falls.

Keywords: Balance, barapodometer, coordination, elderly.

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700 A Modern Review of the Non-Invasive Continuous Blood Glucose Measuring Devices and Techniques for Remote Patient Monitoring System

Authors: Muhibul Haque Bhuyan

Abstract:

Diabetes disease that arises from the higher glucose level due to insulin shortage or insulin opposition in the human body has become a common disease in the world. No medicine can cure it completely. However, by taking medicine, maintaining diets, and having exercises regularly, a diabetes patient can keep his glucose level within the specified limits and in this way, he/she can lead a normal life like a healthy person. But to control glucose levels, a patient needs to monitor them regularly. Various techniques are being used over the last four decades. This modern review article aims to provide a comparative study report on various blood glucose monitoring techniques in a very concise and organized manner. The review mainly emphasizes working principles, cost, technology, sensors, measurement types, measurement accuracy, advantages, and disadvantages, etc. of various techniques and then compares among each other. Besides, the use of algorithms and simulators for the growth of this technology is also presented. Finally, current research trends of this measurement technology have also been discussed.

Keywords: blood glucose measurement, sensors, measurement devices, invasive and non-invasive techniques

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699 Review and Evaluation of Trending Canonical Correlation Analyses-Based Brain-Computer Interface Methods

Authors: Bayar Shahab

Abstract:

The fast development of technology that has advanced neuroscience and human interaction with computers has enabled solutions to various problems and issues of this new era. The Brain-Computer Interface (BCI) has opened the door to several new research areas and have been able to provide solutions to critical and vital issues such as supporting a paralyzed patient to interact with the outside world, controlling a robot arm, playing games in VR with the brain, driving a wheelchair. This review presents the state-of-the-art methods and improvements of canonical correlation analyses (CCA), an SSVEP-based BCI method. These are the methods used to extract EEG signal features or, to be said differently, the features of interest that we are looking for in the EEG analyses. Each of the methods from oldest to newest has been discussed while comparing their advantages and disadvantages. This would create a great context and help researchers understand the most state-of-the-art methods available in this field, their pros and cons, and their mathematical representations and usage. This work makes a vital contribution to the existing field of study. It differs from other similar recently published works by providing the following: (1) stating most of the main methods used in this field in a hierarchical way, (2) explaining the pros and cons of each method and their performance, (3) presenting the gaps that exist at the end of each method that can improve the understanding and open doors to new researches or improvements. 

Keywords: BCI, CCA, SSVEP, EEG

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698 Thermosensitive Hydrogel Development for Its Possible Application in Cardiac Cell Therapy

Authors: Lina Paola Orozco-Marín, Yuliet Montoya, John Bustamante

Abstract:

Ischemic events can culminate in acute myocardial infarction with irreversible cardiac lesions that cannot be restored due to the limited regenerative capacity of the heart. Tissue engineering proposes therapeutic alternatives by using biomaterials to resemble the native extracellular medium combined with healthy and functional cells. This research focused on developing a natural thermosensitive hydrogel, its physical-chemical characterization and in vitro biocompatibility determination. Hydrogels’ morphological characterization was carried out through scanning electron microscopy and its chemical characterization by employing Infrared Spectroscopy technic. In addition, the biocompatibility was determined using fetal human ventricular cardiomyocytes cell line RL-14 and the MTT cytotoxicity test according to the ISO 10993-5 standard. Four biocompatible and thermosensitive hydrogels were obtained with a three-dimensional internal structure and two gelation times. The results show the potential of the hydrogel to increase the cell survival rate to the cardiac cell therapies under investigation and lay the foundations to continue with its characterization and biological evaluation both in vitro and in vivo models.

Keywords: cardiac cell therapy, cardiac ischemia, natural polymers, thermosensitive hydrogel

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697 Development of Electrospun Membranes with Defined Polyethylene Collagen and Oxide Architectures Reinforced with Medium and High Intensity Statins

Authors: S. Jaramillo, Y. Montoya, W. Agudelo, J. Bustamante

Abstract:

Cardiovascular diseases (CVD) are related to affectations of the heart and blood vessels, within these are pathologies such as coronary or peripheral heart disease, caused by the narrowing of the vessel wall (atherosclerosis), which is related to the accumulation of Low-Density Lipoproteins (LDL) in the arterial walls that leads to a progressive reduction of the lumen of the vessel and alterations in blood perfusion. Currently, the main therapeutic strategy for this type of alteration is drug treatment with statins, which inhibit the enzyme 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase), responsible for modulating the rate of cholesterol production and other isoprenoids in the mevalonate pathway. This enzyme induces the expression of LDL receptors in the liver, increasing their number on the surface of liver cells, reducing the plasma concentration of cholesterol. On the other hand, when the blood vessel presents stenosis, a surgical procedure with vascular implants is indicated, which are used to restore circulation in the arterial or venous bed. Among the materials used for the development of vascular implants are Dacron® and Teflon®, which perform the function of re-waterproofing the circulatory circuit, but due to their low biocompatibility, they do not have the ability to promote remodeling and tissue regeneration processes. Based on this, the present research proposes the development of a hydrolyzed collagen and polyethylene oxide electrospun membrane reinforced with medium and high-intensity statins, so that in future research it can favor tissue remodeling processes from its microarchitecture.

Keywords: atherosclerosis, medium and high-intensity statins, microarchitecture, electrospun membrane

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696 Gait Biometric for Person Re-Identification

Authors: Lavanya Srinivasan

Abstract:

Biometric identification is to identify unique features in a person like fingerprints, iris, ear, and voice recognition that need the subject's permission and physical contact. Gait biometric is used to identify the unique gait of the person by extracting moving features. The main advantage of gait biometric to identify the gait of a person at a distance, without any physical contact. In this work, the gait biometric is used for person re-identification. The person walking naturally compared with the same person walking with bag, coat and case recorded using long wave infrared, short wave infrared, medium wave infrared and visible cameras. The videos are recorded in rural and in urban environments. The pre-processing technique includes human identified using You Only Look Once, background subtraction, silhouettes extraction and synthesis Gait Entropy Image by averaging the silhouettes. The moving features are extracted from the Gait Entropy Energy Image. The extracted features are dimensionality reduced by the Principal Component Analysis and recognized using different classifiers. The comparative results with the different classifier show that Linear Discriminant Analysis outperform other classifiers with 95.8% for visible in the rural dataset and 94.8% for longwave infrared in the urban dataset.

Keywords: biometric, gait, silhouettes, You Only Look Once

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695 Automated 3D Segmentation System for Detecting Tumor and Its Heterogeneity in Patients with High Grade Ovarian Epithelial Cancer

Authors: D. A. Binas, M. Konidari, C. Bourgioti, L. Angela Moulopoulou, T. L. Economopoulos, G. K. Matsopoulos

Abstract:

High grade ovarian epithelial cancer (OEC) is the most fatal gynecological cancer and poor prognosis of this entity is closely related to considerable intratumoral genetic heterogeneity. By examining imaging data, it is possible to assess the heterogeneity of tumorous tissue. This study presents a methodology for aligning, segmenting and finally visualizing information from various magnetic resonance imaging series, in order to construct 3D models of heterogeneity maps from the same tumor in OEC patients. The proposed system may be used as an adjunct digital tool by health professionals for personalized medicine, as it allows for an easy visual assessment of the heterogeneity of the examined tumor.

Keywords: K-means segmentation, ovarian epithelial cancer, quantitative characteristics, registration, tumor visualization.

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694 Graves’ Disease and Its Related Single Nucleotide Polymorphisms and Genes

Authors: Yuhong Lu

Abstract:

Graves’ Disease (GD), an autoimmune health condition caused by the over reactiveness of the thyroid, affects about 1 in 200 people worldwide. GD is not caused by one specific single nucleotide polymorphism (SNP) or gene mutation, but rather determined by multiple factors, each differing from each other. Malfunction of the genes in Human Leukocyte Antigen (HLA) family tend to play a major role in autoimmune diseases, but other genes, such as LOC101929163, have functions that still remain ambiguous. Currently, little studies were done to study GD, resulting in inconclusive results. This study serves not only to introduce background knowledge about GD, but also to organize and pinpoint the major SNPs and genes that are potentially related to the occurrence of GD in humans. Collected from multiple sources from genome-wide association studies (GWAS) Central, the potential SNPs related to the causes of GD are included in this study. This study has located the genes that are related to those SNPs and closely examines a selected sample. Using the data from this study, scientists will then be able to focus on the most expressed genes in GD patients and develop a treatment for GD.

Keywords: CTLA4, Graves’ Disease, HLA, single nucleotide polymorphism, SNP.

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693 Pain and Lumbar Muscle Activation before and after Functional Task in Nonspecific Chronic Low Back Pain

Authors: Lídia E. O. Cruz, Adriano P. C. Calvo, Renato J. Soares, Regiane A. Carvalho

Abstract:

Individuals with non-specific chronic low back pain may present altered movement patterns during functional activities. However, muscle behavior before and after performing a functional task with different load conditions is not yet fully understood. The aim of this study is to analyze lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground (with and without load) in individuals with nonspecific chronic low back pain. 20 subjects with nonspecific chronic low back pain and 20 healthy subjects participated in this study. A surface electromyography was performed in the ilio-costal, longissimus and multifidus muscles to evaluate lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground, with and without load. The symptomatic participants had greater lumbar muscle activation compared to the asymptomatic group, more evident in performing the task without load, with statistically significant difference (p = 0,033) between groups for the right multifidus muscle. This study showed that individuals with nonspecific chronic low back pain have higher muscle activation before and after performing a functional task compared to healthy participants.

Keywords: Chronic low back pain, functional task, lumbar muscles, muscle activity.

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692 Towards End-To-End Disease Prediction from Raw Metagenomic Data

Authors: Maxence Queyrel, Edi Prifti, Alexandre Templier, Jean-Daniel Zucker

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Analysis of the human microbiome using metagenomic sequencing data has demonstrated high ability in discriminating various human diseases. Raw metagenomic sequencing data require multiple complex and computationally heavy bioinformatics steps prior to data analysis. Such data contain millions of short sequences read from the fragmented DNA sequences and stored as fastq files. Conventional processing pipelines consist in multiple steps including quality control, filtering, alignment of sequences against genomic catalogs (genes, species, taxonomic levels, functional pathways, etc.). These pipelines are complex to use, time consuming and rely on a large number of parameters that often provide variability and impact the estimation of the microbiome elements. Training Deep Neural Networks directly from raw sequencing data is a promising approach to bypass some of the challenges associated with mainstream bioinformatics pipelines. Most of these methods use the concept of word and sentence embeddings that create a meaningful and numerical representation of DNA sequences, while extracting features and reducing the dimensionality of the data. In this paper we present an end-to-end approach that classifies patients into disease groups directly from raw metagenomic reads: metagenome2vec. This approach is composed of four steps (i) generating a vocabulary of k-mers and learning their numerical embeddings; (ii) learning DNA sequence (read) embeddings; (iii) identifying the genome from which the sequence is most likely to come and (iv) training a multiple instance learning classifier which predicts the phenotype based on the vector representation of the raw data. An attention mechanism is applied in the network so that the model can be interpreted, assigning a weight to the influence of the prediction for each genome. Using two public real-life data-sets as well a simulated one, we demonstrated that this original approach reaches high performance, comparable with the state-of-the-art methods applied directly on processed data though mainstream bioinformatics workflows. These results are encouraging for this proof of concept work. We believe that with further dedication, the DNN models have the potential to surpass mainstream bioinformatics workflows in disease classification tasks.

Keywords: Metagenomics, phenotype prediction, deep learning, embeddings, multiple instance learning.

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691 Geometrical Based Unequal Droplet Splitting Using Microfluidic Y-Junction

Authors: Bahram Talebjedi, Amirmohammad Sattari, Ahmed Zoher Sihorwala, Mina Hoorfar

Abstract:

Among different droplet manipulations, controlled droplet-splitting is of great significance due to its ability to increase throughput and operational capability. Furthermore, unequal droplet-splitting can provide greater flexibility and a wider range of dilution factors. In this study, we developed two-dimensional, time-dependent complex fluid dynamics simulations to model droplet formation in a flow focusing device, followed by splitting in a Y-shaped junction with sub-channels of unequal widths. From the results obtained from the numerical study, we correlated the diameters of the droplets in the sub-channels to the Weber number, thereby demarcating the droplet splitting and non-splitting regimes.

Keywords: Microfluidics, unequal droplet splitting, two phase flow, flow focusing device.

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690 Enhancing Human Mobility Exoskeleton Comfort Using Admittance Controller

Authors: Alexandre Rabaseda, Emelie Seguin, Marc Doumit

Abstract:

Human mobility exoskeletons have been in development for several years and are becoming increasingly efficient. Unfortunately, user comfort was not always a priority design criterion throughout their development. To further improve this technology, exoskeletons should operate and deliver assistance without causing discomfort to the user. For this, improvements are necessary from an ergonomic point of view. The device’s control method is important when endeavoring to enhance user comfort. Exoskeleton or rehabilitation device controllers use methods of control called interaction controls (admittance and impedance controls). This paper proposes an extended version of an admittance controller to enhance user comfort. The control method used consists of adding an inner loop that is controlled by a proportional-integral-derivative (PID) controller. This allows the interaction force to be kept as close as possible to the desired force trajectory. The force-tracking admittance controller modifies the actuation force of the system in order to follow both the desired motion trajectory and the desired relative force between the user and the exoskeleton.

Keywords: Mobility assistive device, exoskeleton, force-tracking admittance controller, user comfort.

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