Search results for: clinical preceptors

Authors: Ceren Kaya, Okan Erkaymaz, Orhan Ayar, Mahmut Özer

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Diabetes Mellitus (Diabetes) is a disease based on insulin hormone disorders and causes high blood glucose. Clinical findings determine that diabetes can be diagnosed by electrophysiological signals obtained from the vital organs. 'Diabetic Retinopathy' is one of the most common eye diseases resulting on diabetes and it is the leading cause of vision loss due to structural alteration of the retinal layer vessels. In this study, features of horizontal and vertical Video-Oculography (VOG) signals have been used to classify non-proliferative and proliferative diabetic retinopathy disease. Twenty-five features are acquired by using discrete wavelet transform with VOG signals which are taken from 21 subjects. Two models, based on multi-layer perceptron and radial basis function, are recommended in the diagnosis of Diabetic Retinopathy. The proposed models also can detect level of the disease. We show comparative classification performance of the proposed models. Our results show that proposed the RBF model (100%) results in better classification performance than the MLP model (94%).

Keywords: Diabetic retinopathy, discrete wavelet transform, multi-layer perceptron, radial basis function, video-oculography.

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Authors: S. Abed, S. O’Neill

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This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.

Keywords: Health care, nurse education, nurse leadership, nursing in Iraq, transformational leadership.

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Authors: Salama Meghriche, Amer Draa, Mohammed Boulemden

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Heart failure is the most common reason of death nowadays, but if the medical help is given directly, the patient-s life may be saved in many cases. Numerous heart diseases can be detected by means of analyzing electrocardiograms (ECG). Artificial Neural Networks (ANN) are computer-based expert systems that have proved to be useful in pattern recognition tasks. ANN can be used in different phases of the decision-making process, from classification to diagnostic procedures. This work concentrates on a review followed by a novel method. The purpose of the review is to assess the evidence of healthcare benefits involving the application of artificial neural networks to the clinical functions of diagnosis, prognosis and survival analysis, in ECG signals. The developed method is based on a compound neural network (CNN), to classify ECGs as normal or carrying an AtrioVentricular heart Block (AVB). This method uses three different feed forward multilayer neural networks. A single output unit encodes the probability of AVB occurrences. A value between 0 and 0.1 is the desired output for a normal ECG; a value between 0.1 and 1 would infer an occurrence of an AVB. The results show that this compound network has a good performance in detecting AVBs, with a sensitivity of 90.7% and a specificity of 86.05%. The accuracy value is 87.9%.

Keywords: Artificial neural networks, Electrocardiogram(ECG), Feed forward multilayer neural network, Medical diagnosis, Pattern recognitionm, Signal processing.

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Authors: SunWoo Lee, TaeBum Lee, YoonHwa Park, YooJeong Kim

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Solar lentigines appear predominantly on chronically sun-exposed areas of skin, such as the face and the back of the hands. Among the several ways to lentigines treatment, quality-switched lasers are well-known effective treatment for removing solar lentigines. The present pilot study was therefore designed to assess the efficacy of quality-switched ruby laser treatment of such lentigines compare between pretreatment and posttreatment of skin brightness. Twenty-two adults with chronic sun-damaged skin (mean age 52.8 years, range 37–74 years) were treated at the Korean site. A 694 nm Q-switched ruby laser was used, with the energy density set from 1.4 to 12.5 J/cm2, to treat solar lentigines. Average brightness of skin color before ruby laser treatment was 137.3 and its skin color was brightened after ruby laser treatment by 150.5. Also, standard deviation of skin color was decreased from 17.8 to 16.4. Regarding the multivariate model, age and energy were identified as significant factors for skin color brightness change in lentigo depigmentation by ruby laser treatment. Their respective odds ratios were 1.082 (95% CI, 1.007–1.163), and 1.431 (95% CI, 1.051–1.946). Lentigo depigmentation treatment using ruby lasers resulted in a high performance in skin color brightness. Among the relative factors involve with ruby laser treatment, age and energy were the most effective factors which skin color change to brighter than pretreatment.

Keywords: Depigmentation, lentigo, quality switched ruby laser, skin color.

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Authors: Paria Soleimani, Arezoo Neshati

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Myocardial infarction is one of the leading causes of death in the world. Some of these deaths occur even before the patient reaches the hospital. Myocardial infarction occurs as a result of impaired blood supply. Because the most of these deaths are due to coronary artery disease, hence the awareness of the warning signs of a heart attack is essential. Some heart attacks are sudden and intense, but most of them start slowly, with mild pain or discomfort, then early detection and successful treatment of these symptoms is vital to save them. Therefore, importance and usefulness of a system designing to assist physicians in early diagnosis of the acute heart attacks is obvious. The main purpose of this study would be to enable patients to become better informed about their condition and to encourage them to seek professional care at an earlier stage in the appropriate situations. For this purpose, the data were collected on 711 heart patients in Iran hospitals. 28 attributes of clinical factors can be reported by patients; were studied. Three logistic regression models were made on the basis of the 28 features to predict the risk of heart attacks. The best logistic regression model in terms of performance had a C-index of 0.955 and with an accuracy of 94.9%. The variables, severe chest pain, back pain, cold sweats, shortness of breath, nausea and vomiting, were selected as the main features.

Keywords: Coronary heart disease, acute heart attacks, prediction, logistic regression.

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Authors: Nevila Alliu, Saimir Heta, Ilma Robo, Vera Ostreni

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Periodontitis as an oral pathology caused by specific bacterial flora functions as a focal infection for the onset and aggravation of arteriosclerosis. These two distant pathologies, since they affect organs at a distance from each other, communicate with each other with correlation at the level of markers of inflammation in the blood. Fluctuations in the level of fibrinogen in the blood, depending on the active or passive phase of the existing periodontitis, affect the promotion of arteriosclerosis. The study is of the brief communication article type with the aim to analyze the effect of non-surgical periodontal treatment on fluctuations in the level of fibrinogen in the blood. The reduction of fibrinogen's level in blood after non-surgical periodontal treatment of periodontitis in the patient's oral cavity, is a common consequence supported by literature sources. Also, the influence of a high amount of fibrinogen in blood on the occurrence of arteriosclerosis at the same patient, is also another important data that again rely on many sources of literature. Thromboembolism and arteriosclerosis, as risk factors expressed in clinical data, have temporary bacteremia in the blood, which can occur significantly and often between phases of non-surgical periodontal treatment of periodontitis, treatments performed with treatment phases and protocols of predetermined treatment. Arterial thromboembolism has a significant factor, such as high levels of fibrinogen in the blood, which are significantly reduced during the period of non-surgical periodontal treatment.

Keywords: Fibrinogen, refractory periodontitis, atherosclerosis, non-surgical, periodontal treatment.

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Authors: Seyed Mazyar Mortazavi, Masod Memari, Hasan Ali Ahmadi, Zhaleh Abed

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VACTERL association is a rare disorder with various congenital malformations. The aetiology remains unknown. Combination of at least three congenital anomalies of the following criteria is required for diagnosis: vertebral defects, anal atresia, cardiac anomalies, tracheo-esophageal fistula, renal anomalies, and limb defects. The first case was 1-day old male neonate with multiple congenital anomalies was bore from 28 years old mother. The mother had history of pregnancy with lymphocyte therapy. His anomalies included: defects in thoracic and lumbar vertebral, anal atresia, bilateral hydronephrosis, atrial septal defect, and lower limb abnormality. Other anomalies were cryptorchidism and nasal canal narrowing. The second case was born with 32 weeks gestational age from mother with history of pregnancy with lymphocyte therapy. He had thoracic vertebral defect, cardiac anomalies and renal defect. diagnosis based on clinical finding is VACTERL association. Early diagnosis is very important to investigation and treatment of other coexistence anomalies. VACTERL association in mothers with history of pregnancy with lymphocyte therapy has suggested possibly of relationship between VACTERL association and this method of pregnancy.

Keywords: Anal atresia, tracheo-esophageal fistula, atrial septal defect, lymphocyte therapy.

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Authors: Sumathi Poobal, G. Ravindran

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Image compression is one of the most important applications Digital Image Processing. Advanced medical imaging requires storage of large quantities of digitized clinical data. Due to the constrained bandwidth and storage capacity, however, a medical image must be compressed before transmission and storage. There are two types of compression methods, lossless and lossy. In Lossless compression method the original image is retrieved without any distortion. In lossy compression method, the reconstructed images contain some distortion. Direct Cosine Transform (DCT) and Fractal Image Compression (FIC) are types of lossy compression methods. This work shows that lossy compression methods can be chosen for medical image compression without significant degradation of the image quality. In this work DCT and Fractal Compression using Partitioned Iterated Function Systems (PIFS) are applied on different modalities of images like CT Scan, Ultrasound, Angiogram, X-ray and mammogram. Approximately 20 images are considered in each modality and the average values of compression ratio and Peak Signal to Noise Ratio (PSNR) are computed and studied. The quality of the reconstructed image is arrived by the PSNR values. Based on the results it can be concluded that the DCT has higher PSNR values and FIC has higher compression ratio. Hence in medical image compression, DCT can be used wherever picture quality is preferred and FIC is used wherever compression of images for storage and transmission is the priority, without loosing picture quality diagnostically.

Keywords: DCT, FIC, PIFS, PSNR.

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Authors: E. Batista, R. Mendes, A. Furtado, M. C. Ferreira, I. Godinho, J. A. Sousa, M. Alvares, R. Martins

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Syringe pumps are commonly used for drug delivery in hospitals and clinical environments. These instruments are critical in neonatology and oncology, where any variation in the flow rate and drug dosing quantity can lead to severe incidents and even death of the patient. Therefore it is very important to determine the accuracy and precision of these devices using the suitable calibration methods. The Volume Laboratory of the Portuguese Institute for Quality (LVC/IPQ) uses two different methods to calibrate syringe pumps from 16 nL/min up to 20 mL/min. The Interferometric method uses an interferometer to monitor the distance travelled by a pusher block of the syringe pump in order to determine the flow rate. Therefore, knowing the internal diameter of the syringe with very high precision, the travelled distance, and the time needed for that travelled distance, it was possible to calculate the flow rate of the fluid inside the syringe and its uncertainty. As an alternative to the gravimetric and the interferometric method, a methodology based on the application of optical technology was also developed to measure flow rates. Mainly this method relies on measuring the increase of volume of a drop over time. The objective of this work is to compare the results of the calibration of two syringe pumps using the different methodologies described above. The obtained results were consistent for the three methods used. The uncertainties values were very similar for all the three methods, being higher for the optical drop method due to setup limitations.

Keywords: Calibration, interferometry, syringe pump, optical method, uncertainty.

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Authors: Mukesh Doble, Sunil K Narayan

Abstract:

Diffuse viral encephalitis may lack fever and other cardinal signs of infection and hence its distinction from other acute encephalopathic illnesses is challenging. Often, the EEG changes seen routinely are nonspecific and reflect diffuse encephalopathic changes only. The aim of this study was to use nonlinear dynamic mathematical techniques for analyzing the EEG data in order to look for any characteristic diagnostic patterns in diffuse forms of encephalitis.It was diagnosed on clinical, imaging and cerebrospinal fluid criteria in three young male patients. Metabolic and toxic encephalopathies were ruled out through appropriate investigations. Digital EEGs were done on the 3rd to 5th day of onset. The digital EEGs of 5 male and 5 female age and sex matched healthy volunteers served as controls.Two sample t-test indicated that there was no statistically significant difference between the average values in amplitude between the two groups. However, the standard deviation (or variance) of the EEG signals at FP1-F7 and FP2-F8 are significantly higher for the patients than the normal subjects. The regularisation dimension is significantly less for the patients (average between 1.24-1.43) when compared to the normal persons (average between 1.41-1.63) for the EEG signals from all locations except for the Fz-Cz signal. Similarly the wavelet dimension is significantly less (P = 0.05*) for the patients (1.122) when compared to the normal person (1.458). EEGs are subdued in the case of the patients with presence of uniform patterns, manifested in the values of regularisation and wavelet dimensions, when compared to the normal person, indicating a decrease in chaotic nature.

Keywords: Chaos, Diffuse encephalitis, Electroencephalogram, Fractal dimension, Fourier spectrum.

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Authors: P. Kowalska, P. Gabka, K. Kamieniarz, M. Kamieniarz, W. Stryla, P. Guzik, T. Krauze

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We have developed a computer program consisting of 6 subtests assessing the children hand dexterity applicable in the rehabilitation medicine. We have carried out a normative study on a representative sample of 285 children aged from 7 to 15 (mean age 11.3) and we have proposed clinical standards for three age groups (7-9, 9-11, 12-15 years). We have shown statistical significance of differences among the corresponding mean values of the task time completion. We have also found a strong correlation between the task time completion and the age of the subjects, as well as we have performed the test-retest reliability checks in the sample of 84 children, giving the high values of the Pearson coefficients for the dominant and non-dominant hand in the range 0.740.97 and 0.620.93, respectively. A new MATLAB-based programming tool aiming at analysis of cardiologic RR intervals and blood pressure descriptors, is worked out, too. For each set of data, ten different parameters are extracted: 2 in time domain, 4 in frequency domain and 4 in Poincaré plot analysis. In addition twelve different parameters of baroreflex sensitivity are calculated. All these data sets can be visualized in time domain together with their power spectra and Poincaré plots. If available, the respiratory oscillation curves can be also plotted for comparison. Another application processes biological data obtained from BLAST analysis.

Keywords: Biomedical data base processing, Computer software, Hand dexterity, Heart rate and blood pressure variability.

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Authors: Zuhrotun Ulya, Muchammad Syamsulhadi, Debree Septiawan

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Patients with bipolar disorder are three times more likely to suffer cardiovascular disorders than the general population, which will influence their level of morbidity and rate of mortality. Bipolar disorder also affects the pulmonary system. The choice of long term-monotherapy and other combinative therapies have clinical impacts on patients. This study investigates the case of a woman who has been suffering from bipolar disorder for 16 years, and who has a history of Steven Johnson Syndrome. At present she is suffering also from cardiovascular and pulmonary disorder. An analysis of the results of this study suggests that there is a relationship between cardiovascular disorder, drug therapies, Steven Johnson Syndrome and mood stabilizer obtained from the PubMed, Cochrane, Medline, and ProQuest (publications between 2005 and 2015). Combination therapy with mood stabilizer is recommended for patients who do not have side effect histories from these drugs. The replacement drugs and combinations may be applied, especially for those with bipolar disorders, and the combination between atypical antipsychotic groups and mood stabilizers is often made. Clinicians, however, should be careful with the patients’ physical and metabolic changes, especially those who have experienced long-term therapy and who showed a history of Steven Johnson Syndrome (for which clinicians probably prescribed one type of medicine).

Keywords: Cardio-pulmonary disease, bipolar disorder, Steven Johnson Syndrome, therapy.

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Authors: Sarkar M. A. Kawsar, Sarkar M. A. Mamun, Md S. Rahman, Hidetaro Yasumitsu, Yasuhiro Ozeki

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Lectins have a good scope in current clinical microbiology research. In the present study evaluated the antimicrobial activities of a D-galactose binding lectin (PnL) was purified from the annelid, Perinereis nuntia (polychaeta) by affinity chromatography. The molecular mass of the lectin was determined to be 32 kDa as a single polypeptide by SDS-PAGE under both reducing and non-reducing conditions. The hemagglutinating activity of the PnL showed against trypsinized and glutaraldehyde-fixed human erythrocytes was specifically inhibited by D-Gal, GalNAc, Galβ1-4Glc and Galα1-6Glc. PnL was evaluated for in vitro antibacterial screening studies against 11 gram-positive and gram-negative microorganisms. From the screening results, it was revealed that PnL exhibited significant antibacterial activity against gram-positive bacteria. Bacillus megaterium showed the highest growth inhibition by the lectin (250 μg/disc). However, PnL did not inhibit the growth of gram-negative bacteria such as Vibrio cholerae and Pseudomonas sp. PnL was also examined for in vitro antifungal activity against six fungal phytopathogens. PnL (100 μg/mL) inhibited the mycelial growth of Alternaria alternata (24.4%). These results indicate that future findings of lectin applications obtained from annelids may be of importance to life sciences.

Keywords: Perinereis nuntia, Lectin, Inhibition zone, Mycelial growth.

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Authors: Shadrack Mambo, Karim Djouani, Yskandar Hamam, Barend van Wyk, Patrick Siarry

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This paper discusses the current trends in medical image registration techniques and addresses the need to provide a solid theoretical foundation for research endeavours. Methodological analysis and synthesis of quality literature was done, providing a platform for developing a good foundation for research study in this field which is crucial in understanding the existing levels of knowledge. Research on medical image registration techniques assists clinical and medical practitioners in diagnosis of tumours and lesion in anatomical organs, thereby enhancing fast and accurate curative treatment of patients. Literature review aims to provide a solid theoretical foundation for research endeavours in image registration techniques. Developing a solid foundation for a research study is possible through a methodological analysis and synthesis of existing contributions. Out of these considerations, the aim of this paper is to enhance the scientific community’s understanding of the current status of research in medical image registration techniques and also communicate to them, the contribution of this research in the field of image processing. The gaps identified in current techniques can be closed by use of artificial neural networks that form learning systems designed to minimise error function. The paper also suggests several areas of future research in the image registration.

Keywords: Image registration techniques, medical images, neural networks, optimisation, transformation.

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Authors: Mai Ali

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Advancing beyond the junior stage of a paediatrician’s career is a crucial step where they accumulate essential skills and knowledge. This process prepares them for the challenges they will encounter throughout their profession, particularly in dealing with paediatric emergencies. This can be especially demanding for trainees specializing in fields like endocrinology, particularly in the management of Diabetic Ketoacidosis (DKA) in the UK. In different societal contexts, junior doctors, whether specializing in paediatrics or other medical fields, are generally expected to possess a fundamental level of knowledge and skills necessary for managing DKA emergencies. These physicians consistently concurred in recognizing prevalent problems in the healthcare facilities they examined. Such issues include the lack of established guidelines for DKA treatment and the inadequate availability of comprehensive training opportunities. The abstract underscores the critical importance of junior paediatricians acquiring expertise in managing paediatric emergencies, with a specific focus on DKA. Commonly, issues like the lack of standardized protocols and training deficiencies are recurring themes across healthcare facilities. This research proposal aims to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom when handling DKA in various clinical contexts. The primary goal is to assess their competency and suggest effective strategies for comprehensive DKA training improvement.

Keywords: DKA management, junior paediatricians, level of competence, standardized protocols.

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Authors: Hassan M. Abo Salem, Xiaolin Huang

Abstract:

Background: The effectiveness of mirror therapy (MT) has been investigated in acute hemiplegia. The present study examines whether MT, given during chronic stroke, was more effective in promoting motor recovery of the lower extremity and walking speed than standard rehabilitation alone. Methods: The study enrolled 30 patients with chronic stroke. Fifteen patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received mirror therapy for 4 weeks, 5 days a week. Main measures: Passive ankle joint dorsiflexion range of motion, gait speed, Brunnstrom stages of motor recovery, plantar flexor muscle tone by Modified Ashworth Scale. Results: No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation, mirror therapy improved Ankle ROM, Brunnstrom stages and waking speed (p < 0.05). However, there were no significant differences between two groups on MAS (P > 0.05).Conclusion: Mirror therapy combined with a conventional stroke rehabilitation program enhances lowerextremity motor recovery and walking speed in chronic stroke patients.

Keywords: Mirror therapy, stroke, MAS, walking speed.

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Authors: Todsaporn Fuangrod, Daryl J. O'Connor, Boyd MC McCurdy, Peter B. Greer

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An electronic portal image device (EPID) has become a method of patient-specific IMRT dose verification for radiotherapy. Research studies have focused on pre and post-treatment verification, however, there are currently no interventional procedures using EPID dosimetry that measure the dose in real time as a mechanism to ensure that overdoses do not occur and underdoses are detected as soon as is practically possible. As a result, an EPID-based real time dose verification system for dynamic IMRT was developed and was implemented with MATLAB/Simulink. The EPID image acquisition was set to continuous acquisition mode at 1.4 images per second. The system defined the time constraint gap, or execution gap at the image acquisition time, so that every calculation must be completed before the next image capture is completed. In addition, the <=-evaluation method was used for dose comparison, with two types of comparison processes; individual image and cumulative dose comparison monitored. The outputs of the system are the <=-map, the percent of <=<1, and mean-<= versus time, all in real time. Two strategies were used to test the system, including an error detection test and a clinical data test. The system can monitor the actual dose delivery compared with the treatment plan data or previous treatment dose delivery that means a radiation therapist is able to switch off the machine when the error is detected.

Keywords: real-time dose verification, EPID dosimetry, simulation, dynamic IMRT

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Authors: Shaila Ahmed, Raghu Prasad Rao Metpally, Sreedhara Sangadala, Boojala Vijay B Reddy

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Bone growth factors, such as Bone Morphogenic Protein-2 (BMP-2) have been approved by the FDA to replace grafting for some surgical interventions, but the high dose requirement limits its use in patients. Noggin, an extracellular protein, blocks the effect of BMP-2 by binding to BMP. Preventing the BMP-2/noggin interaction will help increase the free concentration of BMP-2 and therefore should enhance its efficacy to induce bone formation. The work presented here involves computational design of novel small molecule inhibitory agents of BMP-2/noggin interaction, based on our current understanding of BMP-2, and its known putative ligands (receptors and antagonists). A successful acquisition of such an inhibitory agent of BMP-2/noggin interaction would allow clinicians to reduce the dose required of BMP-2 protein in clinical applications to promote osteogenesis. The available crystal structures of the BMPs, its receptors, and the binding partner noggin were analyzed to identify the critical residues involved in their interaction. In presenting this study, LUDI de novo design method was utilized to perform virtual screening of a large number of compounds from a commercially available library against the binding sites of noggin to identify the lead chemical compounds that could potentially block BMP-noggin interaction with a high specificity.

Keywords: Transforming growth factor-beta, Bone morphogenic proteins, Noggin, LUDI de novo design method, CAP small molecules.

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Authors: Rozhgar A. Khailany, Mehri Igci, Emine Bayraktar, Sakip Erturhan, Metin Karakok, Ahmet Arslan

Abstract:

Kidney cancer is the most lethal urological cancer accounting for 3% of adult malignancies. VHL, a tumor-suppressor gene, is best known to be associated with renal cell carcinoma (RCC). The VHL functions as negative regulator of hypoxia inducible factors. Recent sequencing efforts have identified several novel frequent mutations of histone modifying and chromatin remodeling genes in ccRCC (clear cell RCC) including PBRM1 and SETD2. The PBRM1 gene encodes the BAF180 protein, which involved in transcriptional activation and repression of selected genes. SETD2 encodes a histone methyltransferase, which may play a role in suppressing tumor development. In this study, RNAs of 30 paired tumor and normal samples that were grouped according to the types of kidney cancer and clinical characteristics of patients, including gender and average age were examined by RT-PCR, SSCP and sequencing techniques. VHL, PBRM1 and SETD2 expressions were relatively down-regulated. However, statistically no significance was found (Wilcoxon signed rank test, p>0.05). Interestingly, no mutation was observed on the contrary of previous studies. Understanding the molecular mechanisms involved in the pathogenesis of RCC has aided the development of molecular-targeted drugs for kidney cancer. Further analysis is required to identify the responsible genes rather than VHL, PBRM1 and SETD2 in kidney cancer.

Keywords: Kidney cancer, molecular biomarker, expression analysis, mutation screening.

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Authors: A.A Abou-Rawash, H.S. Abd EL-Hamed. H A. Abd-Ellatieff, S. M. Elsamanoudy

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Clinically, chickens showed progressively developed clinical signs represented by sever cyanosis of the comb and wattles with hemorrhage at the shanks, depression, and ruffling feathers with loss of appetite and high daily mortalities. The ducks showed severe neurological signs as torticollus, seizures and inability to stand with mild signs of diarrhea and depression. Grossly, chickens showed hemorrhages and congestion in most of the organs particularly lung, liver, spleen, trachea and kidney. The examined ducks showed multiple petechial hemorrhages, multifocal hemorrhagic necrosis in the pancreas, pulmonary edema, congestion and hemorrhage in meninges and congestion in the skeletal muscles. Histopathology revealed severe congestion and hemorrhages in most of the organs particularly lung, liver and kidney. Microscopic erosive tracheitis, sever pulmonary congestion and perivascular oedema and lymphogranulocytic pneumonia were constant. The liver showed hepatocyts necrosis and lympho-granulocytic infiltration. The kidney showed renal tubular necrosis and diffuse congestion. Multifocal, neuronal necrosis, hemorrhages, multifocal glial nodules, lympho- histiocytic perivascular cuffing, and occasional neuronophagia were observed in the cerebrum. Other organs showed moderate changes.

Keywords: Chicken, Ducks, H5N1 Avian Influenza, Pathology

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Authors: Aref Aasi, Sahar Ebrahimi Bajgani, Erfan Aasi

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Breast cancer (BC) continues to be the most frequent cancer in females and causes the highest number of cancer-related deaths in women worldwide. Inspired by recent advances in studying the relationship between different patient attributes and features and the disease, in this paper, we have tried to investigate the different classification methods for better diagnosis of BC in the early stages. In this regard, datasets from the University Hospital Centre of Coimbra were chosen, and different machine learning (ML)-based and neural network (NN) classifiers have been studied. For this purpose, we have selected favorable features among the nine provided attributes from the clinical dataset by using a random forest algorithm. This dataset consists of both healthy controls and BC patients, and it was noted that glucose, BMI, resistin, and age have the most importance, respectively. Moreover, we have analyzed these features with various ML-based classifier methods, including Decision Tree (DT), K-Nearest Neighbors (KNN), eXtreme Gradient Boosting (XGBoost), Logistic Regression (LR), Naive Bayes (NB), and Support Vector Machine (SVM) along with NN-based Multi-Layer Perceptron (MLP) classifier. The results revealed that among different techniques, the SVM and MLP classifiers have the most accuracy, with amounts of 96% and 92%, respectively. These results divulged that the adopted procedure could be used effectively for the classification of cancer cells, and also it encourages further experimental investigations with more collected data for other types of cancers.

Keywords: Breast cancer, health diagnosis, Machine Learning, biomarker classification, Neural Network.

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Authors: Walid MOUDANI

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The healthcare environment is generally perceived as being information rich yet knowledge poor. However, there is a lack of effective analysis tools to discover hidden relationships and trends in data. In fact, valuable knowledge can be discovered from application of data mining techniques in healthcare system. In this study, a proficient methodology for the extraction of significant patterns from the Coronary Heart Disease warehouses for heart attack prediction, which unfortunately continues to be a leading cause of mortality in the whole world, has been presented. For this purpose, we propose to enumerate dynamically the optimal subsets of the reduced features of high interest by using rough sets technique associated to dynamic programming. Therefore, we propose to validate the classification using Random Forest (RF) decision tree to identify the risky heart disease cases. This work is based on a large amount of data collected from several clinical institutions based on the medical profile of patient. Moreover, the experts- knowledge in this field has been taken into consideration in order to define the disease, its risk factors, and to establish significant knowledge relationships among the medical factors. A computer-aided system is developed for this purpose based on a population of 525 adults. The performance of the proposed model is analyzed and evaluated based on set of benchmark techniques applied in this classification problem.

Keywords: Multi-Classifier Decisions Tree, Features Reduction, Dynamic Programming, Rough Sets.

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Authors: Aizreena Azaman, Mai Ishibashi, Masanori Ishizawa, Shin-Ichiroh Yamamoto

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Sensory input plays an important role to human posture control system to initiate strategy in order to counterpart any unbalance condition and thus, prevent fall. In previous study, joint stiffness was observed able to describe certain issues regarding to movement performance. But, correlation between balance ability and joint stiffness is still remains unknown. In this study, joint stiffening strategy at ankle and hip were observed under different sensory manipulations and its correlation with conventional clinical test (Functional Reach Test) for balance ability was investigated. In order to create unstable condition, two different surface perturbations (tilt up-tilt (TT) down and forward-backward (FB)) at four different frequencies (0.2, 0.4, 0.6 and 0.8 Hz) were introduced. Furthermore, four different sensory manipulation conditions (include vision and vestibular system) were applied to the subject and they were asked to maintain their position as possible. The results suggested that joint stiffness were high during difficult balance situation. Less balance people generated high average joint stiffness compared to balance people. Besides, adaptation of posture control system under repetitive external perturbation also suggested less during sensory limited condition. Overall, analysis of joint stiffening response possible to predict unbalance situation faced by human

Keywords: Balance ability, joint stiffness, sensory, adaptation, dynamic.

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Authors: Anis S. Shuib, Peter R. Hoskins, William J. Easson

Abstract:

Cardiovascular diseases, principally atherosclerosis, are responsible for 30% of world deaths. Atherosclerosis is due to the formation of plaque. The fatty plaque may be at risk of rupture, leading typically to stroke and heart attack. The plaque is usually associated with a high degree of lumen reduction, called a stenosis.It is increasingly recognized that the initiation and progression of disease and the occurrence of clinical events is a complex interplay between the local biomechanical environment and the local vascular biology. The aim of this study is to investigate the flow behavior through a stenosed artery. A physical experiment was performed using an artery model and blood analogue fluid. An axisymmetric model constructed consists of contraction and expansion region that follow a mathematical form of cosine function. A 30% diameter reduction was used in this study. The flow field was measured using particle image velocimetry (PIV). Spherical particles with 20μm diameter were seeded in a water-glycerol-NaCl mixture. Steady flow Reynolds numbers are 250. The area of interest is the region after the stenosis where the flow separation occurs. The velocity field was measured and the velocity gradient was investigated. There was high particle concentration in the recirculation zone. High velocity gradient formed immediately after the stenosis throat created a lift force that enhanced particle migration to the flow separation area.

Keywords: Stenosis artery, Biofluid mechanics, PIV

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Authors: Zahra Emami, Mohammad Ebrahim Khamseh, Nahid Hashemi Madani, Iman Kermani

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The aim of the study was to map scientific research on adrenal gland diseases in the Middle East countries through the Web of Science database using scientometric analysis. Data were analyzed with Excel software; and HistCite was used for mapping of the scientific texts. In this study, from a total of 268 retrieved records, 1125 authors from 328 institutions published their texts in 138 journals. Among 17 Middle East countries, Turkey ranked first with 164 documents (61.19%), Israel ranked second with 47 documents (15.53%) and Iran came in the third place with 26 documents. Most of the publications (185 documents, 69.2%) were articles. Among the universities of the Middle East, Istanbul University had the highest science production rate (9.7%). The Journal of Clinical Endocrinology & Metabolism had the highest TGCS (243 citations). In the scientific mapping, 7 clusters were formed based on TLCS (Total Local Citation Score) & TGCS (Total Global Citation Score). considering the study results, establishment of scientific connections and collaboration with other countries and use of publications on adrenal gland diseases from high ranking universities can help in the development of this field and promote the medical practice in this regard. Moreover, investigation of the formed clusters in relation to Congenital Hyperplasia and puberty related disorders can be research priorities for investigators.

Keywords: Mapping, scientific research, adrenal gland diseases, scientometric.

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Authors: Sarkar M. A. Kawsar, Sarkar M. A. Mamun, Md S. Rahman, Hidetaro Yasumitsu, Yasuhiro Ozeki

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The present study has been taken to explore the screening of in vitro antimicrobial activities of D-galactose-binding sponge lectin (HOL-30). HOL-30 was purified from the marine demosponge Halichondria okadai by affinity chromatography. The molecular mass of the lectin was determined to be 30 kDa with a single polypeptide by SDS-PAGE under non-reducing and reducing conditions. HOL-30 agglutinated trypsinized and glutaraldehydefixed rabbit and human erythrocytes with preference for type O erythrocytes. The lectin was subjected to evaluation for inhibition of microbial growth by the disc diffusion method against eleven human pathogenic gram-positive and gram-negative bacteria. The lectin exhibited strong antibacterial activity against gram-positive bacteria, such as Bacillus megaterium and Bacillus subtilis. However, it did not affect against gram-negative bacteria such as Salmonella typhi and Escherichia coli. The largest zone of inhibition was recorded of Bacillus megaterium (12 in diameter) and Bacillus subtilis (10 mm in diameter) at a concentration of the lectin (250 μg/disc). On the other hand, the antifungal activity of the lectin was investigated against six phytopathogenic fungi based on food poisoning technique. The lectin has shown maximum inhibition (22.83%) of mycelial growth of Botrydiplodia theobromae at a concentration of 100 μg/mL media. These findings indicate that the lectin may be of importance to clinical microbiology and have therapeutic applications.

Keywords: Antibacterial, Halichondria okadai, Inhibition zone, Lectin.

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Authors: Neilal A. Isaac, Madison Edwards, Kirthana Sugunathevan, Mohan Kumar

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The COVID-19 pandemic challenged the education system and forced medical schools to transition to online learning. With this transition, one of the major concerns for students and educators was to ensure that Physical Examination (PE) skills were still being mastered. Thus, the formative peer assessment model was designed to enhance the learning of PE skills during the COVID-19 pandemic in the online learning landscape. Year 1 and year 2 students enrolled in clinical skills courses at the University of Medicine and Health Sciences, St. Kitts were asked to record themselves demonstrating PE skills with a healthy patient volunteer after every skills class. Each student was assigned to exchange feedback with one peer in the course. At the end of the first two semesters of this learning activity, a cross-sectional survey was conducted for the two cohorts of year-1 and year-2 students. The year-1 cohorts most frequently rated the peer assessment exercise as 4 on a 5-point Likert scale, with a mean score of 3.317 [2.759, 3.875]. The year-2 cohorts most frequently rated the peer assessment exercise as 4 on a 5-point Likert scale, with a mean score of 3.597 [2.978, 4.180]. Students indicated that guidance from faculty, flexible deadlines, and detailed and timely feedback from peers were areas for improvement in this process.

Keywords: COVID-19 pandemic, distant learning, online medical education, peer assessment, physical examination.

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Authors: Chia-Feng Lu, Yuh-Jen Wang, Shin Teng, Yu-Te Wu, Sui-Hing Yan

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Brain functional networks based on resting-state EEG data were compared between patients with mild Alzheimer’s disease (mAD) and matched patients with amnestic subtype of mild cognitive impairment (aMCI). We integrated the time–frequency cross mutual information (TFCMI) method to estimate the EEG functional connectivity between cortical regions and the network analysis based on graph theory to further investigate the alterations of functional networks in mAD compared with aMCI group. We aimed at investigating the changes of network integrity, local clustering, information processing efficiency, and fault tolerance in mAD brain networks for different frequency bands based on several topological properties, including degree, strength, clustering coefficient, shortest path length, and efficiency. Results showed that the disruptions of network integrity and reductions of network efficiency in mAD characterized by lower degree, decreased clustering coefficient, higher shortest path length, and reduced global and local efficiencies in the delta, theta, beta2, and gamma bands were evident. The significant changes in network organization can be used in assisting discrimination of mAD from aMCI in clinical.

Keywords: EEG, functional connectivity, graph theory, TFCMI.

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Authors: Carmen Grigoraş, Victor Grigoraş, Daniela Boişteanu

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The standard investigational method for obstructive sleep apnea syndrome (OSAS) diagnosis is polysomnography (PSG), which consists of a simultaneous, usually overnight recording of multiple electro-physiological signals related to sleep and wakefulness. This is an expensive, encumbering and not a readily repeated protocol, and therefore there is need for simpler and easily implemented screening and detection techniques. Identification of apnea/hypopnea events in the screening recordings is the key factor for the diagnosis of OSAS. The analysis of a solely single-lead electrocardiographic (ECG) signal for OSAS diagnosis, which may be done with portable devices, at patient-s home, is the challenge of the last years. A novel artificial neural network (ANN) based approach for feature extraction and automatic identification of respiratory events in ECG signals is presented in this paper. A nonlinear principal component analysis (NLPCA) method was considered for feature extraction and support vector machine for classification/recognition. An alternative representation of the respiratory events by means of Kohonen type neural network is discussed. Our prospective study was based on OSAS patients of the Clinical Hospital of Pneumology from Iaşi, Romania, males and females, as well as on non-OSAS investigated human subjects. Our computed analysis includes a learning phase based on cross signal PSG annotation.

Keywords: Artificial neural networks, feature extraction, obstructive sleep apnea syndrome, pattern recognition, signalprocessing.

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Authors: Ravi Kiran Pothamsetty, Radha Rani Ghosh, Baby Paul Thaliath

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Radiation therapy has undergone many advancements and evloved from 2D to 3D. Recently, with rapid pace of drug discoveries, cutting edge technology, and clinical trials has made innovative advancements in computer technology and treatment planning and upgraded to intensity modulated radiotherapy (IMRT) which delivers in homogenous dose to tumor and normal tissues. The present study was a hospital-based experience comparing two different conformal radiotherapy techniques for brain tumors. This analytical study design has been conducted at Regional Cancer Centre, India from January 2014 to January 2015. Ten patients have been selected after inclusion and exclusion criteria. All the patients were treated on Artiste Siemens Linac Accelerator. The tolerance level for maximum dose was 6.0 Gyfor lenses and 54.0 Gy for brain stem, optic chiasm and optical nerves as per RTOG criteria. Mean and standard deviation values of PTV98%, PTV 95% and PTV 2% in IMRT were 93.16±2.9, 95.01±3.4 and 103.1±1.1 respectively; for 3DCRT were 91.4±4.7, 94.17±2.6 and 102.7±0.39 respectively. PTV max dose (%) in IMRT and 3D-CRT were 104.7±0.96 and 103.9±1.0 respectively. Maximum dose to the tumor can be delivered with IMRT with acceptable toxicity limits. Variables such as expertise, location of tumor, patient condition, and TPS influence the outcome of the treatment.

Keywords: IMRT, 3D CRT, Brain, tumors, OARs, RTOG.

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