Search results for: cardiac patient

Authors: Anjan Babu G, Sumana G, Rajasekhar M

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Many inherited diseases and non-hereditary disorders are common in the development of renal cystic diseases. Polycystic kidney disease (PKD) is a disorder developed within the kidneys in which grouping of cysts filled with water like fluid. PKD is responsible for 5-10% of end-stage renal failure treated by dialysis or transplantation. New experimental models, application of molecular biology techniques have provided new insights into the pathogenesis of PKD. Researchers are showing keen interest for developing an automated system by applying computer aided techniques for the diagnosis of diseases. In this paper a multilayered feed forward neural network with one hidden layer is constructed, trained and tested by applying back propagation learning rule for the diagnosis of PKD based on physical symptoms and test results of urinalysis collected from the individual patients. The data collected from 50 patients are used to train and test the network. Among these samples, 75% of the data used for training and remaining 25% of the data are used for testing purpose. Further, this trained network is used to implement for new samples. The output results in normality and abnormality of the patient.

Keywords: Dialysis, Hereditary, Transplantation, Polycystic, Pathogenesis.

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Authors: A. Seham A. Elgamal, Reham H. Saleh

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Chronic kidney disease became a global health problem worldwide. Therefore, in order to maintain a patient’s life and improve the survival rate, hemodialysis is essential to replace the function of their kidneys. However, those patients may complain about multiple physical and psychological stressors due to the nature of the disease and the need for frequent hemodialysis sessions. So, those patients use various strategies to cope with the stressors related to their disease and the treatment procedures. Cross-sectional, descriptive study was carried out to achieve the aim of the study. A convenient sample including all adult patients was recruited for this study. Hemodialysis Stressors Scale (HSS) and Jalowiec Coping Scale (JCS) were used to investigate the stressors and coping strategies of 89 hemodialysis patients, at a governmental hospital (King Khalid Hospital-Jeddah). Results of the study revealed that 50.7% experienced physiological stressors and 38% experienced psychosocial stressors. Also, optimistic, fatalistic, and supportive coping strategies were the most common coping strategies used by the patients with mean scores (2.88 + 0.75, 2.87 + 0.75, and 1.82 + 0.71), respectively. In conclusion, being familiar with the types of stressors and the effective coping strategies of hemodialysis patients and their families are important in order to enhance their adaptation with chronic kidney diseases.

Keywords: Coping strategies, hemodialysis, physiological stressors, psychological stressors.

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Authors: Charles D. Otine, Samuel B. Kucel, Lena Trojer

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Selecting the data modeling technique for an information system is determined by the objective of the resultant data model. Dimensional modeling is the preferred modeling technique for data destined for data warehouses and data mining, presenting data models that ease analysis and queries which are in contrast with entity relationship modeling. The establishment of data warehouses as components of information system landscapes in many organizations has subsequently led to the development of dimensional modeling. This has been significantly more developed and reported for the commercial database management systems as compared to the open sources thereby making it less affordable for those in resource constrained settings. This paper presents dimensional modeling of HIV patient information using open source modeling tools. It aims to take advantage of the fact that the most affected regions by the HIV virus are also heavily resource constrained (sub-Saharan Africa) whereas having large quantities of HIV data. Two HIV data source systems were studied to identify appropriate dimensions and facts these were then modeled using two open source dimensional modeling tools. Use of open source would reduce the software costs for dimensional modeling and in turn make data warehousing and data mining more feasible even for those in resource constrained settings but with data available.

Keywords: About Database, Data Mining, Data warehouse, Dimensional Modeling, Open Source.

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Authors: Yung-Ting Chang, Chung-You Tsai, Yu-Chuan Li

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Nosocomial (i.e., hospital-acquired) infections (NI) is a major cause of morbidity and mortality in hospitals. NI rate is higher in intensive care units (ICU) than in the general ward due to patients with severe symptoms, poor immunity, and accepted many invasive therapies. Contact behaviors between health caregivers and patients is one of the infect factors. It is difficult to obtain complete contact records by traditional method of retrospective analysis of medical records. This paper establishes a contact history inferential model (CHIM) intended to extend the use of Proximity Sensing of rapid frequency identification (RFID) technology to transferring all proximity events between health caregivers and patients into clinical events (close-in events, contact events and invasive events).The results of the study indicated that the CHIM can infer proximity care activities into close-in events and contact events. The infection control team could redesign and build optimal workflow in the ICU according to the patient-specific contact history which provided by our automatic tracing system.

Keywords: Active Radio Frequency Identification, Intensive Care Unit, Nosocomial Infections

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Authors: Si Mon Kueh, Tom J. Kazmierski

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There are about 1% of the world population suffering from the hidden disability known as epilepsy and major developing countries are not fully equipped to counter this problem. In order to reduce the inconvenience and danger of epilepsy, different methods have been researched by using a artificial neural network (ANN) classification to distinguish epileptic waveforms from normal brain waveforms. This paper outlines the aim of achieving massive ANN parallelization through a dedicated hardware using bit-serial processing. The design of this bit-serial Neural Processing Element (NPE) is presented which implements the functionality of a complete neuron using variable accuracy. The proposed design has been tested taking into consideration non-idealities of a hardware ANN. The NPE consists of a bit-serial multiplier which uses only 16 logic elements on an Altera Cyclone IV FPGA and a bit-serial ALU as well as a look-up table. Arrays of NPEs can be driven by a single controller which executes the neural processing algorithm. In conclusion, the proposed compact NPE design allows the construction of complex hardware ANNs that can be implemented in a portable equipment that suits the needs of a single epileptic patient in his or her daily activities to predict the occurrences of impending tonic conic seizures.

Keywords: Artificial Neural Networks, bit-serial neural processor, FPGA, Neural Processing Element.

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Authors: Emad Alenany, M. Adel El-Baz

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In this paper, the flow of different classes of patients into a hospital is modelled and analyzed by using the queueing network analyzer (QNA) algorithm and discrete event simulation. Input data for QNA are the rate and variability parameters of the arrival and service times in addition to the number of servers in each facility. Patient flows mostly match real flow for a hospital in Egypt. Based on the analysis of the waiting times, two approaches are suggested for improving performance: Separating patients into service groups, and adopting different service policies for sequencing patients through hospital units. The separation of a specific group of patients, with higher performance target, to be served separately from the rest of patients requiring lower performance target, requires the same capacity while improves performance for the selected group of patients with higher target. Besides, it is shown that adopting the shortest processing time and shortest remaining processing time service policies among other tested policies would results in, respectively, 11.47% and 13.75% reduction in average waiting time relative to first come first served policy.

Keywords: Queueing network, discrete-event simulation, health applications, SPT.

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Authors: May-Ling Tan, Yi Su, Chi-Wan Lim, Liang Zhong, Ru-San Tan

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This paper describes an automatic algorithm to restore the shape of three-dimensional (3D) left ventricle (LV) models created from magnetic resonance imaging (MRI) data using a geometry-driven optimization approach. Our basic premise is to restore the LV shape such that the LV epicardial surface is smooth after the restoration. A geometrical measure known as the Minimum Principle Curvature (κ2) is used to assess the smoothness of the LV. This measure is used to construct the objective function of a two-step optimization process. The objective of the optimization is to achieve a smooth epicardial shape by iterative in-plane translation of the MRI slices. Quantitatively, this yields a minimum sum in terms of the magnitude of κ 2, when κ2 is negative. A limited memory quasi-Newton algorithm, L-BFGS-B, is used to solve the optimization problem. We tested our algorithm on an in vitro theoretical LV model and 10 in vivo patient-specific models which contain significant motion artifacts. The results show that our method is able to automatically restore the shape of LV models back to smoothness without altering the general shape of the model. The magnitudes of in-plane translations are also consistent with existing registration techniques and experimental findings.

Keywords: Magnetic Resonance Imaging, Left Ventricle, ShapeRestoration, Principle Curvature, Optimization

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Authors: R. Schweighoffer, N. Nagy, E. Reeves, B. Liebig

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Due to aging populations, the need for seamless palliative care provision is of central interest for western societies. An essential aspect of palliative care delivery is the quality of collaboration amongst palliative care providers. Therefore, the current research is based on Bainbridge’s conceptual framework, which provides an outline for the evaluation of palliative care provision. This study is the first one to investigate the predictive validity of spatial distribution on the quantity of interaction amongst various palliative care providers. Furthermore, based on the familiarity principle, we examine whether the extent of collaboration influences the perceived quality of collaboration among palliative care providers in urban versus rural areas of Switzerland. Based on a population-representative survey of Swiss palliative care providers, the results of the current study show that professionals in densely populated areas report higher absolute numbers of interactions and are more satisfied with their collaborative practice. This indicates that palliative care providers who work in urban areas are better embedded into networks than their counterparts in more rural areas. The findings are especially important, considering that efficient collaboration is a prerequisite to achieve satisfactory patient outcomes. Conclusively, measures should be taken to foster collaboration in weakly interconnected palliative care networks.

Keywords: Collaboration, healthcare networks, palliative care, Switzerland.

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Authors: Okolie Uchenna, Ehiemere Ijeoma, Ezenduka Pauline, Ogbu Sylvester

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A cross sectional survey design was used to collect data from 370 diabetic patients. Two instruments were used in obtaining data; in-depth interview guide and researchers- developed questionnaire. Fisher's exact test was used to investigate association between the identified factors and nonadherence. Factors identified were: socio-demographic factors such as: gender, age, marital status, educational level and occupation; psychosocial obstacles such as: non-affordability of prescribed diet, frustration due to the restriction, limited spousal support, feelings of deprivation, feeling that temptation is inevitable, difficulty in adhering in social gatherings and difficulty in revealing to host that one is diabetic; health care providers obstacles were: poor attitude of health workers, irregular diabetes education in clinics , limited number of nutrition education sessions/ inability of the patients to estimate the desired quantity of food, no reminder post cards or phone calls about upcoming patient appointments and delayed start of appointment / time wasting in clinics.

Keywords: Behavior change, diabetes mellitus, dietarymanagement, diet adherence.

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Authors: Z. Karakus, Z. Ozer

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Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

Keywords: E-Learning, Medication Administration, Nursing, Nursing Students.

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Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: Data integrity, data integrity challenges, hospital information systems, South Africa.

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Authors: K. Shiba, T. Kobayashi, T. Kaburagi, Y. Kurihara

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Elderly population in the world is increasing, and consequently, their nursing burden is also increasing. In such situations, monitoring and evaluating their daily action facilitates efficient nursing care. Especially, we focus on an unconscious activity during sleep, i.e. turnover. Monitoring turnover during sleep is essential to evaluate various conditions related to sleep. Bedsores are considered as one of the monitoring conditions. Changing patient’s posture every two hours is required for caregivers to prevent bedsore. Herein, we attempt to develop an unconstrained nocturnal monitoring system using a sensing device based on piezoelectric ceramics that can detect the vibrations owing to human body movement on the bed. In the proposed method, in order to construct a multi-points sensing, we placed two sensing devices under the right and left legs at the head-side of an ordinary bed. Using this equipment, when a subject lies on the bed, feature is calculated from the output voltages of the sensing devices. In order to evaluate our proposed method, we conducted an experiment with six healthy male subjects. Consequently, the period during which turnover occurs can be correctly classified as the turnover period with 100% accuracy.

Keywords: Turnover, piezoelectric ceramics, multi-points sensing, unconstrained monitoring system.

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Authors: Dana Gabriková, Martin Mistrík, Jarmila Bernasovská, Iveta Tóthová, Jana Kisková

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The Roma (Gypsies) is a transnational minority with a high degree of consanguineous marriages. Similar to other genetically isolated founder populations, the Roma harbor a number of unique or rare genetic disorders. This paper discusses about a rare form of Charcot-Marie-Tooth disease – type 4G (CMT4G), also called Hereditary Motor and Sensory Neuropathy type Russe, an autosomal recessive disease caused by mutation private to Roma characterized by abnormally increased density of non-myelinated axons. CMT4G was originally found in Bulgarian Roma and in 2009 two putative causative mutations in the HK1 gene were identified. Since then, several cases were reported in Roma families mainly from Bulgaria and Spain. Here we present a Slovak Roma family in which CMT4G was diagnosed on the basis of clinical examination and genetic testing. This case is a further proof of the role of the HK1 gene in pathogenesis of the disease. It confirms that mutation in the HK1 gene is a common cause of autosomal recessive CMT disease in Roma and should be considered as a common part of a diagnostic procedure.

Keywords: Gypsies, HK1, HSMN-Russe, rare disease.

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Authors: Gry M, Bergström J, Lengquist J, Lindberg J, Drobin K, Schwenk J, Nilsson P, Schuppe-Koistinen I.

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Sensitive and predictive DILI (Drug Induced Liver Injury) biomarkers are needed in drug R&D to improve early detection of hepatotoxicity. The discovery of DILI biomarkers that demonstrate the predictive power to identify individuals at risk to DILI would represent a major advance in the development of personalized healthcare approaches. In this healthy volunteer acetaminophen study (4g/day for 7 days, with 3 monitored nontreatment days before and 4 after), 450 serum samples from 32 subjects were analyzed using protein profiling by antibody suspension bead arrays. Multiparallel protein profiles were generated using a DILI target protein array with 300 antibodies, where the antibodies were selected based on previous literature findings of putative DILI biomarkers and a screening process using pre dose samples from the same cohort. Of the 32 subjects, 16 were found to develop an elevated ALT value (2Xbaseline, responders). Using the plasma profiling approach together with multivariate statistical analysis some novel findings linked to lipid metabolism were found and more important, endogenous protein profiles in baseline samples (prior to treatment) with predictive power for ALT elevations were identified.

Keywords: DILI, Plasma profiling, PLSDA, Randomforest.

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Authors: Radhe Tado, Ashish B. Deoghare, K. M. Pandey

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The aim of this study is to estimate the effect of blood flow through the coronary artery in human heart so as to assess the coronary artery disease.Velocity, wall shear stress (WSS), strain rate and wall pressure distribution are some of the important hemodynamic parameters that are non-invasively assessed with computational fluid dynamics (CFD). These parameters are used to identify the mechanical factors responsible for the plaque progression and/or rupture in left coronary arteries (LCA) in coronary arteries.The initial step for CFD simulations was the construction of a geometrical model of the LCA. Patient specific artery model is constructed using computed tomography (CT) scan data with the help of MIMICS Research 19.0. For CFD analysis ANSYS FLUENT-14.5 is used.Hemodynamic parameters were quantified and flow patterns were visualized both in the absence and presence of coronary plaques. The wall pressure continuously decreased towards distal segments and showed pressure drops in stenotic segments. Areas of high WSS and high flow velocities were found adjacent to plaques deposition.

Keywords: Computational fluid dynamics, hemodynamics, velocity, strain rate, wall pressure, wall shear stress.

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Authors: Ayesha Zaman, Tanvir Atahary, Shahida Rafiq

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Functional Magnetic Resonance Imaging(fMRI) is a noninvasive imaging technique that measures the hemodynamic response related to neural activity in the human brain. Event-related functional magnetic resonance imaging (efMRI) is a form of functional Magnetic Resonance Imaging (fMRI) in which a series of fMRI images are time-locked to a stimulus presentation and averaged together over many trials. Again an event related potential (ERP) is a measured brain response that is directly the result of a thought or perception. Here the neuronal response of human visual cortex in normal healthy patients have been studied. The patients were asked to perform a visual three choice reaction task; from the relative response of each patient corresponding neuronal activity in visual cortex was imaged. The average number of neurons in the adult human primary visual cortex, in each hemisphere has been estimated at around 140 million. Statistical analysis of this experiment was done with SPM5(Statistical Parametric Mapping version 5) software. The result shows a robust design of imaging the neuronal activity of human visual cortex.

Keywords: Echo Planner Imaging, Event related Response, General Linear Model, Visual Neuronal Response.

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Authors: J. Bernasovská, R. Lohajová Behulová, E. Petrejčiková, I. Boroňová, I. Bernasovský

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Y chromosome microdeletions are the most common genetic cause of male infertility and screening for these microdeletions in azoospermic or severely oligospermic men is now standard practice. Analysis of the Y chromosome in men with azoospermia or severe oligozoospermia has resulted in the identification of three regions in the euchromatic part of the long arm of the human Y chromosome (Yq11) that are frequently deleted in men with otherwise unexplained spermatogenic failure. PCR analysis of microdeletions in the AZFa, AZFb and AZFc regions of the human Y chromosome is an important screening tool. The aim of this study was to analyse the type of microdeletions in men with fertility disorders in Slovakia. We evaluated 227 patients with azoospermia and with normal karyotype. All patient samples were analyzed cytogenetically. For PCR amplification of sequence-tagged sites (STS) of the AZFa, AZFb and AZFc regions of the Y chromosome was used Devyser AZF set. Fluorescently labeled primers for all markers in one multiplex PCR reaction were used and for automated visualization and identification of the STS markers we used genetic analyzer ABi 3500xl (Life Technologies). We reported 13 cases of deletions in the AZF region 5,73%. Particular types of deletions were recorded in each region AZFa,b,c .The presence of microdeletions in the AZFc region was the most frequent. The study confirmed that percentage of microdeletions in the AZF region is low in Slovak azoospermic patients, but important from a prognostic view.

Keywords: AZF, male infertility, microdeletions, Y chromosome.

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Authors: B. Stroetmann, A. Aisenbrey

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The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging and therapy, laboratory diagnostics, medical information technology, and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better, and more cost effective. The optimization of clinical workflows requires a multidisciplinary focus and a collaborative approach of e.g. medical advisors, researchers and scientists as well as healthcare economists. This new form of collaboration brings together experts with deep technical experience, physicians with specialized medical knowledge as well as people with comprehensive knowledge about health economics. As Charles Darwin is often quoted as saying, “It is neither the strongest of the species that survive, nor the most intelligent, but the one most responsive to change," We believe that those who can successfully manage this change will emerge as winners, with valuable competitive advantage. Current medical information and knowledge are some of the core assets in the healthcare industry. The main issue is to connect knowledge holders and knowledge recipients from various disciplines efficiently in order to spread and distribute knowledge.

Keywords: Business Excellence, Clinical Knowledge, Knowledge Management, Knowledge Services, Learning Organizations, Trust.

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Authors: M. Gooroochurn, D. Kerr, K. Bouazza-Marouf, M. Vloeberghs

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This paper presents the automated methods employed for extracting craniofacial landmarks in white light images as part of a registration framework designed to support three neurosurgical procedures. The intraoperative space is characterised by white light stereo imaging while the preoperative plan is performed on CT scans. The registration aims at aligning these two modalities to provide a calibrated environment to enable image-guided solutions. The neurosurgical procedures can then be carried out by mapping the entry and target points from CT space onto the patient-s space. The registration basis adopted consists of natural landmarks (eye corner and ear tragus). A 5mm accuracy is deemed sufficient for these three procedures and the validity of the selected registration basis in achieving this accuracy has been assessed by simulation studies. The registration protocol is briefly described, followed by a presentation of the automated techniques developed for the extraction of the craniofacial features and results obtained from tests on the AR and FERET databases. Since the three targeted neurosurgical procedures are routinely used for head injury management, the effect of bruised/swollen faces on the automated algorithms is assessed. A user-interactive method is proposed to deal with such unpredictable circumstances.

Keywords: Face Processing, Craniofacial Feature Extraction, Preoperative to Intraoperative Registration, Registration Basis.

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Authors: Bayar Shahab

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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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Authors: S. Ishak, M. G. Nasuruddin

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Traditional Malay performances are carried out for both entertainment and curing purposes. In curing rituals, the men and women serving as shamans, communicates with the spirits and beings from the nether world to facilitate the curing process. The dependency on engaging with these other-worldly beings however, have raised religious issues of being syirik, namely practicing in rituals which are religiously forbidden. This study aims to observe how ritual leaders attempt to negotiate the fine balance between what has been religiously forbidden and the psychological and sociological needs of the patient. Two curing rituals, the main peteri and the malibobou were chosen to exemplify the communication between the physical and spiritual realities. In both rituals, the healers engaged in procedures of curing as they attempted to diagnose sicknesses and proffer cures with the help of the spirits. The main peteri was conducted by a male shaman, the tuk teri whereas the malibobou was conducted by a female ritual specialist, the bobohizan. Main peteri and the malibobou both ended with ritually thanking and sending off the spirits back to their nether, invisible domains. These curing rituals heal not only the sick individual, but by extension, the village community. Therefore, there is a need to reconcile these rituals with religious tenets, beliefs and sociological-political-cultural dimensions.

Keywords: Traditional healing, trance, spirits, main peteri, bobohizan.

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Authors: Kyoung-Jong Park, Woong-Gi Jeon, Hee-Cheol Kim, Dong-Eog Kim, Heung-Kook Choi

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The brain MR imaging-based clinical research and analysis system were specifically built and the development for a large-scale data was targeted. We used the general clinical data available for building large-scale data. Registration period for the selection of the lesion ROI and the region growing algorithm was used and the Mesh-warp algorithm for matching was implemented. The accuracy of the matching errors was modified individually. Also, the large ROI research data can accumulate by our developed compression method. In this way, the correctly decision criteria to the research result was suggested. The experimental groups were age, sex, MR type, patient ID and smoking which can easily be queries. The result data was visualized of the overlapped images by a color table. Its data was calculated by the statistical package. The evaluation for the utilization of this system in the chronic ischemic damage in the area has done from patients with the acute cerebral infarction. This is the cause of neurologic disability index location in the center portion of the lateral ventricle facing. The corona radiate was found in the position. Finally, the system reliability was measured both inter-user and intra-user registering correlation.

Keywords: Software tool design, Cerebral infarction, Brain MR image, Registration

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Authors: Muhammad Shahid, Nasir-uddin Khan, Mushtaq Hussain, Muhammad Liaquat Ali, Asif Mansoor

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Tuberculosis (TB) remains a leading cause of infectious mortality. It is primarily transmitted by the respiratory route, individuals with active disease may infect others through airborne particles which releases when they cough, talk, or sing and subsequently inhale by others. In order to study the effect of the Bacilli Calmette-Guerin (BCG) vaccine after vaccination of TB patient, a Vaccinated Susceptible Infected and Recovered (VSIR) mathematical model is being developed to achieve the desired objectives. The mathematical model, so developed, shall be used to quantify the effect of BCG Vaccine to protect the immigrant young adult person. Moreover, equations are to be established for the disease endemic and free equilibrium states and subsequently utilized in disease stability analysis. The stability analysis will give a complete picture of disease annihilation from the total population if the total removal rate from the infectious group should be greater than total number of dormant infections produced throughout infectious period.

Keywords: Bacillus Calmette-Guerin vaccine, disease-free equilibrium state, VSIR Quantification, disease stability analysis.

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Authors: Lubis A., Setiawati L., Setyoningrum A. R., Suryawan A., Irwanto

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Asthma is a condition that causing chronic health problems in children. In addition to basic therapy against disease, we must try to reduce the impact of chronic health problems and also optimize their medical aspect of growth and development. A boy with mild asthma attack frequent episode did not showed any improvement with medical treatment and his asthma control test was 11. From radiologic examination he got hyperaerated lung and billateral sinusitis maxillaris; skin test results were house dust, food and pet allergy; an overweight body; bad school grades; psychological and environmental problem. We followed and evaluated this boy in 6 months, treated holistically. Even we could not do much on environmental but no more psychological and school problems, his on a good bodyweight and his asthma control test was 22. A case of a child with mild asthma attack frequent episode was reported. Asthma clinical course show no significant improvement when other predisposing factor is not well-controlled and a child’s growth and development may be affected. Improving condition of the patient can be created with the help of loving and caring way of nurturing from the parents and supportive peer group. Therefore, continuous and consistent monitoring is required because prognosis of asthma is generally good when regularly and properly controlled.

Keywords: Asthma, chronic health problems, growth and development.

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Authors: Tianqiao Zhang, Ye Tian, Yanliang Yin, Yichao Tian, Suzhai Tian, Weige Sun, Ruoliang Tang

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Heavy biomechanical loads at workplaces may lead to high risks of work-related musculoskeletal disorders (WMSDs). However, there is a lack of investigations on the efficacy of the ergonomic interventions with theoretical frameworks. This study aimed to formulate an Omaha System based remote intervention program on the WMSDs among nurses by systematic literature review, interviews, expert consultation. After screening title and abstract, 11 articles out of the initial search results (i.e., n=1,418) were included, 12 nurses were interviewed, and 10 experts were consulted to review the initial intervention program. Modification to the draft included (1) supplementing traditional Chinese medicine practices, (2) adding the use of assistive patient handling equipment, (3) revising the on-line training method, (4) editing and proofreading the main text of the initial program, (5) adding quizzes and exercise scales, (6) it was determined that the associated coursework should be announced promptly with multiple follow-up reminders, and (7) removing bodyweight superman exercise, and peaceful/calm meditation. In the end, the final intervention program was developed.

Keywords: Omaha System, nurses, remote intervention, musculoskeletal disease.

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Authors: Salama Meghriche, Amer Draa, Mohammed Boulemden

Abstract:

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: Mugabe Nzarama Gabriel

Abstract:

In Rwanda, many healthcare organizations are still using a paper based patients’ data record system although it still present weaknesses to share health patients’ information across different services when necessary. In developed countries, the EHR has been put in place to revolutionize the paper based record system but still the EHR has some challenges related to privacy, security, or interoperability. The purpose of this research was to assess the existing patients’ data record system in healthcare sector in Rwanda, see what an EHR can improve to the system in place and assess the acceptance of EHR as system which is interoperable, very secure and interoperable and see whether stakeholders are ready to adopt the system. The case based methodology was used and TAM theoretical framework to design the questionnaire for the survey. A judgmental sample across two cases, CHUB and Hopital de Nemba, has been selected and SPSS has been used for descriptive statistics. After a qualitative analysis, the findings showed that the paper based record is useful, gives complete information about the patient, protects the privacy of patients but it is still less secure and less interoperable. The respondents shown that they are ready to use the proposed EHR System and want it secure, capable of enforcing the privacy but still they are not all ready for the interoperability. A conclusion has been formulated; recommendations and further research have been proposed.

Keywords: EHR system, healthcare service, TAM, privacy, interoperability.

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Authors: Rosemarie Velik

Abstract:

Gait disturbance, particularly freezing of gait (FOG), is a phenomenon that is common in Parkinson’s patients and significantly contributes to a loss of function and independence. Walking performance and number of freezing episodes have been known to respond favorably to sensory cues of different modalities. However, a topic that has so far barely been touched is how to resolve freezing episodes via sensory cues once they have appeared. In this study, we analyze the effect of five different sensory cues on the duration of freezing episodes: (1) vibratory alert, (2) auditory alert, (3) vibratory rhythm, (4) auditory rhythm, (5) visual cue in form of parallel lines projected to the floor. The motivation for this study is to investigate the possibility of the design of a gait assistive device for Parkinson’s patients. Test subjects were 7 Parkinson’s patients regularly suffering from FOG. The patients had to repeatedly walk a pre-defined course and cues were triggered always 2 s after freezing onset. The effect was analyzed via experimental measurements and patient interviews. The measurements showed that all 5 sensory cues led to a decrease of the average duration of freezing: baseline (7.9s), vibratory alert (7.1s), auditory alert (6.7s), auditory rhythm (6.4s), vibratory rhythm (6.3s), and visual cue (5.3s). Nevertheless, interestingly, patients subjectively evaluated the audio alert and vibratory signals to have a significantly better effect for reducing their freezing duration than the visual cue.

Keywords: Auditory cueing, freezing of gait, gait assistance, Parkinson’s disease, vibratory cueing, visual cueing

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Authors: Min Kook Choi, Hyun Gyu Lee, Ryan You, Byeong-Seok Shin, Sang-Chul Lee

Abstract:

Wireless capsule Endoscopy (WCE) has rapidly shown its wide applications in medical domain last ten years thanks to its noninvasiveness for patients and support for thorough inspection through a patient-s entire digestive system including small intestine. However, one of the main barriers to efficient clinical inspection procedure is that it requires large amount of effort for clinicians to inspect huge data collected during the examination, i.e., over 55,000 frames in video. In this paper, we propose a method to compute meaningful motion changes of WCE by analyzing the obtained video frames based on regional optical flow estimations. The computed motion vectors are used to remove duplicate video frames caused by WCE-s imaging nature, such as repetitive forward-backward motions from peristaltic movements. The motion vectors are derived by calculating directional component vectors in four local regions. Our experiments are performed on small intestine area, which is of main interest to clinical experts when using WCEs, and our experimental results show significant frame reductions comparing with a simple frame-to-frame similarity-based image reduction method.

Keywords: Wireless capsule endoscopy, optical flow, duplicated image, duplicated frame.

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Authors: Paria Soleimani, Arezoo Neshati

Abstract:

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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