Search results for: Followed up patients

Authors: Helena Costa Oliveira, Carmem Oliveira, Rita Moutinho

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The Balanced Scorecard (BSC) is a continuous strategic monitoring model focused not only on financial issues but also on internal processes, patients/users, and learning and growth. Initially dedicated to business management, it currently serves organizations of other natures - such as hospitals. This paper presents a BSC designed for a Portuguese Acute Pain Unit (APU). This study is qualitative and based on the experience of collaborators at the APU. The management of APU is based on four perspectives – users, internal processes, learning and growth, and financial and legal. For each perspective, there were identified strategic objectives, critical factors, lead indicators and initiatives. The strategic map of the APU outlining sustained strategic relations among strategic objectives. This study contributes to the development of research in the health management area as it explores how organizational insufficiencies and inconsistencies in this particular case can be addressed, through the identification of critical factors, to clearly establish core outcomes and initiatives to set up.

Keywords: Acute pain unit, balanced scorecard, hospital management, organizational performance, Portugal.

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Authors: S. Kurien, S. Satpathy, S. K. Gupta, S. K. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: Adverse events, health care technology, public sector hospital, reporting systems.

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Authors: Mukhtar H. Hassan, Muhammed A. Basher, Elhadi E. Saad, Almahdi M. Almahdi

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The aim of this study was to demonstrate the possible effect of some variables such as age, gender, blood sugar level, and duration of diabetes on the serum level of zinc in diabetic individuals from Murzuk area. Serum zinc (Zn), Fasting blood sugar (FBS), hemoglobin HbA1c (HbA1c) were evaluated in 46 type I diabetic subjects (group 1), 48 type II diabetic subjects (group 2) and 43 healthy individuals (control) of both genders aged (30-81) years. Data showed that both diabetic groups have significantly higher (P<0.05) serum levels of Zn, FBS and HbA1c compared with controls. No significant (p>0.05) differences in serum Zn levels were observed between Males and Females. Serum Zn levels were non-significantly decreased with increasing age. In type II diabetic subjects, serum Zn levels were non-significantly decreased with increasing duration of disease whereas those in type I were non-significantly increased.

Keywords: Blood sugar, diabetes, HbA1c, zinc.

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Authors: V. Masilamani, C. Vanniarajan, Kamala Krithivasan

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As the Computed Tomography(CT) requires normally hundreds of projections to reconstruct the image, patients are exposed to more X-ray energy, which may cause side effects such as cancer. Even when the variability of the particles in the object is very less, Computed Tomography requires many projections for good quality reconstruction. In this paper, less variability of the particles in an object has been exploited to obtain good quality reconstruction. Though the reconstructed image and the original image have same projections, in general, they need not be the same. In addition to projections, if a priori information about the image is known, it is possible to obtain good quality reconstructed image. In this paper, it has been shown by experimental results why conventional algorithms fail to reconstruct from a few projections, and an efficient polynomial time algorithm has been given to reconstruct a bi-level image from its projections along row and column, and a known sub image of unknown image with smoothness constraints by reducing the reconstruction problem to integral max flow problem. This paper also discusses the necessary and sufficient conditions for uniqueness and extension of 2D-bi-level image reconstruction to 3D-bi-level image reconstruction.

Keywords: Discrete Tomography, Image Reconstruction, Projection, Computed Tomography, Integral Max Flow Problem, Smooth Binary Image.

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Authors: Mohd Azrul Hisham Mohd Adib, Nur Hazreen Mohd Hasni

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A three-dimensional and pulsatile blood flow in the left ventricle of heart model has been studied numerically. The geometry was derived from a simple approximation of the left ventricle model and the numerical simulations were obtained using a formulation of the Navier-Stokes equations. In this study, simulation was used to investigate the pattern of flow velocity in 3D model of heart with consider the left ventricle based on critical parameter of blood under steady condition. Our results demonstrate that flow velocity focused from mitral valve channel and continuous linearly to left ventricle wall but this skewness progresses into outside wall in atrium through aortic valve with random distribution that is irregular due to force subtract from ventricle wall during cardiac cycle. The findings are the prediction of the behavior of the blood flow velocity pattern in steady flow condition which can assist the medical practitioners in their decision on the patients- treatments.

Keywords: Mitral Valve, Aortic Valve, Cardiac Cycle, Leaflet, Biomechanics, Left Ventricle

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Authors: Binnur Sagbas

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Artificial joint replacements such as total knee and total hip prosthesis have been applied to the patients who affected by osteoarthritis. Although different material combinations are used for these joints, biopolymers are most commonly preferred materials especially for acetabular cup and tibial component of hip and knee joints respectively. The main limitation that shortens the service life of these prostheses is wear. Wear is complicated phenomena and it must be considered with friction and lubrication. In this study, micro wave (MW) induced argon+oxygen plasma surface modification were applied on ultra-high molecular weight polyethylene (UHMWPE) and vitamin E blended UHMWPE (VE-UHMWPE) biopolymer surfaces to improve surface wettability and wear resistance of the surfaces. Contact angel measurement method was used for determination of wettability. Ball-on-disc wear test was applied under 25% bovine serum lubrication conditions. The results show that surface wettability and wear resistance of both material samples were increased by plasma surface modification.

Keywords: Artificial joints, plasma surface modification, UHMWPE, vitamin E, wear.

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Authors: Roman Major, Klaudia Trembecka-Wojciga, Juergen Markus Lackner, Boguslaw Major

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The future and the development of science is therefore seen in interdisciplinary areas such as biomedical engineering. Selfassembled structures, similar to stem cell niches would inhibit fast division process and subsequently capture the stem cells from the blood flow. By means of surface topography and the stiffness as well as microstructure progenitor cells should be differentiated towards the formation of endothelial cells monolayer which effectively will inhibit activation of the coagulation cascade. The idea of the material surface development met the interest of the clinical institutions, which support the development of science in this area and are waiting for scientific solutions that could contribute to the development of heart assist systems. This would improve the efficiency of the treatment of patients with myocardial failure, supported with artificial heart assist systems. Innovative materials would enable the redesign, in the post project activity, construction of ventricular heart assist.

Keywords: Bio-inspired materials, electron microscopy, haemocompatibility, niche-like structures, thin coatings.

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Authors: Ebrahim Farahmand, Ali Mahani

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Wireless sensor networks (WSNs) can facilitate continuous monitoring of patients and increase early detection of emergency conditions and diseases. High density WSNs helps us to accurately monitor a remote environment by intelligently combining the data from the individual nodes. Due to energy capacity limitation of sensors, enhancing the lifetime and the reliability of WSNs are important factors in designing of these networks. The clustering strategies are verified as effective and practical algorithms for reducing energy consumption in WSNs and can tackle WSNs limitations. In this paper, an Energy-efficient weight-based Clustering Protocol (EWCP) is presented. Artificial retina is selected as a case study of WSNs applied in body sensors. Cluster heads’ (CHs) selection is equipped with energy efficient parameters. Moreover, cluster members are selected based on their distance to the selected CHs. Comparing with the other benchmark protocols, the lifetime of EWCP is improved significantly.

Keywords: Clustering of WSNs, healthcare monitoring, weight-based clustering, wireless sensor networks.

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Authors: Tsair-Fwu Lee , Hui-Min Ting , Pei-Ju Chao, Jing-Chuan Jiang, Min-Yuan Chao, Wen-Cheng Chen, Long-Chang Chen, Jia-Ming Wu

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The purpose of this study is to derive parameters estimating for the Lyman–Kutcher–Burman (LKB) normal tissue complication probability (NTCP) model using analysis of scintigraphy assessments and quality of life (QoL) measurement questionnaires for the parotid gland (xerostomia). In total, 31 patients with head-and-neck (HN) cancer were enrolled. Salivary excretion factor (SEF) and EORTC QLQ-H&N35 questionnaires datasets are used for the NTCP modeling to describe the incidence of grade 4 xerostomia. Assuming that n= 1, NTCP fitted parameters are given as TD50= 43.6 Gy, m= 0.18 in SEF analysis, and as TD50= 44.1 Gy, m= 0.11 in QoL measurements, respectively. SEF and QoL datasets can validate the Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC) guidelines well, resulting in NPV-s of 100% for the both datasets and suggests that the QUANTEC 25/20Gy gland-spared guidelines are suitable for clinical used for the HN cohort to effectively avoid xerostomia.

Keywords: HN, NTCP, SEF, QoL, QUANTEC

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Authors: S. Nurdiana, A. S. Nor Haziqah, M. K. Nur Ezwa Khairunnisa, S. Nurul `Izzati, Y. Siti Amna M. J. Norashirene, I. Nur Hilwani

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Azadirachta excelsa or locally known as sentang are frequently used as a traditional medicine by diabetes patients in Malaysia. However, less attention has been given to their toxicity effect. Thus, the study is an attempt to examine the protective effect of A. excelsa on the pancreas and to determine possible toxicity mediated by the extract. Diabetes was induced experimentally in rats by high-fat-diet for 16 weeks followed by intraperitoneal injection of streptozotocin at dosage of 35 mg/kg of body weight. Declination of the fasting blood glucose level was observed after continuous administration of A. excelsa for 14 days twice daily. This is due to the refining structure of the pancreas. However, surprisingly, the plant extract reduced the leukocytes, erythrocytes, hemoglobin, MCHC and lymphocytes. In addition, the rat treated with the plant extract exhibited increment in AST and eosinocytes level. Overall, the finding shows that A. excelsa possesses antidiabetic activity by improving the structure of pancreatic islet of Langerhans but involved in ameliorating of hematology and biochemical parameters.

Keywords: Azadirachta excelsa, diabetes, pancreas, hematobiochemical parameters.

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Authors: Ali Anaissi, Paul J. Kennedy, Madhu Goyal

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Analysis and visualization of microarraydata is veryassistantfor biologists and clinicians in the field of diagnosis and treatment of patients. It allows Clinicians to better understand the structure of microarray and facilitates understanding gene expression in cells. However, microarray dataset is a complex data set and has thousands of features and a very small number of observations. This very high dimensional data set often contains some noise, non-useful information and a small number of relevant features for disease or genotype. This paper proposes a non-linear dimensionality reduction algorithm Local Principal Component (LPC) which aims to maps high dimensional data to a lower dimensional space. The reduced data represents the most important variables underlying the original data. Experimental results and comparisons are presented to show the quality of the proposed algorithm. Moreover, experiments also show how this algorithm reduces high dimensional data whilst preserving the neighbourhoods of the points in the low dimensional space as in the high dimensional space.

Keywords: Linear Dimension Reduction, Non-Linear Dimension Reduction, Principal Component Analysis, Biologists.

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Authors: Marine A. Balayan, Susanna S. Mirzabekyan, Marine Isajanyan, Zaven S. Pepoyan, Аrmen H. Trchounian, Аstghik Z. Pepoyan, Helena Bujdakova

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It has been shown that pH 7,3 and 37 0C are the optimal condition for the growth of E. coli “ASAP". The cells grow well on Glucose, Lactose, D-Mannitol, D-Sorbitol, (+)-Xylose, L- (+)-Arabinose and Dulcitol. No growth has been observed on Sucrose, Inositol, Phenylalanine, and Tryptophan. The strain is sensitive to a range of antibiotics. The present study has demonstrated that E. coli “ASAP" inhibit the growth of S. enterica ATCC #700931 in vitro. The studies on conjugating activity has revealed no conjugant of E. coli “ASAP" with plasmid strains E. coli G35#59 and S. enterica ATCC #700931. On the other hand, the conjugants with low frequencies were obtained from E. coli “ASAP" with E. coli G35#61, and E. coli “ASAP" with randomly chosen isolate from healthy human gut microflora: E. coli E6. The results of present study have demonstrated improvements in gut microflora condition of patients with different diseases after the administration of “ASAP"

Keywords: E. coli, ASAP, Probiotic formula, gut microflora.

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Authors: Sajid Abbas, Joon Pyo Hong, Jung-Ryun Lee, Seungryong Cho

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Computed tomography and laminography are heavily investigated in a compressive sensing based image reconstruction framework to reduce the dose to the patients as well as to the radiosensitive devices such as multilayer microelectronic circuit boards. Nowadays researchers are actively working on optimizing the compressive sensing based iterative image reconstruction algorithm to obtain better quality images. However, the effects of the sampled data’s properties on reconstructed the image’s quality, particularly in an insufficient sampled data conditions have not been explored in computed laminography. In this paper, we investigated the effects of two data properties i.e. sampling density and data incoherence on the reconstructed image obtained by conventional computed laminography and a recently proposed method called spherical sinusoidal scanning scheme. We have found that in a compressive sensing based image reconstruction framework, the image quality mainly depends upon the data incoherence when the data is uniformly sampled.

Keywords: Computed tomography, Computed laminography, Compressive sending, Low-dose.

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Authors: Novita Verayanti Manalu, Alvin Salim, Esti Yunitasari

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Background: Palliative care is caring holistically for patients and families to improve their quality of life. The approach by a multidisciplinary team requires integrated collaboration based on sufficient knowledge of the principles of palliative care as a whole, especially for nurses. Therefore, this study wants to find out the level of knowledge about palliative care of the nurses along the relationship with attitude and performance. Method: This study applies cross-sectional survey design and allows the respondents to fill two questionnaires to determine the level of knowledge and attitude toward palliative care, while one questionnaire is filled by the head nurse to evaluate nurses’ performance. The relationship was analyzed by Spearman rho’s correlation in alpha < 0.05 by SPSS. Results: The majority of respondents were females, age above 25 years old, and married. Most of the nurses are staff nurses and the ratio of education level is not significantly different. The knowledge level is poor, while the attitude and performance are in adequate level. Knowledge may affect attitude, but it does not happen toward performance. Conclusion: There is a need for increased knowledge about palliative care to improve attitude and work performance. Future researchers might use this finding as reference to conduct further study in improving knowledge of palliative care.

Keywords: Knowledge, attitude, work performance, palliative care.

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Authors: Nisar Ahmed Memon, Anwar Majid Mirza, S.A.M. Gilani

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Segmentation is an important step in medical image analysis and classification for radiological evaluation or computer aided diagnosis. The CAD (Computer Aided Diagnosis ) of lung CT generally first segment the area of interest (lung) and then analyze the separately obtained area for nodule detection in order to diagnosis the disease. For normal lung, segmentation can be performed by making use of excellent contrast between air and surrounding tissues. However this approach fails when lung is affected by high density pathology. Dense pathologies are present in approximately a fifth of clinical scans, and for computer analysis such as detection and quantification of abnormal areas it is vital that the entire and perfectly lung part of the image is provided and no part, as present in the original image be eradicated. In this paper we have proposed a lung segmentation technique which accurately segment the lung parenchyma from lung CT Scan images. The algorithm was tested against the 25 datasets of different patients received from Ackron Univeristy, USA and AGA Khan Medical University, Karachi, Pakistan.

Keywords: Computer Aided Diagnosis, Medical ImageProcessing, Region Growing, Segmentation, Thresholding,

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Authors: R. C. Barbuti, M. N. Oliveira, N. P. Perina, C. Haro, P. Bosch, C. S. Bogsan, J. N. Eisig, T. Navarro-Rodriguez

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The management of Helicobacter pylori (H. pylori) eradication is still a matter of discussion, full effectiveness is rarely achieved, and it has many adverse effects. The use of probiotics may be associated with better eradication rates and possibly prevention of adverse events due to antibiotic therapy. The present clinical study was undertaken to evaluate the efficacy of a specially designed fermented milk product, containing Bifidobacterium lactis B420, on the eradication of H. pylori infection in a prospective, randomized, double-blind, controlled study in humans. Four test fermented milks (FM) were specially designed in which counts of viable cells in all products were 10^10 Log CFU. 100 mL-1 for Bifidobacterium lactis - Bifidobacterium species 420. 190 subjects infected with H. pylori, with previous diagnosis of functional dyspepsia according to Rome III criteria entered the study. Bifidobacterium lactis B420, administered twice a day for 90 days was not able to eradicate H. pylori in Brazilian patients with functional dyspepsia.

Keywords: Antibacterial Therapy, Bifidobacteria Fermented milk, Helicobacter pylori, probiotics.

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Authors: Javed Khan, Aamir Saeed Malik, Nidal Kamel, Sarat Chandra Dass, Azura Mohd Affandi

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Low contrast images can result from the wrong setting of image acquisition or poor illumination conditions. Such images may not be visually appealing and can be difficult for feature extraction. Contrast enhancement of color images can be useful in medical area for visual inspection. In this paper, a new technique is proposed to improve the contrast of color images. The RGB (red, green, blue) color image is transformed into normalized RGB color space. Adaptive histogram equalization technique is applied to each of the three channels of normalized RGB color space. The corresponding channels in the original image (low contrast) and that of contrast enhanced image with adaptive histogram equalization (AHE) are morphed together in proper proportions. The proposed technique is tested on seventy color images of acne patients. The results of the proposed technique are analyzed using cumulative variance and contrast improvement factor measures. The results are also compared with decorrelation stretch. Both subjective and quantitative analysis demonstrates that the proposed techniques outperform the other techniques.

Keywords: Contrast enhancement, normalized RGB, adaptive histogram equalization, cumulative variance.

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Authors: I-En Lin, Feng-Jung Yang

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In addition to kidney transplant, renal replacement therapy involves hemodialysis and peritoneal dialysis (PD). PD possesses advantages such as maintaining stable physiological blood status and blood pressure, alleviating anemia, and improving mobility, which make it an ideal method for at-home dialysis treatment. However, potential danger still exists despite the numerous advantages of PD, particularly when patients require dialysis exchange four to five times a day, during which improper operation can easily lead to peritonitis. The process of draining and filling is called an exchange and takes about 30 to 40 minutes. Connecting the transfer set requires sterile technique. Transfer set may require a new cap each time that it disconnects from the bag after an exchange. There are many chances to get infection due to unsafe behavior (ex: hand tremor, poor eyesight and weakness, cap fall-down). The proposed semi-automatic connection mechanism used in the PD can greatly reduce infection chances. This light-weight connection device is portable. The device also does not require using throughout the entire process. It is capable of significantly improving quality of life. Therefore, it is very promising to adopt in home care application.

Keywords: Automatic connection, catheter, glomerulonephritis, peritoneal dialysis.

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Authors: Vallejo Michael, Acuña Edgar, Roa Juan David, Peñuela Rosa, Parra Alejandra, Casallas Daniela, Rodriguez Sheyla

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Congenital Zika Virus Syndrome is an entity composed by a variety of birth defects presented in newborns that have been exposed to the Zika Virus during pregnancy. The syndrome characteristic features are severe microcephaly, cerebral tissue abnormalities, ophthalmological abnormalities such as uveitis and chorioretinitis, arthrogryposis, clubfoot deformity and muscular tone abnormalities. The confirmatory test is the Reverse transcription polymerase chain reaction (RT-PCR) associated to the physical findings. Here we present the case of a newborn with microcephaly whose mother presented a confirmed Zika Virus infection during the third trimester of pregnancy, despite of the evident findings and the history of Zika infection the RT-PCR in amniotic and cerebrospinal fluid of the newborn was negative. RT-PCR has demonstrated a low sensibility in samples with low viral loads, reason why, we propose a clinical diagnosis in patients with clinical history of Zika Virus infection during pregnancy accompanied by evident clinical manifestations of the child.

Keywords: Zika Virus, polymerase chain reaction, microcephaly, amniotic fluid.

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Authors: Hironobu Murayama, Shohei Shimizu, Masakazu Ohnuki, Hisanori Mihara, Tohru Kanada

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Disordered function of maniphalanx and difficulty with ambulation will occur insofar as a human has a failure in the spinal marrow. Cervical spondylotic myelopathy as one of the myelopathy emanates from not only external factors but also increased age. In addition, the diacrisis is difficult since cervical spondylotic myelopathy is evaluated by a doctor-s neurological remark and imaging findings. As a quantitative method for measuring the degree of disability, hand-operated triangle step test (for short, TST) has formulated. In this research, a full automatic triangle step counter apparatus is designed and developed to measure the degree of disability in an accurate fashion according to the principle of TST. The step counter apparatus whose shape is a low triangle pole displays the number of stepping upon each corner. Furthermore, the apparatus has two modes of operation. Namely, one is for measuring the degree of disability and the other for rehabilitation exercise. In terms of usefulness, clinical practice should be executed before too long.

Keywords: Cervical spondylotic myelopathy, disorder of lower limbs, measuringfunction, rehabilitation function, full automatic apparatus, triangle step test.

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Authors: Jih-Rue Pan, Feng-Chuan Pan

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Today-s healthcare industries had become more patient-centric than profession-centric, from which the issues of quality of healthcare and the patient safety are the major concerns in the modern healthcare facilities. An unplanned extubation (UE) may be detrimental to the patient-s life, and thus is one of the major indexes of patient safety and healthcare quality. A high UE rate not only defeated the healthcare quality as well as the patient safety policy but also the nurses- morality, and job satisfaction. The UE problem in a psychiatric hospital is unique and may be a tough challenge for the healthcare professionals for the patients were mostly lacking communication capabilities. We reported with this essay a particular project that was organized to reduce the UE rate from the current 2.3% to a lower and satisfactory level in the long-term care units of a psychiatric hospital. The project was conducted between March 1st, 2011 and August 31st, 2011. Based on the error information gathered from varied units of the hospital, the team analyzed the root causes with possible solutions proposed to the meetings. Four solutions were then concluded with consensus and launched to the units in question. The UE rate was now reduced to a level of 0.17%. Experience from this project, the procedure and the tools adopted would be good reference to other hospitals.

Keywords: Unplanned extubation, patient safety, error information

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Authors: M.H. Ahmad Fadzil, Hurriyatul Fitriyah, Esa Prakasa, Hermawan Nugroho, S.H. Hussein, Azura Mohd. Affandi

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Psoriasis is a chronic inflammatory skin condition which affects 2-3% of population around the world. Psoriasis Area and Severity Index (PASI) is a gold standard to assess psoriasis severity as well as the treatment efficacy. Although a gold standard, PASI is rarely used because it is tedious and complex. In practice, PASI score is determined subjectively by dermatologists, therefore inter and intra variations of assessment are possible to happen even among expert dermatologists. This research develops an algorithm to assess psoriasis lesion for PASI scoring objectively. Focus of this research is thickness assessment as one of PASI four parameters beside area, erythema and scaliness. Psoriasis lesion thickness is measured by averaging the total elevation from lesion base to lesion surface. Thickness values of 122 3D images taken from 39 patients are grouped into 4 PASI thickness score using K-means clustering. Validation on lesion base construction is performed using twelve body curvature models and show good result with coefficient of determinant (R2) is equal to 1.

Keywords: 3D digital imaging, base construction, PASI, psoriasis lesion thickness.

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Authors: Nadia Masood Khan, Muhammad Salman Khan, Gul Muhammad Khan

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Cardiologists perform cardiac auscultation to detect abnormalities in heart sounds. Since accurate auscultation is a crucial first step in screening patients with heart diseases, there is a need to develop computer-aided detection/diagnosis (CAD) systems to assist cardiologists in interpreting heart sounds and provide second opinions. In this paper different algorithms are implemented for automated heart sound classification using unsegmented phonocardiogram (PCG) signals. Support vector machine (SVM), artificial neural network (ANN) and cartesian genetic programming evolved artificial neural network (CGPANN) without the application of any segmentation algorithm has been explored in this study. The signals are first pre-processed to remove any unwanted frequencies. Both time and frequency domain features are then extracted for training the different models. The different algorithms are tested in multiple scenarios and their strengths and weaknesses are discussed. Results indicate that SVM outperforms the rest with an accuracy of 73.64%.

Keywords: Pattern recognition, machine learning, computer aided diagnosis, heart sound classification, and feature extraction.

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Authors: A. Shukla, A. Tarsauliya, R. Tiwari, S. Sharma

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Cancer classification to their corresponding cohorts has been key area of research in bioinformatics aiming better prognosis of the disease. High dimensionality of gene data has been makes it a complex task and requires significance data identification technique in order to reducing the dimensionality and identification of significant information. In this paper, we have proposed a novel approach for classification of oral cancer into metastasis positive and negative patients. We have used significance analysis of microarrays (SAM) for identifying significant genes which constitutes gene signature. 3 different gene signatures were identified using SAM from 3 different combination of training datasets and their classification accuracy was calculated on corresponding testing datasets using k-Nearest Neighbour (kNN), Fuzzy C-Means Clustering (FCM), Support Vector Machine (SVM) and Backpropagation Neural Network (BPNN). A final gene signature of only 9 genes was obtained from above 3 individual gene signatures. 9 gene signature-s classification capability was compared using same classifiers on same testing datasets. Results obtained from experimentation shows that 9 gene signature classified all samples in testing dataset accurately while individual genes could not classify all accurately.

Keywords: Cancer, Gene Signature, SAM, Classification.

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Authors: Hadeer R. M. Tawfik, Rania A. K. Birry, Amani A. Saad

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Eyes are considered to be the most sensitive and important organ for human being. Thus, any eye disorder will affect the patient in all aspects of life. Cataract is one of those eye disorders that lead to blindness if not treated correctly and quickly. This paper demonstrates a model for automatic detection, classification, and grading of cataracts based on image processing techniques and artificial intelligence. The proposed system is developed to ease the cataract diagnosis process for both ophthalmologists and patients. The wavelet transform combined with 2D Log Gabor Wavelet transform was used as feature extraction techniques for a dataset of 120 eye images followed by a classification process that classified the image set into three classes; normal, early, and advanced stage. A comparison between the two used classifiers, the support vector machine SVM and the artificial neural network ANN were done for the same dataset of 120 eye images. It was concluded that SVM gave better results than ANN. SVM success rate result was 96.8% accuracy where ANN success rate result was 92.3% accuracy.

Keywords: Cataract, classification, detection, feature extraction, grading, log-gabor, neural networks, support vector machines, wavelet.

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Authors: Sotirios Raptis

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Health and Social care (HSc) services planning and scheduling are facing unprecedented challenges, due to the pandemic pressure and also suffer from unplanned spending that is negatively impacted by the global financial crisis. Data-driven approaches can help to improve policies, plan and design services provision schedules using algorithms that assist healthcare managers to face unexpected demands using fewer resources. The paper discusses services packing using statistical significance tests and machine learning (ML) to evaluate demands similarity and coupling. This is achieved by predicting the range of the demand (class) using ML methods such as Classification and Regression Trees (CART), Random Forests (RF), and Logistic Regression (LGR). The significance tests Chi-Squared and Student’s test are used on data over a 39 years span for which data exist for services delivered in Scotland. The demands are associated using probabilities and are parts of statistical hypotheses. These hypotheses, as their NULL part, assume that the target demand is statistically dependent on other services’ demands. This linking is checked using the data. In addition, ML methods are used to linearly predict the above target demands from the statistically found associations and extend the linear dependence of the target’s demand to independent demands forming, thus, groups of services. Statistical tests confirmed ML coupling and made the prediction statistically meaningful and proved that a target service can be matched reliably to other services while ML showed that such marked relationships can also be linear ones. Zero padding was used for missing years records and illustrated better such relationships both for limited years and for the entire span offering long-term data visualizations while limited years periods explained how well patients numbers can be related in short periods of time or that they can change over time as opposed to behaviours across more years. The prediction performance of the associations were measured using metrics such as Receiver Operating Characteristic (ROC), Area Under Curve (AUC) and Accuracy (ACC) as well as the statistical tests Chi-Squared and Student. Co-plots and comparison tables for the RF, CART, and LGR methods as well as the p-value from tests and Information Exchange (IE/MIE) measures are provided showing the relative performance of ML methods and of the statistical tests as well as the behaviour using different learning ratios. The impact of k-neighbours classification (k-NN), Cross-Correlation (CC) and C-Means (CM) first groupings was also studied over limited years and for the entire span. It was found that CART was generally behind RF and LGR but in some interesting cases, LGR reached an AUC = 0 falling below CART, while the ACC was as high as 0.912 showing that ML methods can be confused by zero-padding or by data’s irregularities or by the outliers. On average, 3 linear predictors were sufficient, LGR was found competing well RF and CART followed with the same performance at higher learning ratios. Services were packed only when a significance level (p-value) of their association coefficient was more than 0.05. Social factors relationships were observed between home care services and treatment of old people, low birth weights, alcoholism, drug abuse, and emergency admissions. The work found  that different HSc services can be well packed as plans of limited duration, across various services sectors, learning configurations, as confirmed by using statistical hypotheses.

Keywords: Class, cohorts, data frames, grouping, prediction, probabilities, services.

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Authors: M. Owlia, M. H. Azarsa, M. Khabbazan, A. Mirbagheri

Abstract:

Proprioceptive neuromuscular facilitation exercises are a series of stretching techniques that are commonly used in rehabilitation and exercise therapy. Assessment of these exercises for true maneuvering requires extensive experience in this field and could not be down with patients themselves. In this paper, we developed software that uses Microsoft Kinect sensor, a spherical color marker, and real-time image processing methods to evaluate patient’s performance in generating true patterns of movements. The software also provides the patient with a visual feedback by showing his/her avatar in a Virtual Reality environment along with the correct path of moving hand, wrist and marker. Primary results during PNF exercise therapy of a patient in a room environment shows the ability of the system to identify any deviation of maneuvering path and direction of the hand from the one that has been performed by an expert physician.

Keywords: Image processing, Microsoft Kinect, proprioceptive neuromuscular facilitation, upper extremities assessment, virtual reality.

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Authors: Sun Woo Lee, Tae Bum Lee, Yoon Hwa Park, Yoo Jeong Kim

Abstract:

Cervical dentinal hypersensitivity (CDH) affects 8-30% of adults and nearly 85% of perio-treated patients. Various treatment schemes have been applied for treating CDH, among them being fluoride application, laser irradiation, and, recently, bioglass. The purpose of this study was to investigate the influence of bioglass, copper-bromide (Cu-Br) laser irradiation and their combination on dentinal tubule occlusion as a potential dentinal hypersensitivity treatment for CDH. 45 human dentin surfaces were organized into three equal groups: group A received Cu-Br laser only; group B received bioglass only; group C received bioglass followed by Cu-Br laser irradiation. Specimens were evaluated with regard to dentinal tubule occlusion under environmental scanning electron microscope. Treatment modality significantly affected dentinal tubule occlusion (p<0.001). Groups B and C scored higher dentinal tubule occlusion than group A. Binary logistic regression showed that bioglass application significantly (p<0.001) contributed to dentinal tubule occlusion, compared with other variables. Under the conditions used herein and within the limitations of this study, bioglass application, alone or combined with Cu-Br laser irradiation, is a superior method for producing dentinal tubule occlusion, and may lead to an effective treatment modality for CDH.

Keywords: Bioglass, Cu-Br laser, cervical dentinal hypersensitivity, dentinal tubule occlusion.

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Authors: Donatien Callon, Ian Lalonde, Mathieu Nadeau, Alexandre Girard

Abstract:

Patient transfer is a challenging, critical task because it exposes caregivers to injury risks. Available transfer devices, like floor lifts, lead to improvements but are far from perfect. They do not eliminate the caregivers’ risk of musculoskeletal disorders, and they can be burdensome to use due to their poor maneuverability. This paper presents a motorized floor lift with a single central motorized wheel connected to an instrumented handle. Admittance controllers are designed to 1) improve the device maneuverability, 2) reduce the required caregiver effort, and 3) ensure the security and comfort of patients. Two controller designs, one with a linear admittance law and a non-linear admittance law with variable damping, were developed and implemented on a prototype. Tests were performed on seven participants to evaluate the performance of the assistance system and the controllers. The experimental results show that 1) the motorized assistance with the variable damping controller improves maneuverability by 28%, 2) reduces the amount of effort required to push the lift by 66% and 3) provides the same level of patient comfort compared to a standard unassisted floor lift.

Keywords: Floor lift, human robot interaction, admittance controller, variable admittance.

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Authors: Chang, Chun-Lang, Liu, Chun-Kai

Abstract:

This study, for its research subjects, uses patients who had undergone total knee replacement surgery from the database of the National Health Insurance Administration. Through the review of literatures and the interviews with physicians, important factors are selected after careful screening. Then using Cross Entropy Method, Genetic Algorithm Logistic Regression, and Particle Swarm Optimization, the weight of each factor is calculated and obtained. In the meantime, Excel VBA and Case Based Reasoning are combined and adopted to evaluate the system. Results show no significant difference found through Genetic Algorithm Logistic Regression and Particle Swarm Optimization with over 97% accuracy in both methods. Both ROC areas are above 0.87. This study can provide critical reference to medical personnel as clinical assessment to effectively enhance medical care quality and efficiency, prevent unnecessary waste, and provide practical advantages to resource allocation to medical institutes.

Keywords: Total knee replacement, Case Based Reasoning, Cross Entropy Method, Genetic Algorithm Logistic Regression, Particle Swarm Optimization.

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