Search results for: Medical Imaging
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 834

Search results for: Medical Imaging

354 Preparation of Polymer-Stabilized Magnetic Iron Oxide as Selective Drug Nanocarriers to Human Acute Myeloid Leukemia

Authors: Kheireddine El-Boubbou

Abstract:

Drug delivery to target human acute myeloid leukemia (AML) using a nanoparticulate chemotherapeutic formulation that can deliver drugs selectively to AML cancer is hugely needed. In this work, we report the development of a nanoformulation made of polymeric-stabilized multifunctional magnetic iron oxide nanoparticles (PMNP) loaded with the anticancer drug Doxorubicin (Dox) as a promising drug carrier to treat AML. Dox@PMNP conjugates simultaneously exhibited high drug content, maximized fluorescence, and excellent release properties. Nanoparticulate uptake and cell death following addition of Dox@PMNPs were then evaluated in different types of human AML target cells, as well as on normal human cells. While the unloaded MNPs were not toxic to any of the cells, Dox@PMNPs were found to be highly toxic to the different AML cell lines, albeit at different inhibitory concentrations (IC50 values), but showed very little toxicity towards the normal cells. In comparison, free Dox showed significant potency concurrently to all the cell lines, suggesting huge potentials for the use of Dox@PMNPs as selective AML anticancer cargos. Live confocal imaging, fluorescence and electron microscopy confirmed that Dox is indeed delivered to the nucleus in relatively short periods of time, causing apoptotic cell death. Importantly, this targeted payload may potentially enhance the effectiveness of the drug in AML patients and may further allow physicians to image leukemic cells exposed to Dox@PMNPs using MRI.

Keywords: Magnetic nanoparticles, drug delivery, acute myeloid leukemia, iron oxide, cancer nanotherapy.

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353 Positioning a Southern Inclusive Framework Embedded in the Social Model of Disability Theory Contextualized for Guyana

Authors: Lidon Lashley

Abstract:

This paper presents how the social model of disability can be used to reshape inclusive education practices in Guyana. Inclusive education in Guyana is metamorphosizing but still firmly held in the tenets of the Medical Model of Disability which influences the experiences of children with Special Education Needs and/or Disabilities (SEN/D). An ethnographic approach to data gathering was employed in this study. Qualitative data were gathered from the voices of children with and without SEN/D as well as their mainstream teachers to present the interplay of discourses and subjectivities in the situation. The data were analyzed using Adele Clarke's situational analysis. The data suggest that it is possible but will be challenging to fully contextualize and adopt Loreman's synthesis and Booths and Ainscow's Index in the two mainstream schools studied. In addition, the data paved the way for the presentation of the 'Southern Inclusive Education Framework for Guyana' and its support tool 'The Inclusive Checker created for Southern mainstream primary classrooms'.

Keywords: Social Model of Disability, Medical Model of Disability, subjectivities, metamorphosis, special education needs, postcolonial Guyana, Quasi-inclusion practices, Guyanese cultural challenges, mainstream primary schools, Loreman's Synthesis, Booths and Ainscow's Index.

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352 Malpractice, Even in Conditions of Compliance with the Rules of Dental Ethics

Authors: Saimir Heta, Kers Kapa, Rialda Xhizdari, Ilma Robo

Abstract:

Despite the existence of different dental specialties, the dentist-patient relationship is unique, in the very fact that the treatment is performed by one doctor and the patient identifies the malpractice presented as part of that doctor's practice; this is in complete contrast to cases of medical treatments where the patient can be presented to a team of doctors, to treat a specific pathology. The rules of dental ethics are almost the same as the rules of medical ethics. The appearance of dental malpractice affects exactly this two-party relationship, created on the basis of professionalism, without deviations in this direction, between the dentist and the patient, but with very narrow individual boundaries, compared to cases of medical malpractice. Malpractice can have different reasons for its appearance, starting from professional negligence, but also from the lack of professional knowledge of the dentist who undertakes the dental treatment. It should always be seen in perspective that we are not talking about the individual - the dentist who goes to work with the intention of harming their patients. Malpractice can also be a consequence of the impossibility, for anatomical or physiological reasons of the tooth under dental treatment, to realize the predetermined dental treatment plan. On the other hand, the dentist himself is an individual who can be affected by health conditions, or have vices that affect the systemic health of the dentist as an individual, which in these conditions can cause malpractice. So, depending on the reason that led to the appearance of malpractice, the method of treatment from a legal point of view also varies, for the dentist who committed the malpractice, evaluating the latter if the malpractice came under the conditions of applying the rules of dental ethics. The deviation from the predetermined dental plan is the minimum sign of malpractice and the latter should not be definitively related only to cases of difficult dental treatments. The identification of the reason for the appearance of malpractice is the initial element, which makes the difference in the way of its treatment, from a legal point of view, and the involvement of the dentist in the assessment of the malpractice committed, must be based on the legislation in force, which must be said to have their specific changes in different states. Malpractice should be referred to, or included in the lectures or in the continuing education of professionals, because it serves as a method of obtaining professional experience in order not to repeat the same thing several times, by different professionals.

Keywords: Dental ethics, malpractice, negligence, legal basis, continuing education, dental treatments.

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351 Replicating Brain’s Resting State Functional Connectivity Network Using a Multi-Factor Hub-Based Model

Authors: B. L. Ho, L. Shi, D. F. Wang, V. C. T. Mok

Abstract:

The brain’s functional connectivity while temporally non-stationary does express consistency at a macro spatial level. The study of stable resting state connectivity patterns hence provides opportunities for identification of diseases if such stability is severely perturbed. A mathematical model replicating the brain’s spatial connections will be useful for understanding brain’s representative geometry and complements the empirical model where it falls short. Empirical computations tend to involve large matrices and become infeasible with fine parcellation. However, the proposed analytical model has no such computational problems. To improve replicability, 92 subject data are obtained from two open sources. The proposed methodology, inspired by financial theory, uses multivariate regression to find relationships of every cortical region of interest (ROI) with some pre-identified hubs. These hubs acted as representatives for the entire cortical surface. A variance-covariance framework of all ROIs is then built based on these relationships to link up all the ROIs. The result is a high level of match between model and empirical correlations in the range of 0.59 to 0.66 after adjusting for sample size; an increase of almost forty percent. More significantly, the model framework provides an intuitive way to delineate between systemic drivers and idiosyncratic noise while reducing dimensions by more than 30 folds, hence, providing a way to conduct attribution analysis. Due to its analytical nature and simple structure, the model is useful as a standalone toolkit for network dependency analysis or as a module for other mathematical models.

Keywords: Functional magnetic resonance imaging, multivariate regression, network hubs, resting state functional connectivity.

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350 Measurements of MRI R2* Relaxation Rate in Liver and Muscle: Animal Model

Authors: Chiung-Yun Chang, Po-Chou Chen, Jiun-Shiang Tzeng, Ka-Wai Mac, Chia-Chi Hsiao, Jo-Chi Jao

Abstract:

This study was aimed to measure effective transverse relaxation rates (R2*) in the liver and muscle of normal New Zealand White (NZW) rabbits. R2* relaxation rate has been widely used in various hepatic diseases for iron overload by quantifying iron contents in liver. R2* relaxation rate is defined as the reciprocal of T2* relaxation time and mainly depends on the constituents of tissue. Different tissues would have different R2* relaxation rates. The signal intensity decay in Magnetic resonance imaging (MRI) may be characterized by R2* relaxation rates. In this study, a 1.5T GE Signa HDxt whole body MR scanner equipped with an 8-channel high resolution knee coil was used to observe R2* values in NZW rabbit’s liver and muscle. Eight healthy NZW rabbits weighted 2 ~ 2.5 kg were recruited. After anesthesia using Zoletil 50 and Rompun 2% mixture, the abdomen of rabbit was landmarked at the center of knee coil to perform 3-plane localizer scan using fast spoiled gradient echo (FSPGR) pulse sequence. Afterwards, multi-planar fast gradient echo (MFGR) scans were performed with 8 various echo times (TEs) to acquire images for R2* measurements. Regions of interest (ROIs) at liver and muscle were measured using Advantage workstation. Finally, the R2* was obtained by a linear regression of ln(sı) on TE. The results showed that the longer the echo time, the smaller the signal intensity. The R2* values of liver and muscle were 44.8 ± 10.9 s-1 and 37.4 ± 9.5 s-1, respectively. It implies that the iron concentration of liver is higher than that of muscle. In conclusion, the more the iron contents in tissue, the higher the R2*. The correlations between R2* and iron content in NZW rabbits might be valuable for further exploration.

Keywords: Liver, MRI, multi-planar fast gradient echo, muscle, R2* relaxation rate.

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349 Grassland Phenology in Different Eco-Geographic Regions over the Tibetan Plateau

Authors: Jiahua Zhang, Qing Chang, Fengmei Yao

Abstract:

Studying on the response of vegetation phenology to climate change at different temporal and spatial scales is important for understanding and predicting future terrestrial ecosystem dynamics and the adaptation of ecosystems to global change. In this study, the Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) dataset and climate data were used to analyze the dynamics of grassland phenology as well as their correlation with climatic factors in different eco-geographic regions and elevation units across the Tibetan Plateau. The results showed that during 2003–2012, the start of the grassland greening season (SOS) appeared later while the end of the growing season (EOS) appeared earlier following the plateau’s precipitation and heat gradients from southeast to northwest. The multi-year mean value of SOS showed differences between various eco-geographic regions and was significantly impacted by average elevation and regional average precipitation during spring. Regional mean differences for EOS were mainly regulated by mean temperature during autumn. Changes in trends of SOS in the central and eastern eco-geographic regions were coupled to the mean temperature during spring, advancing by about 7d/°C. However, in the two southwestern eco-geographic regions, SOS was delayed significantly due to the impact of spring precipitation. The results also showed that the SOS occurred later with increasing elevation, as expected, with a delay rate of 0.66 d/100m. For 2003–2012, SOS showed an advancing trend in low-elevation areas, but a delayed trend in high-elevation areas, while EOS was delayed in low-elevation areas, but advanced in high-elevation areas. Grassland SOS and EOS changes may be influenced by a variety of other environmental factors in each eco-geographic region.

Keywords: Grassland, phenology, MODIS, eco-geographic regions, elevation, climatic factors, Tibetan Plateau.

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348 Successful Management of a Boy with Mild Persistent Asthma (A Longitudinal Case)

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

Abstract:

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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347 A Framework for Early Differential Diagnosis of Tropical Confusable Diseases Using the Fuzzy Cognitive Map Engine

Authors: Faith-Michael E. Uzoka, Boluwaji A. Akinnuwesi, Taiwo Amoo, Flora Aladi, Stephen Fashoto, Moses Olaniyan, Joseph Osuji

Abstract:

The overarching aim of this study is to develop a soft-computing system for the differential diagnosis of tropical diseases. These conditions are of concern to health bodies, physicians, and the community at large because of their mortality rates, and difficulties in early diagnosis due to the fact that they present with symptoms that overlap, and thus become ‘confusable’. We report on the first phase of our study, which focuses on the development of a fuzzy cognitive map model for early differential diagnosis of tropical diseases. We used malaria as a case disease to show the effectiveness of the FCM technology as an aid to the medical practitioner in the diagnosis of tropical diseases. Our model takes cognizance of manifested symptoms and other non-clinical factors that could contribute to symptoms manifestations. Our model showed 85% accuracy in diagnosis, as against the physicians’ initial hypothesis, which stood at 55% accuracy. It is expected that the next stage of our study will provide a multi-disease, multi-symptom model that also improves efficiency by utilizing a decision support filter that works on an algorithm, which mimics the physician’s diagnosis process.

Keywords: Medical diagnosis, tropical diseases, fuzzy cognitive map, decision support filters, malaria differential diagnosis.

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346 Drop Impact Study on Flexible Superhydrophobic Surface Containing Micro-Nano Hierarchical Structures

Authors: Abinash Tripathy, Girish Muralidharan, Amitava Pramanik, Prosenjit Sen

Abstract:

Superhydrophobic surfaces are abundant in nature. Several surfaces such as wings of butterfly, legs of water strider, feet of gecko and the lotus leaf show extreme water repellence behaviour. Self-cleaning, stain-free fabrics, spill-resistant protective wears, drag reduction in micro-fluidic devices etc. are few applications of superhydrophobic surfaces. In order to design robust superhydrophobic surface, it is important to understand the interaction of water with superhydrophobic surface textures. In this work, we report a simple coating method for creating large-scale flexible superhydrophobic paper surface. The surface consists of multiple layers of silanized zirconia microparticles decorated with zirconia nanoparticles. Water contact angle as high as 159±10 and contact angle hysteresis less than 80 was observed. Drop impact studies on superhydrophobic paper surface were carried out by impinging water droplet and capturing its dynamics through high speed imaging. During the drop impact, the Weber number was varied from 20 to 80 by altering the impact velocity of the drop and the parameters such as contact time, normalized spread diameter were obtained. In contrast to earlier literature reports, we observed contact time to be dependent on impact velocity on superhydrophobic surface. Total contact time was split into two components as spread time and recoil time. The recoil time was found to be dependent on the impact velocity while the spread time on the surface did not show much variation with the impact velocity. Further, normalized spreading parameter was found to increase with increase in impact velocity.

Keywords: Contact angle, contact angle hysteresis, contact time, superhydrophobic.

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345 On The Analysis of a Compound Neural Network for Detecting Atrio Ventricular Heart Block (AVB) in an ECG Signal

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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344 Ozone Therapy and Pulsed Electromagnetic Fields Interplay in Controlling Tumor Growth, Symptom and Pain Management: A Case Report

Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

Abstract:

Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: Cancer, complementary and alternative medicine, ozone therapy, palliative care, PEMF Therapy.

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343 The Experiences of Coronary Heart Disease Patients: Biopsychosocial Perspective

Authors: Christopher C. Anyadubalu

Abstract:

Biological, psychological and social experiences and perceptions of healthcare services in patients medically diagnosed of coronary heart disease were investigated using a sample of 10 participants whose responses to the in-depth interview questions were analyzed based on inter-and-intra-case analyses. The results obtained revealed that advancing age, single status, divorce and/or death of spouse and the issue of single parenting negatively impacted patients- biopsychosocial experiences. The patients- experiences of physical signs and symptoms, anxiety and depression, past serious medical conditions, use of self-prescribed medications, family history of poor mental/medical or physical health, nutritional problems and insufficient physical activities heightened their risk of coronary attack. Collectivist culture served as a big source of relieve to the patients. Patients- temperament, experience of different chronic life stresses/challenges, mood alteration, regular drinking, smoking/gambling, and family/social impairments compounded their health situation. Patients were satisfied with the biomedical services rendered by the healthcare personnel, whereas their psychological and social needs were not attended to. Effective procedural treatment model, a holistic and multidimensional approach to the treatment of heart disease patients was proposed.

Keywords: Biopsychosocial, Coronary Heart Disease, Experience, Patients, Perception, Perspective.

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342 Urbanization and Income Inequality in Thailand

Authors: Acumsiri Tantiakrnpanit

Abstract:

This paper aims to examine the relationship between urbanization and income inequality in Thailand during the period 2002–2020, using a panel of data for 76 provinces collected from Thailand’s National Statistical Office (Labor Force Survey: LFS), as well as geospatial data from the U.S. Air Force Defense Meteorological Satellite Program (DMSP) and the Visible Infrared Imaging Radiometer Suite Day/Night band (VIIRS-DNB) satellite for 19 selected years. This paper employs two different definitions to identify urban areas: 1) Urban areas defined by Thailand's National Statistical Office (LFS), and 2) Urban areas estimated using nighttime light data from the DMSP and VIIRS-DNB satellite. The second method includes two sub-categories: 2.1) Determining urban areas by calculating nighttime light density with a population density of 300 people per square kilometer, and 2.2) Calculating urban areas based on nighttime light density corresponding to a population density of 1,500 people per square kilometer. The empirical analysis based on Ordinary Least Squares (OLS), fixed effects, and random effects models reveals a consistent U-shaped relationship between income inequality and urbanization. The findings from the econometric analysis demonstrate that urbanization or population density has a significant and negative impact on income inequality. Moreover, the square of urbanization shows a statistically significant positive impact on income inequality. Additionally, there is a negative association between logarithmically transformed income and income inequality. This paper also proposes the inclusion of satellite imagery, geospatial data, and spatial econometric techniques in future studies to conduct quantitative analysis of spatial relationships.

Keywords: Income inequality, nighttime light, population density, Thailand, urbanization.

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341 Improving 99mTc-tetrofosmin Myocardial Perfusion Images by Time Subtraction Technique

Authors: Yasuyuki Takahashi, Hayato Ishimura, Masao Miyagawa, Teruhito Mochizuki

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Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of 99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of 99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the 99mTc-tetorofosmin myocardial SPECT image is considerably improved.

Keywords: 99mTc-tetrofosmin, dynamic SPECT, time subtraction, semiconductor detector.

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340 A Two-Stage Expert System for Diagnosis of Leukemia Based on Type-2 Fuzzy Logic

Authors: Ali Akbar Sadat Asl

Abstract:

Diagnosis and deciding about diseases in medical fields is facing innate uncertainty which can affect the whole process of treatment. This decision is made based on expert knowledge and the way in which an expert interprets the patient's condition, and the interpretation of the various experts from the patient's condition may be different. Fuzzy logic can provide mathematical modeling for many concepts, variables, and systems that are unclear and ambiguous and also it can provide a framework for reasoning, inference, control, and decision making in conditions of uncertainty. In systems with high uncertainty and high complexity, fuzzy logic is a suitable method for modeling. In this paper, we use type-2 fuzzy logic for uncertainty modeling that is in diagnosis of leukemia. The proposed system uses an indirect-direct approach and consists of two stages: In the first stage, the inference of blood test state is determined. In this step, we use an indirect approach where the rules are extracted automatically by implementing a clustering approach. In the second stage, signs of leukemia, duration of disease until its progress and the output of the first stage are combined and the final diagnosis of the system is obtained. In this stage, the system uses a direct approach and final diagnosis is determined by the expert. The obtained results show that the type-2 fuzzy expert system can diagnose leukemia with the average accuracy about 97%.

Keywords: Expert system, leukemia, medical diagnosis, type-2 fuzzy logic.

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339 Antibiotic Prescribing in the Acute Care in Iraq

Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

Abstract:

Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, antibiotic misuse, Iraq, prescribing.

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338 Lung Cancer Detection and Multi Level Classification Using Discrete Wavelet Transform Approach

Authors: V. Veeraprathap, G. S. Harish, G. Narendra Kumar

Abstract:

Uncontrolled growth of abnormal cells in the lung in the form of tumor can be either benign (non-cancerous) or malignant (cancerous). Patients with Lung Cancer (LC) have an average of five years life span expectancy provided diagnosis, detection and prediction, which reduces many treatment options to risk of invasive surgery increasing survival rate. Computed Tomography (CT), Positron Emission Tomography (PET), and Magnetic Resonance Imaging (MRI) for earlier detection of cancer are common. Gaussian filter along with median filter used for smoothing and noise removal, Histogram Equalization (HE) for image enhancement gives the best results without inviting further opinions. Lung cavities are extracted and the background portion other than two lung cavities is completely removed with right and left lungs segmented separately. Region properties measurements area, perimeter, diameter, centroid and eccentricity measured for the tumor segmented image, while texture is characterized by Gray-Level Co-occurrence Matrix (GLCM) functions, feature extraction provides Region of Interest (ROI) given as input to classifier. Two levels of classifications, K-Nearest Neighbor (KNN) is used for determining patient condition as normal or abnormal, while Artificial Neural Networks (ANN) is used for identifying the cancer stage is employed. Discrete Wavelet Transform (DWT) algorithm is used for the main feature extraction leading to best efficiency. The developed technology finds encouraging results for real time information and on line detection for future research.

Keywords: ANN, DWT, GLCM, KNN, ROI, artificial neural networks, discrete wavelet transform, gray-level co-occurrence matrix, k-nearest neighbor, region of interest.

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337 Health Hazards Related to Computer Use: Experience of the National Institute for Medical Research in Tanzania

Authors: V. P. Mvungi, J. Mcharo, M. E. Mmbuji, L. E. Mgonja, A. Y. Kitua

Abstract:

This paper is based on a study conducted in 2006 to assess the impact of computer usage on health of National Institute for Medical Research (NIMR) staff. NIMR being a research Institute, most of its staff spend substantial part of their working time on computers. There was notion among NIMR staff on possible prolonged computer usage health hazards. Hence, a study was conducted to establish facts and possible mitigation measures. A total of 144 NIMR staff were involved in the study of whom 63.2% were males and 36.8% females aged between 20 and 59 years. All staff cadres were included in the sample. The functions performed by Institute staff using computers includes; data management, proposal development and report writing, research activities, secretarial duties, accounting and administrative duties, on-line information retrieval and online communication through e-mail services. The interviewed staff had been using computers for 1-8 hours a day and for a period ranging from 1 to 20 years. The study has indicated ergonomic hazards for a significant proportion of interviewees (63%) of various kinds ranging from backache to eyesight related problems. The authors highlighted major issues which are substantially applicable in preventing occurrences of computer related problems and they urged NIMR Management and/or the government of Tanzania opts to adapt their practicability.

Keywords: Computers ergonomic hazards, computer usagehealth hazards.

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336 Developing of Knowledge-Based System for the Medical Treatment with Herbs

Authors: Rujijan Vichivanives

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This research aims to create a knowledge-based system as a database for self-healthcare analysis, diagnosis of simple illnesses, and the use of Thai herbs instead of modern medicine by using principles of Thai traditional medication theory. These were disseminated by website network programs within Suan Sunandha Rajabhat University. The population used in this study was divided into two groups: the first group consisted of four experts of Thai traditional medication and the second group was 300 website users. The methods used for collecting data were paper questionnaires and poll questionnaires on the website. The statistics used for analyzing data was at an average level. The results were divided into three parts: the first part was the development of a knowledge-based system and the second part was applied programs on website. Both parts could be fulfilled and achieved according to the set goal. The third part was the evaluation of the study: The evaluation of the viewpoints of the experts towards website designs were evaluated at a good level of 4.20. The satisfaction evaluation of the users was found at a good level of average satisfactory level at 4.24. It was found that the young population of those under the age of 16 had less cares about their health than the population of other teenagers, working age adults and those of older age. The research findings should be extended in order to encourage the lifestyle modifications to people of all ages by using the self-healthcare principles.

Keywords: Developing, Herbs, Knowledge-based system, Medical treatment.

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335 A Hybrid Image Fusion Model for Generating High Spatial-Temporal-Spectral Resolution Data Using OLI-MODIS-Hyperion Satellite Imagery

Authors: Yongquan Zhao, Bo Huang

Abstract:

Spatial, Temporal, and Spectral Resolution (STSR) are three key characteristics of Earth observation satellite sensors; however, any single satellite sensor cannot provide Earth observations with high STSR simultaneously because of the hardware technology limitations of satellite sensors. On the other hand, a conflicting circumstance is that the demand for high STSR has been growing with the remote sensing application development. Although image fusion technology provides a feasible means to overcome the limitations of the current Earth observation data, the current fusion technologies cannot enhance all STSR simultaneously and provide high enough resolution improvement level. This study proposes a Hybrid Spatial-Temporal-Spectral image Fusion Model (HSTSFM) to generate synthetic satellite data with high STSR simultaneously, which blends the high spatial resolution from the panchromatic image of Landsat-8 Operational Land Imager (OLI), the high temporal resolution from the multi-spectral image of Moderate Resolution Imaging Spectroradiometer (MODIS), and the high spectral resolution from the hyper-spectral image of Hyperion to produce high STSR images. The proposed HSTSFM contains three fusion modules: (1) spatial-spectral image fusion; (2) spatial-temporal image fusion; (3) temporal-spectral image fusion. A set of test data with both phenological and land cover type changes in Beijing suburb area, China is adopted to demonstrate the performance of the proposed method. The experimental results indicate that HSTSFM can produce fused image that has good spatial and spectral fidelity to the reference image, which means it has the potential to generate synthetic data to support the studies that require high STSR satellite imagery.

Keywords: Hybrid spatial-temporal-spectral fusion, high resolution synthetic imagery, least square regression, sparse representation, spectral transformation.

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334 Prospects for Sustainable Chemistry in South Africa: A Plural Healthcare System

Authors: Ntokozo C. Mthembu

Abstract:

The notion of sustainable chemistry has become significant in the discourse for a global post-colonial era, including South Africa, especially when it comes to access to the general health system and related policies in relation to disease or ease of human life. In view of the stubborn vestiges of coloniality in the daily lives of indigenous African people in general, the fundamentals of present Western medical and traditional medicine systems and related policies in the democratic era were examined in this study. The situation of traditional healers in relation to current policy was also reviewed. The advent of democracy in South Africa brought about a variety of development opportunities and limitations, particularly with respect to indigenous African knowledge systems such as traditional medicine. There were high hopes that the limitations of previous narrow cultural perspectives would be rectified in the democratic era through development interventions, but some sections of society, such as traditional healers, remain marginalised. The Afrocentric perspective was explored in dissecting government interventions related to traditional medicine. This article highlights that multiple medical systems should be adopted and that health policies should be aligned in order to guarantee mutual respect and to address the remnants of colonialism in South Africa, Africa and the broader global community.

Keywords: Traditional healing system, healers, pluralist healthcare system, post-colonial era.

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333 Dynamic Features Selection for Heart Disease Classification

Authors: Walid MOUDANI

Abstract:

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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332 Shannon-Weaver Biodiversity of Neutrophils in Fractal Networks of Immunofluorescence for Medical Diagnostics

Authors: N.E.Galich

Abstract:

We develop new nonlinear methods of immunofluorescence analysis for a sensitive technology of respiratory burst reaction of DNA fluorescence due to oxidative activity in the peripheral blood neutrophils. Histograms in flow cytometry experiments represent a fluorescence flashes frequency as functions of fluorescence intensity. We used the Shannon-Weaver index for definition of neutrophils- biodiversity and Hurst index for definition of fractal-s correlations in immunofluorescence for different donors, as the basic quantitative criteria for medical diagnostics of health status. We analyze frequencies of flashes, information, Shannon entropies and their fractals in immunofluorescence networks due to reduction of histogram range. We found the number of simplest universal correlations for biodiversity, information and Hurst index in diagnostics and classification of pathologies for wide spectra of diseases. In addition is determined the clear criterion of a common immunity and human health status in a form of yes/no answers type. These answers based on peculiarities of information in immunofluorescence networks and biodiversity of neutrophils. Experimental data analysis has shown the existence of homeostasis for information entropy in oxidative activity of DNA in neutrophil nuclei for all donors.

Keywords: blood and cells fluorescence in diagnostics ofdiseases, cytometric histograms, entropy and information in fractalnetworks of oxidative activity of DNA, long-range chromosomalcorrelations in living cells.

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331 Multimodal Biometric System Based on Near- Infra-Red Dorsal Hand Geometry and Fingerprints for Single and Whole Hands

Authors: Mohamed K. Shahin, Ahmed M. Badawi, Mohamed E. M. Rasmy

Abstract:

Prior research evidenced that unimodal biometric systems have several tradeoffs like noisy data, intra-class variations, restricted degrees of freedom, non-universality, spoof attacks, and unacceptable error rates. In order for the biometric system to be more secure and to provide high performance accuracy, more than one form of biometrics are required. Hence, the need arise for multimodal biometrics using combinations of different biometric modalities. This paper introduces a multimodal biometric system (MMBS) based on fusion of whole dorsal hand geometry and fingerprints that acquires right and left (Rt/Lt) near-infra-red (NIR) dorsal hand geometry (HG) shape and (Rt/Lt) index and ring fingerprints (FP). Database of 100 volunteers were acquired using the designed prototype. The acquired images were found to have good quality for all features and patterns extraction to all modalities. HG features based on the hand shape anatomical landmarks were extracted. Robust and fast algorithms for FP minutia points feature extraction and matching were used. Feature vectors that belong to similar biometric traits were fused using feature fusion methodologies. Scores obtained from different biometric trait matchers were fused using the Min-Max transformation-based score fusion technique. Final normalized scores were merged using the sum of scores method to obtain a single decision about the personal identity based on multiple independent sources. High individuality of the fused traits and user acceptability of the designed system along with its experimental high performance biometric measures showed that this MMBS can be considered for med-high security levels biometric identification purposes.

Keywords: Unimodal, Multi-Modal, Biometric System, NIR Imaging, Dorsal Hand Geometry, Fingerprint, Whole Hands, Feature Extraction, Feature Fusion, Score Fusion

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330 Image Analysis for Obturator Foramen Based on Marker-Controlled Watershed Segmentation and Zernike Moments

Authors: Seda Sahin, Emin Akata

Abstract:

Obturator Foramen is a specific structure in Pelvic bone images and recognition of it is a new concept in medical image processing. Moreover, segmentation of bone structures such as Obturator Foramen plays an essential role for clinical research in orthopedics. In this paper, we present a novel method to analyze the similarity between the substructures of the imaged region and a hand drawn template as a preprocessing step for computation of Pelvic bone rotation on hip radiographs. This method consists of integrated usage of Marker-controlled Watershed segmentation and Zernike moment feature descriptor and it is used to detect Obturator Foramen accurately. Marker-controlled Watershed segmentation is applied to separate Obturator Foramen from the background effectively. Then, Zernike moment feature descriptor is used to provide matching between binary template image and the segmented binary image for final extraction of Obturator Foramens. Finally, Pelvic bone rotation rate calculation for each hip radiograph is performed automatically to select and eliminate hip radiographs for further studies which depend on Pelvic bone angle measurements. The proposed method is tested on randomly selected 100 hip radiographs. The experimental results demonstrated that the proposed method is able to segment Obturator Foramen with 96% accuracy.

Keywords: Medical image analysis, marker-controlled watershed segmentation, segmentation of bone structures on hip radiographs, pelvic bone rotation rate, zernike moment feature descriptor.

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329 Ultrasound Therapy: Amplitude Modulation Technique for Tissue Ablation by Acoustic Cavitation

Authors: Fares A. Mayia, Mahmoud A. Yamany, Mushabbab A. Asiri

Abstract:

In recent years, non-invasive Focused Ultrasound (FU) has been utilized for generating bubbles (cavities) to ablate target tissue by mechanical fractionation. Intensities >10 kW/cm2 are required to generate the inertial cavities. The generation, rapid growth, and collapse of these inertial cavities cause tissue fractionation and the process is called Histotripsy. The ability to fractionate tissue from outside the body has many clinical applications including the destruction of the tumor mass. The process of tissue fractionation leaves a void at the treated site, where all the affected tissue is liquefied to particles at sub-micron size. The liquefied tissue will eventually be absorbed by the body. Histotripsy is a promising non-invasive treatment modality. This paper presents a technique for generating inertial cavities at lower intensities (< 1 kW/cm2). The technique (patent pending) is based on amplitude modulation (AM), whereby a low frequency signal modulates the amplitude of a higher frequency FU wave. Cavitation threshold is lower at low frequencies; the intensity required to generate cavitation in water at 10 kHz is two orders of magnitude lower than the intensity at 1 MHz. The Amplitude Modulation technique can operate in both continuous wave (CW) and pulse wave (PW) modes, and the percentage modulation (modulation index) can be varied from 0 % (thermal effect) to 100 % (cavitation effect), thus allowing a range of ablating effects from Hyperthermia to Histotripsy. Furthermore, changing the frequency of the modulating signal allows controlling the size of the generated cavities. Results from in vitro work demonstrate the efficacy of the new technique in fractionating soft tissue and solid calcium carbonate (Chalk) material. The technique, when combined with MR or Ultrasound imaging, will present a precise treatment modality for ablating diseased tissue without affecting the surrounding healthy tissue.

Keywords: Focused ultrasound therapy, Histotripsy, generation of inertial cavitation, mechanical tissue ablation.

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328 Chronic Patients- Prescription Refill Intentions

Authors: Ching - Yi Lee, I-Hsiung Tseng, Feng-Chuan Pan

Abstract:

Environment today is featured with aging population, increasing prevalence of chronic disease and complex of medical treatment. Safe use of pharmaceutics relied very much on the efforts made by both the health- related organizations and as well as the government agencies. As far as the specialization concern in providing health services to the patients, the government actively issued and implemented the divisions of medical treatment and pharmaceutical to improve the quality of care and to reduce medication errors and ensure public health. Pharmaceutical sub-sector policy has been implemented for 13 years. This study attempts to explore the factors that affect the patients- behavior intention of refilling a prescription from a NHIB pharmacy. Samples were those patients refilling their prescriptions with the case NHIB pharmacies. A self-administered questionnaire was used to collect respondents- information while the patients or family members visit the pharmacy for the refilling. 1,200 questionnaires were dispatched in 37 pharmacies that randomly selected from Pingtung City, Dongkang, Chaozhou, Hengchun areas. 732 responses were gained with 604 valid samples for further analyses. Results of data analyses indicated that respondents- attitude, subjective norm, perceived behavior control and behavior intentions toward refilling behavior varied from some demographic variables to another. This research also suggested adding actual behavior, either by a self-report or observed, into the research.

Keywords: Separation of dispensing and prescribing, prescriptions refill slip, NHIB contracted pharmacy, drug safety, theory of planned behavior.

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327 Computer Countenanced Diagnosis of Skin Nodule Detection and Histogram Augmentation: Extracting System for Skin Cancer

Authors: S. Zith Dey Babu, S. Kour, S. Verma, C. Verma, V. Pathania, A. Agrawal, V. Chaudhary, A. Manoj Puthur, R. Goyal, A. Pal, T. Danti Dey, A. Kumar, K. Wadhwa, O. Ved

Abstract:

Background: Skin cancer is now is the buzzing button in the field of medical science. The cyst's pandemic is drastically calibrating the body and well-being of the global village. Methods: The extracted image of the skin tumor cannot be used in one way for diagnosis. The stored image contains anarchies like the center. This approach will locate the forepart of an extracted appearance of skin. Partitioning image models has been presented to sort out the disturbance in the picture. Results: After completing partitioning, feature extraction has been formed by using genetic algorithm and finally, classification can be performed between the trained and test data to evaluate a large scale of an image that helps the doctors for the right prediction. To bring the improvisation of the existing system, we have set our objectives with an analysis. The efficiency of the natural selection process and the enriching histogram is essential in that respect. To reduce the false-positive rate or output, GA is performed with its accuracy. Conclusions: The objective of this task is to bring improvisation of effectiveness. GA is accomplishing its task with perfection to bring down the invalid-positive rate or outcome. The paper's mergeable portion conflicts with the composition of deep learning and medical image processing, which provides superior accuracy. Proportional types of handling create the reusability without any errors.

Keywords: Computer-aided system, detection, image segmentation, morphology.

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326 Relationship between Mental Health and Food Access among Healthcare College Students in a Snowy Area in Japan

Authors: Yuki Irie, Shota Ogawa, Hitomi Kosugi, Hiromitsu Shinozaki

Abstract:

Dropout rates in higher educational institutions pose significant challenges for both students and institutions, with poor mental health (MH) emerging as a key risk factor. Healthcare college students, including medical students, are particularly vulnerable to MH issues due to the demanding academic schedules they face. Poor mental health (MH) would be considered as a key risk factor for dropout from higher educational institutions that pose significant challenges for both students and institutions. And, inadequate food access (FA) has been related to poor MH. Given that targeted students may experience multiple risk factors for poor MH and vulnerable FA, the study aims to clarify the relationship between MH and FA to enhance student well-being. A cross-sectional design was used to explore the association between MH status and FA among 421 students (147 male, 274 female). Participants completed two questionnaires assessing MH and FA during winter 2022. The mean MH score was 6.7 ± 4.6, with higher scores indicating worse MH (max. score 27). While year-round FA showed no significant association with MH, FA during winter was significantly associated with MH (p = 0.01). Although car ownership did not directly impact MH, it was significantly associated with FA (p < 0.01), thus indirectly influencing MH. Our findings underscore the importance of FA in promoting MH, particularly during winter. Adopting a lifestyle that facilitates easier FA may be beneficial for MH, given its indirect association with MH outcomes. These insights emphasize the significance of addressing FA-related challenges to enhance student’s mental well-being.

Keywords: Mental health, food access, co-medical students, lifestyle.

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325 Post-Traumatic Stress Disorder: Management at the Montfort Hospital

Authors: Kay-Anne Haykal, Issack Biyong

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The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: Post-Traumatic Stress Disorder, diagnosis, co-morbidities, mental health disorders.

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