Search results for: Emergency Medical Services

Authors: Ayat E. Ali, Christeen R. Aziz, Merna A. Helmy, Mohammed M. Malek, Sherif H. El-Gohary

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Goal: Purpose of the project was to make a plastic surgery prediction by using pre-operative images for the plastic surgeries’ patients and to show this prediction on a screen to compare between the current case and the appearance after the surgery. Methods: To this aim, we implemented a software which used data from the internet for facial skin diseases, skin burns, pre-and post-images for plastic surgeries then the post- surgical prediction is done by using K-nearest neighbor (KNN). So we designed and fabricated a smart mirror divided into two parts a screen and a reflective mirror so patient's pre- and post-appearance will be showed at the same time. Results: We worked on some skin diseases like vitiligo, skin burns and wrinkles. We classified the three degrees of burns using KNN classifier with accuracy 60%. We also succeeded in segmenting the area of vitiligo. Our future work will include working on more skin diseases, classify them and give a prediction for the look after the surgery. Also we will go deeper into facial deformities and plastic surgeries like nose reshaping and face slim down. Conclusion: Our project will give a prediction relates strongly to the real look after surgery and decrease different diagnoses among doctors. Significance: The mirror may have broad societal appeal as it will make the distance between patient's satisfaction and the medical standards smaller.

Keywords: K-nearest neighbor, face detection, vitiligo, bone deformity.

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Authors: Seungwoo Kim, Hyojune Chae, Yongrae Jung, Jongwook Kim

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Recent medical studies have investigated the importance of enteral feeding and the use of feeding pumps for recovering patients unable to feed themselves or gain nourishment and nutrients by natural means. The most of enteral feeding system uses a peristaltic tube pump. A peristaltic pump is a form of positive displacement pump in which a flexible tube is progressively squeezed externally to allow the resulting enclosed pillow of fluid to progress along it. The squeezing of the tube requires a precise and robust controller of the geared motor to overcome parametric uncertainty of the pumping system which generates due to a wide variation of friction and slip between tube and roller. So, this paper proposes fuzzy adaptive controller for the robust control of the peristaltic tube pump. This new adaptive controller uses a fuzzy multi-layered architecture which has several independent fuzzy controllers in parallel, each with different robust stability area. Out of several independent fuzzy controllers, the most suited one is selected by a system identifier which observes variations in the controlled system parameter. This paper proposes a design procedure which can be carried out mathematically and systematically from the model of a controlled system. Finally, the good control performance, accurate dose rate and robust system stability, of the developed feeding pump is confirmed through experimental and clinic testing.

Keywords: Enteral Feeding Pump, Peristaltic Tube Pump, Fuzzy Adaptive Control, Fuzzy Multi-layered Controller, Look-up Table..

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

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

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

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Authors: Asif Ali, Daud Salim Faruquie

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With the advancement of knowledge about the utility and impact of sustainability, its feasibility has been explored into different walks of life. Scientists, however; have established their knowledge in four areas viz environmental, economic, social and cultural, popularly termed as four pillars of sustainability. Aspects of environmental and economic sustainability have been rigorously researched and practiced and huge volume of strong evidence of effectiveness has been founded for these two sub-areas. For the social and cultural aspects of sustainability, dependable evidence of effectiveness is still to be instituted as the researchers and practitioners are developing and experimenting methods across the globe. Therefore, the present research aimed to identify globally used practices of social and cultural sustainability and through evidence synthesis assess their outcomes to determine the effectiveness of those practices. A PICO format steered the methodology which included all populations, popular sustainability practices including walkability/cycle tracks, social/recreational spaces, privacy, health & human services and barrier free built environment, comparators included ‘Before’ and ‘After’, ‘With’ and ‘Without’, ‘More’ and ‘Less’ and outcomes included Social well-being, cultural coexistence, quality of life, ethics and morality, social capital, sense of place, education, health, recreation and leisure, and holistic development. Search of literature included major electronic databases, search websites, organizational resources, directory of open access journals and subscribed journals. Grey literature, however, was not included. Inclusion criteria filtered studies on the basis of research designs such as total randomization, quasirandomization, cluster randomization, observational or single studies and certain types of analysis. Studies with combined outcomes were considered but studies focusing only on environmental and/or economic outcomes were rejected. Data extraction, critical appraisal and evidence synthesis was carried out using customized tabulation, reference manager and CASP tool. Partial meta-analysis was carried out and calculation of pooled effects and forest plotting were done. As many as 13 studies finally included for final synthesis explained the impact of targeted practices on health, behavioural and social dimensions. Objectivity in the measurement of health outcomes facilitated quantitative synthesis of studies which highlighted the impact of sustainability methods on physical activity, Body Mass Index, perinatal outcomes and child health. Studies synthesized qualitatively (and also quantitatively) showed outcomes such as routines, family relations, citizenship, trust in relationships, social inclusion, neighbourhood social capital, wellbeing, habitability and family’s social processes. The synthesized evidence indicates slight effectiveness and efficacy of social and cultural sustainability on the targeted outcomes. Further synthesis revealed that such results of this study are due weak research designs and disintegrated implementations. If architects and other practitioners deliver their interventions in collaboration with research bodies and policy makers, a stronger evidence-base in this area could be generated.

Keywords: Built environment, cultural sustainability, social sustainability, sustainable architecture.

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Authors: A. Razavykia, A. Esmaeilzadeh, S. Iranmanesh

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Many orthopedic implants like proximal humerus cases require lower surface roughness and almost immediate/short lead time surgery. Thus, rapid response from the manufacturer is very crucial. Tool path strategy of milling process has a direct influence on the surface roughness and lead time of medical implant. High-speed milling as promised process would improve the machined surface quality, but conventional or super-abrasive grinding still required which imposes some drawbacks such as additional costs and time. Currently, many CAD/CAM software offers some different tool path strategies to milling free form surfaces. Nevertheless, the users must identify how to choose the strategies according to cutting tool geometry, geometry complexity, and their effects on the machined surface. This study investigates the effect of different tool path strategies for milling a proximal humerus head during finishing operation on stainless steel 316L. Experiments have been performed using MAHO MH700 S vertical milling machine and four machining strategies, namely, spiral outward, spiral inward, and radial as well as zig-zag. In all cases, the obtained surfaces were analyzed in terms of roughness and dimension accuracy compared with those obtained by simulation. The findings provide evidence that surface roughness, dimensional accuracy, and machining time have been affected by the considered tool path strategy.

Keywords: CAD/CAM software, milling, orthopedic implants, tool path strategy.

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Authors: Tessy Treesa Jose, Sripathy M. Bhat

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Nursing is recognized as a stressful occupation and has indicated a probable high prevalence of distress. It is a helping profession requiring a high degree of commitment and involvement. If stress is intense, continuous and repeated, it becomes a negative phenomenon or "distress," which can lead to physical illness and psychological disorders. The frequency of common psychosomatic symptoms including sleeping problems, tension headache, chronic fatigue, palpitation etc. may be an indicator of nurses’ work-related stress level. Objectives of the study were to determine psychiatric morbidity among nurses and to find its association with selected variables. The study population consisted of 1040 registered nurses working in selected medical college hospitals and government hospitals of Udupi and Mangalore districts. Descriptive survey design was used to conduct the study. Subjects were selected by using purposive sampling. Data were gathered by administering background proforma and General Health questionnaire. Severe distress was experienced by 0.9% of nurses and 5.6% had some evidence of distress. Subjects who did not have any distress were 93.5%. No significant association between psychiatric morbidity in nurses and demographic variables was observed. With regard to work variables significant association is observed between psychiatric morbidity and total years of experience (z=10.67, p=0.03) and experience in current area of work (z=9.43, p=0.02).

Keywords: Psychiatric morbidity, nurse, selected hospitals, working.

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Authors: Intan Maisarah Abd Rahim, Herlina Abdul Rahim, Rashidah Ghazali

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Diabetes is a medical condition that can lead to various diseases such as stroke, heart disease, blindness and obesity. In clinical practice, the concern of the diabetic patients towards the blood glucose examination is rather alarming as some of the individual describing it as something painful with pinprick and pinch. As for some patient with high level of glucose level, pricking the fingers multiple times a day with the conventional glucose meter for close monitoring can be tiresome, time consuming and painful. With these concerns, several non-invasive techniques were used by researchers in measuring the glucose level in blood, including ultrasonic sensor implementation, multisensory systems, absorbance of transmittance, bio-impedance, voltage intensity, and thermography. This paper is discussing the application of the near-infrared (NIR) spectroscopy as a non-invasive method in measuring the glucose level and the implementation of the linear system identification model in predicting the output data for the NIR measurement. In this study, the wavelengths considered are at the 1450 nm and 1950 nm. Both of these wavelengths showed the most reliable information on the glucose presence in blood. Then, the linear Autoregressive Moving Average Exogenous model (ARMAX) model with both un-regularized and regularized methods was implemented in predicting the output result for the NIR measurement in order to investigate the practicality of the linear system in this study. However, the result showed only 50.11% accuracy obtained from the system which is far from the satisfying results that should be obtained.

Keywords: Diabetes, glucose level, linear, near-infrared (NIR), non-invasive, prediction system.

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Authors: Chih-I. Tsai, Yu-Chien. Lin

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Through experiences of clinical practices, it is discovered that locations on the body at a level of four fingerbreadth above and below the joints are the points at which muscles connect to tendons, and since the muscles and tendons possess opposite characteristics, muscles are full of blood but lack qi, while tendons are full of qi but lack blood, these points on our body become easily blocked. It is proposed that through doing acupuncture or creating localized pressure to the areas four fingerbreadths above and below our joints, with an elastic bandage, we could help the energy, also known as qi, to flow smoothly in our body and further improve our health. Based on the Four Fingers Theory, we understand that human height is 22 four fingerbreadths. In addition, qi and blood travel through 24 meridians, 50 times each day, and they flow through 6 cun with every human breath. We can also understand the average number of human heartbeats is 75 times per minute. And the function of qi-blood circulation system in Traditional Chinese Medicine is the same as the blood circulation in Western Medical Science. Informed by Four Fingers Theory, this study further examined its applications in acupuncture practices. The research question is how Four Fingers Theory proves what has been mentioned in Nei Jing that there are 66 acupoints under a human’s elbow and knee. In responding to the research question, there are 66 acupoints under a human’s elbow and knee. Four Fingers Theory facilitated the creation of the acupuncture naming and teaching system. It is expected to serve as an approachable and effective way to deliver knowledge of acupuncture to the public worldwide.

Keywords: Four Fingers theory, Meridians circulation, 66 Acupoints under a human’s elbow and knee, acupuncture.

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Authors: Jing Jia, Shanqing Huang, Fang Liu, Qiang Ren, Gui Li, Mengyun Cheng, Chufeng Jin, Yican Wu

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Medical image registration is the key technology in image guided radiation therapy (IGRT) systems. On the basis of the previous work on our IGRT prototype with a biorthogonal x-ray imaging system, we described a method focused on the 2D/2D rigid-body registration using multiresolution pyramid based mutual information in this paper. Three key steps were involved in the method ： firstly, four 2D images were obtained including two x-ray projection images and two digital reconstructed radiographies（DRRs ） as the input for the registration ； Secondly, each pair of the corresponding x-ray image and DRR image were matched using multiresolution pyramid based mutual information under the ITK registration framework ； Thirdly, we got the final couch offset through a coordinate transformation by calculating the translations acquired from the two pairs of the images. A simulation example of a parotid gland tumor case and a clinical example of an anthropomorphic head phantom were employed in the verification tests. In addition, the influence of different CT slice thickness were tested. The simulation results showed that the positioning errors were 0.068±0.070, 0.072±0.098, 0.154±0.176mm along three axes which were lateral, longitudinal and vertical. The clinical test indicated that the positioning errors of the planned isocenter were 0.066, 0.07, 2.06mm on average with a CT slice thickness of 2.5mm. It can be concluded that our method with its verified accuracy and robustness can be effectively used in IGRT systems for patient setup.

Keywords: 2D/2D registration, image guided radiation therapy, multi resolution pyramid, mutual information.

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Authors: A. Vassila, D. Kalogeropoulos, R. Rawashdeh, N. Hall, N. Rahman, M. Fabian, S. Thulasidharan, H. Parwez

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Necrotising scleritis is a severe form of scleritis and poses a significant threat to vision. It can manifest in various systemic autoimmune disorders, systemic vasculitis, or as a consequence of microbial infections. The objective of this study is to present a case of necrotizing scleritis associated with scleroderma, which was further complicated by a secondary Staphylococcus epidermidis infection. This is a retrospective analysis, which examines the medical records of a patient who was hospitalised in the Eye Unit at University Hospital Southampton. A 78-year-old woman presented at the eye casualty department of our unit with a two-week history of progressively worsening pain in her left eye. She received a diagnosis of necrotising scleritis and was admitted to the hospital for further treatment. It was decided to commence a three-day course of intravenous methylprednisolone followed by a tapering regimen of oral steroids. Additionally, a conjunctival swab was taken, and two days later, it revealed the presence of S. epidermidis, indicating a potential secondary infection. Given this finding, she was also prescribed topical (Ofloxacin 0.3% - four times daily) and oral (Ciprofloxacin 750 mg – twice daily) antibiotics. The inflammation and symptoms gradually improved, leading to the patient being scheduled for a scleral graft and applying an amniotic membrane to cover the area of scleral thinning. Rheumatoid arthritis and granulomatosis with polyangiitis are the most commonly identifiable systemic diseases associated with necrotising scleritis. Although association with scleroderma is extremely rare, early identification and treatment are necessary to prevent scleritis-related complications.

Keywords: Scleritis, necrotizing scleritis, scleroderma, autoimmune disease.

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Authors: Jefrey Pilusa, Tumisang Seodigeng

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This research discusses a South African case study for the potential of utilizing refuse-derived fuel (RDF) obtained from non-burn treatment of health care risk waste (HCRW) as potential feedstock for green energy production. This specific waste stream can be destroyed via non-burn treatment technology involving high-speed mechanical shredding followed by steam or chemical injection to disinfect the final product. The RDF obtained from this process is characterised by a low moisture, low ash, and high calorific value which means it can be potentially used as high-value solid fuel. Due to the raw feed of this RDF being classified as hazardous, the final RDF has been reported to be non-infectious and can blend with other combustible wastes such as rubber and plastic for waste to energy applications. This study evaluated non-burn treatment technology as a possible solution for on-site destruction of HCRW in South African private and public health care centres. Waste generation quantities were estimated based on the number of registered patient beds, theoretical bed occupancy. Time and motion study was conducted to evaluate the logistics viability of on-site treatment. Non-burn treatment technology for HCRW is a promising option for South Africa, and successful implementation of this method depends upon the initial capital investment, operational cost and environmental permitting of such technology; there are other influencing factors such as the size of the waste stream, product off-take price as well as product demand.

Keywords: Autoclave, disposal, fuel, incineration, medical waste.

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Authors: Jiakai Li, Gursel Serpen, Steven Selman, Matt Franchetti, Mike Riesen, Cynthia Schneider

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This paper presents the development of a Bayesian belief network classifier for prediction of graft status and survival period in renal transplantation using the patient profile information prior to the transplantation. The objective was to explore feasibility of developing a decision making tool for identifying the most suitable recipient among the candidate pool members. The dataset was compiled from the University of Toledo Medical Center Hospital patients as reported to the United Network Organ Sharing, and had 1228 patient records for the period covering 1987 through 2009. The Bayes net classifiers were developed using the Weka machine learning software workbench. Two separate classifiers were induced from the data set, one to predict the status of the graft as either failed or living, and a second classifier to predict the graft survival period. The classifier for graft status prediction performed very well with a prediction accuracy of 97.8% and true positive values of 0.967 and 0.988 for the living and failed classes, respectively. The second classifier to predict the graft survival period yielded a prediction accuracy of 68.2% and a true positive rate of 0.85 for the class representing those instances with kidneys failing during the first year following transplantation. Simulation results indicated that it is feasible to develop a successful Bayesian belief network classifier for prediction of graft status, but not the graft survival period, using the information in UNOS database.

Keywords: Bayesian network classifier, renal transplantation, graft survival period, United Network for Organ Sharing

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Authors: María-Dolores Afonso-Suárez, Nayra Pumar-Carreras, Juan Ruiz-Alzola

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This research addresses the use of an e-Learning creation methodology for learning objects. Throughout the process, indicators are being gathered, to determine if it responds to the main objectives of an engineering discipline. These parameters will also indicate if it is necessary to review the creation cycle and readjust any phase. Within the project developed for this study, apart from the use of structured methods, there has been a central objective: the establishment of a learning atmosphere. A place where all the professionals involved are able to collaborate, plan, solve problems and determine guides to follow in order to develop creative and innovative solutions. It has been outlined as a blended learning program with an assessment plan that proposes face to face lessons, coaching, collaboration, multimedia and web based learning objects as well as support resources. The project has been drawn as a long term task, the pilot teaching actions designed provide the preliminary results object of study. This methodology is been used in the creation of learning content for the African countries of Senegal, Mauritania and Cape Verde. It has been developed within the framework of the MACbioIDi, an Interreg European project for the International cooperation and development. The educational area of this project is focused in the training and advice of professionals of the medicine as well as engineers in the use of applications of medical imaging technology, specifically the 3DSlicer application and the Open Anatomy Browser.

Keywords: Teaching contents engineering, e-learning, blended learning, international cooperation, 3DSlicer, open anatomy browser.

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Authors: Khaled M. Ali, M. A. Abdel-Hamid, Ayman A. Mostafa

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Objective: Safety and efficacy of Ahmed glaucoma valve implantation for the management of uveitis induced glaucoma evaluated on the five dogs with uncontrollable glaucoma. Materials and Methods: Ahmed Glaucoma Valve (AGV®; New World Medical, Rancho Cucamonga, CA, USA) is a flow restrictive, nonobstructive self-regulating valve system. Preoperative ocular evaluation included direct ophthalmoscopy and measurement of the intraocular pressure (IOP). The implant was examined and primed prior to implantation. The selected site of the valve implantation was the superior quadrant between the superior and lateral rectus muscles. A fornix-based incision was made through the conjunectiva and Tenon’s capsule. A pocket is formed by blunt dissection of Tenon’s capsule from the episclera. The body of the implant was inserted into the pocket with the leading edge of the device around 8-10 mm from the limbus. Results: No post-operative complications were detected in the operated eyes except a persistent corneal edema occupied the upper half of the cornea in one case. Hyphaema was very mild and seen only in two cases which resolved quickly two days after surgery. Endoscopical evaluation for the operated eyes revealed a normal ocular fundus with clearly visible optic papilla, tapetum and retinal blood vessels. No evidence of hemorrhage, infection, adhesions or retinal abnormalities was detected. Conclusion: Ahmed glaucoma valve is safe and effective implant for treatment of uveitic glaucoma in dogs.

Keywords: Ahmed valve, endoscopy, glaucoma, ocular fundus.

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Authors: H. B. Kekre, Sudeep D. Thepade

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The automatic construction of large, high-resolution image vistas (mosaics) is an active area of research in the fields of photogrammetry [1,2], computer vision [1,4], medical image processing [4], computer graphics [3] and biometrics [8]. Image stitching is one of the possible options to get image mosaics. Vista Creation in image processing is used to construct an image with a large field of view than that could be obtained with a single photograph. It refers to transforming and stitching multiple images into a new aggregate image without any visible seam or distortion in the overlapping areas. Vista creation process aligns two partial images over each other and blends them together. Image mosaics allow one to compensate for differences in viewing geometry. Thus they can be used to simplify tasks by simulating the condition in which the scene is viewed from a fixed position with single camera. While obtaining partial images the geometric anomalies like rotation, scaling are bound to happen. To nullify effect of rotation of partial images on process of vista creation, we are proposing rotation invariant vista creation algorithm in this paper. Rotation of partial image parts in the proposed method of vista creation may introduce some missing region in the vista. To correct this error, that is to fill the missing region further we have used image inpainting method on the created vista. This missing view regeneration method also overcomes the problem of missing view [31] in vista due to cropping, irregular boundaries of partial image parts and errors in digitization [35]. The method of missing view regeneration generates the missing view of vista using the information present in vista itself.

Keywords: Vista, Overlap Estimation, Rotation Invariance, Missing View Regeneration.

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Authors: S. Aberkane, N. Djabali, S. Fafi, A. Baghezza

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Chronic illnesses affect many Algerians. It is possible to investigate the impact of illness representations and coping on quality of life and whether illness representations are indirectly associated with quality of life through their influence on coping. This study aims at investigating the relationship between illness perception, coping strategies and quality of life with chronic illness. Illness perceptions are indirectly associated with the quality of life through their influence on coping mediation. A sample of 316 participants with chronic illness living in the region of Batna, Algeria, has been adopted in this study. A correlation statistical analysis is used to determine the relationship between illness perception, coping strategies, and quality of life. Multiple regression analysis was employed to highlight the predictive ability of the dimensions of illness perception and coping strategies on the dependent variables of quality of life, where mediation analysis is considered in the exploration of the indirect effect significance of the mediator. This study provides insights about the relationship between illness perception, coping strategies and quality of life in the considered sample (r = 0.39, p < 0.01). Therefore, it proves that there is an effect of illness identity perception, external and medical attributions related to emotional role, physical functioning, and mental health perceived, and these were fully mediated by the asking for assistance (c’= 0.04, p < 0.05), the guarding (c’= 0.00, p < 0.05), and the task persistence strategy (c’= 0.05, p < 0.05). The findings imply partial support for the common-sense model of illness representations in a chronic illness population. Directions for future research are highlighted, as well as implications for psychotherapeutic interventions which target unhelpful beliefs and maladaptive coping strategies (e.g., cognitive behavioral therapy).

Keywords: Chronic illness, coping, illness perception, quality of life, self-regulation model.

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Authors: Y. Kumru, K. Enhos, H. Köymen

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In this paper, we report the experimental results on using complementary Golay coded signals at 7.5 MHz to detect breast microcalcifications of 50 µm size. Simulations using complementary Golay coded signals show perfect consistence with the experimental results, confirming the improved signal to noise ratio for complementary Golay coded signals. For improving the success on detecting the microcalcifications, orthogonal complementary Golay sequences having cross-correlation for minimum interference are used as coded signals and compared to tone burst pulse of equal energy in terms of resolution under weak signal conditions. The measurements are conducted using an experimental ultrasound research scanner, Digital Phased Array System (DiPhAS) having 256 channels, a phased array transducer with 7.5 MHz center frequency and the results obtained through experiments are validated by Field-II simulation software. In addition, to investigate the superiority of coded signals in terms of resolution, multipurpose tissue equivalent phantom containing series of monofilament nylon targets, 240 µm in diameter, and cyst-like objects with attenuation of 0.5 dB/[MHz x cm] is used in the experiments. We obtained ultrasound images of monofilament nylon targets for the evaluation of resolution. Simulation and experimental results show that it is possible to differentiate closely positioned small targets with increased success by using coded excitation in very weak signal conditions.

Keywords: Coded excitation, complementary Golay codes, DiPhAS, medical ultrasound.

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Authors: M. Aghili, S. Tabarestani, C. Freytes, M. Shojaie, M. Cabrerizo, A. Barreto, N. Rishe, R. E. Curiel, D. Loewenstein, R. Duara, M. Adjouadi

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A major challenge in medical studies, especially those that are longitudinal, is the problem of missing measurements which hinders the effective application of many machine learning algorithms. Furthermore, recent Alzheimer's Disease studies have focused on the delineation of Early Mild Cognitive Impairment (EMCI) and Late Mild Cognitive Impairment (LMCI) from cognitively normal controls (CN) which is essential for developing effective and early treatment methods. To address the aforementioned challenges, this paper explores the potential of using the eXtreme Gradient Boosting (XGBoost) algorithm in handling missing values in multiclass classification. We seek a generalized classification scheme where all prodromal stages of the disease are considered simultaneously in the classification and decision-making processes. Given the large number of subjects (1631) included in this study and in the presence of almost 28% missing values, we investigated the performance of XGBoost on the classification of the four classes of AD, NC, EMCI, and LMCI. Using 10-fold cross validation technique, XGBoost is shown to outperform other state-of-the-art classification algorithms by 3% in terms of accuracy and F-score. Our model achieved an accuracy of 80.52%, a precision of 80.62% and recall of 80.51%, supporting the more natural and promising multiclass classification.

Keywords: eXtreme Gradient Boosting, missing data, Alzheimer disease, early mild cognitive impairment, late mild cognitive impairment, multiclass classification, ADNI, support vector machine, random forest.

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Authors: Amal E. Shehata, Manal E. Fareed

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Osteoarthritis (OA) is the most prevalent and far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint. Patients suffering from osteoarthritis often complain of dull ache pain on movement. Physical agents can fight the painful process when correctly indicated and used such as heat or cold therapy Aim. This study was carried out to: Compare the effect of cold, warm and contrast therapy on controlling knee osteoarthritis associated problems. Setting: The study was carried out in orthopedic outpatient clinics of Menoufia University and teaching Hospitals, Egypt. Sample: A convenient sample of 60 adult patients with unilateral knee osteoarthritis. Tools: three tools were utilized to collect the data. Tool I : An interviewing questionnaire. It comprised of three parts covering  sociodemographic data, medical data and adverse effects of the treatment protocol. Tool II : Knee Injury and Osteoarthritis Outcome Score (KOOS) It consists of five main parts. Tool II1 : 0-10 Numeric pain rating scale. Results: reveled that the total knee symptoms score was decreased from moderate symptoms pre intervention to mild symptoms after warm and contrast method of therapy, but the contrast therapy had significant effect in reducing the knee symptoms and pain than the other symptoms. Conclusions: all of the three methods of therapy resulted in improvement in all knee symptoms and pain but the most appropriate protocol of treatment to relive symptoms and pain was contrast therapy.

Keywords: Knee Osteoarthritis, Cold, Warm and Contrast Therapy.

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Authors: Salma El Hajjami, Jamal Malki, Alain Bouju, Mohammed Berrada

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With the expansion of machine learning and data mining in the context of Big Data analytics, the common problem that affects data is class imbalance. It refers to an imbalanced distribution of instances belonging to each class. This problem is present in many real world applications such as fraud detection, network intrusion detection, medical diagnostics, etc. In these cases, data instances labeled negatively are significantly more numerous than the instances labeled positively. When this difference is too large, the learning system may face difficulty when tackling this problem, since it is initially designed to work in relatively balanced class distribution scenarios. Another important problem, which usually accompanies these imbalanced data, is the overlapping instances between the two classes. It is commonly referred to as noise or overlapping data. In this article, we propose an approach called: One Side Behavioral Noise Reduction (OSBNR). This approach presents a way to deal with the problem of class imbalance in the presence of a high noise level. OSBNR is based on two steps. Firstly, a cluster analysis is applied to groups similar instances from the minority class into several behavior clusters. Secondly, we select and eliminate the instances of the majority class, considered as behavioral noise, which overlap with behavior clusters of the minority class. The results of experiments carried out on a representative public dataset confirm that the proposed approach is efficient for the treatment of class imbalances in the presence of noise.

Keywords: Machine learning, Imbalanced data, Data mining, Big data.

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Authors: Lucy Ampaw-Asiedu, Terri R. Norton

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In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.

Keywords: Disaster management, safe spaces, structural design, tornado, vulnerability.

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Authors: Abdolghani Ebrahimi, Diego Klabjan, Chenxi Ge, Daniela Ladner, Parker Stride

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In this work, we use machine learning and data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. Our work applies modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Keywords: machine learning, liver cirrhosis, subgraph mining, supervised learning

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Authors: Yemisi Rufina Alli Smith, Isaac Gbadura Adanlawo

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Liver disorders are one of the major problems of the world. Despite its frequent occurrence, high morbidity and high mortality, its medical management is currently inadequate. This study was designed to evaluate the hepatoprotective effect of saponin extract of the root of Garcinia kola on the integrity of the liver of paracetamol induced wistar albino rats. Twenty five (25) male adult wistar albino rats were divided into five (5) groups. Group I was the Control group that received distilled water only, group II was the negative control that received 2 g/kg of paracetamol on the 13th day, and group III, IV and V were pre-treated with 100, 200 and 400mg/kg of the saponin extract before inducing the liver damage on the 13th day with 2 g/kg of paracetamol. Twenty four (24) h after administration, the rats were sacrificed and blood samples were collected. The serum Alanine Transaminase (ALT), Aspartate Transaminase (AST), Alkaline Phosphatase (ALP) activities, Bilirubin and conjugated bilirubin, glucose and protein concentrations were evaluated. The liver was fixed immediately in Formalin and was processed and stained in Haematoxylin and Eosin (H&E). Administration of saponin extract from the root of Garcinia kola significantly decreased paracetamol induced elevated enzymes in the test group. Also histological observations showed that saponin extract of the root of Garcinia kola exhibited a significant liver protection against the toxicant as evident by the cells trying to return to normal. Saponin extract from the root of Garcinia kola indicated a protection of structural integrity of the hepatocytic cell membrane and regeneration of the damaged liver.

Keywords: Garcinia kola, Hepatoprotective, paracetamol, Saponin.

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Authors: Chao Yi, Cunyue Lu, Lingwei Quan

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Piezoelectric linear motors have the characteristics of great electromagnetic compatibility, high positioning accuracy, compact structure and no deceleration mechanism, which make it promising to applicate in micro-miniature precision drive systems. However, most piezoelectric motors are employed by flexible clamping, which has insufficient rigidity and is difficult to use in rapid positioning. Another problem is that this clamping method seriously affects the vibration efficiency of the vibrating unit. In order to solve these problems, this paper proposes a piezoelectric stack linear motor based on double-end rigid clamping. First, a piezoelectric linear motor with a length of only 35.5 mm is designed. This motor is mainly composed of a motor stator, a driving foot, a ceramic friction strip, a linear guide, a pre-tightening mechanism and a base. This structure is much simpler and smaller than most similar motors, and it is easy to assemble as well as to realize precise control. In addition, the properties of piezoelectric stack are reviewed and in order to obtain the elliptic motion trajectory of the driving head, a driving scheme of the longitudinal-shear composite stack is innovatively proposed. Finally, impedance analysis and speed performance testing were performed on the piezoelectric linear motor prototype. The motor can measure speed up to 25.5 mm/s under the excitation of signal voltage of 120 V and frequency of 390 Hz. The result shows that the proposed piezoelectric stacked linear motor obtains great performance. It can run smoothly in a large speed range, which is suitable for various precision control in medical images, aerospace, precision machinery and many other fields.

Keywords: Elliptical trajectory, linear motor, piezoelectric stack, rigid clamping.

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Authors: Tahsien Mohamed Okasha, Warda Youssef Mohamed Morsy, Hanan Elsayed Zaghla

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We hypothesized that post cardiac arrest patients with Glasgow Coma Scale (GCS) score of less than 8 and who will be exposed to therapeutic hypothermia protocol will exhibit improvement in their neurological performance. 17 subjects were enrolled in this study all over one year. The study was carried out using Quasi-experimental research design. Four tools were used for data collection of this study: Demographic and medical data sheet, Post cardiac arrest health assessment sheet, Bedside Shivering Assessment Scale (BSAS), and Glasgow Pittsburgh cerebral performance category scale (CPC). The mean age was X̅ ± SD = 53 ± 8.122 years, 47.1% were arrested because of cardiac etiology. 35.3% subjects were initially arrested in form of ventricular tachycardia (VT), 23.5% initially arrested in form of ventricular fibrillation (VF), and 29.4% in form of A-Systole. Favorable neurological outcome was seen among 70.6%. There was significant statistical difference in WBC, Platelets, blood gases value, random blood sugar. Also, initial arrest rhythm, etiology of cardiac arrest, and shivering status were significantly correlated with cerebral performance categories score. Therapeutic hypothermia has positive effects on neurological performance among post cardiac arrest patients with GCS score of less than 8. Replication of the study on larger probability sample, with randomized control trial design is recommended with further study for suggesting nursing protocol for patients undergoing therapeutic hypothermia is recommended.

Keywords: Therapeutic hypothermia, neurological performance, after resuscitation from cardiac arrest, initial arrest rhythm.

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Authors: Sundararajan Sangeetha, Joseph Jesu Christopher, Swaminathan Ramakrishnan

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In this work, the primary compressive strength components of human femur trabecular bone are qualitatively assessed using image processing and wavelet analysis. The Primary Compressive (PC) component in planar radiographic femur trabecular images (N=50) is delineated by semi-automatic image processing procedure. Auto threshold binarization algorithm is employed to recognize the presence of mineralization in the digitized images. The qualitative parameters such as apparent mineralization and total area associated with the PC region are derived for normal and abnormal images.The two-dimensional discrete wavelet transforms are utilized to obtain appropriate features that quantify texture changes in medical images .The normal and abnormal samples of the human femur are comprehensively analyzed using Harr wavelet.The six statistical parameters such as mean, median, mode, standard deviation, mean absolute deviation and median absolute deviation are derived at level 4 decomposition for both approximation and horizontal wavelet coefficients. The correlation coefficient of various wavelet derived parameters with normal and abnormal for both approximated and horizontal coefficients are estimated. It is seen that in almost all cases the abnormal show higher degree of correlation than normals. Further the parameters derived from approximation coefficient show more correlation than those derived from the horizontal coefficients. The parameters mean and median computed at the output of level 4 Harr wavelet channel was found to be a useful predictor to delineate the normal and the abnormal groups.

Keywords: Image processing, planar radiographs, trabecular bone and wavelet analysis.

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Authors: Blessing Ojeme, Frederick Quinn, Russell Karls, Shannon Quinn

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The detection and segmentation of mitochondria from fluorescence microscopy is crucial for understanding the complex structure of the nervous system. However, the constant fission and fusion of mitochondria and image distortion in the background make the task of detection and segmentation challenging. Although there exists a number of open-source software tools and artificial intelligence (AI) methods designed for analyzing mitochondrial images, the availability of only a few combined expertise in the medical field and AI required to utilize these tools poses a challenge to its full adoption and use in clinical settings. Motivated by the advantages of automated methods in terms of good performance, minimum detection time, ease of implementation, and cross-platform compactibility, this study proposes a fully automated framework for the detection and segmentation of mitochondria using both image shape information and descriptive statistics. Using the low-cost, open-source Python and OpenCV library, the algorithms are implemented in three stages: pre-processing; image binarization; and coarse-to-fine segmentation. The proposed model is validated using the fluorescence mitochondrial dataset. Ground truth labels generated using Labkit were also used to evaluate the performance of our detection and segmentation model using precision, recall and rand index. The study produces good detection and segmentation results and reports the challenges encountered during the image analysis of mitochondrial morphology from the fluorescence mitochondrial dataset. A discussion on the methods and future perspectives of fully automated frameworks concludes the paper.

Keywords: 2D, Binarization, CLAHE, detection, fluorescence microscopy, mitochondria, segmentation.

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Authors: Claude Takenga, Rolf-Dietrich Berndt, Erling Si, Markus Diem, Guohui Qiao, Melanie Gau, Michael Brandstoetter, Martin Kampel, Michael Dworzak

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In patients with acute lymphoblastic leukaemia (ALL), treatment response is increasingly evaluated with minimal residual disease (MRD) analyses. Flow Cytometry (FCM) is a fast and sensitive method to detect MRD. However, the interpretation of these multi-parametric data requires intensive operator training and experience. This paper presents a pipeline-software, as a ready-to-use FCM-based MRD-assessment tool for the daily clinical practice for patients with ALL. The new tool increases accuracy in assessment of FCM-MRD in samples which are difficult to analyse by conventional operator-based gating since computer-aided analysis potentially has a superior resolution due to utilization of the whole multi-parametric FCM-data space at once instead of step-wise, two-dimensional plot-based visualization. The system developed as a telemedical network reduces the work-load and lab-costs, staff-time needed for training, continuous quality control, operator-based data interpretation. It allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise for the benefit of an even larger community of diseased children worldwide. We established a telemedical network system for analysis and clinical follow-up and treatment monitoring of Leukaemia. The system is scalable and adapted to link several centres and laboratories worldwide.

Keywords: Data security, flow cytometry, leukaemia, telematics platform, telemedicine.

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Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahbobeh Gholipour

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Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.

Keywords: Hypertension, dietary intake, weight, waist circumference, North of Iran.

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Authors: Frank C. Pan, Che-Long Su, Ching-Hsuen Chen

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Background, measuring an individual-s Health Literacy is gaining attention, yet no appropriate instrument is available in Taiwan. Measurement tools that were developed and used in western countries may not be appropriate for use in Taiwan due to a different language system. Purpose of this research was to develop a Health Literacy measurement instrument specific for Taiwan adults. Methods, several experts of clinic physicians; healthcare administrators and scholars identified 125 common used health related Chinese phrases from major medical knowledge sources that easy accessible to the public. A five-point Likert scale is used to measure the understanding level of the target population. Such measurement is then used to compare with the correctness of their answers to a health knowledge test for validation. Samples, samples under study were purposefully taken from four groups of people in the northern Pingtung, OPD patients, university students, community residents, and casual visitors to the central park. A set of health knowledge index with 10 questions is used to screen those false responses. A sample size of 686 valid cases out of 776 was then included to construct this scale. An independent t-test was used to examine each individual phrase. The phrases with the highest significance are then identified and retained to compose this scale. Result, a Taiwan Health Literacy Scale (THLS) was finalized with 66 health-related phrases under nine divisions. Cronbach-s alpha of each division is at a satisfactory level of 89% and above. Conclusions, factors significantly differentiate the levels of health literacy are education, female gender, age, family members of stroke victims, experience with patient care, and healthcare professionals in the initial application in this study..

Keywords: Health literacy, health knowledge, REALM, THLS.

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