Search results for: Cancer Patients

Authors: Laila Ozola, Evita Straumite

Abstract:

Celiac disease is a permanent enteropathy caused by the ingestion of gluten, a protein occurring in wheat, rye and barley. The only way of the effective daily treatment is a strict gluten-free diet. From the investigation of products available in the local market, it was found that Latvian producers do not offer gluten-free products. The aim of this research was to study and analyze changes of celiac patient’s attitude to gluten-free product quality and availability in the Latvian market and purchasing habits. The survey was designed using website www.visidati.lv, and a questionnaire was sent to people suffering from celiac disease. The first time the respondents were asked to fill in the questionnaire in 2011, but now repeatedly from the beginning of September 2013 till the end of January 2014. The questionnaire was performed with 75 celiac patients, respondents were from all Latvian regions and they answered 16 questions. One of the most important questions was aimed to find out consumers’ opinion about quality of gluten-free products, consumption patterns of gluten-free products, and, moreover, their interest in products made in Latvia. Respondents were asked to name gluten-free products they mainly buy and give specific purchase locations, evaluate the quality of products and necessity for products produced in Latvia. The results of questionnaire show that the consumers are satisfied with the quality of gluten-free flour, flour blends, sweets and pasta, but are not satisfied with the quality of bread and confectionery available in the Latvian markets.

Keywords: Consumers, gluten-free products, quality, survey.

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

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

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

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Authors: Mohsen A. Bakouri, Andrey V. Savkin, Abdul-Hakeem H. Alomari, Robert F. Salamonsen, Einly Lim, Nigel H. Lovell

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Physiological control of a left ventricle assist device (LVAD) is generally a complicated task due to diverse operating environments and patient variability. In this work, a tracking control algorithm based on sliding mode and feed forward control for a class of discrete-time single input single output (SISO) nonlinear uncertain systems is presented. The controller was developed to track the reference trajectory to a set operating point without inducing suction in the ventricle. The controller regulates the estimated mean pulsatile flow Qp and mean pulsatility index of pump rotational speed PIω that was generated from a model of the assist device. We recall the principle of the sliding mode control theory then we combine the feed-forward control design with the sliding mode control technique to follow the reference trajectory. The uncertainty is replaced by its upper and lower boundary. The controller was tested in a computer simulation covering two scenarios (preload and ventricular contractility). The simulation results prove the effectiveness and the robustness of the proposed controller

Keywords: robust control system, discrete-sliding mode, left ventricularle assist devicse, pulsatility index.

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Authors: Wen-Shyong Tzou, Chih-Ching Huang, Chin-Hwa Hu, Ying-Tsang Lo, Tun-Wen Pai, Chia-Yin Chiang, Chung-Hao Li, Hong-Jyuan Jian

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Plasmin plays an important role in the human circulatory system owing to its catalytic ability of fibrinolysis. The immediate injection of plasmin in patients of strokes has intrigued many scientists to design vectors that can transport plasmin to the desired location in human body. Here we predict the structure of human plasmin and investigate the interaction of plasmin with the gold-nanoparticle. Because the crystal structure of plasminogen has been solved, we deleted N-terminal domain (Pan-apple domain) of plasminogen and generate a mimic of the active form of this enzyme (plasmin). We conducted a simulated annealing process on plasmin and discovered a very large conformation occurs. Kringle domains 1, 4 and 5 had been observed to leave its original location relative to the main body of the enzyme and the original doughnut shape of this enzyme has been transformed to a V-shaped by opening its two arms. This observation of conformational change is consistent with the experimental results of neutron scattering and centrifugation. We subsequently docked the plasmin on the simulated gold surface to predict their interaction. The V-shaped plasmin could utilize its Kringle domain and catalytic domain to contact the gold surface. Our findings not only reveal the flexibility of plasmin structure but also provide a guide for the design of a plasmin-gold nanoparticle.

Keywords: Docking, gold nanoparticle, molecular simulation, plasmin.

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Authors: Gabriel Sitler, Yousef Sardahi, Asad Salem

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This paper presents an optimal and robust sliding mode controller (SMC) to regulate the position of the knee joint angle for patients suffering from knee injuries. The controller imitates the role of active orthoses that produce the joint torques required to overcome gravity and loading forces and regain natural human movements. To this end, a mathematical model of the shank, the lower part of the leg, is derived first and then used for the control system design and computer simulations. The design of the controller is carried out in optimal and multi-objective settings. Four objectives are considered: minimization of the control effort and tracking error; and maximization of the control signal smoothness and closed-loop system’s speed of response. Optimal solutions in terms of the Pareto set and its image, the Pareto front, are obtained. The results show that there are trade-offs among the design objectives and many optimal solutions from which the decision-maker can choose to implement. Also, computer simulations conducted at different points from the Pareto set and assuming knee squat movement demonstrate competing relationships among the design goals. In addition, the proposed control algorithm shows robustness in tracking a standard gait signal when accounting for uncertainty in the shank’s parameters.

Keywords: Optimal control, multi-objective optimization, sliding mode control, wearable knee exoskeletons.

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Authors: Brahmi Brahim, Mohammad Habibur Rahman, Maarouf Saad, Cristóbal Ochoa Luna

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A repetitive training movement is an efficient method to improve the ability and movement performance of stroke survivors and help them to recover their lost motor function and acquire new skills. The ETS-MARSE is seven degrees of freedom (DOF) exoskeleton robot developed to be worn on the lateral side of the right upper-extremity to assist and rehabilitate the patients with upper-extremity dysfunction resulting from stroke. Practically, rehabilitation activities are repetitive tasks, which make the assistive/robotic systems to suffer from repetitive/periodic uncertainties and external perturbations induced by the high-order dynamic model (seven DOF) and interaction with human muscle which impact on the tracking performance and even on the stability of the exoskeleton. To ensure the robustness and the stability of the robot, a new nonlinear backstepping control was implemented with designed tests performed by healthy subjects. In order to limit and to reject the periodic/repetitive disturbances, an iterative estimator was integrated into the control of the system. The estimator does not need the precise dynamic model of the exoskeleton. Experimental results confirm the robustness and accuracy of the controller performance to deal with the external perturbation, and the effectiveness of the iterative estimator to reject the repetitive/periodic disturbances.

Keywords: Backstepping control, iterative control, rehabilitation, ETS-MARSE.

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Authors: P. Pongsumpun, I.M. Tang

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Plasmodium vivax malaria differs from P. falciparum malaria in that a person suffering from P. vivax infection can suffer relapses of the disease. This is due the parasite being able to remain dormant in the liver of the patients where it is able to re-infect the patient after a passage of time. During this stage, the patient is classified as being in the dormant class. The model to describe the transmission of P. vivax malaria consists of a human population divided into four classes, the susceptible, the infected, the dormant and the recovered. The effect of a time delay on the transmission of this disease is studied. The time delay is the period in which the P. vivax parasite develops inside the mosquito (vector) before the vector becomes infectious (i.e., pass on the infection). We analyze our model by using standard dynamic modeling method. Two stable equilibrium states, a disease free state E0 and an endemic state E1, are found to be possible. It is found that the E0 state is stable when a newly defined basic reproduction number G is less than one. If G is greater than one the endemic state E1 is stable. The conditions for the endemic equilibrium state E1 to be a stable spiral node are established. For realistic values of the parameters in the model, it is found that solutions in phase space are trajectories spiraling into the endemic state. It is shown that the limit cycle and chaotic behaviors can only be achieved with unrealistic parameter values.

Keywords: Equilibrium states, Hopf bifurcation, limit cyclebehavior, local stability, Plasmodium Vivax, time delay.

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

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

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

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Authors: Vladyslav Povoroznyuk, Oksana Ivanyk, Nataliia Dzerovych

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In the diagnostics of osteoporosis, the gold standard is considered to be bone mineral density; however, X-ray densitometry is not an accurate indicator of osteoporotic fracture risk under all circumstances. In this regard, the search for new methods that could determine the indicators not only of the mineral density, but of the bone tissue quality, is a logical step for diagnostic optimization. One of these methods is the evaluation of trabecular bone quality. The aim of this study was to examine the quality and mineral density of spine bone tissue, femoral neck, and body composition of women depending on the duration of the postmenopausal period, to determine the correlation of body fat with indicators of bone mineral density and quality. The study examined 179 women in premenopausal and postmenopausal periods. The patients were divided into the following groups: Women in the premenopausal period and women in the postmenopausal period at various stages (early, middle, late postmenopause). A general examination and study of the above parameters were conducted with General Electric X-ray densitometer. The results show that bone quality and mineral density probably deteriorate with advancing of postmenopausal period. Total fat and lean mass ratio is not likely to change with age. In the middle and late postmenopausal periods, the bone tissue mineral density of the spine and femoral neck increases along with total fat mass.

Keywords: Osteoporosis, bone tissue mineral density, bone quality, fat mass, lean mass, postmenopausal osteoporosis.

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Authors: Gaetano Zazzaro, Angelo Martone, Roberto V. Montaquila, Luigi Pavone

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Seizure is the main factor that affects the quality of life of epileptic patients. The diagnosis of epilepsy, and hence the identification of epileptogenic zone, is commonly made by using continuous Electroencephalogram (EEG) signal monitoring. Seizure identification on EEG signals is made manually by epileptologists and this process is usually very long and error prone. The aim of this paper is to describe an automated method able to detect seizures in EEG signals, using knowledge discovery in database process and data mining methods and algorithms, which can support physicians during the seizure detection process. Our detection method is based on Artificial Neural Network classifier, trained by applying the multilayer perceptron algorithm, and by using a software application, called Training Builder that has been developed for the massive extraction of features from EEG signals. This tool is able to cover all the data preparation steps ranging from signal processing to data analysis techniques, including the sliding window paradigm, the dimensionality reduction algorithms, information theory, and feature selection measures. The final model shows excellent performances, reaching an accuracy of over 99% during tests on data of a single patient retrieved from a publicly available EEG dataset.

Keywords: Artificial Neural Network, Data Mining, Electroencephalogram, Epilepsy, Feature Extraction, Seizure Detection, Signal Processing.

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Authors: A. Ahmed Haza’a, M. Ali Odhah, S. Ahmed Al-Ahdal, A. Saleh Al-Jaradi, G. Ghaleb Alrubaiee

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Patient safety in hospitals is an essential professional indicator that should be noticed. The threat of fires is potentially the most dangerous risk that could harm patients and personnel. The aim of the study is to assess the knowledge of operating room (OR) staff toward prevention and control sources of fires. Data collection was done between March 1 and March 30, 2022. A descriptive cross-sectional study was conducted. The sample of the study consisted of 89 OR staff from different governmental hospitals. Convenient sampling was applied to select the sample size. Official approvals were obtained from selected settings for start collection data. Data were collected using a close-ended questionnaire and tested for knowledge. This study was conducted in four governmental hospitals in Sana'a, Yemen. Most of the OR staff were male. Of these, 50.6% of them were operation technician professionals. More than two-thirds of OR staff have less than ten years of experience; 93% of OR staff had inadequate knowledge of sources of fires, and inadequate knowledge toward control and prevention of fires (73%, 79.8%), respectively; 77.5% of OR staff had inadequate knowledge of prevention and control sources of fires. The study concluded that most of OR staff had inadequate knowledge of sources, controls, and prevention of fires, while 22.5% of them had adequate knowledge of prevention and control sources of fires. We recommended the implementation of training programs toward sources, controls, and prevention of fires or related workshops in their educational planning for OR staff of hospitals.

Keywords: Staff, fire source, operation room safety.

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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: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Dzerovych, Roksolana Povoroznyuk, Oksana Ivanyk

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Deficiency and insufficiency of Vitamin D is a pandemic of the 21^st century. Obesity patients have a lower level of vitamin D, but the literature data are contradictory. The purpose of this study is to investigate deficiency and insufficiency vitamin D in postmenopausal women with obesity. We examined 1007 women aged 50-89 years. Mean age was 65.74±8.61 years; mean height was 1.61±0.07 m; mean weight was 70.65±13.50 kg; mean body mass index was 27.27±4.86 kg/m², and mean 25(OH) D levels in serum was 26.00±12.00 nmol/l. The women were divided into the following six groups depending on body mass index: I group – 338 women with normal body weight, II group – 16 women with insufficient body weight, III group – 382 women with excessive body weight, IV group – 199 women with obesity of class I, V group – 60 women with obesity of class II, and VI group – 12 women with obesity of class III. Level of 25(OH)D in serum was measured by means of an electrochemiluminescent method - Elecsys 2010 analyzer (Roche Diagnostics, Germany) and cobas test-systems. 34.4% of the examined women have deficiency of vitamin D and 31.4% insufficiency. Women with obesity of class I (23.60±10.24 ng/ml) and obese of class II (22.38±10.34 ng/ml) had significantly lower levels of 25 (OH) D compared to women with normal body weight (28.24±12.99 ng/ml), p=0.00003. In women with obesity, BMI significantly influences vitamin D level, and this influence does not depend on the season.

Keywords: Obesity, body mass index, vitamin D deficiency/insufficiency, postmenopausal women, age.

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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: Tariq Ali Gujar, Anita Hökelmann

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Postural balance plays essential role throughout life in daily activities. Somatosensory, visual and vestibular inputs play the fundamental role in maintaining body equilibrium to balance the posture. The aim of this study was to find out electroencephalography (EEG) responses during balance activity of young people during Sensory Organization Balance Test. The outcome of this study will help to create the fitness and neurorehabilitation plan. 25 young people (25 ± 3.1 years) have been analyzed on Balance Master NeuroCom® with the coupling of Brain Vision 32 electrode wireless EEG system during the Sensory Organization Test. From the results it has been found that the balance score of samples is significantly higher under the influence of somatosensory input as compared to visual and vestibular input (p < 0.05). The EEG between somatosensory and visual input to balance the posture showed significantly higher (p < 0.05) alpha and beta activities during somatosensory input in somatosensory, attention and visual functions of the cortex whereas executive and motor functions of the cerebral cortex showed significantly higher (p < 0.05) alpha EEG activity during the visual input. The results suggest that somatosensory and attention function of the cerebral cortex has alpha and beta activity, respectively high during somatosensory and vestibular input in maintaining balance. In patients with balance impairments both physical and cognitive training, including neurofeedback will be helpful to improve balance abilities.

Keywords: Balance, electroencephalography activity, somatosensory, visual, vestibular.

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Authors: Yahia Massinissa, Kalla A, Yahia M, Benbia S

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A lot of recent research have spoken on the relation between the increase of the homocysteinemia and some kinds of cancer . For that, our study was based on the research of a possible relation between the increase of the concentration of this amino-acid in the plasma and the appearance of the disease of the Acute Lymphoblastic Leukaemia in a part of Algerian children with Berber origin in the East of Algeria . The study has done on 47 ill persons with an average age of (09±06 ) years , with whom the disease has diagnosed by blood and marrow examination in the hospital of blood diseases in the CHU of Batna, and on 194 healthy witnesses of the same age. The two groups were benefited by a dosage of the concentration of the homocysteine vitamin B9 ,vitamin B12 , and also of the study of special polymorphisms of indispensable enzymes in the metabolism of this acid , and that by the use of the method ( Light cycler ) Real time PCR , on the following enzymes : MS ( C2756G ), MSR ( A66G ) ,MTHFR1 ( C677T ) and MTHFR2 (A1298C). The obtained results have revealed that the rate of the homozygote muted genotype is the less frequent in the two groups , and that exist at list one genotype of each enzyme in the ill group and in which the percentage exceed with remarkable way the same genotype in the healthy group and we notice specially the muted genotype GG of -the methionine synthetase-and the form TT of the enzyme – methyline tetra hydrofolate reductase – We notice the existence of considerable number of genotypes in the ill group lied with characteristic increase of this Amino-acid ,and that for the reduction of the biologic activity of these enzymes which become inefficient in the transfer of the homocysteine into the methionine and cause the diminution of the biologic activity of these enzymes and with consequence the reduction of the percentage of methylic radicals in the DNA of studied genes and that lead to the increase of the activity and the capacity of transcription , and it-s so probably that this last one is one of the factors of this disease especially if we know that the specific check-up of vitamins is normal and similar in the two groups , which ovoid the hypothesis of the reduction of vitamins . We notice also that the heterozygote genotype is the less in the sick category except the MTHFR2. Wild genotype is more frequent in the witness group except MSR. Even these results are partials; they open a new way in the genetic diagnosis of this malicious disease which allow a precocious diagnosis and the use of an effective and appropriated treatment in the same time.

Keywords: Genetic polymorphism, Acute Lymphoblastic Leukaemia, Biomarkers, Metabolism of homocystein

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Authors: Aljabryn Dalal Hamad

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The present explanatory study concerns with the relation between Diabetes Mellitus and Food Balance in the Kingdom of Saudi Arabia during 2005-2010, using published data. Results illustrated that Saudi citizen daily protein consumption (DPC) during 2005-2007 (g/capita/day) is higher than the average global consumption level of protein with 15.27%, daily fat consumption (DFC) with 24.56% and daily energy consumption (DEC) with 16.93% and increases than recommended level by International Nutrition Organizations (INO) with 56% for protein, 60.49% for fat and 27.37% for energy. On the other hand, DPC per capita in Saudi Arabia decreased during the period 2008-2010 from 88.3 to 82.36 gram/ day. Moreover, DFC per capita in Saudi Arabia decreased during the period 2008-2010 from 3247.90 to 3176.43 Cal/capita/ day, and daily energy consumption (DEC) of Saudi citizen increases than world consumption with 16.93%, whereas increases with 27.37% than INO. Despite this, DPC, DFC and DEC per capita in Saudi Arabia still higher than world mean. On the other side, results illustrated that the number of diabetic patients in Saudi Arabia during the same period (2005-2010). The curve of diabetic patient’s number in Saudi Arabia during 2005-2010 is regular ascending with increasing level ranged between 7.10% in 2005 and 12.44% in 2010. It is essential to devise Saudi National programs to educate the public about the relation of food balances and diabetes so it could be avoided, and provide citizens with healthy dietary balances tables.

Keywords: Diabetes Mellitus, Food Balance, Energy, Fat, Protein, Saudi Arabia.

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Authors: Taruna Katyal Arora, Geeta Kumari, Hari Shankar, Neelima Mishra

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Substandard and counterfeit antimalarials is a major problem in malaria endemic areas. The availability of counterfeit/ substandard medicines is not only decreasing the efficacy in patients, but it is also one of the contributing factors for developing antimalarial drug resistance. Owing to this, a pilot study was conducted to survey quality of drugs collected from different malaria endemic areas of India. Artesunate+Sulphadoxine-Pyrimethamine (AS+SP), Artemether-Lumefantrine (AL), Chloroquine (CQ) tablets were randomly picked from public health facilities in selected states of India. The quality of antimalarial drugs from these areas was assessed by using Global Pharma Health Fund Minilab test kit. This includes physical/visual inspection and disintegration test. Thin-layer chromatography (TLC) was carried out for semi-quantitative assessment of active pharmaceutical ingredients. A total of 45 brands, out of which 21 were for CQ, 14 for AL and 10 for AS+SP were tested from Uttar Pradesh (U.P.), Mizoram, Meghalaya and Gujrat states. One out of 45 samples showed variable disintegration and retension factor. The variable disintegration and retention factor which would have been due to substandard quality or other factors including storage. However, HPLC analysis confirms standard active pharmaceutical ingredient, but may be due to humid temperature and moisture in storage may account for the observed result.

Keywords: Antimalarial medicines, counterfeit, substandard, thin layer chromatography.

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Authors: Amean A. Yasir, Zainab Kh. A. Al-Mahdi Al-Amean

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In both developed and developing countries, obesity among women is increasing, but in different patterns and at very different speeds. It may have a negative effect on health, leading to reduced life expectancy and/or increased health problems. This research studied the age distribution among obese women, the types of overweight and obesity, and the extent of the problem of overweight/obesity and the obesity etiological factors among women in Hillah city in central Iraq. A total of 322 overweight and obese women were included in the study, those women were randomly selected. The Body Mass Index was used as indicator for overweight/ obesity. The incidence of overweight/obesity among age groups were estimated, the etiology factors included genetic, environmental, genetic/environmental and endocrine disease. The overweight and obese women were screened for incidence of infection and/or diseases. The study found that the prevalence of 322 overweight and obese women in Hillah city in central Iraq was 19.25% and 80.78%, respectively. The obese women types were recorded based on BMI and WHO classification as class-1 obesity (29.81%), class-2 obesity (24.22%) and class-3 obesity (26.70%), the result was discrepancy non-significant, P value < 0.05. The incidence of overweight in women was high among those aged 20-29 years (90.32%), 6.45% aged 30-39 years old and 3.22% among ≥ 60 years old, while the incidence of obesity was 20.38% for those in the age group 20-29 years, 17.30% were 30-39 years, 23.84% were 40-49 years, 16.92% were 50-59 years group and 21.53% were ≥ 60 years age group. These results confirm that the age can be considered as a significant factor for obesity types (P value < 0.0001). The result also showed that the both genetic factors and environmental factors were responsible for incidents of overweight or obesity (84.78%) p value < 0.0001. The results also recorded cases of different repeated infections (skin infection, recurrent UTI and influenza), cancer, gallstones, high blood pressure, type 2 diabetes, and infertility. Weight stigma and bias generally refers to negative attitudes; Obesity can affect quality of life, and the results of this study recorded depression among overweight or obese women. This can lead to sexual problems, shame and guilt, social isolation and reduced work performance. Overweight and Obesity are real problems among women of all age groups and is associated with the risk of diseases and infection and negatively affects quality of life. This result warrants further studies into the prevalence of obesity among women in Hillah City in central Iraq and the immune response of obese women.

Keywords: Obesity, overweight, Iraq, body mass index.

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Authors: Carmen Grigoraş, Victor Grigoraş, Daniela Boişteanu

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

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

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Authors: 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: Alexander Hendricks, Sean Nevin, Clayton Wikoff, Melissa Dougherty, Jacob Orlita, Rafiqul Noorani

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Knee orthotics play an important role in aiding in the recovery of those with knee injuries, especially athletes. However, structural knee orthotics is often very expensive, ranging between $300 and $800. The primary reason for this project was to answer the question: can 3D printed orthotics represent a viable and cost-effective alternative to present structural knee orthotics? The primary objective for this research project was to design a knee orthotic for athletes with knee injuries for a low-cost under $100 and evaluate its effectiveness. The initial design for the orthotic was done in SolidWorks, a computer-aided design (CAD) software available at Loyola Marymount University. After this design was completed, finite element analysis (FEA) was utilized to understand how normal stresses placed upon the knee affected the orthotic. The knee orthotic was then adjusted and redesigned to meet a specified factor-of-safety of 3.25 based on the data gathered during FEA and literature sources. Once the FEA was completed and the orthotic was redesigned based from the data gathered, the next step was to move on to 3D-printing the first design of the knee brace. Subsequently, physical therapy movement trials were used to evaluate physical performance. Using the data from these movement trials, the CAD design of the brace was refined to accommodate the design requirements. The final goal of this research means to explore the possibility of replacing high-cost, outsourced knee orthotics with a readily available low-cost alternative.

Keywords: Knee Orthotics, 3D printing, finite element analysis.

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Authors: Cleto J. Sauer Jr

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Introduction: Brazil’s new national curriculum guidelines (NCG) for medical education were published in 2014, presenting active learning methodologies as a cornerstone. Simulation was initially applied for aviation pilots’ training and is currently applied in health sciences. The high-fidelity simulator replicates human body anatomy in detail, also reproducing physiological functions and its use is increasing in medical schools. Realistic Simulation (RS) has pedagogical aspects that are aligned with Brazil’s NCG teaching concepts. The main objective of this study is to carry on a narrative review on RS’s aspects that are aligned with Brazil’s new NCG teaching concepts. Methodology: A narrative review was conducted, with search in three databases (PubMed, Embase and BVS) of studies published between 2010 and 2020. Results: After systematized search, 49 studies were selected and divided into four thematic groups. RS is aligned with new Brazilian medical curriculum as it is an active learning methodology, providing greater patient safety, uniform teaching, and student's emotional skills enhancement. RS is based on reflective learning, a teaching concept developed for adult’s education. Conclusion: RS is a methodology aligned with NCG teaching concepts and has potential to assist in the implementation of new Brazilian medical school’s curriculum. It is an immersive and interactive methodology, which provides reflective learning in a safe environment for students and patients.

Keywords: Curriculum, high-fidelity simulator, medical education, realistic simulation.

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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: Mojiri M, Ghazi Khanloo Sani K, Moghim Beigi A

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The aim of this study was to compare the sensitometric properties of commonly used radiographic films processed with chemical solutions in different workload hospitals. The effect of different processing conditions on induced densities on radiologic films was investigated. Two accessible double emulsions Fuji and Kodak films were exposed with 11-step wedge and processed with Champion and CPAC processing solutions. The mentioned films provided in both workloads centers, high and low. Our findings displays that the speed and contrast of Kodak filmscreen in both work load (high and low) is higher than Fuji filmscreen for both processing solutions. However there was significant differences in films contrast for both workloads when CPAC solution had been used (p=0.000 and 0.028). The results showed base plus fog density for Kodak film was lower than Fuji. Generally Champion processing solution caused more speed and contrast for investigated films in different conditions and there was significant differences in 95% confidence level between two used processing solutions (p=0.01). Low base plus fog density for Kodak films provide more visibility and accuracy and higher contrast results in using lower exposure factors to obtain better quality in resulting radiographs. In this study we found an economic advantages since Champion solution and Kodak film are used while it makes lower patient dose. Thus, in a radiologic facility any change in film processor/processing cycle or chemistry should be carefully investigated before radiological procedures of patients are acquired.

Keywords: Sensitometry, densitometry, Radiographic film, processing solution

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Authors: Kanthida Kusonmano, Michael Netzer, Bernhard Pfeifer, Christian Baumgartner, Klaus R. Liedl, Armin Graber

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Availability of high dimensional biological datasets such as from gene expression, proteomic, and metabolic experiments can be leveraged for the diagnosis and prognosis of diseases. Many classification methods in this area have been studied to predict disease states and separate between predefined classes such as patients with a special disease versus healthy controls. However, most of the existing research only focuses on a specific dataset. There is a lack of generic comparison between classifiers, which might provide a guideline for biologists or bioinformaticians to select the proper algorithm for new datasets. In this study, we compare the performance of popular classifiers, which are Support Vector Machine (SVM), Logistic Regression, k-Nearest Neighbor (k-NN), Naive Bayes, Decision Tree, and Random Forest based on mock datasets. We mimic common biological scenarios simulating various proportions of real discriminating biomarkers and different effect sizes thereof. The result shows that SVM performs quite stable and reaches a higher AUC compared to other methods. This may be explained due to the ability of SVM to minimize the probability of error. Moreover, Decision Tree with its good applicability for diagnosis and prognosis shows good performance in our experimental setup. Logistic Regression and Random Forest, however, strongly depend on the ratio of discriminators and perform better when having a higher number of discriminators.

Keywords: Classification, High dimensional data, Machine learning

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Authors: Ryuji Yamazaki, Masahiro Kochi, Weiran Zhu, Hiroko Kase

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In care for older adults, behavioral and psychological symptoms of dementia (BPSD) like agitation and aggression are distressing for patients and their caretakers, often resulting in premature institutionalization with increased costs of care. To improve mood and mitigate symptoms, as a non-pharmaceutical approach, emotion-oriented therapy like reminiscence work is adopted in face-to-face communication. Telecommunication support is expected to be provided by robotic media as a bridge for digital divide for those with dementia and facilitate social interaction both verbally and nonverbally. The purpose of this case study is to explore the conditions in which robotic media can effectively attract attention from older adults with dementia and promote their well-being. As a pilot study, we introduced the pillow-phone Hugvie^®, a huggable humanly shaped communication medium to five residents with dementia at a care facility, to investigate how the following conditions work for the elderly when they use the medium; 1) no sound, 2) radio, non-interactive, 3) daily conversation, and 4) reminiscence work. As a result, under condition 4, reminiscence work, the five participants kept concentration in interacting with the medium for a longer duration than other conditions. In condition 4, they also showed larger amount of utterances than under other conditions. These results indicate that providing topics related to personal histories through robotic media could affect communication positively and should, therefore, be further investigated. In addition, the issue of ethical implications by using persuasive technology that affects emotions and behaviors of older adults is also discussed.

Keywords: BPSD, reminiscence, tactile telecommunication, utterances.

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Authors: Angela–M. Paleologou, Aphrodite Dellaporta

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Erroneous computer entry problems [here: 'e'errors] in hospital labs threaten the patients-–health carers- relationship, undermining the health system credibility. Are e-errors random, and do lab professionals make them accidentally, or may they be traced through meaningful determinants? Theories on internal causality of mistakes compel to seek specific causal ascriptions of hospital lab eerrors instead of accepting some inescapability. Undeniably, 'To Err is Human'. But in view of rapid global health organizational changes, e-errors are too expensive to lack in-depth considerations. Yet, that efunction might supposedly be entrenched in the health carers- job description remains under dispute – at least for Hellenic labs, where e-use falls behind generalized(able) appreciation and application. In this study: i) an empirical basis of a truly high annual cost of e-errors at about €498,000.00 per rural Hellenic hospital was established, hence interest in exploring the issue was sufficiently substantiated; ii) a sample of 270 lab-expert nurses, technicians and doctors were assessed on several personality, burnout and e-error measures, and iii) the hypothesis that the Hardiness vs Alienation personality construct disposition explains resistance vs proclivity to e-errors was tested and verified: Hardiness operates as a resilience source in the encounter of high pressures experienced in the hospital lab, whereas its 'opposite', i.e., Alienation, functions as a predictor, not only of making e-errors, but also of leading to burn-out. Implications for apt interventions are discussed.

Keywords: Hospital lab, personality hardiness/alienation, e-errors' cost, burnout.

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Authors: Do Thi Ha, Khanitta Nuntaboot

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Background: Competency of nurses is vital to safe nursing practice as well as essential component to drive quality of nursing services. There exists little up to date information concerning actual competency among Vietnamese nurses. Purposes: The purpose of this study is to identify the actual nursing competency among nurses in clinical settings in Vietnam. Methods: A qualitative study, ethnographic method, comprised of the participant-observation, in-depth interview, and focus group discussion with multidisciplinary groups of nurses employing in Cho Ray hospital, Vietnam, managers/administrators, nurse teachers, medical doctors, other health care providers, patients and family members which derived from purposeful sampling technique. Content analysis was used for data analysis. Results: Five essential themes of nursing competencies among nurses were identified include (1) knowledge, (2) skills, (3) attitude and value-based nursing practice, (4) legal and ethical competencies, and (5) transcultural competencies. Basic and advanced knowledge were identified as further two dimensions of knowledge. There were five sub themes identified as further dimensions of skills include technical skills, communication skills, organizing and management skills, teamwork and interrelationship, and critical thinking skills. Conclusions: The findings from this study provide valuable information and understanding of the actual competency among nurses in clinical settings in Vietnam. It is expected that this understanding would assist in developing a guide to nursing education and training, nursing practice and relevant policy regulation used for promoting nursing competency among nurses.

Keywords: Nursing competency, qualitative design, ethnographic method, Vietnam.

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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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