Search results for: Clinical Pathway

Authors: Fahad Shahbaz Khan, Rao Muhammad Anwer, Olof Torgersson, Göran Falkman

Abstract:

Data mining has been used very frequently to extract hidden information from large databases. This paper suggests the use of decision trees for continuously extracting the clinical reasoning in the form of medical expert-s actions that is inherent in large number of EMRs (Electronic Medical records). In this way the extracted data could be used to teach students of oral medicine a number of orderly processes for dealing with patients who represent with different problems within the practice context over time.

Keywords: Data mining, Oral Medicine, Decision Trees, WEKA.

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Authors: Jienny Lee, In-Soo Cho, Sang-Ho Cha

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Adult mesenchymal stem cells (MSCs) have been investigated using preclinical approaches for tissue regeneration. Porcine MSCs (pMSCs) are capable of growing and attaching to plastic with a fibroblast-like morphology and then differentiating into bone, adipose, and cartilage tissues in vitro. This study was conducted to investigate the proliferating abilities, differentiation potentials, and multipotency of miniature pig adipose tissue-derived MSCs (mpAD-MSCs) with or without long-term cryopreservation, considering that cryostorage has the potential for use in clinical applications. After confirming the characteristics of the mpAD-MSCs, we examined the effect of long-term cryopreservation (> 2 years) on expression of cell surface markers (CD34, CD90 and CD105), proliferating abilities (cumulative population doubling level, doubling time, colony-forming unit, and MTT assay) and differentiation potentials into mesodermal cell lineages. As a result, the expression of cell surface markers is similar between thawed and fresh mpAD-MSCs. However, long-term cryopreservation significantly lowered the differentiation potentials (adipogenic, chondrogenic, and osteogenic) of mpAD-MSCs. When compared with fresh mpAD-MSCs, thawed mpAD-MSCs exhibited lower expression of mesodermal cell lineage-related genes such as peroxisome proliferator-activated receptor-g2, lipoprotein lipase, collagen Type II alpha 1, osteonectin, and osteocalcin. Interestingly, long-term cryostoraged mpAD-MSCs exhibited significantly higher cell viability than the fresh mpAD-MSCs. Long-term cryopreservation induced a 30% increase in the cell viability of mpAD-MSCs when compared with the fresh mpAD-MSCs at 5 days after thawing. However, long-term cryopreservation significantly lowered expression of stemness markers such as Oct3/4, Sox2, and Nanog. Furthermore, long-term cryopreservation negatively affected expression of senescence-associated genes such as telomerase reverse transcriptase and heat shock protein 90 of mpAD-MSCs when compared with the fresh mpAD-MSCs. The results from this study might be important for the successful application of MSCs in clinical trials after long-term cryopreservation.

Keywords: Mesenchymal stem cells, Cryopreservation, Stemness, Senescence.

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Authors: Adama Sow, Abdoulaye Guiss´e, Oumar Niang

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To assist medical diagnosis, we propose a federation of several existing and open medical ontologies and terminologies. The goal is to merge the strengths of all these resources to provide clinicians the access to a variety of shared knowledges that can facilitate identification and association of human diseases and all of their available characteristic signs such as symptoms and clinical signs. This work results to an integration model loaded from target known ontologies of the bioportal platform such as DOID, MESH, and SNOMED for diseases selection, SYMP, and CSSO for all existing signs.

Keywords: Medical decision, medical ontologies, ontologies integration, linked data, knowledge ingeneering, e-health system.

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Authors: Abdulkareem Hamid, Adam Daïch

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Camptothecin (CPT) is a cytotoxic quinoline alkaloid, which inhibits the DNA enzyme topoisomerase I (topo I). It was discovered in 1966 by M. E. Wall and M. C. Wani in systematic screening of natural products for anticancer drugs. It was isolated from the bark and stem of Camptotheca acuminata (Camptotheca, Happy tree), a tree native in China. CPT showed remarkable anticancer activity in preliminary clinical trials but also low solubility and (high) adverse drug reaction. Because of these disadvantages synthetic and medicinal chemists have developed numerous syntheses of Camptothecine [1][2][3] and various derivatives to increase the benefits of the chemical, with good results. In our method CPT analogues has be six steps starting from available material DL Malic acid.

Keywords: Camptothecine, synthesis, analogue.

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Authors: S. M. M. Syairah, M. H. Rajikin, A-R. Sharaniza

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Several embryonic cellular mechanism including cell cycle, growth and apoptosis are regulated by phosphatidylinositol-3- kinase (PI3K)/Akt signaling pathway. The goal of present study is to determine the effects of annatto (Bixa orellana)-derived δ-tocotrienol (δ-TCT) on the regulations of PI3K/Akt genes in murine morula. Twenty four 6-8 week old (23-25g) female balb/c mice were randomly divided into four groups (G1-G4; n=6). Those groups were subjected to the following treatments for 7 consecutive days: G1 (control) received tocopherol stripped corn oil, G2 was given 60 mg/kg/day of δ-TCT mixture (contains 90% delta & 10% gamma isomers), G3 was given 60 mg/kg/day of pure δ-TCT (>98% purity) and G4 received 60 mg/kg/day α-TOC. On Day 8, females were superovulated with 5 IU Pregnant Mare’s Serum Gonadotropin (PMSG) for 48 hours followed with 5 IU human Chorionic Gonadotropin (hCG) before mated with males at the ratio of 1:1. Females were sacrificed by cervical dislocation for embryo collection 48 hours post-coitum. About fifty morulas from each group were used in the gene expression analyses using Affymetrix QuantiGene Plex 2.0 Assay. Present data showed a significant increase (p<0.05) in the average number (mean + SEM) of morula produced in G2 (27.32 + 0.23), G3 (25.42 + 0.21) and G4 (27.21 + 0.34) compared to control group (G1 – 14.61 + 0.25). This is parallel with the high expression of PDK1 gene with increase of 2.75-fold (G2), 3.07-fold (G3) and 3.59-fold (G4) compared to G1. From the present data, it can be concluded that supplementation with δ-TCT(s) and α-TOC induced high expression of PDK1 in G2-G4 which enhanced the PI3K/Akt signaling activity, resulting in the increased number of morula.

Keywords: Embryonic development, morula, nicotine, vitamin E.

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Authors: T. Aboumahboub, R. Brecha, H. B. Shrestha, U. F. Hutfilter, A. Geiges, W. Hare, M. Schaeffer, L. Welder, M. Gidden

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The proposed stringent mitigation targets require an immediate start for a drastic transformation of the whole energy system. The current Australian energy system is mainly centralized and fossil fuel-based in most states with coal and gas-fired plants dominating the total produced electricity over the recent past. On the other hand, the country is characterized by a huge, untapped renewable potential, where wind and solar energy could play a key role in the decarbonization of the Australia’s future energy system. However, integrating high shares of such variable renewable energy sources (VRES) challenges the power system considerably due to their temporal fluctuations and geographical dispersion. This raises the concerns about flexibility gap in the system to ensure the security of supply with increasing shares of such intermittent sources. One main flexibility dimension to facilitate system integration of high shares of VRES is to increase the cross-sectoral integration through coupling of electricity to other energy sectors alongside the decarbonization of the power sector and reinforcement of the transmission grid. This paper applies a multi-sectoral energy system optimization model for Australia. We investigate the cost-optimal configuration of a renewable-based Australian energy system and its transformation pathway in line with the ambitious range of proposed climate change mitigation targets. We particularly analyse the implications of linking the electricity and transport sectors in a prospective, highly renewable Australian energy system.

Keywords: Decarbonization, energy system modeling, sector coupling, variable renewable energies.

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Authors: Azaz Zaman, Imtiaz Uddin Chowdhury, Mohammad Shariful Islam

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Corporate governance has become a crucial issue in both the business and academic world as a result of world-wide financial scandals and lack of trust in corporate practices. There is no doubt that in order to thrive and attain growth in the market, a company must earn the trust of its stakeholders by consistently delivering on its commitments. Directors of the companies thus comprehend the importance of upfront communication with relevant stakeholders to increase their confidence. The authors of this article argue that practicing good corporate governance is not enough in this highly competitive market place; corporate leaders need to market their good corporate governance practices in order to make the company more attractive to investors. This article also contends that the strength of corporate governance relies wholly upon the extent to which it is communicated simply, effectively and unceasingly to its stakeholders. The main objective of this study, therefore, is to explore the importance of branding good corporate governance in order to increase corporate brand equity, attract investors, and capture market share. A structured questionnaire comprising three sections and a total of 34 questions was prepared and surveyed by the authors among respondents residing in Bangladesh and who also have an academic and corporate background, to investigate the potential impact of branding good corporate governance in the market place. High mean values for individual questions and overall section depict that communicating and branding good corporate governance to the stakeholders will not only boost the investors’ confidence but also increase the corporate brand equity, yielding both profitable and sustainable business environment.

Keywords: Brand equity, investors’ preference, good corporate governance, sustainable business environment.

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Authors: Heather M. Roxborough, Paul L. Hewitt, Gordon L. Flett, Jasmin Abizadeh

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This work represents the first review paper to explore the relationship between perfectionistic personality and borderline personality organization. The developmental origins, identity diffusion, interpersonal difficulties, and defense mechanisms that are common to both borderline personality and the interpersonal components of perfectionism are explored, and existing research on perfectionism and borderline personality is reviewed. The importance of the link between perfectionism and borderline features is discussed in terms of its contribution to the conceptual understanding of personality pathology as well as to applied clinical practices.

Keywords: Borderline personality organization, defenses, identity, interpersonal problems, perfectionism.

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Authors: K. Aloui, M. S. Naceur

Abstract:

The main objective of this paper is to provide an efficient tool for delineating brain tumors in three-dimensional magnetic resonance images. To achieve this goal, we use basically a level-sets approach to delineating three-dimensional brain tumors. Then we introduce a compression plan of 3D brain structures based for the meshes simplification, adapted for time to the specific needs of the telemedicine and to the capacities restricted by network communication. We present here the main stages of our system, and preliminary results which are very encouraging for clinical practice.

Keywords: Medical imaging, level-sets, compression, meshess implification, telemedicine.

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Authors: David Cobham

Abstract:

In higher education, a great degree of importance is placed on the internationalisation of the student experience. This is seen as a valuable contributor to elements such as building confidence, broadening knowledge, creating networks, and connections and enhancing employability for current students who will become the next generation of managers in technology and business. The COVID-19 pandemic has affected all areas of people’s lives. The limitations of travel coupled with the fears and concerns generated by the health risks have dramatically reduced the opportunity for students to engage with this agenda. Institutions of higher education have been required to rethink fundamental aspects of their business model from recruitment and enrolment, through learning approaches, assessment methods and the pathway to employment. This paper presents a case study which focuses on student mobility and how the physical experience of being in another country either to study, to work, to volunteer or to gain cultural and social enhancement has of necessity been replaced by alternative approaches. It considers trans-national education as an alternative to physical study overseas, virtual mobility and internships as an alternative to international work experience and adopting collaborative on-line projects as an alternative to in-person encounters. The paper concludes that although these elements have been adopted to address the current situation, the lessons learnt and the feedback gained suggests that they have contributed successfully in new and sometimes unexpected ways, and that they will persist beyond the present to become part of the "new normal" for the future. That being the case, senior leaders of institutions of higher education will be required to revisit their international plans and to rewrite their international strategies to take account of and build upon these changes.

Keywords: Trans-national education, internationalisation, higher education management, virtual mobility.

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Authors: Essam Abd-Elrazek

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With the rapid growth in business size, today-s businesses orient Throughout thirty years local, national and international experience in medicine as a medical student, junior doctor and eventually Consultant and Professor in Anaesthesia, Intensive Care and Pain Management, I note significant generalised dissatisfaction among medical students and doctors regarding their medical education and practice. We repeatedly hear complaints from patients about the dysfunctional health care system they are dealing with and subsequently the poor medical service that they are receiving. Medical students are bombarded with lectures, tutorials, clinical rounds and various exams. Clinicians are weighed down with a never-ending array of competing duties. Patients are extremely unhappy about the long waiting lists, loss of their records and the continuous deterioration of the health care service. This problem has been reported in different countries by several authors [1,2,3]. In a trial to solve this dilemma, a genuine idea has been suggested implementing computer technology in medicine [2,3]. Computers in medicine are a medium of international communication of the revolutionary advances being made in the application of the computer to the fields of bioscience and medicine [4,5]. The awareness about using computers in medicine has recently increased all over the world. In Misr University for Science & Technology (MUST), Egypt, medical students are now given hand-held computers (Laptop) with Internet facility making their medical education accessible, convenient and up to date. However, this trial still needs to be validated. Helping the readers to catch up with the on going fast development in this interesting field, the author has decided to continue reviewing the literature, exploring the state-of-art in computer based medicine and up dating the medical professionals especially the local trainee Doctors in Egypt. In part I of this review article we will give a general background discussing the potential use of computer technology in the various aspects of the medical field including education, research, clinical practice and the health care service given to patients. Hope this will help starting changing the culture, promoting the awareness about the importance of implementing information technology (IT) in medicine, which is a field in which such help is needed. An international collaboration is recommended supporting the emerging countries achieving this target.

Keywords: Medical Informatics, telemedicine, e-health systems.

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Authors: Mustafa M. Donma, Orkide Donma

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Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.

Keywords: Blood pressure, children, index, metabolic syndrome, obesity.

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Authors: Eun-Geun Kim, Won-Pil Park, Dae-Gon Woo, Chang-Yong Ko, Yong-Heum Lee, Dohyung Lim, Tae-Min Shin, Han-Sung Kim, Gyoun-Jung Lee

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Functional gastrointestinal disorders affect millions of people spread all age regardless of race and sex. There are, however, rare diagnostic methods for the functional gastrointestinal disorders because functional disorders show no evidence of organic and physical causes. Our research group identified recently that the gastrointestinal tract well in the patients with the functional gastrointestinal disorders becomes more rigid than healthy people when palpating the abdominal regions overlaying the gastrointestinal tract. Aim of this study is, therefore, to develop a diagnostic system for the functional gastrointestinal disorders based on ultrasound technique, which can quantify the characteristic above related to the rigidity of the gastrointestinal tract well. Ultrasound system was designed. The system consisted of transmitter, ultrasonic transducer, receiver, TGC, and CPLD, and verified via a phantom test. For the phantom test, ten soft-tissue specimens were harvested from porcine. Five of them were then treated chemically to mimic a rigid condition of gastrointestinal tract well, which was induced by functional gastrointestinal disorders. Additionally, the specimens were tested mechanically to identify if the mimic was reasonable. The customized ultrasound system was finally verified through application to human subjects with/without functional gastrointestinal disorders (Normal and Patient Groups). It was identified from the mechanical test that the chemically treated specimens were more rigid than normal specimen. This finding was favorably compared with the result obtained from the phantom test. The phantom test also showed that ultrasound system well described the specimen geometric characteristics and detected an alteration in the specimens. The maximum amplitude of the ultrasonic reflective signal in the rigid specimens (0.2±0.1Vp-p) at the interface between the fat and muscle layers was explicitly higher than that in the normal specimens (0.1±0.0Vp-p). Clinical tests using our customized ultrasound system for human subject showed that the maximum amplitudes of the ultrasonic reflective signals near to the gastrointestinal tract well for the patient group (2.6±0.3Vp-p) were generally higher than those in normal group (0.1±0.2Vp-p). Here, maximum reflective signals was appeared at 20mm depth approximately from abdominal skin for all human subjects, corresponding to the location of the boundary layer close to gastrointestinal tract well. These results suggest that newly designed diagnostic system based on ultrasound technique may diagnose enough the functional gastrointestinal disorders.

Keywords: Functional Gastrointestinal Disorders, DiagnosticSystem, Phantom Test, Ultrasound System.

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Authors: Hélène Brisebois, Claude Bélanger, Marie-Pier Léger-Bélanger, Valérie Lamontagne

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This study examines the mediating effects of male dyadic adjustment on the relationships between attachment and attributional styles, and both psychological and physical husband violence. Based on data from 68 married violent men recruited through community organizations that work with violent men, regression analyses showed that husbands- dyadic adjustment mediates the associations between avoidant attachment and attributional style, and psychological aggression, but not physical violence. Scientific and clinical implications are discussed

Keywords: Attachment, attributions, dyadic adjustment, marital violence.

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Authors: Mohd Kamir Yusof, Suhailan Dato' Safei

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Images are important in disease research, education, and clinical medicine. This paper presents a Web Service Platform (WSP) for support multiple programming languages to access image from biomedical databases. The main function WSP is to allow web users access image from biomedical databases. The WSP will receive web user-s queries. After that, it will send to Querying Server (QS) and the QS will search and retrieve data from biomedical databases. Finally, the information will display to the web users. Simple application is developed and tested for experiment purpose. Result from experiment indicated WSP can be used in biomedical environment.

Keywords: Biomedical, Image, Web Service Platform

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Authors: Mayssa Bensalah, Atef Boujelben, Mouna Baklouti, Mohamed Abid

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Image segmentation has a fundamental role in analysis and interpretation for many applications. The automated segmentation of organs and tissues throughout the body using computed imaging has been rapidly increasing. Indeed, it represents one of the most important parts of clinical diagnostic tools. In this paper, we discuss a thorough literature review of recent methods of tumour segmentation from medical images which are briefly explained with the recent contribution of various researchers. This study was followed by comparing these methods in order to define new directions to develop and improve the performance of the segmentation of the tumour area from medical images.

Keywords: Features extraction, image segmentation, medical images, tumour detection.

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Authors: Faris Tarlochan, Siva Mahesh Tangutooru

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Lateral Geniculate Nucleus (LGN) is the relay center in the visual pathway as it receives most of the input information from retinal ganglion cells (RGC) and sends to visual cortex. Low threshold calcium currents (IT) at the membrane are the unique indicator to characterize this firing functionality of the LGN neurons gained by the RGC input. According to the LGN functional requirements such as functional mapping of RGC to LGN, the morphologies of the LGN neurons were developed. During the neurological disorders like glaucoma, the mapping between RGC and LGN is disconnected and hence stimulating LGN electrically using deep brain electrodes can restore the functionalities of LGN. A computational model was developed for simulating the LGN neurons with three predominant morphologies each representing different functional mapping of RGC to LGN. The firings of action potentials at LGN neuron due to IT were characterized by varying the stimulation parameters, morphological parameters and orientation. A wide range of stimulation parameters (stimulus amplitude, duration and frequency) represents the various strengths of the electrical stimulation with different morphological parameters (soma size, dendrites size and structure). The orientation (0-1800) of LGN neuron with respect to the stimulating electrode represents the angle at which the extracellular deep brain stimulation towards LGN neuron is performed. A reduced dendrite structure was used in the model using Bush–Sejnowski algorithm to decrease the computational time while conserving its input resistance and total surface area. The major finding is that an input potential of 0.4 V is required to produce the action potential in the LGN neuron which is placed at 100 μm distance from the electrode. From this study, it can be concluded that the neuroprostheses under design would need to consider the capability of inducing at least 0.4V to produce action potentials in LGN.

Keywords: Lateral geniculate nucleus, visual cortex, finite element, glaucoma, neuroprostheses.

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Authors: Petr Šifta, Václav Bittner, Martin Kysela, Matěj Kolář

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The purpose of the research described in this work is to answer how to measure the rheologic (viscoelastic) properties tendo–deformational characteristics of soft tissue. The method would also resemble muscle palpation examination as it is known in clinical practice. For this purpose, an instrument with the working name “myotonometer” has been used. At present, there is lack of objective methods for assessing the muscle tone by viscous and elastic properties of soft tissue. That is why we decided to focus on creating or finding quantitative and qualitative methodology capable to specify muscle tone.

Keywords: Rheologicproperties, tendo–deformational characteristics, viscosity, elasticity, hypertonus, spasticity.

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Authors: Hai-Ying Liu, Yi-Hao Chen, Shu-Yin Pang, Feng-Hua Wang, Xiao-Fang Peng, Li-Yuan Yang, Zheng-Rong Chen, Yi Chen, Bing Zhu

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Objective: Biliary atresia (BA) is characterized by progressive liver fibrosis. Epithelial-mesenchymal transition (EMT) has been implicated as a key mechanism in the pathogenesis of organ fibrosis. MiR-200a has been shown to repress EMT. We aim to explore the role of miR-200a in the fibrogenesis of BA. Methods: We obtained the plasma samples and liver samples from patients with BA or controls to examine the role of miR-200a. Histological liver fibrosis was assessed using the Ishak fibrosis scores. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was performed to detect the expression of miR-200a in plasma. We also evaluated the expression of miR-200a in liver tissues using tyramide signal amplification fluorescence in situ hybridization (TSA-FISH). The expression of EMT related proteins zinc finger E-box-binding homeobox 1 (ZEB1), E-cadherin and α-smooth muscle actin (α-SMA) in the liver sections were detected by immunohistochemical staining. Results: We found that the expression of miR-200a was both elevated in the plasma and liver tissues from BA patients compared with the controls. The hepatic expression of ZEB1 and α-SMA were markedly increased in the liver sections from BA patients compared to the controls, whereas E-cadherin was downregulated in the BA group. Simultaneously, we noted that the hepatic expression of miR-200a, E-cadherin and α-SMA were upregulated with the progression of liver fibrosis in the BA group, while ZEB1 was downregulated with the progression of liver fibrosis in BA patients. Conclusion: These findings suggest EMT has a critical effect on the fibrotic process of BA, and the interaction between miR-200a and ZEB1 may regulate EMT and eventually influence liver fibrogenesis of BA.

Keywords: Biliary atresia, liver fibrosis, MicroRNA, epithelial-mesenchymal transition, zinc finger e-box-binding homeobox 1.

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Authors: Nahla Al-Bayyari, Rae’d Hailat

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Vitamin D deficiency and overweight are common in women suffering from polycystic ovary syndrome (PCOS). Weight gain in PCOS is an important factor for the development of menstrual dysfunction and signs of hyperandrogenism and alopecia. Features of PCOS such as oligomenorrhea can be predicted by anthropometric measurements as body mass index (BMI). Therefore, the aim of this trial was to study the effect of 50,000 IU/week of vitamin D₃ supplementation on the body composition and on the anthropometric measurements of overweight women with PCOS and to examine the impact of this effect on ovaries ultrasonography and menstrual cycle regularity. The study design was a prospective randomized, double-blinded placebo-controlled clinical trial conducted on 60 overweight Jordanian women aged (18-49) years with PCOS and vitamin D deficiency. The study participants were divided into two groups; vitamin D group (n = 30) who were assigned to receive 50,000 IU/week of vitamin D₃ and placebo group (n = 30) who were assigned to receive placebo tablets orally for 90 days. The anthropometric measurements and body composition were measured at baseline and after treatment for the PCOS and vitamin D deficient women. Also, assessment of the participants’ picture of ovaries by ultrasound and menstrual cycle regulatory were performed before and after treatment. Results showed that there were no significant (p > 0.05) differences between the placebo and vitamin D group basal 25(OH)D levels, body composition and anthropometric parameters. After treatment, vitamin D group serum levels of 25(OH)D increased (12.5 ± 0.61 to 50.2 ± 2.04 ng/mL, (p < 0.001), and decreased (50.2 ± 2.04 to 48.2 ± 2.03 ng/mL, p < 0.001) after 14 days of vitamin D₃ treatment cessation. There were no significant changes in the placebo group. In the vitamin D group, there were significant (p < 0.001) decreases in body weight, BMI, waist, and hip circumferences and fat mass. In addition, there were significant increases (p < 0.05) in fat free mass and total body water. These improvements in both anthropometric and body composition as well as in 25(OH)D concentrations, resulted in significant improvements in the picture of PCOS women ovaries ultrasonography and in menstrual cycle regularity, where nearly most of them (93%) had regular cycles after vitamin D₃ supplementation. In the placebo group, there were only significant decreases (p < 0.05) in waist and hip circumferences. It can be concluded that vitamin D supplementation improving serum 25(OH)D levels and PCOS prognosis by reducing body weight of overweight PCOS women and regulating their menstrual cycle.

Keywords: Anthropometric, overweight, polycystic ovary syndrome, vitamin D3.

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Authors: Yue-Der Lin, Wei-Ting Liu, Ching-Che Tsai, Wen-Hsiu Chen

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PPG is a potential tool in clinical applications. Among such, the relationship between respiration and PPG signal has attracted attention in past decades. In this research, a bivariate AR spectral estimation method was utilized for the coherence analysis between these two signals. Ten healthy subjects participated in this research with signals measured at different respiratory rates. The results demonstrate that high coherence exists between respiration and PPG signal, whereas the coherence disappears in breath-holding experiments. These results imply that PPG signal reveals the respiratory information. The utilized method may provide an attractive alternative approach for the related researches.

Keywords: Coherence analysis, photoplethysmography (PPG), bivariate AR spectral estimation.

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Authors: K. Aloui, M. S. Naceur

Abstract:

The main objective of this paper is to provide an efficient tool for delineating brain tumors in three-dimensional magnetic resonance images and set up compression-transmit schemes to distribute result to the remote doctor. To achieve this goal, we use basically a level-sets approach to delineating brain tumors in threedimensional. Then introduce a new compression and transmission plan of 3D brain structures based for the meshes simplification, adapted for time to the specific needs of the telemedicine and to the capacities restricted by wireless network communication. We present here the main stages of our system, and preliminary results which are very encouraging for clinical practice.

Keywords: Medical imaging, level-sets, compression, meshessimplification, telemedicine, wireless transmission.

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Authors: Yazhi Huang, Jing Yang, Dingge Ying, Yan Zhang, Vorasuk Shotelersuk, Nattiya Hirankarn, Pak Chung Sham, Yu Lung Lau, Wanling Yang

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Human leukocyte antigen (HLA) typing from next generation sequencing (NGS) data has the potential for applications in clinical laboratories and population genetic studies. Here we introduce a novel technique for HLA typing from NGS data based on read-mapping using a comprehensive reference panel containing all known HLA alleles and de novo assembly of the gene-specific short reads. An accurate HLA typing at high-digit resolution was achieved when it was tested on publicly available NGS data, outperforming other newly-developed tools such as HLAminer and PHLAT.

Keywords: Human leukocyte antigens, next generation sequencing, whole exome sequencing, HLA typing.

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Authors: U. Rubins, Z. Marcinkevics, K.Volceka

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The cardiovascular system has become the most important subject of clinical research, particularly measurement of arterial blood flow. Therefore correct determination of arterial diameter is crucial. We propose a novel, semi-automatic method for artery lumen detection. The method is based on Gaussian probability function. Usability of our proposed method was assessed by analyzing ultrasound B-mode CFA video sequences acquired from eleven healthy volunteers. The correlation coefficient between the manual and semi-automatic measurement of arterial diameter was 0.996. Our proposed method for detecting artery boundary is novel and accurate enough for the measurement of artery diameter.

Keywords: Ultrasound, boundary detection, artery diameter, curve fitting.

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Authors: Bimali Sanjeevani Weerakoon, Toshiaki Osuga, Takehisa Konishi

Abstract:

Magnetic Resonance Imaging Contrast Agents (MRI-CM) are significant in the clinical and biological imaging as they have the ability to alter the normal tissue contrast, thereby affecting the signal intensity to enhance the visibility and detectability of images. Superparamagnetic Iron Oxide (SPIO) nanoparticles, coated with dextran or carboxydextran are currently available for clinical MR imaging of the liver. Most SPIO contrast agents are T2 shortening agents and Resovist (Ferucarbotran) is one of a clinically tested, organ-specific, SPIO agent which has a low molecular carboxydextran coating. The enhancement effect of Resovist depends on its relaxivity which in turn depends on factors like magnetic field strength, concentrations, nanoparticle properties, pH and temperature. Therefore, this study was conducted to investigate the impact of field strength and different contrast concentrations on enhancement effects of Resovist. The study explored the MRI signal intensity of Resovist in the physiological range of plasma from T2-weighted spin echo sequence at three magnetic field strengths: 0.47 T (r1=15, r2=101), 1.5 T (r1=7.4, r2=95), and 3 T (r1=3.3, r2=160) and the range of contrast concentrations by a mathematical simulation. Relaxivities of r1 and r2 (L mmol-1 Sec-1) were obtained from a previous study and the selected concentrations were 0.05, 0.06, 0.07, 0.08, 0.09, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 2.0, and 3.0 mmol/L. T2-weighted images were simulated using TR/TE ratio as 2000 ms /100 ms. According to the reference literature, with increasing magnetic field strengths, the r1 relaxivity tends to decrease while the r2 did not show any systematic relationship with the selected field strengths. In parallel, this study results revealed that the signal intensity of Resovist at lower concentrations tends to increase than the higher concentrations. The highest reported signal intensity was observed in the low field strength of 0.47 T. The maximum signal intensities for 0.47 T, 1.5 T and 3 T were found at the concentration levels of 0.05, 0.06 and 0.05 mmol/L, respectively. Furthermore, it was revealed that, the concentrations higher than the above, the signal intensity was decreased exponentially. An inverse relationship can be found between the field strength and T2 relaxation time, whereas, the field strength was increased, T2 relaxation time was decreased accordingly. However, resulted T2 relaxation time was not significantly different between 0.47 T and 1.5 T in this study. Moreover, a linear correlation of transverse relaxation rates (1/T2, s–1) with the concentrations of Resovist can be observed. According to these results, it can conclude that the concentration of SPIO nanoparticle contrast agents and the field strengths of MRI are two important parameters which can affect the signal intensity of T2-weighted SE sequence. Therefore, when MR imaging those two parameters should be considered prudently.

Keywords: Concentration, Resovist, Field strength, Relaxivity, Signal intensity.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Metabolic syndrome (MetS) is a severe health problem caused by morbid obesity, the severest form of obesity. The components of MetS are rather stable in adults. However, the diagnosis of MetS in morbid obese (MO) children still constitutes a matter of discussion. The aim of this study was to develop a formula, which facilitated the diagnosis of MetS in MO children and was capable of discriminating MO children with and without MetS findings. The study population comprised MO children. Age and sex-dependent body mass index (BMI) percentiles of the children were above 99. Increased blood pressure, elevated fasting blood glucose (FBG), elevated triglycerides (TRG) and/or decreased high density lipoprotein cholesterol (HDL-C) in addition to central obesity were listed as MetS components for each child. Two groups were constituted. In the first group, there were 42 MO children without MetS components. Second group was composed of 44 MO children with at least two MetS components. Anthropometric measurements including weight, height, waist and hip circumferences were performed during physical examination. BMI and homeostatic model assessment of insulin resistance (HOMA-IR) values were calculated. Informed consent forms were obtained from the parents of the children. Institutional Non-Interventional Clinical Studies Ethics Committee approved the study design. Routine biochemical analyses including FBG, insulin (INS), TRG, HDL-C were performed. The performance and the clinical utility of Diagnostic Obesity Notation Model Assessment Metabolic Syndrome Index (DONMA MetS index) [(INS/FBG)/(HDL-C/TRG)*100] was tested. Appropriate statistical tests were applied to the study data. p value smaller than 0.05 was defined as significant. MetS index values were 41.6 ± 5.1 in MO group and 104.4 ± 12.8 in MetS group. Corresponding values for HDL-C values were 54.5 ± 13.2 mg/dl and 44.2 ± 11.5 mg/dl. There was a statistically significant difference between the groups (p < 0.001). Upon evaluation of the correlations between MetS index and HDL-C values, a much stronger negative correlation was found in MetS group (r = -0.515; p = 0.001) in comparison with the correlation detected in MO group (r = -0.371; p = 0.016). From these findings, it was concluded that the statistical significance degree of the difference between MO and MetS groups was highly acceptable for this recently introduced MetS index. This was due to the involvement of all of the biochemically defined MetS components into the index. This is particularly important because each of these four parameters used in the formula is a cardiac risk factor. Aside from discriminating MO children with and without MetS findings, MetS index introduced in this study is important from the cardiovascular risk point of view in MetS group of children.

Keywords: Fasting blood glucose, high density lipoprotein cholesterol, insulin, metabolic syndrome, morbid obesity, triglycerides.

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Authors: Shishen Xie, Yingda L. Xie

Abstract:

Tuberculosis (TB) is a potentially serious infectious disease that remains a health concern. The Interferon Gamma Release Assay (IGRA) is a blood test to find out if an individual is tuberculous positive or negative. This study applies statistical analysis to the clinical data of interferon-gamma levels of seventy-three subjects who diagnosed pulmonary TB in an anti-tuberculous treatment. Data analysis is performed to determine if there is a significant decline in interferon-gamma levels for the subjects during a period of six months, and to infer if the anti-tuberculous treatment is effective.

Keywords: Data analysis, interferon gamma release assay, statistical methods, tuberculosis infection.

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Authors: Won-Pil Park, Qyoun-Jung Lee, Dae-Gon Woo, Chang-Yong Ko, Eun-Geun Kim, Dohyung Lim, Yong-Heum Lee, Tae-Min Shin, Han-Sung Kim

Abstract:

The disaster from functional gastrointestinal disorders has detrimental impact on the quality of life of the effected population and imposes a tremendous social and economic burden. There are, however, rare diagnostic methods for the functional gastrointestinal disorders. Our research group identified recently that the gastrointestinal tract well in the patients with the functional gastrointestinal disorders becomes more rigid than healthy people when palpating the abdominal regions overlaying the gastrointestinal tract. Objective of current study is, therefore, identify feasibility of a diagnostic system for the functional gastrointestinal disorders based on ultrasound technique, which can quantify the characteristics above. Two-dimensional finite difference (FD) models (one normal and two rigid model) were developed to analyze the reflective characteristic (displacement) on each soft-tissue layer responded after application of ultrasound signals. The FD analysis was then based on elastic ultrasound theory. Validation of the model was performed via comparison of the characteristic of the ultrasonic responses predicted by FD analysis with that determined from the actual specimens for the normal and rigid conditions. Based on the results from FD analysis, ultrasound system for diagnosis of the functional gastrointestinal disorders was developed and clinically tested via application of it to 40 human subjects with/without functional gastrointestinal disorders who were assigned to Normal and Patient Groups. The FD models were favorably validated. The results from FD analysis showed that the maximum displacement amplitude in the rigid models (0.12 and 0.16) at the interface between the fat and muscle layers was explicitly less than that in the normal model (0.29). The results from actual specimens showed that the maximum amplitude of the ultrasonic reflective signal in the rigid models (0.2±0.1Vp-p) at the interface between the fat and muscle layers was explicitly higher than that in the normal model (0.1±0.2 Vp-p). Clinical tests using our customized ultrasound system showed that the maximum amplitudes of the ultrasonic reflective signals near to the gastrointestinal tract well for the patient group (2.6±0.3 Vp-p) were generally higher than those in normal group (0.1±0.2 Vp-p). Here, maximum reflective signals was appeared at 20mm depth approximately from abdominal skin for all human subjects, corresponding to the location of the boundary layer close to gastrointestinal tract well. These findings suggest that our customized ultrasound system using the ultrasonic reflective signal may be helpful to the diagnosis of the functional gastrointestinal disorders.

Keywords: Finite Difference (FD) Analysis, FunctionalGastrointestinal Disorders, Gastrointestinal Tract, UltrasonicResponses.

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Authors: Muhammad Tariq, Jafar Khan Kasi, Samiullah, Ajab Khan Kasi

Abstract:

Biosensors are playing vital role in industrial, clinical, and chemical analysis applications. Among other techniques, ZnO based biosensor is an easy approach due to its exceptional chemical and electrical properties. ZnO nanorods have positively charged isoelectric point which helps immobilize the negative charge glucose oxides (GOx). Here, we report ZnO nanorods based biosensors for the immobilization of GOx. The ZnO nanorods were grown by hydrothermal method on indium tin oxide substrate (ITO). The fabrication of biosensors was carried through batch processing using conventional photolithography. The buffer solutions of GOx were prepared in phosphate with a pH value of around 7.3. The biosensors effectively immobilized the GOx and result was analyzed by calculation of voltage and current on nanostructures.

Keywords: Hydrothermal growth, zinc dioxide, biosensors.

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Authors: Young-Seok Choi

Abstract:

The neural stimulation has been gaining much interest in neuromodulation research and clinical trials. For efficiency, there is a need for variable electrical stimulation such as current and voltage stimuli as well as wireless framework. In this regard, we develop the wireless neural stimulator capable of voltage and current stimuli. The system consists of ZigBee which is a wireless communication module and stimulus generator. The stimulus generator with 8-bits resolution enable both mono-polar and bi-polar waveform in voltage (-3.3~3.3V) and current(-330~330µA) stimulus mode which is controllable. The experimental results suggest that the proposed neural stimulator can play a role as an effective approach for neuromodulation.

Keywords: Neural stimulator, current stimulation, voltage stimulation, neuromodulation

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