Search results for: Clinical Pathway

Authors: Chin-Ming Hong, Chin-Teng Lin, Chao-Yen Huang, Yi-Ming Lin

Abstract:

In this article, we propose an Intelligent Medical Diagnostic System (IMDS) accessible through common web-based interface, to on-line perform initial screening for osteoporosis. The fundamental approaches which construct the proposed system are mainly based on the fuzzy-neural theory, which can exhibit superiority over other conventional technologies in many fields. In diagnosis process, users simply answer a series of directed questions to the system, and then they will immediately receive a list of results which represents the risk degrees of osteoporosis. According to clinical testing results, it is shown that the proposed system can provide the general public or even health care providers with a convenient, reliable, inexpensive approach to osteoporosis risk assessment.

Keywords: BMD, osteoporosis, IMDS, fuzzy-neural theory, web interface.

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Authors: Mounira Rouaïnia, Mohamed Salah Medjram, Noureddine Doghmane

Abstract:

In Multiple Sclerosis, pathological changes in the brain results in deviations in signal intensity on Magnetic Resonance Images (MRI). Quantitative analysis of these changes and their correlation with clinical finding provides important information for diagnosis. This constitutes the objective of our work. A new approach is developed. After the enhancement of images contrast and the brain extraction by mathematical morphology algorithm, we proceed to the brain segmentation. Our approach is based on building statistical model from data itself, for normal brain MRI and including clustering tissue type. Then we detect signal abnormalities (MS lesions) as a rejection class containing voxels that are not explained by the built model. We validate the method on MR images of Multiple Sclerosis patients by comparing its results with those of human expert segmentation.

Keywords: EM algorithm, Magnetic Resonance Imaging, Mathematical morphology, Markov random model.

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Authors: Rizna Triana Dewi, Sanro Tachibana, Ahmad Darmawan

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The bioassay-guided isolation and purification of an ethyl acetate extract of Aspergillus terreus MC751 led to the characterization of butyrolactone I as an antidiabetic and antioxidant. The antidiabetic activity of butyrolactone I was evaluated by α- glucosidase and α-amylase inhibition assays. Butyrolactone I demonstrated significant concentration-dependent, mixed-type inhibitory activity against yeast α-glucosidase with an IC50 of 54μM. However, the compound exhibited less activity against rat intestinal α-glucosidase and α-amylase. This is the first report on α-glucosidase inhibitory activity of butyrolactone I. The antioxidative activity of butyrolactone I was evaluated based on scavenging effects on 1,1- diphenyl-2-picrylhydrazyl (DPPH) (IC50 =51 μM) and hydrogen peroxide (IC50= 141 μM) radicals as well as a reducing power assay. The results suggest that butyrolactone I is a promising antidiabetic as well as antioxidant and should be considered for clinical trials.

Keywords: Aspergillus terreus MC751, antidiabetic, antioxidant, Butyrolactone I.

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Authors: Ireneusz Majsterek, Anna Merecz, Agnieszka Sliwinska, Marcin Kosmalski, Jacek Kasznicki, Jozef Drzewoski

Abstract:

Oxidative stress is considered to be the cause for onset and the progression of type 2 diabetes mellitus (T2DM) and complications including neuropathy. It is a deleterious process that can be an important mediator of damage to cell structures: protein, lipids and DNA. Data suggest that in patients with diabetes and diabetic neuropathy DNA repair is impaired, which prevents effective removal of lesions. Objective: The aim of our study was to evaluate the association of the hOGG1 (326 Ser/Cys) and XRCC1 (194 Arg/Trp, 399 Arg/Gln) gene polymorphisms whose protein is involved in the BER pathway with DNA repair efficiency in patients with diabetes type 2 and diabetic neuropathy compared to the healthy subjects. Genotypes were determined by PCR-RFLP analysis in 385 subjects, including 117 with type 2 diabetes, 56 with diabetic neuropathy and 212 with normal glucose metabolism. The polymorphisms studied include codon 326 of hOGG1 and 194, 399 of XRCC1 in the base excision repair (BER) genes. Comet assay was carried out using peripheral blood lymphocytes from the patients and controls. This test enabled the evaluation of DNA damage in cells exposed to hydrogen peroxide alone and in the combination with the endonuclease III (Nth). The results of the analysis of polymorphism were statistically examination by calculating the odds ratio (OR) and their 95% confidence intervals (95% CI) using the ¤ç2-tests. Our data indicate that patients with diabetes mellitus type 2 (including those with neuropathy) had higher frequencies of the XRCC1 399Arg/Gln polymorphism in homozygote (GG) (OR: 1.85 [95% CI: 1.07-3.22], P=0.3) and also increased frequency of 399Gln (G) allele (OR: 1.38 [95% CI: 1.03-1.83], P=0.3). No relation to other polymorphisms with increased risk of diabetes or diabetic neuropathy. In T2DM patients complicated by neuropathy, there was less efficient repair of oxidative DNA damage induced by hydrogen peroxide in both the presence and absence of the Nth enzyme. The results of our study suggest that the XRCC1 399 Arg/Gln polymorphism is a significant risk factor of T2DM in Polish population. Obtained data suggest a decreased efficiency of DNA repair in cells from patients with diabetes and neuropathy may be associated with oxidative stress. Additionally, patients with neuropathy are characterized by even greater sensitivity to oxidative damage than patients with diabetes, which suggests participation of free radicals in the pathogenesis of neuropathy.

Keywords: Diabetic neuropathy, oxidative stress, gene polymorphisms, oxidative DNA damage.

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Authors: L. Ramirez, E. Guillén, J. Sánchez

Abstract:

Some of the main goals about telecare such as monitoring, treatment, telediagnostic are deployed with the integration of applications with specific appliances. In order to achieve a coherent model to integrate software, hardware, and healthcare systems, different telehealth models with Internet of Things (IoT), cloud computing, artificial intelligence, etc. have been implemented, and their advantages are still under analysis. In this paper, we propose an integrated model based on IoT architecture and cloud computing telehealth center. Analytics module is presented as a solution to control an ideal diagnostic about some diseases. Specific features are then compared with the recently deployed conventional models in telemedicine. The main advantage of this model is the availability of controlling the security and privacy about patient information and the optimization on processing and acquiring clinical parameters according to technical characteristics.

Keywords: Analytics, telemedicine, internet of things, cloud computing.

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Authors: Sana Ktata, Kaïs Ouni, Noureddine Ellouze

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Electrocardiogram (ECG) data compression algorithm is needed that will reduce the amount of data to be transmitted, stored and analyzed, but without losing the clinical information content. A wavelet ECG data codec based on the Set Partitioning In Hierarchical Trees (SPIHT) compression algorithm is proposed in this paper. The SPIHT algorithm has achieved notable success in still image coding. We modified the algorithm for the one-dimensional (1-D) case and applied it to compression of ECG data. By this compression method, small percent root mean square difference (PRD) and high compression ratio with low implementation complexity are achieved. Experiments on selected records from the MIT-BIH arrhythmia database revealed that the proposed codec is significantly more efficient in compression and in computation than previously proposed ECG compression schemes. Compression ratios of up to 48:1 for ECG signals lead to acceptable results for visual inspection.

Keywords: Discrete Wavelet Transform, ECG compression, SPIHT.

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Authors: Hirofumi Taki, Takuya Sakamoto, Makoto Yamakawa, Tsuyoshi Shiina, Toru Sato

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For the improvement of the ability in detecting small calcifications using Ultrasonography (US) we propose a novel indicator of calcifications in an ultrasound B-mode image without decrease in frame rate. Since the waveform of an ultrasound pulse changes at a calcification position, the decorrelation of adjacent scan lines occurs behind a calcification. Therefore, we employ the decorrelation of adjacent scan lines as an indicator of a calcification. The proposed indicator depicted wires 0.05 mm in diameter at 2 cm depth with a sensitivity of 86.7% and a specificity of 100%, which were hardly detected in ultrasound B-mode images. This study shows the potential of the proposed indicator to approximate the detectable calcification size using an US device to that of an X-ray imager, implying the possibility that an US device will become a convenient, safe, and principal clinical tool for the screening of breast cancer.

Keywords: Ultrasonography, Calcification, Decorrelation, Forward scattered wave

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Authors: Bilge S. Oduncu, Sevil Yucel, Ismail Aydin, Isil D. Sener, Gokhan Yamaner

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The dental composites are preferably used as filling materials due to their esthetic appearances. Nevertheless one of the major problems, during the application of the dental composites, is shape change named as “polymerisation shrinkage" affecting clinical success of the dental restoration while photo-polymerisation. Polymerisation shrinkage of composites arises basically from the formation of a polymer due to the monomer transformation which composes of an organic matrix phase. It was sought, throughout this study, to detect and evaluate the structural polymerisation shrinkage of prepared dental composites in order to optimize the effects of various fillers included in hydroxyapatite (HA)-reinforced dental composites and hence to find a means to modify the properties of these dental composites prepared with defined parameters. As a result, the shrinkage values of the experimental dental composites were decreased by increasing the filler content of composites and the composition of different fillers used had effect on the shrinkage of the prepared composite systems.

Keywords: Dental composites, hydroxyapatite (HA), BisGMA, shrinkage.

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Authors: Thaweesak Yingthawornsuk, Chusak Thanawattano

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Acoustical properties of speech have been shown to be related to mental states of speaker with symptoms: depression and remission. This paper describes way to address the issue of distinguishing depressed patients from remitted subjects based on measureable acoustics change of their spoken sound. The vocal-tract related frequency characteristics of speech samples from female remitted and depressed patients were analyzed via speech processing techniques and consequently, evaluated statistically by cross-validation with Support Vector Machine. Our results comparatively show the classifier's performance with effectively correct separation of 93% determined from testing with the subjectbased feature model and 88% from the frame-based model based on the same speech samples collected from hospital visiting interview sessions between patients and psychiatrists.

Keywords: Depression, SVM, Vocal Extract, Vocal Tract

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Authors: Jagmohan Mago, Parvinder S. Sandhu, Neeru Chawla

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In this paper, a Bayesian Network (BN) based system is presented for providing clinical decision support to healthcare practitioners in rural or remote areas of India for young infants or children up to the age of 5 years. The government is unable to appoint child specialists in rural areas because of inadequate number of available pediatricians. It leads to a high Infant Mortality Rate (IMR). In such a scenario, Intelligent Pediatric System provides a realistic solution. The prototype of an intelligent system has been developed that involves a knowledge component called an Intelligent Pediatric Assistant (IPA); and User Agents (UA) along with their Graphical User Interfaces (GUI). The GUI of UA provides the interface to the healthcare practitioner for submitting sign-symptoms and displaying the expert opinion as suggested by IPA. Depending upon the observations, the IPA decides the diagnosis and the treatment plan. The UA and IPA form client-server architecture for knowledge sharing.

Keywords: Network, Based Intelligent, Pediatric System

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Authors: Yan Xu, Toshihiro Nishimura

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Segmentation in ultrasound images is challenging due to the interference from speckle noise and fuzziness of boundaries. In this paper, a segmentation scheme using fuzzy c-means (FCM) clustering incorporating both intensity and texture information of images is proposed to extract breast lesions in ultrasound images. Firstly, the nonlinear structure tensor, which can facilitate to refine the edges detected by intensity, is used to extract speckle texture. And then, a spatial FCM clustering is applied on the image feature space for segmentation. In the experiments with simulated and clinical ultrasound images, the spatial FCM clustering with both intensity and texture information gets more accurate results than the conventional FCM or spatial FCM without texture information.

Keywords: fuzzy c-means, spatial information, structure tensor, ultrasound image segmentation

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Authors: Afaf Alharbi, Qianni Zhang

Abstract:

The identification of malignant tissue in histopathological slides holds significant importance in both clinical settings and pathology research. This paper presents a methodology aimed at automatically categorizing cancerous tissue through the utilization of a multiple instance learning framework. This framework is specifically developed to acquire knowledge of the Bernoulli distribution of the bag label probability by employing neural networks. Furthermore, we put forward a neural network-based permutation-invariant aggregation operator, equivalent to attention mechanisms, which is applied to the multi-instance learning network. Through empirical evaluation on an openly available colon cancer histopathology dataset, we provide evidence that our approach surpasses various conventional deep learning methods.

Keywords: Attention Multiple Instance Learning, Multiple Instance Learning, transfer learning, histopathological slides, cancer tissue classification.

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Authors: Vahid Fayaz , Asieh Tavakol

Abstract:

To investigate the applicability of the EDR-2 film for clinical radiation dosimetry, percentage depth-doses, profiles and distributions in open and dynamically wedged fields were measured using film and compared with data from a Treatment Planning system.The validity of the EDR2 film to measure dose in a plane parallel to the beam was tested by irradiating 10 cm×10 cm and 4 cm×4 cm fields from a Siemens, primus linac with a 6MV beam and a source-to-surface distance of 100 cm. The film was placed Horizontally between solid water phantom blocks and marked with pin holes at a depth of 10 cm from the incident beam surface. The film measurement results, in absolute dose, were compared with ion chamber measurements using a Welhoffer scanning water tank system and Treatment Planning system. Our results indicate a maximum underestimate of calculated dose of 8 % with Treatment Planning system.

Keywords: 6MV Photon , EDR-2 film, Radiotherapy, TreatmentPlanning system

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Authors: Guohua Cao, Xu Dong

Abstract:

X-ray Fluorescence Molecular Imaging (XFMI) holds great promise as a low-cost molecular imaging modality for biomedical applications with high chemical sensitivity. However, for in vivo biomedical applications, a key technical bottleneck is the relatively low chemical sensitivity of XFMI, especially at a reasonably low radiation dose. In laboratory x-ray source based XFMI, one of the main factors that limits the chemical sensitivity of XFMI is the scattered x-rays. We will present our latest findings on improving the chemical sensitivity of XFMI using excitation beam spectrum optimization. XFMI imaging experiments on two mouse-sized phantoms were conducted at three different excitation beam spectra. Our results show that the minimum detectable concentration (MDC) of iodine can be readily increased by five times via excitation spectrum optimization. Findings from this investigation could find use for in vivo pre-clinical small-animal XFMI in the future.

Keywords: Molecular imaging, X-ray fluorescence, chemical sensitivity, X-ray scattering.

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Authors: Ibrahim I. Elshahawy

Abstract:

The objective of the present study was to investigate the effect of green tea extract on serum oxidant and antioxidant profile, liver and kidney function. 40 Friesian calves are included in this study and allocated into two groups: Group I (n=20) clinically healthy calves showing no clinical abnormalities, not receiving any treatment and served as control; group II (n=20) received green tea extract (GTE) for 30 days. Non-significant changes in blood urea nitrogen (BUN) were detected between groups, on contrary, serum creatinine and activities of liver enzymes aspartate transaminase (AST) and alanine transaminase (ALT) were significantly different between two groups. There were significant increases in the mean values of serum antioxidative parameters (total antioxidant capacity, catalase, superoxide dismutase, reduced glutathione and glutathione peroxidase) in group II. Whereas, the activity of lipid peroxidase significantly decreased in GTE treated calves when compared to control.

Keywords: Green tea extract, antioxidants, oxidants, calves.

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Authors: I. Slim, H. Akkari, A. Ben Abdallah, I. Bhouri, M. Hedi Bedoui

Abstract:

Osteoporosis is a common disease characterized by low bone mass and deterioration of micro-architectural bone tissue, which provokes an increased risk of fracture. This work treats the texture characterization of trabecular bone radiographs. The aim was to analyze according to clinical research a group of 174 subjects: 87 osteoporotic patients (OP) with various bone fracture types and 87 control cases (CC). To characterize osteoporosis, Fractal and MultiFractal (MF) methods were applied to images for features (attributes) extraction. In order to improve the results, a new method of MF spectrum based on the q-stucture function calculation was proposed and a combination of Fractal and MF attributes was used. The Support Vector Machines (SVM) was applied as a classifier to distinguish between OP patients and CC subjects. The features fusion (fractal and MF) allowed a good discrimination between the two groups with an accuracy rate of 96.22%.

Keywords: Fractal, micro-architecture analysis, multifractal, SVM, osteoporosis.

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Authors: Pradip Deb

Abstract:

Quantitative radiobiological models can be used to assess the optimum clinical outcome from sophisticated therapeutic modalities by calculating tumor control probability (TCP) and normal tissue complication probability (NTCP). In this study two 3D-CRT and an IMRT treatment plans were developed with an initial prescription dose of 60 Gy in 2 Gy/fraction to prostate. Sensitivity of TCP and Complication free tumor control probability (P+) to the different values of α/β ratio was investigated for various prescription doses planned to be delivered in either a fixed number of fractions (I) or in a fixed dose per fraction (II) in each of the three different treatment plans. High dose/fraction and high α/β value result in comparatively smaller P+ and IMRT plans resulted in the highest P+, mainly due to the decrease in NTCP. If α/β is lower than expected, better tumor control can be achieved by increasing dose/fraction but decreasing the number of fractions.

Keywords: Linear Quadratic Model, TCP, NTCP, α/β ratio.

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Authors: Hae-Yeoun Lee

Abstract:

Quantification of cardiac function is performed by calculating blood volume and ejection fraction in routine clinical practice. However, these works have been performed by manual contouring, which requires computational costs and varies on the observer. In this paper, an automatic left ventricle segmentation algorithm on cardiac magnetic resonance images (MRI) is presented. Using knowledge on cardiac MRI, a K-mean clustering technique is applied to segment blood region on a coil-sensitivity corrected image. Then, a graph searching technique is used to correct segmentation errors from coil distortion and noises. Finally, blood volume and ejection fraction are calculated. Using cardiac MRI from 15 subjects, the presented algorithm is tested and compared with manual contouring by experts to show outstanding performance.

Keywords: Cardiac MRI, Graph searching, Left ventricle segmentation, K-means clustering.

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Authors: Werner Reichenfelser, Harald Hackl, Josef Hufgard, Karin Gstaltner, Margit Gfoehler

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Training with Functional Electrical Stimulation (FES) has both physiological and psychological benefits for spinal cord injured subjects. Commonly used methods for quantification of spasticity have shown controversial reliability. In this study we propose a method for quick determination of spasticity in spinal cord injured subjects on a cycling and measurement system. 23 patients did training sessions on an instrumented mobile FES cycle three times a week over two months as part of their clinical rehabilitation program. Spasticity (MAS) and the legs resistance to the pedaling motion were assessed before and after the FES training and measurements were done on the subjects ability to pedal with our without motor assistance. Measurements with test persons with incomplete spastic paraplegia have shown that spasticity is decreased after a 30 min cycling training with functional electrical stimulation (FES).

Keywords: Spasticity, paraplegia, spinal cord injury, functional electrical stimulation.

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Authors: Amany S. Youssef, Suzan A.M. El Feky, Samy A. El-Asser, Rasha A.M. Abd Allah

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Surgical site infections (SSIs) are the most common nosocomial infection in surgical patients resulting in significant increases in postoperative morbidity and mortality. The commonly causative bacteria developed resistance to virtually all antibiotics available. The aim of this study was to isolation and identification the most common bacteria that cause SSIs in Medical Research Institute, and to compare their sensitivity to selected group of antibiotics and natural products (garlic, oregano, olive, and Nigella sativa oils). The isolated pathogens collected from infected surgical wounds were identified, and their sensitivities to the antibiotics commonly available for clinical use, and also to the different concentrations of the used natural products were investigated. The results indicate to the potential therapeutic effect of the tested natural products in treatment of surgical wound infections.

Keywords: Surgical wounds, multi-resistant bacteria, bacterial sensitivity, natural oils.

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Authors: Dalanya Asaad Mohammed, Dara Abdul Razaq

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A total of twenty tensile biopsies were collected from children undergoing tonsillectomy from teaching hospital ENT department and Kurdistan private hospital in sulaimani city. All biopsies were homogenized and cultured; the obtained bacterial isolates were purified and identified by biochemical tests and VITEK 2 compact system. Among the twenty studied samples, only one Pseudomonas putida with probability of 99% was isolated. Antimicrobial susceptibility was carried out by disk diffusion method, Pseudomonas putida showed resistance to all antibiotics used except vancomycin. The isolate further subjected to PCR and DNA sequence analysis of blaVIM gene using different set of primers for different regions of VIM gene. The results were found to be PCR positive for the blaVIM gene. To determine the sequence of blaVIM gene, DNA sequencing performed. Sequence alignment of blaVIM gene with previously recorded blaVIM gene in NCBI- database showed that P. putida isolate have different blaVIM gene.

Keywords: Clinical isolates, Putida, Sulaimani, Vim gene.

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Authors: Tasnuva Tamanna, Sanjida Halim Topa

Abstract:

Sputum smear conversion after one month of antituberculosis therapy in new smear positive pulmonary tuberculosis patients (PTB+) is a vital indicator towards treatment success. The objective of this study is to determine the rate of sputum smear conversion in new PTB+ patients after one month under treatment of National Institute of Diseases of the Chest and Hospital (NIDCH). Analysis of sputum smear conversion was done by re-clinical examination with sputum smear microscopic test after one month. Socio-demographic and hematological parameters were evaluated to perceive the correlation with the disease status. Among all enrolled patients only 33.33% were available for follow up diagnosis and of them only 42.86% patients turned to smear negative. Probably this consequence is due to non-coherence to the proper disease management. 66.67% and 78.78% patients reported low haemoglobin and packed cell volume level respectively whereas 80% and 93.33% patients accounted accelerated platelet count and erythrocyte sedimentation rate correspondingly.

Keywords: Followed up patients, PTB+ patients, sputum smear conversion, and sputum smear microscopic test.

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Authors: Manfred Hartmann, Andreas Graef, Hannes Perko, Christoph Baumgartner, Tilmann Kluge

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In this paper we introduce a novel method for the characterization of synchronziation and coupling effects in multivariate time series that can be used for the analysis of EEG or ECoG signals recorded during epileptic seizures. The method allows to visualize the spatio-temporal evolution of synchronization and coupling effects that are characteristic for epileptic seizures. Similar to other methods proposed for this purpose our method is based on a regression analysis. However, a more general definition of the regression together with an effective channel selection procedure allows to use the method even for time series that are highly correlated, which is commonly the case in EEG/ECoG recordings with large numbers of electrodes. The method was experimentally tested on ECoG recordings of epileptic seizures from patients with temporal lobe epilepsies. A comparision with the results from a independent visual inspection by clinical experts showed an excellent agreement with the patterns obtained with the proposed method.

Keywords: EEG, epilepsy, regression analysis, seizurepropagation.

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Authors: M. Volpini, D. Alves, A. Horta, M. Borges, P. Reis

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The gait pattern in people that present motor limitations foment the demand for auxiliary locomotion devices. These artifacts for movement assistance vary according to its shape, size and functional features, following the clinical applications desired. Among the ortheses of lower limbs, the ankle-foot orthesis aims to improve the ability to walk in people with different neuromuscular limitations, although they do not always answer patients' expectations for their aesthetic and functional characteristics. The purpose of this study is to explore the possibility of using new design in additive manufacturer to reproduce the shape and functional features of a ankle-foot orthesis in an efficient and modern way. Therefore, this work presents a study about the performance of the mechanical forces through the analysis of finite elements in an ankle-foot orthesis. It will be demonstrated a study of distribution of the stress on the orthopedic device in orthostatism and during the movement in the course of patient's walk.

Keywords: Additive manufacture, new designs, orthoses, finite elements.

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Authors: Abdel-Rahman A., El Okle O. S.

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Fever, bloody diarrhea and high mortality rate were the main clinical finding in a group of fattening calves. Analysis of corn silage revealed presence of aflatoxins at level of 370 ppb. This level of aflatoxins in the feed of cattle is somewhat low to be the main cause of reported signs. Leukocytopenia, anemia, decreased lymphocytic activity and lowered phagocytic index are the main hematological and immunological alterations in diseased calves. Bacteriological investigation revealed isolation of pathogenic Salmonella typhimurium from the rectal swabs of diseased calves. Our results suggested that, long duration of exposure to aflatoxins even at small concentrations may considered as predisposing factor for the incidence of natural infectious outbreaks as salmonellosis due to its immunosuppressive effect. We can conclude that the veterinarians and owners must be given an attention to the relation between aflatoxicosis and salmonellosis under field condition. We are recommended that the treatment program during similar outbreaks must be including anti-aflatoxins preparations beside the antimicrobial therapy.

Keywords: Aflatoxins, Calves, Salmonellosis.

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Authors: N. A. Ibrahim, A. Kudus, I. Daud, M. R. Abu Bakar

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Competing risks survival data that comprises of more than one type of event has been used in many applications, and one of these is in clinical study (e.g. in breast cancer study). The decision tree method can be extended to competing risks survival data by modifying the split function so as to accommodate two or more risks which might be dependent on each other. Recently, researchers have constructed some decision trees for recurrent survival time data using frailty and marginal modelling. We further extended the method for the case of competing risks. In this paper, we developed the decision tree method for competing risks survival time data based on proportional hazards for subdistribution of competing risks. In particular, we grow a tree by using deviance statistic. The application of breast cancer data is presented. Finally, to investigate the performance of the proposed method, simulation studies on identification of true group of observations were executed.

Keywords: Competing risks, Decision tree, Simulation, Subdistribution Proportional Hazard.

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Authors: Elya S. Pepoyan, Astghik Z. Pepoyan

Abstract:

The Zung self-depression scale and Beck Anxiety Inventory were used both to study the depression and anxiety levels of Armenian Crohn’s disease patients, and to reveal the relation between emotional status and placebo effect of these patients. On the other hand, the blood cell analyses and gut bacteria investigations were used to assess the placebo effect on ESR, and haemoglobin-s and leukocyte-s levels as well as gut commensal E. coli quantities of these patients. Despite of registered high levels of depression and anxiety, the high placebo effect on psychoemotional status for investigated patients during the investigations was described. On the other hand, no positive effect of placebo on measurements of ESP and hemoglobin-s levels of Crohn’s disease patients was revealed. The importance of use of psychotherapies for optimal outcomes during treatments of Crohn’s disease is discussed.

Keywords: Crohn's disease, emotional disorders, placebo, gut microflora and blood composition.

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Authors: D. Estrella, A. Silva, R. Zapata, H. Rubio

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A total of 100 primary caregivers (mothers, fathers, grandparents) with at least one child or grandchild with a diagnosis of congenital bilateral profound deafness were assessed in order to evaluate the functionality of families with a deaf member, who was evaluated by specialists in audiology, molecular biology, genetics and psychology. After confirmation of the clinical diagnosis, DNA from the patients and parents were analyzed in search of the 35delG deletion of the GJB2 gene to determine who possessed the mutation. All primary caregivers were provided psychological support, regardless of whether or not they had the mutation, and prior and subsequent, the family APGAR test was applied. All parents, grandparents were informed of the results of the genetic analysis during the psychological intervention. The family APGAR, after psychological and genetic counseling, showed that 14% perceived their families as functional, 62% moderately functional and 24% dysfunctional. This shows the importance of psychological support in family functionality that has a direct impact on the quality of life of these families.

Keywords: Deafness, psychological support, family, adaptation to disability.

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Authors: Guillermo Vilalta, Félix Nieto, Carlos Vaquero, José A. Vilalta

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Abdominal aortic aneurysms rupture (AAAs) is one of the main causes of death in the world. This is a very complex phenomenon that usually occurs “without previous warning". Currently, criteria to assess the aneurysm rupture risk (peak diameter and growth rate) can not be considered as reliable indicators. In a first approach, the main geometric parameters of aneurysms have been linked into five biomechanical factors. These are combined to obtain a dimensionless rupture risk index, RI(t), which has been validated preliminarily with a clinical case and others from literature. This quantitative indicator is easy to understand, it allows estimating the aneurysms rupture risks and it is expected to be able to identify the one in aneurysm whose peak diameter is less than the threshold value. Based on initial results, a broader study has begun with twelve patients from the Clinic Hospital of Valladolid-Spain, which are submitted to periodic follow-up examinations.

Keywords: AAA, rupture risk prediction, biomechanical factors, AAA geometric characterization.

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Authors: K.Mala, V.Sadasivam, S.Alagappan

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Advances in clinical medical imaging have brought about the routine production of vast numbers of medical images that need to be analyzed. As a result an enormous amount of computer vision research effort has been targeted at achieving automated medical image analysis. Computed Tomography (CT) is highly accurate for diagnosing liver tumors. This study aimed to evaluate the potential role of the wavelet and the neural network in the differential diagnosis of liver tumors in CT images. The tumors considered in this study are hepatocellular carcinoma, cholangio carcinoma, hemangeoma and hepatoadenoma. Each suspicious tumor region was automatically extracted from the CT abdominal images and the textural information obtained was used to train the Probabilistic Neural Network (PNN) to classify the tumors. Results obtained were evaluated with the help of radiologists. The system differentiates the tumor with relatively high accuracy and is therefore clinically useful.

Keywords: Fuzzy c means clustering, texture analysis, probabilistic neural network, LVQ neural network.

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