Search results for: blood saturation

Authors: G. Dottavio, M. F. Andrade, F. Renard, V. Cheutet, A.-L. L. S. Vercraene, P. Hoang, S. Briet, R. Dachicourt, Y. Baizet

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An important number of technological equipment and high-skilled workers over long periods of time have to be mobilized during nuclear decommissioning processes. The related operations generate complex flows of waste and high inventory levels, associated to information flows of heterogeneous types. Taking into account that more than 10 decommissioning operations are on-going in France and about 50 are expected toward 2025: A big challenge is addressed today. The management of decommissioning and dismantling of nuclear installations represents an important part of the nuclear-based energy lifecycle, since it has an environmental impact as well as an important influence on the electricity cost and therefore the price for end-users. Bringing new technologies and new solutions into decommissioning methodologies is thus mandatory to improve the quality, cost and delay efficiency of these operations. The purpose of our project is to improve decommissioning management efficiency by developing a decision-support framework dedicated to plan nuclear facility decommissioning operations and to optimize waste evacuation by means of a logistic approach. The target is to create an easy-to-handle tool capable of i) predicting waste flows and proposing the best decommissioning logistics scenario and ii) managing information during all the steps of the process and following the progress: planning, resources, delays, authorizations, saturation zones, waste volume, etc. In this article we present our results from waste nuclear flows simulation during decommissioning process, including discrete-event simulation supported by FLEXSIM 3-D software. This approach was successfully tested and our works confirms its ability to improve this type of industrial process by identifying the critical points of the chain and optimizing it by identifying improvement actions. This type of simulation, executed before the start of the process operations on the basis of a first conception, allow ‘what-if’ process evaluation and help to ensure quality of the process in an uncertain context. The simulation of nuclear waste flows before evacuation from the site will help reducing the cost and duration of the decommissioning process by optimizing the planning and the use of resources, transitional storage and expensive radioactive waste containers. Additional benefits are expected for the governance system of the waste evacuation since it will enable a shared responsibility of the waste flows.

Keywords: Nuclear decommissioning, logistical optimization, decision-support framework, waste management.

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Authors: K. Obikeze, P. Mugabo, I. Green, D. Dietrich, A. Burger

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Leonotisleonurus a shrub indigenous to Southern Africa is widely used in traditional medicine to treat a variety of conditions ranging from skin diseases and cough to epileptic fits and ‘heart problems’. Studies on the aqueous extract of the leaves have indicated cycloxegenase enzyme inhibitory activity and an antihypertensive effect. Five methanol leaf extract fractions (MLEa - MLEe) of L. leonurus were tested on anaesthetized normotensive male Wistar rats (AWR) and isolated perfused working rat hearts (IWH). Fraction MLEc (0.01mg/kg – 0.05mg/kg) induced significant increases in BP and HR in AWR and positive chronotropic and inotropic effects in IWH (1.0mg/ml – 5.0mg/ml). Pre-administration of atenolol (2.0mg/kg) and prazosin (60μg/kg) significantly inhibited MLEc effect on HR and MAP respectively in vivo, while atenolol (7.0mg/ml) pre-perfusion significantly inhibited MLEc effect in vitro. The hypertensive effect of MLEc is probably via β1agonism. Results also indicate the presence of multiple cardioactive compounds in L. leonurus.

Keywords: Cardiovascular effect, in vitro, in vivo, isolated perfused working heart, Leonotis leonurus, rat.

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Authors: A. Doosti, P. Ghasemi Dehkordi, M. Zamani, S. Taheri, M. Banitalebi, M. Mahmoudzadeh

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The p53 tumor suppressor gene plays two important roles in genomic stability: blocking cell proliferation after DNA damage until it has been repaired, and starting apoptosis if the damage is too critical. Codon 72 exon4 polymorphism (Arg72Pro) of the P53 gene has been implicated in cancer risk. Various studies have been done to investigate the status of p53 at codon 72 for arginine (Arg) and proline (Pro) alleles in different populations and also the association of this codon 72 polymorphism with various tumors. Our objective was to investigate the possible association between P53 Arg72Pro polymorphism and susceptibility to colorectal cancer among Isfahan and Chaharmahal Va Bakhtiari (a part of south west of Iran) population. We investigated the status of p53 at codon 72 for Arg/Arg, Arg/Pro and Pro/Pro allele polymorphisms in blood samples from 145 colorectal cancer patients and 140 controls by Nested-PCR of p53 exon 4 and digestion with BstUI restriction enzyme and the DNA fragments were then resolved by electrophoresis in 2% agarose gel. The Pro allele was 279 bp, while the Arg allele was restricted into two fragments of 160 and 119 bp. Among the 145 colorectal cancer cases 49 cases (33.79%) were homozygous for the Arg72 allele (Arg/Arg), 18 cases (12.41%) were homozygous for the Pro72 allele (Pro/Pro) and 78 cases (53.8%) found in heterozygous (Arg/Pro). In conclusion, it can be said that p53Arg/Arg genotype may be correlated with possible increased risk of this kind of cancers in south west of Iran.

Keywords: TP53, Polymorphism, Colorectal Cancer, Iran

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Authors: Giovanni Luca Masala

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Pattern recognition is the research area of Artificial Intelligence that studies the operation and design of systems that recognize patterns in the data. Important application areas are image analysis, character recognition, fingerprint classification, speech analysis, DNA sequence identification, man and machine diagnostics, person identification and industrial inspection. The interest in improving the classification systems of data analysis is independent from the context of applications. In fact, in many studies it is often the case to have to recognize and to distinguish groups of various objects, which requires the need for valid instruments capable to perform this task. The objective of this article is to show several methodologies of Artificial Intelligence for data classification applied to biomedical patterns. In particular, this work deals with the realization of a Computer-Aided Detection system (CADe) that is able to assist the radiologist in identifying types of mammary tumor lesions. As an additional biomedical application of the classification systems, we present a study conducted on blood samples which shows how these methods may help to distinguish between carriers of Thalassemia (or Mediterranean Anaemia) and healthy subjects.

Keywords: Computer Aided Detection, mammary tumor, pattern recognition, thalassemia.

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Authors: Vasco A. P. Cadavez, Fernando C. Monteiro

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The objective of this study was to develop and compare alternative prediction equations of lean meat proportion (LMP) of lamb carcasses. Forty (40) male lambs, 22 of Churra Galega Bragançana Portuguese local breed and 18 of Suffolk breed were used. Lambs were slaughtered, and carcasses weighed approximately 30 min later in order to obtain hot carcass weight (HCW). After cooling at 4º C for 24-h a set of seventeen carcass measurements was recorded. The left side of carcasses was dissected into muscle, subcutaneous fat, inter-muscular fat, bone, and remainder (major blood vessels, ligaments, tendons, and thick connective tissue sheets associated with muscles), and the LMP was evaluated as the dissected muscle percentage. Prediction equations of LMP were developed, and fitting quality was evaluated through the coefficient of determination of estimation (R2 e) and standard error of estimate (SEE). Models validation was performed by k-fold crossvalidation and the coefficient of determination of prediction (R2 p) and standard error of prediction (SEP) were computed. The BT2 measurement was the best single predictor and accounted for 37.8% of the LMP variation with a SEP of 2.30%. The prediction of LMP of lamb carcasses can be based simple models, using as predictors the HCW and one fat thickness measurement.

Keywords: Bootstrap, Carcass, Lambs, Lean meat

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Authors: Nneka N. Uchegbu

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Physical, sensory properties and hypoglycemic effect of crackers produced from sprouted pigeon pea, unripe plantain and brewers’ spent grain fed to diabetic rats were investigated. Different composite flours were used to produce crackers. Physical and sensory properties of the crackers, the blood serum of the rats and changes in the rat body weight were measured. Spread ratio and break strength of the crackers from different flour blends ranges from 7.01 g to 8.51 g and 1.87 g to 3.01 g respectively. The acceptability of the crackers revealed that Sample A (100% wheat crackers) was not significantly (p>0.05) different from Samples C and D. Feeding the rats with formulated crackers caused an increase in the body weight of the rats but a reduced body weight was observed in diabetic rats fed with normal rat feed. The result indicated that cracker produced from the formulated flour blends caused a significant hypoglycemic effect in diabetic rats and led to a reduction of measured biochemical indices. Therefore, this work showed that consumption of crackers from the above formulated flour blend was able to decrease hyperglycemia in diabetic rats.

Keywords: Hypoglycemia, hyperlipidemia, total lipid, triglyceride, total cholesterol.

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Authors: H. Feza Carlak, N. G. Gencer

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To increase the temperature contrast in thermal images, the characteristics of the electrical conductivity and thermal imaging modalities can be combined. In this experimental study, it is objected to observe whether the temperature contrast created by the tumor tissue can be improved just due to the current application within medical safety limits. Various thermal breast phantoms are developed to simulate the female breast tissue. In vitro experiments are implemented using a thermal infrared camera in a controlled manner. Since experiments are implemented in vitro, there is no metabolic heat generation and blood perfusion. Only the effects and results of the electrical stimulation are investigated. Experimental study is implemented with two-dimensional models. Temperature contrasts due to the tumor tissues are obtained. Cancerous tissue is determined using the difference and ratio of healthy and tumor images. 1 cm diameter single tumor tissue causes almost 40 °mC temperature contrast on the thermal-breast phantom. Electrode artifacts are reduced by taking the difference and ratio of background (healthy) and tumor images. Ratio of healthy and tumor images show that temperature contrast is increased by the current application.

Keywords: Medical diagnostic imaging, breast phantom, active thermography, breast cancer detection.

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Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and yawning is a pathological symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved and with yawning is highly correlated with cortisol levels in healthy people. Saliva samples from 59 participants were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, together with EMG data and questionnaire data: Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details. Exclusion criteria: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was nonsignificant. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with yawning. Further research is exploring the use of cortisol as an early diagnostic tool for MS. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: Cortisol, Multiple Sclerosis, Yawning, Thompson’s Cortisol Hypothesis.

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Authors: Fernando C. Monteiro, Vasco Cadavez

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This paper presents a method for the detection of OD in the retina which takes advantage of the powerful preprocessing techniques such as the contrast enhancement, Gabor wavelet transform for vessel segmentation, mathematical morphology and Earth Mover-s distance (EMD) as the matching process. The OD detection algorithm is based on matching the expected directional pattern of the retinal blood vessels. Vessel segmentation method produces segmentations by classifying each image pixel as vessel or nonvessel, based on the pixel-s feature vector. Feature vectors are composed of the pixel-s intensity and 2D Gabor wavelet transform responses taken at multiple scales. A simple matched filter is proposed to roughly match the direction of the vessels at the OD vicinity using the EMD. The minimum distance provides an estimate of the OD center coordinates. The method-s performance is evaluated on publicly available DRIVE and STARE databases. On the DRIVE database the OD center was detected correctly in all of the 40 images (100%) and on the STARE database the OD was detected correctly in 76 out of the 81 images, even in rather difficult pathological situations.

Keywords: Diabetic retinopathy, Earth Mover's distance, Gabor wavelets, optic disc detection, retinal images

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Authors: FH. Sarieddeen, R. El Berbari, S. Imad, J. Abdel Baki, M. Hamad, R. Blanc, A. Nakib, Y.Chenoune

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Brain ArterioVenous Malformation (BAVM) is an abnormal tangle of brain blood vessels where arteries shunt directly into veins with no intervening capillary bed which causes high pressure and hemorrhage risk. The success of treatment by embolization in interventional neuroradiology is highly dependent on the accuracy of the vessels visualization. In this paper the performance of clustering techniques on vessel segmentation from 3- D rotational angiography (3DRA) images is investigated and a new technique of segmentation is proposed. This method consists in: preprocessing step of image enhancement, then K-Means (KM), Fuzzy C-Means (FCM) and Expectation Maximization (EM) clustering are used to separate vessel pixels from background and artery pixels from vein pixels when possible. A post processing step of removing false-alarm components is applied before constructing a three-dimensional volume of the vessels. The proposed method was tested on six datasets along with a medical assessment of an expert. Obtained results showed encouraging segmentations.

Keywords: Brain arteriovenous malformation (BAVM), 3-D rotational angiography (3DRA), K-Means (KM) clustering, Fuzzy CMeans (FCM) clustering, Expectation Maximization (EM) clustering, volume rendering.

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Authors: Permphan Dharmasaroja

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Acute disseminated encephalomyelitis (ADEM) has been reported to develop after a hymenoptera sting, but its pathogenesis is not known in detail. Myelin basic protein (MBP)- specific T cells have been detected in the blood of patients with ADEM, and a proportion of these patients develop multiple sclerosis (MS). In an attempt to understand the mechanisms underlying ADEM, molecular mimicry between hymenoptera venom peptides and the human immunodominant MBP peptide was scrutinized, based on the sequence and structural similarities, whether it was the root of the disease. The results suggest that the three wasp venom peptides have low sequence homology with the human immunodominant MBP residues 85-99. Structural similarity analysis among the three venom peptides and the MS-related HLA-DR2b (DRA, DRB1*1501)-associated immunodominant MHC binding/TCR contact residues 88-93, VVHFFK showed that hyaluronidase residues 7-12, phospholipase A1 residues 98-103, and antigen 5 residues 109-114 showed a high degree of similarity 83.3%, 100%, and 83.3% respectively. In conclusion, some wasp venom peptides, particularly phospholipase A1, may potentially act as the molecular motifs of the human 3HLA-DR2b-associated immunodominant MBP88-93, and possibly present a mechanism for induction of wasp sting-associated ADEM.

Keywords: central nervous system, Hymenoptera, myelin basicprotein, molecular mimicry.

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Authors: Hai Xu, Yiwei Wang, Xi Bao, Bihua Deng, Pengcheng Li, Yu Lu

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T7 phage could be used as a perfect vector for peptides expression and haptens presentation. T7-3GnRH recombinant phage was constructed by inserting three copies of Gonadotrophin Releasing Hormone (GnRH) gene into the multiple cloning site of T7 Select 415-1b phage genome. The positive T7-3GnRH phage was selected by using polymerase chain reaction amplification, and the p10B-3GnRH fusion protein was verified by SDS-PAGE and Western-blotting assay. T7-3GnRH vaccine was made and immunized with 10¹⁰ pfu in 0.2 ml per dose in mice. Blood samples were collected at an interval in weeks, and anti-GnRH antibody and testosterone concentrations were detected by ELISA and radioimmunoassay, respectively. The results show that T7-3GnRH phage particles confer a high immunogenicity to the GnRH-derived epitope. Moreover, the T7-3GnRH vaccine induced higher level of anti-GnRH antibody than ImproVac^®. However, the testosterone concentrations in both immunized groups were at a similar level, and the testis developments were significantly inhibited compared to controls. These findings demonstrated that the anti-GnRH antibody could neutralize the endogenous GnRH to down regulate testosterone level and limit testis development, highlighting the potential value of T7-3GnRH in the immunocastration vaccine research.

Keywords: Gonadotrophin releasing hormone, GnRH, immunocastration, T7 phage, phage vaccine.

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Authors: Masaki Yamaguchi, Daimei Sasayama, Shinsuke Washizuka

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The goal of this study was to examine the possibility of salivary cytokines for the screening of attention deficit hyperactivity disorder (ADHD) in children. We carried out a case-control study, including 19 children with ADHD and 17 healthy children (controls). A multiplex bead array immunoassay was used to conduct a multi-analysis of 27 different salivary cytokines. Six salivary cytokines (interleukin (IL)-1β, IL-8, IL12p70, granulocyte colony-stimulating factor (G-CSF), interferon gamma (IFN-γ), and vascular endothelial growth factor (VEGF)) were significantly associated with the presence of ADHD (p < 0.05). An informative salivary cytokine panel was developed using VEGF by logistic regression analysis (odds ratio: 0.251). Receiver operating characteristic analysis revealed that assessment of a panel using VEGF showed “good” capability for discriminating between ADHD patients and controls (area under the curve: 0.778). ADHD has been hypothesized to be associated with reduced cerebral blood flow in the frontal cortex, due to reduced VEGF levels. Our study highlights the possibility of utilizing differential salivary cytokine levels for point-of-care testing (POCT) of biomarkers in children with ADHD.

Keywords: Cytokine, saliva, attention deficit hyperactivity disorder, child, biomarker.

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support operational decisions in Emergency Medical Service (EMS) systems regarding the assignment of medical emergency requests to Emergency Departments (ED). This problem is called “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of a first phase of review of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a mission. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the travelling time and to free-up the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs also considering the expected time performance in the subsequent phases of the process, such as the case mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to compare different hospital selection policies. The model was implemented with the AnyLogic software and finally validated on a realistic case. The hospital selection policy that returned the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, based on a retrospective estimation of the TTP, and a dynamic approach, focused on a predictive estimation of the TTP which is determined with a constantly updated Winters forecasting model. Findings reveal that considering the minimization of TTP is the best hospital selection policy. It allows to significantly reducing service throughput times in the ED with a negligible increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms on TTP estimation, than a retrospective approach. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: Emergency medical services, hospital selection, discrete event simulation, forecast model.

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Authors: Ceren Kaya, Okan Erkaymaz, Orhan Ayar, Mahmut Özer

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Diabetes Mellitus (Diabetes) is a disease based on insulin hormone disorders and causes high blood glucose. Clinical findings determine that diabetes can be diagnosed by electrophysiological signals obtained from the vital organs. 'Diabetic Retinopathy' is one of the most common eye diseases resulting on diabetes and it is the leading cause of vision loss due to structural alteration of the retinal layer vessels. In this study, features of horizontal and vertical Video-Oculography (VOG) signals have been used to classify non-proliferative and proliferative diabetic retinopathy disease. Twenty-five features are acquired by using discrete wavelet transform with VOG signals which are taken from 21 subjects. Two models, based on multi-layer perceptron and radial basis function, are recommended in the diagnosis of Diabetic Retinopathy. The proposed models also can detect level of the disease. We show comparative classification performance of the proposed models. Our results show that proposed the RBF model (100%) results in better classification performance than the MLP model (94%).

Keywords: Diabetic retinopathy, discrete wavelet transform, multi-layer perceptron, radial basis function, video-oculography.

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Authors: Salim Cerig, Fatime Geyikoglu, Murat Bakir, Suat Colak, Merve Sonmez, Kubra Koc

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Cisplatin (CIS) is one of the most effective an anticancer drug and also toxic to cells by activating oxidative stress. Oleuropein (OLE) has key role against oxidative stress in mammalian cells, but the role of this antioxidant in the toxicity of CIS remains unknown. The aim of the present study was to investigate the efficacy of OLE on CIS-induced liver damages in male rats. With this aim, male Sprague Dawley rats were randomly assigned to one of eight groups: Control group; the group treated with 7 mg/kg/day CIS; the groups treated with 50, 100 and 200 mg/kg/day OLE (i.p.); and the groups treated with OLE for three days starting at 24 h following CIS injection. After 4 days of injections, serum was provided to assess the blood AST, ALT and LDH values. The liver tissues were removed for histological, biochemical (TAC, TOS and MDA) and genotoxic evaluations. In the CIS treated group, the whole liver tissue showed significant histological changes. Also, CIS significantly increased both the incidence of oxidative stress and the induction of 8-hydroxy-deoxyguanosine (8-OH-dG). Moreover, the rats taking CIS have abnormal results on liver function tests. However, these parameters reached to the normal range after administration of OLE for 3 days. Finally, OLE demonstrated an acceptable high potential and was effective in attenuating CIS-induced liver injury. In this trial, the 200 mg/kg dose of OLE firstly appeared to induce the most optimal protective response.

Keywords: Antioxidant response, cisplatin, histology, liver, oleuropein, 8-OhdG.

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Authors: H. Djaara, M. Yahia, H. Bousselsela, N Khelif, A. Zidani, S. Benbia.

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Von Willebrand-s disease is the most common inherited bleeding disorder in humans, it caused by qualitative abnormalities of the von Willebrand factor (vWF). Our objective is to determine the prevalence of this disease at part of the Algerian population in the East and the South by a biological diagnosis based on specific biological tests (automated platelet count, the bleeding time (TS), the time of cephalin + activator (TCA), measure of the prothrombin rate (TP), vWF rate and factor VIII rate, Molecular electrophoresis of vWF multimers in agarose gel in the presence of SDS). Four patients of type III or severe Willebrand-s disease were found on 200 suspect cases. All cases are showed a deficit in vWF rate (< 5%), and factor VIII (P<0, 0001), and lengthening very significantly high of the TCA (P<0, 0001) and of the bleeding time (P<0,0001), with a normal blood platelet rate (P=0,7433) and a normal prothrombin rate (P=0,5808), an absence of all the multimers of vWF in plasma patients. The severe Willebrand-s disease is not only one pathology of primary haemostasis, but it can be accompanied by coagulation-s anomaly due to deficit in factor VIII. At this studied population, von Willebrand-s disease is less frequent (2%) than other hemorrhagic syndromes identified by the differential diagnosis like the thrombocytopenia (36%).

Keywords: Von Willebrand's disease, differential diagnosis, von Willebrand factor, factor VIII, biological diagnosis, thrombocytopenia.

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Authors: Paria Soleimani, Arezoo Neshati

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Myocardial infarction is one of the leading causes of death in the world. Some of these deaths occur even before the patient reaches the hospital. Myocardial infarction occurs as a result of impaired blood supply. Because the most of these deaths are due to coronary artery disease, hence the awareness of the warning signs of a heart attack is essential. Some heart attacks are sudden and intense, but most of them start slowly, with mild pain or discomfort, then early detection and successful treatment of these symptoms is vital to save them. Therefore, importance and usefulness of a system designing to assist physicians in early diagnosis of the acute heart attacks is obvious. The main purpose of this study would be to enable patients to become better informed about their condition and to encourage them to seek professional care at an earlier stage in the appropriate situations. For this purpose, the data were collected on 711 heart patients in Iran hospitals. 28 attributes of clinical factors can be reported by patients; were studied. Three logistic regression models were made on the basis of the 28 features to predict the risk of heart attacks. The best logistic regression model in terms of performance had a C-index of 0.955 and with an accuracy of 94.9%. The variables, severe chest pain, back pain, cold sweats, shortness of breath, nausea and vomiting, were selected as the main features.

Keywords: Coronary heart disease, acute heart attacks, prediction, logistic regression.

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Authors: Ali Akbar Sadat Asl

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

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

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Authors: I. Boroňová, J. Bernasovská, J. Kmec, E. Petrejčíková

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Dilated cardiomyopathy (DCM) is a severe cardiovascular disorder characterized by progressive systolic dysfunction due to cardiac chamber dilatation and inefficient myocardial contractility often leading to chronic heart failure. Recently, a genome-wide association studies (GWASs) on DCM indicate that the ZBTB17 gene rs10927875 single nucleotide polymorphism is associated with DCM. The aim of the study was to identify the distribution of ZBTB17 gene rs10927875 polymorphism in 50 Slovak patients with DCM and 80 healthy control subjects using the Custom Taqman®SNP Genotyping assays. Risk factors detected at baseline in each group included age, sex, body mass index, smoking status, diabetes and blood pressure. The mean age of patients with DCM was 52.9±6.3 years; the mean age of individuals in control group was 50.3±8.9 years. The distribution of investigated genotypes of rs10927875 polymorphism within ZBTB17 gene in the cohort of Slovak patients with DCM was as follows: CC (38.8%), CT (55.1%), TT (6.1%), in controls: CC (43.8%), CT (51.2%), TT (5.0%). The risk allele T was more common among the patients with dilated cardiomyopathy than in normal controls (33.7% versus 30.6%). The differences in genotype or allele frequencies of ZBTB17 gene rs10927875 polymorphism were not statistically significant (p=0.6908; p=0.6098). The results of this study suggest that ZBTB17 gene rs10927875 polymorphism may be a risk factor for susceptibility to DCM in Slovak patients with DCM. Studies of numerous files and additional functional investigations are needed to fully understand the roles of genetic associations.

Keywords: Dilated cardiomyopathy, SNP polymorphism, ZBTB17 gene.

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Authors: H. Alabed, K. Abuzayan. L. Fgie, K. Zarug

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Ramadan requires individuals to abstain from food and fluid intake between sunrise and sunset; physiological considerations predict that poorer mood, physical performance and mental performance will result. In addition, any difficulties will be worsened because preparations for fasting and recovery from it often mean that nocturnal sleep is decreased in length, and this independently affects mood and performance.

A difficulty of interpretation in many studies is that the observed changes could be due to fasting but also to the decreased length of sleep and altered food and fluid intakes before and after the daytime fasting. These factors were separated in this study, which took place over three separate days and compared the effects of different durations of fasting (4, 8 or 16h) upon a wide variety of measures (including subjective and objective assessments of performance, body composition, dehydration and responses to a short bout of exercise) - but with an unchanged amount of nocturnal sleep, controlled supper the previous evening, controlled intakes at breakfast and daytime naps not being allowed. Many of the negative effects of fasting observed in previous studies were present in this experiment also. These findings indicate that fasting was responsible for many of the changes previously observed, though some effect of sleep loss, particularly if occurring on successive days (as would occur in Ramadan) cannot be excluded.

Keywords: Drinking, Eating, Mental Performance, Physical Performance, Social Activity, Blood, Sleepiness.

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Authors: Yong Zhao, Jian He, Cheng Zhang

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Cardiovascular disease resulting from hypertension poses a significant threat to human health, and early detection of hypertension can potentially save numerous lives. Traditional methods for detecting hypertension require specialized equipment and are often incapable of capturing continuous blood pressure fluctuations. To address this issue, this study starts by analyzing the principle of heart rate variability (HRV) and introduces the utilization of sliding window and power spectral density (PSD) techniques to analyze both temporal and frequency domain features of HRV. Subsequently, a hypertension prediction network that relies on HRV is proposed, combining Resnet, attention mechanisms, and a multi-layer perceptron. The network leverages a modified ResNet18 to extract frequency domain features, while employing an attention mechanism to integrate temporal domain features, thus enabling auxiliary hypertension prediction through the multi-layer perceptron. The proposed network is trained and tested using the publicly available SHAREE dataset from PhysioNet. The results demonstrate that the network achieves a high prediction accuracy of 92.06% for hypertension, surpassing traditional models such as K Near Neighbor (KNN), Bayes, Logistic regression, and traditional Convolutional Neural Network (CNN).

Keywords: Feature extraction, heart rate variability, hypertension, residual networks.

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Authors: Justina I. R. Udotong

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Diagnostic enzymes like aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were determined as indices of heavy metal pollution in Tilapia guinensis. Three different sets of fishes treated with lead (Pb), iron (Fe) and copper (Cu) were used for the study while a fourth group with no heavy metal served as a control. Fishes in each of the groups were exposed to 2.65mg/l of Pb, 0.85mg/l of Fe and 0.35 mg/l of Cu in aerated aquaria for 96 hours. Tissue fractionation of the liver tissues was carried out and the three diagnostic enzymes (AST, ALT, and ALP) were estimated. Serum levels of the same diagnostic enzymes were also measured. The mean values of the serum enzyme activity for ALP in each experimental group were 19.5±1.62, 29.67±2.17 and 1.15±0.27 IU/L for Pb, Fe and Cu groups compared with 9.99±1.34 IU/L enzyme activity in the control. This result showed that Pb and Fe caused increased release of the enzyme into the blood circulation indicating increased tissue damage while Cu caused a reduction in the serum level as compared with the level in the control group. The mean values of enzyme activity obtained in the liver were 102.14±6.12, 140.17±2.06 and 168.23±3.52 IU/L for Pb, Fe and Cu groups, respectively compared to 91.20±9.42 IU/L enzyme activity for the control group. The serum and liver AST and ALT activities obtained in Pb, Fe, Cu and control groups are reported. It was generally noted that the presence of the heavy metal caused liver tissues damage and consequent increased level of the diagnostic enzymes in the serum.

Keywords: Diagnostic enzymes, enzyme activity, heavy metals, tissues investigations.

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Authors: T. Wresdiyati, S. Sa’diah, A. Winarto

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Diabetes mellitus (DM) is a metabolic disease that can be indicated by the high level of blood glucose. The objective of this study was to observe the antidiabetic properties of ethanolic extract of Indonesian Swietenia mahagoni Jacq. seed on the profile of pancreatic superoxide dismutase and β-cells in the alloxan- experimental diabetic rats. The Swietenia mahagoni seed was obtained from Leuwiliang-Bogor, Indonesia. Extraction of Swietenia mahagoni was done by using ethanol with maceration methods. A total of 25 male Sprague dawley rats were divided into five groups; (a) negative control group, (b) positive control group (DM), (c) DM group that was treated with Swietenia mahagoni seed extract, (d) DM group that was treated with acarbose, and (e) non-DM group that was treated with Swietenia mahagoni seed extract. The DM groups were induced by alloxan (110 mg/kgBW). The extract was orally administrated to diabetic rats 500 mg/kg/BW/day for 28 days. The extract showed hypoglycemic effect, increased body weight, increased the content of superoxide dismutase in the pancreatic tissue, and delayed the rate of β-cells damage of experimental diabetic rats. These results suggested that the ethanolic extract of Indonesian Swietenia mahagoni Jacq. seed could be proposed as a potential anti-diabetic agent.

Keywords: β-cell, diabetes mellitus, superoxide dismutase, Swietenia mahagoni.

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Authors: S. Bouharati, I. Bouharati, C. Benzidane, F. Alleg, M. Belmahdi

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Sensors possess several properties of physical measures. Whether devices that convert a sensed signal into an electrical signal, chemical sensors and biosensors, thus all these sensors can be considered as an interface between the physical and electrical equipment. The problem is the analysis of the multitudes of saved settings as input variables. However, they do not all have the same level of influence on the outputs. In order to identify the most sensitive parameters, those that can guide users in gathering information on the ground and in the process of model calibration and sensitivity analysis for the effect of each change made. Mathematical models used for processing become very complex. In this paper a fuzzy rule-based system is proposed as a solution for this problem. The system collects the available signals information from sensors. Moreover, the system allows the study of the influence of the various factors that take part in the decision system. Since its inception fuzzy set theory has been regarded as a formalism suitable to deal with the imprecision intrinsic to many problems. At the same time, fuzzy sets allow to use symbolic models. In this study an example was applied for resolving variety of physiological parameters that define human health state. The application system was done for medical diagnosis help. The inputs are the signals expressed the cardiovascular system parameters, blood pressure, Respiratory system paramsystem was done, it will be able to predict the state of patient according any input values.

Keywords: Sensors, Sensivity, fuzzy logic, analysis, physiological parameters, medical diagnosis.

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Authors: Teti Estiasih, Harijono, Weny Bekti Sunarharum, Atina Rahmawati

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This research studied the hypoglycemic effect of water soluble polysaccharide (WSP) extracted from yam (Dioscorea hispida) tuber by three different methods: aqueous extraction, papain assisted extraction, and tempeh inoculums assisted extraction. The two later extraction methods were aimed to remove WSP binding protein to have more pure WSP. The hypoglycemic activities were evaluated by means in vivo test on alloxan induced hyperglycemic rats, glucose response test (GRT), in situ glucose absorption test using everted sac, and short chain fatty acids (SCFAs) analysis. All yam WSP extracts exhibited ability to decrease blood glucose level in hyperglycemia condition as well as inhibited glucose absorption and SCFA formation. The order of hypoglycemic activity was tempeh inoculums assisted- >papain assisted- >aqueous WSP extracts. GRT and in situ glucose absorption test showed that order of inhibition was papain assisted- >tempeh inoculums assisted- >aqueous WSP extracts. Digesta of caecum of yam WSP extracts oral fed rats had more SCFA than control. Tempeh inoculums assisted WSP extract exhibited the most significant hypoglycemic activity.

Keywords: hypoglycemic activity, papain, tempeh inoculums, water soluble polysaccharides, yam (Discorea hispida)

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Authors: Simon Bambang Widjanarko, Novita Wijayanti, Aji Sutrisno

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There is long history of konjac tubers being used as a cure for certain diseases in China and Japan. Konjac flour is prepared from konjac tubers and it contains high concentration of glucomannan. Konjac Glucomannan (KGM) is dietary fiber and the role of which has been demonstrated in weight reduction, lowering blood cholesterol and sugar level, promoting intestinal activity etc. Konjac glucomanan has a property of swelling by absorbing water, more than a hundred times its own weight. Therefore it helps increasing weight of feces, water content of feces, and promotes satiety feeling. Mode of actions of dietary fibre as laxatives agents includes holding water inside the bowel lumen, inhibition of water absorption in the colon and stimulating colonic motility. Number of fecal pellets did not effected in rats were fed on 300 and 600 mg/kg of konjac flour, as well as constipated control and Dulcolax treatment. Water content, weight of fecal pellets and gastrointestinal transit ratio were higher in rats treated with 600 mg/kg than 300 mg/kg of konjac flour. Rats were administered with Dulcolax showed the highest gastrointestinal transit ratio, followed by 600 mg/kg konjac flour. The lowest feed consumption was noted in 600 mg/kg konjac flour diet group.

Keywords: Laxative, konjac flour, Amorphophallus muelleri Blume, glucomannan, constipation.

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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: G. Feletti, D. Tedesco, P. Trucco

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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of a first phase of revision of the technical-scientific literature concerning the indicators currently in use for the performance measurement of EMS. It emerges that current studies focus on two distinct areas and independent objectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). Conversely, the perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal covers the end-to-end healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid even to EMS aspects that in current literature tend to be neglected or underestimated. In particular, the integration of the two processes enables to evaluate the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering, besides the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating firstly the ones not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draw us to exclude additional indicators due to unavailability of data required for their computation. The final dashboard, that was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness on EDs accessibility in real time. The association of each KPI to the EMS phase it refers to enabled the design of a well-balanced dashboard, covering both efficiency and effectiveness performance objectives of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient care are covered by traditional KPIs. Future developments could be directed to building a hierarchical dashboard, composed by a high-level minimal set of KPIs for measuring the basic performance of the EMS system, at an aggregate level, and lower levels of KPIs that bring additional and more detailed information on specific performance dimensions or EMS phases.

Keywords: Emergency Medical Services, Key Performance Indicators, Dashboard, Decision Support.

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Authors: Rassoli Aisa, Abrishami Movahhed Arezu, Faturaee Nasser, Seddighi Amir Saeed, Shafigh Mohammad

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Cardiovascular diseases are one of the most common causes of mortality in developed countries. Coronary artery abnormalities and carotid artery stenosis, also known as silent death, are among these diseases. One of the treatment methods for these diseases is to create a deviatory pathway to conduct blood into the heart through a bypass surgery. The saphenous vein is usually used in this surgery to create the deviatory pathway. Unfortunately, a re-surgery will be necessary after some years due to ignoring the disagreement of mechanical properties of graft tissue and/or applied prostheses with those of host tissue. The objective of the present study is to clarify the viscoelastic behavior of human saphenous tissue. The stress relaxation tests in circumferential and longitudinal direction were done in this vein by exerting 20% and 50% strains. Considering the stress relaxation curves obtained from stress relaxation tests and the coefficients of the standard solid model, it was demonstrated that the saphenous vein has a non-linear viscoelastic behavior. Thereafter, the fitting with Fung’s quasilinear viscoelastic (QLV) model was performed based on stress relaxation time curves. Finally, the coefficients of Fung’s QLV model, which models the behavior of saphenous tissue very well, were presented.

Keywords: Fung’s quasilinear viscoelastic (QLV) model, strain rate, stress relaxation test, uniaxial tensile test, viscoelastic behavior.

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