Search results for: critically ill patients

Authors: S. Fallah, M. Seifi, M. Firoozrai, T. Godarzi, M. Jafarzadeh, L. H. Ghohari

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The ε4 allele of the ε2, ε3 and ε4 protein isoform polymorphism in the gene encoding apolipoprotein E (Apo E) has previously been associated with increased cardiac artery disease (CAD); therefore to investigate the significance of this polymorphism in pathogenesis of CAD in Iranian patients with stenosis and control subjects. To investigate the association between  Apo E polymorphism and coronary artery disease we performed a comparative case control study of the frequency of Apo E  polymorphism in One hundred CAD patients with stenosis who underwent coronary angiography (>50% stenosis) and 100 control subjects (<10% stenosis). The Apo E alleles and genotypes were determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). We observed an association between the Apo E polymorphism and CAD in this study. These data suggest that the Apo ε4 and ε2 alleles increase the risk for CAD in Iranian population (χ2 =4.26, p= 0.05, OR=2 and χ2 =0.38, p=0.53, OR=1.2). These results suggest that ε4 and ε2 alleles are risk factors for stenosis.

Keywords: Arterial blood vessels, atherosclerosis, cholesterol.

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Authors: Syeda Maria Ali Shah, Asif Mansoor, Talat Sharafat Rehmani, Safia Mirza

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The stock market of any country acts as a predictor of the economy. The spread of the COVID-19 pandemic has severely impacted the global financial markets. Besides, it has also critically affected the economy of Pakistan. In this study, we consider the role of the Karachi Stock Exchange (KSE) with regard to the Pakistan Stock Exchange and quantify the impact on macroeconomic variables in presence of COVID-19. The suitable macroeconomic variables are used to quantify the impact of COVID-19 by developing the stochastic model. The sufficiency of the computed model is attained by means of available techniques in the literature. The estimated equations are used to forecast the impact of pandemic on macroeconomic variables. The constructed model can help the policymakers take counteractive measures for restricting the influence of viruses on the Karachi Stock Market.

Keywords: COVID-19, Karachi Stock Market, macroeconomic variables, stochastic model, forecasting.

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Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

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This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: Antinuclear antibody, Subclinical hypothyroidism, Thyroxin, TPO antibody.

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Authors: Abdur-Rahman M. A., R. M. Mohd. Ali, R. A. I. R. Yaacob.

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In the fifteenth century, the Malacca Empire emerged as the centre of Islamic civilization in the Malay Archipelago. The history had been recorded in Sulalat Al-Salatin, an important literary source about the genealogy of all Kings in Malacca. The objective of this study was to analyze the understanding of sayings from Prophet Muhammad among Malays in Malacca during the fifteenth century through all of the hadith quoted in Sulalat Al-Salatin. This study used content analysis methodology to validate the sayings where all of them were critically analyzed and compared with the classical hadith sources from prominent Muslim scholars. As a result, only two out of the four quotations were considered as authentic sayings of Prophet Muhammad. This study also showed the importance of the palace as the centre of the Islamic education system and the role played by Muslim preachers from outside of Malacca to propagate Islam in Malacca.

Keywords: Hadith in Malay Annals, Malay Annals, SejarahMelayu, Sulalat Al-Salatin.

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Authors: Hanadi Mubarak AL-Mubaraki, Michael Busler

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In the context of business incubation (BI) as strategic enablers, this paper critically reviews the literature relating to the strategic benefits of BI in the Middle East. The taxonomy of BI benefits in the strategic elements on 1) type, 2) financial model, 3) services, 4) objectives, 5) number of clients, 6) number of graduates, and 7) jobs creation. Understanding the importance of BI benefits can be significant in the economic development although most incubators lead to diversify the economy. Thus, taxonomies of the benefits of BI are produced from both the academic literature and published case studies. In this way, a classification of strategic benefits elements as they relate to incubators has been developed to provide a greater understanding of the benefits needed to obtain a specific element. The result of this paper is Business incubators is aimed entrepreneurship, jobs creation, research commercialization and profitable enterprises in Middle Eastern countries.

Keywords: Economic Development, Incubators, Middle East, Strategic.

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Authors: Amir Mohammad Fathollahi Fard, Mostafa Hajiaghaei-Keshteli, Mohammad Mahdi Paydar

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With increasing life expectancy in developed countries, the role of home care services is highlighted by both academia and industrial contributors in Home Health Care Supply Chain (HHCSC) companies. The main decisions in such supply chain systems are the location of pharmacies, the allocation of patients to these pharmacies and also the routing and scheduling decisions of nurses to visit their patients. In this study, for the first time, an integrated model is proposed to consist of all preliminary and necessary decisions in these companies, namely, location-allocation-routing model. This model is a type of NP-hard one. Therefore, an Imperialist Competitive Algorithm (ICA) is utilized to solve the model, especially in large sizes. Results confirm the efficiency of the developed model for HHCSC companies as well as the performance of employed ICA.

Keywords: Home health care supply chain, location-allocation-routing problem, imperialist competitive algorithm, optimization.

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Authors: Chun-Cheng Lin

Abstract:

Noise level has critical effects on the diagnostic performance of signal-averaged electrocardiogram (SAECG), because the true starting and end points of QRS complex would be masked by the residual noise and sensitive to the noise level. Several studies and commercial machines have used a fixed number of heart beats (typically between 200 to 600 beats) or set a predefined noise level (typically between 0.3 to 1.0 μV) in each X, Y and Z lead to perform SAECG analysis. However different criteria or methods used to perform SAECG would cause the discrepancies of the noise levels among study subjects. According to the recommendations of 1991 ESC, AHA and ACC Task Force Consensus Document for the use of SAECG, the determinations of onset and offset are related closely to the mean and standard deviation of noise sample. Hence this study would try to perform SAECG using consistent root-mean-square (RMS) noise levels among study subjects and analyze the noise level effects on SAECG. This study would also evaluate the differences between normal subjects and chronic renal failure (CRF) patients in the time-domain SAECG parameters. The study subjects were composed of 50 normal Taiwanese and 20 CRF patients. During the signal-averaged processing, different RMS noise levels were adjusted to evaluate their effects on three time domain parameters (1) filtered total QRS duration (fQRSD), (2) RMS voltage of the last QRS 40 ms (RMS40), and (3) duration of the low amplitude signals below 40 μV (LAS40). The study results demonstrated that the reduction of RMS noise level can increase fQRSD and LAS40 and decrease the RMS40, and can further increase the differences of fQRSD and RMS40 between normal subjects and CRF patients. The SAECG may also become abnormal due to the reduction of RMS noise level. In conclusion, it is essential to establish diagnostic criteria of SAECG using consistent RMS noise levels for the reduction of the noise level effects.

Keywords: Signal-averaged electrocardiogram, Ventricular latepotentials, Chronic renal failure, Noise level effects.

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Authors: K. Jyothi, T. S. Mohamed Saleem, L. Vineela, C. Gopinath, K. B. Yadavender Reddy

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Objective: Acute coronary syndrome is a clinical condition encompassing ST segments elevation myocardial infraction, Non ST segment is elevation myocardial infraction and un stable angina is characterized by ruptured coronary plaque, stress and myocardial injury. Angina pectoris is a pressure like pain in the chest that is induced by exertion or stress and relived with in the minute after cessation of effort or using sublingual nitroglycerin. The present research was undertaken to study the drug utilization pattern of antiplatelet drugs for the ischemic heart disease in a tertiary care hospital. Method: The present study is retrospective drug utilization study and study period is 6months. The data is collected from the discharge case sheet of general medicine department from medical department Rajiv Gandhi institute of medical sciences, Kadapa. The tentative sample size fixed was 250 patients. Out of 250 cases 19 cases was excluded because of unrelated data. Results: A total of 250 prescriptions were collected for the study according to the inclusion criteria 233 prescriptions were diagnosed with ischemic heart disease 17 prescriptions were excluded due to unrelated information. out of 233 prescriptions 128 are male (54.9%) and 105 patients are were female (45%). According to the gender distribution, the prevalence of ischemic heart disease in males are 90 (70.31%) and females are 39 (37.1%). In the same way the prevalence of ischemic heart disease along with cerebrovascular disease in males are 39 (29.6%) and females are 66 (62.6%). Conclusion: We found that 94.8% of drug utilization of antiplatelet drugs was achieved in the Rajiv Gandhi institute of medical sciences, Kadapa from 2011-2012.

Keywords: Angina pectoris, aspirin, clopidogrel, myocardial infarction.

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Authors: Ammal M. Metwally, Lobna A. El Etreby, Rehan M. Saleh, Ghada Abdrabou, Somia I. Salama, Amira Orabi, Mohamed Abdelrahman

Abstract:

Hepatitis C virus infection is a public health threat in Egypt. To control infection, efforts should be spent to encourage healthy behavior. This study aimed to assess the level of behavioral development in order to create a positive environment for the adoption of the recommended behaviors. The study was conducted over one year from Jan. 2011 till Jan. 2012.Knowledge, attitude and behavior of 540 HCV patients and 102 of their contacts were assessed and the level of behavioral development was determined. The study revealed that the majority of patients and contacts knew that HCV infection is dangerous with perceived concern for early diagnosis and treatment. More than 75% knew the correct modes of transmission. The assessment showed positive attitudes towards the recommended practices with intention to adopt those practices. Strategies of creating opportunities to continue the recommended behaviors should be adopted together with the reinforcement of social support.

Keywords: Hepatitis C virus, Level of behavioral development, recommended behaviors.

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Authors: I. Abasi, L. Fata, M. Sadeghi, S. Banihashemi, A. Mohammadee

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Background: Dimensional and transdiagnostic approaches as a result of high comorbidity among mental disorders have captured researchers and clinicians interests for exploring the latent factors to development and maintenance of some psychological disorders. The goal of present study is comparing some of these common factors between generalized anxiety disorder and unipolar mood disorder. Methods: 27 patients with generalized anxiety disorder, 29 patients with depression disorder were recruited by using SCID-I and 69 non-clinical populations were selected by using GHQ cut off point. MANCOVA was used for analyzing data. Results: The results show that worry, rumination, intolerance of uncertainty, maladaptive metacognitive beliefs, and experiential avoidance were all significantly different between GAD and unipolar mood disorder groups. However, there weren’t any significant differences in difficulties in emotion regulation and neuroticism between GAD and unipolar mood disorder groups. Discussion: Results indicate that although there are some transdiagnostic and common factors in GAD and unipolar mood disorder, there may be some specific vulnerability factors for each disorder. Further study is needed for answering these questions.

Keywords: Depression, emotion regulation, generalized anxiety disorder, transdiagnostic.

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Authors: Wen-Tsann Lin, Yung-Tsan Jou, Yih-Chuan Wu, Yuan-Du Hsiao

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The Emergency Department of a medical center in Taiwan cooperated to conduct the research. A predictive model of triage system is contracted from the contract procedure, selection of parameters to sample screening. 2,000 pieces of data needed for the patients is chosen randomly by the computer. After three categorizations of data mining (Multi-group Discriminant Analysis, Multinomial Logistic Regression, Back-propagation Neural Networks), it is found that Back-propagation Neural Networks can best distinguish the patients- extent of emergency, and the accuracy rate can reach to as high as 95.1%. The Back-propagation Neural Networks that has the highest accuracy rate is simulated into the triage acuity expert system in this research. Data mining applied to the predictive model of the triage acuity expert system can be updated regularly for both the improvement of the system and for education training, and will not be affected by subjective factors.

Keywords: Back-propagation Neural Networks, Data Mining, Emergency Department, Triage System.

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Authors: Seung You Na, Joo Hyun Jung, Jin Young Kim, Mohammad AhangarKiasari

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There are various kinds of medical equipment which requires relatively accurate positional adjustments for successful treatment. However, patients tend to move without notice during a certain span of operations. Therefore, it is common practice that accompanying operators adjust the focus of the equipment. In this paper, tracking controllers for medical equipment are suggested to replace the operators. The tracking controllers use AHRS sensor information to recognize the movements of patients. Sensor fusion is applied to reducing the error magnitudes through linear Kalman filters. The image processing of optical markers is included to adjust the accumulation errors of gyroscope sensor data especially for yaw angles. The tracking controller reduces the positional errors between the current focus of a device and the target position on the body of a patient. Since the sensing frequencies of AHRS sensors are very high compared to the physical movements, the control performance is satisfactory. The typical applications are, for example, ESWT or rTMS, which have the error ranges of a few centimeters.

Keywords: AHRS, Sensor fusion, Tracking control, Position and posture.

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Authors: Ibrahim Aly , Rabab Zalat, Bahaa EL Deen W. El Aswad, Ismail M. Moharm , Basam M. Masoud, Tarek Diab

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The objective of the present study was to evaluate the novel nanomagnetic beads based–latex agglutination assay (NMB-LAT) as a simple test for diagnosis of S. haematobium as well as standardize the novel nanomagnetic beads based –ELISA (NMB-ELISA). According to urine examination this study included 85 S. haematobium infected patients, 30 other parasites infected patients and 25 negative control samples. The sensitivity of novel NMB-LAT was 82.4% versus 96.5% and 88.2% for NMB-ELISA and currently used sandwich ELISA respectively. The specificity of NMB-LAT was 83.6% versus 96.3% and 87.3% for NMB-ELISA and currently used sandwich ELISA respectively. In conclusion, the novel NMB-ELISA is a valuable applicable diagnostic technique for diagnosis of human schistosomiasis haematobium. The novel NMB-ELISA assay is a suitable applicable diagnostic method in field survey especially when followed by ELISA as a confirmatory test in query false negative results. Trials are required to increase the sensitivity and specificity of NMB-ELISA assay.

Keywords: Diagnosis, Latex agglutination, Nanomagnetic beads, Sandwich ELISA.

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Authors: Maruful H. Mazumder, Raymond I. Gilbert, Zhen- T. Chang

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A reliable estimate of the average bond stress within the anchorage of steel reinforcing bars in tension is critically important for the design of reinforced concrete member. This paper describes part of a recently completed experimental research program in the Centre for Infrastructure Engineering and Safety (CIES) at the University of New South Wales, Sydney, Australia aimed at assessing the effects of different factors on the anchorage requirements of modern high strength steel reinforcing bars. The study found that an increase in the anchorage length and bar diameter generally leads to a reduction of the average ultimate bond stress. By the extension of a well established analytical model of bond and anchorage, it is shown here that the differences in the average ultimate bond stress for different anchorage lengths is associated with the variable degree of plastic deformation in the tensile zone of the concrete surrounding the bar.

Keywords: Anchorage, Bond stress, Development length, Reinforced concrete.

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Authors: Ç. Erdoğan, T. Turan

Abstract:

Pediatric cancer patients experience multiple distressing, challenges, physical symptom such as fatigue, pain, sleep disturbance, and balance impairment that continue years after treatment completion. In recent years, yoga is often used in children with cancer to cope with these symptoms. Yoga practice is defined as a unique physical activity that combines physical practice, breath work and mindfulness/meditation. Yoga is an increasingly popular mind-body practice also characterized as a mindfulness mode of exercise. This study aimed to evaluate the impact of yoga intervention of children with cancer. This article planned searching the literature in this field. It has been determined that individualized yoga is feasible and provides benefits for inpatient children, improves health-related quality of life, physical activity levels, physical fitness. After yoga program, children anxiety score decreases significantly. Additionally, individualized yoga is feasible for inpatient children receiving intensive chemotherapy. As a result, yoga is an alternative and complementary medicine that can be safely used in children with cancer.

Keywords: Cancer treatment, children, nursing, yoga.

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Authors: Redha M. Elhuni

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The critical key success factors, which have to be targeted with appropriate change management, are the user acceptance and support of a new Enterprise Resource Planning (ERP) system at the early implementation stages. This becomes even more important in Arab context where national and organisational culture with a different value and belief system, resulting in different management styles, might not complement with Western business culture embedded in the predefined standard business processes of existing ERP packages. This study explains and critically evaluates research into national and organizational culture and the influence of different national cultures on the implementation and reengineering process of ERP packages in an Arab context. Using a case study, realized through a quantitative survey testing five of Martinsons’s and Davison’s propositions in a Libyan sample company, confirmed the expected results from the literature review that culture has an impact on the implementation process and that employee empowerment is an unavoidable consequence of an ERP implementation.

Keywords: Enterprise resource planning, ERP systems, organisational culture, Arab context.

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Authors: Taweechai Nuntawisuttiwong, Natasha Dejdumrong

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Geometric modeling plays an important role in the constructions and manufacturing of curve, surface and solid modeling. Their algorithms are critically important not only in the automobile, ship and aircraft manufacturing business, but are also absolutely necessary in a wide variety of modern applications, e.g., robotics, optimization, computer vision, data analytics and visualization. The calculation and display of geometric objects can be accomplished by these six techniques: Polynomial basis, Recursive, Iterative, Coefficient matrix, Polar form approach and Pyramidal algorithms. In this research, the coefficient matrix (simply called monomial form approach) will be used to model polynomial rectangular patches, i.e., Said-Ball, Wang-Ball, DP, Dejdumrong and NB1 surfaces. Some examples of the monomial forms for these surface modeling are illustrated in many aspects, e.g., construction, derivatives, model transformation, degree elevation and degress reduction.

Keywords: Monomial form, rectangular surfaces, CAGD curves, monomial matrix applications.

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Authors: Yishu Gong, Liangliang Yang, Jianyu Zhang, Zhengyu Chen, Sihong He, Xusheng Zhang, Wei Zhang

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Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that affects millions of people worldwide and is characterized by cognitive decline and behavioral changes. People living with Alzheimer’s disease often find it hard to complete routine tasks. However, there are limited objective assessments that aim to quantify the difficulty of certain tasks for AD patients compared to non-AD people. In this study, we propose to use speech emotion recognition (SER), especially the frustration level as a potential biomarker for quantifying the difficulty patients experience when describing a picture. We build an SER model using data from the IEMOCAP dataset and apply the model to the DementiaBank data to detect the AD/non-AD group difference and perform longitudinal analysis to track the AD disease progression. Our results show that the frustration level detected from the SER model can possibly be used as a cost-effective tool for objective tracking of AD progression in addition to the Mini-Mental State Examination (MMSE) score.

Keywords: Alzheimer’s disease, Speech Emotion Recognition, longitudinal biomarker, machine learning.

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Authors: Luan Mavriqi, Ilma Robo, Emin Kuzimi, Egresa Baca

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The process of skeletal growth in an adolescent significantly affects the displacement of implants placed in the palatine suture. The problems caused by this process have an impact on the dental function and aesthetics of the affected data. If fixed prostheses are placed based on implants, the whole structure would impede maxillary growth. This is the significant difference between the maxilla and the mandible, as the lower jaw has no growth process that affects the movement of the implants or the latter to inhibit the growth of the jaw. In a teenager patient an accident occurred accompanied by loss of maxillary central incisors. The main complaint of patients is aesthetics and phonetics. Dental history of patients refers to the presence of a Maryland bridge that was accompanied by dissatisfaction on the part of the patient. Implant placement is not indicated as jaw augmentation may lead to displacement of the implant. The treatment plan includes the placement of implants in the palatum where this bone thickness allows as a procedure.in this article only the first stage of treatment is presented. Implant treatment is ongoing, will be followed by the second phase of treatment when the patient has reached the age of 18 years.

Keywords: Implants, palatum, adolescent, primary incisor teeth.

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Authors: Zuraida Alwadood, Adibah Shuib, Norlida Abd Hamid

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This paper presents the review of past studies concerning mathematical models for rescheduling passenger railway services, as part of delay management in the occurrence of railway disruption. Many past mathematical models highlighted were aimed at minimizing the service delays experienced by passengers during service disruptions. Integer programming (IP) and mixed-integer programming (MIP) models are critically discussed, focusing on the model approach, decision variables, sets and parameters. Some of them have been tested on real-life data of railway companies worldwide, while a few have been validated on fictive data. Based on selected literatures on train rescheduling, this paper is able to assist researchers in the model formulation by providing comprehensive analyses towards the model building. These analyses would be able to help in the development of new approaches in rescheduling strategies or perhaps to enhance the existing rescheduling models and make them more powerful or more applicable with shorter computing time.

Keywords: Mathematical modelling, Mixed-integer programming, Railway rescheduling, Service delays.

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Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

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A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: Critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team.

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Authors: L. S. Godlevsky, N. V. Kresyun, V. P. Martsenyuk, K. S. Shakun, T. V. Tatarchuk, K. O. Prybolovets, L. F. Kalinichenko, M. Karpinski, T. Gancarczyk

Abstract:

Structures of eye bottom were extracted using multiscale texture gradient method and color characteristics of macular zone and vessels were verified in CIELAB scale. The difference of average values of L*, a* and b* coordinates of CIE (International Commision of Illumination) scale in patients with diabetes and healthy volunteers was compared. The average value of L* in diabetic patients exceeded such one in the group of practically healthy persons by 2.71 times (P < 0.05), while the value of a* index was reduced by 3.8 times when compared with control one (P < 0.05). b* index exceeded such one in the control group by 12.4 times (P < 0.05). The integrated index on color difference (ΔE) exceeded control value by 2.87 times (P < 0.05). More pronounced differences with ΔE were followed by a shorter period of MA appearance with a correlation level at -0.56 (P < 0.05). The specificity of diagnostics raised by 2.17 times (P < 0.05) and negative prognostic index exceeded such one determined with the expert method by 2.26 times (P < 0.05).

Keywords: Diabetic retinopathy, multiscale texture gradient, color spectrum analysis.

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Authors: Boroňová I., Bernasovská J., Kľoc J., Tomková Z., Petrejčíková E., Gabriková D., Mačeková S.

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Osteoporosis is a complex health disease characterized by low bone mineral density, which is determined by an interaction of genetics with metabolic and environmental factors. Current research in genetics of osteoporosis is focused on identification of responsible genes and polymorphisms. TNFRSF11B gene plays a key role in bone remodeling. The aim of this study was to investigate the genotype and allele distribution of A163G (rs3102735) osteoprotegerin gene promoter and G1181C (rs2073618) osteoprotegerin first exon polymorphisms in the group of 180 unrelated postmenopausal women with diagnosed osteoporosis and 180 normal controls. Genomic DNA was isolated from peripheral blood leukocytes using standard methodology. Genotyping for presence of different polymorphisms was performed using the Custom Taqman®SNP Genotyping assays. Hardy-Weinberg equilibrium was tested for each SNP in the groups of participants using the chi-square (χ²) test. The distribution of investigated genotypes in the group of patients with osteoporosis were as follows: AA (66.7%), AG (32.2%), GG (1.1%) for A163G polymorphism; GG (19.4%), CG (44.4%), CC (36.1%) for G1181C polymorphism. The distribution of genotypes in normal controls were follows: AA (71.1%), AG (26.1%), GG (2.8%) for A163G polymorphism; GG (22.2%), CG (48.9%), CC (28.9%) for G1181C polymorphism. In A163G polymorphism the variant G allele was more common among patients with osteoporosis: 17.2% versus 15.8% in normal controls. Also, in G1181C polymorphism the phenomenon of more frequent occurrence of C allele in the group of patients with osteoporosis was observed (58.3% versus 53.3%). Genotype and allele distributions showed no significant differences (A163G: χ²=0.270, p=0.605; χ²=0.250, p=0.616; G1181C: χ²= 1.730, p=0.188; χ²=1.820, p=0.177). Our results represents an initial study, further studies of more numerous file and associations studies will be carried out. Knowing the distribution of genotypes is important for assessing the impact of these polymorphisms on various parameters associated with osteoporosis. Screening for identification of “at-risk” women likely to develop osteoporosis and initiating subsequent early intervention appears to be most effective strategy to substantially reduce the risks of osteoporosis.

Keywords: Osteoporosis, Real-time PCR method, SNP polymorphisms.

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Authors: Qiang Fu, Md. Abu Saleh

Abstract:

Research studies are highly fragmented when an Innovation Management Framework is being discussed. With the aim to identify an Innovation Management Framework/Assessment Tool suitable for Small & Medium Enterprises (SMEs) in the service industry, this researcher critically reviewed existing innovation management frameworks and assessment models/tools and discovered a number of literature gaps. It is established that the existing literature lacks generally agreed innovation management dimensions, commonly accepted knowledge creation through empirical studies on innovation management in SMEs, effective innovation management performance measurements, suitable innovation management framework in SMEs, and studies on innovation management in the service industry, in particular in retail SMEs. As such, there is a dire need to develop an appropriate firm-level innovation management framework suitable for SMEs in the service industry for future research projects and further studies. In addition, this researcher also discussed the significance of establishing such an innovation management framework.

Keywords: innovation management, innovation management framework, innovation management assessment tools, SMEs, service industry

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Authors: Rajashekar Patil, S. Mohan Kumar, Shreya Ajmera

Abstract:

To understand complex living system an effort has made by mechanical engineers and dentists to deliver prompt products and services to patients concerned about their aesthetic look. Since two decades various bracket systems have designed involving techniques like milling, injection molding which are technically not flexible for the customized dental product development. The aim of this paper to design, develop a customized system which is economical and mainly emphasizes the expertise design and integration of engineering and dental fields. A custom made selfadjustable lingual bracket and customized implants are designed and developed using computer aided design (CAD) and rapid prototyping technology (RPT) to improve the smiles and to overcome the difficulties associated with conventional ones. Lengthy orthodontic treatment usually not accepted by the patients because the patient compliance is lost. Patient-s compliance can be improved by facilitating faster tooth movements by designing a localized dental vibrator using advanced engineering principles.

Keywords: Orthodontics, Prosthodontics, Lingual bracket, Implants, Dental vibrator, Computer aided design, Rapid prototyping technology.

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Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

Abstract:

Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m²), B – 442 females with obesity (BMI >29.9 kg/m²)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p<0.001). TBS was significantly higher in women with increased body weight compared to obese and metabolic syndrome patients. Analysis showed significant positive correlation between waist circumference, triglycerides level and BMD of lumbar spine and femur. Significant negative association between serum HDL level and BMD of investigated sites was established. The TBS (L1-L4) indexes positively correlated with HDL (high-density lipoprotein) level. Despite the fact that BMD indexes were better in women with metabolic syndrome, the frequency of non-vertebral fractures was significantly higher in this group of patients.

Keywords: Bone mineral density, trabecular bone score, metabolic syndrome, fracture.

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Authors: Manisha Rathi, Thierry Chaussalet

Abstract:

Hospital staff and managers are under pressure and concerned for effective use and management of scarce resources. The hospital admissions require many decisions that have complex and uncertain consequences for hospital resource utilization and patient flow. It is challenging to predict risk of admissions and length of stay of a patient due to their vague nature. There is no method to capture the vague definition of admission of a patient. Also, current methods and tools used to predict patients at risk of admission fail to deal with uncertainty in unplanned admission, LOS, patients- characteristics. The main objective of this paper is to deal with uncertainty in health system variables, and handles uncertain relationship among variables. An introduction of machine learning techniques along with statistical methods like Regression methods can be a proposed solution approach to handle uncertainty in health system variables. A model that adapts fuzzy methods to handle uncertain data and uncertain relationships can be an efficient solution to capture the vague definition of admission of a patient.

Keywords: Admission, Fuzzy, Regression, Uncertainty

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Authors: Yuwaraj M. Ghugal, Ajay G. Dahake

Abstract:

A trigonometric shear deformation theory for flexure of thick beams, taking into account transverse shear deformation effects, is developed. The number of variables in the present theory is same as that in the first order shear deformation theory. The sinusoidal function is used in displacement field in terms of thickness coordinate to represent the shear deformation effects. The noteworthy feature of this theory is that the transverse shear stresses can be obtained directly from the use of constitutive relations with excellent accuracy, satisfying the shear stress free conditions on the top and bottom surfaces of the beam. Hence, the theory obviates the need of shear correction factor. Governing differential equations and boundary conditions are obtained by using the principle of virtual work. The thick cantilever isotropic beams are considered for the numerical studies to demonstrate the efficiency of the. Results obtained are discussed critically with those of other theories.

Keywords: Trigonometric shear deformation, thick beam, flexure, principle of virtual work, equilibrium equations, stress.

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Authors: P. Sanzo

Abstract:

Increased physical fitness participation has been paralleled by increasedoveruse injuries such as insertional Achilles tendinosis (AT). Treatment has provided inconsistentresults. The use of extracorporeal shockwave therapy (ECSWT) offers a new treatment consideration.The purpose of this study was to assess the effects of ECSWTon pain, function, range of motion (ROM), joint mobility and strength in patients with AT. Thirty subjects were treated with ECSWT and measures were takenbefore and three months after treatment. There was significant differences in visual analog scale (VAS) scores for pain at rest (p=0.002); after activity (p= 0.0001); overall improvement(p=0.0001); Lower Extremity Functional Scale (LEFS) scores (p=0.002); dorsiflexion range of motion (ROM) (p=0.0001); plantarflexion strength (p=0.025); talocrural joint anterior glide (p=0.046); and subtalar joint medial and lateral glide (p=0.025).ECSWT offers a new intervention that may limit the progression of the disorder and the long term healthcare costs associated with AT.

Keywords: Extracorporeal shockwave therapy, shockwave therapy, Achilles tendinosis, range of motion, strength, joint mobility

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Authors: Anjan Babu G, Sumana G, Rajasekhar M

Abstract:

Many inherited diseases and non-hereditary disorders are common in the development of renal cystic diseases. Polycystic kidney disease (PKD) is a disorder developed within the kidneys in which grouping of cysts filled with water like fluid. PKD is responsible for 5-10% of end-stage renal failure treated by dialysis or transplantation. New experimental models, application of molecular biology techniques have provided new insights into the pathogenesis of PKD. Researchers are showing keen interest for developing an automated system by applying computer aided techniques for the diagnosis of diseases. In this paper a multilayered feed forward neural network with one hidden layer is constructed, trained and tested by applying back propagation learning rule for the diagnosis of PKD based on physical symptoms and test results of urinalysis collected from the individual patients. The data collected from 50 patients are used to train and test the network. Among these samples, 75% of the data used for training and remaining 25% of the data are used for testing purpose. Further, this trained network is used to implement for new samples. The output results in normality and abnormality of the patient.

Keywords: Dialysis, Hereditary, Transplantation, Polycystic, Pathogenesis.

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