Search results for: high risk cardiac patients.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6975

Search results for: high risk cardiac patients.

6915 A Study of Relationship between Mountaineering Participation Motivation and Risk Perception

Authors: Yen-Chieh Wen, Ching-Hui Lin

Abstract:

The main purpose of this study is to analyze climbers involved in motivation and risk perception and analysis of the predictive ability of the risk perception "mountaineering" involved in motivation. This study used questionnaires, to have to climb the 3000m high mountain in Taiwan climbers object to carry out an investigation in order to non-random sampling, a total of 231 valid questionnaires were. After statistical analysis, the study found that: 1. Climbers the highest climbers involved in motivation "to enjoy the natural beauty of the fun. 2 climbers for climbers "risk perception" the highest: the natural environment of risk. 3. Climbers “seeking adventure stimulate", “competence achievement" motivation highly predictive of risk perception. Based on these findings, this study not only practices the recommendations of the outdoor leisure industry, and also related research proposals for future researchers.

Keywords: Mountaineering, motivation, risk perception, decision-making.

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6914 The Experiences of Coronary Heart Disease Patients: Biopsychosocial Perspective

Authors: Christopher C. Anyadubalu

Abstract:

Biological, psychological and social experiences and perceptions of healthcare services in patients medically diagnosed of coronary heart disease were investigated using a sample of 10 participants whose responses to the in-depth interview questions were analyzed based on inter-and-intra-case analyses. The results obtained revealed that advancing age, single status, divorce and/or death of spouse and the issue of single parenting negatively impacted patients- biopsychosocial experiences. The patients- experiences of physical signs and symptoms, anxiety and depression, past serious medical conditions, use of self-prescribed medications, family history of poor mental/medical or physical health, nutritional problems and insufficient physical activities heightened their risk of coronary attack. Collectivist culture served as a big source of relieve to the patients. Patients- temperament, experience of different chronic life stresses/challenges, mood alteration, regular drinking, smoking/gambling, and family/social impairments compounded their health situation. Patients were satisfied with the biomedical services rendered by the healthcare personnel, whereas their psychological and social needs were not attended to. Effective procedural treatment model, a holistic and multidimensional approach to the treatment of heart disease patients was proposed.

Keywords: Biopsychosocial, Coronary Heart Disease, Experience, Patients, Perception, Perspective.

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6913 User Pattern Learning Algorithm based MDSS(Medical Decision Support System) Framework under Ubiquitous

Authors: Insung Jung, Gi-Nam Wang

Abstract:

In this paper, we present user pattern learning algorithm based MDSS (Medical Decision support system) under ubiquitous. Most of researches are focus on hardware system, hospital management and whole concept of ubiquitous environment even though it is hard to implement. Our objective of this paper is to design a MDSS framework. It helps to patient for medical treatment and prevention of the high risk patient (COPD, heart disease, Diabetes). This framework consist database, CAD (Computer Aided diagnosis support system) and CAP (computer aided user vital sign prediction system). It can be applied to develop user pattern learning algorithm based MDSS for homecare and silver town service. Especially this CAD has wise decision making competency. It compares current vital sign with user-s normal condition pattern data. In addition, the CAP computes user vital sign prediction using past data of the patient. The novel approach is using neural network method, wireless vital sign acquisition devices and personal computer DB system. An intelligent agent based MDSS will help elder people and high risk patients to prevent sudden death and disease, the physician to get the online access to patients- data, the plan of medication service priority (e.g. emergency case).

Keywords: Neural network, U-healthcare, MDSS, CAP, DSS.

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6912 Rebuilding the Dental Hygiene Habits of the Hospitalized Patients with Schizophrenia

Authors: Chia-Jou Hsieh, Feng-Chuan Pan

Abstract:

Oral health is particular important to the hospitalized patients with chronic schizophrenia for an extreme high potential of the respiratory infections. Due to the degeneration of physical capability, patients of this kind typically fall dependent in the activity of daily living (ADL). A very high percentage of patients had dental problems of which mostly could be easily avoid by easy regular tooth brushing. Purpose of the project is to develop a mechanism in helping the schizophrenia patients in rebuilding a tooth-cleaning habit. The project observed and evaluated the tooth-cleaning behavior of 100 male patients in a psychiatric hospital, and found the majority of them ignored such an activity in a three-month period of time. In the meantime, the primary care-givers were not aware or not convinced the importance of such a need of dental hygiene, and thus few if any tooth cleaning training or knowledge on dental hygiene were given to the patients. The project then developed a program based on the numerous observations and discussions. The improvement program included patients- group education, care-givers- training, and a tool-kit for tooth-brush holding was erected. The project launched with some incentive package. The outcomes were encouraging with 87% of the patients had rebuilt their tooth-brushing habits against previous 22%, and the tooth cleaning kits were 100% kept against 22% in the past. This project had significantly improved the oral health of the patients. The project, included the procedure and the tool-kit holder specific for this purpose, was a good examples for psychiatric hospitals.

Keywords: Schizophrenia, dental hygiene, tool-kit holder, health education

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6911 Review Risk and Threats Due to Dam Break

Authors: A.Roshandel, N.Hedayat, H.kiamanesh

Abstract:

The one of most important objects in implementation of damage analysis observations is manner of dam break wave propagation. In this paper velocity and wave height due dam break in with and without tailwater states for appointment hazardous lands and flood radius are investigate. In order to modeling above phenomenon finite volume method of Roe type for solving shallow water equations is used. Results indicated that in the dry bed state risk radius due to dam break is too high. While in the wet bed risk radius has a less wide. Therefore in the first state constructions and storage facilities are encountered with destruction risk. Further velocity due to dam break in the second state is more comparing to the first state. Hence erosion and scour the river bed in the dry bed is too more compare to the wet bed.

Keywords: Dam break, finite volume method, tailwater, risk radius, scour

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6910 Correlated Neural Activity in Cortex and Thalamus Following Brain Injury

Authors: Young-Seok Choi

Abstract:

It has been known that a characteristic Burst-Suppression (BS) pattern appears in EEG during the early recovery period following Cardiac Arrest (CA). Here, to explore the relationship between cortical and subcortical neural activities underlying BS, extracellular activity in the parietal cortex and the centromedian nucleus of the thalamus and extradural EEG were recorded in a rodent CA model. During the BS, the cortical firing rate is extraordinarily high, and that bursts in EEG correlate to dense spikes in cortical neurons. Newly observed phenomena are that 1) thalamic activity reemerges earlier than cortical activity following CA, and 2) the correlation coefficient of cortical and thalamic activities rises during BS period. These results would help elucidate the underlying mechanism of brain recovery after CA injury.

Keywords: Cortex, thalamus, cardiac arrest, burst-suppression.

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6909 Feasibility of Risk Assessment for Type 2 Diabetes in Community Pharmacies Using Two Different Approaches: A Pilot Study in Thailand

Authors: Thitaporn Thoopputra, Tipaporn Pongmesa, Shuchuen Li

Abstract:

Aims: To evaluate the application of non-invasive diabetes risk assessment tool in community pharmacy setting. Methods: Thai diabetes risk score was applied to assess individuals at risk of developing type 2 diabetes. Interactive computer-based risk screening (IT) and paper-based risk screening (PT) tools were applied. Participants aged over 25 years with no known diabetes were recruited in six participating pharmacies. Results: A total of 187 clients, mean aged (+SD) was 48.6 (+10.9) years. 35% were at high risk. The mean value of willingness-to-pay for the service fee in IT group was significantly higher than PT group (p=0.013). No significant difference observed for the satisfaction between groups. Conclusions: Non-invasive risk assessment tool, whether paper-based or computerized-based can be applied in community pharmacy to support the enhancing role of pharmacists in chronic disease management. Long term follow up is needed to determine the impact of its application in clinical, humanistic and economic outcomes.

Keywords: Community pharmacy, intervention, prevention, risk assessment, type 2 diabetes.

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6908 Minimizing Risk Costs through Optimal Responses in NPD Projects

Authors: Chan-Sik Kim, Jong-Seong Kim, Se Won Lee, Hoo-Gon Choi

Abstract:

In rapidly changing market environment, firms are investing a lot of time and resources into new product development (NPD) projects to make profit and to obtain competitive advantage. However, failure rate of NPD projects is becoming high due to various internal and external risks which hinder successful NPD projects. To reduce the failure rate, it is critical that risks have to be managed effectively and efficiently through good strategy, and treated by optimal responses to minimize risk cost. Four strategies are adopted to handle the risks in this study. The optimal responses are characterized by high reduction of risk costs with high efficiency. This study suggests a framework to decide the optimal responses considering the core risks, risk costs, response efficiency and response costs for successful NPD projects. Both binary particles warm optimization (BPSO) and multi-objective particle swarm optimization (MOPSO) methods are mainly used in the framework. Although several limitations exist in use for real industries, the frame work shows good strength for handling the risks with highly scientific ways through an example.

Keywords: NPD projects, risk cost, strategy, optimal responses, Particle Swarm Optimization.

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6907 UEMSD Risk Identification – Case Study

Authors: K. Sekulová, M. Šimon

Abstract:

The article demonstrates on a case study how it is possible to identify MSD risk. It is based on a dissertation Risk identification model of occupational diseases formation in relation to the work activity that determines what risk can endanger workers who are exposed to the specific risk factors. It is evaluated based on statistical calculations. These risk factors are main cause of upperextremities musculoskeletal disorders.

Keywords: Case study, upper-extremity musculoskeletal disorders, ergonomics.

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6906 Microalbuminuria in Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome

Authors: Sharan Badiger, Prema T. Akkasaligar, Patil LS, Manish Patel, Biradar MS

Abstract:

Human immunodeficiency virus infection and acquired immunodeficiency syndrome is a global pandemic with cases reporting from virtually every country and continues to be a common infection in developing country like India. Microalbuminuria is a manifestation of human immunodeficiency virus associated nephropathy. Therefore, microalbuminuria may be an early marker of human immunodeficiency virus associated nephropathy, and screening for its presence may be beneficial. A strikingly high prevalence of microalbuminuria among human immunodeficiency virus infected patients has been described in various studies. Risk factors for clinically significant proteinuria include African - American race, higher human immunodeficiency virus ribonucleic acid level and lower CD4 lymphocyte count. The cardiovascular risk factors of increased systolic blood pressure and increase fasting blood sugar level are strongly associated with microalbuminuria in human immunodeficiency virus patient. These results suggest that microalbuminuria may be a sign of current endothelial dysfunction and micro-vascular disease and there is substantial risk of future cardiovascular disease events. Positive contributing factors include early kidney disease such as human immunodeficiency virus associated nephropathy, a marker of end organ damage related to co morbidities of diabetes or hypertension, or more diffuse endothelial cells dysfunction. Nevertheless after adjustment for non human immunodeficiency virus factors, human immunodeficiency virus itself is a major risk factor. The presence of human immunodeficiency virus infection is independent risk to develop microalbuminuria in human immunodeficiency virus patient. Cardiovascular risk factors appeared to be stronger predictors of microalbuminuria than markers of human immunodeficiency virus severity person with human immunodeficiency virus infection and microalbuminuria therefore appear to potentially bear the burden of two separate damage related to known vascular end organ damage related to know vascular risk factors, and human immunodeficiency virus specific processes such as the direct viral infection of kidney cells.The higher prevalence of microalbuminuria among the human immunodeficiency virus infected could be harbinger of future increased risks of both kidney and cardiovascular disease. Further study defining the prognostic significance of microalbuminuria among human immunodeficiency virus infected persons will be essential. Microalbuminuria seems to be a predictor of cardiovascular disease in diabetic and non diabetic subjects, hence it can also be used for early detection of micro vascular disease in human immunodeficiency virus positive patients, thus can help to diagnose the disease at the earliest.

Keywords: Acquired immunodeficiency syndrome, Human immunodeficiency virus, Microalbuminuria.

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6905 Modeling of Blood Flow Velocity into the Main Artery via Left Ventricle of Heart during Steady Condition

Authors: Mohd Azrul Hisham Mohd Adib, Nur Hazreen Mohd Hasni

Abstract:

A three-dimensional and pulsatile blood flow in the left ventricle of heart model has been studied numerically. The geometry was derived from a simple approximation of the left ventricle model and the numerical simulations were obtained using a formulation of the Navier-Stokes equations. In this study, simulation was used to investigate the pattern of flow velocity in 3D model of heart with consider the left ventricle based on critical parameter of blood under steady condition. Our results demonstrate that flow velocity focused from mitral valve channel and continuous linearly to left ventricle wall but this skewness progresses into outside wall in atrium through aortic valve with random distribution that is irregular due to force subtract from ventricle wall during cardiac cycle. The findings are the prediction of the behavior of the blood flow velocity pattern in steady flow condition which can assist the medical practitioners in their decision on the patients- treatments.

Keywords: Mitral Valve, Aortic Valve, Cardiac Cycle, Leaflet, Biomechanics, Left Ventricle

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6904 Overview of Operational Risk Management Methods

Authors: Milan Rippel, Pert Teplý

Abstract:

Operational risk has become one of the most discussed topics in the financial industry in the recent years. The reasons for this attention can be attributed to higher investments in information systems and technology, the increasing wave of mergers and acquisitions and emergence of new financial instruments. In addition, the New Basel Capital Accord (known as Basel II) demands a capital requirement for operational risk and further motivates financial institutions to more precisely measure and manage this type of risk. The aim of this paper is to shed light on main characteristics of operational risk management and common applied methods: scenario analysis, key risk indicators, risk control self assessment and loss distribution approach.

Keywords: Operational risk, economic capital, key risk indicators, loss distribution approach.

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6903 Methods for Data Selection in Medical Databases: The Binary Logistic Regression -Relations with the Calculated Risks

Authors: Cristina G. Dascalu, Elena Mihaela Carausu, Daniela Manuc

Abstract:

The medical studies often require different methods for parameters selection, as a second step of processing, after the database-s designing and filling with information. One common task is the selection of fields that act as risk factors using wellknown methods, in order to find the most relevant risk factors and to establish a possible hierarchy between them. Different methods are available in this purpose, one of the most known being the binary logistic regression. We will present the mathematical principles of this method and a practical example of using it in the analysis of the influence of 10 different psychiatric diagnostics over 4 different types of offences (in a database made from 289 psychiatric patients involved in different types of offences). Finally, we will make some observations about the relation between the risk factors hierarchy established through binary logistic regression and the individual risks, as well as the results of Chi-squared test. We will show that the hierarchy built using the binary logistic regression doesn-t agree with the direct order of risk factors, even if it was naturally to assume this hypothesis as being always true.

Keywords: Databases, risk factors, binary logisticregression, hierarchy.

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6902 Risk Assessment Results in Biogas Production from Agriculture Biomass

Authors: Sandija Zeverte-Rivza, Irina Pilvere, Baiba Rivza

Abstract:

The use of renewable energy sources incl. biogas has become topical in accordance with the increasing demand for energy, decrease of fossil energy resources and the efforts to reduce greenhouse gas emissions as well as to increase energy independence from the territories where fossil energy resources are available.

As the technologies of biogas production from agricultural biomass develop, risk assessment and risk management become necessary for farms producing such a renewable energy. The need for risk assessments has become particularly topical when discussions on changing the biogas policy in the EU take place, which may influence the development of the sector in the future, as well as the operation of existing biogas facilities and their income level.

The current article describes results of the risk assessment for farms producing biomass from agriculture biomass in Latvia, the risk assessment system included 24 risks, that affect the whole biogas production process and the obtained results showed the high significance of political and production risks.

Keywords: Biogas production, risks, risk assessment.

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6901 Risk Monitoring through Traceability Information Model

Authors: Juan P. Zamora, Wilson Adarme, Laura Palacios

Abstract:

This paper shows a traceability framework for supply risk monitoring, beginning with the identification, analysis, and evaluation of the supply chain risk and focusing on the supply operations of the Health Care Institutions with oncology services in Bogota, Colombia. It includes a brief presentation of the state of the art of the Supply Chain Risk Management and traceability systems in logistics operations, and it concludes with the methodology to integrate the SCRM model with the traceability system.

Keywords: Supply risk, risk monitoring, supply chain risk management, cancer drugs, traceability systems.

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6900 Financial Analysis Analogies for Software Risk

Authors: Masood Uzzafer

Abstract:

A dynamic software risk assessment model is presented. Analogies between dynamic financial analysis and software risk assessment models are established and based on these analogies it suggested that dynamic risk model for software projects is the way to move forward for the risk assessment of software project. It is shown how software risk assessment change during different phases of a software project and hence requires a dynamic risk assessment model to capture these variations. Further evolution of dynamic financial analysis models is discussed and mapped to the evolution of software risk assessment models.

Keywords: Software Risk Assessment, Software ProjectManagement, Software Cost, Dynamic Modeling.

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6899 The Diet Adherence in Cardiovascular Disease Risk Factors Patients in the North of Iran Based on the Mediterranean Diet Adherence

Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahboobeh Gholipour, Moona Naghshbandi

Abstract:

Background and objectives: Before any nutritional intervention, it is necessary to have the prospect of eating habits of people with cardiovascular risk factors. In this study, we assessed the adherence of healthy diet based on Mediterranean dietary pattern and related factors in adults in the north of Iran. Methods: This study was conducted on 550 men and women with cardiovascular risk factors that referred to Heshmat hospital in Rasht, northern Iran. Information was collected by interview and reading medical history and measuring anthropometric indexes. The Mediterranean Diet Adherence Screener was used for assessing dietary adherence, this screener was modified according to religious beliefs and culture of Iran. Results: The mean age of participants was 58±0.38 years. The mean of body mass index was 27±0.01 kg/m2, and the mean of waist circumference was 98±0.2 cm. The mean of dietary adherence was 5.76±0.07. 45% of participants had low adherence, and just 4% had suitable adherence. The mean of dietary adherence in men was significantly higher than women (p=0. 07). Participants in rural area and high educational participants insignificantly had an unsuitable dietary Adherence. There was no significant association between some cardiovascular disease risk factors and dietary adherence. Conclusion: Education to different group about dietary intake correction and using a Mediterranean dietary pattern that is similar to dietary intake in the north of Iran, for controlling cardiovascular disease is necessary.

Keywords: Dietary adherence, Mediterranean dietary pattern, cardiovascular disease, north of Iran.

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6898 The Prevalence of Transfusion-Transmitted Virus (TTV) Infection inIranian Patients with Chronic Hepatitis B

Authors: P. Ghasemi Dehkordi, A. Doosti, M. R. Hajimirzaei

Abstract:

TTV is an unenveloped circular single-stranded DNA virus with a diameter of 30-32 nm that first was described in 1997 in Japan. TTV was detected in various populations without proven pathology, including blood donors and in patients with chronic HBV and HCV hepatitis. The aim of this study was to determine the prevalence of TTV DNA in Iranian patients with chronic hepatitis B and C. Viral TTV-DNA was studied in 442 samples (202 with HBV, 138 with HCV and 102 controls) collected from west south of Iran. All extracted serum DNA was amplified by TTV ORF1 gene specific primers using the semi nested PCR technique. TTV DNA was detected in the serum of 8.9% and 10.8% patients with chronic hepatitis B and C, respectively. Prevalence of TTV-DNA in the serum of 102 controls was 2.9%. Results showed significant relation of TTV with HBV and HCV in patients by using T test examination (P<0.01). The prevalence of TTV-DNA in Iranian hepatitis B and C patients is rather high, and compare with other countries. To control and prevention of the distribution of TT-virus, examination of the blood and blood products it seems to be necessary.

Keywords: Transfusion-transmitted virus (TTV), Hepatitis Cvirus (HCV), Hepatitis B virus (HBV), ORF1 gene, Semi nested PCR, Iran.

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6897 Study of Reporting System for Adverse Events Related to Common Medical Devices at a Tertiary Care Public Sector Hospital in India

Authors: S. Kurien, S. Satpathy, S. K. Gupta, S. K. Arya, D. K. Sharma

Abstract:

Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: Adverse events, health care technology, public sector hospital, reporting systems.

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6896 Cardiac Function and Morphological Adaptations in Endurance and Resistance Athletes: Evaluation using a new Method

Authors: K. Hosseini, MD., R. Mazaheri, MD., H.R. Khoddami Vishteh, MD., M.A. Mansournia, MD., H. Angoorani, MD

Abstract:

Background: Tissue Doppler Echocardiography (TDE) assesses diastolic function more accurately than routine pulse Doppler echo. Assessment of the effects of dynamic and static exercises on the heart by using TDE can provides new information about the athlete-s heart syndrome. Methods: This study was conducted on 20 elite wrestlers, 14 endurance runners at national level and 21 non-athletes as the control group. Participants underwent two-dimensional echocardiography, standard Doppler and TDE. Results: Wrestlers had the highest left ventricular mass index, enddiastolic inter-ventricular septum thickness and left ventricular Posterior wall thickness. Runners had the highest Left ventricular end-diastolic volume, LV ejection fraction, stroke volume and cardiac output. In TDE, the early diastolic velocity of mitral annulus to the late diastolic velocity ratio in athletic groups was greater than the controls with no significant difference. Conclusion: In spite of cardiac morphological changes in athletes, TDE shows that cardiac diastolic function won-t be adversely affected.

Keywords: Tissue Doppler Echocardiography, Diastolic function, Athlete's heart syndrome, Static exercise, Dynamic exercise

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6895 Camel Thorn Has Hepatoprotective Activity against Carbon Tetrachloride or Acetaminophen Induced Hepatotoxicity, but Enhances the Cardiac Toxicity of Adriamycin in Rodents

Authors: A. G. Abdellatif, H. M.Gargoum, A. A. Debani, M. Bengleil, S. Alshalmani, N. El Zuki, O. El Fitouri

Abstract:

In this study the administration of 660 mg/kg of the ethanolic extract of the Alhagigraecorum (Camel Thorn)to mice, showed a significant decrease in the level of transaminases in animals treated with a combination of CTE plus carbon tetrachloride (CCl4) or acetaminophen as compared to animals receiving CCl4 or acetaminophen alone. Histopatological investigation also confirmed that, camel thorn extract protects liver against damage-induced either by carbon tetrachloride or acetaminophen. On the other hand the cardiac toxicity produced by adriamycine was significantly increased in the presence of the ethanolic extract of camel thorn. Our study suggested that camel thorn can protect the liver against the injury produced by carbon tetrachloride or acetaminophen, with unexpected increase in the cardiac toxicity –induced by adriamycin in rodents.

Keywords: Acetaminophen, Adriamycin, Alhagi graecorum, Carbon tetrachloride.

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6894 Effects of Bay Leaves on Blood Glucose and Lipid Profiles on the Patients with Type 1 Diabetes

Authors: Abdulrahim Aljamal

Abstract:

Bay leaves have been shown to improve insulin function in vitro but the effects on people have not been determined. The objective of this study was to determine if bay leaves may be important in the prevention and/or alleviation of type 1 diabetes. Methods: Fifty five people with type 1 diabetes were divided into two groups, 45 given capsules containing 3 g of bay leaves per day for 30 days and 10 given a placebo capsules. Results All the patients consumed bay leaves shows reduced serum glucose with significant decreases 27% after 30 d. Total cholesterol decreased, 21 %, after 30 days with larger decreases in low density lipoprotein (LDL) 24%. High density lipoprotein (HDL) increased 20% and Triglycerides also decreased 26%. There were no significant changes in the placebo group. Conclusion, this study demonstrates that consumption of bay leaves, 3 g/d for 30 days, decreases risk factors for diabetes and cardiovascular diseases and suggests that bay leaves may be beneficial for people with type 1 diabetes.

Keywords: bay leave, cholesterol, diabetes, triglycerides

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6893 A Decision Support System for Predicting Hospitalization of Hemodialysis Patients

Authors: Jinn-Yi Yeh, Tai-Hsi Wu

Abstract:

Hemodialysis patients might suffer from unhealthy care behaviors or long-term dialysis treatments. Ultimately they need to be hospitalized. If the hospitalization rate of a hemodialysis center is high, its quality of service would be low. Therefore, how to decrease hospitalization rate is a crucial problem for health care. In this study we combined temporal abstraction with data mining techniques for analyzing the dialysis patients' biochemical data to develop a decision support system. The mined temporal patterns are helpful for clinicians to predict hospitalization of hemodialysis patients and to suggest them some treatments immediately to avoid hospitalization.

Keywords: Hemodialysis, Temporal abstract, Data mining, Healthcare quality.

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6892 A Deep-Learning Based Prediction of Pancreatic Adenocarcinoma with Electronic Health Records from the State of Maine

Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

Abstract:

Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: Cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma.

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6891 Role of Oxidative DNA Damage in Pathogenesis of Diabetic Neuropathy

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

Abstract:

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

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

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6890 Surveying Earthquake Vulnerabilities of District 13 of Kabul City, Afghanistan

Authors: Mohsen Mohammadi, Toshio Fujimi

Abstract:

High population and irregular urban development in Kabul city, Afghanistan's capital, are among factors that increase its vulnerability to earthquake disasters (on top of its location in a high seismic region); this can lead to widespread economic loss and casualties. This study aims to evaluate earthquake risks in Kabul's 13th district based on scientific data. The research data, which include hazard curves of Kabul, vulnerability curves, and a questionnaire survey through sampling in district 13, have been incorporated to develop risk curves. To estimate potential casualties, we used a set of M parameters in a model developed by Coburn and Spence. The results indicate that in the worst case scenario, more than 90% of district 13, which comprises mostly residential buildings, is exposed to high risk; this may lead to nearly 1000 million USD economic loss and 120 thousand casualties (equal to 25.88% of the 13th district's population) for a nighttime earthquake. To reduce risks, we present the reconstruction of the most vulnerable buildings, which are primarily adobe and masonry buildings. A comparison of risk reduction between reconstructing adobe and masonry buildings indicates that rebuilding adobe buildings would be more effective.

Keywords: Earthquake risk evaluation, Kabul, mitigation, vulnerability.

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6889 Quantitative Indicator of Abdominal Aortic Aneurysm Rupture Risk Based on its Geometric Parameters

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

Abstract:

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

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

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6888 Cardiac Disorder Classification Based On Extreme Learning Machine

Authors: Chul Kwak, Oh-Wook Kwon

Abstract:

In this paper, an extreme learning machine with an automatic segmentation algorithm is applied to heart disorder classification by heart sound signals. From continuous heart sound signals, the starting points of the first (S1) and the second heart pulses (S2) are extracted and corrected by utilizing an inter-pulse histogram. From the corrected pulse positions, a single period of heart sound signals is extracted and converted to a feature vector including the mel-scaled filter bank energy coefficients and the envelope coefficients of uniform-sized sub-segments. An extreme learning machine is used to classify the feature vector. In our cardiac disorder classification and detection experiments with 9 cardiac disorder categories, the proposed method shows significantly better performance than multi-layer perceptron, support vector machine, and hidden Markov model; it achieves the classification accuracy of 81.6% and the detection accuracy of 96.9%.

Keywords: Heart sound classification, extreme learning machine

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6887 Operating Model of Obstructive Sleep Apnea Patients in North Karelia Central Hospital

Authors: L. Korpinen, T. Kava, I. Salmi

Abstract:

This study aimed to describe the operating model of obstructive sleep apnea. Due to the large number of patients, the role of nurses in the diagnosis and treatment of sleep apnea was important. Pulmonary physicians met only a minority of the patients. The sleep apnea study in 2018 included about 800 patients, of which about 28% were normal and 180 patients were classified as severe (apnea-hypopnea index [AHI] over 30). The operating model has proven to be workable and appropriate. The patients understand well that they may not be referred to a pulmonary doctor. However, specialized medical follow-up on professional drivers continues every year.

Keywords: Sleep, apnea patient, operating model, hospital.

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6886 Toward a Risk Assessment Model Based On Multi-Agent System for Cloud Consumer

Authors: Saadia Drissi, Siham Benhadou, Hicham Medromi

Abstract:

The cloud computing is an innovative paradigm that introduces several changes in technology that have resulted a new ways for cloud providers to deliver their services to cloud consumers mainly in term of security risk assessment, thus, adapting a current risk assessment tools to cloud computing is a very difficult task due to its several characteristics that challenge the effectiveness of risk assessment approaches. As consequence, there is a need of risk assessment model adapted to cloud computing. This paper requires a new risk assessment model based on multi-agent system and AHP model as fundamental steps towards the development of flexible risk assessment approach regarding cloud consumers.

Keywords: Cloud computing, risk assessment model, multi-agent system, AHP model, cloud consumer.

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