Search results for: patient dosimetry
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 375

Search results for: patient dosimetry

165 The Effect of Press Fit on Osseointegration of Acetabular Cup

Authors: Nor Azali Azmir, Iskhrizat Taib, Mohammed Rafiq Abdul Kadir

Abstract:

The primary cause of Total Hip Replacement (THR) failure for younger patients is aseptic loosening. This complication is twice more likely to happen in acetabular cup than in femoral stem. Excessive micromotion between bone and implant will cause loosening and it depends in patient activities, age and bone. In this project, the effects of different metal back design of press fit on osseointegration of the acetabular cup are carried out. Commercial acetabular cup designs, namely Spiked, Superfix and Quadrafix are modelled and analyzed using commercial finite element software. The diameter of acetabular cup is based on the diameter of acetabular rim to make sure the component fit to the acetabular cavity. A new design of acetabular cup are proposed and analyzed to get better osseointegration between the bones and implant interface. Results shows that the proposed acetabular cup designs are more stable compared to other designs with respect to stress and displacement aspects.

Keywords: Finite element analysis, total hip replacement, acetabular cup, loosening.

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164 Telehealth Ecosystem: Challenge and Opportunity

Authors: R. Poonsuph

Abstract:

Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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163 Analytics Model in a Telehealth Center Based on Cloud Computing and Local Storage

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

Abstract:

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

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

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162 EPR Hiding in Medical Images for Telemedicine

Authors: K. A. Navas, S. Archana Thampy, M. Sasikumar

Abstract:

Medical image data hiding has strict constrains such as high imperceptibility, high capacity and high robustness. Achieving these three requirements simultaneously is highly cumbersome. Some works have been reported in the literature on data hiding, watermarking and stegnography which are suitable for telemedicine applications. None is reliable in all aspects. Electronic Patient Report (EPR) data hiding for telemedicine demand it blind and reversible. This paper proposes a novel approach to blind reversible data hiding based on integer wavelet transform. Experimental results shows that this scheme outperforms the prior arts in terms of zero BER (Bit Error Rate), higher PSNR (Peak Signal to Noise Ratio), and large EPR data embedding capacity with WPSNR (Weighted Peak Signal to Noise Ratio) around 53 dB, compared with the existing reversible data hiding schemes.

Keywords: Biomedical imaging, Data security, Datacommunication, Teleconferencing.

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161 Fractal Analysis on Human Colonic Pressure Activities based on the Box-counting Method

Authors: Rongguo Yan, Guozheng Yan, Banghua Yang

Abstract:

The colonic tissue is a complicated dynamic system and the colonic activities it generates are composed of irregular segmental waves, which are referred to as erratic fluctuations or spikes. They are also highly irregular with subunit fractal structure. The traditional time-frequency domain statistics like the averaged amplitude, the motility index and the power spectrum, etc. are insufficient to describe such fluctuations. Thus the fractal box-counting dimension is proposed and the fractal scaling behaviors of the human colonic pressure activities under the physiological conditions are studied. It is shown that the dimension of the resting activity is smaller than that of the normal one, whereas the clipped version, which corresponds to the activity of the constipation patient, shows with higher fractal dimension. It may indicate a practical application to assess the colonic motility, which is often indicated by the colonic pressure activity.

Keywords: Colonic pressure activity, erratic fluctuations, fractal dimension and spikes.

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160 Cardiovascular Modeling Software Tools in Medicine

Authors: J. Fernandez, R. Fernandez de Canete, J. Perea-Paizal, J. C. Ramos-Diaz

Abstract:

The high prevalence of cardiovascular diseases has provoked a raising interest in the development of mathematical models in order to evaluate the cardiovascular function both under physiological and pathological conditions. In this paper, a physical model of the cardiovascular system with intrinsic regulation is presented and implemented by using the object-oriented Modelica simulation software tools.  For this task, a multi-compartmental system previously validated with physiological data has been built, based on the interconnection of cardiovascular elements such as resistances, capacitances and pumping among others, by following an electrohydraulic analogy. The results obtained under both physiological and pathological scenarios provide an easy interpretative key to analyze the hemodynamic behavior of the patient. The described approach represents a valuable tool in the teaching of physiology for graduate medical and nursing students among others.

Keywords: Cardiovascular system, Modelica simulation software, physical modeling, teaching tool.

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159 Development of Position Changing System for Obstructive Sleep Apnea Patient using HRV

Authors: Soo- Young Ye, Dong-Hyun Kim

Abstract:

Obstructive sleep apnea in patients, between 70 and 80 percent, can be cured with just a posture correcting. The most import thing to do this is detection of obstructive sleep apnea. Detection of obstructive sleep apnea can be performed through heart rate variability analysis using power spectrum density analysis. After HRV analysis we needed to know the current position information for correcting the position. The pressure sensors of the array type were used to obtain position information. These sensors can obtain information from the experimenter about position. In addition, air cylinder corrected the position of the experimenter by lifting the bed. The experimenter can be changed position without breaking during sleep by the system. Polysomnograph recording were obtained from 10 patients. The results of HRV analysis were that NLF and LF/HF ratio increased, while NHF decreased during OSA. Position change had to be done the periods.

Keywords: Obstructive sleep apnea, Heart rate variability, Air cylinder, PSD, RR interval, ANS

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158 Design and Development of a 3D Printed Myoelectric-Controlled Prosthesis Hand Using sEMG Sensor

Authors: Sher Shermin Azmiri Khan, Syeda Jannatul Ferdous, Sushmita Chakraborty

Abstract:

Over the last decades, biomedical engineering prosthetics become one of the most essential grounds. Prosthetic hands are rapidly evolving. Therefore, for designing prosthetic components, it is essential to improve quality such as make it affordable and improve patient comfort and mobility by making them lightweight and easy to wear. In this paper, we proposed a myoelectric controlled prosthesis hand. We can fabricate and manufacture customized cost-effective, small volumes of 3D printed hand which is interesting. The total weight of an adult hand is about 1000 gm including a battery. The prosthetic hand is built up with low-cost materials and techniques, the cost of manufacturing will be approximately US$145. The hand can grip objects of different shapes and sizes. The 3D printed hand can rotate its wrist like a human hand. The prosthetic hand is capable of showing some types of human gestures.

Keywords: Prosthetic Hand, sEMG, 3D printing, Arduino.

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157 Scattering Operator and Spectral Clustering for Ultrasound Images: Application on Deep Venous Thrombi

Authors: Thibaud Berthomier, Ali Mansour, Luc Bressollette, Frédéric Le Roy, Dominique Mottier, Léo Fréchier, Barthélémy Hermenault

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Deep Venous Thrombosis (DVT) occurs when a thrombus is formed within a deep vein (most often in the legs). This disease can be deadly if a part or the whole thrombus reaches the lung and causes a Pulmonary Embolism (PE). This disorder, often asymptomatic, has multifactorial causes: immobilization, surgery, pregnancy, age, cancers, and genetic variations. Our project aims to relate the thrombus epidemiology (origins, patient predispositions, PE) to its structure using ultrasound images. Ultrasonography and elastography were collected using Toshiba Aplio 500 at Brest Hospital. This manuscript compares two classification approaches: spectral clustering and scattering operator. The former is based on the graph and matrix theories while the latter cascades wavelet convolutions with nonlinear modulus and averaging operators.

Keywords: Deep venous thrombosis, ultrasonography, elastography, scattering operator, wavelet, spectral clustering.

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156 Foot Recognition Using Deep Learning for Knee Rehabilitation

Authors: Rakkrit Duangsoithong, Jermphiphut Jaruenpunyasak, Alba Garcia

Abstract:

The use of foot recognition can be applied in many medical fields such as the gait pattern analysis and the knee exercises of patients in rehabilitation. Generally, a camera-based foot recognition system is intended to capture a patient image in a controlled room and background to recognize the foot in the limited views. However, this system can be inconvenient to monitor the knee exercises at home. In order to overcome these problems, this paper proposes to use the deep learning method using Convolutional Neural Networks (CNNs) for foot recognition. The results are compared with the traditional classification method using LBP and HOG features with kNN and SVM classifiers. According to the results, deep learning method provides better accuracy but with higher complexity to recognize the foot images from online databases than the traditional classification method.

Keywords: Convolutional neural networks, deep learning, foot recognition, knee rehabilitation.

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155 Machine Learning for Aiding Meningitis Diagnosis in Pediatric Patients

Authors: Karina Zaccari, Ernesto Cordeiro Marujo

Abstract:

This paper presents a Machine Learning (ML) approach to support Meningitis diagnosis in patients at a children’s hospital in Sao Paulo, Brazil. The aim is to use ML techniques to reduce the use of invasive procedures, such as cerebrospinal fluid (CSF) collection, as much as possible. In this study, we focus on predicting the probability of Meningitis given the results of a blood and urine laboratory tests, together with the analysis of pain or other complaints from the patient. We tested a number of different ML algorithms, including: Adaptative Boosting (AdaBoost), Decision Tree, Gradient Boosting, K-Nearest Neighbors (KNN), Logistic Regression, Random Forest and Support Vector Machines (SVM). Decision Tree algorithm performed best, with 94.56% and 96.18% accuracy for training and testing data, respectively. These results represent a significant aid to doctors in diagnosing Meningitis as early as possible and in preventing expensive and painful procedures on some children.

Keywords: Machine learning, medical diagnosis, meningitis detection, gradient boosting.

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154 Preserved Relative Differences between Regions of Different Thermal Scans

Authors: Tahir Majeed, Michael Handschuh, René Meier

Abstract:

Rheumatoid Arthritis patients have swelling and pain in joints of the hand. The regions where the patient feels pain also show increased body temperature. Thermal cameras can be used to detect the rise in temperature of the affected regions. To monitor the progression of Rheumatoid Arthritis, patients must visit the clinic regularly for scanning and examination. After scanning and evaluation, the dosage of the medicine is regulated accordingly. To monitor the disease progression over time, the correlation of the images between different visits must be established. It has been observed that the thermal measurements do not remain the same over time, even within a single scanning, when low-cost thermal cameras are used. In some situations, temperatures can vary as much as 2◦C within the same scanning sequence. In this paper, it has been shown that although the absolute temperature varies over time, the relative difference between different regions remains similar. Results have been computed over four scanning sequences and are presented.

Keywords: Relative thermal difference, rheumatoid arthritis, thermal imaging, thermal sensors.

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153 Rationality and Evidence of Pre-Prepared Treatment Plan in Oesophageal HDR Brachytherapy

Authors: Jim Meng, Mammo Yewondwossen

Abstract:

As a part of routine oesophageal HDR Brachytherapy procedure, treatment planning takes about 45 minutes while patients are under light sedation. Some patients may suffer gagging and/or spasms before the 90-minute brachytherapy procedure complete, and the treatment may need to be aborted. A pre-prepared plan generated before patient’s sedation may reduce the brachytherapy procedure time by 40 minutes. This paper reports rationality and evidence of pre-prepared treatment plans. A retrospective study of 28 patients confirms that pre-prepared plans would be acceptable for all reviewed patients. The rationality is further confirmed by a systemic study with a wide range of applicator curvature and treatment volume. Detailed comparison between CT based treatment plans and pre-prepared plans are discussed. The argument holds for endobronchial HDR brachytherapy too. With the above evidence, pre-prepared plans have been used for all oesophageal and endobronchial HDR brachytherapy cases in our clinic.

Keywords: HDR brachytherapy, treatment planning, oesophageal carcinoma.

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152 Active Imagination: The Effective Factor in the Practice of Psychotherapy

Authors: Sonia Regina Lyra

Abstract:

The desire for unequivocal clarity is understandable, but this can make one forget that things of the soul are experiential processes, or transformations, which should never be designated unilaterally if it is not wanted to transform something that moves, a living thing, into something static. Among the so-called ‘things of the soul’ there are especially spontaneous fantasies, that emerge during the processes, as a result from the use of the active imagination technique, for when fantasy is not forced, violated, or subjugated by an illegitimate, intellectually preconceived idea, then it is a legitimate and authentic product of the unconscious mind. This is how one can gain access to unadulterated information about everything that transcends the conscious mind. However, it is vital to discern between ego and non-ego, because this principle will result in a release of energy and a renewal of life, which will come to have meaning. This study will deal with the active imagination as a knowledge that depends on the individual experience of the therapist because the patient will be taken just to reach where the unconscious of the therapist was assimilated to his own conscience. In this way, the therapist becomes the method itself, being his personality, a fundamental part of an effective factor.

Keywords: Active imagination, effective factor, symptom, transformation.

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151 Evaluation of the Role of Advocacy and the Quality of Care in Reducing Health Inequalities for People with Autism, Intellectual and Developmental Disabilities at Sheffield Teaching Hospitals

Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: Autism, intellectual developmental disabilities, advocacy, health inequalities, quality of care.

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150 Observations about the Principal Components Analysis and Data Clustering Techniques in the Study of Medical Data

Authors: Cristina G. Dascâlu, Corina Dima Cozma, Elena Carmen Cotrutz

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The medical data statistical analysis often requires the using of some special techniques, because of the particularities of these data. The principal components analysis and the data clustering are two statistical methods for data mining very useful in the medical field, the first one as a method to decrease the number of studied parameters, and the second one as a method to analyze the connections between diagnosis and the data about the patient-s condition. In this paper we investigate the implications obtained from a specific data analysis technique: the data clustering preceded by a selection of the most relevant parameters, made using the principal components analysis. Our assumption was that, using the principal components analysis before data clustering - in order to select and to classify only the most relevant parameters – the accuracy of clustering is improved, but the practical results showed the opposite fact: the clustering accuracy decreases, with a percentage approximately equal with the percentage of information loss reported by the principal components analysis.

Keywords: Data clustering, medical data, principal components analysis.

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149 Association of Overweight and Obesity with Breast Cancer

Authors: Amir Ghasemlouei, Alireza Khalaj

Abstract:

Breast cancer is in the top rate of cancer. We analyzed the prevalence of obesity and its association with breast cancer and finally we reviewed 25 article that 320 patient and 320 control which enrolled to our study. The distribution of breast cancer patients and controls with respect to their anthropometric indices in patients with higher weight, which was statistically significant (60.2 ± 10.2 kg) compared with control group (56.1 ± 11.3 kg). The body mass index of patients was (26.06+/-3.42) and significantly higher than the control group (24.1+/-1.7). Obesity leads to increased levels of adipose tissue in the body that can be stored toxins and carcinogens to produce a continuous supply. Due to the high level of fat and the role of estrogen in a woman which is endogenous estrogen of the tumor and regulates the activities of growth steroids, obesity has confirmed as a risk factor for breast cancer. Our study and other studies have shown that obesity is a risk factor for breast cancer. And it can be prevented with a weight loss intervention for breast cancer in the future.

Keywords: Breast cancer, review study, obesity, overweight.

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148 A Neural Network Approach in Predicting the Blood Glucose Level for Diabetic Patients

Authors: Zarita Zainuddin, Ong Pauline, C. Ardil

Abstract:

Diabetes Mellitus is a chronic metabolic disorder, where the improper management of the blood glucose level in the diabetic patients will lead to the risk of heart attack, kidney disease and renal failure. This paper attempts to enhance the diagnostic accuracy of the advancing blood glucose levels of the diabetic patients, by combining principal component analysis and wavelet neural network. The proposed system makes separate blood glucose prediction in the morning, afternoon, evening and night intervals, using dataset from one patient covering a period of 77 days. Comparisons of the diagnostic accuracy with other neural network models, which use the same dataset are made. The comparison results showed overall improved accuracy, which indicates the effectiveness of this proposed system.

Keywords: Diabetes Mellitus, principal component analysis, time-series, wavelet neural network.

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147 Concepts Extraction from Discharge Notes using Association Rule Mining

Authors: Basak Oguz Yolcular

Abstract:

A large amount of valuable information is available in plain text clinical reports. New techniques and technologies are applied to extract information from these reports. In this study, we developed a domain based software system to transform 600 Otorhinolaryngology discharge notes to a structured form for extracting clinical data from the discharge notes. In order to decrease the system process time discharge notes were transformed into a data table after preprocessing. Several word lists were constituted to identify common section in the discharge notes, including patient history, age, problems, and diagnosis etc. N-gram method was used for discovering terms co-Occurrences within each section. Using this method a dataset of concept candidates has been generated for the validation step, and then Predictive Apriori algorithm for Association Rule Mining (ARM) was applied to validate candidate concepts.

Keywords: association rule mining, otorhinolaryngology, predictive apriori, text mining

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146 Orthosis and Finite Elements: A Study for Development of New Designs through Additive Manufacturing

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

Abstract:

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

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

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145 Blood Elements Activation in Hemodialysis – Animal Model Studies

Authors: Karolina Grzeszczuk-Kuć, Jolanta Bujok, Tomasz Walski, Małgorzata Komorowska

Abstract:

Haemodialysis (HD) is a procedure saving patient lives around the world, unfortunately it brings numerous complications. Oxidative stress is one of the major factors which lead to erythrocytes destruction during extracorporeal circulation. Repeated HD procedures destroy blood elements and the organism is not able to keep up with their production. 30 HD procedures on healthy sheep were performed to evaluate effects of such treatment. Oxidative stress study was performed together with an analysis of basic blood parameters and empirical assessment of dialyzer condition after the procedure. A reversible decline in absolute leukocyte count, during first 30 min of HD, was observed. Blood clots were formed in the area of the blood inlet and outlet of the dialyzer. Our results are consistent with outcomes presented throughout the literature specifically with respect to the effects observed in humans and will provide a basis to evaluate methods for blood protection during haemodialysis.

Keywords: Animal model, blood components, haemodialysis, leukocytes, oxidative stress, sheep.

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144 Localisation of Anatomical Soft Tissue Landmarks of the Head in CT Images

Authors: M. Ovinis, D. Kerr, K. Bouazza-Marouf, M. Vloeberghs

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In this paper, algorithms for the automatic localisation of two anatomical soft tissue landmarks of the head the medial canthus (inner corner of the eye) and the tragus (a small, pointed, cartilaginous flap of the ear), in CT images are describet. These landmarks are to be used as a basis for an automated image-to-patient registration system we are developing. The landmarks are localised on a surface model extracted from CT images, based on surface curvature and a rule based system that incorporates prior knowledge of the landmark characteristics. The approach was tested on a dataset of near isotropic CT images of 95 patients. The position of the automatically localised landmarks was compared to the position of the manually localised landmarks. The average difference was 1.5 mm and 0.8 mm for the medial canthus and tragus, with a maximum difference of 4.5 mm and 2.6 mm respectively.The medial canthus and tragus can be automatically localised in CT images, with performance comparable to manual localisation

Keywords: Anatomical soft tissue landmarks, automatic localisation, Computed Tomography (CT)

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143 Low-Cost Robotic-Assisted Laparoscope

Authors: Ege Can Onal, Enver Ersen, Meltem Elitas

Abstract:

Laparoscopy is a surgical operation, well known as keyhole surgery. The operation is performed through small holes, hence, scars of a patient become much smaller, patients can recover in a short time and the hospital stay becomes shorter in comparison to an open surgery. Several tools are used at laparoscopic operations; among them, the laparoscope has a crucial role. It provides the vision during the operation, which will be the main focus in here. Since the operation area is very small, motion of the surgical tools might be limited in laparoscopic operations compared to traditional surgeries. To overcome this limitation, most of the laparoscopic tools have become more precise, dexterous, multi-functional or automated. Here, we present a robotic-assisted laparoscope that is controlled with pedals directly by a surgeon. Thus, the movement of the laparoscope might be controlled better, so there will not be a need to calibrate the camera during the operation. The need for an assistant that controls the movement of the laparoscope will be eliminated. The duration of the laparoscopic operation might be shorter since the surgeon will directly operate the camera.

Keywords: Laparoscope, laparoscopy, low-cost, minimally invasive surgery, robotic-assisted surgery.

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142 Application of Intuitionistic Fuzzy Cross Entropy Measure in Decision Making for Medical Diagnosis

Authors: Shikha Maheshwari, Amit Srivastava

Abstract:

In medical investigations, uncertainty is a major challenging problem in making decision for doctors/experts to identify the diseases with a common set of symptoms and also has been extensively increasing in medical diagnosis problems. The theory of cross entropy for intuitionistic fuzzy sets (IFS) is an effective approach in coping uncertainty in decision making for medical diagnosis problem. The main focus of this paper is to propose a new intuitionistic fuzzy cross entropy measure (IFCEM), which aid in reducing the uncertainty and doctors/experts will take their decision easily in context of patient’s disease. It is shown that the proposed measure has some elegant properties, which demonstrates its potency. Further, it is also exemplified in detail the efficiency and utility of the proposed measure by using a real life case study of diagnosis the disease in medical science.

Keywords: Intuitionistic fuzzy cross entropy (IFCEM), intuitionistic fuzzy set (IFS), medical diagnosis, uncertainty.

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141 Brain Drain of Doctors; Causes and Consequences in Pakistan

Authors: Muhammad Wajid Tahir, Rubina Kauser, Majid Ali Tahir

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Pakistani doctors (MBBS) are emigrating towards developed countries for professional adjustments. This study aims to highlight causes and consequences of doctors- brain drain from Pakistan. Primary data was collected from Mayo Hospital, Lahore by interviewing doctors (n=100) through systematic random sampling technique. It found that various socio-economic and political conditions are working as push and pull factors for brain drain of doctors in Pakistan. Majority of doctors (83%) declared poor remunerations and professional infrastructure of health department as push factor of doctors- brain drain. 81% claimed that continuous instability in political situation and threats of terrorism are responsible for emigration of doctors. 84% respondents considered fewer opportunities of further studies responsible for their emigration. Brain drain of doctors is affecting health sector-s policies / programs, standard doctor-patient ratios and quality of health services badly.

Keywords: Brain Drain, Emigration, Remuneration, Politicalinstability, MBBS doctors

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140 Comparison between Associative Classification and Decision Tree for HCV Treatment Response Prediction

Authors: Enas M. F. El Houby, Marwa S. Hassan

Abstract:

Combined therapy using Interferon and Ribavirin is the standard treatment in patients with chronic hepatitis C. However, the number of responders to this treatment is low, whereas its cost and side effects are high. Therefore, there is a clear need to predict patient’s response to the treatment based on clinical information to protect the patients from the bad drawbacks, Intolerable side effects and waste of money. Different machine learning techniques have been developed to fulfill this purpose. From these techniques are Associative Classification (AC) and Decision Tree (DT). The aim of this research is to compare the performance of these two techniques in the prediction of virological response to the standard treatment of HCV from clinical information. 200 patients treated with Interferon and Ribavirin; were analyzed using AC and DT. 150 cases had been used to train the classifiers and 50 cases had been used to test the classifiers. The experiment results showed that the two techniques had given acceptable results however the best accuracy for the AC reached 92% whereas for DT reached 80%.

Keywords: Associative Classification, Data mining, Decision tree, HCV, interferon.

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139 Automatic Classification of the Stand-to-Sit Phase in the TUG Test Using Machine Learning

Authors: Y. A. Adla, R. Soubra, M. Kasab, M. O. Diab, A. Chkeir

Abstract:

Over the past several years, researchers have shown a great interest in assessing the mobility of elderly people to measure their functional status. Usually, such an assessment is done by conducting tests that require the subject to walk a certain distance, turn around, and finally sit back down. Consequently, this study aims to provide an at home monitoring system to assess the patient’s status continuously. Thus, we proposed a technique to automatically detect when a subject sits down while walking at home. In this study, we utilized a Doppler radar system to capture the motion of the subjects. More than 20 features were extracted from the radar signals out of which 11 were chosen based on their Intraclass Correlation Coefficient (ICC > 0.75). Accordingly, the sequential floating forward selection wrapper was applied to further narrow down the final feature vector. Finally, five features were introduced to the Linear Discriminant Analysis classifier and an accuracy of 93.75% was achieved as well as a precision and recall of 95% and 90% respectively.

Keywords: Doppler radar system, stand-to-sit phase, TUG test, machine learning, classification

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138 Pulse Oximeter Concept for Vascular Occlusion Test

Authors: Fatanah M. Suhaimi, J. Geoffrey Chase, Christopher G. Pretty, Rodney Elliott, Geoffrey M. Shaw

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Microcirculatory dysfunction is very common in sepsis and may results in organ failure and increased risk of death. Analyzing oxygen utilization can potentially assess microcirculation function of an individual. In this study, a modified pulse oximeter is used to extract information signals due to absorption of red (R) and infrared (IR) light. IR and R signal are related to the overall blood volume and reduced hemoglobin, respectively. Differences between these two signals thus represent the amount of oxygenated hemoglobin. Avascular occlusion test has been conducted on healthy individuals to validate the pulse oximeter concept. In this test, both R and IR signals rapidly changed according to the occlusion process. The pulse oximeter concept presented is capable of extracting valuable information to assess microcirculation condition. Implementing this concept on ICU patients has the potential to aid sepsis diagnosis and provide more accurate tracking of patient state and sepsis status.

Keywords: Microcirculation, sepsis, sepsis diagnosis, oxygen extraction.

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137 Inflammatory Markers in the Blood and Chronic Periodontitis

Authors: Saimir Heta, Ilma Robo, Nevila Alliu, Tea Meta

Abstract:

Background: Plasma levels of inflammatory markers are the expression of the infectious wastes of existing periodontitis, as well as of existing inflammation everywhere in the body. Materials and Methods: The study consists of the clinical part of the measurement of inflammatory markers of 23 patients diagnosed with chronic periodontitis and the recording of parental periodontal parameters of patient periodontal status: hemorrhage index and probe values, before and 7-10 days after non-surgical periodontal treatment. Results: The level of fibrinogen drops according to the categorization of disease progression, active and passive, with the biggest % (18%-30%) at the fluctuation 10-20 mg/d. Fluctuations in fibrinogen level according to the age of patients in the range 0-10 mg/dL under 40 years and over 40 years was 13%-26%, in the range 10-20 mg/dL was 26%-22%, in the 20-40 mg/dL was 9%-4%. Conclusions: Non-surgical periodontal treatment significantly reduces the level of non-inflammatory markers in the blood. Oral health significantly reduces the potential source for periodontal bacteria, with the potential of promoting thromboembolism, through interaction between thrombocytes.

Keywords: Chronic periodontitis, atherosclerosis, risk factor, inflammatory markers.

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136 Segmenting Ultrasound B-Mode Images Using RiIG Distributions and Stochastic Optimization

Authors: N. Mpofu, M. Sears

Abstract:

In this paper, we propose a novel algorithm for delineating the endocardial wall from a human heart ultrasound scan. We assume that the gray levels in the ultrasound images are independent and identically distributed random variables with different Rician Inverse Gaussian (RiIG) distributions. Both synthetic and real clinical data will be used for testing the algorithm. Algorithm performance will be evaluated using the expert radiologist evaluation of a soft copy of an ultrasound scan during the scanning process and secondly, doctor’s conclusion after going through a printed copy of the same scan. Successful implementation of this algorithm should make it possible to differentiate normal from abnormal soft tissue and help disease identification, what stage the disease is in and how best to treat the patient. We hope that an automated system that uses this algorithm will be useful in public hospitals especially in Third World countries where problems such as shortage of skilled radiologists and shortage of ultrasound machines are common. These public hospitals are usually the first and last stop for most patients in these countries.

Keywords: Endorcardial Wall, Rician Inverse Distributions, Segmentation, Ultrasound Images.

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