Search results for: patients with chronic disease

Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires were returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age ranges from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge; however, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non- significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: Gene Profiling, Knowledge, Malaysia, Physician.

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Authors: G. Tamilpavai, C. Vishnuppriya

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Studying DNA (deoxyribonucleic acid) sequence is useful in biological processes and it is applied in the fields such as diagnostic and forensic research. DNA is the hereditary information in human and almost all other organisms. It is passed to their generations. Earlier stage detection of defective DNA sequence may lead to many developments in the field of Bioinformatics. Nowadays various tedious techniques are used to identify defective DNA. The proposed work is to analyze and identify the cancer-causing DNA motif in a given sequence. Initially the human DNA sequence is separated as k-mers using k-mer separation rule. The separated k-mers are clustered using Self Organizing Map (SOM). Using Levenshtein distance measure, cancer associated DNA motif is identified from the k-mer clusters. Experimental results of this work indicate the presence or absence of cancer causing DNA motif. If the cancer associated DNA motif is found in DNA, it is declared as the cancer disease causing DNA sequence. Otherwise the input human DNA is declared as normal sequence. Finally, elapsed time is calculated for finding the presence of cancer causing DNA motif using clustering formation. It is compared with normal process of finding cancer causing DNA motif. Locating cancer associated motif is easier in cluster formation process than the other one. The proposed work will be an initiative aid for finding genetic disease related research.

Keywords: Bioinformatics, cancer motif, DNA, k-mers, Levenshtein distance, SOM.

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Authors: M. Umar Farooq, T. Ahmad Afridi, M. Zia-Ul-Islam Arsalan, U. Hussain Haider, S. Ullah

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Cancer, a leading fatal disease worldwide, can be treated with various techniques including radiation therapy. It involves the use of ionizing radiation to target cancer cells. On basis of source placement, radiation therapy is of two types i.e., Brachytherapy and External Beam Radiotherapy (EBRT). EBRT has evolved from 2-D conventional therapy to 3-D Conformal radiotherapy (3D-CRT) and then Intensity-Modulated Radiotherapy (IMRT). IMRT improves dose conformity and sparing of organs at risk. Volumetric Modulated Arc Therapy (VMAT) is a modern technique that uses treatment delivery in arcs with rotation of the gantry. In this report, a dosimetry comparison was performed between IMRT and VMAT. This study was conducted in the Radiotherapy Department of the Institute of Nuclear Medicine and Oncology Lahore (INMOL). Ten patients with Prostate Carcinoma were selected for this study to compare the methods. Simulation of these patients was done with help of a CT Simulator. All target volumes and organs were delineated by the oncologists. Then suitable fields/arcs were applied which cover volumes effectively. This was followed by the optimization of plans for both techniques for every patient. Finally, a comparison of evaluating parameters e.g., Conformity Index (CI), Volume Coverage, Homogeneity Index (HI), Organ Doses, and MUs (Monitor Units) was performed. We obtained better results of target conformity indices from VMAT (CI = 1.16) than IMRT (CI = 1.24). VMAT was better in organ sparing too. Also, VMAT shows fewer MUs (733 MUs) as compared to IMRT (2149 MUs). From this study, it is concluded that VMAT is a better treatment technique than IMRT. This technique will enhance treatment efficiency as it takes less time in obtaining the required results. Also, a very less scatter dose will be delivered to the patient.

Keywords: 2-D Conventional Radiotherapy, 3-D Conformal Radiotherapy, Intensity Modulated Radiotherapy, Prostate Carcinoma, Radiotherapy, Volumetric Modulated Arc Therapy.

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Authors: Petr V. Vasilev, Eduard V. Volkov, Alexej N. Godok, Alexej A, Grischschuk, Vitalij A. Rybalchenko

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Laser Doppler flowmetry is a modern method of noninvasive microcirculation investigation. The aim of our study was to use this method in the examination of patients with secondary lymphedema of the lower extremities and obliterating atherosclerosis of lower extremities. In the analysis of the amplitude-frequency spectrum of secondary lymphedema patients we have identified remarkable changes. To describe the changes we used a special amplitude rate. In both of patients groups this rate was significally (p<0.05) different with the control group. So the marker phenomena of the amplitude-frequency spectrum of the LDF signal were identified. It is suggested that there is a limfodynamics contribution to the formation of the output signal of laser Doppler flowmetry. These data have fundamental meaning and are interesting for practical medicine, as they give an opportunity to further developments for the use of laser Doppler flowmetry in the diagnostics and monitoring the effectiveness of the treatment.

Keywords: laser Doppler flowmetry, secondary lymphedema of the lower extremities, obliterating atherosclerosis, non-invasive diagnostics.

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Authors: Mawahib Gafare Abdalrahman Ahmed, Abdallah Belal Adam, John Ojur Dennis

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Air bubbles have been detected in human circulation of end-stage renal disease patients who are treated by hemodialysis. The consequence of air embolism, air bubbles, is under recognized and usually overlooked in daily practice. This paper shows results of a capacitor based detection method that capable of detecting the presence of air bubbles in the blood stream in different frequencies. The method is based on a parallel plates capacitor made of platinum with an area of 1.5 cm2 and a distance between the two plates is 1cm. The dielectric material used in this capacitor is Dextran70 solution which mimics blood rheology. Simulations were carried out using RC circuit at two frequencies 30Hz and 3 kHz and results compared with experiments and theory. It is observed that by injecting air bubbles of different diameters into the device, there were significant changes in the capacitance of the capacitor. Furthermore, it is observed that the output voltage from the circuit increased with increasing air bubble diameter. These results demonstrate the feasibility of this approach in improving air bubble detection in Hemodialysis.

Keywords: Air bubbles, Hemodialysis, Capacitor, Dextran70, Air bubbles diameters.

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Authors: N. H. Harun, A. S. Abdul Nasir, M. Y. Mashor, R. Hassan

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Leukaemia is a blood cancer disease that contributes to the increment of mortality rate in Malaysia each year. There are two main categories for leukaemia, which are acute and chronic leukaemia. The production and development of acute leukaemia cells occurs rapidly and uncontrollable. Therefore, if the identification of acute leukaemia cells could be done fast and effectively, proper treatment and medicine could be delivered. Due to the requirement of prompt and accurate diagnosis of leukaemia, the current study has proposed unsupervised pixel segmentation based on clustering algorithm in order to obtain a fully segmented abnormal white blood cell (blast) in acute leukaemia image. In order to obtain the segmented blast, the current study proposed three clustering algorithms which are k-means, fuzzy c-means and moving k-means algorithms have been applied on the saturation component image. Then, median filter and seeded region growing area extraction algorithms have been applied, to smooth the region of segmented blast and to remove the large unwanted regions from the image, respectively. Comparisons among the three clustering algorithms are made in order to measure the performance of each clustering algorithm on segmenting the blast area. Based on the good sensitivity value that has been obtained, the results indicate that moving kmeans clustering algorithm has successfully produced the fully segmented blast region in acute leukaemia image. Hence, indicating that the resultant images could be helpful to haematologists for further analysis of acute leukaemia.

Keywords: Acute Leukaemia Images, Clustering Algorithms, Image Segmentation, Moving k-Means.

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Authors: K. Biswas, U. H. Armin, S. M. J. Prodhan, J. A. Prithul, S. Sarker, F. Afrin

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Alzheimer’s disease (AD) (a progressive neurodegenerative disorder) is mostly predominant cause of dementia in the elderly. Prolonging the function of acetylcholine by inhibiting both acetylcholinesterase and butyrylcholinesterase is most effective treatment therapy of AD. Traditionally Pterocarpus santalinus L. is widely known for its medicinal use. In this study, in vitro acetylcholinesterase inhibitory activity was investigated and methanolic extract of the plant showed significant activity. To confirm this activity (in vivo), learning and memory enhancing effects were tested in mice. For the test, memory impairment was induced by scopolamine (cholinergic muscarinic receptor antagonist). Anti-amnesic effect of the extract was investigated by the passive avoidance task in mice. The study also includes brain acetylcholinesterase activity. Results proved that scopolamine induced cognitive dysfunction was significantly decreased by administration of the extract solution, in the passive avoidance task and inhibited brain acetylcholinesterase activity. These results suggest that bark extract of Pterocarpus santalinus can be better option for further studies on AD via their acetylcholinesterase inhibitory actions.

Keywords: Pterocarpus santalinus, cholinesterase inhibitor, passive avoidance, Alzheimer’s disease.

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Authors: Muhibul H. Bhuyan, Mafujul Hasan

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If a person can monitor his/her heart rate regularly then he/she can detect heart disease early and thus he/she can enjoy longer life span. Therefore, this disease should be taken seriously. Hence, many health care devices and monitoring systems are being designed to keep track of the heart disease. This work reports a design and simulation processes of an Arduino microcontroller based heart rate measurement and monitoring system in Proteus environment. Clipping sensors were utilized to sense the heart rate of an individual from the finger tips. It is a digital device and uses mainly infrared (IR) transmitter (mainly IR LED) and receiver (mainly IR photo-transistor or IR photo-detector). When the heart pumps the blood and circulates it among the blood vessels of the body, the changed blood pressure is detected by the transmitter and then reflected back to the receiver accordingly. The reflected signals are then processed inside the microcontroller through a software written assembly language and appropriate heart rate (HR) is determined by it in beats per minute (bpm) from the detected signal for a duration of 10 seconds and display the same in bpm on the LCD screen in digital format. The designed system was simulated on several persons with varying ages, for example, infants, adult persons and active athletes. Simulation results were found very satisfactory.

Keywords: Heart rate measurement, design, simulation, Proteus, Arduino Uno microcontroller.

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Authors: John Tolentino, Yong Seok Park

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There are currently many people living with limb loss in the USA. The main causes for amputation can range from vascular disease, to trauma, or cancer. This number is expected increase over the next decade. Many patients have a single prosthetic for the first year but end up getting a second one to accommodate their changing physique. Afterwards, the prosthesis gets replaced every three to five years depending on how often it is used. This could cost the patient up to $500,000 throughout their lifetime. Complications do not end there, however. Due to the absence of nerves, it becomes more difficult to traverse terrain with a prosthetic. Moving on an incline or decline becomes difficult, thus curbs and stairs can be a challenge. Certain physical activities, such as cycling, could be even more strenuous. It will need to be relearned to accommodate for the change in weight, center of gravity, and transfer of energy from the leg to the pedal. The purpose of this research project is to develop a new, alternate below-knee cycling prosthetic using Dieter & Schmidt’s design process approach. It will be subjected to fatigue analysis under dynamic loading to observe the limitations as well as the strengths and weaknesses of the prosthetic. Benchmark comparisons will be made between existing prosthetics and the proposed one, examining the benefits and disadvantages. The resulting prosthetic will be 3D printed using acrylonitrile butadiene styrene (ABS) or polycarbonate (PC) plastic.

Keywords: 3D printing, cycling, prosthetic design, synthetic design.

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Authors: Aliza Lee, Mark Wilt, John Bonk, Scott Floyd, Bradley Hoffman, Karen Uchmanowicz

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Bipartite medial cuneiforms are relatively rare but may play a significant role in biomechanical and gait abnormalities. It is believed that a bipartite medial cuneiform may alter the available range of motion due to its larger morphological variant, thus limiting the metatarsal plantarflexion needed to achieve adequate hallux dorsiflexion for normal gait. Radiographic and clinical assessment were performed on two patients who reported with foot pain along the first ray. Both patients had visible bipartite medial cuneiforms on MRI. Using gait plate and Metascan ™ analysis, both were noted to have four measurements far beyond the expected range. Medial and lateral heel peak pressure, hallux peak pressure, and 1st metatarsal peak pressure were all noted to be increased. These measurements are believed to be increased due to the hindrance placed on the available ROM of the first ray by the increased size of the medial cuneiform. A larger patient population would be needed to fully understand this developmental anomaly.

Keywords: Bipartite medial cuneiforms, cuneiform, developmental anomaly, gait abnormality.

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Authors: Achitphol Chookaew, Paramee Thongsukhsai, Patamarerk Engsontia, Narongwit Nakwan, Pritsana Raugrut

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Lung cancer is one of the most common malignancies and primary cause of death due to cancer worldwide. Non-small cell lung cancer (NSCLC) is the main subtype in which majority of patients present with advanced-stage disease. Herein, we analyzed differentially expressed genes to find potential biomarkers for lung cancer diagnosis as well as prognostic markers. We used transcriptome data from our 2 NSCLC patients and public data (GSE81089) composing of 8 NSCLC and 10 normal lung tissues. Differentially expressed genes (DEGs) between NSCLC and normal tissue and between early-stage and late-stage NSCLC were analyzed by the DESeq2. Pairwise correlation was used to find the DEGs with false discovery rate (FDR) adjusted p-value £ 0.05 and |log2 fold change| ³ 4 for NSCLC versus normal and FDR adjusted p-value £ 0.05 with |log2 fold change| ³ 2 for early versus late-stage NSCLC. Bioinformatic tools were used for functional and pathway analysis. Moreover, the top ten genes in each comparison group were verified the expression and survival analysis via GEPIA. We found 150 up-regulated and 45 down-regulated genes in NSCLC compared to normal tissues. Many immnunoglobulin-related genes e.g., IGHV4-4, IGHV5-10-1, IGHV4-31, IGHV4-61, and IGHV1-69D were significantly up-regulated. 22 genes were up-regulated, and five genes were down-regulated in late-stage compared to early-stage NSCLC. The top five DEGs genes were KRT6B, SPRR1A, KRT13, KRT6A and KRT5. Keratin 6B (KRT6B) was the most significantly increased gene in the late-stage NSCLC. From GEPIA analysis, we concluded that IGHV4-31 and IGKV1-9 might be used as diagnostic biomarkers, while KRT6B and KRT6A might be used as prognostic biomarkers. However, further clinical validation is needed.

Keywords: Bioinformatics, differentially expressed genes, non-small cell lung cancer, transcriptomics.

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Authors: L. Nekoozad, M. Salehi Barough, B. Salmasian

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Introduction: Some parameters should be considered to investigate the chronic effects of radiation absorption in radiation workers. Trace elements are parameters which small changes in them can cause significant effects on live systems. The role of trace element concentration in human health is significant. These elements play an important role in the developing and functioning of the immune system, cellular respiration, and oxidation processes. Considering the importance and necessity of this issue and few studies, measurements of concentration changes of these elements due to the absorbed dose are important. Purpose: This study aimed to determine the biological effects of occupational dose absorption on plasma and erythrocyte concentration of Zn and Cu in the radiology staff of Tehran Oil Hospital. Material and methods: In this analytical-comparative study, 72 people have entered. 36 people (18 males and 18 females) were selected as radiology staff in the diagnostic and therapeutic departments of Tehran Oil Hospital. And 36 people (18 males and 18 females) were selected as general section staff in the same hospital as a control group. Radiology and control groups’ age and sex were matched. 10 ml of venous blood was taken from all people.  An atomic absorption spectrometer was used to obtain zinc and copper plasma concentrations. Levine test was used to compare these results validity. Results: The mean concentrations of copper and zinc were measured as 0.951 and 0.754 mg/L in the plasma phase and 3.2  and 0.401 mg/L in the RBC phase for the radiology group.  Copper and zinc average concentrations, respectively 0.976 and 0.813 mg/L in the plasma phase and 2.906 and 0.476 mg/L in the RBC phase, were measured for the control group. These elements Concentrations in the plasma phase were significantly different from that of the control group, but the concentrations in the red blood cell phase did not show a significant difference compared to the control group. In comparison, a separate comparison between men and women in the experimental and control groups showed a significant difference in the values of the elements mentioned. With a significant increase in samples, a better justification than the available statistical results can be extracted. Conclusions: Within this study results, chronic occupational probabilistic absorption destructive effects (even within the permitted range) on blood trace element concentration have been confirmed.

Keywords: Chronic absorption, atomic absorption spectrometry, radiology staff, trace element concentration.

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Authors: A. Khelifi, D. Ahmed, R. Salem, N. Ali

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Large patients’ queues at pharmacies and hospitals are a problem that faces the supposedly smooth and healthy environment in United Arab Emirates. As this sometimes leads to dissatisfaction from visiting patients, we tried to solve this problem with additional beneficial functions by developing the Hospital-Pharmacy Management System. The primary purpose of this research is to develop a system that joins the databases of a hospital and a pharmacy together for a better integrated system that provides a better coherent working environment. Three methods are used to design the system. These methods are detailed literature review, an extensive feasibility study and surveys for doctors, hospital IT managers and End-users. Interviews and surveys with related stakeholders were done to depict system’s requirements; design and prototype. The prototype illustrates system’s features and its client and server architecture. The system has a mobile application for visiting patients to, mainly, keep track of their prescriptions and access to their personal information. The server side allows doctors to submit the prescriptions online to pharmacists who will process them. This system is expected to reduce the long waiting queues of patients and increase their satisfaction while also reducing doctors and pharmacists’ stress and facilitating their work. It will be deployed to users of Android devices only. This limitation will be resolved, as one of main future enhancements, once the system finds acceptance from hospitals and pharmacies in United Arab Emirates.

Keywords: Hospital, Information System, Integration, Pharmacy.

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Authors: P. Pongsumpun

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The Swine flu outbreak in humans is due to a new strain of influenza A virus subtype H1N1 that derives in part from human influenza, avian influenza, and two separated strains of swine influenza. It can be transmitted from human to human. A mathematical model for the transmission of Swine flu is developed in which the human populations are divided into two classes, the risk and non-risk human classes. Each class is separated into susceptible, exposed, infectious, quarantine and recovered sub-classes. In this paper, we formulate the dynamical model of Swine flu transmission and the repetitive contacts between the people are also considered. We analyze the behavior for the transmission of this disease. The Threshold condition of this disease is found and numerical results are shown to confirm our theoretical predictions.

Keywords: Mathematical model, Steady state, Swine flu, threshold condition.

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Authors: L. Salhi, M. Talbi, A. Cherif

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This paper presents a new strategy of identification and classification of pathological voices using the hybrid method based on wavelet transform and neural networks. After speech acquisition from a patient, the speech signal is analysed in order to extract the acoustic parameters such as the pitch, the formants, Jitter, and shimmer. Obtained results will be compared to those normal and standard values thanks to a programmable database. Sounds are collected from normal people and patients, and then classified into two different categories. Speech data base is consists of several pathological and normal voices collected from the national hospital “Rabta-Tunis". Speech processing algorithm is conducted in a supervised mode for discrimination of normal and pathology voices and then for classification between neural and vocal pathologies (Parkinson, Alzheimer, laryngeal, dyslexia...). Several simulation results will be presented in function of the disease and will be compared with the clinical diagnosis in order to have an objective evaluation of the developed tool.

Keywords: Formants, Neural Networks, Pathological Voices, Pitch, Wavelet Transform.

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Authors: O. Iyare, A. H. Afolayan, O. T. Oluwadare, B. K. Alese

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Access to advanced medical services has been one of the medical challenges faced by our present society especially in distant geographical locations which may be inaccessible. Then the need for telemedicine arises through which live videos of a doctor can be streamed to a patient located anywhere in the world at any time. Patients’ medical records contain very sensitive information which should not be made accessible to unauthorized people in order to protect privacy, integrity and confidentiality. This research work focuses on a more robust security measure which is biometric (fingerprint) as a form of access control to data of patients by the medical specialist/practitioner.

Keywords: Biometrics, telemedicine, privacy, patient information.

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Authors: Adekunle O. Afolabi, Pekka Toivanen

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The world is expected to experience growth in the number of ageing population, and this will bring about high cost of providing care for these valuable citizens. In addition, many of these live with chronic diseases that come with old age. Providing adequate care in the face of rising costs and dwindling personnel can be challenging. However, advances in technologies and emergence of the Internet of Things are providing a way to address these challenges while improving care giving. This study proposes the integration of recommendation systems into homecare to provide real-time recommendations for effective management of people receiving care at home and those living with chronic diseases. Using the simplified Training Logic Concept, stakeholders and requirements were identified. Specific requirements were gathered from people living with cancer. The solution designed has two components namely home and community, to enhance recommendations sharing for effective care giving. The community component of the design was implemented with the development of a mobile app called Recommendations Sharing Community for Aged and Chronically Ill People (ReSCAP). This component has illustrated the possibility of real-time recommendations, improved recommendations sharing among care receivers and between a physician and care receivers. Full implementation will increase access to health data for better care decision making.

Keywords: Recommendation systems, healthcare, internet of things, real-time, homecare.

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Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, Burns, FLAMES, scoring systems, outcome.

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Authors: Mohsen Shirani, Micaela Demichela

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During the last decades, a number of food crises such as Bovine Spongiform Encephalopathy (BSE), Mad-Cow disease, Dioxin in chicken food, Food-and-Mouth Disease (FMD), have certainly inflected the reliability of the food industry. Consequently, the trend in applying different scientific methods of risk assessment in food safety has obtained more attentions in the academic and practice. However, lack of practical approach considering entire food supply chain is tangible in the academic literature. In this regard, this paper aims to apply risk assessment tool (FMEA) with integration of Human Factor along the entire supply chain of food production and test the method in a case study of Diary production, and analyze its results.

Keywords: Food Risk Assessment, FMEA, Human Factor.

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Authors: Lindsay Fink, Sarha Smith-Moyo, Leanne W. Charlesworth

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In recent years, the number of individuals experiencing homelessness has increased in the United States. This paper analyzes 2019 data from 16 different emergency shelters in Monroe County, located in Upstate New York. The data were collected through the County’s Homeless Management Information System (HMIS), and individuals were de-identified and de-duplicated for analysis. The purpose of this study is to explore the basic characteristics of the homeless population in Monroe County, and the dynamics of shelter use. The results of this study showed gender as a significant factor when analyzing the relationship between demographic variables and recorded reasons for shelter entry. Results also indicated that age and ethnicity did not significantly influence odds of re-entering a shelter, but did significantly influence reasons for shelter entry. Overall, the most common recorded cause of shelter entry in 2019 in the examined county was eviction by primary tenant. Recommendations to better address recurrent shelter entry and potential chronic homelessness include more consideration for the diversity existing within the homeless population, and the dynamics leading to shelter stays, including enhanced funding and training for shelter staff, as well as expanded access to permanent supportive housing programs.

Keywords: Chronic homelessness, homeless shelter stays, permanent supportive housing, shelter population dynamics.

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Authors: Shaival Dalal, Nilesh Shah, Dinshaw Pardiwala, David Rajan, Satyen Sanghavi, Charul Bhanji

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Autologous Chondrocyte Implantation (ACI) is used worldwide since 1998 to treat cartilage defect. GEL based ACI is a new tissue-engineering technique to treat full thickness cartilage defect with fibrin and thrombin as scaffold for chondrocytes. Purpose of this study is to see safety and efficacy of gel based ACI for knee cartilage defect in multiple centres with different surgeons. Gel-based Autologous Chondrocyte Implantation (GACI) has shown effectiveness in treating isolated cartilage defect of knee joint. Long term results are still needed to be studied. This study was followed-up up to two years and showed benefit to patients. All enrolled patients with a mean age of 28.5 years had an average defect size of3 square centimeters, and were grade IV as per ICRS grading. All patients were followed up several times and at several intervals at 6th week, 8th week, 11th week, 17th week, 29th week, 57th week after surgery. The outcomes were measured based on the IKDC (subjective and objective) and MOCART scores.

Keywords: Knee, chondrocyte, autologous chondrocyte implantation, gel.

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Authors: Climstein Mike, Walsh Joe, John Best, Heazlewood Ian Timothy, Burke Stephen, Kettunen Jyrki, Adams Kent, DeBeliso Mark

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Recently, the health of retired National Football League players, particularly lineman has been investigated. A number of studies have reported increased cardiometabolic risk, premature ardiovascular disease and incidence of type 2 diabetes. Rugby union players have somatotypes very similar to National Football league players which suggest that rugby players may have similar health risks. The International Golden Oldies World Rugby Festival (GORF) provided a unique opportunity to investigate the demographics of veteran rugby players. METHODOLOGIES: A cross-sectional, observational study was completed using an online web-based questionnaire that consisted of medical history and physiological measures. Data analysis was completed using a one sample t-test (<50yrs versus >50yrs) and Chi-square test. RESULTS: A total of 216 veteran rugby competitors (response rate = 6.8%) representing 10 countries, aged 35-72 yrs (mean 51.2, S.D. ±8.0), participated in the online survey. As a group, the incidence of current smokers was low at 8.8% (avg 72.4 cigs/wk) whilst the percentage consuming alcohol was high (93.1% (avg 11.2 drinks/wk). Competitors reported the following top six chronic diseases/disorders; hypertension (18.6%), arthritis (OA/RA, 11.5%), asthma (9.3%), hyperlipidemia (8.2%), diabetes (all types, 7.5%) and gout (6%), there were significant differences between groups with regard to cancer (all types) and migraines. When compared to the Australian general population (Australian Bureau of Statistics data, n=18,000), GORF competitors had a Climstein Mike, Walsh Joe (corresponding author) and Burke Stephen School of Exercise Science, Australian Catholic University, 25A Barker Road, Strathfield, Sydney, NSW, 2016, Australia (e-mail: [email protected], [email protected], [email protected]). John Best is with Orthosports, 160 Belmore Rd., Randwick, Sydney,NSW 2031, Australia (e-mail: [email protected]). Heazlewood, Ian Timothy is with School of Environmental and Life Sciences, Faculty Education, Health and Science, Charles Darwin University, Precinct Yellow Building 2, Charles Darwin University, NT 0909, Australia (e-mail: [email protected]). Kettunen Jyrki Arcada University of Applied Sciences, Jan-Magnus Janssonin aukio 1, FI-00550, Helsinki, Finland (e-mail: [email protected]). Adams Kent is with California State University Monterey Bay, Kinesiology Department, 100 Campus Center, Seaside, CA., 93955, USA (email: [email protected]). DeBeliso Mark is with Department of Physical Education and Human Performance, Southern Utah University, 351 West University Blvd, Cedar City, Utah, USA (e-mail: [email protected]). significantly lower incidence of anxiety (p<0.01), arthritis (p<0.06), depression (p<.01) however, a significantly higher incidence of diabetes (p<0.03) and hypertension (p<0.01). The GORF competitors also reported taking the following prescribed medications; antihypertensive (13%), hypolipidemics (8%), non-steroidal anti-inflammatory (6%), and anticoagulants (4%). Significant differences between groups were observed in antihypertensives, anticoagulants and hypolipidemics. There were significant (p<0.05) differences between groups (<50yrs versus >50yrs) with regard to height (180 vs 177cm), weight (97.6 vs 93.1Kg-s), BMI (30 vs 29.7kg/m2) and waist circumference (85.7 vs 93.1cm) however, there were no differences in subsequent parameters of systolic blood pressure, diastolic blood pressure, total cholesterol, HDL-C, LDL-C, triglycerides-C or fasting plasma glucose. CONCLUSIONS: This represents the first collection of demographics on this cohort. GORF participants demonstrated increased cardiometabolic risk with regard to the incidence of hypercholesterolemia, hypertension and type 2 diabetes. Preventative strategies should be developed to reduce this risk with education of these risks for future participants.

Keywords: Masters athlete, rugby union, risk factors, chronic disease.

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Authors: Laila Seada, Ashraf Ibrahim, Amjad Al Shammari

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Background and Objectives: Breast carcinoma is the most common cancer of females in Hail region, accounting for 31% of all diagnosed cancer cases followed by thyroid carcinoma (25%) and colorectal carcinoma (13%). Methods: In the present retrospective study, all cases of breast lesions received at the histopathology department in King Khalid Hospital, Hail, during the period from May 2011 to April 2016 have been retrieved from department files. For all cases, a trucut biopsy, lumpectomy, or modified radical mastectomy was available for histopathologic diagnosis, while 105/140 (75%) had, as well, preoperative fine needle aspirates (FNA). Results: 49 cases out of 140 (35%) breast lesions were carcinomas: 44/49 (89.75%) was invasive ductal, 2/49(4.1%) invasive lobular carcinomas, 1/49(2.05%) intracystic low grade papillary carcinoma and 2/49 (4.1%) ductal carcinoma in situ (DCIS). Mean age for malignant cases was 45.06 (+/-10.58): 32.6% were below the age of 40 and 30.6 below 50 years, 18.3% below 60 and 16.3% below 70 years. For the benign group, mean age was 32.52 (+/10.5) years. Benign lesions were in order of frequency: 34 fibroadenomas, 14 fibrocystic disease, 12 chronic mastitis, five granulomatous mastitis, three intraductal papillomas, and three benign phyllodes tumor. Tubular adenoma, lipoma, skin nevus, pilomatrixoma, and breast reduction specimens constituted the remaining specimens. Conclusion: Breast lesions are common in our series and invasive carcinoma accounts for more than 1/3^rd of the lumps, with 63.2% incidence in pre-menopausal ladies, below the age of 50 years. FNA as a non-invasive procedure, proved to be an effective tool in diagnosing both benign and malignant/suspicious breast lumps and should continue to be used as a first assessment line of palpable breast masses.

Keywords: Age incidence, breast carcinoma, fine needle aspiration, Hail Region.

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Authors: P. Murphy, D. Vasic, A. W. Gunaratne, T. Tugonon, M. Ison, C. Pagonis, E. T. Sitchon, A. Le Busque, T. J. Borody

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Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by an alteration in bowel movements. There are three different types of IBS: diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-C) and IBS with mixed bowel habit (IBS-M). Antimicrobials are increasingly being used as treatment for all types of IBS. Due to this increased use and subsequent success, the gut microbiome as a factor in the etiology of IBS is becoming more apparent. Accepted standard treatment has focused on IBS-C and involves either vancomycin or rifaximin. Here, we report on a cohort of 18 patients treated with both vancomycin and rifaximin for IBS-D. These patients’ records were reviewed retrospectively. In this cohort, patients were aged between 24-74 years (mean 44 years) and nine were female. At baseline all patients had diarrhea, four with mucus and one with blood. Other reported symptoms include abdominal pain (n = 11) bloating (n = 9), flatulence (n = 7), fatigue (n = 4) and nausea (n = 3). Patient’s treatments were personalized according to their symptom severity and tolerability and were treated with a combination of rifaximin (500-3000 mg/d) and vancomycin (500 mg-1500 mg/d) for an ongoing period. Follow-ups were conducted between 2-32 weeks. Of all patients, 89% reported improvement of at least 1 symptom, one reported no change and one patient’s symptoms got worse. The success of this combination treatment could be due to the different mechanisms of action undertaken by each medication. Vancomycin works by inhibiting the cell wall of the bacteria and rifaximin by inhibiting protein synthesis. This success in treatment validates the idea that IBS-D may be driven by a bacterial infection of the gastrointestinal microbiome. As IBS-D presents similarly to Clostridium difficile and symptom improvement can occur with the same treatment as Clostridium difficile of rifaximin and vancomycin, there is reason to suggest that the infectious agent could be an unidentified strain of Clostridium. Although these results offer some validity to the theory, more research is required.

Keywords: Clostridium difficile infection, diarrhea predominant irritable bowel syndrome, microbiome, vancomycin/rifaximin combination.

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Authors: Mukhtar H. Hassan, Muhammed A. Basher, Elhadi E. Saad, Almahdi M. Almahdi

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The aim of this study was to demonstrate the possible effect of some variables such as age, gender, blood sugar level, and duration of diabetes on the serum level of zinc in diabetic individuals from Murzuk area. Serum zinc (Zn), Fasting blood sugar (FBS), hemoglobin HbA1c (HbA1c) were evaluated in 46 type I diabetic subjects (group 1), 48 type II diabetic subjects (group 2) and 43 healthy individuals (control) of both genders aged (30-81) years. Data showed that both diabetic groups have significantly higher (P<0.05) serum levels of Zn, FBS and HbA1c compared with controls. No significant (p>0.05) differences in serum Zn levels were observed between Males and Females. Serum Zn levels were non-significantly decreased with increasing age. In type II diabetic subjects, serum Zn levels were non-significantly decreased with increasing duration of disease whereas those in type I were non-significantly increased.

Keywords: Blood sugar, diabetes, HbA1c, zinc.

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Authors: P. Sanzo

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Ten percent of the population will develop plantar fasciitis (PF) during their lifetime. Two million people are treated yearly accounting for 11-15% of visits to medical professionals. Treatment ranges from conservative to surgical intervention. The purpose of this study was to assess the effects of extracorporeal shockwave therapy (ECSWT) on heel pain, function, range of motion (ROM), and strength in patients with PF. One hundred subjects were treated with ECSWT and measures were taken before and three months after treatment. There was significant differences in visual analog scale scores for pain at rest (p=0.0001); after activity (p= 0.0001) and; overall improvement (p=0.0001). There was also significant improvement in Lower Extremity Functional Scale scores (p=0.0001); ankle plantarflexion (p=0.0001), dorsiflexion (p=0.001), and eversion (p=0.017),and first metatarsophalangeal joint flexion (p=0.002) and extension (p=0.003) ROM. ECSWT is an effective treatment improving heel pain, function and ROM in patients with PF.

Keywords: Extracorporeal shockwave therapy, shockwave therapy, plantar fasciitis, heel pain, function, range of motion, strength.

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Authors: Ali Anaissi, Paul J. Kennedy, Madhu Goyal

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Analysis and visualization of microarraydata is veryassistantfor biologists and clinicians in the field of diagnosis and treatment of patients. It allows Clinicians to better understand the structure of microarray and facilitates understanding gene expression in cells. However, microarray dataset is a complex data set and has thousands of features and a very small number of observations. This very high dimensional data set often contains some noise, non-useful information and a small number of relevant features for disease or genotype. This paper proposes a non-linear dimensionality reduction algorithm Local Principal Component (LPC) which aims to maps high dimensional data to a lower dimensional space. The reduced data represents the most important variables underlying the original data. Experimental results and comparisons are presented to show the quality of the proposed algorithm. Moreover, experiments also show how this algorithm reduces high dimensional data whilst preserving the neighbourhoods of the points in the low dimensional space as in the high dimensional space.

Keywords: Linear Dimension Reduction, Non-Linear Dimension Reduction, Principal Component Analysis, Biologists.

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Authors: Sunitha. S.L., V. Udayashankara

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Background noise is particularly damaging to speech intelligibility for people with hearing loss especially for sensorineural loss patients. Several investigations on speech intelligibility have demonstrated sensorineural loss patients need 5-15 dB higher SNR than the normal hearing subjects. This paper describes Discrete Cosine Transform Power Normalized Least Mean Square algorithm to improve the SNR and to reduce the convergence rate of the LMS for Sensory neural loss patients. Since it requires only real arithmetic, it establishes the faster convergence rate as compare to time domain LMS and also this transformation improves the eigenvalue distribution of the input autocorrelation matrix of the LMS filter. The DCT has good ortho-normal, separable, and energy compaction property. Although the DCT does not separate frequencies, it is a powerful signal decorrelator. It is a real valued function and thus can be effectively used in real-time operation. The advantages of DCT-LMS as compared to standard LMS algorithm are shown via SNR and eigenvalue ratio computations. . Exploiting the symmetry of the basis functions, the DCT transform matrix [AN] can be factored into a series of ±1 butterflies and rotation angles. This factorization results in one of the fastest DCT implementation. There are different ways to obtain factorizations. This work uses the fast factored DCT algorithm developed by Chen and company. The computer simulations results show superior convergence characteristics of the proposed algorithm by improving the SNR at least 10 dB for input SNR less than and equal to 0 dB, faster convergence speed and better time and frequency characteristics.

Keywords: Hearing Impairment, DCT Adaptive filter, Sensorineural loss patients, Convergence rate.

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Authors: Nisar Ahmed Memon, Anwar Majid Mirza, S.A.M. Gilani

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Segmentation is an important step in medical image analysis and classification for radiological evaluation or computer aided diagnosis. The CAD (Computer Aided Diagnosis ) of lung CT generally first segment the area of interest (lung) and then analyze the separately obtained area for nodule detection in order to diagnosis the disease. For normal lung, segmentation can be performed by making use of excellent contrast between air and surrounding tissues. However this approach fails when lung is affected by high density pathology. Dense pathologies are present in approximately a fifth of clinical scans, and for computer analysis such as detection and quantification of abnormal areas it is vital that the entire and perfectly lung part of the image is provided and no part, as present in the original image be eradicated. In this paper we have proposed a lung segmentation technique which accurately segment the lung parenchyma from lung CT Scan images. The algorithm was tested against the 25 datasets of different patients received from Ackron Univeristy, USA and AGA Khan Medical University, Karachi, Pakistan.

Keywords: Computer Aided Diagnosis, Medical ImageProcessing, Region Growing, Segmentation, Thresholding,

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Authors: Abdelgawad, Salah El-Tahawy

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This paper aimed to establish econometrical equation models for the Nile delta region in Egypt, which will represent a basement for future predictions of Lumpy skin disease outbreaks and its pathway in relation to climate change. Data of lumpy skin disease (LSD) outbreaks were collected from the cattle farms located in the provinces representing the Nile delta region during 1 January, 2015 to December, 2015. The obtained results indicated that there was a significant association between the degree of the LSD outbreaks and the investigated climate factors (temperature, wind speed, and humidity) and the outbreaks peaked during the months of June, July, and August and gradually decreased to the lowest rate in January, February, and December. The model obtained depicted that the increment of these climate factors were associated with evidently increment on LSD outbreaks on the Nile Delta of Egypt. The model validation process was done by the root mean square error (RMSE) and means bias (MB) which compared the number of LSD outbreaks expected with the number of observed outbreaks and estimated the confidence level of the model. The value of RMSE was 1.38% and MB was 99.50% confirming that this established model described the current association between the LSD outbreaks and the change on climate factors and also can be used as a base for predicting the of LSD outbreaks depending on the climatic change on the future.

Keywords: LSD, climate factors, econometric models, Nile Delta.

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