The Care Management Network as an Effective Intervention in Mitigating the Risks of Hypertension

Hospitals in southern Hualien teamed with the Hypertension Joint Care Network. Working with the network, the team provided a special designed health education to the individual who had been identified as a hypertension patient in the outpatient department. Some metabolism improvements achieved. This is a retrospective study by purposively taking 106 patients from a hospital between 2008 and 2010. Records of before and after education intervention of the objects was collected and analyzed to see the how the intervention affected the patients- hypertension control via clinical parameter monitoring. The results showed that the clinical indicators, the LDL-C, the cholesterol and the systolic blood pressure were significantly improved. The study provides evidence for the effectiveness of the network in controlling hypertension.

Antibacterial Effect of Silver Nanoparticles on Multi Drug Resistant Pseudomonas Aeruginosa

Multidrug resistant organisms have been taunting the medical world for the last few decades. Even with new antibiotics developed, resistant strains have emerged soon after. With the advancement of nanotechnology, we investigated colloidal silver nanoparticles for its antimicrobial activity against Pseudomonas aeruginosa. This organism is a multidrug resistant which contributes to the high morbidity and mortality in immunocompromised patients. Five multidrug resistant strains were used in this study. The antimicrobial effect was studied using the disc diffusion and broth dilution techniques. An inhibition zone of 11 mm was observed with 10 μg dose of the nanoparticles. The nanoparticles exhibited MIC of 50 μg/ml when added at the lag phase and the subinhibitory concentration was measured as 100 μg/ml. The MIC50 value showed to be 15 μg/ml. This study suggests that silver nanoparticles can be further developed as an antimicrobial agent, hence decreasing the burden of the multidrug resistance phenomena.

Processing the Medical Sensors Signals Using Fuzzy Inference System

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

Aggressive Interactions in Hospital Emergency Units

International literature emphasizes on the concern regarding the phenomenon of aggression in hospital. This paper focuses on the reality of aggressive interactions reigning within an emergency triage involving three chaps of protagonists: the professionals, the patients and their carers. The data collection was made from a grid of observation, in which the various variables exposed in the literature were integrated. They observations took place around the clock, for three weeks, at the rate of one week a month. In this research 331 aggressive interactions have been listed and analyzed by means of the software SPSS. This research is one of the very few continuous observation surveys in the literature. It shows the various human factors at play in the emergence of aggressive interaction. The data may be used both for taking steps in primary prevention, thanks to the analysis of interaction modes, and in secondary prevention by integrating the useful results in situational prevention.

Using Data Mining Techniques for Finding Cardiac Outlier Patients

In this paper we used data mining techniques to identify outlier patients who are using large amount of drugs over a long period of time. Any healthcare or health insurance system should deal with the quantities of drugs utilized by chronic diseases patients. In Kingdom of Bahrain, about 20% of health budget is spent on medications. For the managers of healthcare systems, there is no enough information about the ways of drug utilization by chronic diseases patients, is there any misuse or is there outliers patients. In this work, which has been done in cooperation with information department in the Bahrain Defence Force hospital; we select the data for Cardiac patients in the period starting from 1/1/2008 to December 31/12/2008 to be the data for the model in this paper. We used three techniques for finding the drug utilization for cardiac patients. First we applied a clustering technique, followed by measuring of clustering validity, and finally we applied a decision tree as classification algorithm. The clustering results is divided into three clusters according to the drug utilization, for 1603 patients, who received 15,806 prescriptions during this period can be partitioned into three groups, where 23 patients (2.59%) who received 1316 prescriptions (8.32%) are classified to be outliers. The classification algorithm shows that the use of average drug utilization and the age, and the gender of the patient can be considered to be the main predictive factors in the induced model.

A Novel EMG Feedback Control Method in Functional Electrical Stimulation Cycling System for Stroke Patients

With getting older in the whole population, the prevalence of stroke and its residual disability is getting higher and higher recently in Taiwan. The functional electrical stimulation cycling system (FESCS) is useful for hemiplegic patients. Because that the muscle of stroke patients is under hybrid activation. The raw electromyography (EMG) represents the residual muscle force of stroke subject whereas the peak-to-peak of stimulus EMG indicates the force enhancement benefiting from ES. It seems that EMG signals could be used for a parameter of feedback control mechanism. So, we design the feedback control protocol of FESCS, it includes physiological signal recorder, FPGA biomedical module, DAC and electrical stimulation circuit. Using the intensity of real-time EMG signal obtained from patients, as a feedback control method for the output voltage of FES-cycling system.

Bioinformatics Profiling of Missense Mutations

The ability to distinguish missense nucleotide substitutions that contribute to harmful effect from those that do not is a difficult problem usually accomplished through functional in vivo analyses. In this study, instead current biochemical methods, the effects of missense mutations upon protein structure and function were assayed by means of computational methods and information from the databases. For this order, the effects of new missense mutations in exon 5 of PTEN gene upon protein structure and function were examined. The gene coding for PTEN was identified and localized on chromosome region 10q23.3 as the tumor suppressor gene. The utilization of these methods were shown that c.319G>A and c.341T>G missense mutations that were recognized in patients with breast cancer and Cowden disease, could be pathogenic. This method could be use for analysis of missense mutation in others genes.

Mathematical Analysis of EEG of Patients with Non-fatal Nonspecific Diffuse Encephalitis

Diffuse viral encephalitis may lack fever and other cardinal signs of infection and hence its distinction from other acute encephalopathic illnesses is challenging. Often, the EEG changes seen routinely are nonspecific and reflect diffuse encephalopathic changes only. The aim of this study was to use nonlinear dynamic mathematical techniques for analyzing the EEG data in order to look for any characteristic diagnostic patterns in diffuse forms of encephalitis.It was diagnosed on clinical, imaging and cerebrospinal fluid criteria in three young male patients. Metabolic and toxic encephalopathies were ruled out through appropriate investigations. Digital EEGs were done on the 3rd to 5th day of onset. The digital EEGs of 5 male and 5 female age and sex matched healthy volunteers served as controls.Two sample t-test indicated that there was no statistically significant difference between the average values in amplitude between the two groups. However, the standard deviation (or variance) of the EEG signals at FP1-F7 and FP2-F8 are significantly higher for the patients than the normal subjects. The regularisation dimension is significantly less for the patients (average between 1.24-1.43) when compared to the normal persons (average between 1.41-1.63) for the EEG signals from all locations except for the Fz-Cz signal. Similarly the wavelet dimension is significantly less (P = 0.05*) for the patients (1.122) when compared to the normal person (1.458). EEGs are subdued in the case of the patients with presence of uniform patterns, manifested in the values of regularisation and wavelet dimensions, when compared to the normal person, indicating a decrease in chaotic nature.

Biosensor Measurement of Urea Coonncentration in Human Blood Serum

An application of the highly biosensor based on pH-sensitive field immobilized urease for urea analysis was demo The main analytical characteristics of the bios determined; the conditions of urea measureme blood were optimized. A conceptual possibility biosensor for detection of urea concentratio patients suffering from renal insufficiency was sensitive and selective effect transistor and monstrated in this work. iosensor developed were ment in real samples of ility of application of the tion in blood serum of as shown.

New Ways for Designing External Fixators Applied in Treatment of Open and Unstable Fractures

This paper deals with a new way for designing external fixators applied in traumatology and orthopaedics. These fixators can be applied in the treatment of open and unstable fractures or for lengthening human or animal bones etc. The new design is based on the development of Ilizarov and other techniques (i.e. shape and weight optimalization based on composite materials, application of smart materials, nanotechnology, low x-ray absorption, antibacterial protection, patient's comfort, reduction in the duration of the surgical treatment, and cost).

The Effect of Press Fit on Osseointegration of Acetabular Cup

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.

Brain MRI Segmentation and Lesions Detection by EM Algorithm

In Multiple Sclerosis, pathological changes in the brain results in deviations in signal intensity on Magnetic Resonance Images (MRI). Quantitative analysis of these changes and their correlation with clinical finding provides important information for diagnosis. This constitutes the objective of our work. A new approach is developed. After the enhancement of images contrast and the brain extraction by mathematical morphology algorithm, we proceed to the brain segmentation. Our approach is based on building statistical model from data itself, for normal brain MRI and including clustering tissue type. Then we detect signal abnormalities (MS lesions) as a rejection class containing voxels that are not explained by the built model. We validate the method on MR images of Multiple Sclerosis patients by comparing its results with those of human expert segmentation.

On The Analysis of a Compound Neural Network for Detecting Atrio Ventricular Heart Block (AVB) in an ECG Signal

Heart failure is the most common reason of death nowadays, but if the medical help is given directly, the patient-s life may be saved in many cases. Numerous heart diseases can be detected by means of analyzing electrocardiograms (ECG). Artificial Neural Networks (ANN) are computer-based expert systems that have proved to be useful in pattern recognition tasks. ANN can be used in different phases of the decision-making process, from classification to diagnostic procedures. This work concentrates on a review followed by a novel method. The purpose of the review is to assess the evidence of healthcare benefits involving the application of artificial neural networks to the clinical functions of diagnosis, prognosis and survival analysis, in ECG signals. The developed method is based on a compound neural network (CNN), to classify ECGs as normal or carrying an AtrioVentricular heart Block (AVB). This method uses three different feed forward multilayer neural networks. A single output unit encodes the probability of AVB occurrences. A value between 0 and 0.1 is the desired output for a normal ECG; a value between 0.1 and 1 would infer an occurrence of an AVB. The results show that this compound network has a good performance in detecting AVBs, with a sensitivity of 90.7% and a specificity of 86.05%. The accuracy value is 87.9%.

Contributory Factors to Diabetes Dietary Regimen Non Adherence in Adults with Diabetes

A cross sectional survey design was used to collect data from 370 diabetic patients. Two instruments were used in obtaining data; in-depth interview guide and researchers- developed questionnaire. Fisher's exact test was used to investigate association between the identified factors and nonadherence. Factors identified were: socio-demographic factors such as: gender, age, marital status, educational level and occupation; psychosocial obstacles such as: non-affordability of prescribed diet, frustration due to the restriction, limited spousal support, feelings of deprivation, feeling that temptation is inevitable, difficulty in adhering in social gatherings and difficulty in revealing to host that one is diabetic; health care providers obstacles were: poor attitude of health workers, irregular diabetes education in clinics , limited number of nutrition education sessions/ inability of the patients to estimate the desired quantity of food, no reminder post cards or phone calls about upcoming patient appointments and delayed start of appointment / time wasting in clinics.

Comparison of Neural Network and Logistic Regression Methods to Predict Xerostomia after Radiotherapy

To evaluate the ability to predict xerostomia after radiotherapy, we constructed and compared neural network and logistic regression models. In this study, 61 patients who completed a questionnaire about their quality of life (QoL) before and after a full course of radiation therapy were included. Based on this questionnaire, some statistical data about the condition of the patients’ salivary glands were obtained, and these subjects were included as the inputs of the neural network and logistic regression models in order to predict the probability of xerostomia. Seven variables were then selected from the statistical data according to Cramer’s V and point-biserial correlation values and were trained by each model to obtain the respective outputs which were 0.88 and 0.89 for AUC, 9.20 and 7.65 for SSE, and 13.7% and 19.0% for MAPE, respectively. These parameters demonstrate that both neural network and logistic regression methods are effective for predicting conditions of parotid glands.

Brain Drain of Doctors; Causes and Consequences in Pakistan

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.

An Evaluation of Sputum Smear Conversion and Haematological Parameter Alteration in Early Detection Period of New Pulmonary Tuberculosis (PTB) Patients

Sputum smear conversion after one month of antituberculosis therapy in new smear positive pulmonary tuberculosis patients (PTB+) is a vital indicator towards treatment success. The objective of this study is to determine the rate of sputum smear conversion in new PTB+ patients after one month under treatment of National Institute of Diseases of the Chest and Hospital (NIDCH). Analysis of sputum smear conversion was done by re-clinical examination with sputum smear microscopic test after one month. Socio-demographic and hematological parameters were evaluated to perceive the correlation with the disease status. Among all enrolled patients only 33.33% were available for follow up diagnosis and of them only 42.86% patients turned to smear negative. Probably this consequence is due to non-coherence to the proper disease management. 66.67% and 78.78% patients reported low haemoglobin and packed cell volume level respectively whereas 80% and 93.33% patients accounted accelerated platelet count and erythrocyte sedimentation rate correspondingly.

Towards Medical Device Maintenance Workflow Monitoring

Concerning the inpatient care the present situation is characterized by intense charges of medical technology into the clinical daily routine and an ever stronger integration of special techniques into the clinical workflow. Medical technology is by now an integral part of health care according to consisting general accepted standards. Purchase and operation thereby represent an important economic position and both are subject of everyday optimisation attempts. For this purpose by now exists a huge number of tools which conduce more likely to a complexness of the problem by a comprehensive implementation. In this paper the advantages of an integrative information-workflow on the life-cycle-management in the region of medical technology are shown.

Gene Expression Signature for Classification of Metastasis Positive and Negative Oral Cancer in Homosapiens

Cancer classification to their corresponding cohorts has been key area of research in bioinformatics aiming better prognosis of the disease. High dimensionality of gene data has been makes it a complex task and requires significance data identification technique in order to reducing the dimensionality and identification of significant information. In this paper, we have proposed a novel approach for classification of oral cancer into metastasis positive and negative patients. We have used significance analysis of microarrays (SAM) for identifying significant genes which constitutes gene signature. 3 different gene signatures were identified using SAM from 3 different combination of training datasets and their classification accuracy was calculated on corresponding testing datasets using k-Nearest Neighbour (kNN), Fuzzy C-Means Clustering (FCM), Support Vector Machine (SVM) and Backpropagation Neural Network (BPNN). A final gene signature of only 9 genes was obtained from above 3 individual gene signatures. 9 gene signature-s classification capability was compared using same classifiers on same testing datasets. Results obtained from experimentation shows that 9 gene signature classified all samples in testing dataset accurately while individual genes could not classify all accurately.

Evaluation of the Impact of Dataset Characteristics for Classification Problems in Biological Applications

Availability of high dimensional biological datasets such as from gene expression, proteomic, and metabolic experiments can be leveraged for the diagnosis and prognosis of diseases. Many classification methods in this area have been studied to predict disease states and separate between predefined classes such as patients with a special disease versus healthy controls. However, most of the existing research only focuses on a specific dataset. There is a lack of generic comparison between classifiers, which might provide a guideline for biologists or bioinformaticians to select the proper algorithm for new datasets. In this study, we compare the performance of popular classifiers, which are Support Vector Machine (SVM), Logistic Regression, k-Nearest Neighbor (k-NN), Naive Bayes, Decision Tree, and Random Forest based on mock datasets. We mimic common biological scenarios simulating various proportions of real discriminating biomarkers and different effect sizes thereof. The result shows that SVM performs quite stable and reaches a higher AUC compared to other methods. This may be explained due to the ability of SVM to minimize the probability of error. Moreover, Decision Tree with its good applicability for diagnosis and prognosis shows good performance in our experimental setup. Logistic Regression and Random Forest, however, strongly depend on the ratio of discriminators and perform better when having a higher number of discriminators.