Abstract: TELMES project aims to develop a securized
multimedia system devoted to medical consultation teleservices. It
will be finalized with a pilot system for a regional telecenters
network that connects local telecenters, having as support
multimedia platforms. This network will enable the implementation
of complex medical teleservices (teleconsulations, telemonitoring,
homecare, urgency medicine, etc.) for a broader range of patients
and medical professionals, mainly for family doctors and those
people living in rural or isolated regions. Thus, a multimedia,
scalable network, based on modern IT&C paradigms, will result. It
will gather two inter-connected regional telecenters, in Iaşi and
Piteşti, Romania, each of them also permitting local connections of
hospitals, diagnostic and treatment centers, as well as local networks
of family doctors, patients, even educational entities. As
communications infrastructure, we aim to develop a combined fixmobile-
internet (broadband) links. Other possible communication
environments will be GSM/GPRS/3G and radio waves. The
electrocardiogram (ECG) acquisition, internet transmission and
local analysis, using embedded technologies, was already
successfully done for patients- telemonitoring.
Abstract: Diabetes mellitus (DM) is frequently characterized by
autonomic nervous dysfunction. Analysis of heart rate variability
(HRV) has become a popular noninvasive tool for assessing the
activities of autonomic nervous system (ANS). In this paper, changes
in ANS activity are quantified by means of frequency and time
domain analysis of R-R interval variability. Electrocardiograms
(ECG) of 16 patients suffering from DM and of 16 healthy volunteers
were recorded. Frequency domain analysis of extracted normal to
normal interval (NN interval) data indicates significant difference in
very low frequency (VLF) power, low frequency (LF) power and
high frequency (HF) power, between the DM patients and control
group. Time domain measures, standard deviation of NN interval
(SDNN), root mean square of successive NN interval differences
(RMSSD), successive NN intervals differing more than 50 ms (NN50
Count), percentage value of NN50 count (pNN50), HRV triangular
index and triangular interpolation of NN intervals (TINN) also show
significant difference between the DM patients and control group.
Abstract: The purpose of this study is to derive parameters
estimating for the Lyman–Kutcher–Burman (LKB) normal tissue
complication probability (NTCP) model using analysis of scintigraphy
assessments and quality of life (QoL) measurement questionnaires for
the parotid gland (xerostomia). In total, 31 patients with
head-and-neck (HN) cancer were enrolled. Salivary excretion factor
(SEF) and EORTC QLQ-H&N35 questionnaires datasets are used for
the NTCP modeling to describe the incidence of grade 4 xerostomia.
Assuming that n= 1, NTCP fitted parameters are given as TD50= 43.6
Gy, m= 0.18 in SEF analysis, and as TD50= 44.1 Gy, m= 0.11 in QoL
measurements, respectively. SEF and QoL datasets can validate the
Quantitative Analyses of Normal Tissue Effects in the Clinic
(QUANTEC) guidelines well, resulting in NPV-s of 100% for the both
datasets and suggests that the QUANTEC 25/20Gy gland-spared
guidelines are suitable for clinical used for the HN cohort to
effectively avoid xerostomia.
Abstract: The hospital and the health-care center of a
community, as a place for people-s life-care and health-care settings,
must provide more and better services for patients or residents. After
Establishing Electronic Medical Record (EMR) system -which is a
necessity- in the hospital, providing pervasive services is a further
step. Our objective in this paper is to use pervasive computing in a
case study of healthcare, based on EMR database that coordinates
application services over network to form a service environment for
medical and health-care. Our method also categorizes the hospital
spaces into 3 spaces: Public spaces, Private spaces and Isolated
spaces. Although, there are many projects about using pervasive
computing in healthcare, but all of them concentrate on the disease
recognition, designing smart cloths, or provide services only for
patient. The proposed method is implemented in a hospital. The
obtained results show that it is suitable for our purpose.
Abstract: A Positron Emission Tomography (PET) is a radioisotope imaging technique that illustrates the organs and the metabolisms of the human body. This technique is based on the simultaneous detection of 511 keV annihilation photons, annihilated as a result of electrons annihilating positrons that radiate from positron-emitting radioisotopes that enter biological active molecules in the body. This study was conducted on ten patients in an effort to conduct patient-related experimental studies. Dosage monitoring for the bladder, which was the organ that received the highest dose during PET applications, was conducted for 24 hours. Assessment based on measuring urination activities after injecting patients was also a part of this study. The MIRD method was used to conduct dosage calculations for results obtained from experimental studies. Results obtained experimentally and theoretically were assessed comparatively.
Abstract: The study of the variability of the postural strategies
in low back pain patients, as a criterion in evaluation of the
adaptability of this system to the environmental demands is the
purpose of this study. A cross-sectional case-control study was
performed on 21 recurrent non-specific low back pain patients and 21
healthy volunteers. The electromyography activity of Deltoid,
External Oblique (EO), Transverse Abdominis/Internal Oblique
(TrA/IO) and Erector Spine (ES) muscles of each person was
recorded in 75 rapid arm flexion with maximum acceleration.
Standard deviation of trunk muscles onset relative to deltoid muscle
onset were statistically analyzed by MANOVA . The results show
that chronic low back pain patients exhibit less variability in their
anticipatory postural adjustments (APAs) in comparison with the
control group. There is a decrease in variability of postural control
system of recurrent non-specific low back pain patients that can
result in the persistence of pain and chronicity by decreasing the
adaptability to environmental demands.
Abstract: This paper proposes a novel architecture for At-
Home medical care which enables senior citizens, patients
with chronic ailments and patients requiring post- operative
care to be remotely monitored in the comfort of their homes.
This architecture is implemented using sensors and wireless
networking for transmitting patient data to the hospitals,
health- care centers for monitoring by medical professionals.
Patients are equipped with sensors to measure their
physiological parameters, like blood pressure, pulse rate etc.
and a Wearable Data Acquisition Unit is used to transmit the
patient sensor data. Medical professionals can be alerted to
any abnormal variations in these values for diagnosis and
suitable treatment. Security threats and challenges inherent to
wireless communication and sensor network have been
discussed and a security mechanism to ensure data
confidentiality and source authentication has been proposed.
Symmetric key algorithm AES has been used for encrypting
the data and a patent-free, two-pass block cipher mode CCFB
has been used for implementing semantic security.
Abstract: Sense-antisense gene pair (SAGP) is a pair of two oppositely transcribed genes sharing a common region on a chromosome. In the mammalian genomes, SAGPs can be organized in more complex sense-antisense gene architectures (CSAGA) in which at least one gene could share loci with two or more antisense partners. Many dozens of CSAGAs can be found in the human genome. However, CSAGAs have not been systematically identified and characterized in context of their role in human diseases including cancers. In this work we characterize the structural-functional properties of a cluster of 5 genes –TMEM97, IFT20, TNFAIP1, POLDIP2 and TMEM199, termed TNFAIP1 / POLDIP2 module. This cluster is organized as CSAGA in cytoband 17q11.2. Affymetrix U133A&B expression data of two large cohorts (410 atients, in total) of breast cancer patients and patient survival data were used. For the both studied cohorts, we demonstrate (i) strong and reproducible transcriptional co-regulatory patterns of genes of TNFAIP1/POLDIP2 module in breast cancer cell subtypes and (ii) significant associations of TNFAIP1/POLDIP2 CSAGA with amplification of the CSAGA region in breast cancer, (ii) cancer aggressiveness (e.g. genetic grades) and (iv) disease free patient-s survival. Moreover, gene pairs of this module demonstrate strong synergetic effect in the prognosis of time of breast cancer relapse. We suggest that TNFAIP1/ POLDIP2 cluster can be considered as a novel type of structural-functional gene modules in the human genome.
Abstract: Background: Widespread use of chemotherapeutic
drugs in the treatment of cancer has lead to higher health hazards
among employee who handle and administer such drugs, so nurses
should know how to protect themselves, their patients and their work
environment against toxic effects of chemotherapy. Aim of this study
was carried out to examine the effect of chemotherapy safety protocol
for oncology nurses on their protective measure practices. Design: A
quasi experimental research design was utilized. Setting: The study
was carried out in oncology department of Menoufia university
hospital and Tanta oncology treatment center. Sample: A
convenience sample of forty five nurses in Tanta oncology treatment
center and eighteen nurses in Menoufiya oncology department.
Tools: 1. an interviewing questionnaire that covering sociodemographic
data, assessment of unit and nurses' knowledge about
chemotherapy. II: Obeservational check list to assess nurses' actual
practices of handling and adminestration of chemotherapy. A base
line data were assessed before implementing Chemotherapy Safety
protocol, then Chemotherapy Safety protocol was implemented, and
after 2 monthes they were assessed again. Results: reveled that 88.9%
of study group I and 55.6% of study group II improved to good total
knowledge scores after educating on the safety protocol, also 95.6%
of study group I and 88.9% of study group II had good total practice
score after educating on the safety protocol. Moreover less than half
of group I (44.4%) reported that heavy workload is the most barriers
for them, while the majority of group II (94.4%) had many barriers
for adhering to the safety protocol such as they didn’t know the
protocol, the heavy work load and inadequate equipment.
Conclusions: Safety protocol for Oncology Nurses seemed to have
positive effect on improving nurses' knowledge and practice.
Recommendation: chemotherapy safety protocol should be instituted
for all oncology nurses who are working in any oncology unit and/ or
center to enhance compliance, and this protocol should be done at
frequent intervals.
Abstract: In this paper, a wavelet-based neural network (WNN) classifier for recognizing EEG signals is implemented and tested under three sets EEG signals (healthy subjects, patients with epilepsy and patients with epileptic syndrome during the seizure). First, the Discrete Wavelet Transform (DWT) with the Multi-Resolution Analysis (MRA) is applied to decompose EEG signal at resolution levels of the components of the EEG signal (δ, θ, α, β and γ) and the Parseval-s theorem are employed to extract the percentage distribution of energy features of the EEG signal at different resolution levels. Second, the neural network (NN) classifies these extracted features to identify the EEGs type according to the percentage distribution of energy features. The performance of the proposed algorithm has been evaluated using in total 300 EEG signals. The results showed that the proposed classifier has the ability of recognizing and classifying EEG signals efficiently.
Abstract: Erroneous computer entry problems [here: 'e'errors] in hospital labs threaten the patients-–health carers- relationship, undermining the health system credibility. Are e-errors random, and do lab professionals make them accidentally, or may they be traced through meaningful determinants? Theories on internal causality of mistakes compel to seek specific causal ascriptions of hospital lab eerrors instead of accepting some inescapability. Undeniably, 'To Err is Human'. But in view of rapid global health organizational changes, e-errors are too expensive to lack in-depth considerations. Yet, that efunction might supposedly be entrenched in the health carers- job description remains under dispute – at least for Hellenic labs, where e-use falls behind generalized(able) appreciation and application. In this study: i) an empirical basis of a truly high annual cost of e-errors at about €498,000.00 per rural Hellenic hospital was established, hence interest in exploring the issue was sufficiently substantiated; ii) a sample of 270 lab-expert nurses, technicians and doctors were assessed on several personality, burnout and e-error measures, and iii) the hypothesis that the Hardiness vs Alienation personality construct disposition explains resistance vs proclivity to e-errors was tested and verified: Hardiness operates as a resilience source in the encounter of high pressures experienced in the hospital lab, whereas its 'opposite', i.e., Alienation, functions as a predictor, not only of making e-errors, but also of leading to burn-out. Implications for apt interventions are discussed.
Abstract: If a possibility distribution and a probability distribution
are describing values x of one and the same system or process
x(t), can they relate to each other? Though in general the possibility
and probability distributions might be not connected at all, we
can assume that in some particular cases there is an association linked
them.
In the presented paper, we consider distributions of bloodstream
concentrations of physiologically active substances and propose that
the probability to observe a concentration x of a substance X can be
produced from the possibility of the event X = x .
The proposed assumptions and resulted theoretical distributions
are tested against the data obtained from various panel studies of the
bloodstream concentrations of the different physiologically active
substances in patients and healthy adults as well.
Abstract: It is believed that DNA damaging toxic metabolites contributes to the development of different pathological conditions. To prevent harmful influence of toxic agents, cells developed number of protecting mechanisms, such as enzymatic reaction of detoxification of reactive metabolites and repair of DNA damage. The aim of the study was to examine the association between polymorphism of GSTT1/GSTM1 and XRCC1/3 genes and coronary artery disease (CAD) incidence. To examine a polymorphism of these genes in CAD susceptibility in patients and controls, PCR based genotyping assay was performed. For GST genes, frequency of GSTM1 null genotype among CAD affected group was significantly increased than in control group (P0.1). We found that neither XRCC1 Arg399Gln nor XRCC3 Thr241Met were associated with CAD risk. Obtained data suggests that GSTM1 null genotype carriers are more susceptible to CAD development.
Abstract: Recent advancements in sensor technologies and
Wireless Body Area Networks (WBANs) have led to the
development of cost-effective healthcare devices which can be used
to monitor and analyse a person-s physiological parameters from
remote locations. These advancements provides a unique opportunity
to overcome current healthcare challenges of low quality service
provisioning, lack of easy accessibility to service varieties, high costs
of services and increasing population of the elderly experienced
globally. This paper reports on a prototype implementation of an
architecture that seamlessly integrates Wireless Body Area Network
(WBAN) with Web services (WS) to proactively collect
physiological data of remote patients to recommend diagnostic
services. Technologies based upon WBAN and WS can provide
ubiquitous accessibility to a variety of services by allowing
distributed healthcare resources to be massively reused to provide
cost-effective services without individuals physically moving to the
locations of those resources. In addition, these technologies can
reduce costs of healthcare services by allowing individuals to access
services to support their healthcare. The prototype uses WBAN body
sensors implemented on arduino fio platforms to be worn by the
patient and an android smart phone as a personal server. The
physiological data are collected and uploaded through GPRS/internet
to the Medical Health Server (MHS) to be analysed. The prototype
monitors the activities, location and physiological parameters such as
SpO2 and Heart Rate of the elderly and patients in rehabilitation.
Medical practitioners would have real time access to the uploaded
information through a web application.
Abstract: The p53 tumor suppressor gene plays two important
roles in genomic stability: blocking cell proliferation after DNA
damage until it has been repaired, and starting apoptosis if the
damage is too critical. Codon 72 exon4 polymorphism (Arg72Pro) of
the P53 gene has been implicated in cancer risk. Various studies have
been done to investigate the status of p53 at codon 72 for arginine
(Arg) and proline (Pro) alleles in different populations and also the
association of this codon 72 polymorphism with various tumors. Our
objective was to investigate the possible association between P53
Arg72Pro polymorphism and susceptibility to colorectal cancer
among Isfahan and Chaharmahal Va Bakhtiari (a part of south west
of Iran) population. We investigated the status of p53 at codon 72 for
Arg/Arg, Arg/Pro and Pro/Pro allele polymorphisms in blood
samples from 145 colorectal cancer patients and 140 controls by
Nested-PCR of p53 exon 4 and digestion with BstUI restriction
enzyme and the DNA fragments were then resolved by
electrophoresis in 2% agarose gel. The Pro allele was 279 bp, while
the Arg allele was restricted into two fragments of 160 and 119 bp.
Among the 145 colorectal cancer cases 49 cases (33.79%) were
homozygous for the Arg72 allele (Arg/Arg), 18 cases (12.41%) were
homozygous for the Pro72 allele (Pro/Pro) and 78 cases (53.8%)
found in heterozygous (Arg/Pro).
In conclusion, it can be said that p53Arg/Arg genotype may be
correlated with possible increased risk of this kind of cancers in south
west of Iran.
Abstract: This paper describes the Multilingual Virtual Simulated Patient framework. It has been created to train the social skills and testing the knowledge of primary health care medical students. The framework generates conversational agents which perform in serveral languages as virtual simulated patients that help to improve the communication and diagnosis skills of the students complementing their training process.
Abstract: This paper discusses the designing of knowledge
integration of clinical information extracted from distributed medical
ontologies in order to ameliorate a machine learning-based multilabel
coding assignment system. The proposed approach is
implemented using a decision tree technique of the machine learning
on the university hospital data for patients with Coronary Heart
Disease (CHD). The preliminary results obtained show a satisfactory
finding that the use of medical ontologies improves the overall
system performance.
Abstract: Chronic diseases prevailed along with economic
growth as well as life style changed in recent years in Taiwan.
According to the governmental statistics, hypertension related disease
is the tenth of death causes with 1,816 died directly from hypertension
in 2010. There were more death causes amongst the top ten had been
proofed that having strong association with the hypertension, such as
heart diseases, cardiovascular diseases, and diabetes. Hypertension or
High blood pressure is one of the major indicators for chronic diseases,
and was generally perceived as the major causes of mortality. The
literature generally suggested that regular physical exercise was
helpful to prevent the occurrence or to ease the progress of a
hypertension. This paper reported the process and outcomes in
detailed of an improvement project of physical exercise intervention
specific for hypertension patients. Physical information were
measured before and after the project to obtain information such as
weight, waistline, cholesterol (HD & LD), blood examination, as well
as self-perceived health status. The intervention project involved a
six-week exercise program, of which contained three times a week, 30
minutes of tutored physical exercise intervention. The project had
achieved several gains in changing the subjects- behavior in terms of
many important biophysical indexes. Around 20% of the participants
had significantly improved their cholesterols, BMI, and changed
unhealthy behaviors. Results from the project were encouraging, and
would be good reference for other samples.
Abstract: Obesity is frequent attendant phenomenon of patients
with endocrinological disease. Between BMI and endocrinological
diseases is close correlation. In thesis we focused on the allocation of
hormone concentration – PTH and TSH, CHOL a mineral element Ca
in a blood serum. The examined group was formed by 100
respondents (women) aged 36 – 83 years, who were divided into two
groups – control group (CG), group with diagnosed endocrine disease
(DED). The concentration of PTH and TSH, Ca and CHOL was
measured through the medium of analyzers Cobas e411 (Japan);
Cobas Integra 400 (Switzerland). At individuals was measured body
weight as well as stature and thereupon from those data we
enumerated BMI. On the basis of Student T-test in biochemical
parameter of PTH and Ca we found out significantly meaningful
difference (p
Abstract: 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.