Search

The epidemic of diabetes, obesity and unhealthy lifestyles have highly contributed to increasing number of patients with heart problems. Wearable fitness trackers are not accurate enough in heart problem detection and the current software-based algorithms, when implemented in devices like smartwatches are not efficient in terms of hardware resource utilization and computational speed. To address these limitations, this paper proposes an automated heartbeat classifying hardware chip-design which can be placed in any kind of wearable device for real-time cardiac monitoring that would help to ensure early diagnosis of any kind of cardiac abnormality. The algorithm burnt on the hardware is a modification of the Pan-Tompkins beat-detection algorithm to which a novel classifier algorithm is added. It exhibits high computational speed with an accuracy of 99.65% in extremely noisy situations, when applied on the MIT/BIH arrhythmia database. The hardware utilization on the SPARTAN-6 FPGA for the presented design is just 32% allowing space for much more multi-tasking and upgrading to be done when implemented on a wearable device as an ASIC.

Background: Management of injuries sustained during cholecystectomy requires expertise and involves a patient who is troubled, usually drained of personal resources. There has been an increase in incidence with laparoscopic cholecystectomy. The standard surgical management done for major biliary injuries is Roux-en-Y Hepaticojejunostomy (R-en-Y HJ). Materials and Methods: Patients managed surgically for definitive management of biliary injuries in the form of R-en-Y HJ were included. Data were collected from prospectively maintained records and through outpatient follow-up. Demographic data, early and late surgical complications, long-term outcomes, and follow-up results were analyzed. Results: Among the 62 patients, 26 were males, with a mean age of 37.4 ± 13.5 years. A total of 24 patients presented with ongoing biliary fistula. The Strasberg–Bismuth type of injury included types E1 in 8 (13%), E2 in 31 (50%), E3 in 19 (30.6%), and E4 in four patients (6.4%). There were no postoperative mortality and morbidity in 27.4% of patients. Atrophy–hypertrophy complex was seen in four patients, vascular injury in six patients, and an internal fistulisation with duodenum in two patients. Presence of comorbidities (P = 0.05), male gender (P = 0.03), tobacco use (P = 0.04), low albumin (P = 0.016), and more proximal (E4-E1) type of injury (P = 0.008) were independent predictors of postoperative morbidity (P < 0.05). The mean duration of patient follow-up was 26.2 ± 21.1 months. Conclusion: Optimization of preoperative nutrition, avoidance of intraoperative blood transfusion, proper timing of repair, and tension-free R-en-Y HJ draining all the ducts which is done at an experienced hepatobiliary center provide the best outcome.

Management of heart failure is a major health care challenge. Healthcare providers are expected to use best practices described in clinical practice guidelines, which typically consist of a long series of complex rules. For heart failure management, the relevant guidelines are nearly 80 pages long. Due to their complexity, the guidelines are often difficult to fully comply with, which can result in suboptimal medical practices. In this paper, we describe a heart failure treatment adviser system that automates the entire set of rules in the guidelines for heart failure management. The system is based on answer set programming, a form of declarative programming suited for simulating human-style reasoning. Given a patient's information, the system is able to generate a set of guideline-compliant recommendations. We conducted a pilot study of the system on 21 real and 10 simulated patients with heart failure. The results show that the system can give treatment recommendations compliant with the guidelines. Out of 187 total recommendations made by the system, 176 were agreed upon by the expert cardiologists. Also, the system missed eight valid recommendations. The reason for the missed and discordant recommendations seems to be insufficient information, differing style, experience, and knowledge of experts in decision-making that were not captured in the system at this time. The system can serve as a point-of-care tool for clinics. Also, it can be used as an educational tool for training physicians and an assessment tool to measure the quality metrics of heart failure care of an institution.

The problem of obtaining an optimal spline with free knots is tantamount to minimizing derivatives of a nonlinear differentiable function over a Banach space on a compact set. While the problem of data interpolation by quadratic splines has been accomplished, interpolation by splines of higher orders is far more challenging. In this paper, to overcome difficulties associated with the complexity of the interpolation problem, the interval over which data points are defined is discretized and continuous derivatives are replaced by their discrete counterparts. The l∞-norm used for maximum rth order curvature (a derivative of order r) is then linearized, and the problem to obtain a near-optimal spline becomes a linear programming (LP) problem, which is solved in polynomial time by using LP methods, e.g., by using the Simplex method implemented in modern software such as CPLEX. It is shown that, as the mesh of the discretization approaches zero, a resulting near-optimal spline approaches an optimal spline. Splines with the desired accuracy can be obtained by choosing an appropriately fine mesh of the discretization. By using cubic splines as an example, numerical results demonstrate that the linear programming (LP) formulation, resulting from the discretization of the interpolation problem, can be solved by linear solvers with high computational efficiency and the resulting spline provides a good approximation to the sought-for optimal spline.

Background/Aim: Hypersplenism due to splenic congestion is observed in portal hypertensive patients. This study was done to know the change in platelets count following early ligation of splenic artery during splenectomy in patients with thrombocytopenia due to portal hypertension with a hypothesis that splenic decongestion results in increased platelets count; thereby platelet transfusion can be avoided. Materials and Methods: Patients with platelets count

Abstract Cathepsin C (CTSC) is a lysosomal cysteine protease constitutively expressed at high levels in the lung, kidney, liver, and spleen. It plays a key role in the activation of serine proteases in cytotoxic T cells, natural killer cells (granzymes A and B), mast cells (chymase and tryptase) and neutrophils (cathepsin G, neutrophil elastase, proteinase 3) underscoring its pivotal significance in immune and inflammatory defenses. Here, we comprehensively review the structural attributes, synthesis, and function of CTSC, with a focus on its variants implicated in the etiopathology of several syndromes associated with neutrophil serine proteases, including Papillon–Lefevre syndrome (PLS), Haim–Munk Syndrome (HMS), and aggressive periodontitis (AP). These syndromes are characterized by palmoplantar hyperkeratosis, and early-onset periodontitis (severe gum disease) resulting in premature tooth loss. Due to the critical role played by CTSC in these and several other conditions it is being explored as a potential therapeutic target for autoimmune and inflammatory disorders. The review also discusses in depth the gene variants of CTSC, and in particular their postulated association with chronic obstructive pulmonary disease (COPD), COVID-19, various cancers, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, sudden cardiac death (SCD), atherosclerotic vascular disease, and neuroinflammatory disease. Finally, the therapeutic potential of CTSC across a range of human diseases is discussed.

Sustainability in freight transportation demands for a balance among economic, environmental, and social aspects in shipping commodities throughout a supply chain. The performance evaluation of sustainable freight transportation (SFT) systems is of prime importance as it facilitates perpetual and objective assessment for advancements towards sustainability targets. In this study, we propose a comprehensive framework to assess the sustainability performance of freight transportation systems. We pinpoint critical success factors (CSFs) affecting the performance of SFT by carrying out an extensive literature review and conducting a Delphi study to seek experts' opinions from industry as well as academia. Further, a comprehensive hierarchical framework is developed to establish inter-relationships among these CSFs followed by prioritisation of these CSFs. The application of the proposed framework is illustrated through a case example. This framework would also serve as a reference for decision-makers in selecting the most sustainable freight transportation system. [ABSTRACT FROM AUTHOR]

Abstract Objectives The study explored the expression profile of miRNAs in Notch-activated periodontal ligament stem cells (PDLSCs) and examined their potential cellular targets. Methods PDLSCs were cultured and treated with indirect immobilized Jagged1. The miRNA expression profile was examined using NanoString analysis. Bioinformatic analysis was performed together with enrichment, and miRNA expression was evaluated and validated using a quantitative polymerase chain reaction (qPCR). Results A total of 26 miRNAs were differentially expressed in Jagged1 treated PDLSCs compared with the controls. Pathway analysis revealed that altered miRNAs were significantly associated with the transforming growth factor β (TGF-β) signaling pathway. Target prediction analysis demonstrated that 11,170 genes as predictable targets of these altered miRNAs. Enrichment of predicted target genes revealed that they were related to ErbB, Ras and MAPK signaling pathways and small GTPase transduction. Conclusions The research concludes that several miRNAs are differentially expressed in jagged-1 treated PDLSCs. In translational terms the differential functionality of these miRNAs offer promise for the development of targeted regenerative materials that are necessary for managing lost tissue replacement in periodontal diseases.

Denture plaque, a biofilm that develops on denture surfaces, could contribute to many oral and systemic afflictions. Hence, a quantitative assessment of denture plaque is important to evaluate the denture hygiene of denture wearers, particularly to prevent plaque biofilm-associated diseases. The aim of this systematic review, therefore, was to review and summarize the visual denture hygiene assessment methods using denture plaque indices and with planimetries published in the literature. English language studies published up to March 2022 in four electronic databases, PubMed, Medline, Embase, and Cochrane Library, were searched, followed by a manual search of Google Scholar by two assessors. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) whenever possible. Details of the visual assessment methods, including the types of denture assessed, its materials and its surfaces, as well as the use of a disclosing agent, were the main outcomes. Of 492 screened studies, 74 were included per the inclusion and exclusion criteria. Of these, 60 studies utilized various denture plaque indices while 18 used planimetries. 43 out of 60 studies with indices and 17 out of 18 studies with planimetries used disclosing agents for visual evaluation of plaque. A total of 21 indices were described in the included studies, of which seven graded a divided denture surface, while the remainder graded entire denture surface. Of the 18 planimetric assessments, one study quantified squares of the disclosed plaques on denture images, 16 studies quantified such pixels with computer programs, and a single study quantified points, pixels, and contour of plaque areas. In summary, denture plaque indices appear to be popular in denture plaque assessment due to their simplicity. Computerized planimetric assessment, though more time-consuming, provides a more accurate assessment of plaque load as it is less prone to subjectivity and assessor errors.