bluuebunny/crossref_metadata_2025 huggingface dataset:
Classification of Human Emotional States Based on Valence-Arousal Scale using Electroencephalogram
Authors: Kumar GS Shashi , Sampathila Niranjana , Martis Roshan Joy
Published: June 2024

Recognition of human emotion states for affective computing based on Electroencephalogram (EEG) signal is an active yet challenging domain of research. In this study we propose an emotion recognition framework based on 2-dimensional valence-arousal model to classify High Arousal-Positive Valence (Happy) and Low Arousal-Negative Valence (Sad) emotions. In total 34 features from time, frequency, statistical and nonlinear domain are studied for their efficacy using Artificial Neural Network (ANN). The EEG signals from various electrodes in different scalp regions viz., frontal, parietal, temporal, occipital are studied for performance. It is found that ANN trained using features extracted from the frontal region has outperformed that of all other regions with an accuracy of 93.25%. The results indicate that the use of smaller set of electrodes for emotion recognition that can simplify the acquisition and processing of EEG data. The developed system can aid immensely to the physicians in their clinical practice involving emotional states, continuous monitoring, and development of wearable sensors for emotion recognition.
Cervical Cancer Prediction by Merging Features of Different Colposcopic Images and Using Ensemble Classifier
Authors: Nikookar Elham , Naderi Ebrahim , Rahnavard Ali
Published: June 2024

Background:

Cervical cancer is a significant cause of cancer mortality in women, particularly in low-income countries. In regular cervical screening methods, such as colposcopy, an image is taken from the cervix of a patient. The particular image can be used by computer-aided diagnosis (CAD) systems that are trained using artificial intelligence algorithms to predict the possibility of cervical cancer. Artificial intelligence models had been highlighted in a number of cervical cancer studies. However, there are a limited number of studies that investigate the simultaneous use of three colposcopic screening modalities including Greenlight, Hinselmann, and Schiller.

Methods:

We propose a cervical cancer predictor model which incorporates the result of different classification algorithms and ensemble classifiers. Our approach merges features of different colposcopic images of a patient. The feature vector of each image includes semantic medical features, subjective judgments, and a consensus. The class label of each sample is calculated using an aggregation function on expert judgments and consensuses.

Results:

We investigated different aggregation strategies to find the best formula for aggregation function and then we evaluated our method using the quality assessment of digital colposcopies dataset, and our approach performance with 96% of sensitivity and 94% of specificity values yields a significant improvement in the field.

Conclusion:

Our model can be used as a supportive clinical decision-making strategy by giving more reliable information to the clinical decision makers. Our proposed model also is more applicable in cervical cancer CAD systems compared to the available methods.
Quantitative Analysis of Image Quality in Low-Dose Computed Tomography Imaging for COVID-19 Patients
Authors: Ghane Behrooz , Karimian Alireza , Mostafapour Samaneh , Gholamiankhak Faezeh , Shojaerazavi Seyedjafar , Arabi Hossein
Published: June 2024

Background:

Computed tomography (CT) scan is one of the main tools to diagnose and grade COVID-19 progression. To avoid the side effects of CT imaging, low-dose CT imaging is of crucial importance to reduce population absorbed dose. However, this approach introduces considerable noise levels in CT images.

Methods:

In this light, we set out to simulate four reduced dose levels (60% dose, 40% dose, 20% dose, and 10% dose) of standard CT imaging using Beer–Lambert's law across 49 patients infected with COVID-19. Then, three denoising filters, namely Gaussian, bilateral, and median, were applied to the different low-dose CT images, the quality of which was assessed prior to and after the application of the various filters via calculation of peak signal-to-noise ratio, root mean square error (RMSE), structural similarity index measure, and relative CT-value bias, separately for the lung tissue and whole body.

Results:

The quantitative evaluation indicated that 10%-dose CT images have inferior quality (with RMSE = 322.1 ± 104.0 HU and bias = 11.44% ± 4.49% in the lung) even after the application of the denoising filters. The bilateral filter exhibited superior performance to suppress the noise and recover the underlying signals in low-dose CT images compared to the other denoising techniques. The bilateral filter led to RMSE and bias of 100.21 ± 16.47 HU and − 0.21% ± 1.20%, respectively, in the lung regions for 20%-dose CT images compared to the Gaussian filter with RMSE = 103.46 ± 15.70 HU and bias = 1.02% ± 1.68% and median filter with RMSE = 129.60 ± 18.09 HU and bias = −6.15% ± 2.24%.

Conclusions:

The 20%-dose CT imaging followed by the bilateral filtering introduced a reasonable compromise between image quality and patient dose reduction.
Electrocardiogram Signals Denoising Using Improved Variational Mode Decomposition
Authors: Malhotra Vikas , Sandhu Mandeep Kaur
Published: June 2024

Background:

Electrocardiogram (ECG) plays a vital role in the analysis of heart activity. It can be used to analyze the different heart diseases and mental stress assessment also. Various noises, such as baseline wandering, muscle artifacts and power line interface disturbs the information within the ECG signal. To acquire correct information from ECG signal, these noises should be removed.

Methods:

In the proposed work, the improved variational mode decomposition (IVMD) method for the removal of noise in ECG signals is used. In the proposed method, the weighted signal amplitude integrated over the timeframe of the ECG signal varies the window size during decomposition. Raw ECG data are extracted from 10 subjects and ECG data are also taken from the MIT BIH database for the proposed method.

Results:

The performance comparison of traditional variational mode decomposition (VMD) and the proposed technique is also calculated using mean square error, percentage root mean square difference, signal to noise ratio and correlation coefficient. The extracted highest signal to noise ratio (SNR) value of acquired ECG signals using traditional VMD is 42db whereas highest value of signal to noise ratio (SNR) using improved VMD (IVMD) is 83db.

Conclusion:

The proposed IVMD technique represented better performance than traditional VMD for denoising of ECG signals.
Demarcating Z-line and Gastric Folds Boundary Based on the Segmentation of the Lower Esophageal Sphincter Images
Authors: Sharifian Rasoul , Nazari Behzad , Sadri Saeed , Adibi Peyman
Published: June 2024

Background and Objective:

The endoscopic diagnosis of pathological changes in the gastroesophageal junction including esophagitis and Barrett's mucosa is based on the visual detection of two boundaries: mucosal color change between esophagus and stomach, and top endpoint of gastric folds. The presence and pattern of mucosal breaks in the gastroesophageal mucosal junction (Z line) classify esophagitis in patients and the distance between the two boundaries points to the possible columnar lined epithelium. Since visual detection may suffer from intra- and interobserver variability, our objective was to define the boundaries automatically based on image processing algorithms, which may enable us to measure the detentions of changes in future studies.

Methods:

To demarcate the Z-line, first the artifacts of endoscopy images are eliminated. In the second step, using SUSAN edge detector, Mahalanobis distance criteria, and Gabor filter bank, an initial contour is estimated for the Z-line. Using region-based active contours, this initial contour converges to the Z-line. Finally, by applying morphological operators and Gabor Filter Bank to the region inside of the Z-line, gastric folds are segmented.

Results:

To evaluate the results, a database consisting of 50 images and their ground truths were collected. The average dice coefficient and mean square error of Z-line segmentation were 0.93 and 3.3, respectively. Furthermore, the average boundary distance criteria are 12.3 pixels. In addition, two other criteria that compare the segmentation of folds with several ground truths, i.e., Sweet-Spot Coverage and Jaccard Index for Golden Standard, are 0.90 and 0.84, respectively.

Conclusions:

Considering the results, automatic segmentation of Z-line and gastric folds are matched to the ground truths with appropriate accuracy.
Development of a Permanent Device for Fertility Period Detection by Basal Body Temperature and Analysis of the Cervical Mucus Potential of Hydrogen
Authors: Mansouri Sofiene
Published: June 2024

Background:

Sometimes, women find it difficult to conceive a baby and others use contraceptives that often have side effects. Researchers have already established the importance of measuring basal body temperature (BBT) and the potential of hydrogen (pH).

Method:

We have designed and realized a device that allows the simultaneous measurement of the BBT and the pH. We used an Arduino Uno board, a pH sensor, and a temperature sensor. The device communicates with a smartphone, can be integrated into all e-health platforms, and can be used at home. We validated our ovulation detector by a measurement campaign on a group of twenty women. If the pH is >7 and at the same time, the BBT is minimum and <36.5°C, the women is in ovulation phase. If the pH is ≤7 and in the same time, the BBT is between 36.5°C and 37°C, the women are in preovulation or follicular phase. If the pH is ≤7 and in the same time, the BBT is >36.5°C, the women are in postovulation or luteal phase.

Results:

We tested the contraceptive aspect of our ovulometer on a set of seven women. We also tested the help of conceiving babies by having intercourse during the ovulation period fixed by our ovulation detector. The results are satisfactory.

Conclusions:

In the final version of our device, we displayed just in “fertility period” if the pH is ≥7 and the BBT is <36.5°C else we displayed in “nonfertility period.”
Tradeoffs between Radiation Exposure to the Lens of the Eyes and Diagnostic Image Quality in Pediatric Brain Computed Tomography
Authors: Karami Vahid , Albosof Mohsen , Gholami Mehrdad , Adeli Mohammad , Hekmatnia Ali , Bagher Sheidaei Mehdi Fallah , Behbahani Ali Taghizadeh , Sharif Hoda Sadat , Jafrasteh Somayeh
Published: June 2024

Background:

Computed tomography (CT) of the brain is associated with radiation exposure to the lens of the eyes. Therefore, it is necessary to optimize scan settings to keep radiation exposure as low as reasonably achievable without compromising diagnostic image information. The aim of this study was to compare the effectiveness of the five practical techniques for lowering eye radiation exposure and their effects on diagnostic image quality in pediatric brain CT.

Methods:

The following scan protocols were performed: reference scan, 0.06-mm Pbeq bismuth shield, 30% globally lowering tube current (GLTC), reducing tube voltage (RTV) from 120 to 90 kVp, gantry tilting, and combination of gantry tilting with bismuth shielding. Radiation measurements were performed using thermoluminescence dosimeters. Objective and subjective image quality was evaluated.

Results:

All strategies significantly reduced eye dose, and increased the posterior fossa artifact index and the temporal lobe artifact index, relative to the reference scan. GLTC and RTV increased image noise, leading to a decrease signal-to-noise ratio and contrast-to-noise ratio. Except for bismuth shielding, subjective image quality was relatively the same as the reference scan.

Conclusions:

Gantry tilting may be the most effective method for reducing eye radiation exposure in pediatric brain CT. When the scanner does not support gantry tilting, GLTC might be an alternative.
Biomarker Discovery by Imperialist Competitive Algorithm in Mass Spectrometry Data for Ovarian Cancer Prediction
Authors: Pirhadi Shiva , Maghooli Keivan , Moteghaed Niloofar Yousefi , Garshasbi Masoud , Mousavirad Seyed Jalaleddin
Published: June 2024

Background:

Mass spectrometry is a method for identifying proteins and could be used for distinguishing between proteins in healthy and nonhealthy samples. This study was conducted using mass spectrometry data of ovarian cancer with high resolution. Usually, diagnostic and monitoring tests are done according to sensitivity and specificity rates; thus, the aim of this study is to compare mass spectrometry of healthy and cancerous samples in order to find a set of biomarkers or indicators with a reasonable sensitivity and specificity rates.

Methods:

Therefore, combination methods were used for choosing the optimum feature set as t-test, entropy, Bhattacharya, and an imperialist competitive algorithm with K-nearest neighbors classifier. The resulting feature from each method was feed to the C5 decision tree with 10-fold cross-validation to classify data.

Results:

The most important variables using this method were identified and a set of rules were extracted. Similar to most frequent features, repetitive patterns were not obtained; the generalized rule induction method was used to identify the repetitive patterns.

Conclusion:

Finally, the resulting features were introduced as biomarkers and compared with other studies. It was found that the resulting features were very similar to other studies. In the case of the classifier, higher sensitivity and specificity rates with a lower number of features were achieved when compared with other studies.
Integrated Biosignal Analysis to Provide Biomarkers for Recognizing Time Perception Difficulties
Authors: Attar Eyad Talal
Published: June 2024

Background:

Time perception refers to the capability to recognize the passage of time. The cerebellum is located at the back of the brain, underlying the occipital and temporal lobes. Dyschronometria is a cerebellar dysfunction, in which a person cannot precisely estimate the amount of time that has passed. Cardiac indicators such as heart rate (HR) variability have been associated with mental function in healthy individuals. Moreover, time perception has been previously studied concerning cardiac signs. Human time perception is influenced by various factors such as attention and drowsiness. An electroencephalogram (EEG) is a suitable modality for evaluating cortical reactions due to its affordability and usefulness. Because EEG has a high sequential outcome, it offers valuable data to explore variability in psychological situations. An electrocardiogram (ECG) records electrical signals from the heart to examine various heart conditions. The electromyography (EMG) technique detects electrical impulses produced by muscles.

Methods:

EEG, ECG, and EMG are integrated during time perception. This study evaluated the human body's time perception through the neurological, cardiovascular, and muscular systems using a simple neurofeedback exercise after time perception tasks. The three biosignals which are EEG, ECG, and EMG were investigated to use them as biomarkers for recognizing time perception difficulty as the main goal of the study. Five healthy college students with no health issues participated, and their EEG, ECG, and EMG were recorded while relaxing and performing a time wall estimation task and neurofeedback training. Previous research has shown the relationship between EEG frequency bands and the frontal center during time perception. Investigating the connection between ECG, EEG, and EMG under time perception conditions is significant.

Results:

The results show that ECG (HR), EEG (Delta wave), and EMG (root mean square) are critical features in time perception difficulties.

Conclusion:

The ability and outcomes of multiple biomarkers might allow for improved diagnosis and monitoring of the progress of any treatment applications such as biofeedback training. Furthermore, those biomarkers could be used as useful for evaluating and treating dyschronometria.
Constructing Multiwavelet-based Shearlets and using Them for Automatic Segmentation of Noisy Brain Images Affected by COVID-19
Authors: Aghazadeh Nasser , Moradi Paria , Noras Parisa
Published: June 2024

Backgorund:

Nowadays, everybody's life is dominated by COVID-19, which might have been the source of severe acute respiratory syndrome coronavirus 2. This virus disrupts the lungs first of all. Recently, it has been found that coronavirus may affect the brain. Because all body actions rely on the brain, hence investigating its healthy is an essential item in coronavirus effects. Method: Brain image segmentation can be helpful in the detection of the regions damaged by the effects of coronavirus. Since every image given by photography devices may have noises, therefore, first of all, the brain magnetic resonance angiography (MRA) images must be denoised for best investigation. In the present paper, we have presented the construction of multishearlets based on multiwavelets for the first time and have used them for the purpose of denoising. Multiwavelets have some advantages to wavelets. Therefore, we have used them in the shearlet system to expand the properties of multiwavelets in all directions. After denoising, we have proposed a scheme for the automatic characterization of the initial curve in the active contour model for segmentation. Detecting the initial curve is a challenging task in active contour-based segmentation because detecting an initial curve far from the desired region can lead to unfavorable results. Results: The results show the performance of using multishearlets in detecting affected regions by COVID-19. Using multishearlets has led to the high value of peak signal-to-noise ratio and Structural similarity index measure in comparison with original shearlets. Original shearlets are constructed from wavelets whereas we have constructed multishearlets from multiwavelets.

Conclusion:

The results show that multishearlets can neutralize the effect of noise in MRA images in a good way rather than shearlets. Moreover, the proposed scheme for segmentation can lead to 0.99 accuracy.
In vitro Studies of Polycaprolactone Nanofibrous Scaffolds Containing Novel Gehlenite Nanoparticles
Authors: Baghbadorani Moloud Amini , Bigham Ashkan , Rafienia Mohammad , Salehi Hossein
Published: June 2024

Background:

Recently, many studies have been done on the physicochemical properties and biocompatibility of polycaprolactone (PCL) scaffolds containing ceramic reinforcers in the field of bone tissue engineering. In this study, the physical, mechanical and biological properties of electrospined-fabricated PCL scaffolds containing gehlenite (GLN) nanoparticles (NPs) as a novel bioceramic were investigated.

Methods:

To obtain the appropriate mechanical properties, the solution contains 3%, 5%, 7%, and 10% wt. of GLN NPs were prepared. Fiber morphology was investigated by scanning electron microscopy. In order to evaluate the NPs distribution, Energy Dispersive X-Ray Spectroscopy, X-ray diffraction, and Fourier Transform Infrared Spectroscopy spectroscopy were used. The scaffold hydrophilicity was measured by the water contact angle test. The tensile test was used to check the mechanical strength of the scaffold. The proliferation of MG-63 cells was evaluated by the MTT test. Alkaline phosphatase (ALP) activity of MG-63 cells was also examined.

Results:

Average fibers' diameters and porosity of PCL/GLN7% were obtained 150–500 nm and 80%, respectively. An increase in the scaffold hydrophilicity was observed by the addition of GLN NPs. The strength of PCL/GLN7% was higher than the blank PCL scaffold. Cell proliferation of scaffolds containing GLN was higher than the blank PCL scaffold. A significant increase in the secretion of ALP for GLN-loaded scaffolds was seen.

Discussion:

The results showed that PCL/GLN7% composite scaffold could be a good candidate for bone tissue engineering.

Conclusion:

The overall results indicate that the scaffold (PCL /GLN7%) has suitable mechanical properties, a great cell compatibility for bone tissue regeneration.
Loss-Modified Transformer-Based U-Net for Accurate Segmentation of Fluids in Optical Coherence Tomography Images of Retinal Diseases
Authors: Darooei Reza , Nazari Milad , Kafieh Rahle , Rabbani Hossein
Published: June 2024

Background:

Optical coherence tomography (OCT) imaging significantly contributes to ophthalmology in the diagnosis of retinal disorders such as age-related macular degeneration and diabetic macular edema. Both diseases involve the abnormal accumulation of fluids, location, and volume, which is vitally informative in detecting the severity of the diseases. Automated and accurate fluid segmentation in OCT images could potentially improve the current clinical diagnosis. This becomes more important by considering the limitations of manual fluid segmentation as a time-consuming and subjective to error method.

Methods:

Deep learning techniques have been applied to various image processing tasks, and their performance has already been explored in the segmentation of fluids in OCTs. This article suggests a novel automated deep learning method utilizing the U-Net structure as the basis. The modifications consist of the application of transformers in the encoder path of the U-Net with the purpose of more concentrated feature extraction. Furthermore, a custom loss function is empirically tailored to efficiently incorporate proper loss functions to deal with the imbalance and noisy images. A weighted combination of Dice loss, focal Tversky loss, and weighted binary cross-entropy is employed.

Results:

Different metrics are calculated. The results show high accuracy (Dice coefficient of 95.52) and robustness of the proposed method in comparison to different methods after adding extra noise to the images (Dice coefficient of 92.79).

Conclusions:

The segmentation of fluid regions in retinal OCT images is critical because it assists clinicians in diagnosing macular edema and executing therapeutic operations more quickly. This study suggests a deep learning framework and novel loss function for automated fluid segmentation of retinal OCT images with excellent accuracy and rapid convergence result.
Optimization of the Manufacturing Process and Mechanical Evaluation of a Functionally Graded Biodegradable Composite Screw for Orthopedic Applications
Authors: Zargar Kharazi Anosheh , Hosseini Emad , Shafaat Amir , Fathi Mohammad Hosein
Published: June 2024

Background:

Metal screws are commonly used for fracture fixations. However, the high modulus of elasticity relative to bones and releasing metallic ions by the metal screw needed a second surgery to remove the implant after the healing period. Furthermore, the removal of metal screws following the healing of the bone is a serious problem that can lead to refracture due to the presence of holes in the screw. Bioresorbable screws can overcome most of the problems associated with metallic screws which motivated research on manufacturing nonmetallic screws.

Methods:

In this study, three-layer poly L-lactic acid/bioactive glass composite screws were manufactured according to functionally graded material theory, by the forging process. All of the physical and chemical parameters in the manufacturing stages from making composite layers to the forging process were optimized to obtain suitable mechanical properties and durability off the screw in load-bearing positions.

Results:

The tri-layer composite screw with unidirectional, ±20° angled, and random fibers orientation from core to shell shows a flexural load of 661.5 ± 20.3 (N) with a decrease about 31% after 4-week degradation. Furthermore, its pull-out force was 1.8 ± 0.1 (N) which is considerably more than the degradable polymeric screws. Moreover, the integrity of the composite screws was maintained during the degradation process.

Conclusions:

By optimizing the manufacturing process and composition of the composite and crystallinity, mechanical properties (flexural, torsion, and pull-out) were improved and making it a perfect candidate for load-bearing applications in orthopedic implants. Improving the fiber/matrix interface through the use of a coupling agent was also considered to preserve the initial mechanical properties. The manufactured screw is sufficiently robust enough to replace metals for orthopedic load-bearing applications.
In-Field Recording of Six Biaxial Angles and Plantar Pressures in Weightlifting through a Wearable System
Authors: Cárdenas-Rodríguez Miguel Fernando , Paute-Tigre Cristhian Geovanny , Bueno-Palomeque Freddy Leonardo
Published: June 2024

Background:

Monitoring and evaluation of the techniques used in weightlifting are based on the subjective observation of the coach, which can ignore important aspects of short duration. This study aimed to implement an embedded system to register the angular variation of the hip, knee, and ankle joints, and plantar pressure during training.

Methods:

Four professional and four amateur athletes performed five snatch lifts. To evaluate the angular measurement, the tests were simultaneously videotaped and the results were contrasted.

Results:

The angular data presented a correlation coefficient of 0.92 and a delay of 495 ± 200 ms. The characterization of the sensors was implemented in a microcontroller with a mean absolute percentage error of 18.8% in the measurements. When comparing the average results between the elite and amateur groups, the amateur group performed a delayed descent in the first three phases of the lift and an accelerated descent in the fourth phase. A not uniform plantar pressure was registered in the same group, causing a reduction in the final speed of recovery with the barbell.

Conclusions:

The proposed system has been developed for biaxial angular registration of hip, knee, ankle, and plantar pressure during weightlifting snatch. The option to contrast between signals presented by the system met the requirements requested by the coaching staff and is seen as a promising quantitative analysis tool to support the coach and the athlete.
Quantitative Evaluation of Scatter Correction in 128-slice Fan-Beam Computed Tomography Scan using Geant4 Application for Tomographic Emission Monte Carlo Simulation
Authors: Azinkhah Iman , Sadeghi Mahdi , Sheikhzadeh Peyman , Malekzadeh Malakeh
Published: June 2024

Background:

Simulation of tomographic imaging systems with fan-beam geometry, estimation of scattered beam profile using Monte Carlo techniques, and scatter correction using estimated data have always been new challenges in the field of medical imaging. The most important aspect is to ensure the results of the simulation and the accuracy of the scatter correction. This study aims to simulate 128-slice computed tomography (CT) scan using the Geant4 Application for Tomographic Emission (GATE) program, to assess the validity of this simulation and estimate the scatter profile. Finally, a quantitative comparison of the results is made from scatter correction.

Methods:

In this study, 128-slice CT scan devices with fan-beam geometry along with two phantoms were simulated by GATE program. Two validation methods were performed to validate the simulation results. The data obtained from scatter estimation of the simulation was used in a projection-based scatter correction technique, and the post-correction results were analyzed using four quantities, such as: pixel intensity, CT number inaccuracy, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR).

Results:

Both validation methods have confirmed the appropriate accuracy of the simulation. In the quantitative analysis of the results before and after the scatter correction, it should be said that the pixel intensity patterns were close to each other, and the accuracy of the CT scan number reached <10%. Moreover, CNR and SNR have increased by more than 30%–65% respectively in all studied areas.

Conclusion:

The comparison of the results before and after scatter correction shows an improvement in CNR and SNR while a reduction in cupping artifact according to pixel intensity pattern and enhanced CT number accuracy.
Collapsed Cone Superposition Algorithm Validation for Chest Wall Tangential Fields using Virtual Wedge Filters
Authors: Zeinali Ahad , Molazadeh Mikaeil , Ganjgahi Samaneh , Saberi Hassan
Published: June 2024

Background:

Virtual wedge (VW) is used in radiotherapy to compensate for missing tissues and create a uniform dose distribution in tissues. According to TECDOC-1583 and technical reports series no. 430, evaluating the dose calculation accuracy is essential for the quality assurance of treatment planning systems (TPSs). In this study, the dose calculation accuracy of the collapsed cone superposition (CCS) algorithm in the postmastectomy radiotherapy of the chest wall for breast cancer was evaluated by comparing the calculated and measured dose in VW fields.

Methods:

Two tangential fields with the typical VW angles were planned using ISOgray TPS in a thorax phantom. The CCS algorithm was used for dose calculation at 6 and 15 MV photon beams. The obtained dose distributions from EBT3 film spaces and TPS were evaluated using the gamma index.

Results:

The measured and calculated dose values using VW in a heterogeneous medium with different beam energies were in a good agreement with each other (acceptance rate: 88.0%–93.4%). The calculated and measured data did not differ significantly with an increase/decrease in wedge angle. In addition, the results demonstrated that ISOgray overestimated and underestimated the dose of the soft tissue and lung in the planned volume, respectively.

Conclusions:

According to the results of gamma index analysis, the calculated dose distribution using VW model with the CCS algorithm in a heterogeneous environment was within acceptable limits.
Home-based care for noncommunicable diseases and patient satisfaction: A community-based cross-sectional study from Tamil Nadu, India
Authors: Ravichandran Ganga , Olickal Jeby Jose
Published: June 2024

Background and Aims:

In Tamil Nadu, India, the government has launched a home-based noncommunicable diseases (NCDs) care scheme to deliver health services at the doorstep of the beneficiaries. Hence, this study aimed to determine patient satisfaction and the factors associated with home-based care for diabetes and hypertension.

Methodology:

This community-based cross-sectional study was conducted from April to May 2022. The sample size was 427, and the participants were selected by a simple random sampling method. We used the Patient Satisfaction Questionnaire-18 to assess satisfaction.

Results:

The overall satisfaction score was 3.63 (0.44). Mean (standard deviation) satisfaction was highest in the financial aspect and the lowest in accessibility and convenience. The prevalence of adequate satisfaction with home-based care was 57% (95% confidence interval [CI]: 51.8%–61.4%). Participants belonging to social class 2 (adjusted prevalence ratio [aPR] = 1.5, 95% CI: 1.15–1.96), P = 0.002), having a duration of NCD between 1 and 5 years (aPR = 1.45, 95% CI: 1.10–1.92, P = 0.008), and not delivering all drugs for NCDs (aPR = 1.37, 95% CI: 1.05–1.80, P = 0.021) were significantly associated with inadequate satisfaction. However, 90% of the participants were willing to continue home-based NCD care.

Conclusion:

Overall, patient satisfaction was 57%. Measures to distribute all the medication and routine monitoring of the scheme are necessary.
The prevalence of metabolic syndrome and its components among South Indian Chenchu tribal adults
Authors: Luc Casey Morgan , Herrera Kara , Allam Ramesh , Gandhamalla Sabitha , Dharmakari Ramkishan , Dinaker Manjunath , Yeldandi Vijay
Published: June 2024

Background:

Dietary patterns are paramount in the prevention and management of metabolic syndrome (MetS) yet the definition and criteria for MetS diagnosis varies. This analysis aims to estimate the prevalence of MetS among the adult Chenchu tribal population comparing International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) definitions of MetS and assess the relationship between dietary patterns and MetS.

Materials and Methods:

Demographics, medical history, nutrition, and physical activity were collected among 337 South Indian Chenchu tribal adults. The prevalence ratios and 95% confidence intervals of MetS using ATP and IDF definitions were estimated and associations between individual components of the MetS definitions, demographics, and dietary patterns were assessed. Pearson correlation coefficients (r) were calculated between the Modified Finnish Diabetic Risk Score (FINDRISC)-Bahasa Indonesia instrument and MetS definitions.

Results:

The prevalence of MetS was low by IDF (25, 7.4%) and ATP (22, 6.5%) definitions, while reporting vigorous physical activity (202, 59.9%) and a “vegetarian” dietary pattern (173, 51.3%) were high. Increasing age, high mutton consumption, and “empty-calorie” dietary pattern were associated with an increased prevalence of MetS, while vigorous physical activity and “vegetarian” dietary pattern were protective of MetS. The modified FINDRISC was not highly correlated with IDF MetS (r = 0.47; P < 0.0001) or ATP MetS (r = 0.11; P = 0.0683).

Conclusions:

Healthy behaviors, such as vigorous physical activity and high vegetable consumption, may contribute to the low prevalence of MetS in Chenchu tribal adults. Future efforts should continue to monitor dietary patterns and the prevalence of MetS in the understudied South Indian Chenchu tribal population.
Dietary patterns among chronic kidney disease patients and their impact on their clinical course: A longitudinal study from rural Kanyakumari
Authors: Chandrasekaran Sundhareshwaran , Mookambika R. V. , Ashok Vishnu G. , Panicker Priya Ravindra , Nithya G.
Published: June 2024

Background:

Nonpharmacological management of chronic kidney disease (CKD) by dietary modifications is an integral part in preventing the disease progression into renal failure. Fish has been recommended as a substitute protein instead of meat in renal diets. However, sardines and dried fish which are a staple diet in coastal areas may cause more harm than benefit. Hence, this study was designed to analyze dietary patterns of sardines, dried fish, meat and salt consumption and its impact among CKD patients.

Materials and Methods:

This longitudinal study was carried out among 100 CKD patients in Nephrology department, excluding seriously ill patients or those on hemodialysis. Dietary patterns were assessed using food frequency questionnaire. Renal parameters and clinical staging were estimated at the beginning of the study and after 2 months.

Results:

The mean age of the CKD patients was 55.29 years. The mean quantities of sardines, dried fish, meat, and salt consumed per week were 375 g, 70.1 g, 115.7 g, and 39.54 g, respectively. There was a statistically significant increase in the mean values of all renal parameters. Patients who had elevated creatinine and potassium levels had a statistically significant higher mean consumption of sardines and salt, respectively.

Conclusion:

The consumption of sardines, meat and salt was very high among the CKD patients. Worsening of disease was seen in almost half the study population. Culturally appropriate dietary guidelines are required for diet modifications in CKD patients.
Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)
Authors: Azubuike Samuel Onyinyechukwu
Published: June 2024

The association between parity and breast cancer has been widely investigated in high-income countries. However, in sub-Saharan African (SSA) region, only a few studies have investigated this association. The aim of this study was to critically review the available evidence, highlighting their strength and weakness, thereby providing a basis for more studies in SSA on the topic. A literature search in MEDLINE, Scopus, PubMed, Google Scholar, and reference list of published studies was conducted. Key case control and cohort studies published between 2000 and 2018 were selected for detailed review based on sample size, geographical distributions, and relevance of the findings. Nonanalytical studies were excluded. The findings were summarized using the tables and forest plots based on R Statistical Software version 3.4.0 (2017). This was primarily to provide visual overview of the reviewed studies and not necessarily to provide a pooled estimate. The conclusion was drawn by comparing the number of observed significant findings (assessed based on confidence intervals) with the number of nonsignificant findings across countries and SSA taking into considerations their strengths and weaknesses. Twenty-six case − control studies and 12 cohort studies across the four regions of the world North America, Europe, Asia, and Africa were reviewed. A reduced risk of breast cancer (especially estrogen receptor [ER] positive breast cancer) was observed in most studies, especially studies from high-income countries. While several studies that reported a nonsignificant observation in SSA were limited in sample size, the few that observed a reduced risk of breast with parity among all women were subject to confounding. Nevertheless, recent studies suggest that the role of parity may be modified by ER status and menopausal status. Further investigation of these suggestions will be needed for a clearer understanding of the relationship between parity and breast cancer in SSA.
A Comparison of the Mydriatic Efficacy of Tropicamide and Phenylephrine Eye Drops Administered as a Vaporized Spray in One Eye and Conventional Drop Instillation in the Other Eye in an Indian Pediatric Cohort
Authors: Vinay P. G. , Bhat Sunayana , Mathews Meera Mary
Published: June 2024

Purpose:

To determine by serial measurements and compare the pupillary mydriasis effect of tropicamide and phenylephrine drops administered as a vaporized spray over closed lids in one eye and through conventional instillation of eye drops in the other eye in a pediatric cohort.

Methods:

This prospective study was conducted on healthy children aged 6–15 years. After visual assessment, investigator 1 examined the child for initial pupillary size. Investigator 2 instilled the drops in one eye and applied the spray to the other eye randomly, and the response of the child was noted using the Wong-Baker pain rating scale. The eyes receiving the spray and the eyes receiving drop instillation were considered as Groups 1 and 2, respectively. Subsequently, serial pupillary measurements were carried out every 10 min for up to 40 min by investigator 1. The patient compliance for the two methods of drug instillation was also compared.

Results:

The study comprised 80 eyes. At 40 min, both the groups showed no statistical difference in the mydriasis effect, with Group 1 showing 7.23 mm mydriasis and Group 2 showing 7.58 mm (P = 0.058). The analysis of the pain rating scale showed better compliance with the spray method of drug instillation, which was statistically significant (P = 0.044).

Conclusions:

Our study shows that spray application is a less invasive method for pupillary dilatation, which has better compliance and provides equally good dilatation as conventional methods. This study proves the efficacy of spray application in an Indian pediatric cohort.
Delayed-Onset Endophthalmitis after Intravitreal Aflibercept Injection
Authors: Akbarzadeh Ali , Rahimi Masoud , Zand Amin , Falavarjani Khalil Ghasemi
Published: June 2024

Purpose:

To describe delayed-onset infectious endophthalmitis 4 months after intravitreal aflibercept injection.

Methods:

An 80-year-old female was referred with signs and symptoms of clinical endophthalmitis 4 months after intravitreal injection of aflibercept for choroidal neovascularization. Noninfectious causes of panuveitis were excluded and she was diagnosed with delayed-onset postinjection infectious endophthalmitis. Vitreous and aqueous specimens were prepared and antibiotics (vancomycin and ceftazidime) were injected intravitreally.

Results:

Vitreous culture was positive for Staphylococcus epidermidis. During the 1st month after the antibiotic injections, symptoms and signs of the patient improved and became stable during the 6-month follow-ups.

Conclusions:

Delayed-onset infectious endophthalmitis can be presented following intravitreal injections. Late presentation of uveitis in postinjected eyes needs complete investigations to rule out infectious endophthalmitis as an ophthalmic emergency.
Clinical Course and Optical Coherence Tomography of Ocular Angiostrongyliasis: A Case Report
Authors: Luangsawang Kanin , Wongsantimeth Veeraphatra , Treeyawedkul Sirinan
Published: June 2024

Purpose:

To report the clinical course and optical coherence tomography (OCT) findings of ocular angiostrongyliasis.

Methods:

A 36-year-old female with a history of ingesting regular raw freshwater shrimp and other raw food presented with acute unilateral painless visual loss in the right eye. Her right eye’s best-corrected visual acuity (BCVA) was 1 ft of the count finger. Fundus examination showed vitritis, generalized retinal pigment epithelial alteration, and a moving roundworm in the vitreous at the 6 o’clock position. Macular OCT of her right eye showed thinning of the retina, loss of the external limiting membrane and ellipsoid zone, subretinal hyper-reflective material clumping, and hyper-reflective foci at the superficial choroidal layer.

Results:

The patient was administered oral and topical prednisolone. The roundworm, identified asAngiostrongyluscantonensis, was wholly extracted from the vitreous using a 23G sclerotomy port and pars plana vitrectomy. The final BCVA was 1 ft of the count finger.

Conclusion:

This case report describes an infrequent presentation and illustrates the clinical course and OCT findings of ocular angiostrongyliasis.
Quantitative Analysis of Inner, Middle, and Outer Retinal Thickness by Optical Coherence Tomography in Children and Adolescents
Authors: Ghassemi Fariba , Salari Farhad , Hatami Vahid , Bazvand Fatemeh , Shamouli Hadi , Mohebbi Masoumeh , Sabour Siamak
Published: June 2024

Purpose:

To describe the variance of inner, middle, and outer retinal layer thicknesses (IRT, MRT, and ORT) at the macular area in children and adolescents with normal eyes in different age groups.

Methods:

This cross-sectional study enrolled subjects aged 5–18 years with normal eyes. The macula was scanned by optical coherence tomography (6 mm × 6 mm AngioScan-Optovue). Four age groups were defined (≤7, 7–10, 11–14, and ≥14 years). The influences of age and gender were analyzed.

Results:

One hundred and thirty-nine eyes of 69 subjects with a mean age of 10.92 ± 3.51 years were registered. The mean whole macular thickness (MT) was 297.32 ± 11.05 in males and 303.197 ± 13.32 in females (P = 0.01, t-test). The MT in each aging group was 301.47 ± 2.5, 295.53 ± 1.71, 300.81 ± 2.12, and 298.6 ± 1.87, subsequently (P = 0.17, analysis of variance test). Significant differences were found between the sexes at the perifoveal area and mainly in IRT. No correlation between eyes was noted. We observed that the RT fluctuates during growth and that gender has some influence on the evolution of RT. IRT and MRT changed reciprocally in all macular areas, whereas ORT expanded in all age groups of children and adolescents.

Conclusions:

No subsegmental retinal thickness difference between eyes was observed in pediatric groups in this study, while gender had some influence on perifoveal IRT. Despite the fact that this study is not a longitudinal study, we can get some insight into the developmental changes in retinal thickness and its clinical applications in children and adolescents.
Dynamic Electrooculography Findings for Medial Rectus Myofascial Release in Esodeviation
Authors: Mohamadi Alireza , Vasaghi-Gharamaleki Behnoosh , Mirzajani Ali , Jafarzadehpur Ebrahim
Published: June 2024

Purpose:

To determine which mechanisms are operative in releasing the extraocular myofascial tissue in response to extraocular myofascial release (EOMR) and to evaluate the effect of EOMR on saccadic velocity and esodeviation angle in patients with convergence spasm.

Methods:

Fourteen patients with convergence spasm aged 20–35 participated in this research. The treatment included touching the medial rectus and its interrelated fascial tissue with the index finger pulp from over the eyelid for at least 300 s and applying very gentle and uniform pressure. We evaluated the saccadic velocity obtained from dynamic electrooculography (EOG) and the angle of deviation. The findings of dynamic EOG were used as a reliable quantitative method to assess eye movement function.

Results:

The amount of esodeviation decreased significantly at both far 2.39Δ, 95% confidence interval (CI) (1.27–3.52) (P = 0.002) and near 5.57Δ, 95% CI (4.67–6.47) (P = 0.001) after two sessions of EOMR in a week. There was no significant difference in saccadic velocities before and after treatment.

Conclusion:

In the short term, the EOMR only affects the static condition of the eye. Therefore, a significant improvement could be seen in the deviometric findings. However, the dynamic properties of the extraocular muscles did not improve and probably needed a more extended treatment period for acting the long-term mechanisms.
Posterior Microphthalmos Pigmentary Retinopathy Syndrome with Angle-Closure Glaucoma
Authors: Sassi Hela , Ammar Khaled , Ouederni Meriem , Cheour Monia
Published: June 2024

Purpose:

To describe a particular form of posterior microphthalmos pigmentary retinopathy syndrome (PMPRS) with an atypical clinical presentation of pigment retinal dystrophy and an association to an inconstant complication which is angle-closure glaucoma (ACG).

Methods:

A 40-year-old male patient with ACG on maximal topical treatment was referred to our department for uncontrolled intraocular pressure. Best-corrected visual acuity was 2/10 in the right eye and light perception in the left eye. Intraocular pressure was 36 mmHg bilaterally. He had 360° peripheral anterior synechiae on gonioscopy. Fundus examination revealed total cupping with pale retinal lesions in both eyes and a few pigment deposits in the midperiphery of the right eye. Multimodal imaging was done.

Results:

Fundus autofluorescence revealed patchy areas of hypoautofluorescence. Optical coherence tomography (OCT) showed bilateral foveoschisis and macular folds. Anterior segment OCT showed a circumferential iridocorneal angle closure. Axial length measured with ultrasound biomicroscopy was 18.4 mm in the right eye and 18.1 in the left eye. Electroretinogram revealed attenuated scotopic responses. The patient was diagnosed with nanophthalmos–retinitis pigmentosa (RP)–foveoschisis syndrome complicated with ACG. A combined surgery with phacoemulsification - anterior vitrectomy - intraocular lens implantation and trabeculectomy was performed in both eyes with a satisfactory outcome.

Conclusions:

In its typical forms, PMPR syndrome is an association of nanophthalmos - RP - foveoschisis and optic nerve head (ONH) drusen. Incomplete phenotypes may lack ONH drusen or foveoschisis. Patients with PMPRS have to be screened for iridocorneal angle synechia and ACG.