RESUMEN

Cardiac autonomic Neuropathy (CAN) is an acute complication of Diabetes mellitus (DM) that does not exhibit overt symptoms in the subclinical stage. Researchers have developed several techniques that have proved to give higher efficiency in classification using software tools. The challenge in implementing the same using hardware for diagnosis fails when classification boundaries are mismatched, as there are more chances of misinterpreting the classes. In this study, we have introduced translational research between the complexity analysis using software and verifying the same by deploying it in hardware using a controller board by investigating the error percentage in classifying normal (N) and early CAN (E). The study reveals that among the segments specific to CAN diagnosis, RR and ST show more error percentages (12±8 %). In contrast, PR and QT show a lesser error percentage (6±4 %) between software and hardware implementation of Fractal dimension (FD) values.

Asunto(s)

RESUMEN

BACKGROUND: The most predominant cancer in India is Oral cancer. Annually 130,000 people yield to oral cancer in India, which translates into about 14 deaths per hour and 60-80% of patients present with advanced disease as compared to 40% in developed countries. AIM: To decide factors associated with primary, secondary and tertiary delays and identify reasons for a lack of follow-up. MATERIALS AND METHODS: This study was conducted at the Kidwai Memorial Institute of Oncology, Bengaluru. A hospitalbased cross-sectional study using the direct personal interview method was done. A total of 200 oral cancer patients were included in the study. RESULTS: 34.5% were men and 65.5% were women. About 97.5% of patients were engaged with either one of the habits like smoking, chewing or alcohol consumption. 84% of patients were not aware of the risk of getting oral cancer. 29% of people agreed that tobacco and alcohol are risk factors for oral cancer and they know about the signs of oral cancer. If detected early, cure rates were higher compared to illiterate people and this difference is statistically significant p< 0.05. 83.5% of patients did not know that oral cancer can be diagnosed early by regular screening of the oral cavity. The cost of staying near a Regional cancer centre, job security, and the social and economic burden on relatives were significant barriers to incomplete treatment and a decreased follow-up rate. CONCLUSION: Low awareness is the main barrier to oral cancer detection. Conducting cancer awareness and screening camps frequently will detect oral cancers at an early stage. KEY WORDS: Oral Cancer, Barriers, Cancer awareness, Oral Screening.

Asunto(s)

RESUMEN

Malignancy, one of the leading causes of death worldwide, accounts for 9.6 million deaths in 2018. Around 1 out of 6 deaths are the direct result of the malignancy. Clinicians claim that age and breast density are two preliminary factors increasing the risk of cancer. The mortality rate brought about by malignant growth in low and high income countries is, for the most part, around 70%. Imaging techniques play a vital role in the detection, and staging, thereby helping in treatment decision making. This review paper presents a comprehensive survey involving a literature study about the evolution and efficacy of various breast cancer detection techniques. This work studies various procedures of imaging techniques such as mammograms, ultrasound, MRI, PET, CT, Terahertz Spectroscopy, Raman Spectroscopy, Optical coherence Tomography, Mass spectroscopy, diffuse reflectance spectroscopy, and Infrared Thermography. Since cancer is a complicated illness with diverse pathophysiologies, numerous modifications of the fundamental detection approach employed in each of these modalities have been performed throughout the years to increase the detection efficiency. This paper covers basic preliminary results with FFPE breast cancer blocks of malignant and normal subjects using THz Techniques that are presented as proof of concept to carry out further research.

Asunto(s)

RESUMEN

A novel synthesis of MgO/ZnO nanocomposite using a template, namely an eggshell membrane (ESM) was attempted. The nanocomposite was characterized by XRD, UV-visible, FTIR, Raman, DLS (zeta potential and particle size distribution), FESEM with EDX, and HRTEM analysis. The presence of periclase cubic MgO (space group Fm3m) and hexagonal wurtzite ZnO (space group P63mc) structures was verified by the XRD results. The average crystallite size of the MgO/ZnO nanocomposite was equal to 9.43 nm. The nanocomposite exhibited an on-set of absorbance close to 300 nm. From the taucs plot, the bandgap of the composite was calculated, and it was equal to 3.63 eV. The FTIR spectrum of the composite showed Mg-O stretching vibration at 455 cm-1 and that of Zn-O at 564 cm-1. The zeta potential and the particle size distribution of the nanocomposite were equal to - 35.5 mV and 176.1 nm. The FESEM images of the nanocomposite appeared as an aggregated honeycomb with a cubic and hexagonal structure. The EDX analysis showed the presence of Mg (23.65 atom%), Zn (27.95 atom%), and O (48.40 atom%). The antibacterial and antifungal activities of the nanocomposite were investigated using the agar-well diffusion method. The antibacterial activity exhibited the highest zone of inhibition for Bacillus subtilis (25 ± 0.41 mm) and Shigella dysenteria (25 ± 0.19 mm), whereas the antifungal activity showed the highest zone of inhibition for Aspergillus terrus (27 ± 0.25 mm). The MIC value of the nanocomposite was equal to 9.37 (µg/mL) for all the bacteria. Hence, it is verified that the present MgO/ZnO nanocomposite could very well be used to treat bacterial and fungal infections.

Asunto(s)

RESUMEN

Purpose: To compare dose volume parameters of target and organs at risk in vaginal vault brachytherapy using ovoids or cylinder in post-operative endometrial carcinoma. Material and methods: The study was done among 25 histologically proven post-operative endometrial carcinoma patients requiring vaginal brachytherapy. All patients underwent both cylinder and ovoids application alternatively on weekly basis. Ovoids size ranged from 2 to 3 cm diameter. Diameters of cylinder ranged between 2.5 and 3.5 cm. Bladder, rectum, urethra, and clinical target volume (CTV) were contoured on CT simulation images. Prescribed dose was 6-7 Gy in 2-3 fractions at 0.5 cm from the surface of applicator. Results: The mean values of D90, D50, V150, V100, V90, and V50 of CTV were comparable between cylinder and ovoids plans. The mean dose of CTV was significantly higher with cylinder than with ovoids, and D100 was significantly higher with ovoids (mean = 15.63 Gy vs. 14.64 Gy, p = 0.016, and D100 = 37.82% vs. 42.86%, p = 0.042, for cylinder vs. ovoids). In the dosimetry of the vault, D90, D50, V100, V90, V50, and mean of the vault did not show any significant difference between cylinder and ovoids. The V150 was significantly higher with cylinder plans than ovoids, and D100 of the vault was significantly higher with ovoids plans (V150 = 14.81% vs. 6.86%, p = 0.02, and D100 = 37.77% vs. 44.80%, p = 0.029, for cylinder vs. ovoids). D0.1cc, D1cc, D2cc, and mean for the bladder, rectum, and urethra were comparable between the cylinder and ovoid plans. Conclusions: The present study showed that the dose to organs at risk, most of the dosimetric parameters of CTV, and vault were comparable between the cylinder and ovoid plans. Both applicators provide good reproducibility. The choice of applicator will ultimately depend on the institutional policies and oncologist decision. However, in patients with dog-ear configuration of the vagina, ovoids may be preferred as per ABS guidelines.

RESUMEN

Squamous cell carcinoma (SCC) has a good prognosis, while metastatic tumors have aggressive behavior. Immunotherapy has become a standard line of treatment in metastatic cancers; pembrolizumab has shown promising results and improved quality of life in recurrent and metastatic cancers. We report a case of recurrent SCC of the skin with extensive disease and a known case of human immunodeficiency virus. He completed standard lines of treatment and currently on immunotherapy. After 3 cycles of immunotherapy plus chemotherapy, he got a complete metabolic response. Our experience showed palliative benefits and increased quality of life.

Asunto(s)

RESUMEN

Groundnut (Arachis hypogaea L.) plants showing distinct symptoms of necrosis of leaves and severe rotting of roots were observed in an agricultural field at Arakkonam, Tamil Nadu, India. The rhizomorphs of the phytopathogenic fungus were obtained from the rotted roots of the diseased plants and were cultured in the laboratory, and based on the morphological characteristics and nucleotide sequencing analysis of ITS and nLSU region, the phytopathogen was identified as Marasmius palmivorus. The isolated fungus produced distinct fruiting bodies (basidiocarps) when grown under the laboratory conditions. The fungus grew as cottony white colonies on the potato dextrose agar medium and were found to contain septate and clamp connections when examined under light microscope. The pathogenicity of the isolated fungus was assessed by inoculating it on healthy groundnut plant under glasshouse conditions; this resulted in the establishment of typical disease symptoms, which confirmed the pathogenicity of the fungus. The fungal pathogen re-isolated from the artificially inoculated plants was used for molecular characterization and confirmed that the organism was M. palmivorus. To the best of our knowledge, this is the first report on the occurrence of M. palmivorus, causing white root rot disease in A. hypogaea L.

Asunto(s)

RESUMEN

Androgen deprivation therapy (ADT) using gonadotropin-releasing hormone agonist (s) (GnRH-A) remains the backbone of advanced prostate cancer treatment. In this review, we assessed the efficacy, safety, and convenience of administration of various GnRH-A. All GnRH-A (goserelin, triptorelin, buserelin, histrelin, and leuprorelin) have comparable potential to suppress testosterone (T) levels (≤50 ng/dL in a month and ≤20 ng/dL in 3 months). However, goserelin has shown better efficacy in maintaining T levels ≤50 ng/dL compared with leuprolide. The incidences of T escape are lower with goserelin and leuprolide than buserelin. Goserelin also has maximum benefit in prostate-specific antigen suppression. In neoadjuvant setting, when only goserelin was used, the 10-year overall survival (OS) rate was 42.6% to 86%. When either goserelin or leuprolide was used, the 10-year OS rate was 62%. As an adjuvant to radical prostatectomy, goserelin had a 10-year survival rate of 87%, and triptorelin had an 8-year survival rate of 84.6%. Goserelin further showed an absolute survival rate of 49% when used as an adjuvant to radiotherapy. The survival rates further improved when GnRH-A are used as combined androgen blockade compared with monotherapy. The frequency and severity of adverse events (hot flushes, fatigue, sexual dysfunction) are comparable among the GnRH-A. Goserelin appears to be the most convenient of all the GnRH-A for administration. Lack of conclusive comparative evidence makes it imperative to have a holistic approach of considering the patient profile and the disease characteristics to select the appropriate GnRH-A for ADT in prostate cancer.

Asunto(s)

RESUMEN

INTRODUCTION: Some people with Parkinson's disease (PD) frequently have an unsteady gait with shuffling, reduced strength, and increased rigidity. This study has investigated the difference in the neuromuscular strategies of people with early-stage PD, healthy older adults (HOA) and healthy young adult (HYA) during short-distance walking. METHOD: Surface electromyogram (sEMG) was recorded from tibialis anterior (TA) and medial gastrocnemius (MG) muscles along with the acceleration data from the lower leg from 72 subjects-24 people with early-stage PD, 24 HOA and 24 HYA during short-distance walking on a level surface using wearable sensors. RESULTS: There was a significant increase in the co-activation, a reduction in the TA modulation and an increase in the TA-MG lateral asymmetry among the people with PD during a level, straight-line walking. For people with PD, the gait impairment scale was low with an average postural instability and gait disturbance (PIGD) score = 5.29 out of a maximum score of 20. Investigating the single and double support phases of the gait revealed that while the muscle activity and co-activation index (CI) of controls modulated over the gait cycle, this was highly diminished for people with PD. The biggest difference between CI of controls and people with PD was during the double support phase of gait. DISCUSSION: The study has shown that people with early-stage PD have high asymmetry, reduced modulation, and higher co-activation. They have reduced muscle activity, ability to inhibit antagonist, and modulate their muscle activities. This has the potential for diagnosis and regular assessment of people with PD to detect gait impairments using wearable sensors.

Asunto(s)

RESUMEN

In this, study, we have investigated to identify the muscle fatigue using spatial maps of High-Density Electromyography (HDEMG). The experiment involves subjects performing plantar flexion at 40% maximum voluntary contraction until fatigue. During the experiment, HDEMG signal was recorded from the tibialis anterior muscle. The monopolar and bipolar spatial intensity maps were extracted from the HDEMG signal. The random forest classifier with different tree configurations was tested to distinguish nonfatigue and fatigue condition. The results indicate that selected electrodes from the differential intensity map results in an accuracy of 83.3% with the number of trees set at 17. This method of spatial analysis of HDEMG signals may be extended to assess fatigue in real life scenarios.

Asunto(s)

RESUMEN

During the last decade, water demand and wastewater generation has increased due to urbanization around the globe which had led to an increase in the utilization of chemicals/synthetic polymers for treating the wastewaters. These synthetic polymers used during the coagulation/flocculation process are non-renewable, non-biodegradable, and have a potential neurotoxic and carcinogenic effect. From the literature it is clear that extracellular polymer substance (EPS) is a potential bioflocculant, moreover it is renewable, biodegradable, eco-friendly, non-toxic as well as economically valued product. The various identification techniques and extraction methods of EPS are elaborated. Further application of EPS as absorbent in removing the dye from the industrial effluent is presented. Moreover EPS as a potential adsorbent for heavy metal removal from the various effluent is discussed. In addition, EPS is also utilized for soil remediation and soil erosion control. Mainly, EPS as bioflocculant in treating raw water, wastewater treatment, leachate and sludge management are summarized in this review.

Asunto(s)

RESUMEN

Objective. Glaucoma is the second cause of vision loss with early diagnosis having significantly better prognosis. We propose the use of hippus, the steady-state pupil oscillations, obtained from an eye-tracker for computerised detection of glaucoma.Approach. Pupillary data were recorded using a commercial eye-tracker device directly to the laptop. A total of 40 glaucoma patients and 30 age-matched controls were recruited for the study. The signals were de-noised, and the entropy of the steady-state oscillations was obtained for two light intensities, 34 and 100 cd m-2.Main results. The results show that at 100 cd m-2, there was significant difference (p < 0.05) between the sample entropy of the healthy eyes (0.55 ± 0.017) and glaucoma eyes (0.7 ± 0.034). The results at 34 cd m-2were also significantly different, though to a lesser extent.Significance. Entropy of the pupillary oscillations, or hippus, obtained using an eye-tracking device showed a significant difference between glaucoma and healthy eyes. The method used commercially available inexpensive hardware and thus has the potential for wide-scale deployment for computerized detection of glaucoma.

Asunto(s)

RESUMEN

Early diagnosis of Parkinson's disease (PD) plays a critical role in effective disease management and delayed disease progression. This study reports a technique that could diagnose and differentiate PD from essential tremor (ET) in its earlier stage using a non-motor phenotype. Autonomic dysfunction, an early symptom in PD patients, is caused by α-synuclein pathogenesis in the central nervous system and can be diagnosed using skin vasomotor response to cold stimuli. In this study, the investigations were performed using data collected from 20 PD, 20 ET and 20 healthy subjects. Infrared thermography was used for the cold stress test to observe subjects' hand temperature before and after cold stimuli. The results show that the recovery rate of hand temperature was significantly different between the groups. The data obtained in the cold stress test were verified using Pearson's cross-correlation technique, which showed that few disease parameters like medication and motor rating score had an impact on the recovery rate of hand temperature in PD subjects. The characteristics of the three groups were compared and classified using the k-means clustering algorithm. The sensitivity and specificity of these techniques were analyzed using an Receiver Operating Characteristic (ROC) curve analyzer. These results show that this non-invasive technique can be used as an effective tool in the diagnosis and differentiation of PD in its early stage.

Asunto(s)

RESUMEN

Surface electromyography (sEMG) of the lower limb muscles has been proposed to evaluate motor dysfunctions in Parkinson's disease (PD) patients. Variability in the sEMG could be used as an indicator of poor muscle coordination, but previous studies have reported conflicting results. This study has examined the variability of muscle using the coefficients of variance of Tibialis anterior (TA) and Medial gastrocnemius (MG) lower limb muscles for 24 PD, 24 age matched controls (CO), and 24 young controls (YC), during different phases of the gait cycle. The gait intervals were measured using the inertial measurement unit (IMU). We observed a statistically significant difference between PD and control for the variability of lower limb muscle when comparing the sub-phases of the gait. It was also found that the difference was more pronounced for the TA muscle.

Asunto(s)

RESUMEN

This study has investigated the efficiency of voice features in estimating the motor Unified Parkinson's Disease Rating Scale (UPDRS) score in Parkinson's disease (PD) patients. A total of 26 PD patients (mean age = 72) and 22 control subjects (mean age = 66.91) were recruited for the study. The sustained phonation /a/, /u/ and /m/ were collected in both off-state and on-state of Levodopa medication. The average motor UPDRS for PD off-state patients was 27.31, on-state was 20.42 and that of controls was 2.63. Voice features were extracted from the phonation tasks and were reduced to the most relevant 6 features for each phonation task using the Least Absolute Shrinkage and Selection Operator (LASSO) feature ranking method. The correlation between the reduced features and motor UPDRS was tested using the Spearman correlation coefficient test. AdaBoost regression learner was trained and used for automatically estimating the motor UPDRS score using the voice features. The results show that the vocal features for /m/ performed best by estimating the motor UPDRS score for PD off-state with the mean absolute error (MAE) of 3.52 and 5.90 for PD on-state. This study shows that assessment of voice can be used for day to day remote monitoring of PD patients.

Asunto(s)

RESUMEN

Background: The enhancement in the performance of the myoelectric pattern recognition techniques based on deep learning algorithm possess computationally expensive and exhibit extensive memory behavior. Therefore, in this paper we report a deep learning framework named 'Low-Complex Movement recognition-Net' (LoCoMo-Net) built with convolution neural network (CNN) for recognition of wrist and finger flexion movements; grasping and functional movements; and force pattern from single channel surface electromyography (sEMG) recording. The network consists of a two-stage pipeline: 1) input data compression; 2) data-driven weight sharing. Methods: The proposed framework was validated on two different datasets- our own dataset (DS1) and publicly available NinaPro dataset (DS2) for 16 movements and 50 movements respectively. Further, we have prototyped the proposed LoCoMo-Net on Virtex-7 Xilinx field-programmable gate array (FPGA) platform and validated for 15 movements from DS1 to demonstrate its feasibility for real-time execution. Results: The effectiveness of the proposed LoCoMo-Net was verified by a comparative analysis against the benchmarked models using the same datasets wherein our proposed model outperformed Twin- Support Vector Machine (SVM) and existing CNN based model by an average classification accuracy of 8.5 % and 16.0 % respectively. In addition, hardware complexity analysis is done to reveal the advantages of the two-stage pipeline where approximately 27 %, 49 %, 50 %, 23 %, and 43 % savings achieved in lookup tables (LUT's), registers, memory, power consumption and computational time respectively. Conclusion: The clinical significance of such sEMG based accurate and low-complex movement recognition system can be favorable for the potential improvement in quality of life of an amputated persons.

RESUMEN

This study reports a surface electromyogram and force of contraction model. The objective was to investigate the effect of changes in the size, type and number of motor units in the Tibialis Anterior muscle to surface electromyogram and force of dorsiflexion. A computational model to simulate surface electromyogram and associated force of contraction by the Tibialis Anterior muscle was developed. This model was simulated for isometric dorsiflexion, and comparative experiments were conducted for validation. Repeated simulations were performed to investigate the different parameters and evaluate inter-experimental variability. An equivalence statistical test and the Bland-Altman method were used to observe the significance between the simulated and experimental data. Simulated and experimentally recorded data had high similarity for the three measures: maximal power of power spectral density (p < 0.0001), root mean square of surface electromyogram (p < 0.0001) and force recorded at the footplate (p < 0.03). Inter-subject variability in the experimental results was in-line with the variability in the repeated simulation results. This experimentally validated computational model for the surface electromyogram and force of the Tibialis Anterior muscle is significant as it allows the examination of three important muscular factors associated with ageing and disease: size, fibre type and number of motor units.

Asunto(s)

RESUMEN

BACKGROUND: Sleep restores physiology and neurochemical components of our body and is essential for physical and mental health. Sleep disorders (SDs) are associated with insulin resistance and metabolic disorders. The association between SDs and diabetes needs to be understood in the Indian population. PURPOSE: The purpose was to investigate the association between SD and diabetes in the Indian population. METHODS: As a part of nationwide Niyantrita Madhumeha Bharata Abhiyaan-2017 (NMB-2017), a cross-sectional study was conducted and data was collected from seven zones of India, after screening through the Indian Diabetes Risk Score (IDRS). The sleep quality was assessed on a scale of 1 to 4 (very good = 1, very bad = 4). The time taken to fall asleep (sleep latency) was assessed on a scale of 0 to 5 ("0" = nil and "5" = >1.5 h). Stress was assessed by the perceived stress scale. RESULTS: Bad sleep quality was positively (odds ratio 1.055, CI [1.001, 1.113], and P < .01) associated with self-reported known diabetes. Increased time taken to fall in sleep (sleep latency) was associated significantly with IDRS high risk (odds ratio 1.085, CI [1.008, 1.168], and P = .01), with an average sleep latency /time takes to fall in sleep (maximum range 5 [>1.5 h], mode 2 [10 to 30 min]) minutes. Moderate stress was significantly associated with bad sleep quality (odds ratio 1.659). CONCLUSION: A positive association of bad sleep quality and stress with diabetes, and an increased sleep latency in the IDRS high-risk population point to the role of modifiable risk factors. Behavioral modification and stress reduction by using yoga may be beneficial in the better management of diabetes.

RESUMEN

In this paper, we have investigated the differences in the voices of Parkinson's disease (PD) and age-matched control (CO) subjects when uttering three phonemes using two complexity measures: fractal dimension (FD) and normalised mutual information (NMI). Three sustained phonetic voice recordings, /a/, /u/ and /m/, from 22 CO (mean age = 66.91) and 24 PD (mean age = 71.83) participants were analysed. FD was first computed for PD and CO voice recordings, followed by the computation of NMI between the test groups: PD-CO, PD-PD and CO-CO. Four features reported in the literature-normalised pitch period entropy (Norm. PPE), glottal-to-noise excitation ratio (GNE), detrended fluctuation analysis (DFA) and glottal closing quotient (ClQ)-were also computed for comparison with the proposed complexity measures. The statistical significance of the features was tested using a one-way ANOVA test. Support vector machine (SVM) with a linear kernel was used to classify the test groups, using a leave-one-out validation method. The results showed that PD voice recordings had lower FD compared to CO (p < 0.008). It was also observed that the average NMI between CO voice recordings was significantly lower compared with the CO-PD and PD-PD groups (p < 0.036) for the three phonetic sounds. The average NMI and FD demonstrated higher accuracy (>80%) in differentiating the test groups compared with other speech feature-based classifications. This study has demonstrated that the voices of PD patients has reduced FD, and NMI between voice recordings of PD-CO and PD-PD is higher compared with CO-CO. This suggests that the use of NMI obtained from the sample voice, when paired with known groups of CO and PD, can be used to identify PD voices. These findings could have applications for population screening.

Asunto(s)