An Advanced Conceptual Diagnostic Healthcare Framework for Diabetes and Cardiovascular Disorders

The data mining along with emerging computing techniques have astonishingly influenced the healthcare industry. Researchers have used different Data Mining and Internet of Things (IoT) for enrooting a programmed solution for diabetes and heart patients. However, still, more advanced and united solution is needed that can offer a therapeutic opinion to individual diabetic and cardio patients. Therefore, here, a smart data mining and IoT (SMDIoT) based advanced healthcare system for proficient diabetes and cardiovascular diseases have been proposed. The hybridization of data mining and IoT with other emerging computing techniques is supposed to give an effective and economical solution to diabetes and cardio patients. SMDIoT hybridized the ideas of data mining, Internet of Things, chatbots, contextual entity search (CES), bio-sensors, semantic analysis and granular computing (GC). The bio-sensors of the proposed system assist in getting the current and precise status of the concerned patients so that in case of an emergency, the needful medical assistance can be provided. The novelty lies in the hybrid framework and the adequate support of chatbots, granular computing, context entity search and semantic analysis. The practical implementation of this system is very challenging and costly. However, it appears to be more operative and economical solution for diabetes and cardio patients.Comment: 11 PAGE

A polymorphism at IGF1 locus is associated with anemia

In vitro and in vivo studies suggest that IGF-1 has a role in erythropoiesis. There is evidence that the rs35767 C/T polymorphism near IGF1 is associated with plasma IGF-1 levels. We investigated the effect of this polymorphism on hemoglobin (Hb) concentration and anemia. The study group comprised 3286 adult Whites. The rs35767 polymorphism was screened using a TaqMan allelic discrimination assay. The rs35767 polymorphism was not associated with age, gender, BMI, waist circumference, smoking, blood pressure, plasma glucose, HbA1c, type 2 diabetes, HOMA-IR, hsCRP, eGFR, and lipid profile. Erythrocyte sedimentation rate (ESR), fibrinogen, and fasting insulin levels were significantly lower in TT genotype carriers compared with C allele carriers. Hb concentration was significantly higher in carriers of the TT genotype compared with C allele carriers, and a lower proportion of TT carriers had anemia. As compared with TT genotype carriers, those bearing the CC genotype had a 2.4-fold higher risk of anemia (OR 2.40, 95%CI 1.19-4.82), and those with the CT genotype had a 2.0-fold higher risk of anemia (OR 2.06, 95%CI 1.04-4.11). The association remained significant when fasting insulin, eGFR, smoking, diabetes, ACE inhibitors, sartans or diuretics treatments, use of metformin and pioglitazone were added to the model, but its independence was not retained after inclusion of fibrinogen and ESR values into the model. In conclusion, rs35767 TT allele carriers exhibited significantly higher concentrations of Hb, and lower risk of anemia compared with C allele carriers supporting the idea that IGF-1 plays a role in erythropoiesis homeostasis

New intelligent network approach for monitoring physiological parameters : the case of Benin

Benin health system is facing many challenges as: (i) affordable high-quality health care to a growing population providing need, (ii) patients’ hospitalization time reduction, (iii) and presence time of the nursing staff optimization. Such challenges can be solved by remote monitoring of patients. To achieve this, five steps were followed. 1) Identification of the Wireless Body Area Network (WBAN) systems’ characteristics and the patient physiological parameters’ monitoring. 2) The national Integrated Patient Monitoring Network (RIMP) architecture modeling in a cloud of Technocenters. 3) Cross-analysis between the characteristics and the functional requirements identified. 4) Each Technocenter’s functionality simulation through: a) the design approach choice inspired by the life cycle of V systems; b) functional modeling through SysML Language; c) the communication technology and different architectures of sensor networks choice studying. 5) An estimate of the material resources of the national RIMP according to physiological parameters. A National Integrated Network for Patient Monitoring (RNIMP) remotely, ambulatory or not, was designed for Beninese health system. The implementation of the RNIMP will contribute to improve patients’ care in Benin. The proposed network is supported by a repository that can be used for its implementation, monitoring and evaluation. It is a table of 36 characteristic elements each of which must satisfy 5 requirements relating to: medical application, design factors, safety, performance indicators and materiovigilance

Genomic African and Native American Ancestry and Chagas Disease: The Bambui (Brazil) Epigen Cohort Study of Aging.

BackgroundThe influence of genetic ancestry on Trypanosoma cruzi infection and Chagas disease outcomes is unknown.Methodology/principal findingsWe used 370,539 Single Nucleotide Polymorphisms (SNPs) to examine the association between individual proportions of African, European and Native American genomic ancestry with T. cruzi infection and related outcomes in 1,341 participants (aged ≥ 60 years) of the Bambui (Brazil) population-based cohort study of aging. Potential confounding variables included sociodemographic characteristics and an array of health measures. The prevalence of T. cruzi infection was 37.5% and 56.3% of those infected had a major ECG abnormality. Baseline T. cruzi infection was correlated with higher levels of African and Native American ancestry, which in turn were strongly associated with poor socioeconomic circumstances. Cardiomyopathy in infected persons was not significantly associated with African or Native American ancestry levels. Infected persons with a major ECG abnormality were at increased risk of 15-year mortality relative to their counterparts with no such abnormalities (adjusted hazard ratio = 1.80; 95% 1.41, 2.32). African and Native American ancestry levels had no significant effect modifying this association.Conclusions/significanceOur findings indicate that African and Native American ancestry have no influence on the presence of major ECG abnormalities and had no influence on the ability of an ECG abnormality to predict mortality in older people infected with T. cruzi. In contrast, our results revealed a strong and independent association between prevalent T. cruzi infection and higher levels of African and Native American ancestry. Whether this association is a consequence of genetic background or differential exposure to infection remains to be determined

Sustaining the Medical Home: How PROMETHEUS Payment Can Revitalize Primary Care

Argues for reforming the current fee-for-service payment system on the PROMETHEUS model of budgeting for a comprehensive episode of care for a condition. Analyzes the implications for a sustainable patient-centered medical home model of care delivery

Arylthioamides and aryliminothioethers as new slow H2S-releasing agents

Hydrogen sulphide (H2S) is emerging as an important endogenous modulator, which exhibits the beneficial effects of nitric oxide (NO) on the cardiovascular (CV) system, without producing toxic metabolites. H2S exhibits the antioxidant properties of inorganic and organic sulphides, behaving as a scavenger of reactive oxygen species. H2S is biosynthesized in mammalian tissues by cystathionine--synthase (CBS) and cystathionine--lyase (CSE) that is the main source of H2S in the CV. H2S trigger other important effects and the activation of ATP-sensitive potassium channel (KATP) accounts for its vasorelaxing and cardioprotective effects. Furthermore, H2S inhibits smooth muscle proliferation and platelet aggregation. In non-CV systems, H2S regulates the functions of the central nervous system, as well as respiratory, gastroenteric, and endocrine systems. Conversely, H2S deficiency contributes to the pathogenesis of hypertension. Likewise, impairment of H2S biosynthesis is involved in CV complications associated with diabetes mellitus. Many experiments suggest a cross-talk between the H2S and the endothelial NO pathways. In particular, recent observations indicate a possible pathogenic link between deficiencies of H2S activity and the progress of endothelial dysfunction. These biological aspects of endogenous H2S have led several authors to look at this mediator as ‘‘the new NO’’, giving attractive opportunities to develop innovative classes of drugs. NaHS is the prototypical example of H2S-generating agent: it is a rapid H2S-donor and the most widely used H2S-donor for experimental purposes. However, this salt is not suitable for clinical applications, as the quick release of H2S may cause adverse effects, such as a rapid and excessive lowering of blood pressure. For a safer and effective pharmacological administration, ideal H2S-donors should generate H2S with slower releasing rates. Organic polysulphides of garlic, such as diallyl disulphide (DADS), act as H2S-releasing compounds, with a relatively slow mechanism that requires the presence of reduced glutathione. Other examples of original synthetic H2S-releasing agents have been described in the literature, including a number of aminothiol derivatives, and the phosphinodithioate derivative GYY4137. Furthermore, some H2S-releasing chemical moieties, such as the dithiolethione, the thioamide and the isothiocyanate, have been used for synthesizing multifunctional drugs. In this study, we report the synthesis and pharmacological evaluation of a series of new arylthioamide and aryliminothioether as “smart” H2S-releasing drugs