Accurate prediction of clinical stroke scales and improved biomarkers of motor impairment from robotic measurements

Objective: One of the greatest challenges in clinical trial design is dealing with the subjectivity and variability introduced by human raters when measuring clinical end-points. We hypothesized that robotic measures that capture the kinematics of human movements collected longitudinally in patients after stroke would bear a significant relationship to the ordinal clinical scales and potentially lead to the development of more sensitive motor biomarkers that could improve the efficiency and cost of clinical trials. Materials and methods: We used clinical scales and a robotic assay to measure arm movement in 208 patients 7, 14, 21, 30 and 90 days after acute ischemic stroke at two separate clinical sites. The robots are low impedance and low friction interactive devices that precisely measure speed, position and force, so that even a hemiparetic patient can generate a complete measurement profile. These profiles were used to develop predictive models of the clinical assessments employing a combination of artificial ant colonies and neural network ensembles. Results: The resulting models replicated commonly used clinical scales to a cross-validated R2 of 0.73, 0.75, 0.63 and 0.60 for the Fugl-Meyer, Motor Power, NIH stroke and modified Rankin scales, respectively. Moreover, when suitably scaled and combined, the robotic measures demonstrated a significant increase in effect size from day 7 to 90 over historical data (1.47 versus 0.67). Discussion and conclusion: These results suggest that it is possible to derive surrogate biomarkers that can significantly reduce the sample size required to power future stroke clinical trials

Neuromuscular disorder as initial manifestation of secondary hyperparathyroidism – a case report

This case report describes a young woman who presented with slowly progressing weakness of the proximal limb muscles and slight decrease of muscle tone but otherwise unremarkable neurological history. Diagnostic workup revealed fatty degeneration of the girdle muscles and an excessive increase of the parathyroid hormone as a result of severe vitamin D deficiency. Secondary hyperparathyroidism was diagnosed, and neurological deficits resolved after treatment of the underlying endocrinopathy

A Proposed Methodology for Cyber Security Mechanism According to the Most Popular Detected Attacks for University Web Application

International audienc

Autosomal dominant polycystic kidney disease and minimal trauma: medical review and case report

Abstract Background Blunt abdominal trauma in the setting of polycystic kidney disease is still scantly described in the literature and management guidelines of such patients are not well-established. Case presentation The authors herein present a case of hypovolemic shock secondary to segmental renal artery bleed in a 75-year-old man with polycystic kidney disease after minimal blunt abdominal trauma, who underwent successful selective arterial embolization, and provide a thorough review of similar cases in the literature, while shedding the light on important considerations when dealing with such patients. Conclusions It is important to suspect renal injury in patients with pre-existing renal lesions irrespective of the mechanism of injury; and, vice-versa to suspect an underlying abnormality in patients with a clinical deterioration that’s out of proportion to the mechanism of injury

Association between universal health coverage and the disease burden of acute illness and injury at the global level

Abstract Background This study examines the relationship between universal health coverage (UHC) and the burden of emergency diseases at a global level. Methods Data on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables 1) coverage of essential health services and 2) proportion of the population spending more than 10% of household income on out-of-pocket health care expenditure, were extracted from the World Bank Database for years preceding our outcome of interest. A linear regression was used to analyze the association between UHC variables and DALYs for emergency diseases, controlling for other variables. Results A total of 132 countries were included. The median national coverage of essential health services index was 67.5/100, while the median national prevalence of catastrophic spending in the sample was 6.74% of households. There was a strong significant relationship between health service coverage and the burden of emergency diseases, with an 11.5-point reduction in DALYs of emergency medical diseases (95% CI -9.5, -14.8) for every point increase in the coverage of essential health services index. There was no statistically significant relationship between catastrophic expenditures and the burden of emergency diseases, which may be indicative of inelastic demand in seeking services for health emergencies. Conclusion Increasing the coverage of essential health services, as measured by the essential health services index, is strongly correlated with a reduction in the burden of emergency conditions. In addition, data affirms that financial protection remains inadequate in many parts of the globe, with large numbers of households experiencing significant economic duress related to seeking healthcare. This evidence supports a strategy of strengthening UHC as a means of combating death and disability from health emergencies, as well as extending protection against impoverishment related to healthcare expenses

Recycled poly(ethylene terephthalate) as dye adsorbent : a mini-review

Poly(ethylene terephthalate) (PET) has become one of the most major post-consumer plastic waste, in addition to poly(ethylene), poly(propylene), poly(styrene) and poly(vinyl chloride). PET bottles are mostly used in packaging of drinking and mineral water as well as soft drinks. This review demonstrates the potential of PET waste as a value added product in dyes adsorption application. Dyes are known to affect human health, aquatic life and the overall ecosystem in adverse way. They need to be removed from wastewater, hence the technologies utilized for such removal are widely investigated. The review presents the different preparation techniques to produce adsorbent from PET waste. Besides that, it discusses the adsorption capacities among the PET adsorbents prepared. Based on the review, it can be concluded that activated carbon produced from PET waste has the potential to be an effective adsorbent for dye adsorption

Data from: Outcomes of systolic heart failure patients presenting with sepsis to the emergency department of a tertiary hospital: a retrospective chart review study from Lebanon

Objectives: Congestive heart failure (CHF) patients may be at a higher risk of mortality from sepsis than patients without CHF due to insufficient cardiovascular reserves during systemic infections. . The aim of this study is to compare sepsis-related mortality between CHF and non-CHF patients in patients presenting to a tertiary medical center. Design: A single centre, retrospective, cohort study. Setting: Conducted in an academic ED between January 2010 and January 2015. Patients’ charts were queried via the hospital’s electronic system. Patients with a diagnosis of sepsis were included. Descriptive analysis was performed on the demographics, characteristics, and outcomes of septic patients of the study population. Participants: A total of 174 patients, of which 87 (50%) were CHF patients. Primary and secondary outcomes: The primary outcome of the study was in-hospital mortality. Secondary outcomes included intensive care unit (ICU), and hospital lengths of stay, and differences in interventions between the two groups. Results: CHF patients had a higher in-hospital mortality (57.5% vs 34.5%). Septic CHF patients had higher odds of death as compared to the control population (OR, 2.45; 95% CI, 1.22-4.88). Secondary analyses showed that CHF patients had lower instances of bacteremia upon presentation to the ED (31.8% vs 46.4%). They had less IV fluid requirements in first 24 hours (2.75 ± 2.28 L vs 3.67 ± 2.82 L, p-value=0.038), had a higher rate of intubation in the ED (24.2% vs 10.6%, p-value=0.025) and required more dobutamine in the first 24 hours (16.1% vs 1.1%, p-value<0.001). Emergency department length of stay was found to be lower in CHF patients (15.12 ± 24.45 hours vs 18.17 ± 26.13 hours, p-value=0.418) and they were more likely to be admitted to the ICU (59.8% vs 48.8%, p-value=0.149). Conclusion: Septic patients with CHF experienced an increased hospital mortality compared to patients without CHF

Data_heart_failure

Raw data of the systolic heart failure and sepsi

Legislative Documents

Also, variously referred to as: House bills; House documents; House legislative documents; legislative documents; General Court documents