Adapted LZW Protocol for ‎ ECG Data Compression

خوارزمية الـ(LZW) هي واحدة من طرق ضغط البيانات المستخدمة في عدة تطبيقات كضغط بيانات تخطيط القلب الكهربائي( ECG) لتقليل حجمها مما يسهل عملية نقلها عبر الشبكة. بما ان بيانات الـ(ECG) الخاصة بالمرضى تنقل عبر الشبكة طول الوقت لذلك ظهرت الحاجة الى تقليل حجمها من اجل ضمان وصولها بالسرعة الممكنة  لقاعدة البيانات. في هذه البحث نحن نهتم بطريقة الـ (LZW) التي هي واحدة من اهم واشهر طرق ضغط البيانات وقد اقترحنا بروتوكول لتحسين الطريقة التي تعتمدها خوارزمية الـ(LZW) في خزن المؤشرات الخاصة بالبيانات المضغوطة. البروتوكول المقترح يمكن ان يقلل حجم المؤشر لخوارزمية الـ(LZW). تم اعتماد خمس عينات اخذت من بنك المعلومات الخاص بـ(Physionet) لغرض اختبار البروتوكول المقترح. وقد اظهرت نتائج الاختبارت العملية ان البروتوكول المقترح يعطي نسبة ضغط افضل لبيانات الـ(ECG) مقارنة بطريقة الـ(LZW) الاصلية.Lempel–Ziv–Welch (LZW) is a data compression method, which is adopted by many applications likes Electrocardiography (ECG) data to reduce the size of transferred data. Because of the ECG data moves over the network all the time, which means there is a need to reduce its size to improve the network performance. In this paper, we concerned with the LZW method, which is one of the important and famous data compression method. We propose a protocol to improve the way in which the LZW saving an index for the compressed data. The proposed protocol could reduce the size of the index in LZW method. Five samples data groups provided by Physionet are used for evaluation. The experimental result shows that the proposed protocol can give best compression ratio compared with the original method

Integration of Evidence Based Medicine into a Medical Curriculum

The College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) was established in January 2004. The four-year curriculum was based on the Problem Based Learning (PBL) format and involved the web-based graduate medical program adopted from the University of Sydney, Australia. At KSAU-HS, one additional semester was added to the beginning of this curriculum to prepare the students in English language skills, PBL, Information Technology and Evidence Based Medicine (EBM). EBM is part of the Personal and Professional Development (PPD) theme of the medical curriculum and is integrated into each stage of the medical curriculum. These modifications of the University of Sydney curriculum are presented here as a model of EBM integration into a college of medicine curriculum

Microfluidics-based super-resolution microscopy enables nanoscopic characterization of blood stem cell rolling.

Hematopoietic stem/progenitor cell (HSPC) homing occurs via cell adhesion mediated by spatiotemporally organized ligand-receptor interactions. Although molecules and biological processes involved in this multistep cellular interaction with endothelium have been studied extensively, molecular mechanisms of this process, in particular the nanoscale spatiotemporal behavior of ligand-receptor interactions and their role in the cellular interaction, remain elusive. We introduce a microfluidics-based super-resolution fluorescence imaging platform and apply the method to investigate the initial essential step in the homing, tethering, and rolling of HSPCs under external shear stress that is mediated by selectins, expressed on endothelium, with selectin ligands (that is, CD44) expressed on HSPCs. Our new method reveals transient nanoscale reorganization of CD44 clusters during cell rolling on E-selectin. We demonstrate that this mechanical force-induced reorganization is accompanied by a large structural reorganization of actin cytoskeleton. The CD44 clusters were partly disrupted by disrupting lipid rafts. The spatial reorganization of CD44 and actin cytoskeleton was not observed for the lipid raft-disrupted cells, demonstrating the essential role of the spatial clustering of CD44 on its reorganization during cell rolling. The lipid raft disruption causes faster and unstable cell rolling on E-selectin compared with the intact cells. Together, our results demonstrate that the spatial reorganization of CD44 and actin cytoskeleton is the result of concerted effect of E-selectin-ligand interactions, external shear stress, and spatial clustering of the selectin ligands, and has significant effect on the tethering/rolling step in HSPC homing. Our new experimental platform provides a foundation for characterizing complicated HSPC homing

Do poor patients suffer from inaccurate diagnoses more than well-to-do patients? A randomized control trial

BACKGROUND: Poor patients have greater morbidity and die up to 10 years earlier than patients who have higher socio-economic status. These findings are often attributed to differences in life-style between groups. The present study aimed at investigating the extent to which physicians contribute to the effect by providing relative poorer care, resulting in relative neglect in terms of time spent with a poor patient and more inaccurate diagnoses. METHODS: A randomised experiment with 45 internal medicine residents. Doctors diagnosed 12 written clinical vignettes that were exactly the same except for the description of the patients' socio-economic status. Each participant diagnosed four of the vignettes in a poor-patient version, fou

A comparison of nutritional intake and daily physical activity of girls aged 8-11 years old in Makkah, Saudi Arabia according to weight status

Abstract Background Obesity rates in Saudi Arabia are amongst the highest in the world. It is known that teenage girls are less active than teenage boys, but less is known about the diet and activity patterns in younger girls. Therefore this study sought to investigate dietary intake and daily physical activity in girls aged 8-11 years old in Saudi Arabia. Methods This was a cross- sectional observational study conducted in seven schools across the city of Makkah. A total of 266 girls had anthropometric measurements taken including height, weight, waist circumference and body fat estimations. Dietary assessment using a 4 day unweighed diet diary was undertaken in 136 of these participants, and 134 agreed to monitor their physical activity for the 4 days using an accelerometer. After exclusion for under-reporting, 109 remained in the dietary analysis and 78 in the physical activity analyses. Differences in means between BMI groups were determined using one-way ANOVA with post hoc Tukey test. Multivariable linear regression analysis was performed to look at the effect of multiple variables on body weight. Results A total of 30% of participants were classified obese or overweight. There was a significant difference in the mean daily energy intake between the BMI groups with the obese group having the highest energy, fat, carbohydrate and protein intake (obese group: 2677 ± 804 kcal/d; healthy weight group: 1806 ± 403 kcal/d, p < 0.001), but the percentage contribution of the macronutrients to energy intake remained the same across the BMI groups. There were no differences in number of steps taken per day or time spent in moderate to vigorous intensity exercise according to BMI category. Most of the girls did not meet daily physical activity guidelines (5969 to 6773 steps per day and 18.5 - 22.5 mins per day of moderate to vigorous activity). Multiple linear regression showed that energy intake positively predicted body weight (Beta = 0.279, p =0 .001), whereas, total energy expenditure per kg of body weight and family income had a significant negative influence on body weight (Beta = −0.661, p < 0.001; −0.131, p = 0.028 respectively). Conclusions The results of this cross sectional analysis suggest that obesity in girls aged 8-11 years is linked to excessive energy intake from all macronutrients and the majority of girls in all weight categories are inactive. Research should be conducted to further investigate causal relationships in longitudinal studies and develop interventions to promote dietary change and activity that is culturally acceptable for girls in Saudi Arabia

Speed Control of a Multi-Motor System Based on Fuzzy Neural Model Reference Method

The direct-current (DC) motor has been widely utilized in many industrial applications, such as a multi-motor system, due to its excellent speed control features regardless of its greater maintenance costs. A synchronous regulator is utilized to verify the response of the speed control. The motor speed can be improved utilizing artificial intelligence techniques, for example fuzzy neural networks (FNNs). These networks can be learned and predicted, and they are useful when dealing with nonlinear systems or when severe turbulence occurs. This work aims to design an FNN based on a model reference controller for separately excited DC motor drive systems, which will be applied in a multi-machine system with two DC motors. The MATLAB/Simulink software package has been used to implement the FNMR and investigate the performance of the multi-DC motor. moreover, the online training based on the backpropagation algorithm has been utilized. The obtained results were good for improving the speed response, synchronizing the motors, and applying load during the work of the motors compared to the traditional PI control method. Finally, the multi-motor system that was controlled by the proposed method has been improved where its speed was not affected by the disturbance. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Taif University, TU: TURSP-2020/211Funding: This research was funded by Taif University, project number (TURSP-2020/211), Taif University, Taif, Saudi Arabia

Longitudinal investigation of training status and cardiopulmonary responses in pre- and early-pubertal children

PurposeThe presence of a maturational threshold that modulates children’s physiological responses to exercise training continues to be debated, not least due to a lack of longitudinal evidence to address this question. The purpose of this study was to investigate the interaction between swim-training status and maturity in nineteen trained (T, 10 ± 1 years, −2.4 ± 1.9 years pre-peak height velocity, 8 boys) and fifteen untrained (UT, 10 ± 1 years, −2.3 ± 0.9 years pre-peak height velocity, 5 boys) children, at three annual measurements.MethodsIn addition to pulmonary gas exchange measurements, stroke volume (SV) and cardiac output ( Q˙) were estimated by thoracic bioelectrical impedance during incremental ramp exercise.ResultsAt baseline and both subsequent measurement points, trained children had significantly (P &#60; 0.05) higher peak oxygen uptake (year 1 T 1.75 ± 0.34 vs. UT 1.49 ± 0.22; year 2 T 2.01 ± 0.31 vs. UT 1.65 ± 0.08; year 3 T 2.07 ± 0.30 vs. UT 1.77 ± 0.16 l min−1) and Q˙ (year 1 T 15.0 ± 2.9 vs. UT 13.2 ± 2.2; year 2 T 16.1 ± 2.8 vs. UT 13.8 ± 2.9; year 3 T 19.3 ± 4.4 vs. UT 16.0 ± 2.7 l min−1). Furthermore, the SV response pattern differed significantly with training status, demonstrating the conventional plateau in UT but a progressive increase in T. Multilevel modelling revealed that none of the measured pulmonary or cardiovascular parameters interacted with maturational status, and the magnitude of the difference between T and UT was similar, irrespective of maturational status.ConclusionThe results of this novel longitudinal study challenge the notion that differences in training status in young people are only evident once a maturational threshold has been exceeded

Non-Communicable Disease Risk Factors among Employees and Their Families of a Saudi University: An Epidemiological Study

Objectives:To assess the prevalence of non-communicable disease (NCD) risk factors among Saudi university employees and their families; to estimate the cardiovascular risk (CVR) amongst the study population in the following 10years. Methods:The NCD risk factors prevalence was estimated using a cross-sectional approach for a sample of employees and their families aged ≥ 18 years old, in a Saudi university (Riyadh in Kingdom of Saudi Arabia; KSA). WHO STEPwise standardized tools were used to estimate NCD risk factors and the Framingham Coronary Heart Risk Score calculator was used to calculate the CVR. Results:Five thousand and two hundred subjects were invited, of whom 4,500 participated in the study, providing a response rate of 87%. The mean age of participants was 39.3±13.4 years. The majority of participants reported low fruit/vegetables consumption (88%), and physically inactive (77%). More than two thirds of the cohort was found to be either overweight or obese (72%), where 36% were obese, and 59% had abdominal obesity. Of the total cohort, 22–37% were found to suffer from dyslipidaemia, 22% either diabetes or hypertension, with rather low reported current tobacco use (12%). One quarter of participants was estimated to have >10% risk to develop cardiovascular disease within the following 10-years. Conclusion:The prevalence of NCD risk factors was found to be substantially high among the university employees and their families in this study

Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants in Pregnancy and Congenital Anomalies: Analysis of Linked Databases in Wales, Norway and Funen, Denmark

Background: Hypothesised associations between in utero exposure to selective serotonin reuptake inhibitors (SSRIs) and congenital anomalies, particularly congenital heart defects (CHD), remain controversial. We investigated the putative teratogenicity of SSRI prescription in the 91 days either side of first day of last menstrual period (LMP). Methods and Findings: Three population-based EUROCAT congenital anomaly registries- Norway (2004–2010), Wales (2000–2010) and Funen, Denmark (2000–2010)—were linked to the electronic healthcare databases holding prospectively collected prescription information for all pregnancies in the timeframes available. We included 519,117 deliveries, including foetuses terminated for congenital anomalies, with data covering pregnancy and the preceding quarter, including 462,641 with data covering pregnancy and one year either side. For SSRI exposures 91 days either side of LMP, separately and together, odds ratios with 95% confidence intervals (ORs, 95%CI) for all major anomalies were estimated. We also explored: pausing or discontinuing SSRIs preconception, confounding, high dose regimens, and, in Wales, diagnosis of depression. Results were combined in meta-analyses. SSRI prescription 91 days either side of LMP was associated with increased prevalence of severe congenital heart defects (CHD) (as defined by EUROCAT guide 1.3, 2005) (34/12,962 [0.26%] vs. 865/506,155 [0.17%] OR 1.50, 1.06–2.11), and the composite adverse outcome of 'anomaly or stillbirth' (473/12962, 3.65% vs. 15829/506,155, 3.13%, OR 1.13, 1.03–1.24). The increased prevalence of all major anomalies combined did not reach statistical significance (3.09% [400/12,962] vs. 2.67% [13,536/506,155] OR 1.09, 0.99–1.21). Adjusting for socio-economic status left ORs largely unchanged. The prevalence of anomalies and severe CHD was reduced when SSRI prescriptions were stopped or paused preconception, and increased when >1 prescription was recorded, but differences were not statistically significant. The dose-response relationship between severe CHD and SSRI dose (meta-regression OR 1.49, 1.12–1.97) was consistent with SSRI-exposure related risk. Analyses in Wales suggested no associations between anomalies and diagnosed depression. Conclusion: The additional absolute risk of teratogenesis associated with SSRIs, if causal, is small. However, the high prevalence of SSRI use augments its public health importance, justifying modifications to preconception care

Real-time compression feedback for patients with in-hospital cardiac arrest: a multi-center randomized controlled clinical trial

Objective: To determine if real-time compression feedback using a non-automated hand-held device improves patient outcomes from in-hospital cardiac arrest (IHCA). Methods: We conducted a prospective, randomized, controlled, parallel study (no crossover) of patients with IHCA in the mixed medical–surgical intensive care units (ICUs) of eight academic hospitals. Patients received either standard manual chest compressions or compressions performed with real-time feedback using the Cardio First Angel™ (CFA) device. The primary outcome was sustained return of spontaneous circulation (ROSC), and secondary outcomes were survival to ICU and hospital discharge. Results: One thousand four hundred fifty-four subjects were randomized; 900 were included. Sustained ROSC was significantly improved in the CFA group (66.7% vs. 42.4%, P < 0.001), as was survival to ICU discharge (59.8% vs. 33.6%) and survival to hospital discharge (54% vs. 28.4%, P < 0.001). Outcomes were not affected by intra-group comparisons based on intubation status. ROSC, survival to ICU, and hospital discharge were noted to be improved in inter-group comparisons of non-intubated patients, but not intubated ones. Conclusion: Use of the CFA compression feedback device improved event survival and survival to ICU and hospital discharge