Empowering Lower Limb Disorder Identification through PoseNet and Artificial Intelligence.

A novel approach is presented in this study for the classification of lower limb disorders, with a specific emphasis on the knee, hip, and ankle. The research employs gait analysis and the extraction of PoseNet features from video data in order to effectively identify and categorize these disorders. The PoseNet algorithm facilitates the extraction of key body joint movements and positions from videos in a non-invasive and user-friendly manner, thereby offering a comprehensive representation of lower limb movements. The features that are extracted are subsequently standardized and employed as inputs for a range of machine learning algorithms, such as Random Forest, Extra Tree Classifier, Multilayer Perceptron, Artificial Neural Networks, and Convolutional Neural Networks. The models undergo training and testing processes using a dataset consisting of 174 real patients and normal individuals collected at the Tehsil Headquarter Hospital Sadiq Abad. The evaluation of their performance is conducted through the utilization of K-fold cross-validation. The findings exhibit a notable level of accuracy and precision in the classification of various lower limb disorders. Notably, the Artificial Neural Networks model achieves the highest accuracy rate of 98.84%. The proposed methodology exhibits potential in enhancing the diagnosis and treatment planning of lower limb disorders. It presents a non-invasive and efficient method of analyzing gait patterns and identifying particular conditions.

The Application of Digital Technologies and Artificial Intelligence in Healthcare: An Overview on Nutrition Assessment.

In the last decade, artificial intelligence (AI) and AI-mediated technologies have undergone rapid evolution in healthcare and medicine, from apps to computer software able to analyze medical images, robotic surgery and advanced data storage system. The main aim of the present commentary is to briefly describe the evolution of AI and its applications in healthcare, particularly in nutrition and clinical biochemistry. Indeed, AI is revealing itself to be an important tool in clinical nutrition by using telematic means to self-monitor various health metrics, including blood glucose levels, body weight, heart rate, fat percentage, blood pressure, activity tracking and calorie intake trackers. In particular, the application of the most common digital technologies used in the field of nutrition as well as the employment of AI in the management of diabetes and obesity, two of the most common nutrition-related pathologies worldwide, will be presented.

Early Detection and Classification of Tomato Leaf Disease Using High-Performance Deep Neural Network.

Tomato is one of the most essential and consumable crops in the world. Tomatoes differ in quantity depending on how they are fertilized. Leaf disease is the primary factor impacting the amount and quality of crop yield. As a result, it is critical to diagnose and classify these disorders appropriately. Different kinds of diseases influence the production of tomatoes. Earlier identification of these diseases would reduce the disease's effect on tomato plants and enhance good crop yield. Different innovative ways of identifying and classifying certain diseases have been used extensively. The motive of work is to support farmers in identifying early-stage diseases accurately and informing them about these diseases. The Convolutional Neural Network (CNN) is used to effectively define and classify tomato diseases. Google Colab is used to conduct the complete experiment with a dataset containing 3000 images of tomato leaves affected by nine different diseases and a healthy leaf. The complete process is described: Firstly, the input images are preprocessed, and the targeted area of images are segmented from the original images. Secondly, the images are further processed with varying hyper-parameters of the CNN model. Finally, CNN extracts other characteristics from pictures like colors, texture, and edges, etc. The findings demonstrate that the proposed model predictions are 98.49% accurate.

WPAN and IoT Enabled Automation to Authenticate Ignition of Vehicle in Perspective of Smart Cities.

Currently, two-wheelers are the most popular mode of transportation, driven by the majority the people. Research by the World Health Organization (WHO) identifies that most two-wheeler deaths are caused due to not wearing a helmet. However, the advancement in sensors and wireless communication technology empowers one to monitor physical things such as helmets through wireless technology. Motivated by these aspects, this article proposes a wireless personal network and an Internet of Things assisted system for automating the ignition of two-wheelers with authorization and authentication through the helmet. The authentication and authorization are realized with the assistance of a helmet node and a two-wheeler node based on 2.4 GHz RF communication. The helmet node is embedded with three flex sensors utilized to experiment with different age groups and under different temperature conditions. The statistical data collected during the experiment are utilized to identify the appropriate threshold value through a t-test hypothesis for igniting the two-wheelers. The threshold value obtained after the t-test is logged in the helmet node for initiating the communication with the two-wheeler node. The pairing of the helmet node along with the RFID key is achieved through 2.4 GHZ RF communication. During real-time implementation, the helmet node updates the status to the server and LABVIEW data logger, after wearing the helmet. Along with the customization of hardware, a LABVIEW data logger is designed to visualize the data on the server side.

Novel Antitubercular 6-Dialkylaminopyrimidine Carboxamides from Phenotypic Whole-Cell High Throughput Screening of a SoftFocus Library: Structure-Activity Relationship and Target Identification Studies.

A BioFocus DPI SoftFocus library of ∼35 000 compounds was screened against Mycobacterium tuberculosis (Mtb) in order to identify novel hits with antitubercular activity. The hits were evaluated in biology triage assays to exclude compounds suggested to function via frequently encountered promiscuous mechanisms of action including inhibition of the QcrB subunit of the cytochrome bc1 complex, disruption of cell-wall homeostasis, and DNA damage. Among the hits that passed this screening cascade, a 6-dialkylaminopyrimidine carboxamide series was prioritized for hit to lead optimization. Compounds from this series were active against clinical Mtb strains, while no cross-resistance to conventional antituberculosis drugs was observed. This suggested a novel mechanism of action, which was confirmed by chemoproteomic analysis leading to the identification of BCG_3193 and BCG_3827 as putative targets of the series with unknown function. Initial structure-activity relationship studies have resulted in compounds with moderate to potent antitubercular activity and improved physicochemical properties.

Oral vaccination with heat inactivated Mycobacterium bovis activates the complement system to protect against tuberculosis.

Tuberculosis (TB) remains a pandemic affecting billions of people worldwide, thus stressing the need for new vaccines. Defining the correlates of vaccine protection is essential to achieve this goal. In this study, we used the wild boar model for mycobacterial infection and TB to characterize the protective mechanisms elicited by a new heat inactivated Mycobacterium bovis vaccine (IV). Oral vaccination with the IV resulted in significantly lower culture and lesion scores, particularly in the thorax, suggesting that the IV might provide a novel vaccine for TB control with special impact on the prevention of pulmonary disease, which is one of the limitations of current vaccines. Oral vaccination with the IV induced an adaptive antibody response and activation of the innate immune response including the complement component C3 and inflammasome. Mycobacterial DNA/RNA was not involved in inflammasome activation but increased C3 production by a still unknown mechanism. The results also suggested a protective mechanism mediated by the activation of IFN-γ producing CD8+ T cells by MHC I antigen presenting dendritic cells (DCs) in response to vaccination with the IV, without a clear role for Th1 CD4+ T cells. These results support a role for DCs in triggering the immune response to the IV through a mechanism similar to the phagocyte response to PAMPs with a central role for C3 in protection against mycobacterial infection. Higher C3 levels may allow increased opsonophagocytosis and effective bacterial clearance, while interfering with CR3-mediated opsonic and nonopsonic phagocytosis of mycobacteria, a process that could be enhanced by specific antibodies against mycobacterial proteins induced by vaccination with the IV. These results suggest that the IV acts through novel mechanisms to protect against TB in wild boar.

Estrategia para la preparación de unidades de salud en buenas prácticas clínicas / Strategy for the preparation of health units for good clinical practices

Introducción: El entorno regulatorio mundial es cada vez más exigente para establecer, implementar y mantener el cumplimiento de las buenas prácticas clínicas (BPC). En Cuba, una respuesta necesaria derivada del desarrollo creciente de la industria farmacéutica y biotecnológica nacional fue la creación del Centro Nacional Coordinador de Ensayos Clínicos (CENCEC). Una de las misiones del CENCEC es preparar a las unidades-sitios clínicos seleccionados que realizan investigaciones clínicas, para su posterior certificación en BPC por la autoridad reguladora nacional, con la finalidad de avalar la calidad que corresponde al proceso de investigación clínica que redunda en una esmerada atención y protección al paciente objeto de estudio. Objetivo: Describir la estrategia del CENCEC para la preparación en BPC de los sitios clínicos seleccionados del Sistema Nacional de Salud (SNS) que participan en ensayos clínicos. Métodos: Se revisan más de 250 documentos normativos emitidos por Europa, Estados Unidos, Japón y los países nórdicos relacionados con aspectos prácticos y éticos para la implementación de las BPC. Se elabora una estrategia para la preparación de los sitios clínicos en BPC concebida en 4 etapas: 1) concepción técnica del proceso y organización documental, 2) selección de los sitios clínicos, 3) diagnóstico y evaluación pre-intervención y 4) preparación para la certificación. Resultados: Se identificaron 80 sitios clínicos que realizan ensayos clínicos en Cuba, de los cuales se seleccionaron 11 para la aplicación de la estrategia. Se elaboró un manual de preparación de los sitios en BPC con los aspectos de mayor impacto en el cumplimiento de las BPC. Se realizaron 40 visitas a los sitios clínicos seleccionados, 12 diagnósticas, 24 de seguimiento, una de inclusión de nuevos sitios, y 3 de declaración de Listo para Certificación...(AU)

Background: The global regulatory environment is increasingly demanding to establish, implement, and maintain the compliance with Good Clinical Practices (GCP). In Cuba, The National Coordinating Center for Clinical Trials (CENCEC) was created as a necessary response derived from the increasing development of the national pharmaceutical and biotechnological industry. One of the missions of the CENCEC is to prepare selected clinical units/sites that conduct clinical research for a further certification in GCP by the national regulatory authority in order to guarantee the quality that corresponds to the process of clinical research, resulting in a careful attention and protection of the patient under study. Objective: To describe the strategy of the CENCEC for the preparation of good clinical practices in the selected clinical sites of the National Health System (SNS) that participate in clinical trials. Methods: More than 250 regulatory documents issued by Europe, the United States, Japan and the Nordic countries, related to ethical and practical aspects for the implementation of good clinical practices, were reviewed. A strategy for the preparation of clinical sites in GCP was conceived in 4 stages: 1) technical design of the process and document organization, 2) selection of the clinical sites, 3) diagnosis and pre-intervention evaluation, and 4) preparation for certification. Results: 80 clinical sites that conduct clinical trials in Cuba were identified, of which 11 were selected for the implementation of the strategy. A manual for the preparation of the sites in GCP with aspects of great impact in compliance with GCP was created. 40 visits were made to the selected clinical sites, 12 of them were diagnostic, 24 were follow-up visits, 1 was made for the inclusion of new sites, and 3 for the statement Ready for Certification...(AU)

Estrategia para la preparación de unidades de salud en buenas prácticas clínicas / Strategy for the preparation of health units for good clinical practices

Introducción: El entorno regulatorio mundial es cada vez más exigente para establecer, implementar y mantener el cumplimiento de las buenas prácticas clínicas (BPC). En Cuba, una respuesta necesaria derivada del desarrollo creciente de la industria farmacéutica y biotecnológica nacional fue la creación del Centro Nacional Coordinador de Ensayos Clínicos (CENCEC). Una de las misiones del CENCEC es preparar a las unidades-sitios clínicos seleccionados que realizan investigaciones clínicas, para su posterior certificación en BPC por la autoridad reguladora nacional, con la finalidad de avalar la calidad que corresponde al proceso de investigación clínica que redunda en una esmerada atención y protección al paciente objeto de estudio. Objetivo: Describir la estrategia del CENCEC para la preparación en BPC de los sitios clínicos seleccionados del Sistema Nacional de Salud (SNS) que participan en ensayos clínicos. Métodos: Se revisan más de 250 documentos normativos emitidos por Europa, Estados Unidos, Japón y los países nórdicos relacionados con aspectos prácticos y éticos para la implementación de las BPC...

Background: The global regulatory environment is increasingly demanding to establish, implement, and maintain the compliance with Good Clinical Practices (GCP). In Cuba, The National Coordinating Center for Clinical Trials (CENCEC) was created as a necessary response derived from the increasing development of the national pharmaceutical and biotechnological industry. One of the missions of the CENCEC is to prepare selected clinical units/sites that conduct clinical research for a further certification in GCP by the national regulatory authority in order to guarantee the quality that corresponds to the process of clinical research, resulting in a careful attention and protection of the patient under study. Objective: To describe the strategy of the CENCEC for the preparation of good clinical practices in the selected clinical sites of the National Health System (SNS) that participate in clinical trials. Methods: More than 250 regulatory documents issued by Europe, the United States, Japan and the Nordic countries, related to ethical and practical aspects for the implementation of good clinical practices, were reviewed...

Influencia de la procedencia del paciente en la evolución clínica del esguince cervical / Influence of the origin of the patient in the clinical course of whiplash

Introducción. El propósito es conocer la influencia que el tipo de contingencia de los pacientes con esguince cervical tiene en su curso evolutivo y en su pronóstico médico-laboral, para establecer la pauta más correcta de actuación que mejore su manejo terapéutico. Material y método. Se ha realizado un análisis dirigido a registrar la evolución clínica de los pacientes con esguince cervical, según el tipo de contingencia que ha generado su situación de incapacidad temporal, valorando determinados parámetros relacionados con el curso clínico de este proceso que pueden influir negativamente en una duración mayor de la incapacidad. Resultados. Los pacientes en situación de incapacidad temporal por un accidente laboral comenzaron antes la rehabilitación, necesitaron menos sesiones de tratamiento y se reincorporaron antes a su actividad laboral que aquellos en baja laboral por enfermedad común, en los que la demora en ser remitidos al gimnasio y el mayor tiempo transcurrido desde el alta de rehabilitación hasta el alta laboral determina una mayor duración de su incapacidad temporal y una mayor repercusión socioeconómica y laboral. Conclusiones. La posibilidad de acortar los tiempos medios transcurridos desde el momento del accidente hasta el alta laboral en la valoración médica final puede mejorar la respuesta clínica al tratamiento aplicado, además de reducir los elevados gastos asociados que implica una duración más prolongada de la incapacidad laboral de los pacientes diagnosticados de esguince cervical

Introduction. This study has aimed to know the influence that the specific contingency of patients with whiplash has on its evolution course and its medical-working prognosis to establish the most appropriate guideline to improve its therapeutic treatment. Material and methods. Part of this study was used to record the clinical evolution of patients with whiplash according to type of contingency that led to temporal incapacity. Some parameters related with the clinical course of this condition that could have a negative influence on the duration of the disability were evaluated. Results. Patients with temporal incapacity due to a working accident started rehabilitation earlier, needed fewer sessions and were able to get back to their working activity sooner than patients on sick leave due to common illness. In the latter group, the delay to be referred to the gym and the longer elapsed time from the time they were discharged from rehab to when they got medical authorization to restart their working activity determines a longer period of working disability and significantly higher socioeconomical and working impact. Conclusions. The possibility of shortening the mean times between the time of accident to return to work in the final medical evaluation may improve the clinical response to the treatment administered, and reduce the high cost associated to a longer period of working incapacity for patients diagnosed with whiplash

Thrombolysis as first choice therapy in prosthetic heart valve thrombosis. A study of 68 patients.

BACKGROUND AND OBJECTIVES: Valvular thrombosis is a serious complication in patients with prosthetic heart valves. Traditional treatment is emergency surgery, but thrombolysis provides a non invasive alternative. In this paper we evaluate the efficacy and safety of thrombolysis in prosthetic heart valve thrombosis. METHODS: Data of 68 patients diagnosed of prosthetic valve thrombosis, treated at the Institute of Cardiology and Cardiovascular Surgery, Havana during a 6-years period were analyzed. They received thrombolysis with a recombinant streptokinase infusion at 250,000 IU in 30 minutes followed by 100,000 IU/hour during 72 hours or less if the thrombosis resolved before. The evaluation was based on clinical and echocardiographic findings. RESULTS: Affected sites were mitral (50 cases), tricuspid (9), and aortic (9). Mean time of prosthesis implantation was 6.8 years. The presentation form was generally heart failure (NYHA functional class III-IV) in 64 (94.1%) patients. Mean time interval between onset of symptoms and diagnosis was 10.6 days. There was total response to treatment in 58 (85.3%) patients, partial in 4 (5.9%) and failure in 6 (8.8%). Recombinant streptokinase overall dose was 5.1 x 10(6) IU and mean infusion time 50 hours. Major hemorrhagic complications were observed in two patients. Five embolic events occurred during thrombolysis. Four patients died. Rethrombosis was noted in 11 patients; 10 were retreated successfully with thrombolysis. CONCLUSIONS: Thrombolysis with recombinant streptokinase is efficacious and safe for the treatment of prosthetic heart valve thrombosis. It does not contraindicate surgical treatment if there is no total response, because patient goes to surgery in better hemodynamic conditions with lower risk. Nowadays it can be considered as first-line treatment in all patients with prosthetic heart valve thrombosis regardless of functional class unless specific contraindications exist.

Prosthetic heart valve thrombosis: pathogenesis, diagnosis and management.

Thrombosis of a prosthetic valve is one of the most severe complications of cardiac valve replacement. The incidence is 0.5% in the aortic and mitral positions and up to 20% in the tricuspid position. The presenting clinical picture ranges from the absence of symptoms to cardiogenic shock. The traditional treatment of this complication has been emergency surgery, but thrombolysis, which has been available for many years, is being considered as the first line of treatment more and more every day. The pathogenesis, diagnosis and treatment of thrombosis of prosthetic heart valves are reviewed here. Thrombolysis, which has an efficacy of over 80%, is emphasized in this review. Embolic complications associated with this therapeutic approach remain a great concern with rates of 3% to 10%, and some authors reporting rates up to 20%.

Thrombolytic treatment as first option in recurrent tricuspid prosthetic valve thrombosis and Ebstein's anomaly.

Ebstein's anomaly is the most frequent cause of congenital tricuspid regurgitation. The coexistence of a mechanical heart prosthesis in a low-pressure circuit and poor compliance in the anticoagulant therapy contributed decisively to the appearance of recurrent mechanical heart valve thrombosis in these patients. A 49 years old female patient is reported where thrombolytic therapy with recombinant Streptokinase (TT-rSK) was the first treatment choice in seven recurrent episodes of prosthetic valve thrombosis.

Thrombolytic treatment as first option in recurrent tricuspid prosthetic valve thrombosis and Ebsteins anomaly

Ebsteins anomaly is the most frequent cause of congenital tricuspid regurgitation. The coexistence of a mechanical heart prosthesis in a low-pressure circuit and poor compliance in the anticoagulant therapy contributed decisively to the appearance of recurrent mechanical heart valve thrombosis in these patients. A 49 years old female patient is reported where thrombolytic therapy with recombinant Streptokinase (TT-rSK) was the first treatment choice in seven recurrent episodes of prosthetic valve thrombosis(AU)

La anomalía de Ebstein es la causa más frecuente de regurgitación tricúspide congénita. La coexistencia de una prótesis mecánica en un centro de baja presión del circuito y los pobres en el cumplimiento de la terapia anticoagulante contribuido de forma decisiva a la aparición recurrente de válvulas cardíacas mecánicas trombosis en estos pacientes. A 49 años de edad del paciente es informado de que el tratamiento trombolítico con estreptoquinasa recombinante (TT-RSK) fue el primer tratamiento de elección en siete episodios recurrentes de trombosis de válvula protésica

La Cirugía a corazón batiente en las urgencias del postoperatorio de la Cirugía de Revascularización Miocárdica / s. t

Se presentan los casos operados de urgencia en nuestra institución en un periodo de 6 años (1998-2003), que durante el postoperatorio de la Cirugía de Revascularización miocárdica se complicaron con la oclusión o disfunción de uno de los injertos, fundamentalmente la arteria mamaria interna (15 casos). Nueve de los mismos fueron reoperados de urgencia sin circulación extracorpórea y sin parada cardíaca y 6 de ellos con la técnica habitual de Circulación extracorpórea y parada cardiopléjica. Se analizan comparativamente los resultados obtenidos, comprobándose una mejor evolución postoperatoria en aquellos reoperados sin circulación extracorpórea y sin parada cardíaca sobre todo en menos complicaciones neurológicas, renales, respiratorias y una mortalidad nula en este grupo contra un 50 por ciento en el grupo reoperados con la técnica habitual. Se discuten los resultados y se hacen las conclusiones, planteándose que esta técnica es factible y realizable con pocas complicaciones y mejor mortalidad en ese tipo de casos(AU)