Enhanced Deep Learning Model for Classification of Retinal Optical Coherence Tomography Images

Retinal optical coherence tomography (OCT) imaging is a valuable tool for assessing the condition of the back part of the eye. The condition has a great effect on the specificity of diagnosis, the monitoring of many physiological and pathological procedures, and the response and evaluation of therapeutic effectiveness in various fields of clinical practices, including primary eye diseases and systemic diseases such as diabetes. Therefore, precise diagnosis, classification, and automated image analysis models are crucial. In this paper, we propose an enhanced optical coherence tomography (EOCT) model to classify retinal OCT based on modified ResNet (50) and random forest algorithms, which are used in the proposed study's training strategy to enhance performance. The Adam optimizer is applied during the training process to increase the efficiency of the ResNet (50) model compared with the common pre-trained models, such as spatial separable convolutions and visual geometry group (VGG) (16). The experimentation results show that the sensitivity, specificity, precision, negative predictive value, false discovery rate, false negative rate accuracy, and Matthew's correlation coefficient are 0.9836, 0.9615, 0.9740, 0.9756, 0.0385, 0.0260, 0.0164, 0.9747, 0.9788, and 0.9474, respectively.

A Lightweight and Robust Secure Key Establishment Protocol for Internet of Medical Things in COVID-19 Patients Care

Due to the outbreak of COVID-19, the Internet of Medical Things (IoMT) has enabled the doctors to remotely diagnose the patients, control the medical equipment, and monitor the quarantined patients through their digital devices. Security is a major concern in IoMT because the Internet of Things (IoT) nodes exchange sensitive information between virtual medical facilities over the vulnerable wireless medium. Hence, the virtual facilities must be protected from adversarial threats through secure sessions. This article proposes a lightweight and physically secure mutual authentication and secret key establishment protocol that uses physical unclonable functions (PUFs) to enable the network devices to verify the doctor's legitimacy (user) and sensor node before establishing a session key. PUF also protects the sensor nodes deployed in an unattended and hostile environment from tampering, cloning, and side-channel attacks. The proposed protocol exhibits all the necessary security properties required to protect the IoMT networks, like authentication, confidentiality, integrity, and anonymity. The formal AVISPA and informal security analysis demonstrate its robustness against attacks like impersonation, replay, a man in the middle, etc. The proposed protocol also consumes fewer resources to operate and is safe from physical attacks, making it more suitable for IoT-enabled medical network applications.

Exploring the Use of Artificial Intelligence Techniques to Detect the Presence of Coronavirus Covid-19 Through Speech and Voice Analysis

The Covid-19 pandemic represents one of the greatest global health emergencies of the last few decades with indelible consequences for all societies throughout the world. The cost in terms of human lives lost is devastating on account of the high contagiousness and mortality rate of the virus. Millions of people have been infected, frequently requiring continuous assistance and monitoring. Smart healthcare technologies and Artificial Intelligence algorithms constitute promising solutions useful not only for the monitoring of patient care but also in order to support the early diagnosis, prevention and evaluation of Covid-19 in a faster and more accurate way. On the other hand, the necessity to realise reliable and precise smart healthcare solutions, able to acquire and process voice signals by means of appropriate Internet of Things devices in real-time, requires the identification of algorithms able to discriminate accurately between pathological and healthy subjects. In this paper, we explore and compare the performance of the main machine learning techniques in terms of their ability to correctly detect Covid-19 disorders through voice analysis. Several studies report, in fact, significant effects of this virus on voice production due to the considerable impairment of the respiratory apparatus. Vocal folds oscillations that are more asynchronous, asymmetrical and restricted are observed during phonation in Covid-19 patients. Voice sounds selected by the Coswara database, an available crowd-sourced database, have been e analysed and processed to evaluate the capacity of the main ML techniques to distinguish between healthy and pathological voices. All the analyses have been evaluated in terms of accuracy, sensitivity, specificity, F1-score and Receiver Operating Characteristic area. These show the reliability of the Support Vector Machine algorithm to detect the Covid-19 infections, achieving an accuracy equal to about 97%.

Healthy and Respectful Workplaces: The Experiences of Dental Hygienists in Canada

INTRODUCTION

Like any health care practitioner, dental hygienists can experience mistreatment in the workplace. They can be subjected to harassment, bullying, abuse, and violence. These negative experiences can have adverse consequences on psychological and physical well-being and can lead to job dissatisfaction, depression, and burnout. The aim of this study was to describe dental hygienists' experiences related to healthy and respectful workplaces.

METHODS

This was an online self-administered survey sent to all members of the Canadian Dental Hygienists Association. Respondents were asked to report the occurrence, frequency, and impact of different types of mistreatment as experienced over their career.

RESULTS

In total, 3,780 dental hygienists responded to the survey (response rate = 22%). More than 70% of respondents experienced some form of mistreatment over their career from dentists, office managers, coworkers, and/or patients. Of those who experienced mistreatment, 67% reported losing the respect they felt for the offending person, 55% reported experiencing symptoms of depression, and 30% quit their job.

CONCLUSIONS

Mistreatment toward dental hygienists can be prevalent in Canadian dental care settings, resulting in negative consequences to dental hygienists' well-being.

KNOWLEDGE TRANSFER STATEMENT

The findings of this article suggest that measures are needed to support healthy and respectful workplaces in Canadian dental care settings. This includes but is not limited to 1) training and education for all members of the dental care team concerning mistreatment, 2) enacting policies in dental care settings to discourage these types of behaviors, and 3) providing help and support to individuals who experience these incidents.

Right inferior phrenic artery injury as a complication of needle aspiration: a case report

Background

To the best of the author’s knowledge, inferior phrenic artery injury was not documented in the literature as a complication of chest tube insertion or needle aspiration, and our case was the first to be mentioned in literature.

Traumatic injury to the inferior phrenic artery is extremely rare. It was reported to be injured by blunt trauma such as motorcar accident and may be associated with another organ injury.

Case presentation

The present case represents an unexpected event of inferior phrenic artery injury due to iatrogenic chest aspiration. Despite the safe maneuver we have approached in our center using a blunt dissection technique rather than the trocar technique, an unexpected complication occurred. The right inferior phrenic artery was injured with subsequent intra-abdominal bleeding and shock. It was treated successfully by endovascular embolization of the bleeding artery.

Conclusions

This complication might add a further morbidity and mortality and raising the responsibility of the surgeon to one of the most common daily surgeon’s practices.

Tanta Protocol for Management of COVID-19: Perspectives from a Developing Country

In late 2019, SARS-COV-2 disease is firstly discovered in Wuhan, China and it reached millions of people worldwide. Later, the World Health Organization (WHO) described COVID-19 as the first pandemic invading the world in 21st century. The WHO has declared that the emerging infection will last long enough to force adjustments not only in people's lifestyles but also in health care system. This amendment is expected to spread through many medical practices and specialties. A lot of diagnostic and therapeutic modalities have been proposed for COVID-19 management. The best strategy for management of patients requires a multi-disciplinary team approach with correct decision regarding the right timing of each modality of treatment. The participating multidisciplinary team for COVID-19 management includes six infectious diseases experts in Tanta University; one critical care management expert; an emergency medicine expert and two pharmacists in Tanta University. In this review, we reported our multi-disciplinary team experience with up to date literature guidance to propose a valid protocol for management of COVID-19 patients in limited resources setting.

Comparative Analysis of the Clinical Outcomes of SMILE and Wavefront-Guided LASIK in Low and Moderate Myopia

PURPOSE

To compare the clinical outcomes of small incision lenticule extraction (SMILE) and wavefront-guided LASIK (WFG LASIK) in eyes with low and moderate myopia.

METHODS

This was a prospective, comparative study enrolling 110 eyes with low and moderate myopia (spherical equivalent ≤ 6.00 diopters [D]). Two groups were differentiated according to the surgical technique used: the WFG LASIK group included 51 eyes (51 patients) undergoing WFG LASIK using the STAR S4IR excimer laser and the iDesign aberrometer (Abbott Medical Optics, Abbott Park, IL) and the SMILE group included 59 eyes (59 patients) undergoing SMILE with the VisuMax platform (Carl Zeiss Meditec, Jena, Germany). Visual, refractive, aberrometric, and contrast sensitivity outcomes were evaluated during a 6-month follow-up.

RESULTS

Mean efficacy index was 0.92 ± 0.11 and 1.12 ± 0.17 in the SMILE and WFG LASIK groups, respectively (P < .001). Postoperative spherical equivalent was within ±0.50 D in 81.54% and 98% of eyes in the SMILE and WFG LASIK groups (P < .001), and postoperative cylinder was 0.50 or below in 84.7% and 100% of eyes, respectively (P = .038). Mean safety index was 0.98 ± 0.08 and 1.20 ± 0.14 in the SMILE and WFG LASIK groups (P < .001), with losses of lines of corrected distance visual acuity in 6.8% and 0.0% of eyes, respectively. Higher increase in higher order (P < .001) and coma (P < .001) root mean square and higher decrease in contrast sensitivity for 6, 12, and 18 cycles/degree (P ≤ .001) were observed after SMILE.

CONCLUSIONS

SMILE and WFG LASIK are efficacious and safe procedures for the correction of low and moderate myopia, but WFG LASIK allows a more predictable outcome and better aberrometric control. [J Refract Surg. 2017;33(5):298-304.].

Testosterone levels and the genetic variation of sex hormone-binding globulin gene of Bubalus bubalis, bulls in Egypt

Testosterone is themain plasma androgen produced and secreted by male testis. To be bioactive, it binds to sex hormonebinding globulin (SHBG), i.e. the major transporter protein of sex steroids in the blood of mammals and other vertebrate species.Firstly, this study aimed to determine the levels of testosterone in different-age groups of buffalo bulls (Bubalus bubalis) in Egypt, and secondly to screen the genetic polymorphisms in their SHBG gene and to investigatewhether these polymorphisms are associated with the level of the circulating serum testosterone. Blood samples were collected from 67 Egyptian buffalo bulls representing four different age-groups and testosterone concentration was measured by radioimmunoassay. Selected DNA samples from different age-groups were sequenced for the full length of theirSHBGgene.Asignificant increase in the concentration of serum testosterone in buffalo bulls was recorded with the advancement of age from 12/18 to 24/36 months. Based on the number of polymorphisms in SHBG gene, the current study reveals the presence of three bull genotypes, of which one is likely to be associated with low testosterone concentration, while other is likely to be associated with an increased testosterone concentration. Such genetic associations can provide a good tool for the selection of bull genotypes with higher testosterone concentrations, which are indispensible for breeding purposes.

The neuro-ophthalmological effects related to long-term occupational exposure to organic solvents in painters

PURPOSE

Organic solvents are widely used in many industries, and usually, exposure occurs with mixtures of solvents. Organic solvent mixtures are known for their ability to affect tissues of high lipid content including the myelin sheath in the nervous system. The purpose of this work was to study the evidence that long-term (more than 10 years) exposure to organic solvent mixtures among painters can induce neuro-ophthalmological effects on the function of retinal ganglion cells and the optic tract.

METHODS

Twenty workers with long-term occupational exposure to mixed organic solvents were compared to 40 control subjects. The controls were matched for age, gender, and demographic characteristics but were not occupationally exposed to any known organic solvents, using the following comparators: visual evoked potential (VEP), electroretinogram (ERG), color vision (CV), and contrast sensitivity (CS) testing. Environmental monitoring was done in the work environment with consideration to the American Conference of Governmental Industrial Hygienists Threshold Limit Values (ACGIH-TLVs).

RESULTS

The exposed group had significantly longer latency and higher amplitude of VEP waves especially P100, higher Color Confusion Index (CCI), especially affecting the blue-yellow spectrum, and lower Log CS. There was no significant difference between exposed and nonexposed groups in full-field flash ERG response; however, in the pattern ERG, the exposed group had significantly longer latency of P50, which reflects changes in the retinal ganglion cell.

CONCLUSION

Long-term occupational exposure to mixed organic solvents appeared to affect the optic tract functions in the form of increasing latency of VEP response, affecting the quality of CV and decreasing CS. It also affects the retinal ganglion cell layer with increased latency of P50 of the pattern ERG response.

An Adapted Ant-Inspired Algorithm for Enhancing Web Service Composition

Web Service Composition (WSC) provides a flexible framework for integrating independent web services to satisfy complex user requirements. WSC aims to choose the best web service from a set of candidates. The candidates have the same functionality and different non-functional criteria such as Quality of Service (QoS). In this work, the authors propose an ant-inspired algorithm for such problem. They named it Flying Ant Colony Optimization (FACO). Flying ants inject pheromone not only on the nodes on their paths but also on neighboring nodes increasing their chances of being explored in future iterations. The amount of pheromone deposited on these neighboring nodes is inversely proportional to the distance between them and the nodes on the path. The authors believe that by depositing pheromone on neighboring nodes, FACO may consider a more diverse population of solutions, which may avoid stagnation. The empirical experiments show that FACO outperform Ant Colony Optimization (ACO) for the WSC problem, in terms of the quality of solutions but it requires slightly more execution time.

Registration of Feature-Poor 3D Measurements from Fringe Projection

We propose a novel method for registration of partly overlapping three-dimensional surface measurements for stereo-based optical sensors using fringe projection. Based on two-dimensional texture matching, it allows global registration of surfaces with poor and ambiguous three-dimensional features, which are common to surface inspection applications. No prior information about relative sensor position is necessary, which makes our approach suitable for semi-automatic and manual measurement. The algorithm is robust and works with challenging measurements, including uneven illumination, surfaces with specular reflection as well as sparsely textured surfaces. We show that precisions of 1 mm and below can be achieved along the surfaces, which is necessary for further local 3D registration.

Aloe vera gel facilitates re-epithelialization of corneal alkali burn in normal and diabetic rats

Purpose

To investigate the efficacy of topical applied aloe vera (AV) and to facilitate the repair of the standardized alkaline corneal ulcer in normal and diabetic rats.

Materials and methods

The corneal alkali-burn injury model was established unilaterally in Wistar rats by filter paper saturated with 0.01 M NaOH contacting the eyes for 45 seconds. Rats were divided into four groups: normal control (NC), normal AV (NAV), diabetic control (DC), and diabetic AV (DAV). NAV and DAV groups were treated with AV gel eye drops four times daily, and NC and DC groups were treated with normal saline for 3 days. Corneal epithelial wound closure and degree of edema were recorded using slit lamp and optical coherence tomography at 0, 24, 48, and 72 hours postwounding. Histological examination was conducted to evaluate the degree of inflammation and the healing effect.

Results

Corneal epithelial wound healing was better in the NAV group than in the NC group, and it was significantly higher in the DAV group than in the DC group (P<0.05). In comparison to the DC group, DAV treated with AV demonstrated a marked reduction in edema at 48 and 72 hours. Histologically, corneal re-epithelialization was complete and higher in DAV group than that in DC group; moreover, the inflammatory cells were increased in DC group than DAV group (P<0.05).

Conclusion

This study demonstrated the efficacy of AV for enhanced corneal re-epithelialization, as well as reduced inflammatory response after alkali burn in rats; therefore, it could be useful as a therapy for diabetic keratopathy.

The Plasmodium falciparum RhopH2 promoter and first 24 amino acids are sufficient to target proteins to the rhoptries

The rhoptry secretory organelles of the malaria parasite, Plasmodium falciparum, contain a RhopH complex, which is composed of the proteins RhopH1, RhopH2, and RhopH3. RhopH1 is encoded by the rhoph1/clag multi-gene family, whereas RhopH2 and RhopH3 are encoded by single-copy genes. The precise function of the RhopH complex has not been identified, but it has been shown that the component proteins are involved in erythrocyte binding and perhaps participate in the formation of the parasitophorous vacuolar membrane. In this study, we have isolated pfrhoph2 promoter plus the signal peptide encoding sequence and generated transgene expression constructs to evaluate a trafficking and the RhopH complex formation in transgenic P. falciparum parasite lines. Interestingly, we found that the N-terminal 24 amino acids of RhopH2, including signal peptide sequence, were sufficient to target GFP to the rhoptries under the rhoph2 promoter. Because it was previously shown that the timing of the expression alone could not target proteins to the apical organelles, this targeting is likely mediated via a unique mechanism that is dependent on N-terminal 24 amino acids of RhopH2 early in the secretory pathway. The N-terminal one third of Clag3.1, which contains a distinct conserved domain with Toxoplasma gondii RON2, can not associate the RhopH complex as a GFP chimera, but a c-Myc-Clag3.1 chimera lacking the C-terminus successfully associates the RhopH complex indicating that cooperation of middle region is likely required but the C-terminus is not necessary.

Effect of prostaglandin A1 on renal hemodynamics in pregnancy toxemia

PGA1 was infused at a constant rate for 2 hours in 35 pregnant women in the third trimester. Twenty-five patients had clinical manifestations of pregnancy toxemia and 10 served as control subjects. Two dose levels (0.5 to 1.0 mug/kg/min) were investigated and obstetric aspects as well as renal hemodynamics were evaluated. At the high-dose level, the drug induced labor in half the subjects (toxemia patients and control subjects) and elicited a hypotensive response only in hypertensive cases. A marked increase in GFR and RPF was achieved at both dose levels in all cases. Plasma electrolytes, osmolality, and urea levels were unaltered. Also, the infusions did not induce any appreciable diuresis or natriuresis. Tph mechanisms of the induced changes and possible etiologic involvement of PGA1 in toxemia are discussed.