Search

One of the common cardiac disorders is a cardiac attack called Myocardial infarction (MI), which occurs due to the blockage of one or more coronary arteries. Timely treatment of MI is important and slight delay results in severe consequences. Electrocardiogram (ECG) is the main diagnostic tool to monitor and reveal the MI signals. The complex nature of MI signals along with noise poses challenges to doctors for accurate and quick diagnosis. Manually studying large amounts of ECG data can be tedious and time-consuming. Therefore, there is a need for methods to automatically analyze the ECG data and make diagnosis. Number of studies has been presented to address MI detection, but most of these methods are computationally expensive and faces the problem of overfitting while dealing real data. In this paper, an effective computer-aided diagnosis (CAD) system is presented to detect MI signals using the convolution neural network (CNN) for urban healthcare in smart cities. Two types of transfer learning techniques are employed to retrain the pre-trained VGG-Net (Fine-tuning and VGG-Net as fixed feature extractor) and obtained two new networks VGG-MI1 and VGG-MI2. In the VGG-MI1 model, the last layer of the VGG-Net model is replaced with a specific layer according to our requirements and various functions are optimized to reduce overfitting. In the VGG-MI2 model, one layer of the VGG-Net model is selected as a feature descriptor of the ECG images to describe it with informative features. Considering the limited availability of dataset, ECG data is augmented which has increased the classification performance. A standard well-known database Physikalisch-Technische Bundesanstalt (PTB) Diagnostic ECG is used for the validation of the proposed framework. It is evident from experimental results that the proposed framework achieves a high accuracy surpasses the existing methods. In terms of accuracy, sensitivity, and specificity; VGG-MI1 achieved 99.02%, 98.76%, and 99.17%, respectively, while VGG-MI2 models achieved an accuracy of 99.22%, a sensitivity of 99.15%, and a specificity of 99.49%. [ABSTRACT FROM AUTHOR]

Objectives : To determine the accuracy of the EOS imaging system compared to the gold standard computed tomography (CT) scan, for the measurement of native and postoperative/prosthetic hip parameters in adolescents and adults. Methods: Medline, Cochrane Systematic Review, and Web of Science databases were searched to obtain relevant articles published between January 1964 and February 2021. All articles published in English. Inclusion and exclusion criteria were developed according to the Population, Intervention, Comparator, Outcome (PICO) framework. Three reviewers independently assessed the quality of included studies using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist. A narrative synthesis of the articles and a meta-analysis were conducted. The heterogeneity exhibited by the effect sizes was obtained using a forest plot, the Q statistic and the I2 index. Reliability coefficients were transformed into Fisher's Z to normalise their distribution and stabilise the variances. For each meta-analysis, an effect size (average reliability coefficient) and a 95% confidence interval were calculated and presented in a forest plot. The amount of radiation dose between modalities was compared. Results: The search retrieved 75 articles, six of which met inclusion and exclusion criteria. The meta-analysis included five of these six studies (sample size from 20 to 90). Comparing EOS and CT, the estimated average correlation (effect size) for combined studies was significantly high (r = 0.84, 95% CI = 0.78 to 0.88, p-value < 0.001). With respect to Pearson's correlation between EOS and CT, the estimated average correlation for combined studies was significantly high (r = 0.86, 95% CI = 0.80 to 0.90, p-value < 0.001). Average radiation dose for EOS was 0.18 ± 0.05 mGy for the anteroposterior view (AP) and 0.45 ± 0.08 mGy for the lateral view; and for CT was 8.4 to 15.6 mGy. Conclusion: The EOS imaging system has a high correlation with CT for preoperative and postoperative/prosthetic hip measurements, with considerably lower irradiation of patients. [ABSTRACT FROM AUTHOR]

Purpose: Pediatric endocrine disorders (PED) are a common component of medical health challenges in Saudi Arabia. We aimed to describe the pattern and clinical outcomes of different non-diabetic pediatric endocrine disorders in Al-Baha Region, Saudi Arabia, aiming for early diagnosis and management. Methods: The clinical and laboratory data of 744 children and adolescents who presented with non-diabetic endocrine disorders and received medical care at the pediatric endocrine clinic et al.-Baha during the period from 2018 to 2022 were retrospectively analyzed based on the records. Results: A total of 744 patients were recruited, 377 were females and 361 were males with a female/male ratio of 1.04/1. The patients' ages ranged from 2 months to 17 years, with a mean age of 9.87 ± 4.59 years. The commonest endocrine disorders were thyroid disorders 234 (31.5%), short stature 176 (23.7%), obesity 123 (16.5%), and calcium phosphate metabolism disorders 117 (15.7%). Other disorders seen were pubertal disorders 27 (3.6%), adrenal gland disorders 22 (3%), syndromes with endocrine features 14 (1.9%), sex development and gender disorders 6 (0.8%), pituitary and hypothalamic disorders 4 (0.5%), and mixed endocrine disorders 4 (0.5%). PED is a substantial source of morbidity in 26 cases and mortality in 2 cases. Conclusions: Thyroid, growth, and obesity disorders were the most common PED. Pediatric endocrine disorders have a substantial source of morbidity and mortality among Saudi children and adolescents. This baseline data is useful for planning PED care at institutional and national levels. [ABSTRACT FROM AUTHOR]

Cloud computing is the most widely adapted computing model to process scientific workloads in remote servers accessed through the internet. In the IaaS cloud, the virtual machine (VM) is the execution unit that processes the user workloads. Virtualization enables the execution of multiple virtual machines (VMs) on a single physical machine (PM). Virtual machine placement (VMP) strategically assigns VMs to suitable physical devices within a data center. From the cloud provider's perspective, the virtual machine must be placed optimally to reduce resource wastage to aid economic revenue and develop green data centres. Cloud providers need an efficient methodology to minimize resource wastage, power consumption, and network transmission delay. This paper uses NSGA-III, a multi-objective evolutionary algorithm, to simultaneously reduce the mentioned objectives to obtain a non-dominated solution. The performance metrics (Overall Nondominated Vector Generation and Spacing) of the proposed NSGA-III algorithm is compared with other multi-objective algorithms, namely VEGA, MOGA, SPEA, and NSGA-II. It is observed that the proposed algorithm performs 7% better that the existing algorithm in terms of ONVG and 12% better results in terms of spacing. ANOVA and DMRT statistical tests are used to cross-validate the results. [ABSTRACT FROM AUTHOR]

In this article, we propose different Hilbert shape-based tunable and multiband polarizers for the lower-terahertz frequency range. The tunability of this structure is achieved using a single-layer graphene sheet placed between the Hilbert resonator and silica substrate. The tunability of the graphene is further controlled using external biasing conditions which affect the chemical potential value of the graphene sheet. The proposed polarizer structure is investigated for different polarization incident conditions (X—polarizer, and Y—polarized) and polarization parameters including reflectance coefficient, transmittance coefficient, polarization conversion rate, co-polarization phase, and cross-polarization phase variations. The proposed polarizer structure can serve as the building block for several lower-terahertz systems because of its reconfigurable behavior. [ABSTRACT FROM AUTHOR]

A comparative study of different highly efficient broadband solar absorbers based on gold resonators is presented. We compare the absorption parameters for cylindrical, hollow cylindrical, pyramid, and sawtooth-shaped gold resonator structures over a wide input incident range at solar frequencies from 100 to 1200 THz (250 to 3000 nm). The performance of the structures is quantified in terms of the absorption, reflectance, and transmittance. We also numerically calculate the behavior of the structures when varying geometric parameters including the overall dimensions, the substrate size, and the resonator thickness. The proposed absorber structures can trap > 98% of the input incident light over a wide range of the terahertz (THz) spectrum. The performance of the absorber structures is compared based on their response to AM1.5 spectral irradiance to confirm their wide absorption behavior across the solar range. The proposed absorber structures offer higher absorption efficiency over a wide range of the solar spectrum. The effect of the height and other physical dimensions on the absorption is also presented. These results will help to choose the operating band for wide-angle and short-angle applications. This article also provides suggestions for the design of selective band absorption by changing the dimensions of such structures. The proposed absorber structures could be applied to design highly efficient solar cells with stable wide-angle behavior across input incident waves. [ABSTRACT FROM AUTHOR]

In this study, a simple hollow core hexagonal structured photonic crystal fiber is offered and analyzed to discern commonly used different type of alcohols in our daily life. The proposed sensor guiding properties are numerically investigated using a full vectorial finite element software-based scheme. To ensure higher accuracy, the properties of alcohols (refractive index and dielectric constant) at different wavelength are used to calculate the behaviour of the sensor. The simulation results ensure that extremely high relative sensitivity around 89% can be achieved from the sensor at optimum structural condition. In addition, other important propagation parameters such as confinement loss (CL), single-mode propagation spot size, numerical aperture, etc., are discussed in detail for various geometric conditions. The structure of that sensor is straightforward, and available commercial fabrication technology can be used to fabricate it without any complexity. [ABSTRACT FROM AUTHOR]

Mathematical knowledge involving whole number multiplication and division is integral to understanding multiplicative structures such as ratios, slope, rate of change, and proportions, which are important in subsequent mathematical learning. In this study, we investigated the effectiveness of a research-based intervention, schema-based instruction (SBI), to teach multiplicative whole number word-problem solving to three-fifth-grade students with mathematics disabilities. SBI emphasizes the underlying mathematical problem structure, uses visual-schematic diagrams to show how quantities in a problem are related, focuses on problem solving procedures grounded in reasoning, and highlights metacognitive strategy knowledge to monitor and reflect on the problem-solving process. We used a multiple probe across participants design to evaluate the functional relation between the SBI intervention and word-problem solving performance. Immediately following treatment as well as 1–3 weeks later, results indicated acquisition and retention of word problem-solving skills by all three students. In addition, the percentage of student use of representations (i.e., drawing a diagram, writing a number sentence) increased from the baseline to the intervention phases. These findings and their relation to theory, research, and practice are discussed. [ABSTRACT FROM AUTHOR]

Background: Proprotein convertase subtilisin/kexin type 9 inhibitors, such as evolocumab, are cholesterol-lowering drugs effective in lowering lipid levels in high-risk patients with primary hypercholesterolemia or mixed dyslipidemia.This study assessed the cost effectiveness of evolocumab in combination with lipid-lowering therapies (LLTs) compared with LLTs alone, from a public healthcare perspective in the Kingdom of Saudi Arabia (KSA).A Markov cohort state transition model was used, incorporating efficacy estimates from the FOURIER clinical trial and baseline cardiovascular event rates observed in clinical practice. Other model inputs were extracted from the literature and Saudi sources.In patients with clinically evident atherosclerotic cardiovascular disease and baseline low-density lipoprotein cholesterol ≥ 70 or ≥ 100 mg/dL, adding evolocumab to a maximally tolerated statin, with or without ezetimibe, was associated with incremental cost-effectiveness ratios (ICERs) of Saudi Arabian riyal (SAR) 109,274 ($US60,708) per quality-adjusted life-year (QALY) gained and SAR75,163 ($US41,757) per QALY gained, respectively. The ICER was SAR22,391 ($US12,440) per QALY gained in patients with heterozygous familial hypercholesterolemia. Sensitivity analysis results were robust to changes in model parameters and fell below the willingness-to-pay threshold of up to three times gross domestic product per capita in 2019 (SAR264,813 [$US147,118]).Evolocumab can be considered a cost-effective treatment option for patients with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia in the KSA.Objective: Proprotein convertase subtilisin/kexin type 9 inhibitors, such as evolocumab, are cholesterol-lowering drugs effective in lowering lipid levels in high-risk patients with primary hypercholesterolemia or mixed dyslipidemia.This study assessed the cost effectiveness of evolocumab in combination with lipid-lowering therapies (LLTs) compared with LLTs alone, from a public healthcare perspective in the Kingdom of Saudi Arabia (KSA).A Markov cohort state transition model was used, incorporating efficacy estimates from the FOURIER clinical trial and baseline cardiovascular event rates observed in clinical practice. Other model inputs were extracted from the literature and Saudi sources.In patients with clinically evident atherosclerotic cardiovascular disease and baseline low-density lipoprotein cholesterol ≥ 70 or ≥ 100 mg/dL, adding evolocumab to a maximally tolerated statin, with or without ezetimibe, was associated with incremental cost-effectiveness ratios (ICERs) of Saudi Arabian riyal (SAR) 109,274 ($US60,708) per quality-adjusted life-year (QALY) gained and SAR75,163 ($US41,757) per QALY gained, respectively. The ICER was SAR22,391 ($US12,440) per QALY gained in patients with heterozygous familial hypercholesterolemia. Sensitivity analysis results were robust to changes in model parameters and fell below the willingness-to-pay threshold of up to three times gross domestic product per capita in 2019 (SAR264,813 [$US147,118]).Evolocumab can be considered a cost-effective treatment option for patients with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia in the KSA.Methods: Proprotein convertase subtilisin/kexin type 9 inhibitors, such as evolocumab, are cholesterol-lowering drugs effective in lowering lipid levels in high-risk patients with primary hypercholesterolemia or mixed dyslipidemia.This study assessed the cost effectiveness of evolocumab in combination with lipid-lowering therapies (LLTs) compared with LLTs alone, from a public healthcare perspective in the Kingdom of Saudi Arabia (KSA).A Markov cohort state transition model was used, incorporating efficacy estimates from the FOURIER clinical trial and baseline cardiovascular event rates observed in clinical practice. Other model inputs were extracted from the literature and Saudi sources.In patients with clinically evident atherosclerotic cardiovascular disease and baseline low-density lipoprotein cholesterol ≥ 70 or ≥ 100 mg/dL, adding evolocumab to a maximally tolerated statin, with or without ezetimibe, was associated with incremental cost-effectiveness ratios (ICERs) of Saudi Arabian riyal (SAR) 109,274 ($US60,708) per quality-adjusted life-year (QALY) gained and SAR75,163 ($US41,757) per QALY gained, respectively. The ICER was SAR22,391 ($US12,440) per QALY gained in patients with heterozygous familial hypercholesterolemia. Sensitivity analysis results were robust to changes in model parameters and fell below the willingness-to-pay threshold of up to three times gross domestic product per capita in 2019 (SAR264,813 [$US147,118]).Evolocumab can be considered a cost-effective treatment option for patients with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia in the KSA.Results: Proprotein convertase subtilisin/kexin type 9 inhibitors, such as evolocumab, are cholesterol-lowering drugs effective in lowering lipid levels in high-risk patients with primary hypercholesterolemia or mixed dyslipidemia.This study assessed the cost effectiveness of evolocumab in combination with lipid-lowering therapies (LLTs) compared with LLTs alone, from a public healthcare perspective in the Kingdom of Saudi Arabia (KSA).A Markov cohort state transition model was used, incorporating efficacy estimates from the FOURIER clinical trial and baseline cardiovascular event rates observed in clinical practice. Other model inputs were extracted from the literature and Saudi sources.In patients with clinically evident atherosclerotic cardiovascular disease and baseline low-density lipoprotein cholesterol ≥ 70 or ≥ 100 mg/dL, adding evolocumab to a maximally tolerated statin, with or without ezetimibe, was associated with incremental cost-effectiveness ratios (ICERs) of Saudi Arabian riyal (SAR) 109,274 ($US60,708) per quality-adjusted life-year (QALY) gained and SAR75,163 ($US41,757) per QALY gained, respectively. The ICER was SAR22,391 ($US12,440) per QALY gained in patients with heterozygous familial hypercholesterolemia. Sensitivity analysis results were robust to changes in model parameters and fell below the willingness-to-pay threshold of up to three times gross domestic product per capita in 2019 (SAR264,813 [$US147,118]).Evolocumab can be considered a cost-effective treatment option for patients with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia in the KSA.Conclusion: Proprotein convertase subtilisin/kexin type 9 inhibitors, such as evolocumab, are cholesterol-lowering drugs effective in lowering lipid levels in high-risk patients with primary hypercholesterolemia or mixed dyslipidemia.This study assessed the cost effectiveness of evolocumab in combination with lipid-lowering therapies (LLTs) compared with LLTs alone, from a public healthcare perspective in the Kingdom of Saudi Arabia (KSA).A Markov cohort state transition model was used, incorporating efficacy estimates from the FOURIER clinical trial and baseline cardiovascular event rates observed in clinical practice. Other model inputs were extracted from the literature and Saudi sources.In patients with clinically evident atherosclerotic cardiovascular disease and baseline low-density lipoprotein cholesterol ≥ 70 or ≥ 100 mg/dL, adding evolocumab to a maximally tolerated statin, with or without ezetimibe, was associated with incremental cost-effectiveness ratios (ICERs) of Saudi Arabian riyal (SAR) 109,274 ($US60,708) per quality-adjusted life-year (QALY) gained and SAR75,163 ($US41,757) per QALY gained, respectively. The ICER was SAR22,391 ($US12,440) per QALY gained in patients with heterozygous familial hypercholesterolemia. Sensitivity analysis results were robust to changes in model parameters and fell below the willingness-to-pay threshold of up to three times gross domestic product per capita in 2019 (SAR264,813 [$US147,118]).Evolocumab can be considered a cost-effective treatment option for patients with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia in the KSA. [ABSTRACT FROM AUTHOR]