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Background Contrast induced nephropathy (CIN) is one of the most important complications of PCI, resulting in increased medical resources, longer hospital stay and higher mortality so it is important to detect early high risk patients for CIN and provide them with preventive measures. In recent years, several studies have demonstrated an association of CHA2DS2-VASc score with cardiovascular prognosis and adverse outcomes in different populations including heart failure, SCAD and ACS beyond the original AF field. The predictive value of the CHA2DS2-VASc score on CIN still remains unclear although all of the components of the CHA2DS2-VASc score are important risk factors for CIN. For this reason, the present study was designed to evaluate the predictive value of preprocedural CHA2DS2-VASc score on the development of CIN in patients with ACS who underwent PCI. Objective To assess the predictive value of the CHA2DS2-VASc Score for contrast induced nephropathy among acute coronary syndrome patients who underwent percutaneous coronary intervention. Material and methods This study is a prospective study conducted over 300 patients with myocardial infarction underwent primary coronary intervention. It took place from February 2020 till September 2020. We analyzed patient's demographic data, clinical data, laboratory data, angiographic data and CHADSVASC score and followed up patients daily for 72 hour after PCI for development of CIN then compared these data in CIN versus non CIN patients trying to find out which of these factors can predict occurrence of CIN and find CHADSVASC score cutoff value for prediction of CIN. Results CIN was developed in 89 patients. A significant relationship existed between CIN and female gender, DM, HTN, door to needle time, killip class above one, contrast volume (p Conclusion CHA2DS2-VASc score is a simple bedside risk score for preprocedure CIN risk stratification among ACS patients who underwent primary PCI. Funding Acknowledgement Type of funding sources: None.

BACKGROUND: MicroRNAs (miRNAs) are small, non-coding RNAs that are important for post-transcriptional gene regulation in both healthy and morbid conditions. Numerous miRNAs promote tumorigenesis, while others have a tumour suppressive effects. Acute myeloid leukaemia (AML) is a heterogeneous group of genetically diverse hematopoietic malignancies with variable response to treatment. AIM: Our study aimed to investigate the possible role of miR-150 in de novo adult AML and the impact of its level on survival, and we used in the silicon analysis to predict the main target genes involved in miR-150 mediated cancer pathway. MATERIAL AND METHODS: We evaluated miR-150 expression profiling assay using TaqMan primer probes RT-PCR in the plasma of 50 adult AML patients, before the start of treatment and at day 28 of treatment, along with 20 normal adult control samples. miR-16 was used as an endogenous reference for standardisation. Follow-up of patients during treatment at day 28 of induction chemotherapy and after one year was done. RESULTS: In this study, we found a significantly lower level of miR-150 in AML patients when compared to controls (p = 0.005) with 0.62 fold change than in healthy controls. Patients were divided into two groups: the low miR-150 group (miR-150 < 1) and the high miR-150 group (miR-150 > 1). A statistically significant difference was found between the two groups regarding initial total leukocytic count and initial PB blast count while for the TLC, HB and PLT count at follow up. No difference in the overall survival between the low and the high miR-150 groups could be demonstrated. CONCLUSION: Our results suggest that miR-150 functions as a tumour suppressor and gatekeeper in inhibiting cell transformation and that its downregulation is required for leukemogenesis.

Background Systemic lupus erythrematosus (SLE) is an autoimmune disease with a myriad of manifestations, that could vary among different ethnic and racial groups. Objectives To study the prevalence of various manifestations of SLE in an Egyptian population. Methods Information in this study was derived from the medical records of SLE patients who followed up in a private clinic in Cairo from January 1980 to June 2016. Results This descriptive retrospective case series included 1109 juvenile (19.4%) and adult (80.6%) patients, of which 114 (10.3%) were males and 995 were females (89.7%). Age of onset showed a mean of 26±11.19 years, and the mean of disease duration was 48.78±58.46 months (median: 26 years). The most common manifestations were synovitis (76.7%), malar rash (48.5%), leukopenia (45.7%), and photosensitivity (45.6%). At least one of the antiphospholipid antibodies was present in 41.8% of the patients tested for APL (636 patients). However thromboembolic manifestations and/or recurrent fetal loss occured in 11.5% of the patients. Neuropsychiatric manifestations were evident only in 6.4% of the patients, with seizures being the most common neuropsychiatric manifestation, present in 4% of the patients. 33.1% of the patients had nephritis, which followed the onset of the disease by a mean duration of 20±21.3 months (median=12 months). There were gender differences in the disease characteristics. Cutaneous vasculitis, nephritis, and hypocomplementemia were statistically higher in males (p=0.012, p=0.01, and p=0.041 respectively). Whereas, synovitis, and alopecia were statistically higher in females (p=0.012 and p=0.006 respectively). Patients with juvenile onset had a statisticaly higher frequency of nephritis (0=0.01), seizures (p=0.012) haemolytic anemia (p=0.001), and hypocomplementinemia (p=0.02). Conclusions Synovitis and malar rash were the most common manifestations in our study. Secondary antiphospholipid was present in 11.5% of the patients. Male patients and juvenile patients showed a tendency towards a more severe disease. Disclosure of Interest None declared

Demand for reliable biometric systems has highly increased during that past decade. However, despite of the efforts conducted in the biometrics field, there is still a possibility of successful fraud attempts. Institutes and large organizations in attempt to improve the systems false acceptance rate (FAR), depend on the concept of using more than one biometric feature to positively identify a person. This technique is referred to as combined biometric. This article presents a design of a low cost biometric system that uses combined biometric features to improve the overall system performance by decreasing the false acceptance rates (FAR) and false rejection rates (FRR). The system creates a unique template for each subject based on both his/her facial expressions and ear patterns. Discrete cosine transformations are employed as a feature extraction method for the system then the template is fed into a back propagated feedforward neural network to classify and identify the target. We demonstrate experimentally, that by using only 4 input images as training images, fed into a two layer neural network with 20 input neurons an overall system success rate of 96.67% can be achieved.

This paper describes a design of a high-speed analog comparator that is realized in 0.5- um CMOS technology. A response time of 1.62 ns was recorded at an average power consumption of 0.58 mW and a supply voltage of 3V. The comparator has been employed in the realization of an 8-bit flash type ADC where a maximum sampling rate of 300 Mb/s was reached.

Compression of medical images should be lossless to preserve details and to avoid wrong diagnosis. However, to achieve high compression ratios while maintaining image quality, only regions of interest (ROI). i.e., abnormal regions need to be losslessly compressed. The rest of the image if lossy compressed can lead to a reasonable overall compression ratios. In this paper, two techniques for determining and extracting the ROI of an MRI brain image are proposed. The first technique is based on the mean squared error (MSE) between a normal and an abnormal brain images. The region that shows high MSE is the ROI. In the other technique, selection of the ROI is based on the gray levels of the image. Any region that possesses a gray level that noticeably differs from the surroundings is the ROI.

Objective This prospective study compares the pain control after total knee replacement using a single-shot femoral nerve block (FNB) against local infiltration analgesia (LIA). Patients and methods Sixty-four patients were included the study. A total of 29 patients received single-shot ultrasound-guided FNB at the end of the procedure, whereas 35 patients received LIA. Both groups were compared as regards pain at 2 and 4 h after surgery, pain before and after physical therapy on the first postoperative day, early flexion of the knee to 90°, total opiate use, and length of stay in the hospital. Results All patients completed the study. The group that received LIA showed significantly less pain at 4 h postoperatively, on the first postoperative day, and after physical therapy. The LIA group also showed significantly better rehabilitation and less hospital stay. Patients who received FNB used significantly more opiate compared with the LIA group. Conclusion LIA gives better pain control compared with single-shot FNB after total knee replacement.

Even though that CDMA 2000 wireless networks is being widely deployed as a cellular digital standard around the world, it has some hidden vulnerabilities when concerned with the security issues. The main focus of this paper is to propose MANAGE1 as a design of a new stream cipher system to be used for data encryption in CDMA wireless networks. This new cipher system is intended to replace the offered data encryption algorithm in CDMA networks known as ORYX. The proposed cipher system is being assessed from different aspects. The first aspect addresses the period and linear complexity profiles of the generated keystream. The second is the statistical properties of the keystream, which are being tested using the standard statistical tests. It is shown that MANAGE1 cipher system improves the practical security over the ORYX, thus ensuring that data security in CDMA networks becomes more reliable to suit the high demand of secure data transmissions in the next generation of wireless communications.

With the advancements in computational techniques and computer technology, biometric-based authentication has a strong potential to be widely utilized in a variety of applications. Among various biometrics, fingerprint-based identification is the most mature and widely accepted technique. In this paper, a fast procedure that exploits the spectral features of the fingerprint to obtain a compact descriptor representation, that is both rotation and translation-invariant, is presented. Experimental results have shown high matching accuracies that are equivalent or even better than those reported in the literature.

Text-independent speaker recognition performance suffers significantly under mismatched coding conditions between training and testing speech data. In this paper, a baseline HMM-based speaker recognition system is tested under various mismatched conditions with a large number of different HMM topologies. Training and testing the models using only the voiced segments of the samples is then considered. A technique based on a diagonal affine transform in the cepstrum domain is proposed, which maps the mismatched test cepstrum data onto the baseline cepstrum domain. Results for 2 different state-of-the-art codecs and a large number of different model topologies show encouraging improvement in performance compared to the mismatched cases

An accurate biometric identification system is a critical requirement in a variety of applications. Iris-based identification has been receiving a lot of attention since its introduction. However, some techniques have limitations in identifying persons accurately and efficiently. In this work, a procedure that captures local and global characteristics of the iris, using a band of log-Gabor filters is proposed. We call the vector that stores these characteristics a feature descriptor or simply the iris descriptor. Our experimental results demonstrate that log-Gabor filters identification capabilities outperform other procedures based on the basic Gabor filters.

A novel CMOS circuit designed to implement a pacemaker based on a new technique that is smart and adaptive. The proposed circuit adapts its feedback according to the heart rate by controlling the calcium and sodium channels. It can easily be implemented within the body, and has a smaller size

I Abstract This work presents an automated method for chromosome segmentation and classifieation. It takes the advantage of tb multi-spectral information in M-FISH chromosome images and dizes the Discrete Wavelet Transform (DWT) and Bayes rule. The results of the suggested method have shown a high performance of 100%, 92%, and 95% correct classification for three different imaging systems.

The paper investigates the performance of an HMM-based text-independent speaker recognition system under different model and feature combinations for matched and mismatched speech coding conditions. The effects of changing the HMM topology and acoustic features is first investigated. Training and testing the models using only the voiced segments of the samples is then considered. The best model structure in each topology is then used to test the effects of speech codecs like G729 at 8 kb/s and G723.1 at 5.3 and 6.3 kb/s, used in multimedia applications, on the performance of both matched and mismatched conditions. To improve the performance in mismatched conditions, a MAP-based adaptation with different amounts of coded training data and a diagonal affine transform for adapting the coded cepstral features to the original PCM cepstral features are investigated. Results show that the proposed techniques improve speaker recognition performance and produce comparable results to the matched condition test.

In this paper the design and the implementation of high and low modulo (2/sup 16/+1) multiplier used in the international data encryption algorithm (IDEA) is presented. The used mathematical formula for each multiplier is provided. The comparison between the high and the low modulo multiplier is discussed and the comparison is performed according to the following: the multiplier location in IDEA structure, the process whether encryption or decryption, the used inputs and keys, the number of gates and the maximum speed. Exploring the differences between them will result in the following: the correct encryption/decryption process, the complete definition of IDEA, increased number of gates in the design of high modulo multiplier to correct the zero input state problem, the ability to customize the IDEA and to increase the operating speed of the target IDEA chip. The two modulo multipliers are implemented on Xilinx FPGA Spartan II family and the target chip is XC2S100-5PQ208C.

This paper presents new design and implementation for the inverse modulo (216 +1) multiplier to be used in the International Data Encryption Algorithm (IDEA) for key scheduling. The design is done using a novel realization of the power algorithm for Euler?s theorem, which results in the fast inverse modulo multiplier. IDEA key schedule modules are easily implemented, but the only overhead is introduced by the inverse modulo multiplier. The task of the inverse modulo multiplier circuit is to generate 18 inverses modulo multiplicative keys. The new design of the inverse modulo multiplier is based on squaring the output from the modulo multiplication operation then storing this output to use it again and this is done 14 successive times. Consequently, this new design results in fast inverse modulo multiplier realization, which calculates the inverse modulo multiplicative key in only 30 clocks rather than 65535 clocks using Euler's theorem only.

Deviation from the normal heart rhythm (arrhythmia) is sometimes life threatening. Fibrillation is a dangerous type of arrhythmia. Once started it can lead to death if left uncontrolled. Severe irregularity in heartbeats means that the heart becomes chaotic. To retain its normal pace, defibrillators and/or pacemakers are usually used. In this paper, synchronization using an artificial sensing system is suggested. A mathematical model comprising a set of nonlinear differential equations is used to construct a synchronization scheme that is capable of enforcing normal heart rhythm. Simulation results have demonstrated the effectiveness of the proposed technique in enforcing the heart to reassume a structurally stable limit cycle state. Moreover, to confirm the results, a nonlinear equivalent circuit representing the describing equations has been designed and tested. Spice simulations results have shown good agreement with those obtained from the mathematical model. The suggested system is applicable to all heart arrhythmia including fibrillation, bradycardia and even cardiac arrest so that it can lead to the development of future smart clinical pacemakers.

Feature extraction represents a crucial step in pattern recognition in general and in speech/speaker recognition in particular. Robustness to most of the common types of noise is essential. This paper presents a discrete wavelet transform-based feature extraction technique for multi-band automatic speech/speaker recognition. Experimental results have shown that this technique is of comparable performance with a full-band (conventional) technique, under matched conditions (clean speech for both training and testing). It has been found that both techniques are complementary under mismatched conditions (clean speech for training and noisy speech for testing), in that if the features extracted using each of them are combined, better recognition rates are attainable especially at low signal-to-noise ratios.

Automatic speech recognition (ASR) using multi-band decomposition provides high recognition rates especially in noisy environments. The discrete wavelet transform (DWT) is known to be an efficient tool for decomposing signals into frequency sub-bands. The concept of feature recombination (FC) as applied to the recognition of spoken Arabic numerals is suggested. Utterances are decomposed using DWT before cepstral coefficients of the resulting sub-bands are calculated. The obtained coefficients are concatenated to form a single feature vector that is used as an input to the speech classifier, e.g. a hidden Markov model (HMM), to compute the likelihood. Simulation results have demonstrated that the achieved correct recognition rates using the suggested method are comparable with the full-band ASR (conventional) system.

Chaotic conditions of the human heart causes arrhythmia. Once started, it can lead to death if left uncontrolled. To retain normal heart rhythm, chaos control through synchronization can be applied. A non-linear equivalent circuit for simulating heart behavior is suggested and tested. It is based on a set of differential equations that models heart dynamics. The obtained simulation results were consistent with those obtained rigorously. They have also demonstrated the effectiveness of the suggested technique in enforcing the heart to resume a structurally stable limit cycle state. The described synchronization technique has proven to be applicable to all heart arrhythmia, including fibrillation, bradycardia and even cardiac arrest. The controller designs described here can lead to the development of future smart clinical pacemakers.

Two high-speed A/D converter architectures are described. They make use of the hardware simplicity of cascaded and cyclic converter architecture. They could directly be cascaded to provide high resolution at reasonable component count. To attain enough speed reserve for cascading, the flash converter architecture is used as their core. Its relative hardware simplicity makes if amenable for monolithic integration. A 14-bit design example that could be used for several high speed applications is given.

A successive-approximation quantization technique in a flash-like architecture is presented. Beside its simple hardware requirements, if allows direct cascading of identical stages without subtracting amplifiers or D/A converters. Speed losses as well as the decision cost per bit are therefore greatly reduced. Due to its modular architecture and low power requirements it is amenable for monolithic fabrication. The technique is useable for several high-resolution high-speed applications such as HDTV, Computer-Aided Tomography, and ultrasound scanning.

Two new circuit techniques for A/D conversion are described. They provide high speed at moderate hardware complexity. The parallel conversion structure is combined with the cyclic structure in a manner that eliminates the need for analog-signal subtraction and/or digital to analog conversion so as to minimize speed loss due to cycling. Besides, using the same hardware for two or more cycles insures a small comparator/bit ratio, a fact which makes both techniques easy to manufacture over a single silicon die. >

A new technique for providing stable, high quality factor Y-gyrators over a wide frequency range is presented. A compensating phase shift that tracks the gyrator's parasitic phase shift is adopted using voltage variable capacitors. The technique has been implemented in an ordinary semi-floating gyrator circuit where the useable frequency range was extended from 60 kHz to 220 kHz. Further, the low frequency Q-factor has been seen to be enchanged. >

A quantization technique that implements a successive approximation algorithm at a low decision cost/bit is described. The non-zero bits in a quantization module are determined using a flash-type quantizer, an R-2R ladder resistor network and a D/A converter. To obtain higher resolution the quantization modules could be directly cascaded or recycled.

Two economical video-speed A/D converter architectures are presented. The output is generated in cascaded or recycled flash quantization blocks. A simple priority encoder, that comprises two gate levels, is suggested. The obtainable throughput rates should satisfy the requirements of a wide spectrum of video applications. Due to their simple hardware, the proposed architectures are amenable for monolithic integration.

Heart sound is one of the oldest means for assessing the function of heart valves. It helps, together with echocardiograms and electrocardiographs, to give a clear and proper diagnosis of several diseases. Artificial neural networks are used to classify several valve-related heart disorders. A library of heart sound files, recorded via the traditional stethoscope, are used to extract relevant features using several signal processing tools, e.g., discrete wavelet transform (DWT), fast Fourier transform (FFT) and linear predictive coding (LPC). The achieved recognition rates were around 95.7%.

The bare ear and the stethoscope were until recently of great help in classifying most heart diseases especially those related to valve problems. The newly developed electronic stethoscope and phonocardiography represent useful tools for recording heart sound signals. In this paper a diagnostic technique for heart diseases using heart sounds is suggested. Wavelet decomposition and mel cepstrum are used for feature extraction. Classification of the different heart diseases is then done using hidden Markov models (HMM). Three different techniques have been used and compared. The obtained recognition rates (RR) were 97.3%, 98.2%, and 99.1%.

In this paper, we present a novel technique for embedding digital "watermarks" into digital audio signals. Watermarking is a technique used to label digital media by hiding copyright or other information into the underlying data. The watermark must be imperceptible and should be robust to attacks and other types of distortion. In addition, the watermark also should be undetectable by all users except the author of the piece. In our method, the watermark is generated by filtering a PN-sequence with a filter that approximates the frequency masking characteristics of the human auditory system (HAS). It is then weighted in the time domain to account for temporal masking. We discuss the detection of the watermark and assess the robustness of our watermarking approach to attacks and various signal manipulations.

We have characterized immunophenotypically defined acute lymphoblastic leukemia (ALL) in Egypt for rearrangements of the antigen receptor genes, and correlated this with rearrangements of ALL-1 and the presence of p53 mutations. Thirty-nine cases were analyzed for rearrangements of the immunoglobulin (Ig) and T-cell receptor (TCR) genes. All precursor B-cell ALLs (12 cases) contained rearranged Ig heavy-chain (JH) region which was biallelic in 92% of these tumors. In addition to JH rearrangements, TCR delta, beta and gamma rearrangements were observed in 80, 40 and 30% of these cases, respectively. TCR genes were invariably rearranged in T-cell ALLs (11 cases). A small fraction (2/11) of T-cell ALL showed concurrent IgJH rearrangement which was monoallelic. Simultaneous rearrangement of IgJH and TCR genes was also observed in both cases of biphenotypic ALL (coexpressing B and T markers). We observed marked heterogeneity in the pattern of rearrangement of antigen receptor genes in mixed-lineage leukemias (ALL coexpressing myeloid-associated markers), including the retention of germline configuration in two cases. Rearrangements of the ALL-1 gene were confined to the leukemias that demonstrated lineage infidelity. Mutations in p53 were infrequent and were present in only three of 47 ALL cases (6%) analyzed; two of these were mixed-lineage leukemias. These results suggest that mixed-lineage and biphenotypic leukemias accumulate pathogenetic lesions that are distinct from B- and T-cell ALL, and that ALL in developing countries includes molecular entities similar to those in developed countries.

Constitutive expression of c-myc resulting from a chromosomal translocation, which juxtaposes c-myc to an immunoglobulin gene, is a pivotal lesion in Burkitt's lymphomas. This deregulated expression of c-myc is associated with mutations in the regulatory regions, i.e. the first exon and the first intron of c-myc in tumors where the chromosomal breakpoint is not itself within the regulatory region. Until recently it was widely believed that the c-myc protein in these tumors is wild type. We have demonstrated that in a fraction of Burkitt's lymphomas from Africa and from the continental USA, and in mouse plasmacytomas, the c-myc gene carries mutations in the coding region. We now show that, occasionally, such mutations are also present in multiple myelomas--tumors which do not carry translocations or amplifications of c-myc. We also show that the frequency of the c-myc coding region mutations in BL is independent of the frequency of mutations in the regulatory region. These results suggest that the mechanisms that induce missense mutations involving the coding region of c-myc may be different from those that lead to mutations in the regulatory regions.

Traditional biometric systems that are based on single biometric usually suffer from problems like unacceptable error rates, spoof attacks and insufficient population coverage. To improve system's reliability, two or more biometrics of the same identity could be combined in a manner that enhances the efficiency of the system. Multi-biometric systems integrate typical physiological (fingerprint, iris, face...etc.) and behavioral (e.g. gait, voice, signature...etc.) traits. However, other features like color of skin, color of irises and height can also be included to enhance the overall performance. In this paper, a framework for integrating a soft biometric like the color of a human iris within a multi modal biometric system that combines hard biometrics such as fingerprint and iris texture. Steerable pyramid filters and multi-channel log-Gabor filters are suggested here for extracting proper features of the fingerprints and iris textures respectively. Experimental results, considering two different fusion strategies, have shown a significant improvement in the performance compared to the results of the standalone combined fingerprint and iris matchers.