Development of an Electronic Stethoscope and a Classification Algorithm for Cardiopulmonary Sounds.

With conventional stethoscopes, the auscultation results may vary from one doctor to another due to a decline in his/her hearing ability with age or his/her different professional training, and the problematic cardiopulmonary sound cannot be recorded for analysis. In this paper, to resolve the above-mentioned issues, an electronic stethoscope was developed consisting of a traditional stethoscope with a condenser microphone embedded in the head to collect cardiopulmonary sounds and an AI-based classifier for cardiopulmonary sounds was proposed. Different deployments of the microphone in the stethoscope head with amplification and filter circuits were explored and analyzed using fast Fourier transform (FFT) to evaluate the effects of noise reduction. After testing, the microphone placed in the stethoscope head surrounded by cork is found to have better noise reduction. For classifying normal (healthy) and abnormal (pathological) cardiopulmonary sounds, each sample of cardiopulmonary sound is first segmented into several small frames and then a principal component analysis is performed on each small frame. The difference signal is obtained by subtracting PCA from the original signal. MFCC (Mel-frequency cepstral coefficients) and statistics are used for feature extraction based on the difference signal, and ensemble learning is used as the classifier. The final results are determined by voting based on the classification results of each small frame. After the testing, two distinct classifiers, one for heart sounds and one for lung sounds, are proposed. The best voting for heart sounds falls at 5-45% and the best voting for lung sounds falls at 5-65%. The best accuracy of 86.9%, sensitivity of 81.9%, specificity of 91.8%, and F1 score of 86.1% are obtained for heart sounds using 2 s frame segmentation with a 20% overlap, whereas the best accuracy of 73.3%, sensitivity of 66.7%, specificity of 80%, and F1 score of 71.5% are yielded for lung sounds using 5 s frame segmentation with a 50% overlap.

Biosorption of lead, Mercury, and cadmium ions by Aspergillus terreus immobilized in a natural matrix.

Our aim was to investigate the biosorption of Pb2+, Hg2+, Cd2 from aqueous solution by Aspergillus terreus (both free and immobilized on loofa sponge discs). Our results show that the adsorption capacity of fungal biomass on loofa sponge (FBLS) is superior to free fungal biomass (FFB). The adsorption selectivity by FBLS was in the order Pb2+>Hg2+>Cd2+. The maximum metal ions adsorbed was 247.2, 37.7, 23.8 mg/g FBLS for Pb2+, Hg2+ and Cd2+, respectively. Metal uptake by FBLS was affected by the pH of the metal solution, but independent of temperature (10-50 degrees C). The Langmuir model was more suitable than the Freundlich model to describe the biosorption process of FBLS. The regenerated FBLS was found to be effective for repeated use for five cycles without significant loss in adsorption capacity. This research demonstrates that FBLS possesses excellent capacity for Pb2+ biosorption from aqueous solution and industrial wastewaters.

Phosphorylated and hypoacetylated mutant p53 enhances cisplatin-induced apoptosis through caspase-9 pathway in the absence of transcriptional activation or translation.

It is not completely understood how certain epithelial cells harboring mutant p53 have better response to chemotherapy. We investigate the mechanism of cisplatin-induced apoptosis in two resistant cell lines (parental TCCSUP and R273L mutant p53 transfectant) and two sensitive cell lines (V143A and N247I mutant p53 transfectants). Activation of caspase 9 was demonstrated by Western blotting, and specific inhibitor for caspase 9 could inhibit apoptosis. Inhibitors for caspases 1, 2, 6, and 8 had no effect on apoptosis. Transcriptional repression of Bcl-2 occurred during apoptosis and could be reversed by the treatment of histone deacetylase inhibitor trichostatin A (TSA). The expression of Noxa, p53 inducible ribonucleotide reductase subunit 2 (p53R2), and p53 inducible death domain (PIDD) gene were not elevated with treatment of cisplatin (CDDP). Surface trafficking of Fas or Fas-L was not observed. Ser15 of wild-type p53 and mutant p53 was phosphorylated in response to cisplatin. Acetylation of wild-type p53 increased, while acetylation of mutant p53 decreased during cisplatin treatment. Both transcriptional inhibitor actinomycin D and translational inhibitor cycloheximide did not inhibit apoptosis. These results indicated that phosphorylated and hypoacetylated mutant p53 could enhance cisplatin-induced apoptosis through activation of caspase 9 independent of transcriptional activation and translation.

Epidemiology and mortality of liver abscess in end-stage renal disease dialysis patients: Taiwan national cohort study.

BACKGROUND AND OBJECTIVES: To determine the incidence rates and mortality of liver abscess in ESRD patients on dialysis. DESIGN SETTING PARTICIPANTS & MEASUREMENTS: Using Taiwan's National Health Insurance Research Database, we collected data from all ESRD patients who initiated dialysis between 2000 and 2006. Patients were followed until death, end of dialysis, or December 31, 2008. Predictors of liver abscess and mortality were identified using Cox models. RESULTS: Of the 53,249 incident dialysis patients identified, 447 were diagnosed as having liver abscesses during the follow-up period (224/100,000 person-years). The cumulative incidence rate of liver abscess was 0.3%, 1.1%, and 1.5% at 1 year, 5 years, and 7 years, respectively. Elderly patients and patients on peritoneal dialysis had higher incidence rates. The baseline comorbidities of diabetes mellitus, polycystic kidney disease, malignancy, chronic liver disease, biliary tract disease, or alcoholism predicted development of liver abscess. Overall in-hospital mortality was 10.1%. CONCLUSIONS: The incidence of liver abscess is high among ESRD dialysis patients. In addition to the well known risk factors of liver abscess, two other important risk factors, peritoneal dialysis and polycystic kidney disease, were found to predict liver abscess in ESRD dialysis patients.

Cs sorption to potential host rock of low-level radioactive waste repository in Taiwan: experiments and numerical fitting study.

A reliable performance assessment of radioactive waste repository depends on better knowledge of interactions between nuclides and geological substances. Numerical fitting of acquired experimental results by the surface complexation model enables us to interpret sorption behavior at molecular scale and thus to build a solid basis for simulation study. A lack of consensus on a standard set of assessment criteria (such as determination of sorption site concentration, reaction formula) during numerical fitting, on the other hand, makes lower case comparison between various studies difficult. In this study we explored the sorption of cesium to argillite by conducting experiments under different pH and solid/liquid ratio (s/l) with two specific initial Cs concentrations (100mg/L, 7.5 × 10(-4)mol/L and 0.01 mg/L, 7.5 × 10(-8)mol/L). After this, numerical fitting was performed, focusing on assessment criteria and their consequences. It was found that both ion exchange and electrostatic interactions governed Cs sorption on argillite. At higher initial Cs concentration the Cs sorption showed an increasing dependence on pH as the solid/liquid ratio was lowered. In contrast at trace Cs levels, the Cs sorption was neither s/l dependent nor pH sensitive. It is therefore proposed that ion exchange mechanism dominates Cs sorption when the concentration of surface sorption site exceeds that of Cs, whereas surface complexation is attributed to Cs uptake under alkaline environments. Numerical fitting was conducted using two different strategies to determine concentration of surface sorption sites: the clay model (based on the cation exchange capacity plus surface titration results) and the iron oxide model (where the concentration of sorption sites is proportional to the surface area of argillite). It was found that the clay model led to better fitting than the iron oxide model, which is attributed to more amenable sorption sites (two specific sorption sites along with larger site density) when using clay model. Moreover, increasing s/l ratio would produce more sorption sites, which helps to suppress the impact of heterogeneous surface on Cs sorption behavior under high pH environments.

Work fatigue and physiological symptoms in different occupations of high-elevation construction workers.

The objective of this study is to investigate whether work fatigue and physiological symptoms that high-elevation construction workers experience would be affected by the occupations. Questionnaires of demographic data and subjective fatigue symptoms as well as some physiological measurements were carried out, pre- and post-shift, on scaffolders, steel fixers, formworkers, electrician-plumbers, concreters and miscellaneous workers at a high-rise building construction site. This study found that some subjective fatigue symptoms coincide with the life style of some workers and that the extent of fatigue symptoms and physiological strains varies among different occupations of construction workers. Scaffolders, steel fixers and formworkers are categorized as physically demanding fatigue type of workers, while concreters, electrician-plumbers and miscellaneous workers as general type. The prevalence and occurrence of subjective fatigue symptoms indicate high-elevation workers have more complaints of "projection of physical impairment" than "drowsiness and dullness" and "difficulty in concentration". Some unexpected changes (i.e., post-shift measurements are greater than pre-shift ones) in some strength tests in scaffolders and concreters were consistent with the observations of how they exercised their bodies during work shift. Considerable variation of average heart rate among occupations was found, with scaffolders the highest and concreters the lowest. This study concludes that questionnaires of subjective fatigue symptoms and some physiological measurements can be used as indicators to predict the extent of strains or hazards which construction workers encounter. In terms of management program of safety and health, more attention should be paid to those physically demanding workers, such as scaffolders, workers with lower sense of safety and health, such as miscellaneous workers, and workers with older age, such as concreters.

Paired removal of color and COD from textile dyeing wastewater by simultaneous anodic and indirect cathodic oxidation.

The anodic and indirect cathodic removals of color and COD from real dyeing wastewater were investigated simultaneously using a stacked Pt/Ti screen anode and a graphite packed-bed cathode in a divided flow-by electrochemical reactor. The anodically generated hypochlorite and cathodically generated hydrogen peroxide were the main species used to remove color and COD in the wastewater. Various experimental operating factors that can affect the removal efficiency were investigated, including the applied current density, the amount of NaCl added, the solution pH in alkaline ranges and the temperature. The color and COD removal efficiencies in the anodic chamber were much higher than those in the cathodic chamber. The overall (anodic plus cathodic) removal efficiencies increased with the applied current density, the amount of NaCl added and the temperature. In contrast, increasing the solution pH decreased the overall removal efficiency. The anodic and cathodic current efficiencies at 20 mA/cm(2) were 63.50% and 19.57%, respectively. In this work the total treatment cost for removing 1g COD was US $0.643 when an air cylinder was used.