Day 1 :
Keynote Forum
Ahmad Baghal
University of Arkansas for Medical Sciences, USA
Keynote: Challenges in extracting and curating acute kidney injury data from institutional research enterprise Data Warehouse
Time : 09:30-10:15
Biography:
Ahmad Baghal is Faculty in the Department of Biomedical Informatics and Director of the Arkansas Clinical Data Repository (AR-CDR) at the University of Arkansas for Medical Sciences (UAMS). He is Health Informaticist with wealth of skills in healthcare and computer technologies acquired across a wide range of professional roles, Postdoctoral Fellowships and Graduate Education in medicine, computer science and biomedical Informatics. He led implementation of clinical Enterprise Data Warehouse and accelerated utilization of several medical and public health projects.
Abstract:
The aim of implementing Clinical Enterprise Data Warehouse (cEDW) at the University of Arkansas for Medical Sciences (UAMS) was to provide researchers dedicated data source for the conduct of clinical and translational research. Retrospective data analysis has increasingly enhanced breadth and wealth of knowledge of diseases and triggered development of novel treatments to improve patients outcomes. Acute Kidney Injury (AKI) is serious medical condition with detrimental health effects, poor outcomes and high mortality rate. It affects 15% of hospitalized patients and incidence of 1% among the general population. However, little is known about predictors of patients’ outcomes: Survival, chronic kidney disease or death. UAMS, in collaboration with four other medical centers, embarked on a study to identify modifiable factors that lead to poor outcomes among AKI patients. The cohort definition included patients who received renal dialysis, had no diagnosis of end stage renal disease and had no history of kidney transplant or chronic kidney disease stage 5 at time of first dialysis. Data points including demographics, diagnoses, procedures, comorbidities, laboratory results and medications, would be extracted from respective medical centres cEDW and because of the different cEDW implementations between the sites, it was expected data harmonization challenges would be raised. The real challenge was extracting and organizing renal dialysis treatment modalities, intermittent haemodialysis and continuous renal replacement therapy, data points from each respective centre cEDW’s flow sheets. Not only some centers used paper-based documentation of modalities, but understanding of clinical workflows was critical in producing complete and meaningful data for analysis.
Keynote Forum
Ahmad Baghal
University of Arkansas for Medical Sciences, USA
Keynote: Challenges in extracting and curating acute kidney injury data from institutional research enterprise Data Warehouse
Time : 09:30-10:15
Biography:
Ahmad Baghal is Faculty in the Department of Biomedical Informatics and Director of the Arkansas Clinical Data Repository (AR-CDR) at the University of
Arkansas for Medical Sciences (UAMS). He is Health Informaticist with wealth of skills in healthcare and computer technologies acquired across a wide range
of professional roles, Postdoctoral Fellowships and Graduate Education in medicine, computer science and biomedical Informatics. He led implementation of
clinical Enterprise Data Warehouse and accelerated utilization of several medical and public health projects.
Abstract:
The aim of implementing Clinical Enterprise Data Warehouse (cEDW) at the University of Arkansas for Medical
Sciences (UAMS) was to provide researchers dedicated data source for the conduct of clinical and translational
research. Retrospective data analysis has increasingly enhanced breadth and wealth of knowledge of diseases and
triggered development of novel treatments to improve patients outcomes. Acute Kidney Injury (AKI) is serious medical
condition with detrimental health effects, poor outcomes and high mortality rate. It affects 15% of hospitalized patients
and incidence of 1% among the general population. However, little is known about predictors of patients’ outcomes:
Survival, chronic kidney disease or death. UAMS, in collaboration with four other medical centers, embarked on a study
to identify modifiable factors that lead to poor outcomes among AKI patients. The cohort definition included patients
who received renal dialysis, had no diagnosis of end stage renal disease and had no history of kidney transplant or chronic
kidney disease stage 5 at time of first dialysis. Data points including demographics, diagnoses, procedures, comorbidities,
laboratory results and medications, would be extracted from respective medical centres cEDW and because of the different
cEDW implementations between the sites, it was expected data harmonization challenges would be raised. The real
challenge was extracting and organizing renal dialysis treatment modalities, intermittent haemodialysis and continuous
renal replacement therapy, data points from each respective centre cEDW’s flow sheets. Not only some centers used
paper-based documentation of modalities, but understanding of clinical workflows was critical in producing complete
and meaningful data for analysis.
Keynote Forum
Ahmed Makki
King Abdulaziz University, Saudi Arabia
Keynote: Integrative medicine & integrated medical education
Time : 10:15-11:00
Biography:
Ahmed Makki works as an Assistant Professor of Surgery at Medical School- Department of Surgery. He works as Examiner of the Royal College of Surgeons in Ireland. I.D. 2121, Examiner of the Royal College of Surgeons of Edinburgh. I.D. 2121, Fellow of the Royal College of Surgeons in Ireland, Fellow of the Royal College of Surgeons of Edinburgh, Fellow of the Royal College of Surgeons of Glasgow and Fellow of the Royal College of Surgeons of England. He has several credentials like Membership of the Royal College of Physicians & Surgeons of Glasgow, Fellowship of the Royal College of Surgeons in Ireland, Fellowship of the Royal College of Surgeons of Edinburgh, Fellowship of the Royal College of Surgeons of Glasgow and Fellowship of the Royal College of Surgeons of England.
Abstract:
In medical practice there is confusion between integrative medicine and integrated medical education, to eliminate this unintended confusion, we have to define each of them clearly. By integrative medicine we mean combination between the western medicine and the complementary alternative medicine, which is based on 5 domains: Biologically based approaches, manipulative therapies, mind-body interventions, alternative medicine and energy therapy, while integrated medical education is a planned interdisciplinary unit of medical educational experience. The set of medical courses and their contents that students learn under guidance of the university to achieve the graduate competencies is known as medical curriculum which has several faces as explicit, implicit, up to extra-curricular
set. The medical curriculum structure may take the form of Discrete, Linear, Pyramidal or Spiral structure. Harden in 1984 had suggested that integration as one of the keys for assessing the degree of innovation in medical curricula through the SPICES strategy, which includes student cantered learning, problem based-learning, integration and community based with systemic approach. In 2000, he proposed harden ladder which explains the 11 blocks that lead to the integration in medical courses ranging from isolation up to multi, inter, tran disciplinary approaches. This entire study illustrates the steps of initiating integrated medical course in details, with illustration of the advantages and disadvantages of integration in medical education. The study also highlights the phases of evaluation and how to improve the existing integrated course via improving content, evaluation methods as well as the outcome of medical education.
Break: Networking & Refreshments 11:00-11:20 @ Foyer
- Tele Medicine | Medical Informatics | Digital Health | Bio Medical Informatics | Health Data Analytics Pediatrics Health | Neonatology & Perinatology | Pediatric Neurology & Psychological Disorders | Pediatric Gastroenterology & Hepatology
Location: Olimpica 1
Chair
Krystian Kubica
Wroclaw University of Science and Technology, Poland
Co-Chair
Jose Eduardo Fernandes Tavora
Universidade Federal de Minas Gerais, Brazil
Session Introduction
Krystian Kubica
Wroclaw University of Science and Technology, Poland
Title: The importance of bile circulation in cholesterol homeostasis - A three-compartment mathematical model analysis
Time : 11:20-11:50
Biography:
Krystian Kubica is Biochemist and Physicist, Head of the Computer Simulation team of Biological Systems at the Department of Biomedical Engineering,
Wroclaw University of Technology. Research interests: Biophysics of biological membranes (lipid phase behaviour, interaction between biologically active compounds and membranes, the influence of molecular probes on membrane properties, the influence of lipid oxidation on membrane properties, membrane electroporation, physiological process modelling cholesterol homeostasis, molecular mechanism of thermoregulation, bone remodelling, pharmacokinetic). He has published 37 research papers. He is also the author of 7 patents. He has an experience in:
• Theoretical and experimental studies on biological membranes.
• Theoretical modeling of biological systems.
• Biochemical techniques of isolation, separation and characterization of biological compounds.
Abstract:
The analysis of the two-compartment model of cholesterol homeostasis has shown a significant influence of the amount of cholesterol carried by the bile on the total cholesterol concentration in the second compartment, peripheral blood. To study the influence of bile circulation on the cholesterol homeostasis, we have developed a three-compartment model by the addition of a new compartment, describing changes of the bile amount in the gallbladder. Now our model allows to consider: Chole-sterol synthesis in the liver, cholesterol exchange kinetics between compartments, the rate of cholesterol entry and loss with bile, the loss of cholesterol due to the conversion into cholic acid, cholesterol consumption by tissues, dietary cholesterol, gallbladder filling and emptying rates and gallbladder bile accumulation ability. Our model consists of three equations (ODE) and fourteen parameters. All parameters in our model can be divided into five groups:
- Parameters whose values result directly from physiological knowledge: The tissues demand for cholesterol, volume of blood serum in the liver and in the blood stream, total amount of bile, loss of cholesterol with feces, time of gallbladder filling and emptying.
- Parameters whose values result indirectly from physiological knowledge through equations describing particular processes. This group includes: Parameter describing the rate of cholesterol synthesis, parameters responsible
- for the rate of cholic acid synthesis and the medium rate of cholic acid flow from the liver into the gallbladder.
- Parameters which are bound together by postulated equations to describe known physiological changes.
- Parameters estimated on the basis of a case study.
- Parameters which could be described as effective rate constants responsible for multistep processes of cholesterol exchange between two compartments: Blood in the liver and peripheral blood.
José Eduardo Fernandes Tavora,
Universidade Federal de Minas Gerais, Brazil
Title: Telemedicine in Lucas Machado educational foundation: Integrating frontiers by technology
Time : 11:50-12:20
Biography:
José Eduardo Fernandes Tavora holds a Medical Degree from the Faculty of Medical Sciences of Minas Gerais (1989) a Bachelor's Degree in Biology from the Pontifical Catholic University of Minas Gerais (1983) and a Master's Degree in Health Sciences from the Minas Gerais State Institute of Health Care (2005). He is currently an Urologist at Vila da Serra Hospital, Coordinator of Urology at Vila da Serra Hospital, Professor and Coordinator of the Robotic Surgery Institute and of the lato sensu Post-graduation in minimally invasive surgery and robotics of the University of Medicine Medical Sciences.
Abstract:
The Medical Sciences University, maintained by the Lucas Machado Educational Foundation, exists for more than 70 years and offers one of the best medical courses in Brazil, according to the Ministry of Education. Our
Institution develops a Telemedicine project started in 2016 in Robotics. Acquired three Robotic Surgery System, Da Vinci (Intuitive Company) at Vila da Serra Hospital in 2016 at Felicio Rocho Hospital in 2017 and Vera Cruz Hospital in 2018 performing 1007 cases. This is part of a strategy to improve the technology to South America, regarding academic model established in three steps: Robotic discipline in graduation medical, post-graduation course in
robotics and a platform surgery training and certifying surgeons. We seek with a platform to make it possible for people from different regions to access online platforms and applications built to allow health professionals who work far from the big centers to access orientations transmitted by professionals of extreme technical quality. The solution also provides artificial intelligence that will help the physician in the possible diagnoses by combining several associated factors indicated during the consultation made by the platform. We apply new learning methods in which the communication network will be possible to coordinate educational activities as well as distance assistance,
including for students during their internship and who undergo the experience of primary care. So we contribute to train professionals who are competent in the use of technology and in the promotion of quality health for all.
Matheus Rodriques da Silva
University Center of Caratinga, Brazil
Title: Re-emergence of yellow fever in Brazil: Incidence study and areas of risk
Time : 12:20-12:50
Biography:
Lamara Laguardia Valente Rocha has completed her PhD at the age of 50 years from Federal University of Viçosa, Minas Gerais, Brazil. She is a professor and
researcher at the Institute of Health Sciences of the University Center of Caratinga and the Faculty of Medical Sciences of Minas Gerais. She has published more than 40 papers and has been serving as an editorial board member.
Abstract:
Yellow Fever (YF) is a viral disease, it is an acute non-contagious zoonotic infection and it causes a great hepatic incapacity. It occurred mainly in the countries of South America and Africa, reaching an average of 200,000 people and 30,000 deaths a year. Brazil has the largest endemic area of Silvestre YF form, while urban transmission occurs mostly in Africa. In the period from 2016 to 2017 Brazil experienced the biggest outbreak of the disease. This descriptive study determined a prevalence of YF in a historical series and evaluated an extension of the areas of risk. The data from 2001 to 2015 were extracted from the national system of notification diseases, and from 2016 to 2018 using the Health Information Bulletins of the Ministry of Health. In the outbreaks of 2016/2017 and 2017/2018 there was a incidence of 0.32/100,000 inhabitants and 0.66/100,000 inhabitants, respectively. These values represented a 13-fold increase when comparing the year of 2016/2017 and the incidence of 2008: 0.02/100,000 inhabitants and 29 times in the period 2017/2018. From 2016 there was an increase of the risk area, which occurred in the North Region, where the Amazon rainforest is located to the states in the Southeast Region as Minas Gerais, SãoPaulo, Espírito Santo and Rio de Janeiro. There was a predominance of the wild form the greater frequency of individuals living in rural areas. The development of an epizootic surveillance and vector control program is essential, in addition to greater access to health services and vaccine coverage programs for the prevention of new outbreaks and the urban form of the disease.
Break: Lunch Break 12:50-13:50 @ Hotel Restaurants
Hoda Dahroug
Egypt ICT Trust Fund, Egypt
Title: Digital transformation role in enhancing the health sector in Egypt
Time : 13:50-14:20
Biography:
Hoda Dahroug holds the position of Regional Projects Director at Egypt ICT Trust Fund; a division jointly established between the Ministry of Communications and Information Technology (MCIT) in Egypt and the UNDP, she acts as the Head of the Community Development Division at MCIT and a member of specialized boards for the development of border areas. She has a vast experience in major project management and implementation as well as in ICT4D programs, especially when working in collaboration with local and international companies or institutions. Moreover, stemming from her solid belief in public private partnerships, she secured foreign investment, created distinguished partnerships and enlarged the support of the public sector in areas such as education, health, women empowerment, youth employment, entrepreneurship, people with disabilities. She participated as a speaker in various regional and international conferences, covering various topics mostly notably South-South Cooperation.
Abstract:
Statement of the Problem: The ever-changing characteristics of technologies have been used in making more progress towards the national strategies and vision as well as the Sustainable Development Goals’ progress in Egypt. In the health sector, one chief step has been made in narrowing the geographic gap and including the most marginalized groups living on the frontiers through the telemedicine program. The program aimed at harnessing ICTs to enhance the medical services provided to rural population. Purpose of this Paper: To identify key steps needed to convince mindsets of beneficiaries and decision makers in order to transform a successful pilot project into a national initiative in order to bridging inequality gaps among all citizens.
Methodology & Theoretical Orientation: Analysis studies, surveys and focus groups discussions.
Findings: Offering remote telemedicine diagnostic services have been a major asset to such communities with respect to adapting new modalities that most fit each region the way that it has been adapted by the president to be a national initiative to cover all governorates across Egypt. The most success factor is to focus on efficiency in the model more than quantity and to continuously monitor and evaluate it to be expanded at the national levels. On this regard, parallelly open dialogues with the regulators and decision-makers to reform the systems by governance of different sectors in accordance with the international standards and conventions.
Gihad Alsaeed
AL-Takhassusi Hospital, Saudi Arabia
Title: Recurrent bacterial meningitis in children: Unusual presentation, approach, and mini review
Time : 14:20-14:50
Biography:
Gihad Alsaeed has graduated from Syria Aleppo University 1991 and completed his Pediatric training at University Hospitals. Also finished his Child health Diploma from the Royal College of Physicians and Surgeons of Ireland 1998 and his Membership of the Royal College of Pediatrics and Child Health of England 2008. He has published about 30 publications in peer review academic journals and 3 Books. He is a full time pediatric consultant in Dr. Sulaiman Alhabib hospital since 2012 and an Editorial Board Member in 2 Journals: Acta Paediatrica and American Journal of Pediatrics.
Abstract:
Recurrent bacterial meningitis in pediatrics is a challenging diagnosis with a limited number of researches about it. Structural approach and early diagnosis of an underlying pathology are crucial to prevent further episodes and improve the overall outcome. 1.3% of children with bacterial meningitis had experienced at lease one previous episode of bacterial meningitis previously. Anatomic abnormalities are the most common predisposing factor of RBM. Congenital ear malformation is the leading cause. Immunodeficienies are of much less importance with terminal complements deficiency as the main cause. Histroy of head trauma is important but should not exclude other possibilities. The aim of this presentation is to present a rare case of RBM and put an approach plan for children with such presentation.
Viviane Klingmann
University Children’s Hospital Düsseldorf, Germany
Title: Acceptability of an orodispersible film compared to syrup in neonates and infants - A randomized controlled trial
Time : 14:50-15:20
Biography:
Viviane Klingmann is a Physician specialised in Paediatric and Adolescence Medicine at University Children’s Hospital Düsseldorf. She started her research career with a thesis on developing methodology, research infrastructure and generation of statistically sound acceptability data for new paediatric galenic formulations (mini-tablets) in comparison to gold standard syrup. Her results enabled the acceptance of solid dosage forms in young children in the EMA guidelines on paediatric galenic formulations and formed the basis for the acceptance of mini-tablets in PIPs for different new drug developments. She continued performing clinical trials on testing the acceptability of different solid oral dosage forms.
Abstract:
Reliable pediatric pharmacotherapy in all age groups requires the availability of age-appropriate drug administration pathways. Orodispersible films (ODF) are a promising pediatric oral dosage form but to date there is a lack of reliable data on ODFs acceptability, swallowability and palatability, especially in very young children. ODFs would meet the targets: One dosage form matching the full range of pediatric patients, a minimum of non-toxic excipients, stable and easily to be produced. The primary objective was to demonstrate non-inferiority in acceptability of a drug-free ODF in comparison to glucose syrup in children aged below one year. Secondary objectives were swallowability and palatability of the two formulations. The study was performed in an open, randomized, two-way cross-over design with three age groups: 2 – 28 days,
29 days – 5 months, 6 – 12 months. 150 children (50 per age group) were randomized to the order of receiving the ODF (2 x 3 cm) and age-adapted amounts of glucose syrup (0.5 to 3ml). Deglutition and swallowing were assessed according to predefined evaluation criteria. The application of the formulations was video documented to evaluate the palatability. The primary objective was confirmed: Non-inferiority of the acceptability of an ODF compared to syrup was clearly demonstrated and even superiority of the ODF could be shown. Also, the secondary endpoints demonstrated positive results including the superior swallowability of an ODF in comparison to syrup. The palatability assessments were in favor of the ODF. ODFs are a promising and safe alternative to liquid formulations, even for very young children.
Break: Networking & Refreshments 15:20-15:40 @ Foyer
Ramy Mohamed
Al-Azhar University, Egypt
Title: Risk factors predicting insulin resistance in obese adolescents
Time : 15:40-16:10
Biography:
Ramy Mohamed, Researcher in Biological Anthropology Department and Consultant of Pediatrics and Neonatology in the National Research Center in Egypt. He has finished his PhD in Child Health and Nutrition at the age of 35 from Institute of Postgraduate Childhood Studies in Shams University. Published four International Publications in reputed journals. He was the organizer and speaker of many great symposiums in the National Research Center. Director of Ganna Hospital, a Hospital of Children and Neonates and in vitro fertilization. He is a member in the Arab Society of Medical Research. He is a member of the EgyptianSociety of Neonates.
Abstract:
Obesity is a hazard mark that associated with insulin resistance (IR).This study aimed to detect which risk factors might provide the greatest predictive value for IR in obese adolescents aged thirteen to seventeen years. One hundred obese adolescents with IR and matched age and sex 100 obese healthy controls
without IR were included. Anthropometry, serum lipids and metabolic biomarkers were measured. Homeostasis. Model Assessment of Insulin Resistance (HOMA-IR) was used to determine insulin Resistance.Significant increase in serum lipids and metabolic parameters in obese cases with IR compared to those without Positive correlations were observed between obesity measurements and metabolic risk markers, including increase of waist to hip ratio (WHR), sum of skin folds, blood pressure, insulin, HOMA-IR, TC, TG and LDL-C levels and decrease of HDL-C in IR adolescents. WHR showed the highest correlations with biochemical markers in IR cases. WHR was able to predict IR with area under the curve = 0.82 and TG-to-HDL-C ratio with area under the curve = 0.87. WHR and lipid/lipoprotein fractions are significantly associated with IR in obese adolescents and might be used for the prediction of IR and for cases at high risk for early intervention.
Maged A. El Wakeel
National Research Centre, Egypt
Title: Bone health in relation to vitamin-D status and serum adipokines in obese Egyptian children
Time : 16:10-16:40
Biography:
Maged A. El Wakeel has completed his PhD in childhood studies at the age of 33 years from Ain-Shams University and was promoted to Associate Professor position at The National Research Centre, Cairo, Egypt. He has published more than 20 papers in reputed journals and has been serving as an reviewer in other journals.
Abstract:
Childhood obesity has been linked to an increase in fracture risk, so the impact of obesity on bone metabolism is becoming a focus of attention to identify factors that may affect bone health in obese children. This study aimed to examine the association between serum 25-Hydroxy vitamin D [25(OH) D], adipokines and bone status in those children 100 obese and 80 non-obese age and sex matched children were enrolled in our study with mean age of (9.7±2.3) and (8.9±1.5) respectively. Anthropometric measurements, femoral neck bone mineral density (BMD) and its Z-score, bone mineral content (BMC) were measured using dual-energy X-ray absorptiometry (DXA) in relation to body weight (kg), we also determined serum 25(OH) D, adiponectin, leptin and lipid profile. HOMA-IR was calculated to assess insulin resistance. It was found that BMC, BMD and BMD Z-score adjusted for weight were significantly lower in obese children as compared to controls (all p<0.05). Obese children had lower levels of 25(OH) D and adiponectin (P<0.01), while higher levels of leptin, total cholesterol (TC) and triglycerides (TG) compared to controls (P<0.01). Both BMC and BMD Z-score showed positive association with 25(OH)D and adiponectin (P<0.01) and -ve association with HOMA-IR, TG and TC (P<0.05). Linear regression analysis showed that 25(OH) D was the most effective factor predicting BMD Z-score and BMC in obese children. Obesity is negatively related to bone health in childhood. Those obese children are at increased risk for vitamin D insufficiency which shows an obvious relationship to lower bone mass, raising the question of supplementation to prevent the deleterious effect of its deficiency on bones and reducing future risk of fracture and osteoporosis.