Search results for: disease cluster

Authors: Merve Aydin, Mağfiret Kara Kaşikçi

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Aim: To determine the perceptions of inpatients about care at Farabi Hospital in KTU. Material and Method: This research was conducted by using the universe known examples of formulas and probability selected by sampling method with 277 chosen patients in the hospital at least 14 days in other internal and surgical clinics except for pediatric, psychiatry, and intensive care unit services between January-March 2014 in KTU Farabi Hospital. The data was collected through the forms of nursing care perception scale of patients and defining characteristics of patients. In the evaluation of data, percentage, mean, Mann Whitney U, Student t and Kurskall Wallis tests were applied. Results: The average point the patients got in nursing care perception scale is 62.64±10.08’dir. 48.7 % of patients regard nursing care well and 36.8 % of them regard it very well. 19 % of the patients regard nursing care badly. When the age, sex, occupation, marital status, educational background, residential place, income level, hospitalization period, hospitalization clinic and having a hospital attendant were compared with nursing care perception average point, the difference among point averages was not found meaningful statistically (p > 0.05). The average point of nursing care perception was found greater in those having chronic disease (p < 0.05). Conclusion: The perception point of patients about nursing care is above the average according to the average of the lowest and highest points. The great majority of patients regard nursing care well or very well.

Keywords: hospital, patient, perception of nursing care, nursing care

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Authors: Gilbert Makanda, Roelf Sypkens

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A mathematical model for knowledge acquisition in teaching and learning is proposed. In this study we adopt the mathematical model that is normally used for disease modelling into teaching and learning. We derive mathematical conditions which facilitate knowledge acquisition. This study compares the effects of dropping out of the course at early stages with later stages of learning. The study also investigates effect of individual interaction and learning from other sources to facilitate learning. The study fits actual data to a general mathematical model using Matlab ODE45 and lsqnonlin to obtain a unique mathematical model that can be used to predict knowledge acquisition. The data used in this study was obtained from the tutorial test results for mathematics 2 students from the Central University of Technology, Free State, South Africa in the department of Mathematical and Physical Sciences. The study confirms already known results that increasing dropout rates and forgetting taught concepts reduce the population of knowledgeable students. Increasing teaching contacts and access to other learning materials facilitate knowledge acquisition. The effect of increasing dropout rates is more enhanced in the later stages of learning than earlier stages. The study opens up a new direction in further investigations in teaching and learning using differential equations.

Keywords: differential equations, knowledge acquisition, least squares nonlinear, dynamical systems

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Authors: Shivkumar Krishnamurti, Ruchi Agarwal

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The study examines the influence of marital status on consumers of products and services using blogs as a source of information. A pre-designed questionnaire was used to collect the primary data from the respondents (experiences). Data were collected from one hundred and eighty seven respondents residing in and around the Emirates of Sharjah and Dubai of the United Arab Emirates. The collected data was analyzed with the help of statistical tools such as averages, percentages, factor analysis, student’s t-test and structural equation modeling technique. Objectives of the study are to know the reasons how married and unmarried or single consumers of products and services are motivated to use blogs as a source of information, to know whether the consumers of products and services irrespective of their marital status share their views and experiences with other bloggers and to know the respondents’ future intentions towards blogging. The study revealed the following: Majority of the respondents have the motivation to blog because they are willing to receive comments on what they post about services, convenience of blogs to search for information about services and products, by blogging respondents share information on the symptoms of a disease/ disorder that may be experienced by someone, helps to share information about ready to cook mix products and are keen to spend more time blogging in the future.

Keywords: blog, consumer, information, marital status

Procedia PDF Downloads 385

Authors: Mohamed Alimoussa, Alice Porebski, Nicolas Vandenbroucke, Rachid Oulad Haj Thami, Sana El Fkihi

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Color and texture are highly discriminant visual cues that provide an essential information in many types of images. Color texture representation and classification is therefore one of the most challenging problems in computer vision and image processing applications. Color textures can be represented in different color spaces by using multiple image descriptors which generate a high dimensional set of texture features. In order to reduce the dimensionality of the feature set, feature selection techniques can be used. The goal of feature selection is to find a relevant subset from an original feature space that can improve the accuracy and efficiency of a classification algorithm. Traditionally, feature selection is focused on removing irrelevant features, neglecting the possible redundancy between relevant ones. This is why some feature selection approaches prefer to use feature clustering analysis to aid and guide the search. These techniques can be divided into two categories. i) Feature clustering-based ranking algorithm uses feature clustering as an analysis that comes before feature ranking. Indeed, after dividing the feature set into groups, these approaches perform a feature ranking in order to select the most discriminant feature of each group. ii) Feature clustering-based subset search algorithms can use feature clustering following one of three strategies; as an initial step that comes before the search, binded and combined with the search or as the search alternative and replacement. In this paper, we propose a new feature clustering-based sequential selection approach for the purpose of color texture representation and classification. Our approach is a three step algorithm. First, irrelevant features are removed from the feature set thanks to a class-correlation measure. Then, introducing a new automatic feature clustering algorithm, the feature set is divided into several feature clusters. Finally, a sequential search algorithm, based on a filter model and a separability measure, builds a relevant and non redundant feature subset: at each step, a feature is selected and features of the same cluster are removed and thus not considered thereafter. This allows to significantly speed up the selection process since large number of redundant features are eliminated at each step. The proposed algorithm uses the clustering algorithm binded and combined with the search. Experiments using a combination of two well known texture descriptors, namely Haralick features extracted from Reduced Size Chromatic Co-occurence Matrices (RSCCMs) and features extracted from Local Binary patterns (LBP) image histograms, on five color texture data sets, Outex, NewBarktex, Parquet, Stex and USPtex demonstrate the efficiency of our method compared to seven of the state of the art methods in terms of accuracy and computation time.

Keywords: feature selection, color texture classification, feature clustering, color LBP, chromatic cooccurrence matrix

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Authors: Fatema Ali Lanewala, Akhtar Jamal Khan

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The ocular complications in renal transplant recipients at the biggest transplant center in Pakistan were seen to be diverse, multiple, and sight-threatening. These complications could mainly be due to the primary disease causing renal failure, the process of transplantation, and/or the medications used pre and post-transplantation. A retrospective case series recently published in the Journal of Pakistan Medical Association highlights the common ocular pathologies encountered in renal transplant population. Majority of the patients suffered from cataract, which is a known side-effect of long-term steroids routinely used for graft survival. There was a unique finding in Pakistani population, never reported before from any other transplant centre world over; a large number of recipients was reported to be suffering from night blindness, which significantly improved on vitamin A supplementation. There were a variety of other ocular complications seen which emphasizes the necessity of ocular care and routine examination of transplant recipient’s eyes by an ophthalmologist in order to avoid visual compromise and improve the quality of life of the transplant recipient.

Keywords: cataract, night blindness, ocular complications, renal transplantation

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Authors: Tamer El-Messery, Beraat Ozcelik

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This study aimed to produce functional yogurt supplemented with microencapsulated krill oil as a source of omega 3, which is known, to maintain the normal brain function, reduce the risk of cancer, and preventing cardiovascular disease. Krill oil was mixed with black cumin oil (1:1) in order to increase its oxidative stability. β-caroteine (10 mg/100 ml) was used as a standard antioxidant. Maltodextrin (MD) was mixed with whey protein concentrate (WPC) and gum Arabic (GA) at the ratio of 8:2:0.5 ratios and used for microencapsulation of single or mixed oils. The microcapsules were dried by freeze and spray drying in order to maximize encapsulation efficiency and minimize lipid oxidation. The feed emulsions used for particle production were characterized for stability, viscosity and particle size, zeta potential, and oxidative stability. The oxidative stability for mixed krill oil and black cumin oil was the highest. The highest encapsulation efficiency was obtained using spray drying, which also showed the highest oxidative stability. The addition of encapsulated krill and black cumin oils (1:1) powder in yogurt manufacture reduced slightly effects on the development of acidity, textural parameters, and water holding capacity of yogurt as compared to control.

Keywords: Krill oil, black cumin oil, micro-encapsulation, oxidative stability, functional yogurt

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Authors: Anandita Mitro, Archana Srivastava, Bidisha Banerjee

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The present paper attempts to analyze the hierarchy and interconnection of factors responsible for the uptake of BCG vaccination in India. The study uses National Family Health Survey (NFHS-5) data which was conducted during 2019-21. The univariate logistic regression method is used to understand the univariate effects while the interconnection effects have been studied using the Categorical Inference Tree (CIT) which is a non-parametric Machine Learning (ML) model. The hierarchy of the factors is further established using Conditional Inference Forest which is an extension of the CIT approach. The results suggest that BCG vaccination coverage was influenced more by system-level factors and awareness than education or socio-economic status. Factors such as place of delivery, antenatal care, and postnatal care were crucial, with variations based on delivery location. Region-specific differences were also observed which could be explained by the factors. Awareness of the disease was less impactful along with the factor of wealth and urban or rural residence, although awareness did appear to substitute for inadequate ANC. Thus, from the policy point of view, it is revealed that certain subpopulations have less prevalence of vaccination which implies that there is a need for population-specific policy action to achieve a hundred percent coverage.

Keywords: vaccination, NFHS, machine learning, public health

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Authors: N. Adjlane, N. Haddad

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The American foulbrood is one of the most serious diseases that may affect brood of larvae and pupae stages. The causative organism is a gram positive bacterium Paaenibacillus larvae. American foulbrood infected apiaries suffer from severe economic losses, resulting from significant decreases in honeybee populations and honey production. The aim of this study was to detect Paenibacillus larvae in the remains collected at the bottom of the hive from the suspected hives by direct PCR and culture growth. A total of 56 suspected beehive wax debris samples collected in 40 different apiaries located in the central region of Algeria. MYPGP the culture medium is used during all the identifications of the bacterium. After positive results on samples, biochemical confirmation tests (test of catalase, presence hydrolysis of casein) and microscopic (gram stain) are used in order to verify the accuracy of the initial results. The QIAamp DNA Mini Kit is used to identify the DNA of Paaenibacillus larvae. Paaenibacillus larvae were identified in 14 samples out of 16 by the PCR. A suspected culture-negative sample was found positive through evaluation with PCR. This research is for the bacterium Paaenibacillus larvae in the debris of the colony is an effective method for diagnosis of the pathology of American foulbrood.

Keywords: Paenibacillus larvae, honeybee, PCR, microbiological method

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Authors: Babatunde Stephen Oladeji, Gloria Asuquo Edet

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The proximate, functional, pasting, and sensory properties of semolina from blends of cassava, maize, and rice were investigated. Cassava, maize, and rice were milled and sieved to pass through a 1000 µm sieve, then blended in the following ratios to produce five samples; FS₁ (40:30:30), FS₂ (20:50:30), FS₃ (25:25:50), FS₄ (34:33:33) and FS₅ (60:20:20) for cassava, maize, and rice, respectively. A market sample of wheat semolina labeled as FSc served as the control. The proximate composition, functional properties, pasting profile, and sensory characteristics of the blends were determined using standard analytical methods. The protein content of the samples ranged from 5.66% to 6.15%, with sample FS₂ having the highest value and being significantly different (p ≤ 0.05). The bulk density of the formulated samples ranged from 0.60 and 0.62 g/ml. The control (FSc) had a higher bulk density of 0.71 g/ml. The water absorption capacity of both the formulated and control samples ranged from 0.67% to 2.02%, with FS₃ having the highest value and FSc having the lowest value (0.67%). The peak viscosity of the samples ranged from 60.83-169.42 RVU, and the final viscosity of semolina samples ranged from 131.17 to 235.42 RVU. FS₅ had the highest overall acceptability score (7.46), but there was no significant difference (p ≤ 0.05) from other samples except for FS₂ (6.54) and FS₃ (6.29). This study establishes that high-quality and consumer-acceptable semolina that is comparable to the market sample could be produced from blends of cassava, maize, and rice.

Keywords: semolina, gluten, celiac disease, wheat allergies

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Authors: Luminiţa Duţică, Gheorghe Duţică

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Many of the interrogations or dilemmas of the contemporary world found the answer in what was generically called the appeal to matrix. This genuine spiritual exercise of re-connection of the present to origins, to the primary source, revealed the ontological condition of timelessness, ahistorical, immutable (epi)phenomena, of those pure essences concentrated in the archetypal-referential layer of the human existence. The musical creation was no exception to this trend, the impasse generated by the deterministic excesses of the whole serialism or, conversely, by some questionable results of the extreme indeterminism proper to the avant-garde movements, stimulating the orientation of many composers to rediscover a universal grammar, as an emanation of a new ‘collective’ order (reverse of the utopian individualism). In this context, the music of oral tradition and therefore the world of the ancient modes represented a true revelation for the composers of the twentieth century, who were suddenly in front of some unsuspected (re)sources, with a major impact on all levels of edification of the musical work: morphology, syntax, timbrality, semantics etc. For the contemporary Romanian creators, the music of rituals, existing in the local archaic culture, opened unsuspected perspectives for which it meant to be a synthetic, inclusive and recoverer vision, where the primary (archetypal) genuine elements merge with the latest achievements of language of the European composers. Thus, anchored in a strong and genuine modal source, the compositions analysed in this paper evoke, in a manner as modern as possible, the atmosphere of some ancestral rituals such as: the invocation of rain during the drought (Paparudele, Scaloianul), funeral ceremony (Bocetul), traditions specific to the winter holidays and new year (Colinda, Cântecul de stea, Sorcova, Folklore traditional dances) etc. The reactivity of those rituals in the sound context of the twentieth century meant potentiating or resizing the archaic spirit of the primordial symbolic entities, in terms of some complexity levels generated by the technique of harmonies of chordal layers, of complex aggregates (gravitational or non-gravitational, geometric), of the mixture polyphonies and with global effect (group, mass), by the technique of heterophony, of texture and cluster, leading to the implementation of some processes of collective improvisation and instrumental theatre.

Keywords: archetype, improvisation, polyphony, ritual, instrumental theatre

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Authors: M. Khorshed Alam, H. Takaba

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The catalytic properties of metal usually change by intermixturing with another metal in polymer electrolyte fuel cells. Pt-Ru alloy is one of the much-talked used alloy to enhance the CO oxidation. In this work, we have investigated the CO coverage on the Pt2Ru3 nanoparticle with different atomic conformation of Pt and Ru using a combination of material informatics with computational chemistry. Density functional theory (DFT) calculations used to describe the adsorption strength of CO and H with different conformation of Pt Ru ratio in the Pt2Ru3 slab surface. Then through the Monte Carlo (MC) simulations we examined the segregation behaviour of Pt as a function of surface atom ratio, subsurface atom ratio, particle size of the Pt2Ru3 nanoparticle. We have constructed a regression equation so as to reproduce the results of DFT only from the structural descriptors. Descriptors were selected for the regression equation; xa-b indicates the number of bonds between targeted atom a and neighboring atom b in the same layer (a,b = Pt or Ru). Terms of xa-H2 and xa-CO represent the number of atoms a binding H2 and CO molecules, respectively. xa-S is the number of atom a on the surface. xa-b- is the number of bonds between atom a and neighboring atom b located outside the layer. The surface segregation in the alloying nanoparticles is influenced by their component elements, composition, crystal lattice, shape, size, nature of the adsorbents and its pressure, temperature etc. Simulations were performed on different size (2.0 nm, 3.0 nm) of nanoparticle that were mixing of Pt and Ru atoms in different conformation considering of temperature range 333K. In addition to the Pt2Ru3 alloy we also considered pure Pt and Ru nanoparticle to make comparison of surface coverage by adsorbates (H2, CO). Hence, we assumed the pure and Pt-Ru alloy nanoparticles have an fcc crystal structures as well as a cubo-octahedron shape, which is bounded by (111) and (100) facets. Simulations were performed up to 50 million MC steps. From the results of MC, in the presence of gases (H2, CO), the surfaces are occupied by the gas molecules. In the equilibrium structure the coverage of H and CO as a function of the nature of surface atoms. In the initial structure, the Pt/Ru ratios on the surfaces for different cluster sizes were in range of 0.50 - 0.95. MC simulation was employed when the partial pressure of H2 (PH2) and CO (PCO) were 70 kPa and 100-500 ppm, respectively. The Pt/Ru ratios decrease as the increase in the CO concentration, without little exception only for small nanoparticle. The adsorption strength of CO on the Ru site is higher than the Pt site that would be one of the reason for decreasing the Pt/Ru ratio on the surface. Therefore, our study identifies that controlling the nanoparticle size, composition, conformation of alloying atoms, concentration and chemical potential of adsorbates have impact on the steadiness of nanoparticle alloys which ultimately and also overall catalytic performance during the operations.

Keywords: anode catalysts, fuel cells, material informatics, Monte Carlo

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Authors: Sanjay Saraf

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The oral cavity can be the site for early manifestations of mucocutaneous disorders (MD) or the only site for occurrence of these disorders. It can also exhibit oral lesions with simultaneous associated skin lesions. The MD involving the oral mucosa commonly presents with signs such as ulcers, vesicles and bullae. The unique environment of the oral cavity may modify these signs of the disease, thereby making the clinical diagnosis an arduous task. In addition to the unique environment of oral cavity, the overlapping of the signs of various mucocutaneous disorders, also makes the clinical diagnosis more intricate. The aim of this review is to present the oral signs of dermatological disorders having common oral involvement and emphasize their importance in early detection of the systemic disorders. The aim is also to highlight the necessity of oral examination by a dermatologist while examining the skin lesions. Prior to the oral examination, it must be imperative for the dermatologists and the dental clinicians to have the knowledge of oral anatomy. It is also important to know the impact of various diseases on oral mucosa, and the characteristic features of various oral mucocutaneous lesions. An initial clinical oral examination is may help in the early diagnosis of the MD. Failure to identify the oral manifestations may reduce the likelihood of early treatment and lead to more serious problems. This paper reviews the oral manifestations of immune mediated dermatological disorders with common oral manifestations.

Keywords: dermatological investigations, genodermatosis, histological features, oral examination

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Authors: Naraporn Taemaitree, Pruet Areesawangvong, Satchachon Changthom, Tanin Titipungul

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Adult intussusception, unlike childhood intussusception, is rare. Approximately 5-15% of cases are idiopathic without a lead point lesion. Secondary intussusception is caused by pathological conditions such as inflammatory bowel disease, postoperative adhesions, Meckel’s diverticulum, benign and malignant lesions, metastatic neoplasms, or even iatrogenically due to the presence of intestinal tubes, jejunostomy feeding tubes or after gastric surgery. Diagnosis can be delayed because of its longstanding, intermittent, and non-specific symptoms. Computed tomography is the most sensitive diagnostic modality and can help distinguish between intussusceptions with and without a lead point and lesion localization. This report presents the case of a 49-year-old man presented with increasing abdominal pain over the past three days, loss of appetite, constipation, and frequent vomiting. Computed tomography revealed distal small bowel obstruction at the right lower quadrant with thickened outer wall and internal non-dilated small bowel loop. Emergency exploratory laparotomy was performed to clear the obstruction, which upon inspection was caused by extremely long Taenia solium parasites.

Keywords: intussusception, tape worm, Taenia solium, abdominal pain

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Authors: Bolawole F. Ogunbodede, Mokolade Johnson, Adetunji Adejumo

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High population growth rate, reactive infrastructure provision, inability of physical planning to cope with developmental pace are responsible for waste water crisis in the Lagos Metropolis. Septic tank is still the most prevalent waste-water holding system. Unfortunately, there is a dearth of septage treatment infrastructure. Public waste-water treatment system statistics relative to the 23 million people in Lagos State is worrisome. 1.85 billion Cubic meters of wastewater is generated on daily basis and only 5% of the 26 million population is connected to public sewerage system. This is compounded by inadequate budgetary allocation and erratic power supply in the last two decades. This paper explored community participatory waste-water management alternative at Oworonshoki Municipality in Lagos. The study is underpinned by decentralized Waste-water Management systems in built-up areas. The initiative accommodates 5 step waste-water issue including generation, storage, collection, processing and disposal through participatory decision making in two Oworonshoki Community Development Association (CDA) areas. Drone assisted mapping highlighted building footage. Structured interviews and focused group discussion of land lord associations in the CDA areas provided collaborator platform for decision-making. Water stagnation in primary open drainage channels and natural retention ponds in framing wetlands is traceable to frequent of climate change induced tidal influences in recent decades. Rise in water table resulting in septic-tank leakage and water pollution is reported to be responsible for the increase in the water born infirmities documented in primary health centers. This is in addition to unhealthy dumping of solid wastes in the drainage channels. The effect of uncontrolled disposal system renders surface waters and underground water systems unsafe for human and recreational use; destroys biotic life; and poisons the fragile sand barrier-lagoon urban ecosystems. Cluster decentralized system was conceptualized to service 255 households. Stakeholders agreed on public-private partnership initiative for efficient wastewater service delivery.

Keywords: health, infrastructure, management, septage, well-being

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Authors: Paramita Banerjee, K. R. S. Chandrakumar, G. P. Das

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Bulk MgH2 has drawn much attention for the purpose of hydrogen storage because of its high hydrogen storage capacity (~7.7 wt %) as well as low cost and abundant availability. However, its practical usage has been hindered because of its high hydrogen desorption enthalpy (~0.8 eV/H2 molecule), which results in an undesirable desorption temperature of 3000C at 1 bar H2 pressure. To surmount the limitations of bulk MgH2 for the purpose of hydrogen storage, a detailed first-principles density functional theory (DFT) based study on the structure and stability of neutral (Mgm) and positively charged (Mgm+) Mg nanoclusters of different sizes (m = 2, 4, 8 and 12), as well as their interaction with molecular hydrogen (H2), is reported here. It has been found that due to the absence of d-electrons within the Mg atoms, hydrogen remained in molecular form even after its interaction with neutral and charged Mg nanoclusters. Interestingly, the H2 molecules do not enter into the interstitial positions of the nanoclusters. Rather, they remain on the surface by ornamenting these nanoclusters and forming new structures with a gravimetric density higher than 15 wt %. Our observation is that the inclusion of Grimme’s DFT-D3 dispersion correction in this weakly interacting system has a significant effect on binding of the H2 molecules with these nanoclusters. The dispersion corrected interaction energy (IE) values (0.1-0.14 eV/H2 molecule) fall in the right energy window, that is ideal for hydrogen storage. These IE values are further verified by using high-level coupled-cluster calculations with non-iterative triples corrections i.e. CCSD(T), (which has been considered to be a highly accurate quantum chemical method) and thereby confirming the accuracy of our ‘dispersion correction’ incorporated DFT calculations. The significance of the polarization and dispersion energy in binding of the H2 molecules are confirmed by performing energy decomposition analysis (EDA). A total of 16, 24, 32 and 36 H2 molecules can be attached to the neutral and charged nanoclusters of size m = 2, 4, 8 and 12 respectively. Ab-initio molecular dynamics (AIMD) simulation shows that the outermost H2 molecules are desorbed at a rather low temperature viz. 150 K (-1230C) which is expected. However, complete dehydrogenation of these nanoclusters occur at around 1000C. Most importantly, the host nanoclusters remain stable up to ~500 K (2270C). All these results on the adsorption and desorption of molecular hydrogen with neutral and charged Mg nanocluster systems indicate towards the possibility of reducing the dehydrogenation temperature of bulk MgH2 by designing new Mg-based nano materials which will be able to adsorb molecular hydrogen via this weak Mg-H2 interaction, rather than the strong Mg-H bonding. Notwithstanding the fact that in practical applications, these interactions will be further complicated by the effect of substrates as well as interactions with other clusters, the present study has implications on our fundamental understanding to this problem.

Keywords: density functional theory, DFT, hydrogen storage, molecular dynamics, molecular hydrogen adsorption, nanoclusters, physisorption

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Authors: P.J. Jiji, B.V. Murlimanju, Latha V. Prabhu, Mangala M. Pai

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Background: The lunate bone dislocation can lead to the compression of the median nerve and subsequent carpal tunnel syndrome. The dislocation can interrupt the vasculature and would cause avascular necrosis. The objective of the present study was to study the morphology and number of the nutrient foramina in the cadaveric dried lunate bones of the Indian population. Methods: The present study included 28 lunate bones (13 right sided and 15 left sided) which were obtained from the gross anatomy laboratory of our institution. The bones were macroscopically observed for the nutrient foramina and the data was collected with respect to their number. The tabulation of the data and analysis were done. Results: All of our specimens (100%) exhibited the nutrient foramina over the non-articular surfaces. The foramina were observed only over the palmar and dorsal surfaces of the lunate bones. The foramen ranged between 2 and 10. The foramina were more in number over the dorsal surface (average number 3.3) in comparison to the palmar surface (average number 2.4). Conclusion: We believe that the present study has provided important data about the nutrient foramina of the lunate bones. The data is enlightening to the orthopedic surgeon and would help in the hand surgeries. The morphological knowledge of the vasculature, their foramina of entry and their number is required to understand the concepts in the lunatomalacia and Kienbock’s disease.

Keywords: avascular necrosis, foramen, lunate, nutrient

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Authors: Dongping Fang, Lian Duan, Xiaojing Yuan, Mike Xu, Allyn Klunder, Kevin Tan, Suiting Cao, Yeqing Ji

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Accurate prediction of a medical condition with straight clinical evidence is a long-sought topic in the medical management and health insurance field. Although great progress has been made with machine learning algorithms, the medical community is still, to a certain degree, suspicious about the model's accuracy and interpretability. This paper presents an innovative hierarchical attention deep learning model to achieve good prediction and clear interpretability that can be easily understood by medical professionals. This deep learning model uses a hierarchical attention structure that matches naturally with the medical history data structure and reflects the member’s encounter (date of service) sequence. The model attention structure consists of 3 levels: (1) attention on the medical code types (diagnosis codes, procedure codes, lab test results, and prescription drugs), (2) attention on the sequential medical encounters within a type, (3) attention on the medical codes within an encounter and type. This model is applied to predict the occurrence of stage 3 chronic kidney disease (CKD3), using three years’ medical history of Medicare Advantage (MA) members from a top health insurance company. The model takes members’ medical events, both claims and electronic medical record (EMR) data, as input, makes a prediction of CKD3 and calculates the contribution from individual events to the predicted outcome. The model outcome can be easily explained with the clinical evidence identified by the model algorithm. Here are examples: Member A had 36 medical encounters in the past three years: multiple office visits, lab tests and medications. The model predicts member A has a high risk of CKD3 with the following well-contributed clinical events - multiple high ‘Creatinine in Serum or Plasma’ tests and multiple low kidneys functioning ‘Glomerular filtration rate’ tests. Among the abnormal lab tests, more recent results contributed more to the prediction. The model also indicates regular office visits, no abnormal findings of medical examinations, and taking proper medications decreased the CKD3 risk. Member B had 104 medical encounters in the past 3 years and was predicted to have a low risk of CKD3, because the model didn’t identify diagnoses, procedures, or medications related to kidney disease, and many lab test results, including ‘Glomerular filtration rate’ were within the normal range. The model accurately predicts members A and B and provides interpretable clinical evidence that is validated by clinicians. Without extra effort, the interpretation is generated directly from the model and presented together with the occurrence date. Our model uses the medical data in its most raw format without any further data aggregation, transformation, or mapping. This greatly simplifies the data preparation process, mitigates the chance for error and eliminates post-modeling work needed for traditional model explanation. To our knowledge, this is the first paper on an interpretable deep-learning model using a 3-level attention structure, sourcing both EMR and claim data, including all 4 types of medical data, on the entire Medicare population of a big insurance company, and more importantly, directly generating model interpretation to support user decision. In the future, we plan to enrich the model input by adding patients’ demographics and information from free-texted physician notes.

Keywords: deep learning, interpretability, attention, big data, medical conditions

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Authors: Mohammad Amjad, Muhammad Iqbal Zafar, Ashfaq Ahmed Maan, Muhammad Tayyab Kashif

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Obesity is an abnormal physical condition where an increased and undesirable fat accumulates in the human body. Obesity is an international phenomenon. In the present study, 12 schools were randomly selected from each district considering the areas i.e. Elite Private Schools in the private sector, Government schools in urban areas and Government schools in rural areas. Interviews were conducted with male students studying in grade 5 to grade 9 in each school. The sample size was 600 students; 300 from Faisalabad district and 300 from Rawalpindi district in Pakistan. A well-structured and pre-tested questionnaire was used for data collection. The calibrated scales were used to attain the heights and weights of the respondents. Obesity of school-going children depends on family types, family size, family history, junk food consumption, mother’s education, weekly time spent in walking, and sports facility at school levels. Academic performance, physical health and psychological health of school going children are affected with obesity. Concrete steps and policies could minimize the incidence of obesity in children in Pakistan.

Keywords: body mass index, cardiovascular disease, fast food, morbidity, overweight

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Authors: Rose Antony, Vivekanand B. Khanapuri, Karuna Jain

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Online groceries have transformed the way the supply chains are managed. These are facing numerous challenges in terms of product wastages, low margins, long breakeven to achieve and low market penetration to mention a few. The e-grocery chains need to overcome these challenges in order to survive the competition. The purpose of this paper is to carry out a structural analysis of the enablers in e-grocery chains by applying Interpretive Structural Modeling (ISM) and MICMAC analysis in the Indian context. The research design is descriptive-explanatory in nature. The enablers have been identified from the literature and through semi-structured interviews conducted among the managers having relevant experience in e-grocery supply chains. The experts have been contacted through professional/social networks by adopting a purposive snowball sampling technique. The interviews have been transcribed, and manual coding is carried using open and axial coding method. The key enablers are categorized into themes, and the contextual relationship between these and the performance measures is sought from the Industry veterans. Using ISM, the hierarchical model of the enablers is developed and MICMAC analysis identifies the driver and dependence powers. Based on the driver-dependence power the enablers are categorized into four clusters namely independent, autonomous, dependent and linkage. The analysis found that information technology (IT) and manpower training acts as key enablers towards reducing the lead time and enhancing the online service quality. Many of the enablers fall under the linkage cluster viz., frequent software updating, branding, the number of delivery boys, order processing, benchmarking, product freshness and customized applications for different stakeholders, depicting these as critical in online food/grocery supply chains. Considering the perishability nature of the product being handled, the impact of the enablers on the product quality is also identified. Hence, study aids as a tool to identify and prioritize the vital enablers in the e-grocery supply chain. The work is perhaps unique, which identifies the complex relationships among the supply chain enablers in fresh food for e-groceries and linking them to the performance measures. It contributes to the knowledge of supply chain management in general and e-retailing in particular. The approach focus on the fresh food supply chains in the Indian context and hence will be applicable in developing economies context, where supply chains are evolving.

Keywords: interpretive structural modelling (ISM), India, online grocery, retail operations, supply chain management

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Authors: Scott Ashby, Emily Granger, Mark Connellan

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Objectives: 1) To identify if emergency coronary angiography improves outcomes in studies examining OHCA from assumed cardiac aetiology? 2) If so, is it indicated in all patients resuscitated following OHCA, and if not, who is it indicated for? 3) How effective are investigations for screening for the appropriate patients? Background: Out-of-hospital cardiac arrest is one of the leading mechanisms of death, and the most common causative pathology is coronary artery disease. In-hospital treatment following resuscitation greatly affects outcomes, yet there is debate over the most effective protocol. Methods: A literature search was conducted over multiple databases to identify all relevant articles published from 2005. An inclusion criterion was applied to all publications retrieved, which were then sorted by type. Results: A total of 3 existing reviews and 29 clinical studies were analysed in this review. There were conflicting conclusions, however increased use of angiography has shown to improve outcomes in the majority of studies, which cover a variety of settings and cohorts. Recommendations: Currently, emergency coronary angiography appears to improve outcomes in all/most cases of OHCA of assumed cardiac aetiology, regardless of ECG findings. Until a better tool for screening is available to reduce unnecessary procedures, the benefits appear to outweigh the costs/risks.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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Authors: Naouelle Azzag, Nadia Haddad, Benoit Durand, Elisabeth Petit, Ali Ammouche, Bruno Chomel, Henri J. Boulouis

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Bartonella henselae is a small, gram negative, arthropod-borne bacterium that has been shown to cause multiple clinical manifestations in humans including cat scratch disease, bacillary angiomatosis, endocarditis, and bacteremia. In this research, we report the results of a cross sectional study of Bartonella henselae bacteremia in stray cats from Algiers. Whole blood of 227 stray cats from Algiers was tested for the presence of Bartonella species by culture and for the evaluation of the genetic diversity of B. henselae strains by multi-locus variable number of tandem repeats assay (MLVA). Bacteremia prevalence was 17% and only B. henselae was identified. Type I was the predominant type (64%). MLVA typing of 259 strains from 30 bacteremic cats revealed 52 different profiles. 51 of these profiles were specific to Algerian cats/identified for the first time. 20/30 cats (67%) harbored 2 to 7 MLVA profiles simultaneously. The similarity of MLVA profiles obtained from the same cat, neighbor-joining clustering and structure-neighbor clustering showed that such a diversity likely results from two different mechanisms occurring either independently or simultaneously independent infections and genetic drift from a primary strain.

Keywords: Bartonella, cat, MLVA, genetic

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Authors: Malinda Sabrina, Khoerul Anwar

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Railway noise generated by pass-by train has been described as a form of environmental pollutants especially for the residential area near the railway. Many studies have shown, that environmental noise particularly transportation noise has negative effects on people which resulting in annoyance and specific health problems such as cardiovascular disease, cognitive impairment and sleep disturbance. Therefore, various attempts are made to reduce the noise. One method of reducing such noise to acceptable noise levels is to build acoustically barrier walls. The objective of this study was to review the method of reducing railway noise and obtain the preliminary design of the acoustics barrier on the edge of railway tracks close to the residential area. The design of this barrier is using the Maekawa's method. Measurements have been performed in residential areas around the railroads in the Karawang - Indonesia with the absence of an acoustical barrier. From the observation, it was found that the railway was passed by five trains within thirty minutes. With the limited distance between the railway tracks and the location of the residential area as well as the street of residents, then it was obtained that a reduction in sound pressure level is 25 dBA. Maximum sound pressure level obtained is 86.9 dBA then by setting the barrier as high as 4 m at a distance, 2.5 m from the railway, the noise level received by residents in the settlement around the railway line becomes 61.9 dBA.

Keywords: acoustics barrier, Maekawa's method, noise attenuation, railway noise

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Authors: Aleksandra Ristic

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The Coronavirus Disease – 2019 hit Europe in February 2020, and infections took place in four waves. It left consequences and demanded changes for the future. More than half of European countries responded quickly by declaring a state of emergency and introducing various containment measures that have had a major impact on individuals’ lives in recent years. Closing public lives was largely achieved by limited access and/or closing public institutions and services, including the closure of educational institutions. Teaching in classrooms converted to distance learning. In the research, we used a quantitative study to analyze various factors of distance learning that influenced pupils in different segments: teachers’ availability, family support, entire online conference learning, successful distance learning, time for themselves, reliable sources, teachers’ feedback, successful distance learning, online participation classes, motivation and teachers’ communication and theoretical review of the importance of digital skills, e-learning Index, World comparison of e-learning in the past, digital education plans for the field of Europe. We have gathered recommendations and distance learning solutions to improve the learning process by strengthening teachers and creating more tiered strategies for setting and achieving learning goals by the children.

Keywords: availability, digital skills, distance learning, resources

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Authors: Mohamed A. Alhammad, Hadia A. Abou-Donia, Mona H. Hashish, Mohamed N. Massoud

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Background: Rotavirus is the leading etiologic agent of severe diarrheal disease in infants and young children worldwide. The present study was aimed 1) to detect rotavirus infection as a cause of diarrhoea among children under 5 years of age using the two serological methods (ELISA and LA) and the PCR technique (2) to evaluate the three methodologies used for human RV detection in stool samples. Materials and Methods: This study was carried out on 247 children less than 5 years old, diagnosed clinically as acute gastroenteritis and attending Alexandria University Children Hospital at EL-Shatby. Rotavirus antigen was screened by ELISA and LA tests in all stool samples, whereas only 100 samples were subjected to RT-PCR method for detection of rotavirus RNA. Results: Out of the 247 studied cases with diarrhoea, rotavirus antigen was detected in 83 (33.6%) by ELISA and 73 (29.6%) by LA, while the 100 cases tested by RT-PCR showed that 44% of them had rotavirus RNA. Rotavirus diarrhoea was significantly presented with a marked seasonal peak during autumn and winter (61.4%). Conclusion: The present study confirms the huge burden of rotavirus as a major cause of acute diarrhoea in Egyptian infants and young children. It was concluded that; LA is equal in sensitivity to ELISA, ELISA is more specific than LA, and RT-PCR is more specific than ELISA and LA in diagnosis of rotavirus infection.

Keywords: rotavirus, diarrhea, immunoenzyme techniques, latex fixation tests, RT-PCR

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Authors: Keith T. S. Tung, Frederick K. Ho, Rosa S. Wong, Camilla K. M. Lo, Wilfred H. S. Wong, C. B. Chow, Patrick Ip

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Objectives: Underage drinking is an important public health problem both locally and globally. Conventional prevention/intervention relies on unidirectional knowledge transfer such as mail leaflets or health talks which showed mixed results in changing the target behaviour. Previously, we conducted a school internet-based intervention which was found to be effective in reducing alcohol use among adolescents, yet the underlying mechanisms have not been properly investigated. This study, therefore, examined the mechanisms that explain how the intervention produced a change in alcohol drinking behaviours among Chinese adolescent as observed in our previous clustered randomised controlled trial (RCT) study. Methods: This is a cluster randomised controlled trial with parallel group design. Participating schools were randomised to the Internet intervention or the conventional health education group (control) with a 1:1 allocation ratio. Secondary 1–3 students of the participating schools were enrolled in this study. The Internet intervention was a web-based quiz game competition, in which participating students would answer 1,000 alcohol-related multiple-choice quiz questions. Conventional health education group received a promotional package on equivalent alcohol-related knowledge. The participants’ alcohol-related attitude, knowledge, and perceived behavioural control were self-reported before the intervention (baseline) and one month and three months after the intervention. Results: Our RCT results showed that participants in the Internet group were less likely to drink (risk ratio [RR] 0.79, p < 0.01) as well as in lesser amount (β -0.06, p < 0.05) compared to those in the control group at both post-intervention follow-ups. Within the intervention group, regression analyses showed that high quiz scorer had greater improvement in alcohol-related knowledge (β 0.28, p < 0.01) and attitude (β -0.26, p < 0.01) at 1 month after intervention, which in turn increased their perceived behavioural control against alcohol use (β 0.10 and -0.26, both p < 0.01). Attitude, compared to knowledge, was found to be a stronger contributor to the intervention effect on perceived behavioural control. Conclusions: Our internet-based intervention has demonstrated effectiveness in reducing the risk of underage drinking when compared with conventional health education. Our study results further showed an attitude to be a more important factor than knowledge in changing health-related behaviour. This has an important implication for future prevention/intervention on an underage drinking problem.

Keywords: adolescents, internet-based intervention, randomized controlled trial, underage drinking

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Authors: Habib Alshuwaikhat, Nahid Hossain

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Residential sector consumes more than half of the produced electricity in Saudi Arabia, and fossil fuel is the main source of energy to meet growing household electricity demand in the Kingdom. Several studies forecasted and expressed concern that unless the domestic energy demand growth is controlled, it will reduce Saudi Arabia’s crude oil export capacity within a decade and the Kingdom is likely to be incapable of exporting crude oil within next three decades. Though the Saudi government has initiated to address the domestic energy demand growth issue, the demand side energy management policies and programs are focused on industrial and commercial sectors. It is apparent that there is an urgent need to develop a comprehensive energy efficiency strategy for addressing efficient energy use in residential sector in the Kingdom. Then again as Saudi Arabia is at its primary stage in addressing energy efficiency issues in its residential sector, there is a scope for the Kingdom to learn from global energy efficiency practices and design its own energy efficiency policies and programs. However, in order to do that sustainable, it is essential to address local contexts of energy efficiency. It is also necessary to find out the policies and programs that will fit to the local contexts. Thus the objective of this study was set to identify globally best practice energy efficiency policies and programs in residential sector that have replication potential in Saudi Arabia. In this regard two sets of multi-criteria decision analysis matrices were developed to evaluate the energy efficiency policies and programs. The first matrix was used to evaluate the global energy efficiency policies and programs, and the second matrix was used to evaluate the replication potential of global best practice energy efficiency policies and programs for Saudi Arabia. Wuppertal Institute’s guidelines for energy efficiency policy evaluation were used to develop the matrices, and the different attributes of the matrices were set through available literature review. The study reveals that the best practice energy efficiency policies and programs with good replication potential for Saudi Arabia are those which have multiple components to address energy efficiency and are diversified in their characteristics. The study also indicates the more diversified components are included in a policy and program, the more replication potential it has for the Kingdom. This finding is consistent with other studies, where it is observed that in order to be successful in energy efficiency practices, it is required to introduce multiple policy components in a cluster rather than concentrate on a single policy measure. The developed multi-criteria decision analysis matrices for energy efficiency policy and program evaluation could be utilized to assess the replication potential of other globally best practice energy efficiency policies and programs for the residential sector of the Kingdom. In addition it has potential to guide Saudi policy makers to adopt and formulate its own energy efficiency policies and programs for Saudi Arabia.

Keywords: Saudi Arabia, residential sector, energy efficiency, policy evaluation

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Authors: Ireneusz Majsterek, Karolina Przybylowska, Lukasz Dziki, Adam Dziki, Jacek Kabzinski

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Colorectal cancer (CRC) is one of the deadliest cancers. Every year we see an increase in the number of cases, and in spite of intensive research etiology of the disease remains unknown. For many years, researchers are seeking to associate genetic factors with an increased risk of CRC, so far it has proved to be a compelling link between the MMR system of DNA repair and hereditary nonpolyposis colorectal cancers (HNPCC). Currently, research is focused on finding the relationship between the remaining DNA repair systems and an increased risk of developing colorectal cancer. The aim of the study was to determine the relationship between gene polymorphisms Ser835Ser of XPF gene and Gly23Ala of XPA gene–elements of NER DNA repair system, and modulation of the risk of colorectal cancer in the Polish population. Determination of the molecular basis of carcinogenesis process and predicting increased risk will allow qualifying patients to increased risk group and including them in preventive program. We used blood collected from 110 patients diagnosed with colorectal cancer. The control group consisted of equal number of healthy people. Genotyping was performed by TaqMan method. The obtained results indicate that the genotype 23Gly/Ala of XPA gene is associated with an increased risk of colorectal cancer, while 23Ala/Ala as well as TCT allele of Ser835Ser of XPF gene may reduce the risk of CRC.

Keywords: NER, colorectal cancer, XPA, XPF, polymorphisms

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Authors: Jirathan Pongchababnapa

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Polyphenols are the most common antioxidant found in plants and are efficient in capturing oxidative free radicals. Antioxidants are substances found in medicinal plants which may have a protective role to play in certain conditions such as heart disease, stroke and some cancers. By relying on these benefits, we have traced out the presence of antioxidant in Camellia sinensis leaves extract. This study aims to evaluate flavonoids content in C. sinensisextract and investigate antioxidant activities by using DPPH and ABTS radical scavenging capacity assay. The total flavonoid content of C. Sinensis extract was determined and expressed as quercetin equivalents (QE)/g measured by the aluminum chloride colorimetric method. The results showed that the IC₅₀ of C. Sinensis leaves extract were 40.90 μg/mL ± 0.755 and32.96 μg/mL ± 0.679 for DPPH and ABTS, respectively. C. Sinensis extract at increasing concentration showed antioxidant activities as a concentration dependent manner. In the DPPH assay, vitamin C was used as a positive control, whereas Trolox was used as a positive control in the ABTS assay. In conclusion, C. Sinensis extract consisted of a high amount of flavonoids content which possesses potent antioxidant activity. However, further investigation on the identification of pure compound of this plant and molecular antioxidant assays are still required.

Keywords: ABTS assay, antioxidant, camellia sinensis, DPPH assay, total flavonoid content

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Authors: Niousha Bagheri Khulenjani, Mohammad Saniee Abadeh

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Learning from very big datasets is a significant problem for most present data mining and machine learning algorithms. MicroRNA (miRNA) is one of the important big genomic and non-coding datasets presenting the genome sequences. In this paper, a hybrid method for the classification of the miRNA data is proposed. Due to the variety of cancers and high number of genes, analyzing the miRNA dataset has been a challenging problem for researchers. The number of features corresponding to the number of samples is high and the data suffer from being imbalanced. The feature selection method has been used to select features having more ability to distinguish classes and eliminating obscures features. Afterward, a Convolutional Neural Network (CNN) classifier for classification of cancer types is utilized, which employs a Genetic Algorithm to highlight optimized hyper-parameters of CNN. In order to make the process of classification by CNN faster, Graphics Processing Unit (GPU) is recommended for calculating the mathematic equation in a parallel way. The proposed method is tested on a real-world dataset with 8,129 patients, 29 different types of tumors, and 1,046 miRNA biomarkers, taken from The Cancer Genome Atlas (TCGA) database.

Keywords: cancer classification, feature selection, deep learning, genetic algorithm

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Authors: F. Marchini, A. Caputo, J. Balonan, F. Fedele, A. Napoli, V. Langher

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Aim: The present study aims to explore the specific role of defense mechanisms in persons with type 2 diabetes mellitus in treatment adherence. Materials and methods: A correlational study design was employed. Thirty-two persons with type 2 diabetes mellitus were enrolled and assessed with Defense Mechanism Inventory, Beck Depression Inventory-II, Toronto Alexithymia Scale and Self-Care Inventory-Revised. Bivariate correlation and two-step regression analyses were performed. Results: Treatment adherence negatively correlates with hetero-directed hostility (r= -.537; p < .01), whereas it is positively associated with principalization (r= .407; p < .05). These two defense mechanisms overall explain an incremental variance of 26.9% in treatment adherence (ΔF=4.189, df1=2, df2 =21, p < .05), over and above the control variables for depression and alexithymia. However, only higher hetero-directed hostility is found to be a solid predictor of a decreased treatment adherence (β=-.497, p < .05). Conclusions: Despite providing preliminary results, this pilot study highlights the original contribution of defense mechanisms in adherence to type 2 diabetes regimens. Specifically, hetero-directed hostility may relate to an unconscious process, according to which disease-related painful feelings are displaced onto care relationships with negative impacts on adherence.

Keywords: alexithymia, defense mechanisms, treatment adherence, type 2 diabetes mellitus

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