Search results for: clinical sentiment

Authors: Dmitry Yu. Korulkin, Raissa A. Muzychkina, Evgenii N. Kojaev

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In review the generalized data about biological activity of anthraquinone-containing plants and specimens on their basis is presented. Data of traditional medicine, results of bioscreening and clinical researches of specimens are analyzed.

Keywords: Anthraquinones, physiologically active substances, phytopreparation, Ramon.

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Authors: Grygorii Kostromin, Vladyslav Povoroznyuk

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Chronic venous diseases (CVD) are one of the common, though controversial problems in medicine. It is generally accepted that this pathology predominantly occurs in women. The issue of excessive weight as a risk factor for CVD is still considered debatable. To the author's best knowledge, today in Ukraine, there are barely any studies that describe the relationship between CVD and obesity. Our study aims to determine the association between age, body composition, obesity and CVD in postmenopausal women. The study was conducted in D. F. Chebotarev Institute of Gerontology, National Academy of Medical Sciences of Ukraine. We have examined 96 postmenopausal women aged 46-85 years (mean age – 66.19 ± 0.96 years), who were divided into two groups depending on the presence of CVD. The women were examined by vascular surgeons. For the diagnosis of CVD, we used clinical, anatomic and pathophysiologic classifications. We also performed clinical, ultrasound and densitometry examinations. We found that the CVD frequency in postmenopausal women increased with age (from 72% in those aged 45-59 years to 84% in those aged 75-89 years). A significant correlation between the total fat mass and age was determined in postmenopausal women with CVD. We also observed a significant correlation between the lower extremities’ fat mass and age in both examined groups. A significant correlation between body mass index and age was determined only in postmenopausal women without CVD.

Keywords: Chronic venous disease, risk factors, age, obesity, postmenopausal women.

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Authors: Salma Ainine, Colin Ritchie, Tracey McFee

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Background: The societal impact of antibiotic resistance is a major public health concern. The increase in incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently crosschecked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014 – September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: Antibiotic resistance, antibiotic stewardship, dental infection and hygiene standards.

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Authors: Kyoung-Jong Park, Woong-Gi Jeon, Hee-Cheol Kim, Dong-Eog Kim, Heung-Kook Choi

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The brain MR imaging-based clinical research and analysis system were specifically built and the development for a large-scale data was targeted. We used the general clinical data available for building large-scale data. Registration period for the selection of the lesion ROI and the region growing algorithm was used and the Mesh-warp algorithm for matching was implemented. The accuracy of the matching errors was modified individually. Also, the large ROI research data can accumulate by our developed compression method. In this way, the correctly decision criteria to the research result was suggested. The experimental groups were age, sex, MR type, patient ID and smoking which can easily be queries. The result data was visualized of the overlapped images by a color table. Its data was calculated by the statistical package. The evaluation for the utilization of this system in the chronic ischemic damage in the area has done from patients with the acute cerebral infarction. This is the cause of neurologic disability index location in the center portion of the lateral ventricle facing. The corona radiate was found in the position. Finally, the system reliability was measured both inter-user and intra-user registering correlation.

Keywords: Software tool design, Cerebral infarction, Brain MR image, Registration

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Authors: Tayyab Hassan, Talha Rehman, Qasim Abdul Aziz, Ahmad Salman

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The constant monitoring of blood glucose level is necessary for maintaining health of patients and to alert medical specialists to take preemptive measures before the onset of any complication as a result of diabetes. The current clinical monitoring of blood glucose uses invasive methods repeatedly which are uncomfortable and may result in infections in diabetic patients. Several attempts have been made to develop non-invasive techniques for blood glucose measurement. In this regard, the existing methods are not reliable and are less accurate. Other approaches claiming high accuracy have not been tested on extended dataset, and thus, results are not statistically significant. It is a well-known fact that acetone concentration in breath has a direct relation with blood glucose level. In this paper, we have developed the first of its kind, reliable and high accuracy breath analyzer for non-invasive blood glucose measurement. The acetone concentration in breath was measured using MQ 138 sensor in the samples collected from local hospitals in Pakistan involving one hundred patients. The blood glucose levels of these patients are determined using conventional invasive clinical method. We propose a linear regression classifier that is trained to map breath acetone level to the collected blood glucose level achieving high accuracy.

Keywords: Blood glucose level, breath acetone concentration, diabetes, linear regression.

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Authors: Kyung Bae Park, Sung Ho Ha

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Online user-generated contents (UGC) significantly change the way customers behave (e.g., shop, travel), and a pressing need to handle the overwhelmingly plethora amount of various UGC is one of the paramount issues for management. However, a current approach (e.g., sentiment analysis) is often ineffective for leveraging textual information to detect the problems or issues that a certain management suffers from. In this paper, we employ text mining of Latent Dirichlet Allocation (LDA) on a popular online review site dedicated to complaint from users. We find that the employed LDA efficiently detects customer complaints, and a further inspection with the visualization technique is effective to categorize the problems or issues. As such, management can identify the issues at stake and prioritize them accordingly in a timely manner given the limited amount of resources. The findings provide managerial insights into how analytics on social media can help maintain and improve their reputation management. Our interdisciplinary approach also highlights several insights by applying machine learning techniques in marketing research domain. On a broader technical note, this paper illustrates the details of how to implement LDA in R program from a beginning (data collection in R) to an end (LDA analysis in R) since the instruction is still largely undocumented. In this regard, it will help lower the boundary for interdisciplinary researcher to conduct related research.

Keywords: Latent Dirichlet allocation, R program, text mining, topic model, user generated contents, visualization.

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Authors: Ilma Robo, Saimir Heta, Edona Hasanaj, Vera Ostreni

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The hybrid layer (HL), the way it is created and how it is protected against degradation over time, is the key to the clinical success of a composite restoration. The composite supports the dentinal structure exactly with the realized surface of micro-retention. Thus, this surface is in direct proportion to its size versus the duration of clinical use of composite dental restoration. Micro-retention occurs between dentin or acidified enamel and adhesive resin extensions versus pre-prepared spaces, such as hollow dentinal tubules. The way the adhesive resin binds to the acidified dentinal structure depends on the physical or chemical factors of this interrelationship between two structures with very different characteristics. During the acidification process, a precursor to the placement of the adhesive resin layer, activation of metalloproteinases of dental origin occurs, enzymes which are responsible for the degradation of the HL. These enzymes have expressed activity depending on the presence of Zn2+ or Ca2+ ions. There are several ways to inhibit these enzymes, and consequently, there are several ways to inhibit the degradation process of the HL. The study aim is to evaluate chlorhexidine (CHX) as a solution element, inhibitor of dentin activated metalloproteinases, as a result of the application of acidification. This study aims to look at this solution in advantage or contraindication theories, already published in the literature.

Keywords: Hybrid layer, chlorhexidine, degradation, smear layer.

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Authors: Ibrahim M. S. Shnawa, Bashar A. H. E. Alsadi, Kalida K. Alniaem

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In the immunologic sense, clinical infection is a state of failure of the immune system to combat the pathogenic weapon of the bacteria invading the host. A motile gram negative vibroid organism associated with marked mono and poly nuclear cell responses was traced during the examination of a clinical material from an infected common carp Cyprinus carpio. On primary plate culture, growth was shown to be pure, dense population of an Aeromonas-like colony morphotype. The pure isolate was found to be; Aerobic, facultatively anaerobic, non-halophilic, grew at 0C, and 37C, oxidase positive utilizes glucose through fermentative pathway, resist 0/129 and novobiocin, produces alanine and lysine decarboxylases but non-producing ornithine dehydrolases. Tests for the in vitro determinants of pathogenicity has shown to be; Betahaemolytic onto blood agar, gelatinase, casienase and amylase producer. Three in vivo determinants of pathogenicity were tested as, the lethal dose fifty, the pathogenesis and pathogenicity. It was evident that 0.1 milliliter of the causal bacterial cell suspension of a density 1 x 107 CFU/ml injected intramuscularly into an average of 100gms fish toke five days incubation period, then at the day six morbidity and mortality were initiated. LD50 was recorded at the day 12 post-infection. Use of an LD50 doses to study the pathogenicity, reveals mononuclear and polynuclear cell responses, on examining the stained direct films of the clinical materials from the experimentally infected fish. Re-isolation tests confirm that the reisolant is same. The course of the infection in natural case was shown manifestation of; skin ulceration, haemorrhage and descaling. On evisceration, the internal organs were shown; congestion in the intestines, spleen and, air sacs. The induced infection showed a milder form of these manifestations. The grading of the virulence of this organism was virulent causing chronic course of infections as indicated from the pathogenesis and pathogenicity studies. Thus the infectious bacteria were consistent with Aeromonas hydrophila, and the infection was chronic.

Keywords: Piscan, inflammatory respnonse, pure culture, pathogen, chronic, infection.

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Authors: Min Kook Choi, Hyun Gyu Lee, Ryan You, Byeong-Seok Shin, Sang-Chul Lee

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Wireless capsule Endoscopy (WCE) has rapidly shown its wide applications in medical domain last ten years thanks to its noninvasiveness for patients and support for thorough inspection through a patient-s entire digestive system including small intestine. However, one of the main barriers to efficient clinical inspection procedure is that it requires large amount of effort for clinicians to inspect huge data collected during the examination, i.e., over 55,000 frames in video. In this paper, we propose a method to compute meaningful motion changes of WCE by analyzing the obtained video frames based on regional optical flow estimations. The computed motion vectors are used to remove duplicate video frames caused by WCE-s imaging nature, such as repetitive forward-backward motions from peristaltic movements. The motion vectors are derived by calculating directional component vectors in four local regions. Our experiments are performed on small intestine area, which is of main interest to clinical experts when using WCEs, and our experimental results show significant frame reductions comparing with a simple frame-to-frame similarity-based image reduction method.

Keywords: Wireless capsule endoscopy, optical flow, duplicated image, duplicated frame.

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Authors: Maha Salah Abdullah Ismail, Mahmoud M. Alsagheir, Mohammed Salah Abd Allah

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Acute respiratory distress syndrome (ARDS) is characterized by permeability pulmonary edema and refractory hypoxemia. Lung-protective ventilation is still the key of better outcome in ARDS. Prone position reduces the trans-pulmonary pressure gradient, recruiting collapsed regions of the lung without increasing airway pressure or hyperinflation. Prone ventilation showed improved oxygenation and improved outcomes in severe hypoxemic patients with ARDS. This study evaluates the effect of prone positioning on mechanically ventilated patients with ARDS. A quasi-experimental design was carried out at Critical Care Units, on 60 patients. Two tools were utilized to collect data; Socio demographic, medical and clinical outcomes data sheet. Results of the present study indicated that prone position improves oxygenation in patients with severe respiratory distress syndrome. The study recommended that use prone position in patients with severe ARDS, as early as possible and for long sessions. Also, replication of this study on larger probability sample at the different geographical location is highly recommended.

Keywords: Acute respiratory distress syndrome, Critical care, Mechanical ventilation and Prone position.

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Authors: Seddeq E. Ghrare, Salahaddin M. Shreef

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Medical image modalities such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), X-ray are adapted to diagnose disease. These modalities provide flexible means of reviewing anatomical cross-sections and physiological state in different parts of the human body. The raw medical images have a huge file size and need large storage requirements. So it should be such a way to reduce the size of those image files to be valid for telemedicine applications. Thus the image compression is a key factor to reduce the bit rate for transmission or storage while maintaining an acceptable reproduction quality, but it is natural to rise the question of how much an image can be compressed and still preserve sufficient information for a given clinical application. Many techniques for achieving data compression have been introduced. In this study, three different MRI modalities which are Brain, Spine and Knee have been compressed and reconstructed using wavelet transform. Subjective and objective evaluation has been done to investigate the clinical information quality of the compressed images. For the objective evaluation, the results show that the PSNR which indicates the quality of the reconstructed image is ranging from (21.95 dB to 30.80 dB, 27.25 dB to 35.75 dB, and 26.93 dB to 34.93 dB) for Brain, Spine, and Knee respectively. For the subjective evaluation test, the results show that the compression ratio of 40:1 was acceptable for brain image, whereas for spine and knee images 50:1 was acceptable.

Keywords: Medical Image, Magnetic Resonance Imaging, Image Compression, Discrete Wavelet Transform, Telemedicine.

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Authors: Anne-Margré C. Vink

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Background. Food-related allergies and intolerances are frequently occurring in dogs. Diagnosis and monitoring according ‘Golden Standard’ of elimination efficiency is, however, time consuming, expensive, and requires expert clinical setting. In order to facilitate rapid and robust, quantitative testing of intolerance, and determining the individual offending foods, a serological test is implicated for Alimentary Induced Diseases and manifestations. Method. As we developed Medisynx IgG Human Screening Test ELISA before and the dog’ immune system is most similar to humans, we were able to develop Medisynx IgG Dog Screening Test ELISA as well. In this randomized, double-blind, split-sample, retro perspective study 47 dogs suffering from Canine Atopic Dermatitis (CAD) and several secondary induced reactions were included to participate in serological Medisynx IgG Dog Screening Test ELISA (within < 0,02 % SD). Results were expressed as titers relative to the standard OD readings to diagnose alimentary induced diseases and monitoring efficacy of an individual eliminating diet in dogs. Split sample analysis was performed by independently sending 2 times 3 ml serum under two unique codes. Results. The veterinarian monitored these dogs to check dog’ results at least at 3, 7, 21, 49, 70 days and after period of 6 and 12 months on an individual negative diet and a positive challenge (retrospectively) at 6 months. Data of each dog were recorded in a screening form and reported that a complete recovery of all clinical manifestations was observed at or less than 70 days (between 50 and 70 days) in the majority of dogs (44 out of 47 dogs =93.6%). Conclusion. Challenge results showed a significant result of 100% in specificity as well as 100% positive predicted value. On the other hand, sensitivity was 95,7% and negative predictive value was 95,7%. In conclusion, an individual diet based on IgG ELISA in dogs provides a significant improvement of atopic dermatitis and pruritus including all other non-specific defined allergic skin reactions as erythema, itching, biting and gnawing at toes, as well as to several secondary manifestations like chronic diarrhoea, chronic constipation, otitis media, obesity, laziness or inactive behaviour, pain and muscular stiffness causing a movement disorders, excessive lacrimation, hyper behaviour, nervous behaviour and not possible to stay alone at home, anxiety, biting and aggressive behaviour and disobedience behaviour. Furthermore, we conclude that a relatively more severe systemic candidiasis, as shown by relatively higher titer (class 3 and 4 IgG reactions to Candida albicans), influence the duration of recovery from clinical manifestations in affected dogs. These findings are consistent with our preliminary human clinical studies.

Keywords: Allergy, canine atopic dermatitis (CAD), food allergens, IgG-ELISA, food-incompatibility.

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Authors: Sharan Badiger, Prema T. Akkasaligar, Deepak Kadeli, M. Vishok

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Neurological disorders are the most debilitating of manifestations seen in patients infected with HIV. The clinical profile of neurological manifestations in HIV patients has undergone a shift in recent years with opportunistic infections being controlled with combination anti-retroviral therapy and the advent of drugs which have higher central nervous system penetrability. The aim of this paper is to study the clinical, investigation profile and various neurological disorders in HIV patients on anti‐retroviral therapy. Fifty HIV patients with neurological manifestations were studied. A complete neurological examination including neurocognitive functioning using Montreal Cognitive Assessment and HIV Dementia scale were assessed. Apart from relevant investigations, CD4 count, cerebrovascular fluid analysis, computed tomography (CT) and magnetic resonance imaging (MRI) of brain were done whenever required. Neurocognitive disorders formed the largest group with 42% suffering from HIV associated Neurocognitive Disorders. Among them, asymptomatic neurocognitive impairment was seen in 28%; mild neurocognitive disorder in 12%, and 2% had HIV‐associated dementia. Opportunistic infections of the nervous system accounted for 32%, with meningitis being the most common. Four patients had space occupying lesions of central nervous system; four tuberculomas, and one toxoplasmosis. With the advent of highly active retroviral therapy, HIV patients have longer life spans with suppression of viral load leading to decrease in opportunistic infections of the nervous system. Neurocognitive disorders are now the most common neurological dysfunction seen and thus neurocognitive assessment must be done in all patients with HIV.

Keywords: Anti retroviral therapy, cognitive dysfunction, dementia, neurological manifestations, opportunistic infections.

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Authors: Jing Jia, Shanqing Huang, Fang Liu, Qiang Ren, Gui Li, Mengyun Cheng, Chufeng Jin, Yican Wu

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Medical image registration is the key technology in image guided radiation therapy (IGRT) systems. On the basis of the previous work on our IGRT prototype with a biorthogonal x-ray imaging system, we described a method focused on the 2D/2D rigid-body registration using multiresolution pyramid based mutual information in this paper. Three key steps were involved in the method ： firstly, four 2D images were obtained including two x-ray projection images and two digital reconstructed radiographies（DRRs ） as the input for the registration ； Secondly, each pair of the corresponding x-ray image and DRR image were matched using multiresolution pyramid based mutual information under the ITK registration framework ； Thirdly, we got the final couch offset through a coordinate transformation by calculating the translations acquired from the two pairs of the images. A simulation example of a parotid gland tumor case and a clinical example of an anthropomorphic head phantom were employed in the verification tests. In addition, the influence of different CT slice thickness were tested. The simulation results showed that the positioning errors were 0.068±0.070, 0.072±0.098, 0.154±0.176mm along three axes which were lateral, longitudinal and vertical. The clinical test indicated that the positioning errors of the planned isocenter were 0.066, 0.07, 2.06mm on average with a CT slice thickness of 2.5mm. It can be concluded that our method with its verified accuracy and robustness can be effectively used in IGRT systems for patient setup.

Keywords: 2D/2D registration, image guided radiation therapy, multi resolution pyramid, mutual information.

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Authors: Tahani Aljohani, Jialin Yu, Alexandra. I. Cristea

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The more an educational system knows about a learner, the more personalised interaction it can provide, which leads to better learning. However, asking a learner directly is potentially disruptive, and often ignored by learners. Especially in the booming realm of MOOC Massive Online Learning platforms, only a very low percentage of users disclose demographic information about themselves. Thus, in this paper, we aim to predict learners’ demographic characteristics, by proposing an approach using linguistically motivated Deep Learning Architectures for Learner Profiling, particularly targeting gender prediction on a FutureLearn MOOC platform. Additionally, we tackle here the difficult problem of predicting the gender of learners based on their comments only – which are often available across MOOCs. The most common current approaches to text classification use the Long Short-Term Memory (LSTM) model, considering sentences as sequences. However, human language also has structures. In this research, rather than considering sentences as plain sequences, we hypothesise that higher semantic - and syntactic level sentence processing based on linguistics will render a richer representation. We thus evaluate, the traditional LSTM versus other bleeding edge models, which take into account syntactic structure, such as tree-structured LSTM, Stack-augmented Parser-Interpreter Neural Network (SPINN) and the Structure-Aware Tag Augmented model (SATA). Additionally, we explore using different word-level encoding functions. We have implemented these methods on Our MOOC dataset, which is the most performant one comparing with a public dataset on sentiment analysis that is further used as a cross-examining for the models' results.

Keywords: Deep learning, data mining, gender predication, MOOCs.

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Authors: Noor Ayuni Che Zakaria, Takashi Komeda, Cheng Yee Low, Kaoru Inoue, Fazah Akhtar Hanapiah

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Previous studies have shown that there are arguments regarding the reliability and validity of the Ashworth and Modified Ashworth Scale towards evaluating patients diagnosed with upper limb disorders. These evaluations depended on the raters’ experiences. This initiated us to develop an upper limb disorder part-task trainer that is able to simulate consistent upper limb disorders, such as spasticity and rigidity signs, based on the Modified Ashworth Scale to improve the variability occurring between raters and intra-raters themselves. By providing consistent signs, novice therapists would be able to increase training frequency and exposure towards various levels of signs. A total of 22 physiotherapists and occupational therapists participated in the study. The majority of the therapists agreed that with current therapy education, they still face problems with inter-raters and intra-raters variability (strongly agree 54%; n = 12/22, agree 27%; n = 6/22) in evaluating patients’ conditions. The therapists strongly agreed (72%; n = 16/22) that therapy trainees needed to increase their frequency of training; therefore believe that our initiative to develop an upper limb disorder training tool will help in improving the clinical education field (strongly agree and agree 63%; n = 14/22).

Keywords: Upper limb disorders, Clinical education tool, Inter/intra-raters variability, Spasticity, Modified Ashworth Scale.

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Authors: B. Golchin, N. Riahi

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One of the most significant issues as attended a lot in recent years is that of recognizing the sentiments and emotions in social media texts. The analysis of sentiments and emotions is intended to recognize the conceptual information such as the opinions, feelings, attitudes and emotions of people towards the products, services, organizations, people, topics, events and features in the written text. These indicate the greatness of the problem space. In the real world, businesses and organizations are always looking for tools to gather ideas, emotions, and directions of people about their products, services, or events related to their own. This article uses the Twitter social network, one of the most popular social networks with about 420 million active users, to extract data. Using this social network, users can share their information and opinions about personal issues, policies, products, events, etc. It can be used with appropriate classification of emotional states due to the availability of its data. In this study, supervised learning and deep neural network algorithms are used to classify the emotional states of Twitter users. The use of deep learning methods to increase the learning capacity of the model is an advantage due to the large amount of available data. Tweets collected on various topics are classified into four classes using a combination of two Bidirectional Long Short Term Memory network and a Convolutional network. The results obtained from this study with an average accuracy of 93%, show good results extracted from the proposed framework and improved accuracy compared to previous work.

Keywords: emotion classification, sentiment analysis, social networks, deep neural networks

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Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: Clinical pharmacy, co-payments, healthcare, medicines.

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Authors: Z. Khoshnood, R. Khoshnood

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The aim of present study was to monitor the presence of Trichodina sp. in Rainbow trout, Oncorhynchus mykiss collected from various fish farms in the western provinces of Iran during January, 2013- January, 2014. Out of 675 sampled fish 335, (49.16%) were infested with Trichodina. The highest prevalence was observed in the spring and winter followed by autumn and summer. In general, the intensity of infection was low except in cases where outbreaks of Trichodiniasis endangered the survival of fish in some ponds. In light infestation Trichodina is usually present on gills, fins and skin of apparently healthy fish. Clinical signs of Trichodiniasis only appear on fish with heavy infections and cases of moderate ones that are usually exposed to one or more stress factors including, rough handling during transportation from ponds, overcrowdness, malnutrition, high of free ammonia and low of oxygen concentration. Clinical signs of Trichodiniasis in sampled fish were sluggish movement, loss of appetite, black coloration, necrosis and ulcer on different parts of the body, detached scales and excessive accumulation of mucous in gill pouches. The most obvious histopathological changes in diseased fish were sloughing of the epidermal layer, aggregation of leucocytes and melanine-carrying cells (between the dermis and hypodermis) and proliferative changes including hyperplasia and hypertrophy of the epithelial lining cells of gill filaments which resulted in fusion of secondary lamellae. Control of Trichodiniasis, has been achieved by formalin bath treatment at a concentration of 250 ppm for one hour.

Keywords: Gill, Histopathology, Rainbow trout, Trichodina.

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Authors: Do Thi Ha, Khanitta Nuntaboot

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Background: Competency of nurses is vital to safe nursing practice as well as essential component to drive quality of nursing services. There exists little up to date information concerning actual competency among Vietnamese nurses. Purposes: The purpose of this study is to identify the actual nursing competency among nurses in clinical settings in Vietnam. Methods: A qualitative study, ethnographic method, comprised of the participant-observation, in-depth interview, and focus group discussion with multidisciplinary groups of nurses employing in Cho Ray hospital, Vietnam, managers/administrators, nurse teachers, medical doctors, other health care providers, patients and family members which derived from purposeful sampling technique. Content analysis was used for data analysis. Results: Five essential themes of nursing competencies among nurses were identified include (1) knowledge, (2) skills, (3) attitude and value-based nursing practice, (4) legal and ethical competencies, and (5) transcultural competencies. Basic and advanced knowledge were identified as further two dimensions of knowledge. There were five sub themes identified as further dimensions of skills include technical skills, communication skills, organizing and management skills, teamwork and interrelationship, and critical thinking skills. Conclusions: The findings from this study provide valuable information and understanding of the actual competency among nurses in clinical settings in Vietnam. It is expected that this understanding would assist in developing a guide to nursing education and training, nursing practice and relevant policy regulation used for promoting nursing competency among nurses.

Keywords: Nursing competency, qualitative design, ethnographic method, Vietnam.

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Authors: Faiza Belbachir, Thibault Schienhinski

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The massive development of online social networks allows users to post and share their opinions on various topics. With this huge volume of opinion, it is interesting to extract and interpret these information for different domains, e.g., product and service benchmarking, politic, system of recommendation. This is why opinion detection is one of the most important research tasks. It consists on differentiating between opinion data and factual data. The difficulty of this task is to determine an approach which returns opinionated document. Generally, there are two approaches used for opinion detection i.e. Lexical based approaches and Machine Learning based approaches. In Lexical based approaches, a dictionary of sentimental words is used, words are associated with weights. The opinion score of document is derived by the occurrence of words from this dictionary. In Machine learning approaches, usually a classifier is trained using a set of annotated document containing sentiment, and features such as n-grams of words, part-of-speech tags, and logical forms. Majority of these works are based on documents text to determine opinion score but dont take into account if these texts are really correct. Thus, it is interesting to exploit other information to improve opinion detection. In our work, we will develop a new way to consider the opinion score. We introduce the notion of trust score. We determine opinionated documents but also if these opinions are really trustable information in relation with topics. For that we use lexical SentiWordNet to calculate opinion and trust scores, we compute different features about users like (numbers of their comments, numbers of their useful comments, Average useful review). After that, we combine opinion score and trust score to obtain a final score. We applied our method to detect trust opinions in TRIPADVISOR collection. Our experimental results report that the combination between opinion score and trust score improves opinion detection.

Keywords: Tripadvisor, Opinion detection, SentiWordNet, trust score.

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Authors: Ashkan Ebadi, Adam Krzyzak

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Recommender systems, also known as recommender engines, have become an important research area and are now being applied in various fields. In addition, the techniques behind the recommender systems have been improved over the time. In general, such systems help users to find their required products or services (e.g. books, music) through analyzing and aggregating other users’ activities and behavior, mainly in form of reviews, and making the best recommendations. The recommendations can facilitate user’s decision making process. Despite the wide literature on the topic, using multiple data sources of different types as the input has not been widely studied. Recommender systems can benefit from the high availability of digital data to collect the input data of different types which implicitly or explicitly help the system to improve its accuracy. Moreover, most of the existing research in this area is based on single rating measures in which a single rating is used to link users to items. This paper proposes a highly accurate hotel recommender system, implemented in various layers. Using multi-aspect rating system and benefitting from large-scale data of different types, the recommender system suggests hotels that are personalized and tailored for the given user. The system employs natural language processing and topic modelling techniques to assess the sentiment of the users’ reviews and extract implicit features. The entire recommender engine contains multiple sub-systems, namely users clustering, matrix factorization module, and hybrid recommender system. Each sub-system contributes to the final composite set of recommendations through covering a specific aspect of the problem. The accuracy of the proposed recommender system has been tested intensively where the results confirm the high performance of the system.

Keywords: Tourism, hotel recommender system, hybrid, implicit features.

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Authors: Aarati Susan Mathew, Radhika Narendra Patel, Jiji Mathew

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A retrospective study conducted at Christian Medical College (CMC) Teaching Hospital, Vellore, India on 14th August 2014 to assess the accuracy of clinically estimated foetal weight upon labour admission. Estimating foetal weight is a crucial factor in assessing maternal and foetal complications during and after labour. Medical notes of ninety-eight postnatal women who fulfilled the inclusion criteria were studied to evaluate the correlation between their recorded Estimated Foetal Weight (EFW) on admission and actual birth weight (ABW) of the newborn after delivery. Data concerning maternal and foetal demographics was also noted. Accuracy was determined by absolute percentage error and proportion of estimates within 10% of ABW. Actual birth weights ranged from 950-4080g. A strong positive correlation between EFW and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the normal weight range (2500-4000g) had a 59.5% estimation accuracy (n=74) compared to pre-term (<40 weeks) with an estimation accuracy of 0% (n=2). Out of the term deliveries, macrosomic babies (>4000g) were underestimated by 25% (n=3) and low birthweight (LBW) babies were overestimated by 12.7% (n=9). Registrars who estimated foetal weight were accurate in babies within normal weight ranges. However, there needs to be an improvement in predicting weight of macrosomic and LBW foetuses. We have suggested the use of an amended version of the Johnson’s formula for the Indian population for improvement and a need to re-audit once implemented.

Keywords: Clinical palpation, estimated foetal weight, pregnancy, India, Johnson’s formula.

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Authors: Abdolghani Ebrahimi, Diego Klabjan, Chenxi Ge, Daniela Ladner, Parker Stride

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In this work, we use machine learning and data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. Our work applies modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Keywords: machine learning, liver cirrhosis, subgraph mining, supervised learning

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Authors: Cornelia-Eugenia Munteanu

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From a psychological perspective, psychopathology is the area of clinical psychology that has at its core psychological assessment and psychotherapy. In day-to-day clinical practice, psychodiagnosis and psychotherapy are used independently, according to their intended purpose and their specific methods of application. The paper explores how the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Mini Mental State Examination-2 (MMSE-2) psychological tools contribute to enhancing the effectiveness of cognitive behavioral psychotherapy (CBT). This combined approach, psychotherapy in conjunction with assessment of personality and cognitive functions, is illustrated by two cases, a severe depressive episode with psychotic symptoms and a mixed anxiety-depressive disorder. The order in which CBT, MMPI-2, and MMSE-2 were used in the diagnostic and therapeutic process was determined by the particularities of each case. In the first case, the sequence started with psychotherapy, followed by the administration of blue form MMSE-2, MMPI-2, and red form MMSE-2. In the second case, the cognitive screening with blue form MMSE-2 led to a personality assessment using MMPI-2, followed by red form MMSE-2; reapplication of the MMPI-2 due to the invalidation of the first profile, and finally, psychotherapy. The MMPI-2 protocols gathered useful information that directed the steps of therapeutic intervention: a detailed symptom picture of potentially self-destructive thoughts and behaviors otherwise undetected during the interview. The memory loss and poor concentration were confirmed by MMSE-2 cognitive screening. This combined approach, psychotherapy with psychological assessment, aligns with the trend of adaptation of the psychological services to the everyday life of contemporary man and paves the way for deepening and developing the field.

Keywords: Assessment, cognitive behavioral psychotherapy, MMPI-2, MMSE-2, psychopathology.

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Authors: Srinivas Bathini, Duraichelvan Raju, Simona Badilescu, Muthukumaran Packirisamy

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A bio-sensing method, based on the plasmonic property of gold nano-islands, has been developed for detection of exosomes in a clinical setting. The position of the gold plasmon band in the UV-Visible spectrum depends on the size and shape of gold nanoparticles as well as on the surrounding environment. By adsorbing various chemical entities, or binding them, the gold plasmon band will shift toward longer wavelengths and the shift is proportional to the concentration. Exosomes transport cargoes of molecules and genetic materials to proximal and distal cells. Presently, the standard method for their isolation and quantification from body fluids is by ultracentrifugation, not a practical method to be implemented in a clinical setting. Thus, a versatile and cutting-edge platform is required to selectively detect and isolate exosomes for further analysis at clinical level. The new sensing protocol, instead of antibodies, makes use of a specially synthesized polypeptide (Vn96), to capture and quantify the exosomes from different media, by binding the heat shock proteins from exosomes. The protocol has been established and optimized by using a glass substrate, in order to facilitate the next stage, namely the transfer of the protocol to a microfluidic environment. After each step of the protocol, the UV-Vis spectrum was recorded and the position of gold Localized Surface Plasmon Resonance (LSPR) band was measured. The sensing process was modelled, taking into account the characteristics of the nano-island structure, prepared by thermal convection and annealing. The optimal molar ratios of the most important chemical entities, involved in the detection of exosomes were calculated as well. Indeed, it was found that the results of the sensing process depend on the two major steps: the molar ratios of streptavidin to biotin-PEG-Vn96 and, the final step, the capture of exosomes by the biotin-PEG-Vn96 complex. The microfluidic device designed for sensing of exosomes consists of a glass substrate, sealed by a PDMS layer that contains the channel and a collecting chamber. In the device, the solutions of linker, cross-linker, etc., are pumped over the gold nano-islands and an Ocean Optics spectrometer is used to measure the position of the Au plasmon band at each step of the sensing. The experiments have shown that the shift of the Au LSPR band is proportional to the concentration of exosomes and, thereby, exosomes can be accurately quantified. An important advantage of the method is the ability to discriminate between exosomes having different origins.

Keywords: Exosomes, gold nano-islands, microfluidics, plasmonic biosensing.

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Authors: Ahaskar Pandey, Gaurav Mukherjee, Sushil Kumar

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The ever growing sentiment of environmentalism across the globe has made many people think on the green lines. But most of such ideas halt short of implementation because of the short term economic viability issues with the concept of going green. In this paper we have tried to amalgamate the green concept with social entrepreneurship for solving a variety of issues faced by the society today. In addition the paper also tries to ensure that the short term economic viability does not act as a deterrent. The paper comes up three sustainable models of social entrepreneurship which tackle a wide assortment of issues such as nutrition problem, land problems, pollution problems and employment problems. The models described fall under the following heads: - Spirulina cultivation: The model addresses nutrition, land and employment issues. It deals with cultivation of a blue green alga called Spirulina which can be used as a very nutritious food. Also, the implementation of this model would bring forth employment to the poor people of the area. - Biocomposites: The model comes up with various avenues in which biocomposites can be used in an economically sustainable manner. This model deals with the environmental concerns and addresses the depletion of natural resources. - Packaging material from empty fruit bunches (EFB) of oil palm: This one deals with air and land pollution. It is intended to be a substitute for packaging materials made from Styrofoam and plastics which are non-biodegradable. It takes care of the biodegradability and land pollution issues. It also reduces air pollution as the empty fruit bunches are not incinerated. All the three models are sustainable and do not deplete the natural resources any further. This paper explains each of the models in detail and deals with the operational/manufacturing procedures and cost analysis while also throwing light on the benefits derived and sustainability aspects.

Keywords: Biodegradable, Pollution, Social entrepreneurship, Sustainability.

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Authors: Abdulfatah Al-Jaradi, Marzoq Ali Odhah, Abdulnasser A. Haza’a

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Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of Antenatal Care (ANC) include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding ANC. Methodology: A descriptive knowledge, attitude, and practice (KAP) study was conducted in public hospitals in Sana'a City, Yemen. The study population included all pregnant women that intended to the prenatal department and clinical outpatient department; the final sample size was 371 pregnant women. A self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women had correct answers in total knowledge regarding ANC, and about two-thirds (67%) of pregnant women had performance practice regarding ANC and two-third (68%) of pregnant women had a positive attitude. Conclusions: More than three quarter of pregnant women had good knowledge level, most of pregnant women had moderate practice level, and more than two-thirds of pregnant women had a positive attitude regarding antenatal care. There was a statistically significant association between overall knowledge and practice level toward ANC and demographic characteristics of pregnant women, at P-value ≤ 0.05. Recommendations: we recommended more education and training courses, lecturers, and education sessions in clinical facilitators focused on ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

Keywords: Antenatal care, knowledge, practice, attitude, pregnant women.

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Authors: Gorazd Karer

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When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents is one of the main tasks of the anesthesiologist. That being said, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. This paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a User-Datagram-Protocol-based (UDP-based) communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of medical-device manufacturer and is implemented in MATLAB-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: Closed-loop control, Depth of Anesthesia, DoA, optical signal acquisition, Patient State index, PSi, UDP communication protocol.

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Authors: K. Afsahi, M. Soheilifar, S. H. Hosseini, O. S. Esmaeili, R. Kezemi, N. Mehrbod, N. Vahed, T. Hajiahmad, N. N. Ansari

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Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of virtual reality (VR) beside conventional rehabilitation versus conventional rehabilitation alone on the spasticity and motor function in stroke patients. Materials and methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were Modified Ashworth scale, Recovery Stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in combination group (P = 0.003). Only wrist extension was varied between groups and was better in combination group. The variables generally had statistically significant difference (P < 0.05). Conclusion: VR plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: Stroke, virtual therapy, efficacy, rehabilitation.

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