3,334 research outputs found

    Perception of mathematics game’s design for primary school: based on teachers’ opinions

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    Unmistakable methods can be used for learning, and they can be looked at in a few viewpoints, particularly those identified with learning results. In this paper, we introduce an examination with a specific end goal to think about the design adequacy and development’s requirement of a game based learning (GBL) approach that is about to be used in LINUS screening for mathematics subject in primary school. The approach includes multiple interaction forms regarding addition and subtraction operation in mathematics based on LINUS constructs. Ten teachers from three different school located in Batu Pahat have participated in the study. The investigations involving survey activity by using questionnaire as the instrument. While breaking down the results, the outcomes demonstrated that the kids observed the amusement to be all the more fulfilling if there are less levels and more colours. Since the survey were conducted to a very common type of school in Malaysia, we believe game that is about to be built based on opinion gained could be utilized as an effective instrument in primary schools to strengthen pupils' lessons

    Predicting the Risk of Mortality in Children using a Fuzzy-Probabilistic Hybrid Model

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    Publisher Copyright: © 2022 Corsino Rey et al.Introduction. The mortality risk in children admitted to Pediatric Intensive Care Units (PICU) is usually estimated by means of validated scales, which only include objective data among their items. Human perceptions may also add relevant information to prognosticate the risk of death, and the tool to use this subjective data is fuzzy logic. The objective of our study was to develop a mathematical model to predict mortality risk based on the subjective perception of PICU staff and to evaluate its accuracy compared to validated scales. Methods. A prospective observational study in two PICUs (one in Spain and another in Latvia) was performed. Children were consecutively included regardless of the cause of admission along a two-year period. A fuzzy set program was developed for the PICU staff to record the subjective assessment of the patients' mortality risk expressed through a short range and a long range, both between 0% and 100%. Pediatric Index of Mortality 2 (PIM2) and Therapeutic Intervention Scoring System 28 (TISS28) were also prospectively calculated for each patient. Subjective and objective predictions were compared using the logistic regression analysis. To assess the prognostication ability of the models a stratified B-random K-fold cross-validation was performed. Results. Five hundred ninety-nine patients were included, 308 in Spain (293 survivors, 15 nonsurvivors) and 291 in Latvia (282 survivors, 9 nonsurvivors). The best logistic classification model for subjective information was the one based on MID (midpoint of the short range), whereas objective information was the one based on PIM2. Mortality estimation performance was 86.3% for PIM2, 92.6% for MID, and the combination of MID and PIM2 reached 96.4%. Conclusions. Subjective assessment was as useful as validated scales to estimate the risk of mortality. A hybrid model including fuzzy information and probabilistic scales (PIM2) seems to increase the accuracy of prognosticating mortality in PICU.publishersversionPeer reviewe

    Machine learning in critical care: state-of-the-art and a sepsis case study

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    Background: Like other scientific fields, such as cosmology, high-energy physics, or even the life sciences, medicine and healthcare face the challenge of an extremely quick transformation into data-driven sciences. This challenge entails the daunting task of extracting usable knowledge from these data using algorithmic methods. In the medical context this may for instance realized through the design of medical decision support systems for diagnosis, prognosis and patient management. The intensive care unit (ICU), and by extension the whole area of critical care, is becoming one of the most data-driven clinical environments. Results: The increasing availability of complex and heterogeneous data at the point of patient attention in critical care environments makes the development of fresh approaches to data analysis almost compulsory. Computational Intelligence (CI) and Machine Learning (ML) methods can provide such approaches and have already shown their usefulness in addressing problems in this context. The current study has a dual goal: it is first a review of the state-of-the-art on the use and application of such methods in the field of critical care. Such review is presented from the viewpoint of the different subfields of critical care, but also from the viewpoint of the different available ML and CI techniques. The second goal is presenting a collection of results that illustrate the breath of possibilities opened by ML and CI methods using a single problem, the investigation of septic shock at the ICU. Conclusion: We have presented a structured state-of-the-art that illustrates the broad-ranging ways in which ML and CI methods can make a difference in problems affecting the manifold areas of critical care. The potential of ML and CI has been illustrated in detail through an example concerning the sepsis pathology. The new definitions of sepsis and the relevance of using the systemic inflammatory response syndrome (SIRS) in its diagnosis have been considered. Conditional independence models have been used to address this problem, showing that SIRS depends on both organ dysfunction measured through the Sequential Organ Failure (SOFA) score and the ICU outcome, thus concluding that SIRS should still be considered in the study of the pathophysiology of Sepsis. Current assessment of the risk of dead at the ICU lacks specificity. ML and CI techniques are shown to improve the assessment using both indicators already in place and other clinical variables that are routinely measured. Kernel methods in particular are shown to provide the best performance balance while being amenable to representation through graphical models, which increases their interpretability and, with it, their likelihood to be accepted in medical practice.Peer ReviewedPostprint (published version

    Unsupervised patient representations from clinical notes with interpretable classification decisions

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    We have two main contributions in this work: 1. We explore the usage of a stacked denoising autoencoder, and a paragraph vector model to learn task-independent dense patient representations directly from clinical notes. We evaluate these representations by using them as features in multiple supervised setups, and compare their performance with those of sparse representations. 2. To understand and interpret the representations, we explore the best encoded features within the patient representations obtained from the autoencoder model. Further, we calculate the significance of the input features of the trained classifiers when we use these pretrained representations as input.Comment: Accepted poster at NIPS 2017 Workshop on Machine Learning for Health (https://ml4health.github.io/2017/

    Fuzzy logic: A “simple” solution for complexities in neurosciences?

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    Background: Fuzzy logic is a multi-valued logic which is similar to human thinking and interpretation. It has the potential of combining human heuristics into computer-assisted decision making, which is applicable to individual patients as it takes into account all the factors and complexities of individuals. Fuzzy logic has been applied in all disciplines of medicine in some form and recently its applicability in neurosciences has also gained momentum.Methods: This review focuses on the use of this concept in various branches of neurosciences including basic neuroscience, neurology, neurosurgery, psychiatry and psychology.Results: The applicability of fuzzy logic is not limited to research related to neuroanatomy, imaging nerve fibers and understanding neurophysiology, but it is also a sensitive and specific tool for interpretation of EEGs, EMGs and MRIs and an effective controller device in intensive care units. It has been used for risk stratification of stroke, diagnosis of different psychiatric illnesses and even planning neurosurgical procedures.Conclusions: In the future, fuzzy logic has the potential of becoming the basis of all clinical decision making and our understanding of neurosciences

    Information Systems and Healthcare XXXIV: Clinical Knowledge Management Systems—Literature Review and Research Issues for Information Systems

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    Knowledge Management (KM) has emerged as a possible solution to many of the challenges facing U.S. and international healthcare systems. These challenges include concerns regarding the safety and quality of patient care, critical inefficiency, disparate technologies and information standards, rapidly rising costs and clinical information overload. In this paper, we focus on clinical knowledge management systems (CKMS) research. The objectives of the paper are to evaluate the current state of knowledge management systems diffusion in the clinical setting, assess the present status and focus of CKMS research efforts, and identify research gaps and opportunities for future work across the medical informatics and information systems disciplines. The study analyzes the literature along two dimensions: (1) the knowledge management processes of creation, capture, transfer, and application, and (2) the clinical processes of diagnosis, treatment, monitoring and prognosis. The study reveals that the vast majority of CKMS research has been conducted by the medical and health informatics communities. Information systems (IS) researchers have played a limited role in past CKMS research. Overall, the results indicate that there is considerable potential for IS researchers to contribute their expertise to the improvement of clinical process through technology-based KM approaches

    Comparison between logistic regression and neural networks to predict death in patients with suspected sepsis in the emergency room

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    INTRODUCTION: Neural networks are new methodological tools based on nonlinear models. They appear to be better at prediction and classification in biological systems than do traditional strategies such as logistic regression. This paper provides a practical example that contrasts both approaches within the setting of suspected sepsis in the emergency room. METHODS: The study population comprised patients with suspected bacterial infection as their main diagnosis for admission to the emergency room at two University-based hospitals. Mortality within the first 28 days from admission was predicted using logistic regression with the following variables: age, immunosuppressive systemic disease, general systemic disease, Shock Index, temperature, respiratory rate, Glasgow Coma Scale score, leucocyte counts, platelet counts and creatinine. Also, with the same input and output variables, a probabilistic neural network was trained with an adaptive genetic algorithm. The network had three neurone layers: 10 neurones in the input layer, 368 in the hidden layer and two in the output layer. Calibration was measured using the Hosmer-Lemeshow goodness-of-fit test and discrimination was determined using receiver operating characteristic curves. RESULTS: A total of 533 patients were recruited and overall 28-day mortality was 19%. The factors chosen by logistic regression (with their score in parentheses) were as follows: immunosuppressive systemic disease or general systemic disease (2), respiratory rate 24–33 breaths/min (1), respiratory rate ≥ 34 breaths/min (3), Glasgow Come Scale score ≤12 (3), Shock Index ≥ 1.5 (2) and temperature <38°C (2). The network included all variables and there were no significant differences in predictive ability between the approaches. The areas under the receiver operating characteristic curves were 0.7517 and 0.8782 for the logistic model and the neural network, respectively (P = 0.037). CONCLUSION: A predictive model would be an extremely useful tool in the setting of suspected sepsis in the emergency room. It could serve both as a guideline in medical decision-making and as a simple way to select or stratify patients in clinical research. Our proposed model and the specific development method – either logistic regression or neural networks – must be evaluated and validated in an independent population
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