Health Care Chatbot Assistant System

Rasa stack consists of many open source AI apparatuses solely utilized in plan to make a logical chatbot. It consists of incredible APIs embedded along the Rasa stack that incorporates  Natural language understanding. It incorporates the sack of words calculation helping in streamlining portrayl utilized in measurable displaying and AI stages and furthermore trend setting innovation. The proposed framework is to make an option in contrast to this ordinary strategy for visiting a clinic and making a meeting with a specialist to get analysis. From the user queries chatbot will, predicts the infection and prescribes treatment along with necessary medicine. It like wise support the utilization of this RASA stage for the client specific format according to their prerequisites and furthermore elevates in building up the system for better efficiency

Strong exciton-localized plasmon coupling in a-Ge24Se76/AuNP heterostructure

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Multicenter evaluation of the clinical utility of laparoscopy-assisted ERCP in patients with Roux-en-Y gastric bypass

Background and Aims The obesity epidemic has led to increased use of Roux-en-Y gastric bypass (RYGB). These patients have an increased incidence of pancreaticobiliary diseases yet standard ERCP is not possible due to surgically altered gastroduodenal anatomy. Laparoscopic-ERCP (LA-ERCP) has been proposed as an option but supporting data are derived from single center small case-series. Therefore, we conducted a large multicenter study to evaluate the feasibility, safety, and outcomes of LA-ERCP. Methods This is retrospective cohort study of adult patients with RYGB who underwent LA-ERCP in 34 centers. Data on demographics, indications, procedure success, and adverse events were collected. Procedure success was defined when all of the following were achieved: reaching the papilla, cannulating the desired duct and providing endoscopic therapy as clinically indicated. Results A total of 579 patients (median age 51, 84% women) were included. Indication for LA-ERCP was biliary in 89%, pancreatic in 8%, and both in 3%. Procedure success was achieved in 98%. Median total procedure time was 152 minutes (IQR 109-210) with median ERCP time 40 minutes (IQR 28-56). Median hospital stay was 2 days (IQR 1-3). Adverse events were 18% (laparoscopy-related 10%, ERCP-related 7%, both 1%) with the clear majority (92%) classified as mild/moderate whereas 8% were severe and 1 death occurred. Conclusion Our large multicenter study indicates that LA-ERCP in patients with RYGB is feasible with a high procedure success rate comparable with that of standard ERCP in patients with normal anatomy. ERCP-related adverse events rate is comparable with conventional ERCP, but the overall adverse event rate was higher due to the added laparoscopy-related events

Effects of cross-section on infiltration and seepage in permeable stormwater channels

Factors affecting the infiltration rate have been studied fairly well by many researches; however, the effects of the cross-section of a permeable stormwater channel on the surface water depth reduction due to infiltration and seepage have largely been neglected. In the present study, towards improving the efficiency of permeable channels, the effects of the three components of a trapezoidal section, namely, the water depth, side slope, and base width, on the infiltration and unsteady seepage rates were investigated. Laboratory studies using models of the channel with unsaturated soil were performed under ponding condition using various initial water levels, base widths, and side slopes for two soil textures, namely, sandy loam and loamy sand. The results showed that the rate of surface water depth reduction by infiltration and seepage increases with increasing water level irrespective of the base width and side slope. In addition, an increase of the side slope increases the infiltration rate, with the effect becoming more significant with increasing initial water level, while the effect of varying the base width is insignificant

Energy Resolution Performance of the CMS Electromagnetic Calorimeter

The energy resolution performance of the CMS lead tungstate crystal electromagnetic calorimeter is presented. Measurements were made with an electron beam using a fully equipped supermodule of the calorimeter barrel. Results are given both for electrons incident on the centre of crystals and for electrons distributed uniformly over the calorimeter surface. The electron energy is reconstructed in matrices of 3 times 3 or 5 times 5 crystals centred on the crystal containing the maximum energy. Corrections for variations in the shower containment are applied in the case of uniform incidence. The resolution measured is consistent with the design goals

Selective Colorimetric Detection of Nitrite in Water using Chitosan Stabilized Gold Nanoparticles Decorated Reduced Graphene oxide

© 2017 The Author(s). Excess nitrite (NO 2 - ) concentrations in water supplies is considered detrimental to the environment and human health, and is associated with incidence of stomach cancer. In this work, the authors describe a nitrite detection system based on the synthesis of gold nanoparticles (AuNPs) on reduced graphene oxide (rGO) using an aqueous solution of chitosan and succinic acid. The AuNPs-rGO nanocomposite was confirmed by different physicochemical characterization methods including transmission electron microscopy, elemental analysis, X-ray diffraction, UV-visible (UV-vis) and Fourier transform infrared spectroscopy. The AuNPs-rGO nanocomposite was applicable to the sensitive and selective detection of NO 2 - with increasing concentrations quantifiable by UV-vis spectroscopy and obvious to the naked eye. The color of the AuNPs-rGO nanocomposite changes from wine red to purple with the addition of different concertation of NO 2 - . Therefore, nitrite ion concentrations can be quantitatively detected using AuNPs-rGO sensor with UV-vis spectroscopy and estimated with the naked eye. The sensor is able to detect NO 2 - in a linear response ranging from 1 to 20 μM with a detection limit of 0.1 μM by spectrophotometric method. The as-prepared AuNPs-rGO nanocomposite shows appropriate selectivity towards NO 2 - in the presence of potentially interfering metal anions

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years