Decision support methods in diabetic patient management by insulin administration neural network vs. induction methods for knowledge classification

Diabetes mellitus is now recognised as a major worldwide public health problem. At present, about 100 million people are registered as diabetic patients. Many clinical, social and economic problems occur as a consequence of insulin-dependent diabetes. Treatment attempts to prevent or delay complications by applying ‘optimal’ glycaemic control. Therefore, there is a continuous need for effective monitoring of the patient. Given the popularity of decision tree learning algorithms as well as neural networks for knowledge classification which is further used for decision support, this paper examines their relative merits by applying one algorithm from each family on a medical problem; that of recommending a particular diabetes regime. For the purposes of this study, OC1 a descendant of Quinlan’s ID3 algorithm was chosen as decision tree learning algorithm and a generating shrinking algorithm for learning arbitrary classifications as a neural network algorithm. These systems were trained on 646 cases derived from two countries in Europe and were tested on 100 cases which were different from the original 646 cases

Preliminary results of high resolution paleoceanography and paleoclimatology during sapropel S1 deposition (South Limnos Basin, North Aegean Sea).

Οι παλαιοπεριβαλλοντικές συνθήκες κατά τη διάρκεια απόθεσης του σαπροπηλού S1 στο Βόρειο Αιγαίο (πυρήνας βαρύτητας Μ-4, μήκους 2,53 m, λεκάνης νότιας Λήμνου) προσδιορίζονται με βάση την ποσοτική ανάλυση μικροπαλαιοντολογικών (βενθονικά και πλαγκτονικά τρηματοφόρα) και γεωχημικών (OC, δ13Corg) δεικτών. Χαρακτηριστικό του πυρήνα Μ-4 είναι η μεγάλη εμφάνιση του S1 που φτάνει το πάχος των 96 cm. Η μελέτη κατέδειξε ότι, το κατώτερο σαπροπηλικό στρώμα S1a αποτέθηκε σε θερμότερες συνθήκες, εντονότερης δυσοξίας, σε σχέση με το ανώτερο σαπροπηλικό στρώμα S1b.. Αύξηση της παραγωγικότητας και καλύτερη διατήρηση του οργανικού υλικού πιστοποιήθηκαν στο κατώτερο τμήμα του S1. Η διακοπή των σαπροπηλικών συνθηκών στα 8,0 Ka BP που χαρακτηρίζεται κυρίως από την αύξηση της σχετικής συχνότητας των συμφυρματοπαγών μορφών των βενθονικών τρηματοφόρων υποστηρίζει συνθήκες υψηλής οξυγόνωσης του πυθμένα και εισροή γλυκών υδάτων.The paleoenviromental conditions during the depositional interval of sapropel S1 in the northeastern Aegean (gravity core M-4, length 2.53 m; south Limnos basin) are studied based on quantitative micropaleontological (benthic and planktonic foraminifera) and geochemical (OC, δ13Corg) analyses. Special feature of core M-4 is the thickness of S1 layer (96 cm). Our study points that sapropelic layer S1a has been deposited in more dysoxic and warmer conditions in respect to S1b. Both primary productivity and preservation of organic material are more intense during the lower part of S1. An interruption of the sapropelic conditions at 8.0 Ka BP which is mainly characterized by the increase of agglutinated foraminiferal forms confirms both higher oxygen bottom conditions and freshwater input

Causes and Pathogenesis of Malignant Mesothelioma

Malignant mesothelioma (MM) is a malignancy that arises from the mesothelium, a thin layer of tissue that covers the body’s serous cavities, such as the pleural, peritoneal, pericardial, and tunica vaginalis of the testis. More than 80% of all mesothelioma cases originate from the pleura and approximately 75–80% of patients are males. It is almost always fatal with most of those affected dying within a year of diagnosis. Asbestos exposure is the most common cause of MM, which mostly affects the pleura. Various factors, including other mineral fibers, carbon nanotubes, or genetic mutations, are also suggested to have a role in the development of MM. The involvement of asbestos, other mineral fibers, nanotechnological products, the simian virus SV40, ionizing radiation, genetic factors, and inflammation in the development of MM has been discussed in this chapter. This study focuses on the role of other mineral fibers, such as erionite, fluoroedenite, balangeroite, and carbon nanotubes, as well as genetic mutations in BAP1 and other genes, in the pathogenesis of MM. The etiology of MM is considered to be complex, and greater knowledge of the pathogenetic pathways may lead to the identification of effective and personalized treatment targets

Mediterranean circulation perturbations over the last five centuries: Relevance to past Eastern Mediterranean Transient-type events

The Eastern Mediterranean Transient (EMT) occurred in the Aegean Sea from 1988 to 1995 and is the most significant intermediate-to-deep Mediterranean overturning perturbation reported by instrumental records. The EMT was likely caused by accumulation of high salinity waters in the Levantine and enhanced heat loss in the Aegean Sea, coupled with surface water freshening in the Sicily Channel. It is still unknown whether similar transients occurred in the past and, if so, what their forcing processes were. In this study, sediments from the Sicily Channel document surface water freshening (SCFR) at 1910 ± 12, 1812 ± 18, 1725 ± 25 and 1580 ± 30 CE. A regional ocean hindcast links SCFR to enhanced deep-water production and in turn to strengthened Mediterranean thermohaline circulation. Independent evidence collected in the Aegean Sea supports this reconstruction, showing that enhanced bottom water ventilation in the Eastern Mediterranean was associated with each SCFR event. Comparison between the records and multi-decadal atmospheric circulation patterns and climatic external forcings indicates that Mediterranean circulation destabilisation occurs during positive North Atlantic Oscillation (NAO) and negative Atlantic Multidecadal Oscillation (AMO) phases, reduced solar activity and strong tropical volcanic eruptions. They may have recurrently produced favourable deep-water formation conditions, both increasing salinity and reducing temperature on multi-decadal time scales

Physical forcing and physical/biochemical variability of the Mediterranean Sea: a review of unresolved issues and directions for future research

This paper is the outcome of a workshop held in Rome in November 2011 on the occasion of the 25th anniversary of the POEM (Physical Oceanography of the Eastern Mediterranean) program. In the workshop discussions, a number of unresolved issues were identified for the physical and biogeochemical properties of the Mediterranean Sea as a whole, i.e., comprising the Western and Eastern sub-basins. Over the successive two years, the related ideas were discussed among the group of scientists who participated in the workshop and who have contributed to the writing of this paper. Three major topics were identified, each of them being the object of a section divided into a number of different sub-sections, each addressing a specific physical, chemical or biological issue: 1. Assessment of basin-wide physical/biochemical properties, of their variability and interactions. 2. Relative importance of external forcing functions (wind stress, heat/moisture fluxes, forcing through straits) vs. internal variability. 3. Shelf/deep sea interactions and exchanges of physical/biogeochemical properties and how they affect the sub-basin circulation and property distribution. Furthermore, a number of unresolved scientific/methodological issues were also identified and are reported in each sub-section after a short discussion of the present knowledge. They represent the collegial consensus of the scientists contributing to the paper. Naturally, the unresolved issues presented here constitute the choice of the authors and therefore they may not be exhaustive and/or complete. The overall goal is to stimulate a broader interdisciplinary discussion among the scientists of the Mediterranean oceanographic community, leading to enhanced collaborative efforts and exciting future discoveries

Towards sustainability in cold chains: Development of a quality, energy and environmental assessment tool (QEEAT)

Quantification of the impact of refrigeration technologies in terms of the quality of refrigerated food, energy usage, and environmental impact is essential to assess cold chain sustainability. In this paper, we present a software tool QEEAT (Quality, Energy and Environmental Assessment Tool) for evaluating refrigeration technologies. As a starting point, a reference product was chosen for the different main food categories in the European cold chain. Software code to predict the products temperature, based on validated heat and mass transfer models, were written in Matlab (The Mathworks Inc., Natick, USA). Also, based on validated kinetic models for the different quality indicators of the reference products, (including fruit, meat, fish, vegetables and dairy products) a software code was written to calculate the quality and safety evolutions of the food product, using the predicted product temperature as input. Finally, software code to calculate the energy usage and Total Equivalent Warming Impact (TEWI) value of different refrigeration technologies was also written in Matlab. All three software codes were integrated, and a graphical user interface was developed. Using the QEEAT, a user can tailor a cold chain scenario by adding cold chain blocks (different steps of a cold chain) and simulating the quality evolution, energy use and emission throughout the chain. Also, the user can modify properties of a cold chain block, by selecting different technologies, or changing set point values. Defaults are provided for input values, and are based on the current practice, and obtained by extensive literature studies and consultation with different experts of the cold chain. Furthermore, the user can build and simulate several chains simultaneously, allowing him/her to compare different chains with respect to quality, energy and emission

Longitudinal Analysis of the Temporal Evolution of Acinetobacter baumannii Strains in Ohio, USA, by Using Rapid Automated Typing Methods

Genotyping methods are essential to understand the transmission dynamics of Acinetobacter baumannii. We examined the representative genotypes of A. baumannii at different time periods in select locations in Ohio, using two rapid automated typing methods: PCR coupled with electrospray ionization mass spectrometry (PCR/ESI-MS), a form of multi-locus sequence typing (MLST), and repetitive-sequence-based-PCR (rep-PCR). Our analysis included 122 isolates from 4 referral hospital systems, in 2 urban areas of Ohio. These isolates were associated with outbreaks at 3 different time periods (1996, 2000 and 2005–2007). Type assignments of PCR/ESI-MS and rep-PCR were compared to each other and to worldwide (WW) clone types. The discriminatory power of each method was determined using the Simpson's index of diversity (DI). We observed that PCR/ESI-MS sequence type (ST) 14, corresponding to WW clone 3, predominated in 1996, whereas ST 12 and 14 co-existed in the intermediate period (2000) and ST 10 and 12, belonging to WW clone 2, predominated more recently in 2007. The shift from WW clone 3 to WW clone 2 was accompanied by an increase in carbapenem resistance. The DI was approximately 0.74 for PCR/ESI-MS, 0.88 for rep-PCR and 0.90 for the combination of both typing methods. We conclude that combining rapid automated typing methods such as PCR/ESI-MS and rep-PCR serves to optimally characterize the regional molecular epidemiology of A. baumannii. Our data also sheds light on the changing sequence types in an 11 year period in Northeast Ohio