Deployment and validation of an AI system for detecting abnormal chest radiographs in clinical settings

BackgroundThe purpose of this paper is to demonstrate a mechanism for deploying and validating an AI-based system for detecting abnormalities on chest X-ray scans at the Phu Tho General Hospital, Vietnam. We aim to investigate the performance of the system in real-world clinical settings and compare its effectiveness to the in-lab performance.MethodThe AI system was directly integrated into the Hospital's Picture Archiving and Communication System (PACS) after being trained on a fixed annotated dataset from other sources. The system's performance was prospectively measured by matching and comparing the AI results with the radiology reports of 6,285 chest X-ray examinations extracted from the Hospital Information System (HIS) over the last 2 months of 2020. The normal/abnormal status of a radiology report was determined by a set of rules and served as the ground truth.ResultsOur system achieves an F1 score—the harmonic average of the recall and the precision—of 0.653 (95% CI 0.635, 0.671) for detecting any abnormalities on chest X-rays. This corresponds to an accuracy of 79.6%, a sensitivity of 68.6%, and a specificity of 83.9%.ConclusionsComputer-Aided Diagnosis (CAD) systems for chest radiographs using artificial intelligence (AI) have recently shown great potential as a second opinion for radiologists. However, the performances of such systems were mostly evaluated on a fixed dataset in a retrospective manner and, thus, far from the real performances in clinical practice. Despite a significant drop from the in-lab performance, our result establishes a reasonable level of confidence in applying such a system in real-life situations

The process of postmerger integration : a review and agenda for future research

Mergers and acquisitions (M&As) continue to be prevalent despite frequently yielding disappointing outcomes. Postmerger integration plays a critical role in M&A success, yet many questions about M&A implementation remain unanswered. In this article, we review research on postmerger integration, which we organize around strategic integration, sociocultural integration, and experience and learning. We then lay out a research agenda that centers on expanding our understanding of processual dynamics in postmerger integration. We focus on opportunities related to temporality, decision-making, practices and tools, and emotionality

Molecular Histopathology and Cytopathology in Cardiovascular Diseases

In this chapter, we describe the most deadly heart diseases, including the fourth parts: Anatomy of the heart, chronic coronary syndrome and acute coronary syndrome and STEMI, Cardiomyopathy, and Pulmonary embolism. The written structure of a component includes Abstract, Pathophysiology, Clinical diagnostic criteria, histopathology, and cytopathology. The content is summarized based on the recommendations of the American Heart Association and the European Society of Cardiology. All images in this chapter are data at our center. In the chapter, we will see the relationship between histopathology and cytopathology and pathophysiology, which will serve as a basis for us to have more studies in the future

A study on multi-criteria decision-making in powder mixed electric discharge machining cylindrical shaped parts

In life as well as in engineering, many times, it is necessary to choose the best option among many different options. That will be more difficult when the criteria given for the selection contradict each other. For example, when external cylindrical grinding, the minimum surface roughness requirement necessitates a small depth of cut and feed rate. The material removal rate will be reduced in this case, and this requirement will conflict with the maximum material removal rate requirement. To solve the above problem, a very useful tool is multi-criteria decision-making (MCDM). In this paper, for the first time, MCDM results for powder mixed discharge machining (PMEDM) cylindrical parts of SKD11 tool steel with copper electrodes have been presented. In this work, eighteen experiments with the L18 (16×53) design using the Taguchi method were conducted. Six main input process parameters include the powder concentration, the pulse current, the servo voltage, the pulse on time, and the pulse off time. To select an alternative that simultaneously ensures two criteria including minimum surface roughness (RS) and maximum material removal speed (MRS), four different MCDM methods including MAIRCA (Multi-Attributive Ideal-Real Comparative Analysis), MARCOS (Measurement of Alternatives and Ranking according to Compromise Solution), TOPSIS (Technique for order of preference by similarity to ideal solution), and EAMR (Area-based Method of Ranking) and two methods of criteria weight calculation including MEREC (Method based on the Removal Effects of Criteria) and Entropy methods were selected. The results of MCDM when PMEDM SKD11 tool steel cylindrical parts with two methods for weight determination and four methods for solving MCDM problem were evaluated. In addition, the best alternative to ensure simultaneous minimum RS and maximum MRS was proposed

Exploiting Context-Aware Event Data for Fault Analysis

Fault analysis in communication networks and distributed systems is a difficult process that heavily depends on system administrator’s experience and supporting tools. This process usually requires analytic techniques and several types of event data including log events, debug messages, trace obtained from these systems to investigate the root cause of faults. This paper introduces an approach of exploiting context-aware data and classification technique for improving this process. This approach uses both event data and context-aware data including CPU load, memory, processes, temperature, status to train a decision tree, and then applies the tree to assess suspected events. We have implemented and experimented the approach on the OpenStack cloud computing system with the Hadoop computing service and MELA event collection system. The experimental results reveal that the accuracy score of the approach reaches 85% on average. The paper also includes detailed analysis for the results

Dexamethasone and long-term outcome of tuberculous meningitis in Vietnamese adults and adolescents.

BACKGROUND: Dexamethasone has been shown to reduce mortality in patients with tuberculous meningitis but the long-term outcome of the disease is unknown. METHODS: Vietnamese adults and adolescents with tuberculous meningitis recruited to a randomised, double-blind, placebo-controlled trial of adjunctive dexamethasone were followed-up at five years, to determine the effect of dexamethasone on long-term survival and neurological disability. RESULTS: 545 patients were randomised to receive either dexamethasone (274 patients) or placebo (271 patients). 50 patients (9.2%) were lost to follow-up at five years. In all patients two-year survival, probabilities tended to be higher in the dexamethasone arm (0.63 versus 0.55; p = 0.07) but five-year survival rates were similar (0.54 versus 0.51, p = 0.51) in both groups. In patients with grade 1 TBM, but not with grade 2 or grade 3 TBM, the benefit of dexamethasone treatment tended to persist over time (five-year survival probabilities 0.69 versus 0.55, p = 0.07) but there was no conclusive evidence of treatment effect heterogeneity by TBM grade (p = 0.36). The dexamethasone group had a similar proportion of severely disabled patients among survivors at five years as the placebo group (17/128, 13.2% vs. 17/116, 14.7%) and there was no significant association between dexamethasone treatment and disability status at five years (p = 0.32). CONCLUSIONS: Adjunctive dexamethasone appears to improve the probability of survival in patients with TBM, until at least two years of follow-up. We could not demonstrate a five-year survival benefit of dexamethasone treatment which may be confined to patients with grade 1 TBM. TRIAL REGISTRATION: ClinicalTrials.gov NCT01317654

Assessment of physical land suitability by GIS-based fuzzy AHP for rubber plantation at the Nam Dong district, Thua Thien Hue province

This research was conducted to determine the main influences and physical factors of land suitability for rubber plantation in the Nam Dong district, Thua Thien Hue province. Six factors such as soil type, soil texture, soil thickness, slope, soil pH and soil organic matter content were considered. Results indicate that soil thickness is has the highest role on the land suitability analysis while soil pH has the lowest. The physical land suitability of rubber plantation was divided into 4 levels: very suitable (10.1%), suitable (15.5%), slightly suitable (3.6%), and currently not suitable (70,8%). This research provides important information for rubber cultivation in projected agricultural land use planning of the Nam Dong district.Nghiên cứu này được thực hiện nhằm xác định sự ảnh hưởng của các yếu tố tự nhiên đến sự thích nghi đất đai của loại hình sử dụng đất trồng cây cao su trên địa bàn huyện Nam Đông, tỉnh Thừa Thiên Huế. Có 6 yếu tố được xem xét trong nghiên cứu này bao gồm: loại đất, thành phần cơ giới, tầng dày canh tác, độ dốc, độ chua và hàm lượng mùn trong đất. Kết quả nghiên cứu chỉ ra rằng tầng dày canh tác là yếu tố có ảnh hưởng lớn nhất đến việc sử dụng đất trồng cây cao su, trong khi đó độ chua là yếu tố có ảnh hưởng ít nhất. Sự thích nghi tự nhiên của loại hình sử dụng đất trồng cây cao su được chia thành 4 mức độ bao gồm rất thích nghi (10,1%), thích nghi (15,5%), tương đối thích nghi (3,6%) và hiện taị không thích nghi (70,8%). Nghiên cứu này cung cấp những thông tin cần thiết và hữu ích cho việc quy hoạch sử dụng đất trồng cây cao su trên địa bàn huyện Nam Đông

Dexamethasone and Long-Term Outcome of Tuberculous Meningitis in Vietnamese Adults and Adolescents

BACKGROUND: Dexamethasone has been shown to reduce mortality in patients with tuberculous meningitis but the long-term outcome of the disease is unknown. METHODS: Vietnamese adults and adolescents with tuberculous meningitis recruited to a randomised, double-blind, placebo-controlled trial of adjunctive dexamethasone were followed-up at five years, to determine the effect of dexamethasone on long-term survival and neurological disability. RESULTS: 545 patients were randomised to receive either dexamethasone (274 patients) or placebo (271 patients). 50 patients (9.2%) were lost to follow-up at five years. In all patients two-year survival, probabilities tended to be higher in the dexamethasone arm (0.63 versus 0.55; p = 0.07) but five-year survival rates were similar (0.54 versus 0.51, p = 0.51) in both groups. In patients with grade 1 TBM, but not with grade 2 or grade 3 TBM, the benefit of dexamethasone treatment tended to persist over time (five-year survival probabilities 0.69 versus 0.55, p = 0.07) but there was no conclusive evidence of treatment effect heterogeneity by TBM grade (p = 0.36). The dexamethasone group had a similar proportion of severely disabled patients among survivors at five years as the placebo group (17/128, 13.2% vs. 17/116, 14.7%) and there was no significant association between dexamethasone treatment and disability status at five years (p = 0.32). CONCLUSIONS: Adjunctive dexamethasone appears to improve the probability of survival in patients with TBM, until at least two years of follow-up. We could not demonstrate a five-year survival benefit of dexamethasone treatment which may be confined to patients with grade 1 TBM. TRIAL REGISTRATION: ClinicalTrials.gov NCT01317654