Machine Learning Algorithms for Classification of Microcirculation Images from Septic and Non-Septic Patients

Sepsis is a life-threatening disease and one of the major causes of death in hospitals. Imaging of microcirculatory dysfunction is a promising approach for automated diagnosis of sepsis. We report a machine learning classifier capable of distinguishing non-septic and septic images from dark field microcirculation videos of patients. The classifier achieves an accuracy of 89.45%. The area under the receiver operating characteristics of the classifier was 0.92, the precision was 0.92 and the recall was 0.84. Codes representing the learned feature space of trained classifier were visualized using t-SNE embedding and were separable and distinguished between images from critically ill and non-septic patients. Using an unsupervised convolutional autoencoder, independent of the clinical diagnosis, we also report clustering of learned features from a compressed representation associated with healthy images and those with microcirculatory dysfunction. The feature space used by our trained classifier to distinguish between images from septic and non-septic patients has potential diagnostic application.Comment: Accepted for publication at 2018 IEEE International Conference on Machine Learning and Applications (IEEE ICMLA

Obstacles and Challenges to Implementing Multi-departmental QI at a Large, Academic Training Center-Lessons Learned from a HCV Screening Program

Objectives: We aimed to double the HCV screening rate of ‘baby-boomers’ admitted to the medicine teaching service at Methodist Hospital over the course of 6 months and demonstrate improved linkage to care for HCV RNA+ individuals. Initial efforts were a collaboration between Emergency Medicine, where faculty had experience implementing an HIV screening program, and Gastroenterology, a key stakeholder in linkage to care. Our pilot period coincided with new state regulations mandating that hospitals implement HCV screening for inpatients. These new regulations dramatically altered the scope and goals of the project.https://jdc.jefferson.edu/patientsafetyposters/1030/thumbnail.jp

A Methodological Study of the Use of “Aha!” Ratings in Research on Insight Problem Solving and Creativity

Creativity is often associated with people experiencing sudden flashes of inspiration and understanding. These type of experiences have been called insights or “Aha!” moments. “Aha!” moments or insightful solutions are often described as answers that suddenly appear in the mind, with little effort, and extreme confidence that the answer is correct. This can be contrasted with incremental or analytically solved problems where solutions are reached through effortful, deliberate, and strategically application of prior knowledge. Researchers have often used subjective ratings of participants’ own “Aha!” experiences to differentiate between insightful and incrementally solved problems. In the current study we investigated the construct validity of these Aha! ratings, by presenting participants with the three different aspects of the “Aha!” rating (Suddenness, Effort, and Confidence) as separate measures to see if these aspect of the solving experience were highly correlated

A novel dietary supplement containing multiple phytochemicals and vitamins elevates hepatorenal and cardiac antioxidant enzymes in the absence of significant serum chemistry and genomic changes

A novel dietary supplement composed of three well-known phytochemicals, namely, Salvia officinalis (sage) extract, Camellia sinensis (oolong tea) extract, and Paullinia cupana (guarana) extract, and two prominent vitamins (thiamine and niacin) was designed to provide nutritional support by enhancing metabolism and maintaining healthy weight and energy. The present study evaluated the safety of this dietary supplement (STG; S, sage; T, tea; G, guarana) and assessed changes in target organ antioxidant enzymes (liver, kidneys and heart), serum chemistry profiles and organ histopathology in Fisher 344 rats. Adult male and female Fisher 344 rats were fed control (no STG) or STG containing (1X and 7X, 1X = daily human dose) diets and sacrificed after 2 and 4 months. Serum chemistry analysis and histopathological examination of three vital target organs disclosed no adverse influence on protein, lipid and carbohydrate profiles, genomic integrity of the liver and/or the tissue architecture. However, analysis of the most important antioxidant components in the liver, kidney and heart homogenates revealed a dramatic increase in total glutathione concentrations, glutathione peroxidase and superoxide dismutase enzyme activities. Concomitantly, oxidative stress levels (malondialdehyde accumulation) in these three organs were less than control. Organ specific serum markers (ALT/AST for the liver; CPK/AST/LDH for the heart; BUN/creatinine for kidneys) and the genomic integrity disclosed no STG-induced alteration. Some of the serum components (lipid and protein) showed insignificant changes. Overall, STG-exposed rats were more active, and the results suggest that STG exposure produces normal serum chemistry coupled with elevated antioxidant capacity in rats fed up to seven times the normal human dose and does not adversely influence any of the vital target organs. Additionally, this study reiterates the potential benefits of exposure to a pharmacologically relevant combination of phytochemicals compared to a single phytochemical entity

Determination of sex from various measurements of human sternum and manubrium in Gujarat population

Background: Determination of sex from the skeletal remains is of immense importance in the field of forensic medicine, physical anthropometry and anthropology. Various previous studies have demonstrated sternum as an important tool for the determination of sex. Aims: Aim of the present study was to establish normal range of values for various dimensions of sternum in the studied population and evaluate the sexual dimorphism in the sternum. Material & Methods: The present study was conducted at M.P. Shah Govt. Medical College, Jamnagar on Computed tomography scans of a total of 83 adult Gujarati individuals (57 males, 26 females). Various sternal and manubrial linear measurements and indices were measured and analyzed. Results: It was found in the study that manubrial length, sterna length, manubrial width and combined length of manubrium and sternum were found to be larger in male and the difference was statistically significant. Among the various indices studied, none showed statistically significant difference between male and female. The combined length of manubrium and sternum was found to be the most accurate for determination of sex among all studied parameters, which accurately indentified 24.56% of sterna as male and 11.53% as female by the method of demarking point. Conclusion: The combined length of sternum and manubrium is the most reliable criteria for the determination of the sex of a sternum. Various indices, defined in relation to manubrium and sternum, were found to be non effective for the determination of sex of a sternum

Correlation between serum ferritin and glycaemic control in patients of type 2 diabetes mellitus: a case control study

Background: Diabetes Mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Ferritin is a ubiquitous intracellular protein complex that reflectes the iron stores of the body. Many cross-sectional studies indicate that increased body iron stores have been associated with the development of glucose intolerance, type 2 diabetes, metabolic syndrome. This study was carried out to find out the relationship between serum ferritin and type 2 diabetes and to see the influence of body iron stores on HbA1c and blood glucose.Methods: This study includes 50 patients suffering from type 2 diabetes and compared with controls at Sir T hospital, Bhavnagar. S. ferritin, Fasting Blood Sugar (FBS), Post Prandial Blood Sugar (PPBS) and HbA1c were measured.Results: Serum ferritin was significantly higher (p<0.0001) in the patients suffering from type 2 diabetes and the correlation between serum ferritin and HbA1c was positive. Patients with type 2 diabetes with increased level of serum ferritin had poor glycemic control reflected by increased levels of HBA1c (r=0.701, p<0.0001)Conclusions: There is a positive association between elevated iron stores measured by serum ferritin levels and type 2 diabetes mellitus. Ferritin levels also correlated FBS, PP2BS and HbA1c.

A Safety Assessment of the Re-opening of an Academic Medical Center Outpatient Endoscopy Unit During the COVID-19 Pandemic

This study aimed to assess outcomes and satisfaction among patients undergoing outpatient endoscopic procedures during the COVID-19 pandemic Identifying the rates of COVID-19 symptom development and post procedure testing would provide critical information on patient safety Assessment of patient experiences would serve as a guide for potential areas of improvement We predicted that with proper protocols in place, outpatient endoscopy was a safe and positive experienc

Evaluation of global composite collection reveals agronomically superior germplasm accessions for chickpea improvement

The rich genetic diversity existing within exotic, indigenous, and diverse germplasm lays the foundation for the continuous improvement of crop cultivars. The composite collection has been suggested as a gateway to identifying superior germplasm for use in crop improvement programs. Here, a chickpea global composite collection was evaluated at five locations in India over two years for five agronomic traits to identify agronomically superior accessions. The desi, kabuli, and intermediate types of chickpea accessions differed significantly for plant height (PLHT) and 100-seed weight (100 SW). In contrast, the intermediate type differed substantially from kabuli for days to maturity (DM). Several highly significant trait correlations were detected across different locations. The most stable and promising accessions from each of the five locations were prioritised based on their superior performance over the best-performing check cultivar. Accordingly, the selected germplasm accessions of desi type showed up to 176% higher seed yield (SY), 29% lower flowering time, 21% fewer maturity days, 64% increase in PLHT, and 183% larger seeds than the check cultivar JG11 or Annigeri. The prioritised kabuli accessions displayed up to 270% more yield, 13% less flowering time, 8% fewer maturity days, 111% increase in PLHT, and 41% larger seeds over the check cultivar KAK2. While the intermediate type accessions had up to 169% better yield, 1% early flowering, 3% early maturity, 54% taller plants, and 25% bigger seeds over the check cultivar JG 11 or KAK2. These accessions can be utilised in chickpea improvement programs to develop high-yielding, early flowering, short duration, taller, and large-seeded varieties with a broad genetic base

Time Value Analysis of Inpatient Endoscopy Workflow

Aims for Improvement Our aim was to evaluate the variables involved in room turnover and identify any delays that lead to the time difference found between inpatient and outpatient rooms. We planned to design an intervention to improve efficiency in the endoscopy suite and complete more inpatient cases. We predicted that completion of more inpatient cases would subsequently decrease the need for cancellation and rescheduling of medically necessary cases on a daily basis