Fine-grained sentiment analysis for measuring customer satisfaction using an extended set of fuzzy linguistic hedges

© 2020 The Authors. Published by Atlantis Press SARL. In recent years, the boom in social media sites such as Facebook and Twitter has brought people together for the sharing of opinions, sentiments, emotions, and experiences about products, events, politics, and other topics. In particular, sentiment-based applications are growing in popularity among individuals and businesses for the making of purchase decisions. Fuzzy-based sentiment analysis aims at classifying customer sentiment at a fine-grained level. This study deals with the development of a fuzzy-based sentiment analysis by extending fuzzy hedges and rule-sets for a more efficient classification of customer sentiment and satisfaction. Prior studies have used a limited number of linguistic hedges and polarity classes in their rule-sets, resulting in the degraded efficiency of their fuzzy-based sentiment analysis systems. The proposed analysis of the current study classifies customer reviews using fuzzy linguistic hedges and an extended rule-set with seven sentiment analysis classes, namely extremely positive, very positive, positive, neutral, negative, very negative, and extremely negative. Then, a fuzzy logic system is applied to measure customer satisfaction at a fine-grained level. The experimental results demonstrate that the proposed analysis has an improved performance over the baseline works

Facial expression recognition using lightweight deep learning modeling

Facial expression is a type of communication and is useful in many areas of computer vision, including intelligent visual surveillance, human-robot interaction and human behavior analysis. A deep learning approach is presented to classify happy, sad, angry, fearful, contemptuous, surprised and disgusted expressions. Accurate detection and classification of human facial expression is a critical task in image processing due to the inconsistencies amid the complexity, including change in illumination, occlusion, noise and the over-fitting problem. A stacked sparse auto-encoder for facial expression recognition (SSAE-FER) is used for unsupervised pre-training and supervised fine-tuning. SSAE-FER automatically extracts features from input images, and the softmax classifier is used to classify the expressions. Our method achieved an accuracy of 92.50% on the JAFFE dataset and 99.30% on the CK+ dataset. SSAE-FER performs well compared to the other comparative methods in the same domain

Mortality risk of long-term amiodarone therapy for atrial fibrillation patients without structural heart disease

Background: Amiodarone is often prescribed in the management of atrial fibrillation (AF) but is known to cause significant end-organ toxicities. In this study, we examined the impact of amiodarone on all-cause mortality in AF patients with structurally normal hearts. Methods: We performed a retrospective cohort analysis of all AF patients with structurally normal hearts who were prescribed antiarrhythmic drugs (AAD) for rhythm control of AF at our institution from 2006 to 2013 (n = 2,077). Baseline differences between the amiodarone (AMIO: n = 403) and other AADs (NON-AMIO: n = 1,674) groups were corrected for using propensity score matching. Results: Amiodarone use as first-line therapy decreased significantly with a higher degree of prescriber specialization in arrhythmia management (31%, 22%, and 9% for primary care physicians, general cardiologists and cardiac electrophysiologists, respectively, p < 0.001). After propensity score matching, baseline comorbidities were balanced between the AMIO and NON-AMIO groups. Over a median follow-up of 28.2 months (range 6.0–100.9 months), amiodarone was associated with increased all-cause (HR 2.41, p = 0.012) and non-cardiac (HR 3.55, p = 0.008) mortality, but not cardiac mortality. AF recurrence and cardiac hospi­talizations were similar between the two study groups. Conclusions: Amiodarone treatment of AF is associated with increased mortality in patients without structural heart disease and therefore should be avoided or only used as a second-line therapy, when other AF therapies fail. Adherence to guideline recommendations in the management of AF patients impacts clinical outcome

Complete Pacemaker Lead Fracture after a Theme Park Ride

Fracture of a pacemaker lead is one of the most common causes of pacemaker malfunction. Lead fractures are seen in approximately 4 % of patients with pacemakers. We present a rare case of complete severance of the tip of a dual chamber pacemaker atrial lead. A 62 years old male presented for a routine device check of his pacemaker, which was originally implanted in 2002 for sick sinus syndrome and had a generator change in 2010. Device check showed a dual chamber pacemaker with right atrial and right ventricular leads and a remaining battery life of 8.6 years. Patient was not pacemaker dependent. Ventricular lead showed normal sensing, impedance and pacing threshold. Atrial lead showed unusually high impedance of 2175 ohms and no capture on testing at voltages as high as 7.5 mV. Further evaluation was done due to abnormal atrial lead test. An EKG was obtained showing normal sinus rhythm and atrial pacing spikes with no capture. Chest X-ray revealed a complete severance and dislocation of the atrial lead tip and an intact ventricular lead. A detailed history was obtained, and patient denied any trauma to the chest or upper extremities, chest pain, shortness of breath, palpitations, syncope or presyncope. Upon further history, patient reported a recent visit to theme park and enjoying high thrill rides. On examination, there were no signs of trauma, erythema, swelling, warmth, drainage or erosion at implant site. The pacemaker setting was changed from DDDR to VVIR, with plans to cap the proximal port of the fractured lead and placing a new atrial lead. Pacemaker lead fractures are reported with an incidence rate of 0.1 to 4.2 % per patient year [1]. The most common site of lead fracture is at the site of entry (40%) followed by between the entry site and generator (28%), close to the generator site (23%) and only (7%) are intravascular fractures [1]. Trauma and subclavian crush syndrome are the most commonly reported causes of pacemaker lead fractures. Pacemaker lead fracture due to physical exertion is an uncommon cause of lead malfunction [2]. Few cases have been reported of traumatic lead fracture due to the blunt chest trauma [3]. Patients with a lead fracture may present with symptoms of dizziness, syncope, chest discomfort, palpitations or, less commonly extra cardiac symptoms like hiccups or may completely be asymptomatic as seen in our patient. Diagnosis can be made by electrogram during device check, ECG and careful review of chest imaging such as chest x ray or fluoroscopy. Treatment is placement of a new lead with or without extraction of the fractured lead. This rare case of pacemaker lead fracture after a theme park ride indicates there may be a risk to pacemaker leads with high velocity amusement park rides which are becoming popular. This may have clinical implications such as a need for caution during amusement park visits and routine pacemaker interrogations after such visits especially in pacemaker dependent patients. References: 1: Alt E, Völker R, Blömer H: Lead fracture in pacemaker patients. Thorac Cardiovasc Surg.1987, 35:101-4.10.1055/s-2007-1020206 2: ohm J: Displacement and fracture of pacemaker electrode during physical exertion. Report on three cases. Acta Med Scand.1972, 192:33-5.10.1111/j.0954-6820.1972.tb04774 3: Bőhm A1, Duray G, Kiss RG: Traumatic Pacemaker lead fracture. Emerg Med J.2013, 30:686.10.1136/emermed-2012-202090

Risk Stratification for Transcatheter Aortic Valve Replacement

Risk assessment models developed from administrative and clinical databases are used for clinical decision making. Since these models are derived from a database, they have an inherent limitation of being as good as the data they are derived from. Many of these models under or overestimate certain clinical outcomes particularly mortality in certain group of patients. Undeniably, there is significant variability in all these models on account of patient population studied, the statistical analysis used to develop the model and the period during which these models were developed. This review aims to shed light on development and application of risk assessment models for cardiac surgery with special emphasis on risk stratification in severe aortic stenosis to select patients for transcatheter aortic valve replacement

A Rare Case of Complete Fragmentation of Pacemaker Lead after a High-Velocity Theme Park Ride

Pacemaker lead fracture is one of the most common causes of pacemaker malfunction and is most frequently associated with weight lifting or chest trauma. These patients usually present with symptoms of dizziness, syncope, chest discomfort, and palpitations or less commonly with extracardiac symptoms. Diagnosis is made by ECG and careful review of chest imaging such as chest X-ray or fluoroscopy. Treatment involves placement of a new lead with or without extraction of the fractured lead. We present an interesting case of complete severance of the tip of a dual-chamber pacemaker’s atrial lead after a high-velocity theme park ride. In our case, the fracture occurred during amusement park rides and went undiagnosed until the patient presented for routine pacemaker evaluation. This case indicates that extreme physical forces in the absence of direct trauma, such as during amusement park rides, may result in lead fractures and patients with pacemakers should be cautioned regarding such activities

Rate and predictors of electrical failure in non-recalled defibrillator leads

Background: Implantable cardioverter defibrillator (ICD) leads are considered as the ‘weakest link’ in defibrillator systems due to FDA recalls and advisories involving popular lead models from major manufacturers. The rate of electrical failure of ICD leads not implicated in a recall is however not well determined. Methods: Medical records of patients implanted with ICDs at hospitals of the University of Pittsburgh Medical Center between 2002 and 2014 were analyzed. Leads were classified as having electrically failed if removed or replaced for reasons other than infection or heart transplantation. Patients were followed to endpoint of death or electrical lead failure. Results: 2410 consecutive ICD recipients (mean age 66 ± 13 years, women 22%, single/dual/biventricular-ICD 20%/44%/36%) were included. During a mean follow-up of 3.9 ± 3.3 years, 1272 patients (53%) died, 55 patients (2.3%) had ICD lead electrical failure, and 1052 (44%) patients were alive with functional leads at the time of last follow-up. Patients with failed leads had higher BMI (p = 0.07), better functional status (p = 0.04), higher serum creatinine (p = 0.004), wider QRS complex (p = 0.01), higher number of implanted leads (p = 0.06) and were more likely to have ischemic cardiomyopathy (p = 0.03). After adjusting for these variables in a binary logistic regression model, only a lower BMI, presence of non-ischemic cardiomyopathy, and a better functional status remained independently predictive of electrical failure. Conclusions: Only 2.3% of non-recalled ICD leads experience electrical failure (annual failure rate of 0.6%). A higher patient functional status, lower BMI, and non-ischemic etiology of cardiomyopathy are independently associated with higher rates of ICD lead failure. Keywords: Defibrillator, Leads, Electrical failure, Recall, Predictor

Some challenges in progressive control of livestock originated zoonotic diseases in Pakistan–a pilot survey

Objective: To document the recent livestock related practices and possible unhygienic ways of pathogen entry. Identification of the potential risk factors for the spread of infection is important to design an evidence-based disease control programme. Methods: Rapid assessment method was adopted and a purposive sample of 60 dairy farmers were interviewed. The following factors were noted for contributing in primary and secondary transmission of zoonotic infections: (i) persons who come in close contact with animals and their secretions, (ii) management strategies of farm animals (sheds and environment), (iii) management practices adopted at farms, (iv) small scale farmers and rural livestock production systems, (v) milk collection systems. Results: This research unveiled the certain routes of zoonotic disease transmission. Certain management practices, precautionary measures and strategies were the pivotal risk factors. Conclusions: The study emphasizes the need to educate the poor livestock keepers

Takotsubo Cardiomyopathy Mimicking Stent Thrombosis After Percutaneous Coronary Intervention

Takotsubo cardiomyopathy, also known as “broken heart syndrome,” is a transient left ventricular dysfunction associated with stress (usually emotional) induced myocardial injury and stunning. It often presents as myocardial infarction on surface electrocardiogram (EKG). Diagnosis is made by coronary angiography, which rules out coronary artery disease and shows pathognomonic apical ballooning. In this article, we present a case of a 72-year-old woman who initially presented with an ST segment elevation myocardial infarction on EKG. Coronary angiography showed severe left anterior descending artery and diagonal lesions requiring percutaneous coronary intervention. Post–percutaneous coronary intervention, EKG changes resolved. The next day, the patient developed recurrent chest pain and her EKG showed diffuse T-wave inversion in precordial leads with reemerging ST segment elevations concerning for stent thrombosis. The patient underwent repeat emergent coronary angiography, which showed patent stents and findings consistent with takotsubo cardiomyopathy