Enhancing Parkinson's disease diagnosis accuracy through speech signal algorithm modeling

Parkinson's disease (PD), one of whose symptoms is dysphonia, is a prevalent neurodegenerative disease. The use of outdated diagnosis techniques, which yield inaccurate and unreliable results, continues to represent an obstacle in early-stage detection and diagnosis for clinical professionals in the medical field. To solve this issue, the study proposes using machine learning and deep learning models to analyze processed speech signals of patients' voice recordings. Datasets of these processed speech signals were obtained and experimented on by random forest and logistic regression classifiers. Results were highly successful, with 90% accuracy produced by the random forest classifier and 81.5% by the logistic regression classifier. Furthermore, a deep neural network was implemented to investigate if such variation in method could add to the findings. It proved to be effective, as the neural network yielded an accuracy of nearly 92%. Such results suggest that it is possible to accurately diagnose early-stage PD through merely testing patients' voices. This research calls for a revolutionary diagnostic approach in decision support systems, and is the first step in a market-wide implementation of healthcare software dedicated to the aid of clinicians in early diagnosis of PD

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Modeling and simulation of short channel length effect in open drain MOSFET THz detectors

Abstract THz radiation detection using FET devices has attracted increasing attention lately. In this paper, we further study a simulated model of FET rectification detection in short channel length. To achieve this, both physics-based analytic model and a detailed TCAD simulation were contacted and compared. The analytical model provided detailed dependence of the response on the channel length below the extension length of the radiation. However, the simulation results were validated by comparison with the experimental data to confirm the validity of the theoretical model. These results present a new model of rectification for short channel lengths and its dependence on the extinction of AC signal through the channel

Magnetohydrodynamic Peristaltic Flow of Jeffry Nanofluid with Heat Transfer Through a Porous Medium in a Vertical Tube

The present paper deals with the peristaltic motion of a non-Newtonian nanofluid with heat transfer through a porous medium inside a vertical tube. The system is stressed by a uniform magnetic field. The viscous dissipation, internal heat generation with radiation effects are considered. A Rung-Kutta-Merson method and a Newton iteration in a shooting and matching technique are used to find the solutions of the momentum, temperature and nanoparticles equations. The numerical formula of the axial velocity, temperature and nanoparticles are obtained as functions of the physical parameters of the problem. Numerical calculations are carried out for these formula. The effects of physical parameters of the problem on this formula are discussed numerically and illustrated graphically througth a set of figures

A novel isatin Schiff based cerium complex: synthesis, characterization, antimicrobial activity and molecular docking studies

Abstract In this work, a novel isatin-Schiff base L2 had been synthesized through a simple reaction between isatin and 2-amino-5-methylthio-1,3,4-thiadiazole. The produced Schiff base L2 was then subjected to a hydrothermal reaction with cerium chloride to produce the cerium (III)-Schiff base complex C2. Several spectroscopic methods, including mass spectra, FT-IR, elemental analysis, UV–vis, 13C-NMR, 1H-NMR, Thermogravimetric Analysis, HR-TEM, and FE-SEM/EDX, were used to completely characterize the produced L2 and C2. A computer simulation was performed using the MOE software program to find out the probable biological resistance of studied compounds against the proteins in some types of bacteria or fungi. To investigate the interaction between the ligand and its complex, we conducted molecular docking simulations using the molecular operating environment (MOE). The docking simulation findings revealed that the complex displayed greater efficacy and demonstrated a stronger affinity for Avr2 effector protein from the fungal plant pathogen Fusarium oxysporum (code 5OD4) than the original ligand. The antibacterial activity of the ligand and its Ce3+ complex were applied in vitro tests against different microorganism. The study showed that the complex was found to be more effective than the ligand

Additional file 1 of A novel isatin Schiff based cerium complex: synthesis, characterization, antimicrobial activity and molecular docking studies

Additional file 1: Fig. S1. The FT-IR spectra of Schiff base L2, and Ce(III)-complex C2. Fig. S2. The electronic absorption spectra of Schiff base L2, and Ce(III)-complex C2. Fig. S3. The 1H-NMR spectrum of Schiff base L2. Fig. S4. The 1H-NMR spectrum of Ce(III)-complex C2. Fig. S5. The 13C-NMR spectrum of Schiff base L2. Fig. S6. The 13C-NMR spectrum of Ce(III)-complex C2. Fig. S7. The mass spectrum of Schiff base L2. Scheme S1. The proposed fragmentation Scheme of Schiff base L2. Fig. S8. The mass spectrum of Ce(III)-complex C2. Scheme S2. The proposed fragmentation Scheme of the Ce(III)-complex C2. Fig. S9. DTA and TGA curves of Ce(III)-Schiff base complex (C2). Fig. S10. EDX images: [a–b] of Schiff base L2 and Ce(III)-complex C2. Table S1. Decomposition steps with the temperature range and weight loss for Ce(III)-Schiff base complex (C2). Table S2. EDX analysis of Schiff base L2. Table S3. EDX analysis of the Ce(III)-complex C2