Neural networks versus Logistic regression for 30 days all-cause readmission prediction

Heart failure (HF) is one of the leading causes of hospital admissions in the US. Readmission within 30 days after a HF hospitalization is both a recognized indicator for disease progression and a source of considerable financial burden to the healthcare system. Consequently, the identification of patients at risk for readmission is a key step in improving disease management and patient outcome. In this work, we used a large administrative claims dataset to (1)explore the systematic application of neural network-based models versus logistic regression for predicting 30 days all-cause readmission after discharge from a HF admission, and (2)to examine the additive value of patients' hospitalization timelines on prediction performance. Based on data from 272,778 (49% female) patients with a mean (SD) age of 73 years (14) and 343,328 HF admissions (67% of total admissions), we trained and tested our predictive readmission models following a stratified 5-fold cross-validation scheme. Among the deep learning approaches, a recurrent neural network (RNN) combined with conditional random fields (CRF) model (RNNCRF) achieved the best performance in readmission prediction with 0.642 AUC (95% CI, 0.640-0.645). Other models, such as those based on RNN, convolutional neural networks and CRF alone had lower performance, with a non-timeline based model (MLP) performing worst. A competitive model based on logistic regression with LASSO achieved a performance of 0.643 AUC (95%CI, 0.640-0.646). We conclude that data from patient timelines improve 30 day readmission prediction for neural network-based models, that a logistic regression with LASSO has equal performance to the best neural network model and that the use of administrative data result in competitive performance compared to published approaches based on richer clinical datasets

Surgical Excision Of Intraoral Lipoma; Case Report

Lipoma is a common tumor of soft tissue. Its location on the oral mucosa is rare, representing 1% to 5% of benign oral tumors although it is the most mesenchymal tumor of the trunk and proximal portions of extremities. Lipoma of the oral cavity may occur in any region. The buccal mucosa, tongue, and floor of the mouth are among the common locations. The clinical presentation is typically as an asymptomatic yellowish mass. The overlying epithelium is intact, and superficial blood vessels are usually evident over the tumor. Other benign connective tissue lesions such as granular cell tumor, neurofibroma, traumatic fibroma and salivary gland lesions (mucocele and mixed tumor) might be included in differential diagnosis. We present a case report of oral lipoma in the left side of the lower lip in 18 years old Saudi patient

MTHFR C677T, PT G20120A and FV Leiden as Risk Factors for Thrombosis in Egyptian Pediatric ALL Patients

Thrombosis is a well-known side effect associated with Acute Lymphoblastic Leukemia (ALL) treatment leading to significant morbidity rates. Thrombosis occurrence in ALL patients seems to be due to the interaction between the disease, the therapy and the possible inherited genetic defects affecting the hemostatic balance. In this study we aimed to assess the prevalence of prothrombotic defects- FV Leiden, MTHFR (Methylene Tetra Hydrofolate Reductase enzyme) C677T & prothrombin (PT) G20210A mutations in Egyptian pediatric ALL patients and its impact on the risk of thrombosis onset as well as to evaluate the impact of the presence of single versus multiple prothrombotic mutations on thrombosis. Sixty three pediatric ALL patients with thrombotic event treated with ALL protocol adopted from SJCRH (Saint Jude Cancer Research Hospital) study XV at the Children\u27s Cancer Hospital in Egypt (CCHE) and 63 matched ALL control patients were enrolled in the study. Restriction fragment polymorphism technique was used to assess the prevalence of the FV Leiden and MTHFR C677T while Allele specific PCR was used for Prothrombin G20210A. Our results showed that MTHFR C677T prevalence between the ALL patients with and without thrombosis was 65% and 38.1% respectively p value = 0.002. The FV Leiden prevalence between the ALL patients with and without thrombosis was 17.5% and 15.9 % respectively p value= 0.81. While the prothrombin G20210A prevalence was 3.2% in both groups. In addition, patients who were older than 10 years or on SR/HR treatment protocol or in induction treatment phase were also at high risk of thrombosis. The presence of MTHFR C677T polymorphism can increase the risk of thrombosis 3 folds more than those patients who didn\u27t have the polymorphism, while FV Leiden and PT G20210A didn\u27t affect the thrombosis risk. Having more than one mutation didn’t show a significant effect on increasing the risk of thrombus incidence (p= 0.087). We concluded that MTHFR C677T is important risk factor for thrombosis in Egyptian pediatric ALL patients. These results may help in the prediction of the thrombosis susceptibility for ALL patients and a prophylaxis therapy may be considered before having the thrombosis. To the best of our knowledge these findings regarding the thrombosis risk factors in Egyptian pediatric ALL patients are first to be reported

Prosthetic Rehabilitation Following Lateral Resection of the Mandible with a Long Cantilever Implant-Supported Fixed Prosthesis: A 3-Year Clinical Report

This clinical report describes the prosthetic management of the surgical reconstruction of a patient after mandibular resection. Complete oral rehabilitation was achieved with a maxillary complete denture and a mandibular implant-supported fixed prosthesis with a custom titanium framework and a long unilateral cantilever

A rare case of posterior uterine rupture with neonatal survival during trial of vaginal birth after cesarean section

Posterior wall uterine rupture is a rare complication. Trial of vaginal birth after cesarean section (CS) is a predisposing factor especially when associated with augmentation of labor. Here we report a case of intrapartum uterine rupture during the second stage of labor in a multiparous woman trying vaginal birth after previous CS. Emergency laparotomy was done and the baby was saved. Repair of the site of the rupture in layers with complete hemostasis was achieved

Physical evaluation of a new pulp capping material developed from portland cement

Background: This study examined the effects of addition of 10% and 25% by weight calcium hydroxide on the physicochemical properties of Portland cement associated with 20% bismuth oxide in order to develop a new pulp capping material. Material and Methods: The solubility, pH value, setting time, compressive strength, and push out bond strength of modified Portland were evaluated and compared to those of mineral trioxide aggregate (MTA) and Portland cement containing 20% bismuth oxide. Results: The statistical analysis was performed with ANOVA and Duncan’s post-hoc test. The results show that the strength properties and push out bond strength of Portland cement were adversely affected by addition of calcium hydroxide especially with a ratio of 25 wt%, however, the setting time and pH were not affected. MTA showed a statistically significant lower setting time than other cements (P≤0.001). Portland cement with bismuth oxide and Port Cal I showed a statistically significant higher Push out Bond strength than MTA and Port Cal II (P=0.001). Conclusions: Taking the setting time, push out bond strength and pH value into account, addition of 10 wt% calcium hydroxide to Portland cement associated with 20% bismuth oxide produces a new pulp capping material with acceptable physical and adhesive properties. Further studies are recommended to test this cement biologically as a new pulp capping material

Accidental diagnosis and conservative management of a case of first-trimester caesarean scar ectopic pregnancy

Cases of Caesarean Scar Ectopic Pregnancy (CSEP) are becoming increasingly common at tertiary care hospitals because of increase in rate of CS. It may lead to horrible consequences, such as uncontrolled bleeding and uterine rupture (UR), which might require hysterectomy and result in subsequent loss of fertility. This report covers a case of a CSEP discovered early at 9 weeks of gestation in a 25-year-old woman coming for antenatal care. Conservative management of the uterus was performed with removal of the sac and repair of the uterine scar. The patient’s postoperative period was uneventful, and she was discharged 3 days after surgery. CSEP should be detected early to prevent its catastrophic sequences. Although it is a rare complication of cesarean section, CSEP must be kept in the minds of obstetricians facing emergency cases

Multi-jet cross sections in deep inelastic scattering at next-to-leading order

We present the perturbative prediction for three-jet production cross section in DIS at the NLO accuracy. We study the dependence on the renormalization and factorization scales of exclusive three-jet cross section. The perturbative prediction for the three-jet differential distribution as a function of the momentum transfer is compared to the corresponding data obtained by the H1 collaboration at HERA.Comment: 5 pages, 3 figure