A hybrid decision support model to discover informative knowledge in diagnosing acute appendicitis

BACKGROUND: The aim of this study is to develop a simple and reliable hybrid decision support model by combining statistical analysis and decision tree algorithms to ensure high accuracy of early diagnosis in patients with suspected acute appendicitis and to identify useful decision rules. METHODS: We enrolled 326 patients who attended an emergency medical center complaining mainly of acute abdominal pain. Statistical analysis approaches were used as a feature selection process in the design of decision support models, including the Chi-square test, Fisher's exact test, the Mann-Whitney U-test (p < 0.01), and Wald forward logistic regression (entry and removal criteria of 0.01 and 0.05, or 0.05 and 0.10, respectively). The final decision support models were constructed using the C5.0 decision tree algorithm of Clementine 12.0 after pre-processing. RESULTS: Of 55 variables, two subsets were found to be indispensable for early diagnostic knowledge discovery in acute appendicitis. The two subsets were as follows: (1) lymphocytes, urine glucose, total bilirubin, total amylase, chloride, red blood cell, neutrophils, eosinophils, white blood cell, complaints, basophils, glucose, monocytes, activated partial thromboplastin time, urine ketone, and direct bilirubin in the univariate analysis-based model; and (2) neutrophils, complaints, total bilirubin, urine glucose, and lipase in the multivariate analysis-based model. The experimental results showed that the model with univariate analysis (80.2%, 82.4%, 78.3%, 76.8%, 83.5%, and 80.3%) outperformed models using multivariate analysis (71.6%, 69.3%, 73.7%, 69.7%, 73.3%, and 71.5% with entry and removal criteria of 0.01 and 0.05; 73.5%, 66.0%, 80.0%, 74.3%, 72.9%, and 73.0% with entry and removal criteria of 0.05 and 0.10) in terms of accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under ROC curve, during a 10-fold cross validation. A statistically significant difference was detected in the pairwise comparison of ROC curves (p < 0.01, 95% CI, 3.13-14.5; p < 0.05, 95% CI, 1.54-13.1). The larger induced decision model was more effective for identifying acute appendicitis in patients with acute abdominal pain, whereas the smaller induced decision tree was less accurate with the test data. CONCLUSIONS: The decision model developed in this study can be applied as an aid in the initial decision making of clinicians to increase vigilance in cases of suspected acute appendicitis

The development of a web-based app employing machine learning for delirium prevention in long-term care facilities in South Korea

Background Long-term care facilities (LCFs) in South Korea have limited knowledge of and capability to care for patients with delirium. They also often lack an electronic medical record system. These barriers hinder systematic approaches to delirium monitoring and intervention. Therefore, this study aims to develop a web-based app for delirium prevention in LCFs and analyse its feasibility and usability. Methods The app was developed based on the validity of the AI prediction model algorithm. A total of 173 participants were selected from LCFs to participate in a study to determine the predictive risk factors for delerium. The app was developed in five phases: (1) the identification of risk factors and preventive intervention strategies from a review of evidence-based literature, (2) the iterative design of the app and components of delirium prevention, (3) the development of a delirium prediction algorithm and cloud platform, (4) a pilot test and validation conducted with 33 patients living in a LCF, and (5) an evaluation of the usability and feasibility of the app, completed by nurses (Main users). Results A web-based app was developed to predict high risk of delirium and apply preventive interventions accordingly. Moreover, its validity, usability, and feasibility were confirmed after app development. By employing machine learning, the app can predict the degree of delirium risk and issue a warning alarm. Therefore, it can be used to support clinical decision-making, help initiate the assessment of delirium, and assist in applying preventive interventions. Conclusions This web-based app is evidence-based and can be easily mobilised to support care for patients with delirium in LCFs. This app can improve the recognition of delirium and predict the degree of delirium risk, thereby helping develop initiatives for delirium prevention and providing interventions. Moreover, this app can be extended to predict various risk factors of LCF and apply preventive interventions. Its use can ultimately improve patient safety and quality of care. © 2022, The Author(s).1

In-Plane Strengthening of Unreinforced Masonry Walls by Glass Fiber-Reinforced Polyurea

Strengthening techniques have been employed in Korea to unreinforced masonry walls (UMWs) for several years to protect them from damage caused by the intermittent occurrence of earthquakes. Polyurea, which has a high tensile strength and elongation rate, can be utilized as a strengthening material to enhance the in-plane strength and ductility of UMWs. Glass fiber-reinforced polyurea (GFRPU) is a composite elastomer manufactured by progressively adding milled glass fiber to polyurea. The purpose of this study is to investigate the enhancement of the in-plane strength and ductility of UMWs using GFRPU, depending on the shape of the GFRPU coating on the wall. Four masonry wall specimens are tested with test variables of the number of strengthening sides and coating shapes. It is illustrated that the GFRPU reinforcement of masonry wall leads to enhanced load-carrying capacity, ductility, and energy absorption. An empirical formula to represent the degree of strengthening effected by GFRPU is proposed in this study. Doi: 10.28991/cej-2021-03091782 Full Text: PD

Out-of-Plane Strengthening of Unreinforced Masonry Walls by Glass Fiber-Reinforced Polyurea

Fiber-reinforced polymer reinforcement or polyurea reinforcement techniques are applied to strengthen unreinforced masonry walls (UMWs). The purpose of this experimental study is to verify the out-of-plane reinforcing effect of sprayed glass fiber-reinforced polyurea (GFRPU), which is a composite elastomer made of polyurea and milled glass fibers on UMW. The out-of-plane strengths and ductile behaviors based on various coating shapes are compared in this study. An empirical formula to describe the degree of reinforcement on the out-of-plane strength of the UMW is derived based on the experimental results. It is observed that the peak load-carrying capacity, ductility, and energy absorption capacity gradually improve with an increase in the strengthening degree or area. Compared with the existing masonry wall reinforcement method, the GFRPU technique is a construction method that can help improve the safety performance along with ease of construction and economic efficiency. Doi: 10.28991/CEJ-2022-08-01-011 Full Text: PD

Comparison of postoperative changes in the distal and proximal segments between conventional and sliding mini-plate fixation following mandibular setback

The purpose of the present study was to evaluate the postoperative three-dimensional (3D) changes in the proximal segments after mandibular setback sagittal split ramus osteotomy and to compare the changes between the conventional mini-plate fixation and semi-rigid sliding plate fixation

Effect of the Phosphorus Gettering on Si Heterojunction Solar Cells

To improve the efficiency of crystalline silicon solar cells, should be collected the excess carrier as much as possible. Therefore, minimizing the recombination both at the bulk and surface regions is important. Impurities make recombination sites and they are the major reason for recombination. Phosphorus (P) gettering was introduced to reduce metal impurities in the bulk region of Si wafers and then to improve the efficiency of Si heterojunction solar cells fabricated on the wafers. Resistivity of wafers was measured by a four-point probe method. Fill factor of solar cells was measured by a solar simulator. Saturation current and ideality factor were calculated from a dark current density-voltage graph. External quantum efficiency was analyzed to assess the effect of P gettering on the performance of solar cells. Minority bulk lifetime measured by microwave photoconductance decay increases from 368.3 to 660.8 mu s. Open-circuit voltage and short-circuit current density increase from 577 to 598 mV and 27.8 to 29.8mA/cm(2), respectively. The efficiency of solar cells increases from 11.9 to 13.4%. P gettering will be feasible to improve the efficiency of Si heterojunction solar cells fabricated on P-doped Si wafers.open1

Evaluating myelophil, a 30% ethanol extract of Astragalus membranaceus and Salvia miltiorrhiza, for alleviating fatigue in long COVID: a real-world observational study

BackgroundPersistent post-infectious symptoms, predominantly fatigue, characterize Long COVID. This study investigated the efficacy of Myelophil (MYP), which contains metabolites extracted from Astragalus membranaceus and Salvia miltiorrhiza using 30% ethanol, in alleviating fatigue among subjects with Long COVID.MethodsIn this prospective observational study, we enrolled subjects with significant fatigue related to Long COVID, using criteria of scores of 60 or higher on the modified Korean Chalder Fatigue scale (mKCFQ11), or five or higher on the Visual Analog Scale (VAS) for brain fog. Utilizing a single-arm design, participants were orally administered MYP (2,000 mg daily) for 4 weeks. Changes in fatigue severity were assessed using mKCFQ11, Multidimensional Fatigue Inventory (MFI-20), and VAS for fatigue and brain fog. In addition, changes in quality of life using the short form 12 (SF-12) were also assessed along with plasma cortisol levels.ResultsA total of 50 participants (18 males, 32 females) were enrolled; 49 were included in the intention-to-treat analysis with scores of 66.9 ± 11.7 on mKCFQ11 and 6.3 ± 1.5 on the brain fog VAS. After 4 weeks of MYP administration, there were statistically significant improvements in fatigue levels: mKCFQ11 was measured at 34.8 ± 17.1 and brain fog VAS at 3.0 ± 1.9. Additionally, MFI-20 decreased from 64.8 ± 9.8 to 49.3 ± 10.8, fatigue VAS dropped from 7.4 ± 1.0 to 3.4 ± 1.7, SF-12 scores rose from 53.3 ± 14.9 to 78.6 ± 14.3, and plasma cortisol levels also elevated from 138.8 ± 50.1 to 176.9 ± 62.0 /mL. No safety concerns emerged during the trial.ConclusionCurrent findings underline MYP’s potential in managing Long COVID-induced fatigue. However, comprehensive studies remain imperative.Clinical Trial Registrationhttps://cris.nih.go.kr, identifier KCT0008948

Isolation and characterization of differentially expressed genes in the mycelium and fruit body of Pleurotus ostreatus

The fruiting body of one of the most widely cultivated mushrooms, the oyster mushroom (Pleurotus ostreatus) is highly interesting, both commercially and scientifically. In the present study, we performed comparative proteomic profiling of P. ostreatus at two unique developmental stages; mycelium and fruit body, using two-dimensional gel electrophoresis (2-DE). Seven hundred fourteen (714) spots were detected and 29 spots (showing a high level of difference in their expressions) were identified by tandem mass spectrometry and basic local alignment search tool (BLAST) searching of an expressed sequence tag (EST) database of P. ostreatus. Among them, six proteins (putative fatty acid oxygenase, heat shock sks2, PriA homologue, Ap-1 like transcription factor YAP7, mung bean seed albumin, and C2H2 Zinc finger domain protein) and one protein (peroxisomal biogenesis factor 6) showed increased expression levels at the fruiting process and the mycelial stage, respectively. Through reverse transcriptase-polymerase chain reaction analysis, priA homologue and AP-1 like transcription factor yap7 showed gradually increased expression from mycelia to fruit body, whereas putative fatty acid oxygenase and heat shock protein sks2 were expressed only in the fruit body. These results provide useful information for future studies of mushroom development of P. ostreatus.Keywords: Developmental stage, mushroom fruiting, Pleurotus ostreatus, protein, two-dimensional gel electrophoresisAfrican Journal of Biotechnology Vol. 12(24), pp. 3790-379

Characteristics of primary and immortalized fibroblast cells derived from the miniature and domestic pigs

<p>Abstract</p> <p>Background</p> <p>The pig, <it>Sus scrofa domestica </it>includes both the miniature and commercial domestic breed. These animals have influenced the human life and economies and have been studied throughout history. Although the miniature breeds are more recent and have increasingly been used in a variety of biomedical studies, their cell lines have rarely been established. Therefore, we sought to establish primary and immortal cell lines derived from both the miniature and domestic pig to better enable insight into possible <it>in vivo </it>growth differences.</p> <p>Results</p> <p>The <it>in vitro </it>lifespan of primary domestic pig fibroblast (PF) and miniature pig fibroblast (MPF) cells using a standard 3T3 protocol was determined. Both of the primary PF and MPF cells were shown to have a two-step replicative senescence barrier. Primary MPF cells exhibited a relatively shorter lifespan and slower proliferation rate compared to those of primary PF cells. Beyond senescence barriers, lifespan-extended PF and MPF cells were eventually established and indicated spontaneous cellular immortalization. In contrast to the immortalized PF cells, immortal MPF cells showed a transformed phenotype and possessed more frequent chromosomal abnormalities and loss of p53 regulatory function. The lifespan of primary MPF and PF cells was extended by inactivation of the p53 function using transduction by SV40LT without any detectable senescent phenotype.</p> <p>Conclusion</p> <p>These results suggest that p53 signaling might be a major determinant for the replicative senescence in the MPF cells that have the shorter lifespan and slower growth rate compared to PF cells <it>in vitro</it>.</p

Reversible Pulmonary Hypertension in Adolescent with Left Atrial Myxoma

We report a patient of left atrial huge myxoma presenting with severe pulmonary hypertension in adolescents. A patient was a 14-year-old boy presented with sudden onset dyspnea. Transthoracic echocardiographic study revealed the presence of a nodular, 4.34 × 8.11 cm sized, mobile, hyperechoic mass in the left atrium and severe pulmonary hypertension with tricuspid insufficiency. After surgical therapy, tricuspid regurgitation and pulmonary hypertension was decreased and the patient was stabilized and had an uneventful clinical course