Intelligent Decision Support Systems- A Framework

Information technology applications that support decision-making processes and problem- solving activities have thrived and evolved over the past few decades. This evolution led to many different types of Decision Support System (DSS) including Intelligent Decision Support System (IDSS). IDSS include domain knowledge, modeling, and analysis systems to provide users the capability of intelligent assistance which significantly improves the quality of decision making. IDSS includes knowledge management component which stores and manages a new class of emerging AI tools such as machine learning and case-based reasoning and learning. These tools can extract knowledge from previous data and decisions which give DSS capability to support repetitive, complex real-time decision making.  This paper attempts to assess the role of IDSS in decision making. First, it explores the definitions and understanding of DSS and IDSS. Second, this paper illustrates a framework of IDSS along with various tools and technologies that support it. Keywords: Decision Support Systems, Data Warehouse, ETL, Data Mining, OLAP, Groupware, KDD, IDS

Hospital Service Quality and Patient Satisfaction: A Moderating Role of Trustworthiness

 The aim of the present study is to determine the effects of hospital service qualities on patient satisfaction in the healthcare sector of Pakistan. By using the non-probability sampling, 292 sample was gathered. Emotional exhaustion, organizational citizenship behavior, hospital and nurses facilities were used as predictors and trustworthiness was used as a moderator. The results from structural equation modeling revealed that hospital facilities quality and OCB have been found positively significant while nursing service quality and emotional exhaustion have been found insignificant in relation with patient satisfaction. Moreover, trustworthiness does not moderates any relationship in the structural model. The study concluded that the staff allocated is manifesting form of behavioral citizenship structured by cultural decorum and locally acceptable norms. Alongside citizenship, high quality miscellaneous supportive provisions comprising of sufficient backup equipment, medical apparatus and tools as well as the regular maintenance of utilities stand as considerable satisfaction determining aspects for patients. The cognitive dimensions in the form of trust structuring attributes don’t really add much to the contributions of facilities and citizenship found in hospitals

An effective deep learning approach for the classification of Bacteriosis in peach leave

Bacteriosis is one of the most prevalent and deadly infections that affect peach crops globally. Timely detection of Bacteriosis disease is essential for lowering pesticide use and preventing crop loss. It takes time and effort to distinguish and detect Bacteriosis or a short hole in a peach leaf. In this paper, we proposed a novel LightWeight (WLNet) Convolutional Neural Network (CNN) model based on Visual Geometry Group (VGG-19) for detecting and classifying images into Bacteriosis and healthy images. Profound knowledge of the proposed model is utilized to detect Bacteriosis in peach leaf images. First, a dataset is developed which consists of 10000 images: 4500 are Bacteriosis and 5500 are healthy images. Second, images are preprocessed using different steps to prepare them for the identification of Bacteriosis and healthy leaves. These preprocessing steps include image resizing, noise removal, image enhancement, background removal, and augmentation techniques, which enhance the performance of leaves classification and help to achieve a decent result. Finally, the proposed LWNet model is trained for leaf classification. The proposed model is compared with four different CNN models: LeNet, Alexnet, VGG-16, and the simple VGG-19 model. The proposed model obtains an accuracy of 99%, which is higher than LeNet, Alexnet, VGG-16, and the simple VGG-19 model. The achieved results indicate that the proposed model is more effective for the detection of Bacteriosis in peach leaf images, in comparison with the existing models

Computed Tomography Severity Grading of Chronic Obstructive Pulmonary Disease based on Volumetric Assessment of Inspiratory and Expiratory Scans

Background & Aims:  To determine attenuation threshold for detection and quantification of air trapping in obstructive airway disease. Quantify airway dysfunction in patients of obstructive airway disease & its correlation with pulmonary function tests. Materials & Methods: Paired HRCT scans of 48 patients were done and correlated with Pulmonary Function Tests taken within 2 weeks of the study. Threshold attenuation value on expiratory scan that signifies air trapping was obtained by correlating relative volumes with PFT parameters (PEF 25-75% & RV/TLC). The lung volumes at this threshold were then correlated with PFT values signifying airway dysfunction (FEV1, FEV1/FVC and PEF 25-75%) and airway dysfunction was then quantified based on these volumes. Results: Maximum correlation of PFT parameters signifying air trapping is with relative volume of limited lung at -850HU (l850) (p -10%). Conclusion: l850 can be used as a CT parameter to quantify airway dysfunction irrespective of presence or absence of emphysema. Severity classification of obstructive airway disease was formulated based on l850

Establishment of the Invasive Cactus Moth, \u3ci\u3eCactoblastis cactorum\u3c/i\u3e (Berg) (Lepidoptera: Pyralidae) in Pakistan: A Potential Threat to Cultivated, Ornamental and Wild \u3ci\u3eOpuntia\u3c/i\u3e spp. (Cactaceae)

Subsequent to the significant accomplishment of biological control of Opuntia weeds in Australia, the larvae of the cactus moth, Cactoblastis cactorum (native to parts of South America), were released in many countries for the biological control of native Opuntia species (Simmonds and Bennett, 1966). Inauspiciously, larvae were also released in the Caribbean, where the moth spread naturally and by the human support all over the region (García-Turudi et al., 1971). Its enhanced dissemination rate and the biological potential for invasiveness, suggests that the cactus moth is likely to become an invasive pest of Opuntia in the Southeast United States, Mexico, and southwestern America. Its damage is restricted mainly to the plants of genus Opuntia (plants with the characteristic of flat prickly pear pads of the former genus Platyopuntia, now considered to be the part of the genus Opuntia). In this region, plants of this genus provide valuable resources for humans, livestock, and wildlife such as food, medicine, and emergency fodder, while in the arid and semi-arid regions, the plants play key roles in ecosystem processes and soil conservation. At present, the cactus moth has developed into a severe threat to the high diversity of prickly pear cacti, all over the world for both the native and cultivated species of Opuntia (IAEA, 2002)

FREQUENCY AND SOURCE OF INFECTION IN PATIENTS WITH SEPSIS

Objective: To determine the frequency and source of infection in patients with sepsis. Patients and Methods: This one year cross sectional study was carried at tertiary care teaching hospital. The criteria for selection is any patient of ≥12 years of age, either gender admitted in ward who came under the criteria for sepsis accordingly as systemic inflammatory response syndrome due to infection as existent etiology or at least with clinical evidence of infection while the necessary specific and relevant investigations were also advised and sort accordingly whereas the blood and urine sample for bacterial culture / sensitivity was collected and sent soon to confirm the diagnosis. The frequency and percentages was calculated while the numerical statistics were used to compute mean ±SD. Results: During one year study period total fifty patients diagnosed with sepsis with the mean age ±SD for whole population was 40.84±6.85 years, of fifty individuals 28 (56%) were males and 22 (44%) were females and majority belonged to rural population (60%). The organ system dysfunction identified were coagulopathy (50%), central nervous system (40%), hepatic (38%) and renal (42%). The common source of infection detected were Respiratory tract infection (16%), urinary tract infections (16%), intravenous catheters (16%) and urethral catheterization (18%) respectively. Conclusion: The study detected higher incidence of infection with gram negative pathogen was common microorganism while the common source of infections identified urethral catheterization (18%), intravenous catheters (16%), urinary tract infections (16%) and respiratory tract infections (16%). Keywords: Sepsis, Blood culture, Source of infection & Systemic inflammatory response syndrome

An international survey on the pragmatic management of epistaxis

Epistaxis is one of the most common ear, nose and throat emergencies. The management of epistaxis has evolved significantly in recent years, including the use of nasal cautery and packs. However, a correct treatment requires the knowledge of nasal anatomy, potential risks, and complications of treatment. Epistaxis is often a simple and readily treatable condition, even though a significant bleed may have potentially severe consequences. At present, there are very few guidelines concerning this topic. The current Survey explored the pragmatic approach in managing epistaxis. A questionnaire, including 7 practical questions has been used. The current International Survey on epistaxis management reported a relevant prevalence (21.7%), mainly during childhood and senescence, an important hospitalization rate (11.8%), the common use of anterior packing and electrocoagulation, and the popular prescription of a vitamin supplement and intranasal creams

LEARN: A multi-centre, cross-sectional evaluation of Urology teaching in UK medical schools

OBJECTIVE: To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. MATERIALS AND METHODS: LEARN was a national multicentre cross-sectional study. Year 2 to Year 5 medical students and FY1 doctors were invited to complete a survey between 3rd October and 20th December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). RESULTS: 7,063/8,346 (84.6%) responses from all 39 UK medical schools were included; 1,127/7,063 (16.0%) were from Foundation Year (FY) 1 doctors, who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and clinical placements in the later years of medical school. 20.1% of FY1 doctors reported no undergraduate clinical attachment in urology. CONCLUSION: LEARN is the largest ever evaluation of undergraduate urology teaching. In the UK, teaching seemed satisfactory as evaluated by the BAUS undergraduate syllabus. However, many students report having no clinical attachments in Urology and some newly qualified doctors report never having inserted a catheter, which is a GMC mandated requirement. We recommend a greater emphasis on undergraduate clinical exposure to urology and stricter adherence to GMC mandated procedures