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

Capsule Endoscopy to Detect Normally Positioned Duodenal Papilla: Performance Comparison of SB and SB2

Purpose. PillCam SB2 capsule endoscopy, an upgraded version of widely used SB capsule endoscopy, was examined for its performance by comparing with SB. Methods. Examinees with various indications were enrolled for SB2 capsule endoscopy; subjects were also enlisted for the old SB capsule endoscopy. Number of photo images containing papilla of Vater was counted. Shape of the papilla seen in each image was evaluated by scoring 3 (fully observable papilla), 2 (more than half outline), or 1 (less than half outline) points. Images obtained from SB and SB2 were also subjectively compared; resolution and brightness were scored by six experienced endoscopists. Results. Baseline characteristics of two study groups (n = 30 each) were not significantly different. Number of images of the papilla revealed to show similar results between SB (3.1 ± 1.1, range 1~5) and SB2 (3.1 ± 1.5, range 1~8) (P = 0.62). The maximum points of outline of papilla evaluated from each subject were also similar between two groups. New SB2 revealed to be superior to SB in terms of resolution but not significantly different in brightness. Conclusion. Our study showed that superiority of SB2 over SB is rather marginal on examining duodenal papilla

KINEMATIC ANALYSIS OF THE WOMEN’S JAVELIN THROW AT THE IAAF WORLD CHAMPIONSHIPS, DAEGU 2011

The purpose of this study was to analyze the kinematic variables for the women's javelin throw at the IAAF World Championships, Daegu 2011. Three-dimensional motion analyses of the eight players who qualified for the final round were carried out to obtain the data. The results showed that average release, attitude, and attack angles were 38.0±2.0°, 40.4±4.3°, and 3.7±1.1°, respectively. At the release, the average inclination angle of the trunk, upper arm, forearm were 60.8±8.3°, 47.3±10.1°, and 62.6±10.6°, respectively. Moreover, the release velocity and the release height results averaged 25.60±1.16 m/s and 1.86±0.05 m. The crossover phase and delivery phase had average distances of 1.88±0.31 m and 1.53±0.21 m. After release, the average distance between the landing foot and the foul line was 1.72±0.63 m

Electric polarization enhancement in multiferroic CoCr2O4 crystals with Cr-site mixing

Single crystals of multiferroic cobalt chromite Co (Cr2-x Cox) O4 have been grown via several methods to have different Co3+ doping levels (x=0.0, 0.14, and 0.18). Under magnetic fields, all the crystals display electric polarization reversal below their spiral spin ordering temperatures. We find that both saturated electric polarization and magnetization under magnetic fields increase significantly with the increase in x. This result can be qualitatively explained by a broken balance between at least two electric polarization contributions existing in CoCr2 O4 and is expected to be useful in tailoring electric polarization in similar kinds of multiferroics. &amp;#169; 2009 American Institute of Physics.open222

Nonvolatile memory characteristics associated with oxygen ion exchange in thin-film transistors with indium-zinc oxide channel and HfO2-x gate oxide

Non-charge-storage-based nonvolatile memory characteristics associated with oxygen ion exchange are demonstrated in a thin-film transistor (TFT) composed of an indium-zinc oxide (IZO) channel and an oxygen-deficient HfO2???x gate oxide. A nonvolatile increase in drain current and a reduced threshold voltage are obtained upon application of positive gate voltage, with the opposite characteristics upon application of negative voltage. The device shows nonvolatile retention properties and suitable endurance properties after repeated operations. Modulation of channel conductance occurs as a results of oxygen ion exchange between the HfO2???x gate oxide and the IZO channel, which consequently alters the oxygen vacancy concentration in the IZO channel; these vacancies act as n-type dopants. For comparison, a device with a thin SiO2 layer inserted between the HfO2???x gate oxide and the IZO channel to prevent oxygen ion exchange shows only the increased threshold voltage upon application of a positive gate voltage as a result of electron charging. These results verify the conductance modulation mechanism associated with oxygen ion exchange at the interface of the HfO2???x gate oxide and the IZO channel. In addition, the nonvolatile memory characteristics of the device are indicative of its potential for non-charge-storage-based nonvolatile memory application