Preset Variables Research Articles

Accuracy of machine learning to predict the outcomes of shoulder arthroplasty: a systematic review

BackgroundArtificial intelligence (AI) uses computer systems to simulate cognitive capacities to accomplish goals like problem-solving and decision-making. Machine learning (ML), a branch of AI, makes algorithms find connections between preset variables, thereby producing prediction models. ML can aid shoulder surgeons in determining which patients may be susceptible to worse outcomes and complications following shoulder arthroplasty (SA) and align patient expectations following SA. However, limited literature is available on ML utilization in total shoulder arthroplasty (TSA) and reverse TSA.MethodsA systematic literature review in accordance with PRISMA guidelines was performed to identify primary research articles evaluating ML’s ability to predict SA outcomes. With duplicates removed, the initial query yielded 327 articles, and after applying inclusion and exclusion criteria, 12 articles that had at least 1 month follow-up time were included.ResultsML can predict 30-day postoperative complications with a 90% accuracy, postoperative range of motion with a higher-than-85% accuracy, and clinical improvement in patient-reported outcome measures above minimal clinically important differences with a 93%–99% accuracy. ML can predict length of stay, operative time, discharge disposition, and hospitalization costs.ConclusionML can accurately predict outcomes and complications following SA and healthcare utilization. Outcomes are highly dependent on the type of algorithms used, data input, and features selected for the model.Level of EvidenceIII

Application of Electrocoagulation for the Removal of Transition Metals in Water

Urban and industrial effluents, stormwater, road runoff, agricultural runoff, urban or mine waste deposits and fuel storage sites can lead to the contamination of water sources with compounds that are hard to biodegrade, such as heavy metals, whose removal requires advanced and expensive technologies. The Sustainable Development Goals (SDGs) established by the UN and the current requirements in terms of energy efficiency, reduction of carbon emissions, water reuse, waste valorization and preservation of public health, have led to a rethink concerning the typology of technologies for the treatment of water and the production of drinking water. Electrocoagulation (EC) stands out in this scenario due to its high efficiency in the removal of several pollutants, production of low sludge volumes and adaptability to the use of renewable energies. This is in addition to the ease with which it can be combined with other water treatment technologies. This work presents a literature review to systematize the use of EC for the removal of transition metals in water to produce drinking water, since these elements are present in several natural water sources and are parameters used in the legislation of many countries for the quality control of drinking water. The works found were analyzed in detail, and relationships between pre-set variables and categories were determined through regression analysis. Generally, it was found that EC is a highly efficient technology for the removal of transition metals in water (above 75% for most metals), specifically through parallel plates technologies with iron and aluminum electrodes with a minimum spacing of 1 cm and density minimum applied current of 10 A/m².

AN ANALYSIS OF THE FACTORS AFFECTING ON DOMESTIC TOURIST SATISFACTION FOR QUALITY OF SERVICES IN SAM MOUNTAIN NATIONAL TOURISM AREA, AN GIANG PROVINCE

This research was conducted in Sam Mountain National Tourism Area (SMNTA), An Giang province in older to evaluate the factors influencing on the domestic tourist’s satisfaction for quality of tourist’ services. There were 150 domestic tourists interviewed with the questionnaire of 19 preset variables. The analysis models with Exploratory Factor Analysis (EFA) and Multiple Linear Regression Analysis (MLRA) were both applied in. The result shows that, in all of factors categorized into four following groups: (1) Infrastructure, (2) Labour, (3) Tourism activities, (4) Supplemental elements, the group 2 – Labour has the highest score of the process, accounting for 34.9% of the variation of dependent variable (satisfaction), meaning that it has the strongest influence on domestics tourist’ satisfaction for tourist services. The group 3 – Type of activities, and 1 - Infrastructure explain 31.9% and 20.3% of the variation of dependent variable respectively. The group of factors 4 – Supplemental elements has less affecting tourist’s satisfaction, only accounts for 11.5%.

Qualitative Research in Surgical Disciplines: Need and Scope

There is a deficient application of qualitative research methods in surgical specialties. The concerned researchers largely focus on quantitative estimates like: health risk, burden, surgical management and objective outcomes. Without qualitative assessment important aspects like: patient’s preparation, perception, satisfaction, coping ability, well-being and functional outcomes are not addressed. In quantitative research, evaluation of pre-set variables is done to primarily study the process and outcomes of healthcare interventions. However, in qualitative research, patient’s experience, emotions, self-image, decision-making, pain perception, coping mechanism and quality of life (QoL) can be assessed. With time, surgeons are emphasizing more on the importance of functional recovery and QoL after surgery in multidisciplinary board discussions, and before making treatment decisions. Qualitative research employs purposive sampling and a meticulous data collection using in-depth interviews (IDIs) and focus group discussions (FGDs) etc. Collected data is analysed using statistical tools post transcription and coding and is suitably presented. Like other research designs, qualitative methods also have uniform criteria’s and standards for quality management. Adoption of qualitative research is critical in filling gaps of patient and surgeon’s perspective and experience of process of surgical care for clinical policy decisions. Integration of qualitative evidence in shared decision-making process will further improve standards and practice of surgical care and enhance doctor-patient relationship.

Educational assessment of the major lower limb amputations videos on YouTube.

Videos of surgical procedures are viewed by some as potential training resources for surgeons and residents. However, there is little evidence on the effectiveness of surgical videos on learning and understanding complex three-dimensional surgical procedures. Lower extremity amputation is a complex surgery, and many residents and surgeons have low exposure to this type of procedures. This paper investigates the educational quality of lower extremity amputation videos posted on YouTube. The search was limited to the first 100 videos. Full-length videos of any major lower limb amputation or disarticulation were included. Key basic video data such as title, YouTube address (http://), country of origin, channel source, uploading date, video duration time, number of views, number of up-voters and number of down-voters were collected. An educational assessment tool has been developed specifically for limb amputations. It consists in 11 items: three general and eight amputation-specific, each having a maximum score of 2. In total, 13 videos met the inclusion criteria for final analysis. Four videos reported the surgical technique of above knee amputation, two reported that of knee disarticulation and the remaining seven videos described below knee amputation. The average score (±SD) was 12.77 ± 5.2 yielding an average grade close to "Fair." A high level of concordance was found between the two assessors (κ = 0.79). No correlation was found between educational assessment tool score and the pre-set variables (r = 0.6, R2 = 35.4%, F = 1.09, P = 0.4). Most videos describing lower extremity amputation techniques were found to be of low-to-moderate quality. Only 4 out of 13 (30.7%) had an excellent educational and technical quality. Surgeons and surgical residents should be aware that not all posted videos on YouTube are beneficial. High educational quality videos are needed since many surgeons and residents have a low exposure to such surgeries.

Different Factors Associated with 2-Year Outcomes in Patients with Branch versus Central Retinal Vein Occlusion Treated with Ranibizumab

To investigate characteristics associated with visual and anatomic outcomes in branch and central retinal vein occlusion (BRVO and CRVO) patients treated with ranibizumab. Post hoc analysis of patients with BRVO and CRVO from 2 multicenter clinical trials who completed month 12 of the HORIZON extension trial. 205 patients with BRVO and 181 patients with CRVO who completed month 12 of the extension trial. With the use of logistic regression, covariates with a P value < 0.20 from univariate analysis were included in multivariate models to identify independent factors associated with a given outcome (at P < 0.05), with preset variables of disease duration and original treatment assignment. Best-corrected visual acuity (BCVA) ≥20/40 (≥70 letters), gain ≥15 letters, and central subfield thickness (CST) ≤250 μm at HORIZON month12. In patients with BRVO, good baseline BCVA (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.30-1.79), male sex (OR, 2.48; 95% CI, 1.20-5.13), and normal hematocrit (low vs. normal, OR, 0.26; 95% CI, 0.12-0.59) predicted BCVA ≥20/40; high central foveal thickness (OR, 1.03; 95% CI, 1.01-1.04) and normal hematocrit (low vs. normal, OR, 0.31; 95% CI, 0.15-0.66) predicted BCVA improvement ≥15 letters; andextensive baseline subretinal fluid modestly predicted CST ≤250 μm (OR, 1.08; 95% CI, 1.00-1.16). In patients with CRVO, good baseline BCVA (OR, 1.59; 95% CI, 1.35-1.89), never smoking (OR, 2.80; 95% CI,1.27-6.17), and young age (OR, 0.58; 95% CI, 0.41-0.82) predicted BCVA ≥20/40; never smoking (OR, 2.13; 95% CI, 1.03-4.39), young age (OR, 0.41; 95% CI, 0.28-0.59), poor baseline BCVA (OR, 0.82; 95% CI, 0.73-0.93), hypertension (OR, 4.47; 95% CI, 1.70-11.75), and low diastolic ocular perfusion pressure (OPP) throughout the study (OR, 0.39; 95% CI, 0.21-0.72) predicted BCVA improvement ≥15 letters; and young age (OR, 0.65; 95% CI, 0.47-0.90), lower mean hematocrit (low vs. normal, OR, 2.81; 95% CI, 1.06-7.49), high systolic OPP throughout the study (OR, 1.61; 95% CI, 1.14-2.27), large areas of central hemorrhage (OR, 1.44; 95% CI, 1.04-2.00), and no subretinal fluid (OR, 2.15; 95% CI, 1.06-4.40) predicted CST ≤250 μm. There are substantial differences in good outcome factors in CRVO versus BRVO, suggesting differences in pathophysiology. Young age, never smoking, hemodilution, and hypertension/high systolic perfusion pressure are more beneficial in CRVO, suggesting that avoidance of sluggish blood flow and maintenance of perfusion may be particularly important in CRVO.

필라테스 참여자의 참여동기는 운동몰입 및 여가만족, 운동지속의도의 관계

This study aims to empirically analyze the association among sport flow, leisure satisfaction, and intention of exercise adherence in accordance with participation motives of pilates participants. Pilates participants were recruited as subjects in pilates centers located in Seoul and Gyeonggi province and 230 samples were collected by using convenience sampling method. The study used 219 samples by excluding 11 questionnaires from those who did not consent to participate in this study or gave in adequate responses. The study conducted frequency analysis, confirmatory factor analysis, and reliability analysis by using SPSS 22 and Amos 22 statistical programs. It also carried out analysis of construct reliability, convergent validity, and discriminant validity and implemented structure equation model to see the association between preset variables. Obtained results are presented as follows. First, exercise flow in accordance with participation motives of pilates participants significantly affected results. Second, leisure satisfaction according to participation motives of pilates participants gave significant impacts on results. Third, intention of exercise adherence according to participation motives of pilates participants did not give huge influences. Fourth, exercise flow of pilates participants did not significantly affect the intention of exercise adherence. Fifth, leisure satisfaction of pilates participants considerably influenced the intention of exercise adherence.

Evaluation of Body Mass Index as a Factor of Outcome in Coronary Artery Bypass Surgery

Background: Obesity is supposed to be a risk factor for patients undergoing coronary artery bypass surgery (CABG) increasing risk of in-hospital mortality and postoperative morbidity. So, this study was conducted to evaluate the outcome of CABG in obese patients in Bangladesh.Methods: This prospective clinical trial was undertaken in the Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from January 2015 to December 2016. A total of 60 consecutive patients were selected for CABG operation and their outcome measured against pre-set variables. Body mass index (BMI) 25kg/m2was considered as cut off value between obese and non-obese patients.Results: Mortality after CABG surgery was 9.5% in obese group and 10.3% in non-obese group (p= 0.976) showing no significant difference but average hospital stay was more in obese group (10.2 + 25 days) than non-obese group (8.3 +3.7 days), p=0.489. Sternal would infection (50.0% &amp;8.69%) and conduit harvest site infection (35.7% &amp;4.34%) is also more in obese group but not significant statistically (p= 0.064 &amp; 0.084 respectively).Conclusion: Patients with a BMI higher than normal are not at greater risk of in-hospital mortality after CABG. But obese patients should be more cared in post operative period for sternal and conduit harvest site infection as infection is more in obese patients.Cardiovasc. j. 2018; 10(2): 150-157

Neighbor-Based Dynamic Connectivity Factor Routing Protocol for Mobile Ad Hoc Network

Recently, Mobile Ad hoc Networks (MANETs) have witnessed rapid development due to the low cost, diversity, and simplicity of mobile devices. Such devices can form a reliable network in a short time for use as a rescue information system after a natural disaster, where the communication infrastructure may no longer be available or accessible. Because the nodes in such a network are free to move at any time in the absence of centralized control, routing is considered to be the most challenging issue. Moreover, some routing protocols, such as Neighbor Coverage-Based Probabilistic Rebroadcast (NCPR), completely rely on preset variables, which are required to be set by the system administrator based on the scenario. Unfortunately, the setting that is proper for a specific scenario is not suitable for another scenario. In addition, some other routing protocols, such as Ad hoc On-demand Distance Vector (AODV), employ the Route REQuest message (RREQ) flooding scheme to find a path to a particular destination in the route discovery stage. Although the flooding scheme guarantees better reachability, it introduces undesirable routing overhead, which in turn leads to system performance degradation. Thus, this paper proposes a novel routing protocol, neighbor-based Dynamic Connectivity Factor routing Protocol (DCFP), that is able to dynamically probe the status of the underlying network without the intervention of a system administrator based on a novel connectivity metric, while reducing the RREQ overhead using a new connectivity factor. Furthermore, extensive simulation experiments are conducted to evaluate the performance of the proposed DCFP, where the NCPR and AODV are used as a benchmark. The proposed DCFP manages to address the need for preset variables in NCPR. Simulation results show that DCFP outperforms both NCPR and AODV in terms of end-to-end delay, normalized routing overhead, MAC collision, energy consumption, network connectivity, and packet delivery ratio due to its novel mechanism for reducing redundant RREQ.

℮-conome: an automated tissue counting platform of cone photoreceptors for rodent models of retinitis pigmentosa

BackgroundRetinitis pigmentosa is characterized by the sequential loss of rod and cone photoreceptors. The preservation of cones would prevent blindness due to their essential role in human vision. Rod-derived Cone Viability Factor is a thioredoxin-like protein that is secreted by rods and is involved in cone survival. To validate the activity of Rod-derived Cone Viability Factors (RdCVFs) as therapeutic agents for treating retinitis Pigmentosa, we have developed e-conome, an automated cell counting platform for retinal flat mounts of rodent models of cone degeneration. This automated quantification method allows for faster data analysis thereby accelerating translational research.MethodsAn inverted fluorescent microscope, motorized and coupled to a CCD camera records images of cones labeled with fluorescent peanut agglutinin lectin on flat-mounted retinas. In an average of 300 fields per retina, nine Z-planes at magnification X40 are acquired after two-stage autofocus individually for each field. The projection of the stack of 9 images is subject to a threshold, filtered to exclude aberrant images based on preset variables. The cones are identified by treating the resulting image using 13 variables empirically determined. The cone density is calculated over the 300 fields.ResultsThe method was validated by comparison to the conventional stereological counting. The decrease in cone density in rd1 mouse was found to be equivalent to the decrease determined by stereological counting. We also studied the spatiotemporal pattern of the degeneration of cones in the rd1 mouse and show that while the reduction in cone density starts in the central part of the retina, cone degeneration progresses at the same speed over the whole retinal surface. We finally show that for mice with an inactivation of the Nucleoredoxin-like genes Nxnl1 or Nxnl2 encoding RdCVFs, the loss of cones is more pronounced in the ventral retina.ConclusionThe automated platform ℮-conome used here for retinal disease is a tool that can broadly accelerate translational research for neurodegenerative diseases.

Value of a serum proteomic signature in the non-invasive evaluation of lung nodules.

10520 Background: The current management of lung nodules leads to futile thoracotomies and a number of missed chances for cure. We hypothesized that a serum proteomic signature may add value to the predictive accuracy of lung cancer derived from combined non-invasive clinical and radiographic data. Methods: Clinical, chest CT imaging and serum-based proteomic data were collected in two prospective cohorts of patients with lung nodules from two institutions. Cohort A included 265 patients (185 all stages NSCLC, 80 controls), and cohort B included 126 patients (44 stage I NSCLCs, 82 controls). All controls were found without a diagnosis of lung cancer at the end of 12 months follow-up. Preset variables were selected on clinical grounds to build multivariable analyses, some of which included age, gender, pack-years of smoking and prior cancer status. CT data included average size, nodule shape, location and presence of calcification. The additive benefit of a previously described 7-peak MALDI MS signature (Y...

Survey of Current Status of the Patients with Home Ventilator in Seoul and Kyunggi Province

Background : Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in addition to evaluating any problems related to patients' home care in our country. Methods : A register of 92 patients with home ventilators in Seoul and Kyunggi Province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. Results : There were 26 males (90%) and their mean age was 48.0 () years. The underlying diseases were : 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT ; n=20, 69%) was more frequently used than the pressure targeted type (PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000 (3,290,000) won for a PTT, and 14,280.000 (3,130,000) won for a VTT. Total cost for the equipment was 11,430,000 (634,000) won. The average cost required for home care per month was 1,120,000 (1,360, 000) won. Conclusion : The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.

Developing real imaginary countries

Development of Green Revolution Game for understanding small group dynamics. Development of Exaction: a whole country simulation. Simulations are not trivial. They are not confined to preset variables. Players can change their circumstances by action. Simulations expose limits of theoretical explanations. Constraints on use of games: ambiguity of developments; time; cost; skills; simplification. Games provide unique confrontation between physical constraints and imagination.

Microprocessor-controlled ventilator monitor with pre-evaluation of preset variables and graphic simulation: a preliminary clinical impression.

The prototype of a fully computerized servoventilator monitor was successfully used to support ventilation in 25 adult patients during a total of 2030 patient hours. This prototype is volume-cycled in active inspiration and time-cycled in the inspiratory pause. During time-cycled expiration, it functions as a constant atmospheric pressure generator, or constant positive-pressure generator if positive end-expiratory pressure is applied. From the information received through a pneumotachometer placed near the patient's airway, a microprocessor controls the mode of ventilation, and monitors and processes the ventilatory data. This computerized device has a high-security keyboard and a visual display screen. Ventilatory data are stored in a timed memory and presented on the screen. By measuring compliance and airway resistance with a standardized cycle, it is possible to define the patient's ventilatory mechanics by a mathematical model and predict the result of any proposed change in preset variables.

Efficacy of pneumatic trousers in refractory prehospital cardiopulmonary arrest

Persons refractory to early application of advanced cardiac life support have a dismal prognosis. New modalities are needed to treat this almost universally lethal condition. We have evaluated pneumatic trousers in the treatment of refractory cardiopulmonary arrest. To date 136 patients have been entered into this controlled, prospective, randomized study. All patients were more than 20 years old and in cardiac arrest of apparent cardiac etiology. Patients were excluded if they had arrested secondary to trauma or overdose, or if an IV could not be started. In addition, patients had to be refractory to therapies included in our paramedic standing orders. If at the end of these standing orders the patient remained in arrest, he was entered into the study and pneumatic trousers were applied or not according to a randomized list. The attempted resuscitation was then continued with no other preset variables. The resuscitation and discharge rates for the control group were 21% and 4%, respectively. With pneumatic trousers, resuscitation increased to 33%, and discharge to 9%. The control group in ventricular fibrillation (VF) had a 27% resuscitation rate and a 5% discharge rate. The pneumatic trousers group with VF had a 35% resuscitation rate and a 12% discharge rate. In pulseless idioventricular rhythm (PIVR), the control group had a 0% resuscitation rate and a 0% discharge rate. In marked contrast, for PIVR the pneumatic trousers group had a 35% resuscitation rate and a 9% discharge rate. The control group in asystole (AS) had a 25% resuscitation rate and a 0% discharge rate. The pneumatic trousers group in AS had a 27% resuscitation rate and a 0% discharge rate. The improvement in resuscitation rate with pneumatic trousers was statistically significant only for the initial rhythm of PIVR (P less than .05). The pneumatic trousers improved resuscitation and discharge rates for refractory VF, but not to a statistically significant degree. These somewhat enhanced resuscitation and discharge rates with the pneumatic trousers make it an adjunct to be considered in refractory arrest.