Abstract: Health and Social care (HSc) services planning and scheduling are facing unprecedented challenges, due to the pandemic pressure and also suffer from unplanned spending that is negatively impacted by the global financial crisis. Data-driven approaches can help to improve policies, plan and design services provision schedules using algorithms that assist healthcare managers to face unexpected demands using fewer resources. The paper discusses services packing using statistical significance tests and machine learning (ML) to evaluate demands similarity and coupling. This is achieved by predicting the range of the demand (class) using ML methods such as Classification and Regression Trees (CART), Random Forests (RF), and Logistic Regression (LGR). The significance tests Chi-Squared and Student’s test are used on data over a 39 years span for which data exist for services delivered in Scotland. The demands are associated using probabilities and are parts of statistical hypotheses. These hypotheses, as their NULL part, assume that the target demand is statistically dependent on other services’ demands. This linking is checked using the data. In addition, ML methods are used to linearly predict the above target demands from the statistically found associations and extend the linear dependence of the target’s demand to independent demands forming, thus, groups of services. Statistical tests confirmed ML coupling and made the prediction statistically meaningful and proved that a target service can be matched reliably to other services while ML showed that such marked relationships can also be linear ones. Zero padding was used for missing years records and illustrated better such relationships both for limited years and for the entire span offering long-term data visualizations while limited years periods explained how well patients numbers can be related in short periods of time or that they can change over time as opposed to behaviours across more years. The prediction performance of the associations were measured using metrics such as Receiver Operating Characteristic (ROC), Area Under Curve (AUC) and Accuracy (ACC) as well as the statistical tests Chi-Squared and Student. Co-plots and comparison tables for the RF, CART, and LGR methods as well as the p-value from tests and Information Exchange (IE/MIE) measures are provided showing the relative performance of ML methods and of the statistical tests as well as the behaviour using different learning ratios. The impact of k-neighbours classification (k-NN), Cross-Correlation (CC) and C-Means (CM) first groupings was also studied over limited years and for the entire span. It was found that CART was generally behind RF and LGR but in some interesting cases, LGR reached an AUC = 0 falling below CART, while the ACC was as high as 0.912 showing that ML methods can be confused by zero-padding or by data’s irregularities or by the outliers. On average, 3 linear predictors were sufficient, LGR was found competing well RF and CART followed with the same performance at higher learning ratios. Services were packed only when a significance level (p-value) of their association coefficient was more than 0.05. Social factors relationships were observed between home care services and treatment of old people, low birth weights, alcoholism, drug abuse, and emergency admissions. The work found that different HSc services can be well packed as plans of limited duration, across various services sectors, learning configurations, as confirmed by using statistical hypotheses.
Abstract: A retrospective study conducted at Christian Medical
College (CMC) Teaching Hospital, Vellore, India on 14th August
2014 to assess the accuracy of clinically estimated foetal weight upon
labour admission. Estimating foetal weight is a crucial factor in
assessing maternal and foetal complications during and after labour.
Medical notes of ninety-eight postnatal women who fulfilled the
inclusion criteria were studied to evaluate the correlation between
their recorded Estimated Foetal Weight (EFW) on admission and
actual birth weight (ABW) of the newborn after delivery. Data
concerning maternal and foetal demographics was also noted.
Accuracy was determined by absolute percentage error and
proportion of estimates within 10% of ABW. Actual birth weights
ranged from 950-4080g. A strong positive correlation between EFW
and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the
normal weight range (2500-4000g) had a 59.5% estimation accuracy
(n=74) compared to pre-term (4000g) were underestimated by 25% (n=3) and low birthweight
(LBW) babies were overestimated by 12.7% (n=9). Registrars who
estimated foetal weight were accurate in babies within normal weight
ranges. However, there needs to be an improvement in predicting
weight of macrosomic and LBW foetuses. We have suggested the use
of an amended version of the Johnson’s formula for the Indian
population for improvement and a need to re-audit once
implemented.
Abstract: The objective of this study was to investigate the lifelong
effect of in utero nutrition fed at different stages of pregnancy in
Bali cows (n = 40): (U1) without in utero nutrition (0 – parturition,
negative control); (U2) 0 – 90 d of gestation; (U3) 90 - 180 d of
gestation; (U4) 180 d – parturition; and (U5) in utero nutrition along
gestation period (0 d to parturition – positive control) on the growth
performance of the offspring to weaning age. The results indicated
that effect of maternal nutrition on male and female offspring were
particularly indicated by the growth performance of both the male
and female offspring from birth to weaning.
Abstract: Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.
Abstract: The objective of this study was to determine the accuracy to estimation fetal weight by Johnson-s method and compares it with actual birth weight. The sample group was 126 infants delivered in Dan KhunThot hospital from January March 2012. Fetal weight was estimated by measuring fundal height according to Johnson-s method. The information was collected by studying historical delivery records and then analyzed by using the statistics of frequency, percentage, mean, and standard deviation. Finally, the difference was analyzed by a paired t-test.The results showed had an average birth weight was 3093.57 ± 391.03 g (mean ± SD) and 3,455 ± 454.55 g average estimated fetal weight by Johnson-s method higher than average actual birth weight was 384.09 grams. When classifying the infants according to birth weight found that low birth weight ( 4000 g) actual birth weight was more than estimated fetal weight. The difference was found between actual birth weight and estimation fetal weight of the minimum weight in high birth weight ( > 4000 g) , the appropriate birth weight (2500-3999g) and low birth weight (
Abstract: Trihalomethanes (THMs) were among the first
disinfection byproducts to be discovered in chlorinated water. The
substances form during a reaction between chlorine and organic
matter in the water. Trihalomethanes are suspected to have negative
effects on birth such as, low birth weight, intrauterine growth
retardation in term births, as well as gestational age and preterm
delivery. There are also some evidences showing these by-products to
be mutagenic and carcinogenic, the greatest amount of evidence being
related to the bladder cancer. However, there exist inconsistencies
regarding such effects of THMs as different studies have provided
different results in this regard. The aim of the present study is to
provide a review of the related researches about the above mentioned
health effects of THMs.
Abstract: The effect of shearing date on behaviors and performances of 20 pregnant Rahmani ewes was evaluated in four groups (5each). Ewes were shorn at 70, 100 and 130 days of pregnancy in the first three groups respectively, while the fourth group was maintained unshorn as a control. Some behavioral and physiological data related to ewes in addition, blood cortisol level were recorded. Results revealed a significant increase in the frequencies of comfort and eating behaviors, respiratory rate, pulse rate, lamb birth weight and blood cortisol level in early and mid pregnancy shorn ewes. Also, a slight increase in pregnancy period was observed for those ewes. On the other hand, social behaviors, and core temperature were not affected by shearing. These results conclude that prenatal shearing (early and mid-pregnancy) of ewes increases the frequencies of comfort and eating behaviors, and improves the survival rates of lambs by increasing their birth weights.
Abstract: Data from 1731 Gentile di Puglia lambs, sired by 65 rams over a 5-year period were analyzed by a mixed model to estimate the variance components for heritability. The considered growth traits were: birth weight (BW), weight at 30 days of age (W30) and average daily gain from birth to 30 days of age (DG). Year of birth, sex of lamb, type of birth (single or twin), dam age at lambing and farm were significant sources of variation for all the considered growth traits. The average lamb weights were 3.85±0.16 kg at birth, 9.57±0.91 kg at 30 days of age and the average daily gain was 191±14 g. Estimates of heritability were 0.33±0.05, 0.41±0.06 and 0.16±0.05 respectively for the same traits. These values suggest there is a good opportunity to improve Gentile di Puglia lambs by selecting animals for growth traits.