360 research outputs found
Retracted: Robotic Process Automation use cases in academia and early implementation experiences
No full textAbstract Retraction: [Ankur Gupta, Purnendu Prabhat, Sahil Sawhney, Rajesh Gupta, Sudeep Tanwar, Neeraj Kumar, Mohammad Shabaz, Robotic Process Automation use cases in academia and early implementation experiences, IET Software 2022 (https://doi.org/10.1049/sfw2.12061)]. The above article from IET Software, published online on 19 May 2022 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the Editor‐in‐Chief, Hana Chockler, the Institution of Engineering and Technology (the IET) and John Wiley and Sons Ltd. This article was published as part of a Guest Edited special issue. Following an investigation, the IET and the journal have determined that the article was not reviewed in line with the journal’s peer review standards and there is evidence that the peer review process of the special issue underwent systematic manipulation. Accordingly, we cannot vouch for the integrity or reliability of the content. As such we have taken the decision to retract the article. The authors have been informed of the decision to retract
Digital Twin and Blockchain for Sustainable Healthcare 5.0
No full textThis book investigates blockchain and digital twin technologies to offer insights into their potential applications in the healthcare industry. It explores how these technologies can work together to build a strong and sustainable healthcare ecosystem, improve patient satisfaction, and streamline administrative procedures. Through examples, case studies and discussions, the book highlights their use in supply chain management, disease prediction, and patient monitoring. It addresses challenges and offers solutions, examining ethical and legal considerations and the integration of patient preferences. • Explores how blockchain technology can support digital twin technology in healthcare applications, facilitating efficient and secure data management. • Studies utilisation of advanced machine learning algorithms and predictive models in healthcare applications. • Discusses how the integration of digital twin and blockchain technologies can contribute to sustainable development in personalised healthcare. • Considers the ethical and legal implications associated with personalised treatment options, providing a comprehensive examination of these considerations. • Integration of patient preferences into personalised healthcare approaches, emphasising the importance of patient-centric care. Aimed at professionals, researchers, and policymakers interested in Healthcare 5.0., the book provides comprehensive coverage of these technologies and their role in shaping sustainable healthcare practices. The Open Access version of this book, available at http://www.taylorfrancis.com, has been made available under a Creative Commons [Attribution-Non Commercial-No Derivatives (CC BY-NC-ND)] 4.0 license
Trusted federated learning for Internet of Medical Things: solutions and challenges
Get PDFThe clinical adoption of state-of-the-art artificial intelligence (AI) applications for disease diagnosis with digital healthcare technologies will ease the burden on medical practitioners, ensure timely interventions, and aid patients’ welfare. The digital innovations in medical data acquisition have made it possible to collect multi-modal data through Internet of Medical Things (IoMT) but the privacy-preserving nature and compliance with medical data regulations often preclude data sharing across organizational and geographical boundaries. An AI model requires high quality and large-scale training datasets collected from diverse sources to mitigate bias and aid better prediction accuracy of the unseen data. With secure and trusted federated learning, the data of an organization can stay local and yet contribute to AI models’ training for building better trained models with improved accuracy and generalization. Thus, the trusted federated learning approaches facilitate sharing the trained AI models across different participating healthcare organizations by breaking down barriers, increasing trust, and preserving privacy for better disease predictions and diagnoses that can increase deployment of AI models in clinical practice. In this chapter, we provide the current state-of-the-art solutions, adoption challenges, and future research directions, and a framework for trusted federated learning in healthcare applications
A secure and scalable IoT consensus protocol
Get PDFSeveral consensus algorithms have been proposed as a way of resolving the Byzantine General problem with respect to blockchain consensus process. However, when these consensus algorithms are applied to a distributed, asynchronous network some suffer with security and/or scalability issues, while others suffer with liveness and/or safety issues. This is because the majority of research have not considered the importance of liveness and safety, with respect to the integrity of the consensus decision. In this paper a novel solution to this challenge is presented. A solution that protects blockchain transactions from fraudulent or erroneous mis-spends. This consensus protocol uses a combination of probabilistic randomness, an isomorphic balance authentication, error detection and synchronised time restrictions, when assessing the authenticity and validity of IoT request. Designed to operate in a distributed asynchronous network, this approach increases scalability while maintaining a high transactional throughput, even when faced with Byzantine failure
Randomized clinical trial: a pilot study investigating the safety and effectiveness of an escalating dose of peginterferon alpha-2a monotherapy for 48 weeks compared with standard clinical care in patients with hepatitis C cirrhosis
No full textBackground: A substantial proportion of patients with chronic hepatitis C virus (HCV) cirrhosis fail to eradicate infection and develop liver-related complications. Despite evidence that interferon-α has an antifibrotic effect, clinical trials have demonstrated that low-dose maintenance interferon does not improve outcomes in patients with compensated HCV cirrhosis following a lead-in phase of interferon. In a pilot study, we have investigated the efficacy of an escalating dose of pegylated interferon α-2a (PEG-IFN2a) as compared with standard clinical care in patients with more advanced HCV Child’s A or B cirrhosis without a lead-in phase.
<p/>Methods: In a prospective study, 40 patients were randomized to receive either standard clinical care (no further antiviral therapy) or 48 weeks of treatment with PEG-IFN2a starting at 90 mcg and escalating to 180 mcg weekly if tolerated. Patients were thereafter followed for a mean duration of 41 months. The primary outcome variables were liver-related death, all-cause mortality and sustained virological response. The secondary outcomes were ‘liver-related events’ and health-related quality of life.
<p/>Results: Both groups were well matched, with treatment well tolerated. The incidences of all-cause mortality (P=0.024) and nononcological liver morbidity (P=0.04) were significantly higher in the control arm after a mean of 47 months of follow-up.
<p/>Conclusion: A 48-week escalating dose of PEG-IFN2a is associated with a significant reduction in all-cause mortality and nononcological liver-related morbidity in this trial. Further investigation of PEG-IFN2a is warranted for patients with advanced HCV-related cirrhosis for whom there is no other treatment and where transplantation is associated with rapid progression to cirrhosis
The Enhanced Liver Fibrosis test maintains its diagnostic and prognostic performance in alcohol-related liver disease: a cohort study
No full textBackground: alcohol is the main cause of chronic liver disease. The Enhanced Liver Fibrosis (ELF) test is a serological biomarker for fibrosis staging in chronic liver disease, however its utility in alcohol-related liver disease warrants further validation. We assessed the diagnostic and prognostic performance of ELF in alcohol-related liver disease. Methods: observational cohort study assessing paired ELF and histology from 786 tertiary care patients with chronic liver disease due to alcohol (n = 81) and non-alcohol aetiologies (n = 705). Prognostic data were available for 64 alcohol patients for a median of 6.4 years. Multiple ELF cut-offs were assessed to determine diagnostic utility in moderate fibrosis and cirrhosis. Survival data were assessed to determine the ability of ELF to predict liver related events and all-cause mortality. Results: ELF identified cirrhosis and moderate fibrosis in alcohol-related liver disease independently of aminotransferase levels with areas under receiver operating characteristic curves of 0.895 (95% CI 0.823–0.968) and 0.923 (95% CI 0.866–0.981) respectively, which were non-inferior to non-alcohol aetiologies. The overall performance of ELF was assessed using the Obuchowski method: in alcohol = 0.934 (95% CI 0.908–0.960); non-alcohol = 0.907 (95% CI 0.895–0.919). Using ELF < 9.8 to exclude and ≧ 10.5 to diagnose cirrhosis, 87.7% of alcohol cases could have avoided biopsy, with sensitivity of 91% and specificity of 85%. A one-unit increase in ELF was associated with a 2.6 (95% CI 1.55–4.31, p < 0.001) fold greater odds of cirrhosis at baseline and 2.0-fold greater risk of a liver related event within 6 years (95% CI 1.39–2.99, p < 0.001). Conclusions: ELF accurately stages liver fibrosis independently of transaminase elevations as a marker of inflammation and has superior prognostic performance to biopsy in alcohol-related liver disease.</p
Stratified medicine: an exploration of the utility of non-invasive serum markers for the management of chronic liver diseases
Get PDFChronic liver disease (CLD), the 3rd commonest cause of premature death in the UK, is detected late when interventions are often ineffective. Non-alcoholic fatty liver disease (NAFLD) and chronic hepatitis C (CHC) account for a significant proportion of CLD in the UK. Numerous direct (molecules involved in matrix biology) and indirect biomarkers (standard laboratory tests) have been successfully developed to detect advanced liver fibrosis. Less success, however, has been achieved in the detection of alternative diagnostic targets such as early stage fibrosis, non-alcoholic steatohepatitis (NASH) and fibrosis evolution. In a study of 17 candidate biomarkers amongst patients with NAFLD, terminal peptide of procollagen 3 was identified as the only biomarker demonstrating good performance for the detection of NASH in both a derivation and validation cohort. Thereafter, these results were further validated in another NAFLD cohort. In a study of 9 biomarkers (indirect and direct) in the detection of fibrosis in NAFLD, direct biomarkers demonstrated better diagnostic performance overall and for early stage fibrosis although some indirect biomarkers identified advanced fibrosis and cirrhosis with good effect. Thereafter, parallel and serial combinations of 3 biomarkers of advanced fibrosis were proposed and successfully employed in a cohort of patients with NAFLD to improve diagnostic performance. In a study of 10 biomarkers in CHC, fibrosis detection was enhanced using complex biomarker panels that incorporated direct tests. Of note, the use an alternative assay for a constituent component significantly affected biomarker panel performance both overall and at diagnostic thresholds. The ability of the biomarkers to monitor fibrosis evolution arising due to putative antifibrotic was then studied in CHC. In the first study, changes in direct biomarker, ELF, could predict fibrosis evolution. In the second study, an improvement of indirect biomarker scores in patients with CHC cirrhosis during treatment was found to denote an improved prognosis
A Projapoti Paperback
No full textThis book may mix stories from Babbitt's 1912 and 1922 editions, titled respectively Jataka Tales and More Jataka Tales. Both were published by The Century Company and illustrated by Ellsworth Young. Simpler drawings here have been substituted for Young's work. There are twenty-one stories here. How the Turtle Saved His Own Life (23) is still wonderfully pleasing The fishes in The Three Fishes (130) are again named as in the standard Kalila and Dimna story, but the story now has to do with one fish who saves two others from a net. The covers present a human child walking in front of a baboon.Ellen C. Babbit
Learning articulated motions from visual demonstration
No full textThesis: S.M. in Computer Science and Engineering, Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, 2014.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.35Cataloged from student-submitted PDF version of thesis.Includes bibliographical references (pages 94-98).Robots operating autonomously in household environments must be capable of interacting with articulated objects on a daily basis. They should be able to infer each object's underlying kinematic linkages purely by observing its motion during manipulation. This work proposes a framework that enables robots to learn the articulation in objects from user-provided demonstrations, using RGB-D sensors. We introduce algorithms that combine concepts in sparse feature tracking, motion segmentation, object pose estimation, and articulation learning, to develop our proposed framework. Additionally, our methods can predict the motion of previously seen articulated objects in future encounters. We present experiments that demonstrate the ability of our method, given RGB-D data, to identify, analyze and predict the articulation of a number of everyday objects within a human-occupied environment.by Sudeep Pillai.S.M. in Computer Science and Engineerin
Prospective evaluation of a primary care referral pathway for patients with non-alcoholic fatty liver disease
Get PDFBACKGROUND & AIMS: We aimed to develop and evaluate a pathway for management of patients with non-alcoholic fatty liver disease (NAFLD) using blood tests to stratify patients in primary care to improve detection of cases of advanced fibrosis and cirrhosis, and avoid unnecessary referrals to secondary care. METHODS: This was a prospective longitudinal cohort study with before-and-after analysis and comparison to unexposed controls. We used a two-step algorithm combining the use of FIB-4 followed by the ELF test if required RESULTS: In total, 3,012 patients were analysed. Use of the pathway detected 5 times more cases of advanced fibrosis (Kleiner F3) and cirrhosis (OR=5.18; 95%CI=2.97 to 9.04; p<0.0001). Unnecessary referrals from primary care to secondary care fell by 81% (OR=0.193; 95%CI 0.111 to 0.337; p<0.0001). Three times more cases of cirrhosis were diagnosed (OR=3.14; 95%CI=1.57 to 24; p=0.00011). Although it was used for only 48% of referrals, significant benefits were observed across all referrals from the practices exposed to the pathway. Unnecessary referrals fell by 77% (OR=0.23; 95% CI=0.658 to 0.082; p=0.006) with a 4-fold improvement in detection of cases of advanced fibrosis and cirrhosis (OR=4.32; 95% CI=1.52 to 12.25; p=0.006). Compared to referrals made before introduction of the pathway, unnecessary referrals fell from 79/83 referrals (95.2%) to 107/152 (70.4%) representing an 88% reduction in unnecessary referrals when the pathway was followed (OR=0.12; 95%CI=0.042 to 0.349; p<0.0001). CONCLUSIONS: The use of non-invasive blood tests for liver fibrosis to stratify patients with NAFLD improves the detection of cases of advanced fibrosis and cirrhosis and reduces unnecessary referrals to secondary care of patients with lesser degrees of liver fibrosis. This strategy improves resource use and benefits patients. LAY SUMMARY: Non-alcoholic fatty liver disease effects up to 30% of the population but only a minority of cases develop liver disease. Our study has shown that established blood tests can be used in primary care to stratify patients with fatty liver disease to reduce unnecessary referrals by 80% and improve the detection of cases of advanced fibrosis 5 fold and cirrhosis 3 fold
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