SISTEM PAKAR DIAGNOSA KERUSAKAN MOTOR KAWASAKI KLX150 MENGGUNAKAN METODE CASE-BASED REASONING DENGAN ALGORITMA 3W-JACCARD

In this day and age, motorbikes have an important role in transportation facilities, motorbike users are increasingly dense, especially in the city of Semarang, which is not accompanied by information media. The lack of media information regarding damage to the motorbike makes it difficult for someone to know the cause of the damage to the motorbike, not to mention the Kawasaki KLX150 which happens a lot of engine damage. For this reason, the expert system diagnoses motor damage by knowing the type of motor damage, after that diagnostics and alternative solutions to the problem are carried out. With this, the method and algorithm used is Case-Based Reasoning (CBR) using the Similarity 3W-Jaccard calculation, this second method and algorithm can be used to diagnose damage from the symptoms in the database. Each symptom has a weighted value of each, including a value of 5 (five) for severe symptoms, relating to engine and electrical parts, a value of 3 (three) for moderate symptoms, relating to braking and chains, a value of 1 (one) mild symptom, relating to with the indicator on the speedometer. The system will display 5 (five) types of damage calculated using the 3W-Jaccard Algorithm sorted by the highest value. The revision process will appear if the similarity calculation results are less than 0.6 (zero point six) because it is considered that the results are not sufficiently similar to the solution to be repaired, it needs to be reviewed and will be entered into the review table, then the expert will find a solution.

Pulmonary function and six-minute-walk test in patients after recovery from COVID-19: A prospective cohort study

Objectives To study abnormality of spirometry, six-minute walk distance, and chest radiograph among patients recovered from Coronavirus Disease 2019 (COVID-19). Methods and study design A prospective cohort study was conducted in 87 COVID-19 confirmed cases who recovered and discharged from a medical school hospital in Thailand. At the follow-up visit on day 60 after onset of symptoms, patients underwent an evaluation by spirometry (FVC, FEV1, FEV1/FVC, FEF25-75, and PEF), a six-minute-walk test (6MWT), and a chest radiograph. Results There were 35 men and 52 women, with a mean age of 39.6±11.8 years and the mean body mass index (BMI) was 23.8±4.3 kg/m2. Of all, 45 cases had mild symptoms; 35 had non-severe pneumonia, and 7 had severe pneumonia. Abnormality in spirometry was observed in 15 cases (17.2%), with 8% of restrictive defect and 9.2% of obstructive defect. Among the patients with an abnormal spirometry, the majority of the cases were in the severe pneumonia group (71.4%), compared with 15.6% in the non-severe pneumonia group, and 10.2% in the mild symptom group (p = 0.001). The mean six-minute-walk distance (6MWD) in the mild symptom and non-severe pneumonia groups was 538±56.8 and 527.5±53.5 meters, respectively. Although the severe pneumonia group tended to have a shorter mean 6-min walking distance, but this was not statistically significant (p = 0.118). Twelve patients (13.8%) had abnormal chest radiographs that showed residual fibrosis. This abnormality was more common in the severe pneumonia group (85.7%) and in others (7.5%) (p<0.001). Conclusions Abnormal spirometry was noted in 17.2% of COVID-19 survivors with both restrictive and obstructive defects. Severe COVID-19 pneumonia patients had higher prevalence rates of abnormal spirometry and residual fibrosis on the chest radiographs when compared to patients in the mild symptom and non-severe pneumonia groups.

COVID 19, Pathophysiology and Prospects for Early Detection in Patients with Mild Symptoms of The Controversial Virus in Underdeveloped Countries

COVID 19 has spread uniformly across the planet without distinction of hemispheres, borders, or climates. However, underdeveloped countries lack sufficient means to effectively detect and cope with the pandemic. The catastrophic economic situation forces indefinite quarantines to avoid health collapse. The scarcity of massive detection tests has led health personnel, the general population and their rulers to ignorance of the true epidemiological magnitude of SARS-CoV-2. Method: A computerized bibliographic search was performed using the Google search engine of original and review articles indexed by Scopus and WOS, in the PubMed / Medline and Cochrane databases to identify all relevant manuscripts and preprints, notices from professional societies and comments from Experts published from the start of the current epidemic related to mild COVID 19 symptoms. Tools, massive methods for detecting the disease and their low availability in underdeveloped countries were analyzed. Inexpensive and easily accessible methods for testing for the disease were discussed. Result: According to the indexed publications on the incidence of hypoxemia as a symptom and parameter of the evolution of the disease, oxygen saturation of less than 93% was determined as the limit to consider the patient suspected of COVID 19. In addition, it was determined after the analysis of published studies show an average prevalence of anosmia-hyposmia as a mild symptom in 69% of patients infected with COVID 19. Conclusion: Suspected cases of COVID 19 infection could be detected by the presence of its prevalent signs and symptoms. More studies are needed to standardize and validate the postulated screening tests.

Pattern of symptoms in head and neck cancer (HNC) survivors treated with radiation therapy (RT): Association with systemic therapy.

5589 Background: We sought, in a large, long-term follow-up cohort, to determine benchmark cross-sectional analysis of HNC patient (pt) symptom profiles as a function of chemotherapy (CT)/RT strategy. Methods: Pts treated with RT with or without CT in remission > 18 mos. were surveyed with the MD Anderson Symptom Inventory–Head and Neck Module (MDASI-HN). Clinical data were extracted. Data were tabulated, and group comparison performed using non-parametric analyses. Results: 250 pts participated; 81% were male. Median age at RT was 54 years. 87% had oropharynx HNC. Most were T1/X (41%), 37% T2 and, 22% T3/4. For N-category, most were N2 (55%), <5% N3, and 40% NX-1. 18% had induction CT, 26% concurrent, 5% both, and 50% had none. At a median follow-up time of 5.9 years (range 2-15), 11% of pts were entirely symptom free, 31% reported ≤mild symptom severity, 20% ≤moderate, and 38% reported ≥1 symptom as severe. 16% of pts receiving RT alone and 11% sequential CT followed by RT were symptom free, vs. 1% of those receiving concurrent CT (chi-square p<0.01), and the symptom distribution profile was distinct (p<0.03). The proportion of pts who received concurrent CT reporting any severe symptom item was 44%, vs. 36% of those not receiving concurrent CT (p=n.s.). No difference was seen in the moderate to severe (M/S) symptom report by treatment group. For all MDASI-HN items, most pts rated “0” or “not present”, except dry mouth and difficulty swallowing items, where mild symptoms were most likely (36% and 33%). The most common symptoms rated M/S were dry mouth, swallowing, choking, fatigue, and mouth and throat mucus reported by 42%, 23%, 18%, 16%, and 16%. MVA demonstrated T-stage and primary site, but not CT cohort correlated with M/S symptom report. Conclusions: Cumulatively, most pts had no more that mild symptom severity, but a substantial group of pts experience M/S levels. The symptom severity profile was highest with concurrent CT, though this effect appears mediated by disease specific factors. The addition of sequential CT to RT did not to appear to alter M/S symptom report substantially; however, concurrent pts were almost never symptom free, in contrast to induction and no CT cohorts.

Interstitial Pneumonia in Patients with Idhiopatic Thrombocytopenic Purpura.

INTRODUCTION: Idhiopatic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by a premature destruction of platelets by macrophage, especially in the spleen. However in some cases, platelet sequestration and destruction may occur in other organs. Chromium labeled platelet sequestration study revealed that liver or precordial area are prominent sites of sequestration in some cases, suggesting that the lung might be the site in certain cases. Some cases of interstitial pneumonia are associated with immunologic injury to the lung and seen in patients with some autoimmune diseases, infections, drugs and transfusion related acute lung injury (TRALI) in which transfusions of platelets and blood products induce acute lung injury due to sequestration of platelets and neutrophils in lungs, sometimes leading to ARDS. We describe here an unusual association between ITP and interstitial pneumonia, suggesting that a lung injury similar to TRALI is involved in acute and recurrent ITP. METHODS: We have identified patients with ITP who developed interstitial pneumonia during the course of ITP. We reviewed their charts and analyzed their clinical courses of ITP and interstitial lung diseases. Laboratory tests and chest X ray or CAT scans were reviewed. The laboratory study included CBC, platelets and platelets activation was measured by PMP (platelet microparticles), expression of CD62p flowcytometrically. RESULTS: We have identified 6 patients with ITP who developed interstitial pneumonia during the course of ITP. In two of six, interstitial pneumonia was detected at the presentation of acute ITP. ITP was severe with platelet counts less than 10.000. Interstitial pneumonia was discovered incidentally by chest X ray and confirmed by CAT scans. A mild symptom of dyspnea was detected in careful examination. One underwent lung biopsy which showed findings consistent with brochiolitis obliterans organizing pneumonia. Repeated CAT scans in 1–3 months revealed marked improvement but residual interstitial infiltrates still persisted. Four others had a long standing chronic ITP with clinical courses characterized by frequent relapses in spite of surgical and medical therapy. Four of six patients had splenectomy. Interstitial lung diseases were detected at the time of a severe relapse with platelet counts of less than 20.000. One patient underwent chromium labeled platelet sequestration study which revealed rapid sequestration of platelets in the lung. Interstitial infiltrates improved following improvement of ITP but two progressed to interstitial pulmonary fibrosis. CD62P measured by flowcytometry was very high in all 3 patients tested, indicating persisting platelet activation in this clinical setting. SUMMARY: We report interstitial pneumonia developing in 6 patients with ITP. Clinically all were asymptomatic and detection of interstitial pneumonia was incidental radiology finding. A mild symptom of exertional dyspnea was present in careful investigation. Chest X ray or CT scans showed nonspecific interstitial infiltrates and showed an overall improvement within months but residual infiltrates persisted. Two progressed to pulmonary fibrosis. We suggest that platelets are sequestered and destroyed in the lung in some patients with ITP, to generate cytokines and lipid mediators that lead to a nonspecific interstitial lung disease.

Aggressiveness of Stagonospora nodorum Isolates Obtained from Wheat in the Northern Great Plains

Isolates of Stagonospora nodorum, obtained from diseased wheat leaves collected in fields in Montana, North Dakota, and South Dakota, were tested on detached seedling leaves of wheat and found to be pathogenic. Differences among isolates chosen at random were detected in the first phase of the inoculations. Isolates associated with severe and mild symptom severity, as measured by lesion size, were selected in phase two. Isolates associated with severe and mild symptom severity were statistically differentiated in phase three. The ability of isolates to cause significant differences in symptom severity was interpreted as differences in aggressiveness. The differences among isolates detected with detached leaf experiments was confirmed with glasshouse inoculations of seedling wheat plants. The high aggressive isolates consistently produced higher symptom severity on wheat seedlings, as measured by percentage necrosis, than low aggressive isolates. Cultivars were consistently differentiated with isolates associated with different levels of aggressiveness. With unselected isolates, the cultivar × isolate interaction was nonsignificant, indicating a lack of specificity. With high and low aggressive isolates, the cultivar × isolate interaction was significant. Considering that the magnitude of the mean squares for interactions were rather low compared to the main effects, it is speculated either that specificity is detected with the present isolates but only at a low level, or that specificity is apparent only when isolate extremes are tested. With studying isolates in phases rather than random comparisons, fungal isolates associated the high and low aggressiveness can be identified and, once identified, isolates from different hosts or geographical areas can be compared in an efficient and meaningful manner.

Use of Codeine-and Dextromethorphan-Containing Cough Syrups in Pediatrics

In making decisions regarding the use of centrally acting antitussives, the practitioner must first consider the indications for the use of any antitussive agent; then, the efficacy and safety of the available agents as compared to those of a nondrug, alternative course of therapy must be considered. As stated in an editorial in the British Medical Journal,1 "the fact that a patient has a cough does not indicate that he needs treatment for it." Nevertheless, we acknowledge the traditional, frequent prescribing and self-administration of antitussive products and the almost placebo nature of many of them. Indications and Contraindications Coughs may be considered reflex responses to mechanical or chemical irritation of the tracheobronchial tree that are mediated by a brainstem "cough center." Thus, coughing serves the beneficial functions of clearing airways of obstructing or irritating material and warning against noxious substances in inspired air.2 In pathologic states (e.g., asthma, chronic obstructive pulmonary disease, chronic bronchitis, and cystic fibrosis), the cough reflex serves to maintain airway patency by clearing excessive secretions. Cough suppression in patients with these conditions may be not only counterproductive but also directly harmful. Clearing of secretions filling the tracheobronchial tree of these patients is essential to management. In other diseases (e.g., influenza), coughing simply may be a response to inflammation of the respiratory epithelium; however, a truly "nonproductive" cough is unusual in infants and young children. Rarely, nonproductive coughing may be severe enough to cause emesis, exhaustion, and loss of sleep. A cough is usually a mild symptom of the common cold, but even in this instance clearing of secretions is probably beneficial.

TOBACCO ETCH VIRUS IN ONTARIO

Tobacco etch is one of the most widespread and injurious viruses on burley tobacco in Ontario. Three strains of this virus were obtained from tobacco collections. Their symptoms and behavior on tobacco and other hosts are described. Tobacco varieties were divided into two groups on the basis of their reaction to the etch virus. The group comprising all burley varieties tested showed severe symptoms while the other, comprising flue cured, dark, and cigar varieties, developed mild symptoms. The F1 from severe-symptom varieties × mild-symptom varieties exhibit mild symptoms while the F2 has segregated into severe- and mild-symptom types. The widespread occurrence of etch is attributed to the prevalence on tobacco of the vector Myzus persicae. A mixture of potato virus X (ringspot strain) and etch causes a more severe disease on burley tobacco than either virus by itself.