Comparative Study of Artificial Intelligence Techniques for the Diagnosis of Chronic Nerve Diseases

Farming is essential to the long-term viability of any economy. It differs in each country, but it is essential for long-term economic success. Only a few of the agricultural industry’s issues include a lack of suitable irrigation systems, weeds, and plant monitoring concerns as a consequence of efficient management in distinct open and closed zones for crop and plant treatment. The objective of this work is to carry out a study on the use of artificial intelligence and computer vision methods for diagnosis of diseases in agro sectors in the context of agribusiness, demonstrating the feasibility of using these techniques as tools to support automation and obtain productivity gains in this sector. During the literary analysis, it was determined that technology could improve efficiency, hence decreasing these types of concerns. Given the consequences of a wrong diagnosis, diagnosis is work that requires a high level of precision. Fuzzy cognitive maps were shown to be the most efficient method of utilizing bibliographically reviewed preferences, which led to the consideration of neural networks as a second option because this technique is the most robust in terms of the qualifying criteria of the data stored in databases.

POCT errors can lead to false potassium results

Point-of-care-testing (POCT) facilitates rapid availability of results that allows prompt clinical decision making. These results must be reliable and the whole process must not compromise its quality. Blood gas analyzers are one of the most used methods for POCT tests in Emergency Departments (ED) and in critical patients. Whole blood is the preferred sample, and we must be aware that hemolysis can occur. These devices cannot detect the presence of hemolysis in the sample, and because of the characteristics of the sample, we cannot visually detect it either. Hemolysis can alter the result of different parameters, including potassium with abnormal high results or masking low levels (hypokalemia) when reporting normal concentrations. Severe hyperkalemia is associated with the risk of potentially fatal cardiac arrhythmia and demands emergency clinical intervention. Hemolysis can be considered the most frequent cause of pseudohyperkalemia (spurious hyperkalemia) or pseudonormokalemia and can be accompanied by a wrong diagnosis and an ensuing inappropriate clinical decision making. A complete review of the potential causes of falsely elevated potassium concentrations in blood is presented in this article. POCT programs properly led and organized by the clinical laboratory can help to prevent errors and their impact on patient care.

Identification Of Dementia In Recent Medicare Claims Data, Compared To Rigorous Clinical Assessments

BACKGROUND Medicare fee-for-service (FFS) claims data are increasingly leveraged for dementia research. Few studies address the validity of recent claims data to identify dementia, or carefully evaluate characteristics of those assigned the wrong diagnosis in claims. METHODS We used claims data from 2014-2018, linked to participants administered rigorous, annual dementia evaluations in five cohorts at the Rush Alzheimer’s Disease Center. We compared prevalent dementia diagnosed through the 2016 cohort evaluation versus claims identification of dementia, applying the Bynum-standard algorithm. RESULTS Of 1,054 participants with Medicare Parts A and B FFS in a 3-year window surrounding their 2016 index date, 136 had prevalent dementia diagnosed during cohort evaluations; the claims algorithm yielded 217. Sensitivity of claims diagnosis was 79%, specificity 88%, positive predictive value 50%, negative predictive value 97%, and overall accuracy 87%. White participants were disproportionately represented among detected dementia cases (true-positive) versus cases missed (false-negative) by claims (90% versus 75%, respectively, p=0.04). Dementia appeared more severe in detected than missed cases in claims (mean MMSE=15.4 versus 22.0, respectively, p<0.001; 28% with no limitations in activities of daily living versus 45%, p=0.046). By contrast, those with “over-diagnosis” of dementia in claims (false-positive) had several worse health indicators than true negatives (eg, self-reported memory concerns=51% versus 29%, respectively, p<0.001; mild cognitive impairment in cohort evaluation=72% versus 44%, p<0.001; mean comorbidities=7 versus 4, p<0.001). CONCLUSIONS Recent Medicare claims perform reasonably well in identifying dementia; however, there are consistent differences in cases of dementia identified through claims than in rigorous cohort evaluations.

Legal Protection for Patients Who Are Harmed as a Result of Wrong Diagnosis of the Doctor in the Service App-Based Health Online

Health service based online appear in the middle of the rapid development of technology and information. But in practice, in community service this raises the problem that the doctor was wrong in making a diagnosis of the patient. This research using the method of normative legal research with the approach of legislation (statue approach) using secondary data consisting of primary material, secondary legal materials and tertiary legal materials. The Data is then analyzed in the normative qualitative and prepared by the method of descriptive analysis that the obtained descriptions thoroughly and ends with a conclusion by using the deductive method as the answers from the problems that have been formulated. The results of this research showed that the health service-based online has been growing in Indonesia. This service is in great demand due to various advantages such as cheaper prices, flexible, wider range, and can improve health services. The implementation of application-based health service of the online organized by the Health Law governing health care. Then Permenkes 20 2019 set more on the health service-based online which is done through the application of health services. The legal protection given to patients who have experienced losses due to get the error diagnosis of the disease is done by a doctor can submit a complaint to MKDKI according to the provisions of Article 66 of the Law Practice of Medicine, in addition, the patient can also ask for damages suffered as a result of the use of health services is in accordance with the provisions UUPK namely through the process of completion for non-litgasi or in litigation. Keywords: The Protection Of The Law, Patients, Health App-Based Online.

Communication barriers that affect medication adherence in patients with learning disabilities

Communication formulates a large part of a consultation and as a practitioner, it is vital to communicate effectively with a patient. Jamara Hignett provides an overview of the communication barriers that affect medication adherence in patients with learning disabilities Having a disability that affects communication can cause particular problems in primary care as inadequate communication can lead to the wrong diagnosis, poor assessments and inadequate health care ( Murphy, 2006 ). All patients are entitled to accessible and appropriate information on prescribed medication to facilitate a deeper understanding of the benefits and harms of treatment ( Grime et al, 2007 ). Reasonable adjustments should be made for learning difficultly patients and this can be in the form of easy reads guides that incorporate larger text, simple information and pictorial explanations. Communication passports are a tool used by people with learning disabilities; these provide both a practical and person-centred approach to passing on key information about people with complex communication difficulties ( Nursing Times, 2018 ). They provide information about the communication needs and health needs of a patient which is useful to assist in bridging the communication gap between nurse practitioner and patient. In a time of technological advancements, a move towards digital passports would be more beneficial with regular updates from the multidisciplinary team. This in turn can be shared across numerous health platforms the patient might come into contact with, allowing the nurse practitioner to better prepare for the patient prior to their consultation. Education on learning disabilities is an area of training that is lacking in general practice; there have been no provisions made to make the training mandatory. Incorporating mandatory yearly staff training will ensure nurse practitioners have the tools and knowledge to adapt communication techniques during a consultation.

A machine and human reader study on AI diagnosis model safety under attacks of adversarial images

While active efforts are advancing medical artificial intelligence (AI) model development and clinical translation, safety issues of the AI models emerge, but little research has been done. We perform a study to investigate the behaviors of an AI diagnosis model under adversarial images generated by Generative Adversarial Network (GAN) models and to evaluate the effects on human experts when visually identifying potential adversarial images. Our GAN model makes intentional modifications to the diagnosis-sensitive contents of mammogram images in deep learning-based computer-aided diagnosis (CAD) of breast cancer. In our experiments the adversarial samples fool the AI-CAD model to output a wrong diagnosis on 69.1% of the cases that are initially correctly classified by the AI-CAD model. Five breast imaging radiologists visually identify 29%-71% of the adversarial samples. Our study suggests an imperative need for continuing research on medical AI model’s safety issues and for developing potential defensive solutions against adversarial attacks.

Pitfalls in Diagnosing Heterotopic Pregnancy in Sub-Saharan Africa: A Case Report at the Yaounde University Teaching Hospital (Cameroon)

Heterotopic pregnancy (HP) is a dizygotic twin pregnancy in which one gestational sac is intrauterine and the other is extrauterine. The prevalence of HP is unknown in Cameroon where the diagnosis is difficult and usually fortuitous like in other resource-poor settings. We herein depict pitfalls and delays in the diagnosis and management of a ruptured heterotopic pregnancy at the Yaounde University Teaching Hospital. After a wrong diagnosis and inadequate treatment, our patient presented at our emergency unit with severe pelvic pain and clinical signs of hemoperitoneum with shock. She underwent a total left salpingectomy through laparotomy. She had a complete spontaneous abortion five days after the surgery. Given that sonography is not routinely available in emergency departments in resource-poor settings, it may be relevant for practitioners to always bear HP in mind when facing ruptured ectopic pregnancies.

Differential Diagnosis of Charcot Neuroarthropathy in Subacute and Chronic Phases: Unusual Diseases

Charcot Neuroarthropaty (CN) is a complication of diabetes with devastating consequences as it produces severe deformities in the foot developing in recurrent ulcers that rise the probability of amputation. There are several diseases mentioned in the literature that have to be considered for the differential diagnosis of CN, often related to the acute phase (gout, ankle sprain, inflammatory arthritis, cellulitis, venous thrombosis) but there is paucity of information related to the differential diagnosis in later stages (coalescence, remodeling) when there is deformity of the foot. Clinicians and diabetologists are not familiarized with orthopedic pathology and do not have in mind certain diseases that could mimic CN in the subacute or chronic phases and this can develop in a wrong diagnosis. It is important to make a correct diagnosis in patients with suspected CN not only in the acute phase but also in the chronic phase to establish an accurate treatment. This article is a review of the differential diagnosis of CN in subacute and chronic phases showing similarities and differences that can help clinicians and diabetologists to make an accurate diagnosis and treatment. We describe unusual diseases like tendon and muscles disorders, Frieberg's disease, complex pain regional syndrome, transient regional osteoporosis and osteomyelitis superimposed to CN and the main features of each one that could help in making a differential diagnosis

The Endothelial Barrier Restricts Endocrine Actions to the Luminal Vascular Receptors: Changing the Paradigm: A Didactic Approach

In 1849, the first list of endocrine hormones was discovered and proposed that the synthesizing gland delivers it to the circulation. The circulatory hormone reaches the target organ, physically unimpeded acts directly on the parenchymal cells. Such a simplistic view persists despite new knowledge of an endothelial wall barrier and implications for every parenchymal cell in the body. This misconception leads to inadequate interpretations of data, wrong diagnosis and therapeutic expectations, erroneous hypotheses, and misleads further research work. The quest of this review is to play down this misconception by pointing out key overlooked findings of the vascular endothelial wall: 1) The selective endothelial barrier physically separates two same-hormone-containing compartments; the endocrine and the interstitial autocrine hormone compartments, 2) the hormone concentrations values in these compartments are independent of each other, 3) in each compartment the hormone acts solely on the receptors of that particular compartment, 4) multiple intravascular endocrine hormones act solely on their corresponding luminal endothelial membrane receptor (LEMR), without directly acting on the parenchymal cells, 5) Agonist-activation of LEMR triggers the release of specific paracrine endothelial agents that in conjunction with autocrine interstitial hormone modulate parenchymal function(s) and perhaps the turnover of the interstitial autocrine hormone, 6) these hormone compartments, functionally interact via paracrine exchange signaling, and the integrated intercourse of all these events result in the final hormonal organ effect. The present challenges to achieving more rationale therapeutic effects are to design agonists or antagonists that exclusively gain access to a target compartment and have high specificity for the receptor of the cells in that compartment.

Communication barriers that affect medication adherence in patients with learning disabilities

Having a disability that affects communication can cause particular problems in primary care as inadequate communication can lead to the wrong diagnosis, poor assessments and inadequate health care ( Murphy, 2006 ). All patients are entitled to accessible and appropriate information on prescribed medication to facilitate a deeper understanding of the benefits and harms of treatment ( Grime et al, 2007 ). Reasonable adjustments should be made for learning difficultly patients and this can be in the form of easy reads guides that incorporate larger text, simple information and pictural explanations. Communication passports are a tool used by learning disabled patients, these provide both a practical and person-centred approach to passing on key information about people with complex communication difficulties ( Nursing Times, 2018 ). They provide information about the communication needs and health needs of a patient which is useful to assist in bridging the communication gap between nurse practitioner and patient. In a time of technological advancements, a move towards digital passports would be more beneficial with regular updates from the multidisciplinary team. This in turn can be shared across numerous health platforms the patient might come into contact with, allowing the nurse practitioner to better prepare for the patient prior to their consultation. Education on learning disabilities is an area of training that is lacking in general practice, there have been no provisions made to make the training mandatory. Incorporating mandatory yearly staff training will ensure nurse practitioners have the tools and knowledge to adapt communication techniques during a consultation.