This document presents a model for an online fuzzy-logic knowledge warehousing and mining system for diagnosing and treating HIV/AIDS. The system would store patient data and medical knowledge about HIV/AIDS. It uses fuzzy logic and data mining to predict HIV/AIDS status, monitor patient health over time, and determine recommended treatment plans. The system was tested on real patient data from a hospital in Nigeria. It aims to provide an efficient way to diagnose, treat, and monitor people living with HIV/AIDS.
The Cochrane Library: Web 2.0 & phisical activity Giuseppe Fattori
This review analyzed 11 studies involving over 5,800 adults to evaluate the effectiveness of remote and web-based interventions for promoting physical activity. The results showed that technology-supported programs can help adults become more active, achieve recommended weekly activity levels, and increase fitness. Improvements were seen when interventions provided personalized support and feedback from professionals via phone, email, or written information. Gains in activity level and fitness were maintained for up to two years with no increase in injury risk. However, more research is still needed to determine the most effective long-term methods for specific groups.
Comparison of Ultrabio HIV DNA PCR and Gag Real-Time PCR Assays for Total Hiv...CrimsonpublishersCJMI
Comparison of Ultrabio HIV DNA PCR and Gag Real-Time PCR Assays for Total Hiv-1 DNA Quantification by Tuofu Zhu in Cohesive Journal of Microbiology & Infectious Disease
The Role of Connected Diagnostics in Strengthening Regional, National and Con...SystemOne
Although numerous disease intelligence and surveillance systems exist, they are plagued with inaccurate or untimely data. We contend, furthermore, that it was this lack of data quality – and not
the lack of surveillance systems or networks – that prevented the global community from acting earlier in response to the Ebola outbreak in 2014–2016. The new field of ‘connected diagnostics’ is one solution to this concern, as it automates data collection directly from the diagnostic instruments to multiple levels of stakeholders for real-time decision-making and policy response.
This article details how the intervention of ‘connected diagnostics’ could solve the primary underlying failure in existing surveillance systems – the lack of accurate and timely data – to enable
difficult political decisions earlier. The use of connectivity solutions can enable critical health and operational data to empower the Africa CDC, regional hubs, and each country with a consistent
and automated data feed while still maintaining country privacy and controls.
Electronic medical records, also known as EHRs, systematically collect electronic health information about individual patients and populations. EHRs can include demographics, medical history, medications, allergies, lab reports, and billing information. EHRs offer potential for quicker access to relevant patient information, regular updates, storage of data in multimedia formats, and increased efficiency in healthcare delivery and decision-making. Both providers and patients can benefit from EHRs, as providers can exchange information through networks and patients can access their records across locations. However, some physicians worry that patient access to notes may increase patient worry, though studies show patients are generally satisfied with EHR access.
A study on “impact of artificial intelligence in covid19 diagnosis”Dr. C.V. Suresh Babu
Although the lungs are one of the most vital organs in the body, they are vulnerable to infection and injury. COVID-19 has put the entire world in an unprecedented difficult situation, bringing life to a halt and claiming thousands of lives all across the world. Medical imaging, such as X-rays and computed tomography (CT), is essential in the global fight against COVID-19, and newly emerging artificial intelligence (AI) technologies are boosting the power of imaging tools and assisting medical specialists. AI can improve job efficiency by precisely identifying infections in X-ray and CT images and allowing further measurement. We focus on the integration of AI with X-ray and CT, both of which are routinely used in frontline hospitals, to reflect the most recent progress in medical imaging and radiology combating COVID-19.
A PROPOSED NEURO-FUZZY MODEL FOR ADULT ASTHMA DISEASE DIAGNOSIScscpconf
The task of medical diagnosis with the help different intelligent system techniques is always crucial because it require high level of accuracy and less time consumption in decision making.
Among all other AI techniques Artificial Neural Networks (ANN) as a tool for medical diagnosis has become the most popular in last few decades due to its flexibility and accuracy. ANN was
developed after getting the inspiration from biological neurons. There are various diseases that are still needed to be diagnosed. Among many other critical diseases like cancer, thyroid disorder, diabetes, heart diseases, neuro diseases, asthma disease was also tried to bediagnosed
effectively with various ANN mechanisms by different researchers. Due to various uncertainties about symptoms the study of Neuro-Fuzzy technique in this context became very popular in last few years. Neuro-Fuzzy now-a-days is one of the most advanced technique that is mainly concatenation of two model-neural networks and the fuzzy logic. In this model various
parameters are used that are much crucial if ill-chosen and may led to failure of the whole system. Recent trend in analysis is following this model for advanced expert work. In this study
an enhanced Neuro-fuzzy model has been proposed for the proper diagnosis of adult Asthma disease and to foster the proper aid or medication to the patients and make physicians alert forthe upcoming disease pattern otherwise they may lack in the process of providing improper medication at right time. In the first phase data collected from various hospitals are used to
train by three different types of learning of ANN like ANN with Self Organizing Maps (SOM),ANN with Learning Vector Quantization (LVQ) and ANN with Backpropagation Algorithm
(BPA) through NF tool for much accurate result. In the second phase fuzzy rule base is appliedto the classified data for the diagnosis of the disease.
This systematic review and meta-analysis examined the association between depressive symptoms and adherence to antiretroviral therapy (ART) among people living with HIV. It analyzed data from 111 studies with 42,366 participants across low, middle, and high income countries. The analysis found that the rate of depressive symptoms among people living with HIV ranged from 12.8% to 78% across studies, while the rate of good ART adherence (≥80%) ranged from 20% to 98%. There was no significant difference in depressive symptom rates by country income, but good adherence was significantly higher in lower income countries (86%) than higher income countries (67.5%). The meta-analysis showed that people living with HIV with depressive symptoms had a
There are several types of surveillance systems that monitor different areas. Security surveillance systems monitor changes within an assigned field using tools like video recordings and data analysis to alert of unwanted events. Health surveillance systems like those used by the WHO and schools monitor disease trends and outbreaks by collecting data from various sources. Home security cameras and sensors are also a type of smaller-scale surveillance system that monitors personal property. Weather surveillance systems use instruments like satellites and sensors to collect weather data and develop forecasts as well as monitor changes in weather patterns.
- A study compared rates of preventable adverse drug events (ADEs) in intensive care units (ICUs) vs. non-ICUs at two hospitals over 6 months.
- The unadjusted ADE rate was twice as high in ICUs, but when adjusted for number of drugs, there was no difference between ICUs and non-ICUs.
- Preventable ADEs occurred due to normal systems failures like poor communication rather than overworked individuals, showing the need for systems solutions over blaming individuals.
This document summarizes a systematic review of 146 studies on determinants of adherence to antiretroviral therapy (ART) among HIV-positive adults in sub-Saharan Africa. The main findings were:
1) Main determinants of non-adherence included use of alcohol, male gender, use of traditional medicine, dissatisfaction with healthcare, depression, stigma, and poor social support.
2) Promoters of adherence included counseling, education, memory aids, and disclosure of HIV status.
3) Determinants of health status had conflicting effects on adherence.
1) The study developed a computational system called C-Path to automatically quantify over 6,600 morphological features from breast cancer epithelium and stroma in histology slides.
2) When applied to two independent patient cohorts (n=248 and n=328), a prognostic model based on the quantified features was strongly associated with patient survival, independent of other factors.
3) Three stromal features were significantly associated with survival, even more so than epithelial features, implicating tumor stroma morphology as a previously unrecognized prognostic factor for breast cancer.
A Survey and Analysis on Classification and Regression Data Mining Techniques...theijes
This document presents a survey and analysis of classification and regression data mining techniques that have been used to predict disease outbreaks in datasets. It provides an overview of different classification and regression models like decision trees, naive Bayes, neural networks, and support vector machines. It also discusses the advantages and disadvantages of these techniques. The goal of the paper is to help researchers establish the best predictive model for disease outbreaks by enhancing existing techniques to maximize accuracy.
Attitude of the youth towards voluntary counselling and testing (vct) of hiv ...Alexander Decker
This document summarizes a study on the attitudes of youth in Accra, Ghana toward voluntary counseling and testing (VCT) for HIV/AIDS. The study found that while knowledge of HIV/AIDS was high, awareness and use of VCT services was low. Most respondents were unaware that VCT services existed or where they could access them. Of those aware of VCT, very few had utilized the services themselves. Fear of knowing their HIV status appeared to be a major barrier preventing youth from seeking VCT. The study concluded that efforts must be made to increase awareness and use of VCT, especially among youth, through expanded information and education campaigns.
Adherencia al tarv en am latina y caribeRosa Alcayaga
This systematic review and meta-analysis examined adherence to antiretroviral therapy (ART) among people living with HIV in Latin America and the Caribbean. The analysis included 53 studies published between 2005-2016 involving over 22,000 individuals across 25 countries. The overall adherence rate was estimated to be 70%, similar to rates in high-income regions. Adherence was higher with shorter recall periods and in lower income countries. Common barriers to adherence included substance abuse, depression, unemployment and pill burden. The review suggests adherence in the region may be below the level needed for long-term viral suppression.
This study examined predictors of loss to follow up (LTFU) in patients receiving antiretroviral therapy (ART) in Ethiopia. The study included 2133 HIV patients who initiated ART between 2005-2013 at a hospital in Ethiopia. 26.7% of patients were lost to follow up, defined as not returning for a refill for at least 3 months. Patients who had regimen substitutions, were adolescents, lacked isoniazid prophylaxis, or had low baseline CD4 counts (<200 cells/mm3) were at higher risk of LTFU. Patients with more advanced clinical stages at initiation were less likely to be lost to follow up. The cumulative incidence of LTFU was 8.
This survey of 948 oncologists from 82 countries investigated which cancer medicines they deemed most essential for public health in their countries. The most commonly selected medicines were doxorubicin, cisplatin, paclitaxel, pembrolizumab, trastuzumab, carboplatin, and 5-fluorouracil - 19 of the top 20 medicines are currently on the WHO Essential Medicines List. Availability of these medicines was lowest in low-income countries, ranging from 9-54% availability, compared to 68-94% availability in high-income countries. Risk of catastrophic health expenditures for cancer treatment was also higher in low-income countries. The findings challenge the feasibility of adding more expensive
UCSF Informatics Day 2014 - Keith R. Yamamoto, "Precision Medicine"CTSI at UCSF
Keith R. Yamamoto, PhD — Opening Remarks – Precision Medicine
Vice Chancellor for Research
Executive Vice Dean of the School of Medicine
Professor of Cellular and Molecular Pharmacology
UCSF
Neuro genetic key based recursive modulo 2 substitution using mutated charact...ijcsity
In this paper, a neural genetic key based technique for encryption (NGKRMSMC) has been proposed
through recursive modulo
-
2 substitution using mutated character code generation for online wireless
communication of data/information.
Both sender and receive
r get synchronized based on their final output
.
The length of the key depends on the number of input and output neurons. Coordinated matching weight
vectors assist to generate chromosomes pool. Genetic secret key is obtained using fitness function, which i
s
the hamming distance between two chromosomes. Crossover and mutation are used to add elitism of
chromosomes.
At first
mutated character code table
based encryption strategy get perform on plain text.
.
Then the intermediate cipher text is yet again encry
pted through recursive positional modulo
-
2 substitution
technique to from next level encrypted text. This 2nd level intermediate cipher text is again encrypted to
form the final cipher text through chaining and cascaded xoring of neuro genetic key with the
identical
length intermediate cipher text block.
Receiver will perform same symmetric operation to get back the plain
text using identical key
This study examined the effects of applying a 40% chlorhexidine varnish on dental plaque. 40 volunteers participated in a clinical trial where their plaque levels, gingival bleeding, and bacterial colony counts were measured after applying the varnish or not applying anything. The results showed that applying the chlorhexidine varnish significantly decreased plaque levels and gingival bleeding in volunteers with poor oral hygiene. It also reduced the frequency of high bacterial colony counts. The varnish was most effective at reducing plaque for patients with high baseline plaque levels. Regular application of chlorhexidine varnish can be an effective way to reduce caries risk for patients with poor oral hygiene.
Diseño y construcción de una máquina serigráfica automatizadaRaúl Cordova
Diseño y construcción de una máquina serigráfica automatizada realizada con microcontrolador MEGA 2560, processing. Por accionamiento electro neumático. Motor paso a paso y sensores de posicionamiento (encoder, sensor infrarrojo).
This document discusses how LGBT youth narratives are portrayed on the TV show Glee. It examines how the show engages with queer temporality through its time slot and use of mobile music. Specifically, it looks at the character development of Kurt and how his storyline does not follow typical coming out narratives. It also analyzes the songs "Prom Queen" and "Teenage Dream" and how their lyrics relate to queer experiences. The document argues television is well-suited to exploring queer temporality through its inherent focus on unfolding stories and scheduling.
Stephanie Degiorgio has a design portfolio that showcases her work. Her website stephanie-degiorgio.com contains more information and examples from her portfolio. The document provides a brief introduction to Stephanie's design work and directs the reader to her website for further details and a full portfolio.
Francisco Sátiro had a dream where he discovered a new planet with three-eyed beings who did not speak his languages. Over a period of months, he found a new transportation method called "jetpacks" and eventually opened a successful jetpack store, becoming popular and wealthy. However, he then woke up and realized the entire experience had just been a dream.
TeachMeetNZ - Engage students and make a difference - 8 June 20131MvdS
Teachers can engage students and make a difference by incorporating interactive activities into their lessons that encourage collaboration and problem-solving, getting to know each student individually to understand their needs and interests, and serving as a role model and source of encouragement for students.
This document discusses how to use social media in a business's marketing mix. It covers why social media should be part of the marketing mix due to its large user bases. It also discusses the pros and cons of using social media, including building relationships but also requiring dedicated time. The document outlines developing goals for different social networks like Facebook, Twitter, and LinkedIn. It also discusses integrating social media marketing across different channels and measuring performance through various metrics. The overall document provides guidance on developing an effective social media strategy and action plan to meet business objectives.
This document provides an overview of user experience (UX) research conducted at the Musei Capitolini museum. It discusses why UX research is important, how the research was conducted, how the data was analyzed, and next steps. The research involved fieldwork where researchers acted as tourists, shadowing and observing real tourists, and interviews with tourists, staff and stakeholders. Data was analyzed using a User Ethnographic Map to identify key categories like what users say, do, feel etc. Next steps include inventorying and categorizing the data and creating mental models of the tourist experience. The document was presented by the "UXL" research team led by a tutor.
Curiosity's science objectives are to explore the habitability of Mars by studying the geology, environment, and potential for past life. It landed in Gale Crater, which preserves a record of diverse sedimentary environments and contains Mount Sharp. Analysis of rocks and sand at Yellowknife Bay found evidence of a ancient habitable environment with sustained water interaction and minerals that could have supported microbial life. Curiosity will continue exploring Mount Sharp to understand the planet's climate history recorded in its layers.
This document reviews the clinical application and performance of pit and fissure sealants. It finds that placement of resin-based sealants on children's and adolescents' permanent molars is effective for caries reduction, with reductions ranging from 58.6% to 86% over 1 to 4 years. Sealants are also effective in reducing caries when reapplied and remain retained on primary molars at rates of 70.6% to 96.3% over 1 to 2.8 years. The use of sealants is associated with reductions in subsequent restorative dental services.
SYSTEMS-LEVEL QUALITY IMPROVEMENTFrom Cues to Nudge A Knolisandrai1k
SYSTEMS-LEVEL QUALITY IMPROVEMENT
From Cues to Nudge: A Knowledge-Based Framework
for Surveillance of Healthcare-Associated Infections
Arash Shaban-Nejad1,2 & Hiroshi Mamiya2 & Alexandre Riazanov3 & Alan J. Forster4 &
Christopher J. O. Baker2,5 & Robyn Tamblyn2 & David L. Buckeridge2
Received: 3 June 2015 /Accepted: 30 September 2015 /Published online: 4 November 2015
# Springer Science+Business Media New York 2015
Abstract We propose an integrated semantic web framework
consisting of formal ontologies, web services, a reasoner and a
rule engine that together recommend appropriate level of
patient-care based on the defined semantic rules and guide-
lines. The classification of healthcare-associated infections
within the HAIKU (Hospital Acquired Infections – Knowl-
edge in Use) framework enables hospitals to consistently fol-
low the standards along with their routine clinical practice and
diagnosis coding to improve quality of care and patient safety.
The HAI ontology (HAIO) groups over thousands of codes
into a consistent hierarchy of concepts, along with relation-
ships and axioms to capture knowledge on hospital-associated
infections and complications with focus on the big four types,
surgical site infections (SSIs), catheter-associated urinary tract
infection (CAUTI); hospital-acquired pneumonia, and blood
stream infection. By employing statistical inferencing in our
study we use a set of heuristics to define the rule axioms to
improve the SSI case detection. We also demonstrate how the
occurrence of an SSI is identified using semantic e-triggers.
The e-triggers will be used to improve our risk assessment of
post-operative surgical site infections (SSIs) for patients un-
dergoing certain type of surgeries (e.g., coronary artery bypass
graft surgery (CABG)).
Keywords Ontologies . Knowledge modeling .
Healthcare-associated infections . Surveillance . Semantic
framework . Surgical site infections
Introduction
Healthcare-associated Infections (HAIs) affect millions of
patients around the world, killing hundreds of thousands
and imposing, directly or indirectly, a significant socio-
economic burden on healthcare systems [1]. According
to the Centers for Disease Control (CDC) [2], hospital-
acquired infections in the U.S., where the point preva-
lence of HAIs among hospitalized patients is 4 %, result
in an estimated 1.7 million infections, which lead to as
many as 99,000 deaths and cost up to $45 billion annually
[3, 4]. Similar or higher rates of HAI occur in other coun-
tries as well with an estimated 10.5 % of patients in Ca-
nadian hospitals having an HAI [5]. Clinical assessment
and laboratory testing are generally used to detect and
confirm an infection, identify its origin, and determine
appropriate infection control methods to stop the infection
from spreading within a healthcare institution. Failure to
monitor, and detect HAI in timely manner can delay di-
agnosis, leading to complications (e.g., sepsis), and
allowing an epid ...
SYSTEMS-LEVEL QUALITY IMPROVEMENTFrom Cues to Nudge A Kno.docxdeanmtaylor1545
The document proposes a knowledge-based framework called HAIKU that uses ontologies, web services, and rules to improve surveillance of healthcare-associated infections. The framework focuses on consistently classifying infections like surgical site infections according to standards and guidelines. It uses the HAI ontology to group thousands of codes into a hierarchy of infection concepts and relationships. Statistical analysis and heuristics are used to define rules to improve detection of surgical site infection cases. The framework aims to use "e-triggers" identified through the ontology to better assess risk of postoperative infections for certain surgeries.
Application of Deep Learning for Early Detection of Covid 19 using CT scan Im...ijtsrd
Machine learning has a vital role in Dataset Analysis and Computer Vision field. Troubles range beginning dataset segmentation, dataset check to structure from motion, object recognition and view thoughtful use machine learning technique to investigate in a row starting visual data. The incidence of COVID 19 in strange part of the humanity is a most important suffering intended for every one the managerial unit of personality country. India is as well incompatible this extremely rough mission used for calculating the disease incidence along with have manage its improvement velocity from side to side a numeral of stringent events. During my job this paper on predict the corona virus is contain significance or not hand baggage in continuing region support up as health monitoring systems. The increasing difficulty in healthcare creates not as high class as by a mature resident, punishment in lush executive most significant to harmful possessions resting on mind excellence as well as escalate think about expenses. Accordingly, present be a require designed for elegant decision support systems to facilitate tin can approve clinician’s to generate improved data’s care decision. A talented go forward be in the direction of power the continuing digitization of healthcare with the intention of generate unparalleled amount of medical information stored in Patients Health Records PHRs and pair it through contemporary Machine Learning ML toolset intended for medical decision support, along with concurrently, develop the proof stand of current datasets. The datasets are composed at KAGGLE it is an online datasets used my paper work. The specific classifications algorithms are applied in SVM, NB and supervised learning Decision Tree are used. Today, gigantic measure of information is gathered in clinical databases. These databases may contain significant data embodied in nontrivial connections among manifestations and analyses. Removing such conditions from recorded information is a lot simpler to done by utilizing clinical frameworks. Such information can be utilized in future clinical dynamic. Dr. C. Yesubai Rubhavathi | Diofrin. J | Vishnu Durga. S | Arunachalam. R | Eben Paul Richard. S "Application of Deep Learning for Early Detection of Covid-19 using CT-scan Images" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-1 , February 2023, URL: https://www.ijtsrd.com/papers/ijtsrd52792.pdf Paper URL: https://www.ijtsrd.com/engineering/computer-engineering/52792/application-of-deep-learning-for-early-detection-of-covid19-using-ctscan-images/dr-c-yesubai-rubhavathi
Communicating Anti-Malaria Drugs Amongst a Group Gynotype Groups in South Eas...semualkaira
The effective communication of risks involved in anti-malaria dosage information dissemination is fundamental in health education and advocacies. Although there is no known pattern of communication perspective regarding numerous health risks involved in self-medication of anti-malaria drugs in Nigeria setting especially as more than half of the entire population relay on self-medication because of poor healthcare system.
Communicating Anti-Malaria Drugs Amongst a Group Gynotype Groups in South Eas...semualkaira
The effective communication of risks involved in anti-malaria dosage information dissemination is fundamental in health education and advocacies. Although there is no known pattern of communication perspective regarding numerous health risks involved in self-medication of anti-malaria drugs in Nigeria setting especially as more than half of the entire population relay on self-medication because of poor healthcare system.
Communicating Anti-Malaria Drugs Amongst ‘A’ Group Gynotype Groups in South E...semualkaira
The effective communication of risks involved in anti-malaria dosage information dissemination is fundamental in health education
and advocacies. Although there is no known pattern of communication perspective regarding numerous health risks involved in
self-medication of anti-malaria drugs in Nigeria setting especially
as more than half of the entire population relay on self-medication
because of poor healthcare system
Vohra P, Jamatia K, Subhada B, Tiwari RV, Althaf MS, Jain C. Correlation of CD4 counts with oral and systemic manifestations in HIV patients. J Family Med Prim Care 2019;8:3247-52.
33.Vohra P, Jamatia K, Subhada B, Tiwari RVC, Althaf MN, Jain C. Correlation of CD4 counts with oral and systemic manifestations in HIV patients. J Family Med Prim Care. 2019 Oct;8(10):3247-3252. doi: 10.4103/jfmpc.jfmpc_767_19. eCollection 2019 Oct. PubMed PMID: 31742150; PubMed Central PMCID: PMC6857402.
This document summarizes a study that correlated CD4 counts with oral and systemic manifestations in 100 HIV-positive patients in India. The study found that lower CD4 counts were associated with a wider range of oral and systemic manifestations, which can serve as a prognostic marker for immune suppression. Specifically, the study found that tuberculosis was the most common systemic manifestation. Candidiasis and chronic generalized periodontitis were the most prevalent oral manifestations in males, while candidiasis and recurrent aphthous ulcers were most common in females. Nearly all patients with CD4 counts below 200 showed oral manifestations, demonstrating a significant correlation between oral manifestations and lower CD4 counts.
This study assessed antiretroviral treatment failure and associated risk factors among HIV patients in Sekota, northeast Ethiopia. The researchers conducted a cross-sectional study of 295 patients on first-line antiretroviral treatment. They found that 16.6% experienced virological failure and 6.1% experienced immunological failure. Poor adherence, CD4 count below 500 cells/μL, and duration of ART between 6-24 months were associated with virological failure. Poor adherence and drug interruption were associated with immunological failure. The study highlights the need for more efforts to address risk factors and maximize viral load testing to monitor treatment failures.
Application of computers in Epidemiology.pptxiqbal606601
Computers play an indispensable role in epidemiology by providing high precision, speed, and accuracy in data collection, analysis, and disease modeling and prediction. They allow epidemiologists to perform complex statistical analyses and simulations to measure disease transmission and identify risk factors. Computer technologies like disease surveillance systems, telemedicine, health management information systems, and geographic information systems have helped improve public health monitoring, access to care, and evidence-based decision making.
Epidemic Alert System: A Web-based Grassroots ModelIJECEIAES
This document summarizes research on web-based epidemic alert systems. It discusses how most current systems analyze large amounts of unstructured data from various online sources using complex algorithms, which can generate imprecise results given the lack of standards. The document then proposes a new grassroots web-based system that collects structured data directly from primary health centers, hospitals, and laboratories. This traditional approach uses threshold values based on percentiles to determine when an epidemic is triggered. If adopted, it could help standardize web-based disease surveillance.
The document summarizes India's National AIDS Control Programme (NACP) which aims to contain the spread of HIV in India through a four-pronged strategy of prevention, care and support, treatment, and strengthening infrastructure. The HIV epidemic in India is concentrated among high-risk groups like female sex workers, men who have sex with men, and injecting drug users. The NACP implements targeted interventions for these groups, promotes condom use, treats sexually transmitted infections, and provides counseling, testing, and treatment services. While the response has stabilized the epidemic in some states, emerging hotspots in northern states require increased focus and attention to fully achieve reversal goals.
The study assessed the knowledge and practice of hepatitis B prevention among 192 healthcare workers in a Nigerian hospital. The results showed that:
1) 99.5% of respondents had good knowledge of hepatitis B infection, though not all with good knowledge carried out good prevention practices.
2) Most respondents had good knowledge of hepatitis B prevention through vaccination, protective equipment, handwashing, and antiseptics.
3) 60.9% reported good prevention practices, though years of experience was not significantly associated with practice level.
4) Barriers to hepatitis B vaccination included vaccine availability, cost, and needle injection fears.
Estimating the Statistical Significance of Classifiers used in the Predictio...IOSR Journals
This document summarizes a research paper that analyzes the statistical significance of different classifiers for predicting tuberculosis. The paper first compares the accuracy of classifiers like decision trees, support vector machines, k-nearest neighbor, and naive Bayes on tuberculosis data. It then evaluates the performance of these classifiers using a paired t-test to select the optimal model. The results showed that support vector machines and decision trees were not statistically significant, while support vector machines combined with naive Bayes and k-nearest neighbor were statistically significant.
Fattori - 50 abstracts of e patient. In collaborazione con Monica DaghioGiuseppe Fattori
This document contains summaries of 50 abstracts related to e-patients and social media. Some key points:
1) Participatory surveillance of hypoglycemia in an online diabetes social network found high rates of hypoglycemic events and related harms like daily worry and withdrawal from activities. Engagement was also high.
2) Analysis of self-reported Parkinson's disease symptom data from an online platform found short-term dynamics like fluctuations exceeding clinically important differences that add to understanding of disease progression.
3) Examination of influential cancer patients on Twitter found most tweets focused on support rather than medical information, indicating its role in online patient community and support.
Evaluation factors contributing to the treatment default by tuberculosis pati...PUBLISHERJOURNAL
Tuberculosis (TB) is one of the biggest public health problem and now ranks alongside Human Immunodeficiency Virus (HIV) as the world’s leading infectious cause of death. Globally, patient compliance with anti-TB therapy estimated as low as 40% in developing countries, remains the principle cause of treatment failure. The aim of this study was to establish the factors contributing to treatment default by Tuberculosis patients at ART clinic in Ishaka Adventist Hospital, Bushenyi District. A cross-sectional and descriptive study which employed both qualitative and quantitative approach of data collection were used. The study was conducted in ART clinic at Ishaka Adventist Hospital, Bushenyi District and it took a period of four weeks. A purposive sampling technique was used to select the study participants. Results showed that out of 38 study participants, majority 26 (68%) were of age 30 years and above. A large proportion 24 (63%) of the participants were unemployed compared to the least 14 (37%) who were employed. Majority 21 (55%) travel at a distance of 10km and above to get TB treatment. Out of 38 participants, majority 26 (68%) did not informed the family or friends when they were on TB treatment. Of 26 participants 16 (61.5%) had fear of being isolated and 2 (7.7%) were other reason of no support. A large proportion of participants rated the attitude of staff who attended to them at the health facility to be unfriendly with 21 (55%) while very few 6 (16%) were rude. The ministry should ensure availability of and access to resources for strengthening systems for delivery of quality tuberculosis treatment, prevention and control.
Keywords: treatment, default, tuberculosis, ART, Uganda
Evaluation factors contributing to the treatment default by tuberculosis pati...PUBLISHERJOURNAL
This document summarizes a study that evaluated factors contributing to treatment default among tuberculosis patients at an ART clinic in Uganda. The study found that the majority of participants were over 30 years old, unemployed, and had to travel over 10km to receive treatment. Most participants were not diagnosed with TB more than a year ago. The majority felt that TB treatment is curative but takes longer than 6 months to complete. Fear of isolation was the most common reason patients did not inform family/friends of their TB status. The study concludes that strengthening TB treatment, prevention, and control systems is needed.
Similar to ONLINE FUZZY-LOGIC KNOWLEDGE WAREHOUSING AND MINING MODEL FOR THE DIAGNOSIS AND THERAPY OF HIV/AIDS (20)
Call For Papers -International Journal of Computational Science and Informati...ijcsity
International Journal of Computational Science and Information Technology (IJCSITY) focuses on Complex systems, information and computation using mathematics and engineering techniques. This is an open access peer-reviewed journal will act as a major forum for the presentation of innovative ideas, approaches, developments, and research projects in the area of Computation the ory and applications. It will also serve to facilitate the exchange of information between researchers and industry professionals to discuss the latest issues and advancement in the area of advanced Computation and its applications.
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5th International Conference on Natural Language Computing Advances (NLCA 2024) will provide an excellent international forum for sharing knowledge and results in theory, methodology, and applications of Natural Language Computing and its advances.
Authors are solicited to contribute to the conference by submitting articles that illustrate research results, projects, surveying works, and industrial experiences that describe significant advances in NLP.
Call For Papers -10th International Conference on Computer Science and Inform...ijcsity
10th International Conference on Computer Science and Information Technology (CSTY 2024) will provide an excellent international forum for sharing knowledge and results in theory, methodology and applications of Computer Science, Engineering and Information Technology. The Conference looks for significant contributions to all major fields of the Computer Science, Engineering and Information Technology in theoretical and practical aspects.
Authors are solicited to contribute to the conference by submitting articles that illustrate research results, projects, surveying works and industrial experiences that describe significant advances in the following areas, but are not limited to.
Call For Papers -InternationalJournalofComputationalScienceandInformationTech...ijcsity
International Journal of Computational Science and Information Technology (IJCSITY) focuses on Complex systems, information and computation using mathematics and engineering techniques. This is an open access peer-reviewed journal will act as a major forum for the presentation of innovative ideas, approaches, developments, and research projects in the area of Computation the ory and applications. It will also serve to facilitate the exchange of information between researchers and industry professionals to discuss the latest issues and advancement in the area of advanced Computation and its applications.
The topics suggested by this journal can be discussed in term of concepts, surveys, state of the art ,research, standards, implementations, running experiments, applications, and industrial case studies. Authors are invited to submit complete unpublished papers, which are not under review in any other conference or journal.
Call F or Papers -5th International Conference on Natural Language Computing ...ijcsity
5th International Conference on Natural Language Computing Advances (NLCA 2024) will provide an excellent international forum for sharing knowledge and results in theory, methodology, and applications of Natural Language Computing and its advances.
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ONLINE FUZZY-LOGIC KNOWLEDGE WAREHOUSING AND MINING MODEL FOR THE DIAGNOSIS AND THERAPY OF HIV/AIDS
1. International Journal of Computational Science and Information Technology (IJCSITY) Vol.1, No.3, August 2013
DOI : 10.5121/ijcsity.2013.1304 27
ONLINE FUZZY-LOGIC KNOWLEDGE
WAREHOUSING AND MINING MODEL FOR
THE DIAGNOSIS AND THERAPY OF
HIV/AIDS
Igodan C. E.1
Akinyokun O.C.2
and Olabode Olatubosun3
1
Department of Computer Science, University of Benin, Benin City, Nigeria
1
charlesigodan@yahoo.com
2,3
Computer Science Department, Federal University of Technology, Akure,
Nigeria
2
akinwole2003@yahoo.co.uk, 3
olabode_olatubosun@yahoo.co.uk
ABSTRACT
The need for a reliable and efficient way of storing and mining data about people living with HIV/AIDs
with the intent to monitor the health status for effective therapy is on the increase. This paper presents a
model of a web-based system for knowledge warehousing and mining of diagnosis and therapy of
HIV/AIDs using Fuzzy Logic and data mining approach. A model was developed, using the predictive
modeling technique, for predicting HIV/AIDs and monitoring of patient health status. The fuzzy inference
rule and a decision support system based on cognitive filtering was employed to determine the possible
course of action to be taken. A case study of some data of PLWH was used and the result obtained shows
that the developed system is efficient. The system uses XAMP on Windows OS platform. The system was
tested and evaluated with satisfactory results.
KEYWORD
Knowledge warehousing, data mining, HIV/AID, Fuzzy logic
1. INTRODUCTION
Medical diagnosis is the ability to form valuable opinions and make good decisions about the
condition of a patient, while therapy is the administration of drugs to patients. The major problem
in the medical field is the diagnosis of disease which is due to human error [1]. In [2] a medical
diagnosis involves the state space search of medical knowledge of a particular disease, patient
history, patient examination and drug. Medical diagnosis and therapy involves the determination
of the nature of a disease from observation of signs and symptoms and subsequent curative
treatment of such a disease. These are the work of a medical expert (Physicians) who possesses a
wealth of knowledge in the field. According to [3], the African AIDS epidemic continues to pose
severe public health and developmental challenges for many African nations. A primary
impediment in the fight against AIDS is lack of information and communication about the
disease. Information and Communications Technology (ICT) hold vast potential to hinder the
spread of the disease, as well as key elements of all aspects of HIV/AIDS strategies, including
prevention, treatment, care and protection to human rights. In [3], the role of information and
communications in the fight against AIDS in the African continent. It is intended to increase
2. International Journal of Computational Science and Information Technology (IJCSITY) Vol.1, No.3, August 2013
28
understanding of how information and communication can offer key resources in relation to
HIV/AIDS, and to suggest key actions information and communications can take to assist in
combating HIV/AIDS.
In [4], it is observed one of the many challenges of access to treatment through anti-retroviral
medication is the difficulty of receiving accurate and up-to-date information at the planning level.
It was noted that Information and Communication Technology (ICT) has been used in a number
of pilot studies to address this bottleneck, by providing an infrastructure for telemedicine and e-
health applications. It was also suggested that Anti-Retroviral Treatment (ART) delivery to poor
communities can be significantly improved by integrating local primary health-care information
with centralized databases to allow national monitoring.
In [5], a framework for the interventions to close the digital divide in AIDS care was developed.
It describes the development and pilot testing of a workshop-style intervention designed to close
the digital divide in AIDS care. [6], evaluated the efficacy of LifeWindows, a theory-based,
computer-administered antiretroviral (ARV) therapy adherence support intervention, delivered to
HIV plus patients at routine clinical care visits. In that study, 594 HIV plus adults receiving HIV
care at five clinics were randomized to intervention or control arms. The result indicated that
intervention versus control impact in the intent-to-treat sample - including participant who’s
ARVs had been entirely discontinued, who infrequently attended care, or infrequently used Life
Windows - did not reach significance. Intervention impact in the On Protocol sample (328
intervention and control arm participants whose ARVs were not discontinued, who attended care
and were exposed to Life Windows regularly) was significant. On Protocol intervention various
control participants achieved significantly higher levels of perfect 3-day ACTG-assessed
adherence over time, with sensitivity analyses maintaining this effect down to 70% adherence.
That study supports the utility of Life Windows and illustrates that patients on ARVs who persist
in care at clinical care sites can benefit from adherence promotion software.
A software engine for the mining and processing, periodic update of the knowledge warehouse
and statistical analysis of findings was developed in [7] for NITDA on its intervention in capacity
building for Nigerian tertiary institutions and by extension the education sector of Nigeria
economy. Infection with HIV is now endemic in several African countries; estimates of the
number of infected people is in millions. Zero prevalence rates of HIV infection vary from less
than 1% up to 20% of the general adult population, and from 27% to 88% of female prostitutes in
the cities of Central and East Africa. It is evident that, in many parts of the continent, HIV
infection has created a major public health problem, which may have reached the same scale as
malaria, diarrhea, respiratory diseases, and malnutrition. In one major hospital in Central Africa,
up to 35% of the children and adults admitted having were HIV infection, and this figure is likely
to increase. Thus, many African clinicians are taking care of HIV-infected patients, and they will
be confronted with an increasing number of AIDS cases in the near future.
A fuzzy rule-based framework for the management of tropical diseases with main focus on
malaria is presented in [8]. The system involves fuzzzification, inference and defuzzification. The
system is able to diagnose malaria case as either mild, moderate, several or very several. The
symptoms and signs of the diseases were fuzzified. With the help of fuzzy rules developed and
the assistance of some medical personnel, the fuzzified variables were composed, inferred and
later defuzzified to give final diagnosis. [9], implemented an evidence based medicine principles
via a computerized clinical decision support system (CDSSs). In [10] a model of asynchronous
collaboration between people with very different knowledge of medicine in which a computer
framework attempts to mediate between patients and physicians to help reduce some of the
differences in communication was designed.
3. International Journal of Computational Science and Information Technology (IJCSITY) Vol.1, No.3, August 2013
29
[11], developed a medical consultation system, CADIAG-4, for general internal medicine, which
is intended to assist the differential diagnostic process by indicating all possible diseases which
might be the cause of patient’s pathological findings, with special emphasis on rare diseases. It
uses the formal framework of fuzzy set theory and fuzzy logic to represent the uncertainty in
medicine. In [12], a fuzzy expert system for heart disease diagnosis was designed. The system has
13 input fields, one output field and rule base. The mamdani inference method – fuzzy expert
system designing, membership function, fuzzy rule base, fuzzification and defuzzification
methods were used. [13], focused on the use of ICT to design a web-based fuzzy expert system
for the management of hypertension using the fuzzy logic method. In the study, systolic blood
pressure, diastolic blood pressure, age and Body Mass Index (BMI) were taken as input
parameters to the fuzzy expert system and hypertension risk as output parameter. The resultant
hypertension risk was based on fuzzy rules that were developed for the expert system. The
defuzzification method was Root Sum Square.
This paper attempts to develop a fuzzy-logic, knowledge warehouse and mining model for
HIV/AIDs diagnosis, therapy and preventive measure. Data were sourced from the University of
Benin Teaching Hospital.
2. SIGNS, SYMPTOMS AND CLASSIFICATION OF HIV/AIDS
According to [14], AIDS in an adult is defined by the existence of at least two major signs
associated with at least one minor sign, in the absence of known causes on immunosuppression
such as cancer, severe malnutrition or other recognized etiologies. However, the presence of
generalized Kaposi sarcoma or cryptococcal meningitis is sufficient by itself for the diagnosis of
AIDS. The major signs are:
a. Weight loss ≤ 10% of body weight
b. Chronic diarrhea (for more than 1 month)
c. Prolonged fever (for more than 1 month) (intermittent of constant)
The minor signs are:
a. Persistent cough (for more than 1 month)
b. Generalized pruritic dermatitis
c. Recurrent zoster
d. Oropharyngeal Candidiasis
e. Chronic progressive and disseminated herpes virus infection
f. Generalized lymphadenopathy
[14] and [15], it is opined that epidemiological studies have demonstrated that HIV has three
major modes of transmission: sexual, parenteral, and perinatal. No evidence exists to support any
other routes of transmission, including through food, water, vectors, or casual contact. HIV has
been identified in the whole blood, serum, tears, saliva, cerebrospinal fluid, brain tissue, urine,
semen, breast milk, amniotic fluid, and vaginal/cervical secretions. However, the low titre of virus
and infrequency of virus isolation from most of these fluids suggest that with the exception of
blood, serum, semen, cervical/vaginal secretions, and breast milk, they play an insignificant role
in HIV transmission.
In the National Guideline for HIV and AIDS Treatment and Care in Adolescent as reported in
[16], diagnosis of HIV infection is based on the demonstration of antibody in plasma or serum,
and of virus in the blood. The virus can be demonstrated in the blood with nucleic acid-based tests
4. International Journal of Computational Science and Information Technology (IJCSITY) Vol.1, No.3, August 2013
30
(PCR for proviral DNA and RT-PCR for plasma viral RNA), culture and p24 antigen assay. With
the technology that is available at present, HIV antibodies are detectable within four to six weeks
of infection, and within 24 weeks in virtually all affected individuals. However, virus can be
detected in plasma at least one week earlier. This period of absent antibody in the presence of
virus in plasma is called the “window period”.
Antiretroviral Therapy has the following components:
a. Pre-treatment Evaluation includes:
i. Complete history and physical examination (always think of Pregnancy,
Anaemia, Hepatitis and TB)
ii. Clinically and Immunological classification of the patient
iii. Check Laboratory results (FBC with differential, ALT, Creatinine, CD4+ cell
count, pregnancy test)
iv. Evaluation of nutritional and psychosocial status
v. Assessment of readiness for therapy
vi. Development of patient-specific adherence strategy
b. Criteria for ART
Initiation of therapy depends on CD4+ cell count and WHO clinical staging:
i. WHO Stage IV disease irrespective of CD4+ cell count
ii. WHO Stage III disease with CD4+ cell counts < 350/mm3
iii. WHO Stage I or II disease with CD4+ cell counts < 200/mm3
iv. Any WHO Stage with CD4+ cell count 200-350 mm3
– consider for therapy
c. Counseling for ART
There are many patients who know their HIV sero-status through VCT and other testing
services but are yet to consider starting ART. However, when a decision is reached to
commence ART, additional counseling is required to address the following issues:
i. ARVs do not offer a cure. HIV may be suppressed but is not eradicated from the
body
ii. Use of ARVs is associated with impaired quality of life and long term survival
iii. ARVs need to be taken daily for life to prevent development of resistance and
treatment failure
v. ARVs, like other medications, are associated with side effects
vi. Better results are obtained with good adherence to the treatment regime
vii. Some patients may fail to respond to treatment and may required changes in their
treatment regime [16]
A Data Warehouse is a subject-oriented, integrated, time-variant and non-volatile collection of
relational/ multidimensional database optimized for decision support which is separated from the
database [17], [18], [19]. It is an information repository in which components (knowledge
components) are cataloged and stored for reuse [20], and has logical structures to store knowledge
that are analogous to the system tables that implement data storage in the data warehouse [21].
The architecture of the knowledge warehouse and mining of diagnosis and therapy of HIV/AIDS
consists of the Knowledge base, Database model, Weighted Averaging Method, Fuzzy logic,
Inference engine, Decision Support Engine, Cognitive filter and Emotional filter as presented in
[7].
5. International Journal of Computational Science and Information Technology (IJCSITY) Vol.1, No.3, August 2013
31
A three tier web based system which has the following elements is proposed:
a. Client-Tier: Provides a Graphical User Interface (GUI) to the end-users, which is
achieved using a web browser, such as Internet Explorer, built using HTML with PHP.
b. Web-Tier: Provides the dynamic content to users; presents the data model to clients;
accepts and analyze user inputs; presents users input to ES for processing and forwards
responses back to user.
c. Database: Stores the object data and handles system logic. It deals with systems rules
and data.
The database model considered for the proposed system employs an object-oriented approach and
is viewed as a network of semantically related structured and unstructured knowledge of the
HIV/AIDS and its diagnosis. Relational database modeling technology is adopted [22]. The
general form of a relation is given by:
R[ai, ai+1, ai+2, ai+3, ai+4 , …, an-1, an,]
Where R represents the name of the relation, the set {ai}, i = 1, 2… n, represents the attributes,
properties and decision variables of R. The database is composed of nine relations and some
presented below
Patient [patientNo, patientName, PatientAddr, patientAge, patientSex, Nationality, MaritalStatus,
BloodGroup, NameAddrofNextofKin
Signs [PatientNo, diseaseID, description-of-sign]
Symptoms [PatientNo, symptomID, description-of disease]
PatientHist [PatientNo, datehist, timeHist, HistLog, patientAddr, occupation, sex]
LabTest [date, patientNo, description-of-lab-test]
HIVDIAGNOSIS [patientNo, Diag-No, Diag-Log]
PatientConsult [patientNo, medical-Pract, dataofConsult]
The activities of the user on the database are described as transaction. A transaction may be
classified as an update or query type:
a. Update Transactions: The update transactions are the activities that are responsible for
the insertion of new records, modification of existing records and deletion of unwanted
records in the database. Update transactions on any database may be carried out by the
Database Administrator (DBA) or some other privileged users. The DBA will be
responsible for the initial creation of the database and modification of the database from
time to time to reflect the current state exhibited in real life. The database is the visual
image of real life of HIV/AIDS and diagnosis of the disease. The database should,
therefore, constantly exhibit the true position of current trends and real life possibilities in
HIV/AIDS and the diagnosis of the disease, to maintain integrity and credibility. The
security and confidentiality of the database can be guaranteed if appropriate right of
human expert access and update database is adequately provided, controlled and
monitored. In this study, the right of privileged users to access and update database is
provided, monitored at the following three levels: Insertion of new records, Modification
of old records, Deletion of unwanted (see Figure 2.1)
b. Query Transaction: query transactions are activities that are responsible for questioning
the database and generate useful reports. In practice, query transactions are carried out on
a database by any authorized user of the database in the category. Database expert users,
Database end user, database casual users.
In order to create the security of the database and the confidentiality of the transactions
carried out on it, each category of users is provided with the appropriate right into the
6. International Journal of Computational Science and Information Technology (IJCSITY) Vol.1, No.3, August 2013
32
database. In the web based system proposed in this study, only the first two access levels
are defined because all end users can query the database and also perform update
transaction if they are interested.
Figure 2.1. Data Processing Module
Algorithm for processing some transactions
* Display general information about HIV/AIDS
Open the File
SELECT About-HIV/AIDS File
FROM File
Filter out all information about HIVAIDS
If there is any Display
Else Return current page
Endif
Close File
* Display a page for prototype diagnosis for HIV/AIDS and proffers possible advice based on
results
Open the File
SELECT Diagnostic File
FROM File
Enter Patient Variables
Perform Fuzzfication to generate Fuzzy value
Click Defuzzify to generate crisp values
if crisp value is POSITIVE
Display information about the level of infection and possible Advice
Elseif Value is Negative
Display information about how to prevent HIV/AIDS and stay safe
Else “Indeterminate”
Display information on Advice to retake the test in few months time
End if
Close File
User Interface
User Identification
Process Manager
User Security Audit trail
Back-End [MySql]
Operating System [Windows]
User
Regist.
Patient
Admin.
Patient
Diagnosis
Therapy
&
Educatio
n
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2.1 Data Warehouse and Mining
This stage involves the conception, acquisition, cleaning and loading of data into the data
warehouse. Specifically, patient’s record was collected from the Introviral Human Virology,
Nigeria (IHVN), U.B.T.H. The data was carefully analyzed. The analysis involves demographics,
study results, problems, therapies, allergies, subjective and physical findings, and encounter
summaries. The data warehouse was created on a centralized server dedicated to fielding data
mining queries. The clinical data was mapped from data structure into relational tables in the
personal computer environment. MySQL was chosen as the Database Engine installed into the
Computer System. For the purpose of this study, a few sample dataset from the data warehouse
was created that was mined for knowledge discovery. Multiple SQL queries were run on the data
warehouse to create the dataset. As each variable is added to the dataset, it is cleansed of
erroneous values, data inconsistencies and formatting discrepancies.
In this study, the predictive model was used to mine the data. The predictive models use data with
known results to develop a model used to explicitly predict values for different data [23]. For
example, a model can be built using the payment history of people to whom you have given loans
to help identify people who are likely to default on loans. The model in this study was built from
the patients’ history which helped to identify the various classes and ranges of infections about
patients. Using the Classification models requires you to identify those characteristics of cases
that indicate to which group each case belongs. This pattern can be used both to understand the
existing data and to predict how new instances will behave. The Data mining creates
classification models by examining already classified data (cases) and inductively finding the
predictive pattern. In some data mining problems, an expert classifies a sample of the database
and this classification is used to create the model which will be applied to the entire database.
2.2 Fuzzy Logic for Diagnosis of HIV/AIDS
The logic of the diagnosis and therapy of HIV/AIDS involves the following phases: Fuzzification,
Fuzzy Inference (Fuzzy Rules) and Defuzzification. Fuzzy logic requires knowledge in order to
reason. The knowledge is provided by the expert who knows the process and stores it in the fuzzy
system. The knowledge repository for HIV/AIDS contains both the qualitative and quantitative
decision variables. These variables are used in the fuzzification, inference, and defuzzification as
discussed in the following sections.
Fuzzy Rule Base
The rule base is defined according to expert’s experience. As used in this research work, Figure
2.2 describes the action to be taken given the states of the inputs variables. Fuzzy logic offers a
possibility to update the knowledge base continuously [24] and by this, previous diagnosis is
improved. After proposition (rules), the next phase is to perform defuzzification in order to
evaluate the crisp output.
The fuzzy logic analysis and control method involves:
a. Receiving of one, a large number, of measurement or assessment of conditions existing in
some system we wish to analyze.
b. Processing all these inputs according to human based, fuzzy "If-Then" rules, which can
be expressed in plain language words, in combination with traditional non-fuzzy
processing.
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c. Averaging and weighting the resulting outputs from all the individual rules into one
single output decision or signal which decides what to do or tells a controlled system
what to do.
The output signal eventually arrived at is a precise appearing, defuzzified, "crisp" value. Fuzzy
Logic Control/Analysis Method diagram is shown in Figure 2.2.
Figure 2.2: Fuzzy Logic Control System
Defuzzification is the process of producing a quantifiable result in fuzzy logic, given fuzzy sets
and corresponding membership degrees. Defuzzification is interpreting the membership degrees
of the fuzzy sets into a specific decision or real value. In this study, the center of gravity (centroid
method) is used for defuzzification given in equation (1):
…………………………………………………………….. (1)
where: xi represent the ith. symptoms, k is the number of items in the fuzzy set and y is the crisp
value.
The average is probably the easiest and the most widespread solution to aggregate information.
The average is defined as the single value which all the individuals of a population should have so
that their total is unchanged. When the sample contains several times the same individuals, it is
possible to reformulate the average as a weighted average by introducing coefficients related to
each individual. So a weighted average is an average in which a weight, wi, is assigned to each
quantity xi to be averaged. The weights determine the relative importance of each quantity on the
average [25].
A physical interview session with some medical doctors working closely with patients living with
the disease was carried out to gather information about the various symptoms of the disease so as
to enable the construction of the analytical membership function shown below. Some of the
diseases are measured by days, weeks or months to ascertain the level of severity, while some are
measured in degrees centigrade. Also some of these symptoms are quantitative while others are
qualitative in nature. Each symptom has its membership function constructed and represents its
degree of severity denoted with letter “X”. Using set theory, the symptoms are represented as:
{X | X is a set of symptoms}
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35
Where x1=chronic-cough, x2=diarrhoea, x3=swollen-gland, x4=weight-loss, x5=frequent-fever, x6=
frequent-yeast-infection, x7=skin-rashes, x8=memory-loss, x9=body-sore, x10=severe-
headache, x11=energy-loss, x12=appetite-loss, x13=pelvic-abdominal-cramp and x1, x2, x3,
…, x13 є X
The analytical representation of membership functions for the various input parameters to the
fuzzy expert system are listed
0, x<7
x= x/14, 7 x<14
1 14 x<20
low
≤
≤
0, x=3
moderate x= x/5, 3 x<5
1, x=5
≤
0, x=6
high x= x/6, 6 x<11
1 x 11
≤
≥
The input variables for swollen gland is measured in centimeters (cm), chronic cough and
diarrhea are measured by the number of days/weeks/ or months of infections.
The analytical representation of membership functions for the weight loss input parameters are
represented:
0, x<1
x= x/2, 1 x<2
1, x=2
low
≤
0, x=3
moderate x= x/5, 3 x<5
1, x=5
≤
0, x=6
high x= x/6, 6 x<11
1, x 11
≤
≥
The analytical representation of membership functions for the frequent fever (measured in o
C
degree) input parameters to the fuzzy expert system is as presented:
0, x<6 low
x= x/37, 11 x<37 moderate
1, x 37 severe
≤
≥
The analytical representation of membership functions for the frequent yeast infection, Skin
rashes, Short-term memory and Body sores (measured in days/weeks or months of infections)
input parameters to the fuzzy expert system is presented:
0, x<7
x= x/12, 7 x<12
1, 12 x<20
low
≤
≤
0, 20 x<25
moderate x= x/30, 25 x<30
1, 30 x<35
≤
≤
≤
0, 35 x<40
high x= x/50, 40 x<50
1 x=50
≤
≤
The analytical representation of membership functions for the Headache, Lack of Energy, Loss
of appetite and Pelvic/Abdominal Cramps (measured by doctor’s physical diagnosis of
infections) input parameters to the fuzzy expert system is as presented:
0, mild
x=
1, severe
low
The input fields of the following membership functions above are just two values (0, 1) sets.
Value ‘0’ means that the illness is absent while ‘1’ meaning the existence of the illness in the
patients. The membership function shapes for the input/output variables were elicited from the
knowledge acquisition sessions with a medical expert in UBTH. The range of fuzzy values for
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36
HIV/AIDS risk is shown in Table 1. The membership function of negative and positive are
trapezoidal and membership function of Indeterminate is triangular. In this study, the
indeterminate fuzzy set explains the inability to detect the AIDS virus because the patient is in his
‘window period’, so a retest is advised after 3 months. The window period is the period of absent
antibody in the presence of virus in plasma [16].
Table 1. Range of fuzzy values for HIV/AIDS risk
Output Ranges Fuzzy Sets
Results
0.0-0.50
0.51-0.52
0.53-1.00
Negative
Indeterminate
Positive
Fuzzy logic resembles human decision making process which allows the use of approximate data
to find precise solution. It allows one to express knowledge with subjective concepts as “very
severe”, “severe”, and “mild” which are mapped into exact numeric ranges which can be
described as the membership function of a fuzzy set for the classification of pattern. For each
quantitative and qualitative variable which do not allow for a precise outcome, a psychometric
scale is drawn to measure its total solution space which is bounded by the smallest value to the
largest allowable value. Given a solution space for the attribute of “HIV/AIDS risk” using a
psychometric scale defined within the range of 1 to 10. This attribute could be broken down to
three fuzzy sets “Negative”, “Indeterminate”, “Positive”. The fuzzy sets are not necessarily
symmetric because the ranges of values they cover are not necessarily equal but always
overlapping to some degree. This is because a value may be a member of more than one set. The
inference procedure employs the averaging method of drawing inference. In this procedure, each
function is clipped at the average and the "fuzzy" centroid of the composite area is computed.
Most of the therapies are qualitative in form, thus they form fuzzy and linguistic variables. The
quantitative variables of the drug therapy can be transformed to fuzzy and linguistic variables
taking the minimum and maximum quantity of drugs prescribed by the system. The CD4+ T-Cell
count helps to monitor disease progression and ART therapy. In this study, the patient’s histories
are mined to determine the stages of the HIV/AIDS treatment that should be and therefore the
drugs regimen are prescribed according the Doctors prescription.
The Antiretroviral Therapies include the following:
a. Pre-treatment Evaluation
b. Initiation of ART: Initiation of therapy depends on CD4+ T-Cell count and WHO clinical
staging.
c. Counseling for ART
These issues should be thoroughly discussed by the Counselor or any health worker who is
directly involved with the patient. They should also do follow-up visits whenever the opportunity
arises [16]. Thus, there is a very dynamic situation in HIV-infected people involving continuous
viral replication and destruction and replacement of CD4+ T cells. While the CD4+ T-cells count
is a less expansion and less technical measure of HIV disease progression, quantifying the viral
load is currently the most direct measurement of the HIV disease process. It has also been used to
assess the risk of disease progression and the response to antiretroviral therapy (ART). As the
disease progresses, CD4+ T-cell count declines but may rebound if therapy is efficacious;
however, this parameter alone is an incomplete marker for clinical assessment of a patient.
Nevertheless, in resource poor settings (which include a large proportion of the most affected
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37
countries), the CD4+ T- cell count is a more affordable and hence more practical yardstick for
monitoring disease progression and ART efficacy [16]. The CD4+ T-cell count in table 1 shows
the various stages of HIV disease progression:
Table 2.2: CD4 T-Cell Count
Stages of Disease CD4+ T-cell
Count
Interpretation
Acute Sero-conversion
Syndrome
>1000/mm3
Low
Early Disease >500/mm3
Mild
Middle-Stage Disease 200-500/mm3
Moderate
Late Disease 50-200/mm3
Severe
Advanced Disease <50/mm3
Very Severe
The therapy datasets are fuzzified using the following functions with the linguistic variables:
Low, Mild, Moderate, Severe and Very Severe. The analytical representation of membership
functions of the therapy for HIV/AIDS is as presented below:
1000, low
500<x 1000, mild
x= 200<x 500 moderate
50<x 200 severe
50 very severe
≥
≤
≤
≤
≤
There are four classes currently available for treatment based on the site and mechanism of action.
Other classes are at various stages of development but are not yet widely available for clinical
use. Different classes and their mechanisms of actions:
a. Non-nucleoside Reverse Transcriptase Inhibitor (NNRTIs)
b. Nucleoside Reverse Transcriptase Inhibitor (NRTIs)
c. Nucleotide Reverse Transcriptase Inhibitor (NtRTIs)
d. Protease Inhibitors (PIs)
Some of the new classes include the Entry Inhibitors which prevent the virus from gaining access
into the cytoplasm of the T-cell. There are categories of these inhibitors:
a. The Chemokine receptors antagonists
b. Attachment inhibitors
c. Fusion inhibitors
According to the [16], it is recommended that combinations of drugs from at least two different
classes be used so that drugs can act on at least two different points in the HIV life cycle.
Monotherapy or dual therapy is not recommended for treatment as the risks of resistance
development are greater. The more the number of sites on the life cycle of the virus the drugs act,
the less the likelihood of development of drug resistance. A minimum of drug including an
NNRTI or a PI is typically used. Based on availability, efficacy and ease of administration, the
following are recommended:
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38
Preferred first line Regiment
ZDV or TDF + 3TC or FTC + EFV or NVP
Other first line Option
ABC or D4T + 3TC or FTC + EFV or NVP
where ZDV = Zidovudine, TDF = Tenofovir, 3TC = Lamivudine, FTC = Emtricitabine,
EFV = Efavirenz, NVP = Nevirapine, ABC = Abacavir and D4T = Stavudine
The Decision Support System module is used to fine-tune and filter results from the data mining
engine. This consists of two sub-components namely:
a. The Cognitive Filter: this sub-module helps to analyze the alternative output reports of
the Data Mining engine using the objective analyses presented to it by the Data
Warehouse, and
b. The Emotional Filter: helps to analyze the output reports of the Cognitive filter on the
basis of the subjective feelings of the Data Warehouse.
The Decision Support System also helps to construct the unstructured information which have
been passed to the data mining engine and have been processed via a “Keyword Analysis” to
determine the degree of relevance to the search query. Also, text analytics technique which is a
process of text mining is used to construct relevant data from unstructured information. When the
results have been adequately filtered by the Decision Support System, they are passed to the user
through an Interface. The end of the DSS is the User Interface which allows the user to interact
with the system by specifying a data mining query or task, providing information about processes
and data warehouse schemas or data structures, evaluate alternative patterns of the data mining,
and visualize the patterns in different forms like tables, Cross Tabs, graphs etc.
3. CONCLUSION
HIV/AIDS is one of the greatest health pandemic in the world over. The social, moral, economic,
psychological and mental state of a person who has the disease can be completely destroyed due
to stigmatization from friends and families except well managed through social therapy. The
continuing spread of the HIV/AIDS pandemic is mostly as a result of ignorance and lack of
acceptance of the fact of the existence of the disease amongst people. The disease is mostly
transmitted through sex, use of infected needles, blood transfusion and contact with infected
blood.
Today’s Internet technology is helping in the dissemination of information about the existence
and realities of the disease; and is also a tool for creating awareness, educating, and helping to
reach out to large number of people on how to control and stop the spread of the disease. Apart
from the use of the Internet, other media like television, radio, tabloid and seminars are also being
used.
The study has been able to make use of open source tools to develop a system which provides an
easy access and storage of large database of people living with HIV/AIDs which are mined so as
to enable prediction of the disease. The system also helps educate about the diagnosis, symptoms,
curative measures and prevention of the disease. Also, data gathered from people living had been
analyzed for effective decision support for the control and management of the disease. The
essence of the analysis is to further create awareness and foster major stakeholders in curbing the
spread of the world’s most dreaded disease.
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39
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Authors:
Igodan Charles Efosa, obtained his B.Sc. degree in Computer Science in 2004 from
University of Benin (UNIBEN) where he works, and M.Tech degree in Computer Science in
2012 from Federal University of Technology, Akure, Nigeria. He is currently working on his
Ph.D. His interests are in Data mining, Soft Computing, and Machine Learning.
Professor Oluwole Charles Akinyokun had BSc. First Class (Combined Honours) in
Computer Science and Mathematics from Obafemi Awolowo University, Ile-Ife, Osun State,
Nigeria in 1979 and PhD in Computing Studies with specialization in Distributed Database
System from the University of East Anglia, Norwich, United Kingdom in 1984. He was a
Lecturer I in 1985, Senior Lecturer in 1987, Reader in 1992 and Professor of Software
Engineering in October 1995. He is a Commonwealth Scholar and Fellow, Fellow of
Nigerian Computer Society (NCS), Member of the Computer Professional Registration Council of Nigeria
(CPN), British Computer Society (BCS) and American Computing Machinery (ACM). He has been
actively involved in Research, Innovation and Development (RID) in Knowledge Engineering in computer
network environment since 1985. He has featured prominently as a Reviewer to many reputable Journals
and Conference Proceedings, External Examiner and Assessor to many Nigerian and overseas universities.
His publications have featured prominently in many reputable national and international conference
proceedings and journals.
Dr. Olabode Olatubosun holds a B.Tech. degree in Ind. Maths, M.Tech. in Computer
science and a PhD in Computer science from the Federal University of Technology, Akure,
Nigeria (1991, 1999 and 2005). He is a researcher of both local and international repute. He
has many articles published in recognized journals and conference proceedings. Presently,
he is a senior lecturer at the Federal University of Technology, Akure. His research interest
includes, Machine learning, AI, Database and ecommerce.
Email:olabode_olatubosun@yahoo.co.uk. Tel:234-8033511257