INDIANAPOLIS, IN, United States
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Raghuram S.,Indiana University – Purdue University Indianapolis | Xia Y.,Indiana University – Purdue University Indianapolis | Ge J.,Indiana University – Purdue University Indianapolis | Palakal M.,Indiana University – Purdue University Indianapolis | And 5 more authors.
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) | Year: 2011

Bayesian network is a widely used tool for data analysis, modeling and decision support in various domains. There is a growing need for techniques and tools which can automatically construct Bayesian networks from massive text or literature data. In practice, Bayesian networks also need be updated when new data is observed, and literature mining is a very important source of new data after the initial network is constructed. Information closely related to Bayesian network usually includes the causal associations, statistics information and experimental results. However, these associations and numerical results cannot be directly integrated with the Bayesian network. The source of the literature and the perceived quality of research needs to be factored into the process of integration. In this demo, we will present a general methodology and toolkit called AutoBayesian that we developed to automatically build and update a Bayesian network based on the casual relationships derived from text mining. © 2011 Springer-Verlag.


Czaja-Mitura I.,My Health Care | Merecz-Kot D.,University of Lodz | Szymczak W.,University of Lodz | Bortkiewicz A.,University of Lodz
Medycyna Pracy | Year: 2013

Background: Several studies have shown an association between work-related stress and risk factors for cardiovascular disease. However, only a few studies concerned the police. The aim of this study was to assess the relationship between the general and work-related stress, and the functioning of the circulatory system in the police staff. Material and Methods: The study group consisted of 126 policemen (aged 37.8±7.3 years), with average employment duration of 14.4±7 years. The study comprised the assessment of health status based on the medical examination and medical history of identified diseases, cardiovascular risk factors and symptoms, dietary habits, physical activity, intake of drugs, data on the family history, determinations of serum total cholesterol, HDL and LDL fractions, triglycerides, and fasting glycemia. The stress level was assessed using the Questionnaire for the Subjective Assessment of Work and Perceived Stress Scale. Results: On medical examination hypertension was found in 36% of the people under study. Chest discomfort was reported by 60% of the subjects. Average body mass index (BMI), serum cholesterol and LDL were elevated (22.7±4.1, 222.6±41.7 mg/dl and 142.7±39.7 mg/dl, respectively). Mean triglyceride, HDL fraction and fasting glucose levels were normal in the whole group. The levels of general and occupational stress were 34.9±4.8 and 128.0±33.3, respectively, being higher than in other occupational groups. In the group with the highest level of stress, there were significantly more people with circulatory problems (81%), drinking strong alcohol at least once a week (27%), working in a 3-shift system (40.5%) and working overtime (44%). Conclusions: The results show that the police are a group at high risk of developing cardiovascular diseases due to work-related stress. © Instytut Medycyny Pracy im. prof. J. Nofera w Łodzi.


Khan Mohammed A.,My Health Care | Medarametla C.,My Health Care | Rabbani M.M.E.,My Health Care | Prashanthi K.,My Health Care
Journal of Diabetes and Metabolic Disorders | Year: 2015

Aim: To evaluate the effect of low-protein diet on renal function in patient with diabetic nephropathy. Materials and methods: This is a case of a 57-year-old obese patient who is a known case of type 2 diabetes, hypertension, benign prostate hypertrophy and chronic kidney disease 4th stage presented with the complaints of weakness, dyspnea, arthralgia, neuropathic pains and pedal edema which are prominent symptoms of Chronic kidney disease. Our healthcare team had visited patient's home and analyzed the available reports on kidney profile, fasting sugar, post prandial sugar, HbA1c, lipid profile test and prescriptions which was found to be high. The glomerular filtration rate, serum creatinine and blood urea were 24 ml/min, 3.4 mg/dL and 90 mg/dL, fasting blood sugar, post prandial blood sugar and HbA1c were 226, 305 and 7.4 %, and total cholesterol and triglycerides were 145 & 95 respectively. Further discussion on diet, it came to know that the patient was on high carbohydrate diet. By considering the objective and subjective data, our team had done the assessment and come to a conclusion that high amount of carbohydrate diet with poor medication adherence had led to the hyperglycemia which developed diabetic nephropathy. We have recommended low protein, unsaturated fat, multivitamins, antioxidants and moderate carbohydrate diet. Two dietary assessment tools had been used in order to monitor patient's adherence to the diet i.e. dietary record book and food frequency questionnaire. Results: We have carefully monitored the serum creatinine, glomerular filtration rate and blood urea for 12 months initially with an interval of 30 days for 3 months and later trimonthly up-to 12 months. Glomerular filtration rate was calculated by using the formula CKD-EPI creatinine equation. The values trend for first three months of serum creatinine and glomerular filtration rate were 2.8 mg/dL, 2.6 mg/dL,1.5 mg/dL and 24 ml/min, 26 ml/min, 51 ml/min respectively. Further, results has shown a significant improvement in the 6th, 9th and 12th month. The values of serum creatinine in the 6th, 9th and 12th month were 1.3 mg/dL, 1.1 mg/dL and 0.9 mg/dL, whereas golmerular filtration rate in the 6th, 9th and 12th month were 61 ml/min, 74 ml/min and 94 ml/min. Conclusion: The present study has demonstrated the protein diet restriction in-order to control the progression of renal failure. The dietary intervention on diabetic nephropathy plays a significant role in controlling the kidney failures. This is the first study, to our knowledge, to demonstrate the impact of pharmacist role in managing diabetic nephropathy by providing pharmaceutical care. Pharmaceutical care services should be encouraged in the community and hospital pharmacy which definitely plays a major impact in reaching the definite outcomes and providing higher quality of life. © 2015 Khan Mohammed et al.


The application of long-term blood pressure monitoring (ABPM) in the occupational medicine practice, its advantages and disadvantages and the diagnostic and prognostic values of the parameters determined during the test were reviewed. The circumstances (e.g., social meeting, phone call) in which blood pressure value significantly differs from its resting value were identified. The methodology and reference values of systolic and diastolic blood pressure proposed by the European Society of Hypertension and the European Society of Cardiology were discussed as well as the recommended values of the blood pressure load. The use of ABPM in the assessment of circadian blood pressure rhythm and the prognostic value of insufficient nocturnal drop (in non-dippers) or excessive nocturnal drop of ABP (in extreme dippers), and inverted circadian ABP variation (in reverse-dippers) was discussed. Attention was paid to the prognostic value of BP variability over short periods of time, which is specified in terms of standard deviation or coefficient of variance. This variability is considered as a factor capable of modifying the course, complications and prognosis of the hypertensive disease. The phenomena of "white coat hypertension" and masked hypertension were also described. It was demonstrated that the use of ABPM in occupational medicine is feasible, especially for preventive purposes, in workers exposed to different adverse work-related factors (noise, electromagnetic fields, shift work). © Instytut Medycyny Pracy im. prof. J. Nofera w Łodzi.


PubMed | My Health Care
Type: Journal Article | Journal: JBI library of systematic reviews | Year: 2016

The exponential increase in prevalence of childhood obesity has become a global concern. Developing countries in Asia are at particular risk due to their stage in the epidemiological and nutrition transition.The review objectives were to summarize the evidence on prevalence of childhood overweight and obesity within developing countries in Asia and to synthesise the best epidemiological association between the dietary patterns of children in the developing countries in Asia and their weight status in terms of obesity.This review considered any studies that included children under 18 years of age who live in developing countries in Asia.This review of epidemiological association considered any analytical observational studies (case-control studies, cohort studies and analytical cross-sectional studies).The focus was to summarise the prevalence of childhood overweight and obesity within developing countries in Asia and synthesise the best available evidence on the relationship between dietary patterns as the exposure variable and childhood overweight and obesity as the outcome.A three-step search strategy was utilised, with an initial limited search of MEDLINE, CINAHL and EMBASE to identify search terms. A second search using all identified keywords and index terms was undertaken across all included databases. Thirdly, the reference list of all identified reports and articles were searched for additional studies. Additional electronic databases searched included: ProQuest, Web of Science, and Scopus. Each database was searched from inception to September 2011, with an English language restriction.All papers selected for retrieval were assessed independently by two reviewers using standardised critical appraisal instruments from the Joanna Briggs Institute.Data was extracted from included studies by two reviewers independently using an adapted version of the standardised data extraction form from the Joanna Briggs Institute.Meta-analysis was not possible because of the heterogeneity of studies in terms of methodology, statistical analyses and outcomes. A narrative summary of results is provided.Fifteen studies were included in the review. The prevalence rates of childhood overweight and obesity in Asian developing countries ranged from 5.1% to 19.9% with no specific trend in age or gender. Several significant but inconsistent statistical associations between dietary patterns and overweight/obesity in children and adolescents were found [high energy diet (OR: 1.80 95%CI 1.10 to 2.90, p<0.05 vs 0.80 95%CI 0.60 to 1.10, p>0.05), low intake of fruit and vegetables (OR: 2.34 95%CI 1.04 to 5.24, p<0.001; 2.00 95%CI 1.10 to 3.40, p<0.05 vs 1.33 95%CI 0.44 to 4.05, p>0.05; 0.70 95%CI 0.50 to 1.00, p>0.05), high meat consumption (RR: 2.40 95%CI 1.00 to 5.60, p<0.05 vs 1.70 95%CI 1.00 to 2.70, p>0.05), eating out (OR: 12.0 95%CI 7.7 to 18.7, p<0.001; 1.70 95%CI 1.04 to 2.90, p<0.05 vs 1.20 95%CI 0.60 to 2.40, p>0.05), fast food intake (OR: 1.50 95%CI 1.12 to 2.02, p<0.05), presence of snacking (OR: 2.34 95%CI 1.01 to 5.54, p=0.05; 1.26 95%CI 1.13 to 1.40, p<0.05 vs 0.80 95%CI 0.48 to 1.32,p=0.377; 0.60 95%CI 0.30 to 0.99, p<0.05; 0.60 95%CI 0.40 to 0.90, p<0.05) and drinking sugar sweetened beverages (OR: 1.60 95%CI 1.02 to 2.50, p<0.05; 1.70 95%CI 1.10 to 2.70, p<0.05 vs 0.93 95%CI 0.82 to 1.05, p>0.05)]. The key limitation was the heterogeneity of studies in terms of measures of dietary patterns and obesity standards.The prevalence rates of childhood overweight and obesity in Asian developing countries ranged from 5.1% to 19.9% with no specific trend in age or gender. From the practice perspective, several significant yet inconsistent statistical associations between dietary patterns and childhood overweight/obesity in children and adolescents were found.This review highlights the need for clinicians to monitor the effects of dietary change on the weight and health status of children in Asian countries.There is a need for valid measures of dietary intake and use of standardised international cut-offs for overweight and obesity, and for future researchers to conduct prospective studies to determine the causal relationship between Asian childrens dietary pattern and their weight status.


Grant
Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase I | Award Amount: 139.07K | Year: 2010

DESCRIPTION (provided by applicant): Dramatic growth of the senior population in the U.S. is widely expected to challenge the capacity of this segment of the U.S. health system. Alternative strategies to support seniors living independently will be critical in meeting the short fall. My Health Care Manager (MHCM) has developed the Senior Care Navigation System (SCANSTM) to provide decision support to Geriatric Care Managers (GCMs), registered nurses and social workers, in the construction of consumer-side care plans for seniors and their caregivers. SCANSTM provides interventions and practical, real-world tools to extend the healthy and active years of life and assist families with critical decisions. Automatic acquisition of knowledge will help to augment MHCM's research staff in order to keep the SCANSTM knowledge base up to date for providing effective and efficient senior care plans. The overall goal for this Fast-Track SBIR research will be for MHCM in collaboration with the Indiana University's School of Informatics to develop an automated knowledge acquisition system that will acquire knowledge from health literature pertinent to senior care. This knowledge in the form of best practices will be used as part of the SCANSTM decision support system. The automatic acquisition of knowledge will greatly increase the overall productivity of the SCANS Research Team. The improvements in quality, timeliness, breadth, depth, and volume of research will be a marketable feature of the SCANSTM product. During Phase I, MHCM will validate the feasibility of automatically acquiring knowledge in literature for senior care planning. MHCM will develop knowledge extraction methodologies for geriatric care in Phase I and will implement 3 of 40 MHCM defined care categories. Phase II will expand on the algorithm(s) developed during Phase I to include an additional 30-37 care categories. MCHM will also develop geriatric care intervention discovery algorithms to be used in finding, updating, and evaluating new knowledge to be included in the SCANSTM knowledgebase. MHCM will verify and validate the feasibility of the knowledge acquisition methods by comparing the current manual research process with an automated acquisition process using literature. MHCM will then augment the knowledge discovered through text mining with an existing Bayesian Reasoning Network model to make the SCANS TM an efficient decision support system for geriatric care. With the completion of Phases I and II, commercialization of the knowledge acquisition system for SCANSTM can then proceed in Phase III of the project. PUBLIC HEALTH RELEVANCE: The goal of this Fast-Track research application is to improve the quality, depth and breadth of research reference material held in the Senior Care Navigation System, SCANS, knowledgebase used by our Geriatric Care Managers. The knowledgebase helps our GCM's to prepare comprehensive care plans for elders and their care givers covering 40 care categories. The intent is to expand the knowledge of and coordinate the services available to seniors and their families for improving their quality of life and for extending independent living.


Grant
Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase II | Award Amount: 1.04M | Year: 2011

DESCRIPTION (provided by applicant): Dramatic growth of the senior population in the U.S. is widely expected to challenge the capacity of this segment of the U.S. health system. Alternative strategies to support seniors living independently will be critical in meeting the short fall. My Health Care Manager (MHCM) has developed the Senior Care Navigation System (SCANSTM) to provide decision support to Geriatric Care Managers (GCMs), registered nurses and social workers, in the construction of consumer-side care plans for seniors and their caregivers. SCANSTM provides interventions and practical, real-world tools to extend the healthy and active years of life and assist families with critical decisions. Automatic acquisition of knowledge will help to augment MHCM's research staff in order to keep the SCANSTM knowledge base up to date for providing effective and efficient senior care plans. The overall goal for this Fast-Track SBIR research will be for MHCM in collaboration with the Indiana University's School of Informatics to develop an automated knowledge acquisition system that will acquire knowledge from health literature pertinent to senior care. This knowledge in the form of best practices will be used as part of the SCANSTM decision support system. Theautomatic acquisition of knowledge will greatly increase the overall productivity of the SCANS Research Team. The improvements in quality, timeliness, breadth, depth, and volume of research will be a marketable feature of the SCANSTM product. During PhaseI, MHCM will validate the feasibility of automatically acquiring knowledge in literature for senior care planning. MHCM will develop knowledge extraction methodologies for geriatric care in Phase I and will implement 3 of 40 MHCM defined care categories. Phase II will expand on the algorithm(s) developed during Phase I to include an additional 30-37 care categories. MCHM will also develop geriatric care intervention discovery algorithms to be used in finding, updating, and evaluating new knowledge to be included in the SCANSTM knowledgebase. MHCM will verify and validate the feasibility of the knowledge acquisition methods by comparing the current manual research process with an automated acquisition process using literature. MHCM will then augment the knowledge discovered through text mining with an existing Bayesian Reasoning Network model to make the SCANS TM an efficient decision support system for geriatric care. With the completion of Phases I and II, commercialization of the knowledge acquisition system for SCANSTM can then proceed in Phase III of the project. PUBLIC HEALTH RELEVANCE: The goal of this Fast-Track research application is to improve the quality, depth and breadth of research reference material held in the Senior Care Navigation System, SCANS, knowledgebase used by our Geriatric Care Managers. The knowledgebase helps our GCM's to prepare comprehensive care plans for elders and their care givers covering 40 care categories. The intent is to expand the knowledge of and coordinate the services available to seniors and their families for improving their quality of life and for extending independent living.


PubMed | My Health Care
Type: | Journal: Journal of diabetes and metabolic disorders | Year: 2015

To evaluate the effect of low-protein diet on renal function in patient with diabetic nephropathy.This is a case of a 57-year-old obese patient who is a known case of type 2 diabetes, hypertension, benign prostate hypertrophy and chronic kidney disease 4(th) stage presented with the complaints of weakness, dyspnea, arthralgia, neuropathic pains and pedal edema which are prominent symptoms of Chronic kidney disease. Our healthcare team had visited patients home and analyzed the available reports on kidney profile, fasting sugar, post prandial sugar, HbA1c, lipid profile test and prescriptions which was found to be high. The glomerular filtration rate, serum creatinine and blood urea were 24ml/min, 3.4mg/dL and 90mg/dL, fasting blood sugar, post prandial blood sugar and HbA1c were 226, 305 and 7.4%, and total cholesterol and triglycerides were 145 & 95 respectively. Further discussion on diet, it came to know that the patient was on high carbohydrate diet. By considering the objective and subjective data, our team had done the assessment and come to a conclusion that high amount of carbohydrate diet with poor medication adherence had led to the hyperglycemia which developed diabetic nephropathy. We have recommended low protein, unsaturated fat, multivitamins, antioxidants and moderate carbohydrate diet. Two dietary assessment tools had been used in order to monitor patients adherence to the diet i.e. dietary record book and food frequency questionnaire.We have carefully monitored the serum creatinine, glomerular filtration rate and blood urea for 12months initially with an interval of 30days for 3months and later trimonthly up-to 12months. Glomerular filtration rate was calculated by using the formula CKD-EPI creatinine equation. The values trend for first three months of serum creatinine and glomerular filtration rate were 2.8 mg/dL, 2.6 mg/dL,1.5 mg/dL and 24 ml/min, 26 ml/min, 51 ml/min respectively. Further, results has shown a significant improvement in the 6th, 9th and 12th month. The values of serum creatinine in the 6th, 9th and 12th month were 1.3 mg/dL, 1.1 mg/dL and 0.9 mg/dL, whereas golmerular filtration rate in the 6th, 9th and 12th month were 61 ml/min, 74 ml/min and 94 ml/min.The present study has demonstrated the protein diet restriction in-order to control the progression of renal failure. The dietary intervention on diabetic nephropathy plays a significant role in controlling the kidney failures. This is the first study, to our knowledge, to demonstrate the impact of pharmacist role in managing diabetic nephropathy by providing pharmaceutical care. Pharmaceutical care services should be encouraged in the community and hospital pharmacy which definitely plays a major impact in reaching the definite outcomes and providing higher quality of life.


PubMed | My Health Care
Type: Journal Article | Journal: Medycyna pracy | Year: 2013

Several studies have shown an association between work-related stress and risk factors for cardiovascular disease. ever, only a few studies concerned the police. The aim of this study was to assess the relationship between the general and work-related stress, and the functioning of the circulatory system in the police staff.The study group consisted of 126 policemen (aged 37.8 +/- 7.3 years), with average employment duration of 14.4 +/- 7 years. The study comprised the assessment of health status based on the medical examination and medical history of identified diseases, cardiovascular risk factors and symptoms, dietary habits, physical activity, intake of drugs, data on the family history, determinations of serum total cholesterol, HDL and LDL fractions, triglycerides, and fasting glycemia . The stress level was assessed using the Questionnaire for the Subjective Assessment of Work and Perceived Stress Scale.On medical examination hypertension was found in 36% of the people under study. Chest discomfort was reported by 60% of the subjects. Average body mass index (BMI), serum cholesterol and LDI, were elevated (22.7 +/- 4.1, 222.6 +/- 41.7 mg/dl and 142.7 +/- 39.7 mg/dl, respectively). Mean triglyceride, HDL fraction and fasting glucose levels were normal in the whole group. The levels of general and occupational stress were 34.914.8 and 128.0+33.3, respectively, being higher than in other occupational groups. In the group with the highest level of stress, there were significantly more people with circulatory problems (81%), drinking strong alcohol at least once a week (27%), working in a 3-shift system (40.5%) and working overtime (44%).The results show that the police are a group at high risk of developing cardiovascular diseases due to work-related stress.


PubMed | My Health Care
Type: Journal Article | Journal: World journal of gastrointestinal endoscopy | Year: 2012

To investigate the role of capsule endoscopy in patients with persistent perianal disease and negative conventional work up for Crohns disease (CD).Patients with perianal disease (abscesses, fistulas, recurrent fissures) were evaluated for underlying CD. Patients who had a negative work up, defined as a negative colonoscopy with a normal ileoscopy or a normal small bowel series or a normal CT/MR enterography, underwent a Pillcam study of the small bowel after signing informed consent. Patients using nonsteroidal anti-inflammatory drugs or who had a history of inflammatory bowel disease or rheumatic disease were excluded.We recruited 26 patients aged 21-61 years (average 35.6 years), 17 males and 9 females. One case could not be evaluated since the capsule did not leave the stomach. In 6 of 25 (24%) patients with a negative standard work up for Crohns disease, capsule endoscopy (CE) findings were consistent with Crohns disease of the small bowel. Family history of CD, white blood cell, hemoglobin, erythrocyte sedimentation rate or C-reactive protein did not predict a diagnosis of CD. Capsule endoscopy findings led to a change in treatment.In patients with perianal disease and a negative conventional work up to exclude CD, CE leads to incremental diagnostic yield of 24%.

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