A Survey Towards Decision Support System on Smart Irrigation Scheduling Using Machine Learning approaches.

From last decade, Big data analytics and machine learning is a hotspot research area in the domain of agriculture. Agriculture analytics is a data intensive multidisciplinary problem. Big data analytics becomes a key technology to perform analysis of voluminous data. Irrigation water management is a challenging task for sustainable agriculture. It depends on various parameters related to climate, soil and weather conditions. For accurate estimation of requirement of water for a crop a strong modeling is required. This paper aims to review the application of big data based decision support system framework for sustainable water irrigation management using intelligent learning approaches. We examined how such developments can be leveraged to design and implement the next generation of data, models, analytics and decision support tools for agriculture irrigation water system. Moreover, water irrigation management need to rapidly adapt state-of-the-art using big data technologies and ICT information technologies with the focus of developing application based on analytical modeling approach. This study introduces the area of research, including a irrigation water management in smart agriculture, the crop water model requirement, and the methods of irrigation scheduling, decision support system, and research motivation.

Matrix Product State-Based Quantum Classifier.

Interest in quantum computing has increased significantly. Tensor network theory has become increasingly popular and widely used to simulate strongly entangled correlated systems. Matrix product state (MPS) is a well-designed class of tensor network states that plays an important role in processing quantum information. In this letter, we show that MPS, as a one-dimensional array of tensors, can be used to classify classical and quantum data. We have performed binary classification of the classical machine learning data set Iris encoded in a quantum state. We have also investigated its performance by considering different parameters on the ibmqx4 quantum computer and proved that MPS circuits can be used to attain better accuracy. Furthermore the learning ability of an MPS quantum classifier is tested to classify evapotranspiration (ET o ) for the Patiala meteorological station located in northern Punjab (India), using three years of a historical data set (Agri). We have used different performance metrics of classification to measure its capability. Finally, the results are plotted and the degree of correspondence among values of each sample is shown.

Clinical comparison of two stylet angles for orotracheal intubation with the GlideScope video laryngoscope.

STUDY OBJECTIVE: To compare the success of orotracheal intubation in 62 seconds or less using the GlideScope video laryngoscope (GVL) and a 60 degrees or 90 degrees angled stylet with reverse loading of the endotracheal tube (ETT). DESIGN: Prospective, randomized study. SETTING: Operating room of a university hospital. PATIENTS: 120 ASA physical status I, II, and III adult patients undergoing elective surgery requiring general anesthesia with orotracheal intubation. INTERVENTIONS: Patients were randomly allocated to two groups (n = 60 each); both groups received general anesthesia and neuromuscular relaxation. A conventional ETT was styleted and then bent from its straight configuration just above the cuff, either at 60 degrees or 90 degrees against its concave natural curve (reverse loading). Four attending anesthesiologists, who were blinded as to stylet assignment (the 60 degrees or 90 degrees group), intubated the tracheas of all patients with the GVL using either the primary or secondary stylet. MEASUREMENTS: The primary outcome was success of orotracheal intubation in 62 seconds or less. The secondary outcome was actual time to intubation (TTI). MAIN RESULTS: The odds ratio (OR) for intubation success was higher in the 90 degrees group than the 60 degrees group (OR = 10.41; P < 0.03), as evidenced by 59 of 60 patients whose tracheas were intubated successfully within 62 seconds, compared with 51 of 60 patients in the 60 degrees group. Seven of the 9 failures were due to inability of the 60 degrees stylet to reach the glottic opening. The three remaining failures were associated with TTI of more than 62 seconds. CONCLUSIONS: The 90 degrees angled malleable stylet with reverse loading of the ETT provided more reliable ETT delivery to the glottic opening and had a higher success rate than the 60 degrees stylet.

Readmissions following pancreaticoduodenectomy for pancreas cancer: a population-based appraisal.

Procedure complexity and volume-outcome relationships have led to increased regionalization of pancreaticoduodenectomy (PD) for pancreas cancer. Knowledge regarding outcomes after PD comes from single-institutional series, which may be limited if a significant number of patients follow up at other hospitals. Thus, readmission data may be underreported. This study utilizes a population-based data set to examine readmission data following PD. California Cancer Registry (1994-2003) was linked to the California's Office of Statewide Health Planning and Development (OSHPD) database; patients with pancreatic adenocarcinoma who had undergone PD, excluding perioperative (30-day) mortality, were identified. All hospital readmissions within 1 year following PD were analyzed with respect to timing, location, and reason for readmission. Our cohort included 2,023 patients who underwent PD for pancreas cancer. Fifty-nine percent were readmitted within 1 year following PD and 47% were readmitted to a secondary hospital. Readmission was associated with worse median survival compared with those not readmitted (10.5 versus 22 months, p<0.0001). Multivariate analysis revealed that increasing T-stage, age, and comorbidities were associated with increased likelihood of readmission. Diagnoses associated with high rates of readmission included progression of disease (24%), surgery-related complications (14%), and infection (13%). Diabetes (1.4%) and pain (1.5%) were associated with low rates of readmission. We found a readmission rate of 59%, which is much higher than previously reported by single institutional series. Concordantly, nearly half of patients readmitted were readmitted to a secondary hospital. Common reasons for readmission included progression of disease, surgical complications, and infection. These findings should assist in both anticipating and facilitating postoperative care as well as managing patient expectations. This study utilizes a novel population-based database to evaluate incidence, timing, location, and reasons for readmission within 1 year following pancreaticoduodenectomy. Fifty-nine percent of patients were readmitted within 1 year after pancreaticoduodenectomy and 47% were readmitted to a secondary hospital.

Utilization of parenteral nutrition following pancreaticoduodenectomy: is routine jejunostomy tube placement warranted?

INTRODUCTION: Complications following pancreaticoduodenectomy (PD) often necessitate nutritional support. This study analyzes the utilization of parenteral nutrition (TPN) during the surgical admission as evidence for or against routine jejunostomy placement. METHODS: The California Cancer Registry (1994-2003) was linked to the California Inpatient File; PD for adenocarcinoma was performed in 1,873 patients. TPN use and enterostomy tube placement were determined and preoperative characteristics predictive of TPN use during the surgical admission were identified. RESULTS: Fourteen percent of patients received TPN, 23% underwent enterostomy tube placement, and 63% received no supplemental nutritional support. TPN was associated with longer hospital stay (18 vs. 13 days, P < 0.0001). The Charlson Comorbidity Index (CCI) > or = 3 had nearly two-fold greater odds of receiving TPN (odds ratio [OR] = 1.85, P < 0.005). CONCLUSION: Approximately 1 in 6 patients undergoing PD received TPN, which was associated with prolonged hospital stay. CCI > or = 3 was associated with increased odds of TPN utilization. Selected jejunostomy placement in patients with high CCI is worthy of consideration.

Perioperative quality-of-care measures for patients undergoing total hip or total knee replacement.

Recent years have seen the proliferation of numerous standards of quality for the process of providing health care, including total joint replacement. These attempts include the implementation of pay-for-reporting and pay-for-performance programs based on quality measures. These programs have often been implemented with few studies of the validity of the quality measures used and with limited input from the orthopedic community. Our project addresses this relative lack of evidence-based measures by developing a set of quality measures that address the perioperative care of patients undergoing total joint replacement. Our goal is to create a model for improving the quality of care and outcomes of total joint replacement in the United States by facilitating physicians in their efforts to apply the best scientific evidence to their daily practice.

Comorbidities play a larger role in predicting health-related quality of life compared to having an ostomy.

BACKGROUND: Previous research suggests an ostomy worsens health-related quality of life (HR-QOL), but comorbidities also can affect HR-QOL. METHODS: Eligible patients had abdominal operation with ostomy (cases) or similar procedure without ostomy (controls). Patients were recruited for this case-control study from 3 Veterans Affairs hospital medical and pharmacy records. Comorbidities were assessed with Charlson-Deyo Comorbidity Index. Multinomial logistic regression evaluated the impact of comorbidities and having an ostomy on HR-QOL, measured using the Medical Outcomes Study Short Form 36 for Veterans. RESULTS: A total of 237 ostomates (cases) and 268 controls were studied. Average age was 69 years; 64% of cases had colostomy, 36% ileostomy. Twenty-nine percent of patients had a high level of comorbidities. Cases and controls were similar except for reasons for undergoing surgery. High comorbidity was a significant predictor of low HR-QOL in 6 domains of the Short Form 36 for Veterans; having an ostomy was a significant predictor in 4. CONCLUSIONS: High comorbidity significantly influences low HR-QOL and impacted more domains than having an ostomy.

Is high BMI associated with specific complications after laparoscopic Roux-en-Y gastric bypass?

Controversy remains whether patients with body mass index (BMI) > or =50 kg/m2 experience more complications after laparoscopic Roux-en-y gastric bypass (LRYGB) than those with a lower BMI. Whether BMI > or =50 kg/m2 is associated with specific complications remains unknown. Charts of 152 patients who underwent LRYGB were reviewed. Logistic regression was used to determine whether high BMI is associated with minor or major complications. Overall, there was a trend that major complications occurred more frequently in patients with BMI > or =50 compared with BMI < 50, (30.4% vs. 19.8%, P = 0.138). Major bleeding complications occurred in 16.1 per cent of high BMI patients as compared with 5.2 per cent with lower BMI (P = 0.025). Multivariate regression found that BMI > or =50 was associated with higher odds of a major technical complication (OR = 2.73, P = 0.04), particularly for bleeding complications (odds ratio [OR] = 5.59, P = 0.01). Male gender was also associated with higher odds of a major technical complication (OR = 3.43, P = 0.04). These results suggest that high BMI patients may be better candidates for other types of weight loss surgery, such as staged procedures, and that surgeons early in their career should operate on patients with lower BMI.

How much do standardized forms improve the documentation of quality of care?

BACKGROUND: Chart abstraction is a common method for measuring the quality of surgical care. In this study we examine how the use of standardized operative dictation and history forms improves documentation rates of bariatric quality measures. MATERIALS AND METHODS: Two independent reviewers evaluated 201 patient charts from two multi-surgeon bariatric surgery practices for documentation of five intraoperative and seven preoperative bariatric quality measures. Group 1 used fully standardized templates to dictate or collect both, while Group 2 did not. Documentation rates were compared between the groups. RESULTS: Operative reports more consistently documented quality assessment information for cases where a dictation template was used versus where it was not (89% versus 58%, respectively, P < 0.001). The greatest discrepancies between the two groups were found in "exploration of the abdomen" (95% in Group 1 versus 43% in Group 2, P < 0.001) and in "evaluation of the gallbladder" (76% versus 28%, P < 0.001). In comparison, overall documentation rates for preoperative comorbidities were greater in both groups but remained higher for Group 1, who used fully standardized forms (98% versus 74%, P < 0.001). Group 1 had statistically significant higher rates of documentation for all seven comorbidities. CONCLUSIONS: The use of standardized dictation templates and history forms is associated with significantly higher documentation rates of quality measures in bariatric surgery. The adoption of these methods into routine use will be needed to allow for wide scale quality assessment and improvement for surgical practices.

Accuracy of staging node-negative pancreas cancer: a potential quality measure.

OBJECTIVE: To determine the optimal number of lymph nodes to examine for accurate staging of node-negative pancreatic adenocarcinoma after pancreaticoduodenectomy. DESIGN, SETTING, AND PATIENTS: Data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program (1988-2002) were used to identify 3505 patients who underwent pancreaticoduodenectomy for adenocarcinoma of the pancreas, including 1150 patients who were pathologically node negative (pN0) and 584 patients with a single positive node (pN1a). Perioperative deaths were excluded. Univariate and multivariate survival analyses were performed. MAIN OUTCOME MEASURE: Examination of 15 lymph nodes appears to be optimal for accurate staging of node-negative adenocarcinoma of the pancreas after pancreaticoduodenectomy. RESULTS: The number of nodes examined ranged from 1 to 54 (median, 7 examined nodes). Univariate survival analysis demonstrated that dichotomizing the pN0 cohort on 15 or more examined lymph nodes resulted in the most statistically significant survival difference (log-rank chi(2) = 14.49). Kaplan-Meier survival curves demonstrated a median survival difference of 8 months (P < .001) in favor of the patients who had 15 or more examined nodes compared with patients with fewer than 15 examined nodes. Multivariate analysis validated that having 15 or more examined nodes was a statistically significant predictor of survival (hazard ratio, 0.63; 95% confidence interval, 0.49-0.80; P < .0001). Furthermore, a multivariate model based on the survival benefit of each additional node evaluated in the pN0 cohort demonstrated only a marginal survival benefit for analysis of more than 15 nodes. Approximately 90% of the pN1a cohort was identified with examination of 15 nodes. CONCLUSIONS: Examination of 15 lymph nodes appears to be optimal to accurately stage node-negative adenocarcinoma of the pancreas after pancreaticoduodenectomy. Furthermore, evaluation of at least 15 lymph nodes of a pancreaticoduodenectomy specimen may serve as a quality measure in the treatment of pancreatic adenocarcinoma.