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"Sharma, Umesh"
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Soft computing techniques in connected healthcare systems
\"This book provides examination of applications of soft computing techniques related to healthcare systems and can be used as a reference guide for assessing the roles that various techniques, such as machine learning, fuzzy logic, and statistical mathematics, play in the advancements of smart healthcare systems. This book is intended for under graduate, and graduate students, researchers and practicing professionals in the field of connected healthcare. It provides an overview for beginners while also addressing professionals in the industry on the importance of soft computing approaches in connected healthcare systems\"-- Provided by publisher.
Book
Adverse effects of tyrosine kinase inhibitors in cancer therapy: pathophysiology, mechanisms and clinical management
Since their invention in the early 2000s, tyrosine kinase inhibitors (TKIs) have gained prominence as the most effective pathway-directed anti-cancer agents. TKIs have shown significant utility in the treatment of multiple hematological malignancies and solid tumors, including chronic myelogenous leukemia, non-small cell lung cancers, gastrointestinal stromal tumors, and HER2-positive breast cancers. Given their widespread applications, an increasing frequency of TKI-induced adverse effects has been reported. Although TKIs are known to affect multiple organs in the body including the lungs, liver, gastrointestinal tract, kidneys, thyroid, blood, and skin, cardiac involvement accounts for some of the most serious complications. The most frequently reported cardiovascular side effects range from hypertension, atrial fibrillation, reduced cardiac function, and heart failure to sudden death. The potential mechanisms of these side effects are unclear, leading to critical knowledge gaps in the development of effective therapy and treatment guidelines. There are limited data to infer the best clinical approaches for the early detection and therapeutic modulation of TKI-induced side effects, and universal consensus regarding various management guidelines is yet to be reached. In this
state-of-the-art
review, we examine multiple pre-clinical and clinical studies and curate evidence on the pathophysiology, mechanisms, and clinical management of these adverse reactions. We expect that this review will provide researchers and allied healthcare providers with the most up-to-date information on the pathophysiology, natural history, risk stratification, and management of emerging TKI-induced side effects in cancer patients.
Journal Article
Investigating methods to enhance interpretability and performance in cardiac MRI for myocardial scarring diagnosis using convolutional neural network classification and One Match
Machine learning (ML) classification of myocardial scarring in cardiac MRI is often hindered by limited explainability, particularly with convolutional neural networks (CNNs). To address this, we developed One Match (OM), an algorithm that builds on template matching to improve on both the explainability and performance of ML myocardial scaring classification. By incorporating OM, we aim to foster trust in AI models for medical diagnostics and demonstrate that improved interpretability does not have to compromise classification accuracy. Using a cardiac MRI dataset from 279 patients, this study evaluates One Match, which classifies myocardial scarring in images by matching each image to a set of labeled template images. It uses the highest correlation score from these matches for classification and is compared to a traditional sequential CNN. Enhancements such as autodidactic enhancement (AE) and patient-level classifications (PLCs) were applied to improve the predictive accuracy of both methods. Results are reported as follows: accuracy, sensitivity, specificity, precision, and F1-score. The highest classification performance was observed with the OM algorithm when enhanced by both AE and PLCs, 95.3% accuracy, 92.3% sensitivity, 96.7% specificity, 92.3% precision, and 92.3% F1-score, marking a significant improvement over the base configurations. AE alone had a positive impact on OM increasing accuracy from 89.0% to 93.2%, but decreased the accuracy of the CNN from 85.3% to 82.9%. In contrast, PLCs improved accuracy for both the CNN and OM, raising the CNN’s accuracy by 4.2% and OM’s by 7.4%. This study demonstrates the effectiveness of OM in classifying myocardial scars, particularly when enhanced with AE and PLCs. The interpretability of OM also enabled the examination of misclassifications, providing insights that could accelerate development and foster greater trust among clinical stakeholders.
Journal Article
Can Teachers' Self-Reported Efficacy, Concerns, and Attitudes Toward Inclusion Scores Predict Their Actual Inclusive Classroom Practices?
This research was undertaken to determine if significant relationships exist between teachers' self-reported attitudes, concerns, and efficacy to teach in inclusive classrooms and their actual classroom behaviour in Winnipeg, Canada. Five teachers completed 3 scales measuring their attitudes to inclusion, their level of concerns about teaching in inclusive classrooms, and their level of efficacy for teaching in inclusive classrooms. They were observed using a newly developed scale to measure their inclusive teaching practices. Each teacher was observed from 3 to 5 hours on different occasions. Data were analysed using 1-tailed Spearman correlations. Results indicated that teachers who were highly inclusive in their classroom practices tended to have significantly lower degrees of concerns and positive attitudes to inclusion. Implications of the research for policymakers, future researchers, and teacher educators are discussed.
Journal Article
Cardiovascular diseases in survivors of childhood cancer
Over the past few decades, the diagnosis and management of children with various malignancies have improved tremendously. As a result, there are an increasing number of children who are long-term cancer survivors. With improved survival, however, has come an increased risk of treatment-related cardiovascular complications that can appear decades after treatment. These problems are serious enough that all caregivers of childhood cancer survivors, including oncologists, cardiologists, and other health care personnel, must pay close attention to the short- and long-term effects of chemotherapy and radiotherapy on these children. This review discusses the effects of treatment-related cardiovascular complications from anthracyclines and radiotherapy and the methods for preventing, screening, and treating these complications.
Journal Article
Adapting to COVID-19 disruptions: student engagement in online learning of accounting
Purpose
This paper aims to provide insights on student engagement in the learning of accounting during the COVID-19 disruptions and the pivot to online learning.
Design/methodology/approach
This paper is based on reflections of academic staff members teaching accounting papers at two large New Zealand universities. Further supporting information was derived from student feedback collected via paper appraisals.
Findings
The findings of this paper suggest that there were some successes and numerous challenges in engaging students in online learning of accounting. Strategies that seem to have worked well include the use of synchronous and asynchronous channels to proactively facilitate and provide learning support to students in online learning. The challenges include frustrations with online technologies and the difficulties of making personal connections with students; therefore, engaging some of the cohort in the learning proved to be difficult.
Research limitations/implications
The findings of this paper suggest that there were some successes and numerous challenges in engaging students in online learning of accounting. Strategies that seem to have worked well include the use of synchronous and asynchronous channels to proactively facilitate and provide learning support to students in online learning. The challenges include frustrations with online technologies and the difficulties of making personal connections with students; therefore, engaging some of the cohort in the learning proved to be difficult. At risk, students were less likely to participate in online live sessions due to issues such as the lack of proper computer equipment, connectivity issues, family responsibilities or the home environment.
Practical implications
This paper has the potential to inform and enhance practices of higher education institutions, accounting educators and other stakeholders such as support staff on strategies that could be implemented to achieve effective student engagement in online accounting education.
Originality/value
This paper is original and contributes towards sharing ideas with the academic community on effective teaching practices used during the COVID-19 pivot to online delivery, which can enhance student engagement in business education.
Journal Article
A Cognitive Study on Traffic Calming Measures at Urban Dwellings
Traffic calming measures aim to lessen accidents and increase user mobility in areas with large pedestrian traffic. Reduced speed zones and infrastructural modifications are two operations carried out to achieve the same. These measures may have the opposite impact on road users´ perception regarding safety and accidents, in case of faulty design or improper location. This study examines road users' behavioral aspects towards such measures in two phases. The first phase identifies the key factors influencing road-user perception and the second phase examines the effect of speed bumps and chicanes on road user´s safety. An online questionnaire was distributed among the road users of Tier-1 and Tier-2 cities of northern India, wherein 303 valid responses were analyzed. Exploratory Factor Analysis (EFA) and a Second-Order Confirmatory Factor Analysis (SCFA) were employed to prove the hypothesized model. The analysis revealed that familiarity, need, and comfort significantly contribute to the road user's positive perception, whereas negative perception incorporated factors such as traffic congestion, sudden speed reduction, and unrecognizable signage on traffic-calmed streets. As a case study, the overall impact of a speed bump was also observed, which was later removed and replaced by Chicanes in response to public outcry and discomfort. A comparative speed profile of both measures suggests their effectiveness and safety criteria. By considering citizens' perceptions and concerns, policymakers can improve the effectiveness of speed-reducing measures that meet the requirements of all road users.
Journal Article
TAVR in cancer patients: outcomes in survivors with radiation and active cancer
[...]while TAVR offers considerable potential for cancer survivors with severe AS and prior C-XRT, managing the increased risk of heart failure exacerbation requires an individualized approach. Outcomes after transcatheter aortic valve replacement in cancer survivors with prior chest radiation therapy: a systematic review and meta-analysis. Outcomes of patients with active cancer after transcatheter aortic valve replacement: an updated meta-analysis. Outcomes after transcatheter aortic valve replacement in cancer survivors with prior chest radiation therapy: an updated systematic review and meta-analysis.
Journal Article