Analysis on the Bus Arrival Time Prediction Model for Human-Centric Services Using Data Mining Techniques.

The human-computer interaction has become inevitable in digital world. HCI helps humans to incorporate technology to resolve even their day-to-day problems. The main objective of the paper is to utilize HCI in Intelligent Transportation Systems. In India, the most common and convenient mode of transportation is the buses. Every state government provides the bus transportation facility to all routes at an affordable cost. The main difficulty faced by the passengers (humans) is lack of information about bus numbers available for the particular route and Estimated Time of Arrival (ETA) of the buses. There may be different reasons for the bus delay. These include heavy traffic, breakdowns, and bad weather conditions. The passengers waiting in the bus stops are neither aware of the delay nor the bus arrival time. These issues can be resolved by providing an HCI-based web/mobile application for the passengers to track their bus locations in real time. They can also check the Estimated Time of Arrival (ETA) of a particular bus, calculated using machine learning techniques by considering the impacts of environmental dynamics, and other factors like traffic density and weather conditions and track their bus locations in real time. This can be achieved by developing a real-time bus management system for the benefit of passengers, bus drivers, and bus managers. This system can effectively address the problems related to bus timing transparency and arrival time forecasting. The buses are equipped with real-time vehicle tracking module containing Raspberry Pi, GPS, and GSM. The traffic density in the current location of the bus and weather data are some of the factors used for the ETA prediction using the Support Vector Regression algorithm. The model showed RMSE of 27 seconds when tested. The model is performing well when compared with other models.

Evaluating the impact of prehospital care on mortality following major trauma in New Zealand: a retrospective cohort study.

BACKGROUND: Injury is a leading cause of death and health loss in New Zealand and internationally. The potentially fatal or severe consequences of many injuries can be reduced through an optimally structured prehospital trauma care system that can provide timely and appropriate care. OBJECTIVE: To investigate the relationship between emergency medical services (EMS) care and survival to hospital for major trauma cases in New Zealand. METHODS: This project is a retrospective cohort study of New Zealand major trauma cases attended by EMS providers over a 2-year period. Outcomes include survival to hospital and survival in hospital for at least 24 hours. The project has three phases: (1) identification of the cohort and assembling a bespoke longitudinal dataset linking EMS, New Zealand Major Trauma Registry and Coronial data; (2) describing the pathways and processes of care to inform an investigation of the relationships between types of EMS care and survival using propensity score modelling to adjust for case-mix differences; (3) assessment of the implications for future practice, policy and research. DISCUSSION: The study findings will help identify opportunities to optimise the delivery of EMS care in New Zealand by informing the development or revision of existing major trauma EMS policies and guidelines, and to provide a baseline for monitoring the impact of future initiatives. Establishing an evidence-base will support a whole-of-system appraisal that could include broader complex variables relating to healthcare services throughout the continuum of trauma care.

Potential survivability of prehospital injury deaths in New Zealand: a cross-sectional study.

INTRODUCTION: Acknowledging a notable gap in available evidence, this study aimed to assess the survivability of prehospital injury deaths in New Zealand. METHODS: A cross-sectional review of prehospital injury death postmortems (PM) undertaken during 2009-2012. Deaths without physical injuries (eg, drownings, suffocations, poisonings), where there was an incomplete body, or insufficient information in the PM, were excluded. Documented injuries were scored using the AIS and an ISS derived. Cases were classified as survivable (ISS <25), potentially survivable (ISS 25-49) and non-survivable (ISS >49). RESULTS: Of the 1796 cases able to be ISS scored, 11% (n=193) had injuries classified as survivable, 28% (n=501) potentially survivable and 61% (n=1102) non-survivable. There were significant differences in survivability by age (p=0.017) and intent (p<0.0001). No difference in survivability was observed by sex, ethnicity, day of week, seasonality or distance to advanced-level hospital care. 'Non-survivable' injuries occurred more commonly among those with multiple injuries, transport-related injuries and aged 15-29 year. The majority of 'survivable' cases were deceased when found. Among those alive when found, around half had received either emergency medical services (EMS) or bystander care. One in five survivable cases were classified as having delays in receiving care. DISCUSSION: In New Zealand, the majority of injured people who die before reaching hospital do so from non-survivable injuries. More than one third have either survivable or potentially survivable injuries, suggesting an increased need for appropriate bystander first aid, timeliness of EMS care and access to advanced-level hospital care.

Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States.

Aotearoa/New Zealand (Aotearoa/NZ) and the United States (U.S.) suffer inequities in health outcomes by race/ethnicity and socioeconomic status. This paper compares both countries' approaches to health equity to inform policy efforts. We developed a conceptual model that highlights how government and private policies influence health equity by impacting the healthcare system (access to care, structure and quality of care, payment of care), and integration of healthcare system with social services. These policies are shaped by each country's culture, history, and values. Aotearoa/NZ and U.S. share strong aspirational goals for health equity in their national health strategy documents. Unfortunately, implemented policies are frequently not explicit in how they address health inequities, and often do not align with evidence-based approaches known to improve equity. To authentically commit to achieving health equity, nations should: 1) Explicitly design quality of care and payment policies to achieve equity, holding the healthcare system accountable through public monitoring and evaluation, and supporting with adequate resources; 2) Address all determinants of health for individuals and communities with coordinated approaches, integrated funding streams, and shared accountability metrics across health and social sectors; 3) Share power authentically with racial/ethnic minorities and promote indigenous peoples' self-determination; 4) Have free, frank, and fearless discussions about impacts of structural racism, colonialism, and white privilege, ensuring that policies and programs explicitly address root causes.

Preventable injury deaths: identifying opportunities to improve timeliness and reach of emergency healthcare services in New Zealand.

BACKGROUND: Traumatic injury is a leading cause of premature death and health loss in New Zealand. Outcomes following injury are very time sensitive, and timely access of critically injured patients to advanced hospital trauma care services can improve injury survival. OBJECTIVE: This cross-sectional study will investigate the epidemiology and geographic location of prehospital fatal injury deaths in relation to access to prehospital emergency services for the first time in New Zealand. DESIGN AND STUDY POPULATION: Electronic Coronial case files for the period 2008-2012 will be reviewed to identify cases of prehospital fatal injury across New Zealand. METHODS: The project will combine epidemiological and geospatial methods in three research phases: (1) identification, enumeration, description and geocoding of prehospital injury deaths using existing electronic injury data sets; (2) geocoding of advanced hospital-level care providers and emergency land and air ambulance services to determine the current theoretical service coverage in a specified time period and (3) synthesising of information from phases I and II using geospatial methods to determine the number of prehospital injury deaths located in areas without timely access to advanced-level hospital care. DISCUSSION: The findings of this research will identify opportunities to optimise access to advanced-level hospital care in New Zealand to increase the chances of survival from serious injury. The resulting epidemiological and geospatial analyses will represent an advancement of knowledge for injury prevention and health service quality improvement towards better patient outcomes following serious injury in New Zealand and similar countries.

Adverse Drug Reaction Reporting in Africa and a Comparison of Individual Case Safety Report Characteristics Between Africa and the Rest of the World: Analyses of Spontaneous Reports in VigiBase®.

INTRODUCTION: Following the start of the World Health Organization (WHO) Programme for International Drug Monitoring (PIDM) by 10 member countries in 1968, it took another 24 years for the first two African countries to join in 1992, by which time the number of member countries in the PIDM had grown to 33. Whilst pharmacovigilance (PV), including the submission of individual case safety reports (ICSR) to VigiBase(®), the WHO global ICSR database, is growing in Africa, no data have been published on the growth of ICSR reporting from Africa and how the features of ICSRs from Africa compare with the rest of the world (RoW). OBJECTIVE: The objective of this paper was to provide an overview of the growth of national PV centres in Africa, the reporting of ICSRs by African countries, and the features of ICSRs from Africa, and to compare ICSRs from Africa with the RoW. METHODS: The search and analysis interface of VigiBase(®)--VigiLyze(®)--was used to characterise ICSRs submitted by African countries and the RoW. The distribution of ICSRs by African countries was listed and characterised by anatomic therapeutic chemical (ATC) code, Medical Dictionary for Regulatory Activities (MedDRA(®)) system organ class (SOC) classification, and patient age and sex. The case-defining features of ICSRs between Africa and the RoW were also compared. RESULTS: The number of African countries in the PIDM increased from 2 in 1992 to 35 at the end of September 2015, and African PIDM members have cumulatively submitted 103,499 ICSRs (0.88 % of global ICSRs) to VigiBase(®). The main class of products in African ICSRs are nucleoside and nucleotide reverse transcriptase inhibitors (14.04 %), non-nucleoside reverse transcriptase inhibitors (9.09 %), antivirals for the treatment of HIV infections (5.50 %), combinations of sulfonamides and trimethoprim (2.98 %) and angiotensin-converting enzyme (ACE) inhibitors (2.42 %). The main product classes implicated in ICSRs from the RoW are tumour necrosis factor-α (TNFα) inhibitors (5.29 %), topical nonsteroidal anti-inflammatory preparations (2.26 %), selective immunosuppressants (2.08 %), selective serotonin reuptake inhibitors (2.04 %) and HMG CoA reductase inhibitors (1.85 %). The main SOCs reported from Africa versus the RoW include skin and subcutaneous tissue disorders (31.14 % vs. 19.58 %), general disorders and administration site conditions (20.91 % vs. 30.49 %) and nervous system disorders (17.48 % vs. 19.13 %). The 18-44 years age group dominated ICSRs from Africa, while the 45-64 years age group dominated the RoW. Identical proportions of females (57 % Africa and the RoW) and males (37 % Africa and the RoW) were represented. CONCLUSIONS: As at the end of September 2015, 35 of 54 African countries were Full Member countries of the PIDM. Although the number of ICSRs from Africa has increased substantially, ICSRs from Africa still make up <1 % of the global total in VigiBase(®). The features of ICSRs from Africa differ to those from the RoW in relation to the classes of products as well as age group of patients affected. The gender of patients represented in these ICSRs are identical.

Pharmacovigilance in resource-limited countries.

In the past 20 years, many low- and middle-income countries have created national pharmacovigilance (PV) systems and joined the WHO's global PV network. However, very few of them have fully functional systems. Scientific evidence on the local burden of medicine-related harm and their preventability is missing. Legislation and regulatory framework as well as financial support to build sustainable PV systems are needed. Public health programs need to integrate PV to monitor new vaccines and medicines introduced through these programs. Signal analysis should focus on high-burden preventable adverse drug problems. Increased involvement of healthcare professionals from public and private sectors, pharmaceutical companies, academic institutions and the public at large is necessary to assure a safe environment for drug therapy. WHO has a major role in supporting and coordinating these developments.

The monitoring medicines project: a multinational pharmacovigilance and public health project.

The Monitoring Medicines project (MM), funded by the FP-7 EU framework, was carried out between 2009 and 2013 by a consortium of 11 partners. The objectives were to support and strengthen consumer reporting of adverse drug reactions (ADRs); expand the role and scope of national pharmacovigilance centres concerning medication errors; promote improved use of pharmacovigilance data; and develop methods to complement spontaneous reporting. The work was organised into four themes: patient reporting; medication errors; drug dependence, counterfeit and substandard medicines and clinical risk estimation; and active and targeted spontaneous pharmacovigilance. MM differed from some other major pharmacovigilance initiatives by having participants from developing countries in Asia and Africa and in leaning towards public health and communicable diseases. MM brought together stakeholders including WHO, drug regulators, pharmacovigilance centres, consumers, public health and disease specialists and patient safety networks. Resources and methodologies developed directly by, or with support from, MM include electronic systems/tools for consumer ADR reporting and cohort event monitoring; publication by WHO of handbooks on consumer reporting, medication errors and pharmacovigilance for TB medicines; methodologies for detecting drug dependence and substandard or counterfeit medicines in ADR databases; and a database on HIV treatment risks with a risk assessment tool. MM enabled stakeholders to achieve more than if they had worked alone in pursuit of patient safety.

Development of an Automated Medical Diagnosis System for Classifying Thyroid Tumor Cells using Multiple Classifier Fusion.

An automated medical diagnosis system has been developed to discriminate benign and malignant thyroid nodules in multi-stained fine needle aspiration biopsy (FNAB) images using multiple classifier fusion and presented in this paper. First, thyroid cell regions are extracted from the auto-cropped sub-image by implementing mathematical morphology segmentation method. Subsequently, statistical features are extracted by two-level wavelet decomposition based on texture characteristics of the thyroid cells. After that, decision tree (DT), k-nearest neighbor (k-NN), Elman neural network (ENN) and support vector machine (SVM) classifiers are used separately to classify thyroid nodules into benign and malignant. The four individual classifier outputs are then fused together using majority voting rule and linear combination rules to improve the performance of the diagnostic system. The classification results of ENN and SVM classifiers show an overall diagnostic accuracy (DA) of 90%, sensitivity (Se) of 85% and 100%, specificity (Sp) of 90% and 90% respectively. However, the best diagnostic accuracy of 96.66% is obtained by multiple classifier fusion with majority voting rule and linear combination rules. The experimental results show that the proposed method is a useful tool for the diagnosis of thyroid cancer and can provide a second opinion for a physician's decision.

Equivalence of the short form of the reynolds adolescent depression scale across groups.

The present study examines the equivalence of the short-form version of the Reynolds Adolescent Depression Scale (RADS-SF) for measuring depression in adolescents across gender, age, and ethnic groups. A sample of 8,692 randomly selected New Zealand secondary school students participated in the Youth'07 Health and Wellbeing Survey that included the RADS-SF. The reliability was assessed using Cronbach's alpha and item-total correlations. The validity was assessed using multigroup confirmatory factor analysis, and correlation to other questions in the survey considered likely to be associated with depression. The RADS-SF scores ranged from 10 to 40 (Mdn = 18), with a mean score of 19.14 (SD = 6.19) and Cronbach's alpha of .88. Configural, metric, and scalar equivalence was supported across gender, age, and ethnic groups (New Zealand European, Maori, Pacific, Asian, and Other), with all tested models having good fit to the data. The correlations between the RADS-SF and other variables such as suicidal ideation and well-being were also equivalent across groups. The RADS-SF was found to be equivalent in measuring depression across age, ethnic groups, and gender in a large population of New Zealand adolescents.

Support Vector Machine based diagnostic system for thyroid cancer using statistical texture features.

OBJECTIVE: The aim of this study was to develop an automated computer-aided diagnostic system for diagnosis of thyroid cancer pattern in fine needle aspiration cytology (FNAC) microscopic images with high degree of sensitivity and specificity using statistical texture features and a Support Vector Machine classifier (SVM). MATERIALS AND METHODS: A training set of 40 benign and 40 malignant FNAC images and a testing set of 10 benign and 20 malignant FNAC images were used to perform the diagnosis of thyroid cancer. Initially, segmentation of region of interest (ROI) was performed by region-based morphology segmentation. The developed diagnostic system utilized statistical texture features derived from the segmented images using a Gabor filter bank at various wavelengths and angles. Finally, the SVM was used as a machine learning algorithm to identify benign and malignant states of thyroid nodules. RESULTS: The SVMachieved a diagnostic accuracy of 96.7% with sensitivity and specificity of 95% and 100%, respectively, at a wavelength of 4 and an angle of 45. CONCLUSION: The results show that the diagnosis of thyroid cancer in FNAC images can be effectively performed using statistical texture information derived with Gabor filters in association with an SVM.

Factors associated with non-participation in one or two follow-up phases in a cohort study of injured adults.

OBJECTIVE: To identify factors associated with non-participation at the 12-month and 24-month follow-up phases of a prospective cohort study of injury outcomes. METHODS: Associations between non-participation at follow-up phases and a range of sociodemographic, injury, health, outcome and administrative factors were examined. RESULTS: An individual's non-participation at 12 months did not necessarily mean non-participation at 24 months. Sociodemographic factors were the most salient for non-participation, regardless of the number of follow-up phases or specific phase considered. CONCLUSIONS: Retention rates in prospective cohort studies of injury outcome may be improved by follow-up of everyone irrespective of previous non-participation, focusing resources to retain men, young adults, indigenous people and those living with people other than family members, and by ensuring that multiple alternative participant contacts are obtained. There is sufficient evidence to be concerned about potential bias given that several of the factors we, and others, have identified as associated with non-participation are also associated with various functional and disability outcomes following injury. This suggests detailed investigations are warranted into the effect non-participation may be having on the estimates for various outcomes.

WHO strategy for collecting safety data in public health programmes: complementing spontaneous reporting systems.

Globally, national pharmacovigilance systems rely on spontaneous reporting in which suspected adverse drug reactions (ADRs) are reported to a national coordinating centre by health professionals, manufacturers or patients. Spontaneous reporting systems are the easiest to establish and the cheapest to run but suffer from poor-quality reports and underreporting. It is difficult to estimate rates and frequencies of ADRs through spontaneous reporting. Public health programmes need to quantify and characterize risks to individuals and communities from their medicines, to minimize harm and improve use, to sustain public confidence in the programmes, and to track problems due to medication errors and poor quality medicines. Additional methods are therefore needed to monitor the quantitative aspects of medicine safety, to better identify specific risk factors and high-risk groups, and to characterize ADRs associated with specific medicines and in specific populations. The present paper introduces two methods, cohort event monitoring and targeted spontaneous reporting, that are being implemented by the WHO, in its public health programmes, to complement spontaneous reporting. The advantages and disadvantages of these methods and how each can be applied in clinical practice are discussed.

Population-based characteristics of fatal and hospital admissions for poisoning in Fiji: TRIP Project-11.

This study investigated the incidence and characteristics of poisoning fatalities and hospital admissions among indigenous Fijians and Indians in Viti Levu, Fiji. Individuals with a mechanism of injury classified as poisoning were identified using the Fiji injury surveillance in hospitals system, a population-based registry established for 12 months in Viti Levu, and analysed using population-based denominators. The mean annual rates of fatalities and hospitalisations were 2.3 and 26.0 per 100 000, respectively. Over two-thirds of poisonings occurred among people of Indian ethnicity. Most intentional poisoning admissions occurred among women (58.3%) and in 15-29-year-old individuals (73.8%). Unintentional poisoning admission rates were highest among Indian boys aged 0-14 years. While over 75% of events occurred at home, the substances involved were not systematically identified. The findings indicate the need for a strategy that addresses the differing contexts across age group, gender and ethnicity, and a lead agency responsible for implementing and monitoring its effectiveness.

Prevalence of sleepiness while driving four-wheel motor vehicles in Fiji: a population-based survey (TRIP 9).

INTRODUCTION: Sleepiness has been shown to be a risk factor for road crashes in high-income countries, but has received little attention in low- and middle-income countries. We examined the prevalence of sleepiness and sleep-related disorders among drivers of four-wheel motor vehicles in Fiji. METHOD: Using a two-stage cluster sampling roadside survey conducted over 12 months, we recruited a representative sample of people driving four-wheel motor vehicles on the island of Viti Levu, Fiji. A structured interviewer-administered questionnaire sought self-report information on driver characteristics including sleep-related measures. RESULTS: The 752 motor vehicle drivers recruited (84% response rate) were aged 17-75 years, with most driving in Viti Levu undertaken by male subjects (93%), and those identifying with Indian (70%) and Fijian (22%) ethnic groups. Drivers who reported that they were not fully alert accounted for 17% of driving, while a further 1% of driving was undertaken by those who reported having difficulty staying awake or feeling sleepy. A quarter of the driving time among 15-24-year-olds included driving while sleepy or not fully alert, with a similar proportion driving while chronically sleep deprived (ie, with less than five nights of adequate sleep in the previous week=27%). Driving while acutely or chronically sleep deprived was generally more common among Fijians compared with Indians. CONCLUSIONS: Driving while not fully alert is relatively common in Fiji. Sleepiness while driving may be an important contributor to road traffic injuries in this and other low- and middle-income countries.

Motorcycle-related trauma in the Philippines resulting in hospital admission: The epidemiology of cases at the Philippine General Hospital

OBJECTIVE: To describe the epidemiology of motorcycle related trauma (MCRT) admitted to the Philippine General Hospital (PGH). METHOD: Restrospective analysis of records of motorcycle crash victims admitted to the Trauma Division, Department of Surgery, PGH from January 1, 2004 to December 31, 2006. RESULTS: MCRT victims comprised 6.7% of all trauma admissions to PGH. Most were males (83.8%) and young adults (median age 26 years), and 38.6% were road users other than motorcycle drivers or passengers (primarily pedestrians). Two-thirds of victims suffered multiple injuries (68.9%). Common injuries were maxillo-facial (78%), fractures of the lower and upper extremeities (46.9% and 36.1%, respectively) and traumatic brain injuries (40.7%). The median length of hospital stay was 13 days. The in-hospital mortality rate was 5.8%, 43% of fatalities were due to traumatic brain injuries. Based on self-reported information, 88% of the motorcyclist victims were riding under the influence of alcohol, and 13% were wearing helmets at the time of the crash. CONCLUSIONS: A significant proportion of MCRT victims are not motorcycle users. There is an urgent need to implement effective strategies to prevent MCRT in the Philippines, including the implementation of enforcement of national laws agains drink driving and use of standard helmets.