Background: Acute febrile encephalopathy (AFE) is defined as fever associated with acute alteration of consciousness, with or without seizure, motor and/ or sensory deficit and total duration of illness one week or less. It is associated with significant morbidity and mortality in children. Various etiologies have been implicated in its causation and differ as per geographical. Efforts to promptly identify the underlying etiology and institute appropriate treatment early and adequately should be our goal so as to avoid any long-term sequelae and death.
Aims and Objectives: To evaluate the clinical profile and aetiology of children presenting with fever and altered sensorium and to assess the predictors of morbidity & mortality related to Acute Febrile Encephalopathy.
Materials and Methods: In this prospective, hospital-based study, a total of 282 children, between 1month to 12 years, presenting to the department of Pediatric Medicine, Calcutta National Medical College, Kolkata, West Bengal, India with fever and altered sensorium were clinically evaluated and investigated. Each patient was examined for vital signs, detailed systemic examination with focus on neurological examination. The etiology of AFE was evaluated based on detailed history, a meticulous clinical examination and relevant investigations.
Results: The incidence of AFE was 5% of the total hospital admissions. Demographic profile showed 166 (58.8%) males, 116 (41.2%) females and 48% of the study population less than 5 years of age. The most important presenting complaints apart from fever and altered sensorium, were convulsion and vomiting. Raised Intracranial tension (58%), low GCS (58%) and shock (48%) were commonest presenting signs. CNS infections were the most common cause of AFE encountered. Low GCS, refractory seizures, multi-organ failure respiratory failure were significantly associated with death (p<0.005).
Conclusions: CNS infections are the leading cause of febrile encephalopathy. Toxic- metabolic and unknown etiologies contributed maximum to the mortality. Low GCS, shock, refractory seizures, multi-organ failure and respiratory failure are associated with higher risk of mortality. Most of the morbidities were observed in auto-immune encephalitis and ADEM and as most of them were curable, early institution of appropriate treatment will decrease morbidity.
:
The immense growth of information has led to the wide usage of recommender systems for retrieving relevant information. One of the widely used methods for recommendation is collaborative filtering. However, such methods suffer from two problems, scalability and sparsity. In the proposed research, the two issues of collaborative filtering are addressed and a cluster-based recommender system is proposed. For the identification of potential clusters from the underlying network, Shapley value concept is used, which divides users into different clusters. After that, the recommendation algorithm is performed in every respective cluster. The proposed system recommends an item to a specific user based on the ratings of the item’s different attributes. Thus, it reduces the running time of the overall algorithm, since it avoids the overhead of computation involved when the algorithm is executed over the entire dataset. Besides, the security of the recommender system is one of the major concerns nowadays. Attackers can come in the form of ordinary users and introduce bias in the system to force the system function that is advantageous for them. In this paper, we identify different attack models that could hamper the security of the proposed cluster-based recommender system. The efficiency of the proposed research is validated by conducting experiments on student dataset.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.