135 research outputs found
Magnetic resonance imaging of pelvic floor dysfunction - joint recommendations of the ESUR and ESGAR Pelvic Floor Working Group
No full textObjective: To develop recommendations that can be used as guidance for standardized approach regarding indications, patient preparation, sequences acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for diagnosis and grading of pelvic floor dysfunction (PFD). Methods: The technique included critical literature between 1993 and 2013 and expert consensus about MRI protocols by the pelvic floor-imaging working group of the European Society of Urogenital Radiology (ESUR) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) from one Egyptian and seven European institutions. Data collection and analysis were achieved in 5 consecutive steps. Eighty-two items were scored to be eligible for further analysis and scaling. Agreement of at least 80 % was defined as consensus finding. Results: Consensus was reached for 88 % of 82 items. Recommended reporting template should include two main sections for measurements and grading. The pubococcygeal line (PCL) is recommended as the reference line to measure pelvic organ prolapse. The recommended grading scheme is the “Rule of three” for Pelvic Organ Prolapse (POP), while a rectocele and ARJ descent each has its specific grading system. Conclusion: This literature review and expert consensus recommendations can be used as guidance for MR imaging and reporting of PFD. Key points: • These recommendations highlight the most important prerequisites to obtain a diagnostic PFD-MRI.• Static, dynamic and evacuation sequences should be generally performed for PFD evaluation.• The recommendations were constructed through consensus among 13 radiologists from 8 institutions. © 2016 The Author(s
Multiple RF carrier distribution in a hybrid radio/fiber system employing a self-pulsating laser diode transmitter
No full textA self-pulsating laser diode is used to generate a multicarrier microwave optical signal for use in a hybrid radio/fiber system. The self-pulsation frequency of the laser is controlled by external light injection, and can be varied between 14-24 GHz. The hybrid radio/fiber system, employing the self-pulsation laser, is used to distribute two 155-Mb/s data signals on two radio frequency (RF) carriers (at 18.5 and 18.9 GHz). Experimental results show the overall system performance for both RF channels, and demonstrate that the performance is improved by around 17 dB compared with the case when the laser is used without external injection, and thus, does not self-pulsat
Study of millimeter wave phase shift in 40 GHz hybrid mode locked lasers
No full textAn investigation into using hybrid mode-locked lasers to implement millimeter wave phase shift is presented. The phase shift is measured directly using a vector network analyzer enabling straightforward characterization of such systems. Both magnitude and phase of the modulation response are measured and a 'plateau' is observed in the magnitude response which corresponds to the locking range of the system. Phase shifts of greater than 90deg are observed and such devices could have application in millimeter wave radio-over-fiber phased array antenna systems.An investigation into using hybrid mode-locked lasers to implement millimeter wave phase shift is presented. The phase shift is measured directly using a vector network analyzer enabling straightforward characterization of such systems. Both magnitude and phase of the modulation response are measured and a ldquoplateaurdquo is observed in the magnitude response which corresponds to the locking range of the system. Phase shifts of greater than 90deg are observed and such devices could have application in millimeter wave radio-over-fiber phased array antenna system
Splenic Injuries at Bugando Medical Centre in Northwestern Tanzania: A Tertiary Hospital Experience.
No full textSplenic injuries constitute a continuing diagnostic and therapeutic challenge to the trauma or general surgeons practicing in developing countries where sophisticated imaging facilities are either not available or exorbitantly expensive. The purpose of this review was to describe our own experience in the management of the splenic injuries outlining the aetiological spectrum, injury characteristics and treatment outcome of splenic injuries in our local environment and to identify predictors of outcome among these patients. A prospective descriptive study of splenic injury patients was carried out at Bugando Medical Centre in Northwestern Tanzania between March 2009 and February 2011. Statistical data analysis was done using SPSS software version 17.0. A total of 118 patients were studied. The male to female ratio was 6.4:1. Their ages ranged from 8 to 74 years with a median age of 22 years. The modal age group was 21-30 years. The majority of patients (89.8%) had blunt trauma and road traffic accidents (63.6%) were the most frequent cause of injuries. Most patients sustained grade III (39.0%) and IV (38.1%) splenic injuries. Majority of patients (86.4%) were treated operatively with splenectomy (97.1%) being the most frequently performed procedure. Postoperative complications were recorded in 30.5% of cases. The overall length of hospital stay (LOS) ranged from 1 day to 120 days with a median of 18 days. Mortality rate was 19.5%. Patients who had severe trauma (Kampala Trauma Score II ≤ 6) and those with associated injuries stayed longer in the hospital (P < 0.001), whereas age of the patient, associated injuries, trauma scores (KTS II), grade of splenic injuries, admission systolic blood pressure ≤ 90 mmHg, estimated blood loss > 2000 mls, HIV infection with CD4 ≤ 200 cells/μl and presence of postoperative complications were significantly associated with mortality (P < 0.001). Trauma resulting from road traffic accidents (RTAs) remains the most common cause of splenic injuries in our setting. Most of the splenic injuries were Grade III & IV and splenectomy was performed in majority of the cases. Non-operative management can be adopted in patients with blunt isolated and low grade splenic injuries but operative management is still indispensable in this part of Tanzania. Urgent preventive measures targeting at reducing the occurrence of RTAs is necessary to reduce the incidence of splenic injuries in our centre
Classification of vehicles' types using histogram oriented gradients: comparative study and modification
No full textThis paper proposes an efficient model for recognizing and classifying a vehicle type. The model localizes each object in the image then identifies the vehicle type. The features of an image are extracted using the histogram oriented gradients (HOG) and ant colony optimization (ACO). A vehicle type is determined using different classifiers namely: the k-nearest neighbor (KNN), support vector machine (SVM), random forest (RF), and Softmax classifiers. The model is implemented and operated on two datasets of vehicles' images as test-beds. From the comparative study, the SVM outperforms the other adopted classifiers and is also better using HOG than that using ACO. A modification is done on HOG by adding the Laplacian filter to select the most significant image features. The accuracy of the SVM classifier using modified HOG outperforms that one using the traditional HOG. The proposed model is analyzed and discussed regardless the local geometric and photometric transformations like illumination variations
Alcohol and illegal drug use behaviors and prescription opioids use: How do nonmedical and medical users compare, and does motive to use really matter?
No full textBackground-Aims: This study compares illegal drug and alcohol use behaviors between medical and nonmedical users of prescription opioids (PO) and nonmedical users with distinct motives to use. Method: An ethically approved cross-sectional study (2010) was conducted on a representative sample of private university students (n = 570), using a self-filled anonymous questionnaire. Results: About 25percent reported using PO only medically and 15percent nonmedically. The prevalence of alcohol and illegal drug use was consistently higher among nonmedical than medical PO users. Adjusting for age and gender, lifetime medical users of PO were more likely to use marijuana only (OR = 1.8, 95percent CI: 1.1, 2.8), while nonmedical users were at higher odds of using marijuana, ecstasy, cocaine-crack, and alcohol problematically. Compared to nonusers, students who took PO nonmedically for nontherapeutic reasons were more likely to use various illegal drugs, but nonmedical users who took PO to relieve pain-help in sleep were only more likely to use marijuana (OR = 2.5, 95percent CI: 1.1, 5.4) and alcohol (e.g. alcohol abuse; OR = 3.8, 95percent CI: = 1.4, 10.1). Conclusion: Youth who use PO nonmedically to self-treat have a different alcohol and illegal drug-using profile than those who take it for nontherapeutic reasons. © 2013 S. Karger AG, Basel.[Anonymous], 2007, MEAS TRANSP IMPR GOO; Becker WC, 2008, DRUG ALCOHOL DEPEN, V94, P38, DOI 10.1016-j.drugalcdep.2007.09.018; Blanco C, 2007, DRUG ALCOHOL DEPEN, V90, P252, DOI 10.1016-j.drugalcdep.2007.04.005; Boyd CJ, 2006, DRUG ALCOHOL DEPEN, V81, P37, DOI 10.1016-j.drugalcdep.2005.05.017; Boyd CJ, 2009, J ADOLESCENT HEALTH, V45, P543, DOI 10.1016-j.jadohealth.2009.03.023; Brands B, 2010, CAN FAM PHYSICIAN, V56, P256; Catalano RF, 2010, ADDICT BEHAV, V36, P79; Compton WM, 2006, DRUG ALCOHOL DEPEN, V81, P103, DOI 10.1016-j.drugalcdep.2005.05.009; Cone EJ, 2004, J ANAL TOXICOL, V28, P616; Fischer B, 2010, CAN J PSYCHIAT, V55, P606; Fredheim OMS, 2010, PEDIATR ANESTH, V20, P537, DOI 10.1111-j.1460-9592.2010.03310.x; Garnier LM, 2009, AM J DRUG ALCOHOL AB, V35, P334, DOI 10.1080-00952990903075059; Ghandour LA, 2011, DRUG ALCOHOL DEPEN, V121, P101; Gilson AM, 2004, J PAIN SYMPTOM MANAG, V28, P176, DOI 10.1016-j.jpainsymman.2004.01.003; Hamunen K, 2009, EUR J PAIN, V13, P954, DOI 10.1016-j.ejpain.2008.11.006; Harrison L., 1997, VALIDITY SELF REPORT, V167, P17; Haydon E, 2005, CAN J PUBLIC HEALTH, V96, P459; International Narcotics Control Board, 2010, REP INT NARC CONTR B; Jessor R., 1987, ALCOHOL DRUGS DRIVIN, V3, P1; Johnston L. D., 2010, MONITORING FUTURE NA, VII; Karam Elie G, 2010, J Med Liban, V58, P76; Karam EG, 2003, SUBSTANCE USE MISUSE; Kendler KS, 2003, ARCH GEN PSYCHIAT, V60, P929, DOI 10.1001-archpsyc.60.9.929; Khantzian EJ, 1997, HARVARD REV PSYCHIAT, V4, P231, DOI 10.3109-10673229709030550; Kroutil LA, 2006, DRUG ALCOHOL DEPEN, V84, P135, DOI 10.1016-j.drugalcdep.2005.12.011; Martins SS, 2009, DRUG ALCOHOL DEPEN, V103, P16, DOI 10.1016-j.drugalcdep.2009.01.019; Martins SS, 2012, PSYCHOL MED, V42, P1261, DOI 10.1017-S0033291711002145; McCabe SE, 2011, ARCH PEDIAT ADOL MED, V165, P729, DOI 10.1001-archpediatrics.2011.114; McCabe SE, 2006, J PSYCHOACTIVE DRUGS, V38, P43; McCabe SE, 2009, ARCH PEDIAT ADOL MED, V163, P739, DOI 10.1001-archpediatrics.2009.120; McCabe SE, 2005, ADDICT BEHAV, V30, P1342, DOI 10.1016-j.addbeh.2005.01.012; McCabe SE, 2009, DRUG ALCOHOL DEPEN, V102, P63, DOI 10.1016-j.drugalcdep.2009.01.007; McCabe SE, 2005, DRUG ALCOHOL DEPEN, V77, P37, DOI 10.1016-j.drugalcdep.2004.07.005; McCabe SE, 2005, ADDICT BEHAV, V30, P789, DOI 10.1016-j.addbeh.2004.08.024; McCabe SE, 2007, ADDICT BEHAV, V32, P562, DOI 10.1016-j.addbeh.2006.05.022; McCabe SE, 2006, J AM COLL HEALTH, V54, P269, DOI 10.3200-JACH.54.5.269-278; Solberg KE, 2008, LANCET, V372, P1137, DOI 10.1016-S0140-6736(08)61463-4; Sung HE, 2005, J ADOLESCENT HEALTH, V37, P44, DOI 10.1016-j.jadohealth.2005.02.013; Zacny J, 2003, DRUG ALCOHOL DEPEN, V69, P215, DOI 10.1016-S0376-8716(03)00003-6; Zacny JP, 2008, J PAIN, V9, P473, DOI 10.1016-j.jpain.2007.12.008; Zarocostas J, 2007, BRIT MED J, V334, P444, DOI 10.1136-bmj.39140.394410.DB24
Prevalence and patterns of commonly abused psychoactive prescription drugs in a sample of university students from Lebanon: An opportunity for cross-cultural comparisons
No full textBackground: Concerns about psychoactive prescription drug abuse among youth are growing worldwide, but the majority of published studies remain from the US and Canada impeding cross-cultural comparisons. This study examines the prevalence, sources, motivations and substance-use correlates of commonly abused medications among youth from Lebanon. Methods: An IRB-approved cross-sectional study was conducted (May 2010) at the American University of Beirut. Proportionate cluster sampling was used to generate a representative sample of AUB students (n=570). A self-filled anonymous questionnaire was administered. Results: Lifetime medical and nonmedical prevalence of medications were (respectively): pain (36.9percent, 15.1percent), anxiety (8.3percent, 4.6percent), sleeping (6.5percent, 5.8percent) and stimulants (2.6percent, 3.5percent). Gender differences were not observed. Lebanese were least likely to report non-medical use. Nonmedical users mostly used the drugs for their intended purpose (e.g., sleeping to help in sleep, stimulants to increase alertness). Parents and pharmacists (without a doctor's prescription) were the top two sources of all medications, except for stimulants (friends predominated). Diversion was observed in about 20percent of the medical users. Lifetime marijuana users and past year alcohol abusers were three times as likely to use any prescription drug nonmedically. Conclusions: In Lebanon, as in Western cultures, a considerable proportion of youth may be self-medicating. The absence of medical supervision coupled with motivations such as to get high renders this issue a high priority on the national youth agenda. Besides larger more comprehensive surveys, the findings signal the immediate need to reinforce relevant policies, and raise awareness among youth, parents, health professionals and other stakeholders. © 2011 Elsevier Ireland Ltd.[Anonymous], 2007, MEAS TRANSP IMPR GOO; Blanco C, 2007, DRUG ALCOHOL DEPEN, V90, P252, DOI 10.1016-j.drugalcdep.2007.04.005; Boyd CJ, 2007, ARCH PEDIAT ADOL MED, V161, P276, DOI 10.1001-archpedi.161.3.276; Boyd CJ, 2009, J ADOLESCENT HEALTH, V45, P543, DOI 10.1016-j.jadohealth.2009.03.023; Brands B, 2010, CAN FAM PHYSICIAN, V56, P256; Catalano RF, 2010, ADDICT BEHAV, V36, P79; Compton WM, 2006, DRUG ALCOHOL DEPEN, V81, P103, DOI 10.1016-j.drugalcdep.2005.05.009; Cotto JH, 2010, GENDER MED, V7, P402, DOI 10.1016-j.genm.2010.09.004; Dib JG, 2004, AM J HEALTH-SYST PH, V61, P794; El-Aneed A, 2009, J SUBST USE, V14, P75, DOI 10.1080-14659890802446087; Figueiras A, 2000, EUR J EPIDEMIOL, V16, P19, DOI 10.1023-A:1007608702063; Fischer B, 2008, J PAIN, V9, P490, DOI 10.1016-j.jpain.2008.03.002; Friedman RA, 2006, NEW ENGL J MED, V354, P1448, DOI 10.1056-NEJMp068010; Garnier LM, 2009, AM J DRUG ALCOHOL AB, V35, P334, DOI 10.1080-00952990903075059; Goldsworthy RC, 2008, AM J PUBLIC HEALTH, V98, P1115, DOI 10.2105-AJPH.2007.123257; Harrison L, 1997, NIDA Res Monogr, V167, P17; Haydon E, 2005, CAN J PUBLIC HEALTH, V96, P459; Hurwitz W, 2005, PAIN MED, V6, P152, DOI 10.1111-j.1526-4637.2005.05024.x; Johnston L.D., 2008, MONITORING FUTURE NA, P77; Johnston LD, 2009, J ADOLESCENT HEALTH, V45, P539, DOI 10.1016-j.jadohealth.2009.09.004; Johnston L D, 1997, NIDA Res Monogr, V167, P59; Karam E, 2000, EUR ADDICT RES, V6, P189, DOI 10.1159-000052045; Karam EG, 2003, SUBSTANCE USE MISUSE; Kheir N, 2008, AM J PHARM EDUC, V72; Kroutil LA, 2006, DRUG ALCOHOL DEPEN, V84, P135, DOI 10.1016-j.drugalcdep.2005.12.011; Kuehn BM, 2007, JAMA-J AM MED ASSOC, V297, P1306, DOI 10.1001-jama.297.12.1306; Kuehn BM, 2006, JAMA-J AM MED ASSOC, V295, P612, DOI 10.1001-jama.295.6.612; Levine SB, 2009, J ADOLESCENT HEALTH, V44, P407, DOI 10.1016-j.jadohealth.2008.08.010; McCabe SE, 2009, ARCH PEDIAT ADOL MED, V163, P739, DOI 10.1001-archpediatrics.2009.120; McCabe SE, 2005, ADDICT BEHAV, V30, P1342, DOI 10.1016-j.addbeh.2005.01.012; McCabe SE, 2005, DRUG ALCOHOL DEPEN, V77, P37, DOI 10.1016-j.drugalcdep.2004.07.005; McCabe SE, 2005, ADDICT BEHAV, V30, P789, DOI 10.1016-j.addbeh.2004.08.024; McCabe SE, 2007, ADDICT BEHAV, V32, P562, DOI 10.1016-j.addbeh.2006.05.022; McCabe SE, 2006, J AM COLL HEALTH, V54, P269, DOI 10.3200-JACH.54.5.269-278; McCauley JL, 2010, J CHILD PSYCHOL PSYC, V51, P84, DOI 10.1111-j.1469-7610.2009.02134.x; Nassar N T, 1973, J Med Liban, V26, P215; Simoni-Wastila L, 2008, J ADDICT MED, V2, P31, DOI 10.1097-ADM.0b013e31815b5590; Solberg KE, 2008, LANCET, V372, P1137, DOI 10.1016-S0140-6736(08)61463-4; Volkow N. D., 2005, NIH PUB; Zarocostas J, 2007, BRIT MED J, V334, P444, DOI 10.1136-bmj.39140.394410.DB7111
Prevalence and clinical value of IgA and hidden rheumatoid factors in juvenile rheumatoid arthritis
No full textBackground: Juvenile rheumatoid arthritis (JRA) is so difficult to be diagnosed early and a small subgroup of patients has positive IgM rheumatoid factor (RF) detected by the standard agglutination techniques.Objective: To investigate the prevalence of IgA and hidden RFs among patients with JRA, to evaluate their diagnostic value in comparison to classic RF and to outline their relation to disease activity, severity as well as to therapy.Methods: The study included 46 patients with JRA (31 females and 15 males). Thirty patients had polyarticular JRA, 9 had oligoarticular JRA and 7 had systemic-onset JRA. Twelve patients had active disease. Thirteen systemic lupus erythematosus patients and 32 healthy subjects were studied as controls. Evaluation was carried out clinically and radiologically (using modified Larsen scoring). Laboratory investigations included CBC, ESR, classic IgM RF (latex agglutination), ANA (indirect immunofluorescence), IgA-RF (ELISA) and hidden RF seropositivity (ion exchange chromatography).Results: All JRA patients had significantly higher IgA-RF (121.5 ± 195.4 mg/dL) and positivity of hidden RF (56.5%) than lupus (14 ± 6.6 mg/dL and 7.7% respectively) and healthy controls (13.7 ± 6.2 mg/dL and 0% respectively). Classic IgM RF had only 10.9% sensitivity in diagnosing JRA. IgA and hidden RFs had higher sensitivities (50% and 56.5% respectively). Specificity, positive and negative predictive values of IgA-RF were 97.7%, 95.8% and 65.7% and for hidden RF, they were 95.5%, 92.9% and 68.3%. Interestingly, combined positivity of IgA and hidden RFs had 100% specificity and positive predictive value for JRA. Classic RF did not correlate with disease activity and severity in terms of ESR, activity score and Larsen Index. In contrast, patients with active disease had significantly higher value of IgA-RF and positivity of hidden RF than those with quiescent disease. Also, IgA-RF had significant positive correlation with ESR, activity score and Larsen index. Similarly, patients with positive hidden RF had significantly higher values of ESR, activity score and Larsen index than those with negative hidden RF. Steroid therapy was associated with significantly higher level of IgA-RF and positivity of hidden RF, perhaps related to disease severity.Conclusion: IgA and hidden RFs are more sensitive tests in diagnosing JRA than classic IgM RF. Also, the combined positivity of IgA and hidden RFs can confirm the diagnosis of JRA in doubtful cases. The fact that IgA and hidden RFs gave positive results in the meantime that classic RF was negative, together with their significant relation to disease activity and severity highlights their clinical value as reliable laboratory markers of JRA.Key words: juvenile rheumatoid arthritis, rheumatoid factors, IgA-RF, hidden RF, SLE
Compact Circuit Simulation Model for On-Chip Inductor and Transformer for RF Integrated Circuits
No full textAn Efficient Fault Diagnosis Framework for Digital Twins Using Optimized Machine Learning Models in Smart Industrial Control Systems
No full textAbstract In recent times, digital twins (DT) is becoming an emerging and key technology for smart industrial control systems and Industrial Internet of things (IIoT) applications. The DT presently supports a significant tool that can generate a huge dataset for fault prediction and diagnosis in a real-time scenario for critical industrial applications with the support of powerful artificial intelligence (AI). The physical assets of DT can produce system performance data that is close to reality, which delivers remarkable opportunities for machine fault diagnosis for effective measured fault conditions. Therefore, this study presents an intelligent and efficient AI-based fault diagnosis framework using new hybrid optimization and machine learning models for industrial DT systems, namely, the triplex pump model and transmission system. The proposed hybrid framework utilizes a combination of optimization techniques (OT) such as the flower pollination algorithm (FPA), particle swarm algorithm (PSO), Harris hawk optimization (HHO), Jaya algorithm (JA), gray wolf optimizer (GWO), and Salp swarm algorithm (SSA), and machine learning (ML) such as K-nearest neighbors (KNN), decision tree (CART), and random forest (RF). The proposed hybrid OT–ML framework is validated using two different simulated datasets which are generated from both the mechanized triplex pump and transmission system models, respectively. From the experimental results, the hybrid FPA–CART and FPA–RF models within the proposed framework give acceptable results in detecting the most relevant subset of features from the two employed datasets while maintaining fault detection accuracy rates exemplified by the original set of features with 96.8% and 85.7%, respectively. Therefore, the results achieve good and acceptable performance compared to the other existing models for fault diagnosis in real time based on critical IIoT fields
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