| 1. |
- Ademuyiwa, Adesoji O., et al.
(author)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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In: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Journal article (peer-reviewed)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 2. |
- Lozano, Rafael, et al.
(author)
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Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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In: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
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Journal article (peer-reviewed)abstract
- Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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| 3. |
- Murray, Christopher J. L., et al.
(author)
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Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
-
In: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1995-2051
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Journal article (peer-reviewed)abstract
- Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation.
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| 4. |
- Stanaway, Jeffrey D., et al.
(author)
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Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
- 2018
-
In: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994
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Journal article (peer-reviewed)abstract
- Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
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| 5. |
- Naqvi, Salman Raza, et al.
(author)
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Agro-industrial residue gasification feasibility in captive power plants : A South-Asian case study
- 2021
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In: Energy. - : Elsevier. - 0360-5442 .- 1873-6785. ; 214
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Journal article (peer-reviewed)abstract
- The objective of this study is to build knowledge on the potential of agro-industrial residue gasification (AIRG) for use in captive power generation through a comprehensive case study. In order to evaluate the economic viability, key performance indicators, such as net present value (NPV), levelized cost of electricity (LCOE), and operating costs etc. are studied. The major textile industry located in the Raiwind area of Punjab province of Pakistan has been selected. The effect and variations of the capacity factor has also been studied coupled with the levelized cost of electricity. The agricultural residue as feedstock to the gasifier is rice husk that is the abundantly available in South Asia. Furthermore, the impact of government subsidies on natural gas is also under the scope of the study. The agro-industrial residue gasification system is found to be a potential alternative to furnace oil (FO) or gas-based captive power plants (CPPs). The results of residue-based gasification system imply a large potential when comparing the cost of electricity with national grid electricity during the peak hours. Therefore, the proposed gasification system offers economic incentives when the textile industry potentially utilizes gasification-based electricity during peak hours and national grid electricity during off-peak hours. (C) 2020 Elsevier Ltd. All rights reserved.
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| 6. |
- Ullah, Hameed, et al.
(author)
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Polyoxometalate based ionic liquids reinforced on magnetic nanoparticles: A sustainable solution for microplastics and heavy metal ions elimination from water
- 2024
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In: Microchemical journal (Print). - : Elsevier. - 0026-265X .- 1095-9149. ; 204
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Journal article (peer-reviewed)abstract
- To purify water from contaminents is essential for life on universe. Here, in this manuscript we introduces an innovative approach to overcome the intricate challenge of eliminating heavy metal ions and microplastics from water. We designed a mesoporous composite materials by synergistically integrating polyoxometalates (POMs) based ionic liquids with silica coated magnetic nanoparticles. The synthesis process initiates with the utilization of highly reduced molybdenum aggregates in polyoxometalate-ionic liquids, reinforced onto magnetic nanoparticles (POM–IL–MNPs). Crafted composites, including Q8[Mo64Ni8La6]@SiO2@Fe3O4, Q10[Mo64Ni8La6]@SiO2@Fe3O4, Q8[Mo176/Mo248]@SiO2@Fe3O4, and Q10[Mo176/Mo248]@SiO2@Fe3O4, are meticulously designed by substituting POM counter cations with long-chain alkyl-based quaternary ammonium salts. The ionic liquids and composites exhibit remarkable hydrophobicity and thermal stability due to large anions and long-chain organic counter cations. Comprehensive characterization, including FT–IR, UV–vis spectroscopy, TGA, DSC, CV, rheological study, elemental analysis, and ICP-AES, ensures a thorough investigation. Additional analyses, such as Powder X-ray diffraction (PXRD), SEM, EDX, DLS, N2 adsorption, and VSM, reveal amorphous crystallinity, distinctive surface morphology, and substantial specific surface area. Core shell structure of POM-IL-MNPs was determined by Transmision electron microscope (TEM), ICP-AES analysis demonstrates metal ion removal efficiencies from 87.35% to 99.98%, with DLS confirming 100% efficiency in PVC beads elimination. This research not only advances water decontamination but also provides valuable insights into designing and characterizing novel materials with promising environmental applications.
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| 7. |
- Baharin, Shamsul Ammar Shamsul, et al.
(author)
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Microwave and Very High Frequency Radiations of The First Narrow Initial Breakdown
- 2021
-
In: 2021 35TH INTERNATIONAL CONFERENCE ON LIGHTNING PROTECTION (ICLP) AND XVI INTERNATIONAL SYMPOSIUM ON LIGHTNING PROTECTION (SIPDA). - : Institute of Electrical and Electronics Engineers (IEEE). - 9781665423465
-
Conference paper (peer-reviewed)abstract
- This paper reports the observation of microwave and very high frequency (VHF) radiation pulses associated with the first narrow (<10us) initial breakdown (IB) pulses of ten negative cloud-to-ground (-CG) flashes. The centre frequency of microwave and VHF sensors was 0.97 GHz and 60 MHz, respectively. We found that all microwave pulses were the initiation event led the first VHF pulses ranging between 0.03187 and 2.57968 mu s and led the first narrow IB pulses ranging between 0.02382 and 2.70202 mu s. Half of the VHF pulses were observed to lead the first narrow IB pulses ranging between 0.03453 and 0.128 mu s. Moreover, polarity of microwave radiation pulses was always positive while the polarity of the first narrow IB pulses always negative. On the other hand, half of VHF radiation pulses had the same polarity as microwave radiation pulses.
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| 8. |
- Baharin, Shamsul Ammar Shamsul, et al.
(author)
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Microwave radiation associated with positive narrow bipolar events
- 2023
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In: Journal of Atmospheric and Solar-Terrestrial Physics. - : Elsevier. - 1364-6826 .- 1879-1824. ; 242
-
Journal article (peer-reviewed)abstract
- In this paper, we examined seven isolated positive Narrow Bipolar Events (NBEs), one positive NBE that initiated an IC flash progressed to a single-stroke Cloud-to-Ground (CG) flash, and one positive NBE that initiated an IC flash. Seven NBEs have been accompanied by significant Very-High Frequency (VHF) and microwave radiation pulses. We recorded all NBEs from two measurement stations (ST1 and ST2) separated at 13.3 km apart which consisted of fast antenna (FA) and slow antenna (SA) sensors, a magnetic field (B-field) sensor, a VHF sensor (60 MHz), and a microwave sensor (0.97 GHz). The waveforms were sampled at 2.5 GHz (400 ps). The key finding is that all microwave radiation pulses have been found to precede both the VHF radiation pulses and NBEs with average lead time of 63 +/- 39 ns and 122 +/- 143 ns, respectively. In comparison to stepped leader pulses or SLPs (conventional breakdown), the average lead time of microwave to VHF for NBEs (fast breakdown) was 88% faster compared to the average lead time of microwave to VHF for SLPs. Moreover, the average lead time of VHF to NBEs was 56% faster when compared to the average lead time of VHF to SLPs. The VHF interferometer map for an isolated NBE (NBE6) showed upward propagation of VHF radiation sources (fast negative breakdown) with initiation altitude, total length of the VHF radiation sources propagation, and estimated velocity were 10.2 +/- 0.3 km, 2.9 +/- 0.6 km, and 1.8 x 108 and 2.8 x 108 ms-1, respectively. On the other hand, interferometer map for an NBE that initiated a single-stroke CG (NBE3) showed bidirectional fast streamers propagation with initiation altitude, total length of the VHF radiation sources propagation, and estimated velocity were 14.0 +/- 0.4 km, 2.9 +/- 0.82 km, and 1.6 x 108 and 2.8 x 108 ms-1, respectively. Clearly, the microwave and VHF radiation pulses associated with positive NBEs have been emitted by different processes of fast breakdown mechanism. Therefore, it can be suggested that the microwave radiation is emitted by electron avalanches/corona while the VHF ra-diation is emitted by fast propagating streamers.
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| 9. |
- Baharin, Shamsul Ammar Shamsul, et al.
(author)
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Microwave radiation associated with stepped leaders of negative cloud-to-ground flashes
- 2022
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In: Atmospheric research. - : Elsevier. - 0169-8095 .- 1873-2895. ; 270
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Journal article (peer-reviewed)abstract
- In this paper, Very-High Frequency (VHF) and microwave radiation pulses associated with stepped leader pulses (conventional breakdown) are examined. A total of 100 stepped leader pulses (SLPs) with the associated 100 quiet periods (QPs) from ten negative cloud-to-ground (CG) flashes within the reversal distance (<8 km) have been analyzed. The QP is defined as the period between two SLPs when no electrical activity within the fast antenna sensor bandwidth was detected. The measurement system is made up of fast antenna (FA) and slow antenna (SA) sensors, a VHF sensor (60 MHz center frequency with 40 MHz bandwidth), and a microwave sensor (0.97 GHz center frequency with 20 MHz bandwidth). The waveforms were sampled at 2.5 GHz (400 ps). The total durations of the SLPs and QPs were 2.648 +/- 1.152 mu s and 2.708 +/- 1.670 mu s, respectively. All microwave and VHF radiation waveforms have been detected as clear individual oscillating pulses. The key finding is that the microwave radiation can be classified into three categories based on the total number of detected individual oscillating pulses during the QP. Two microwave pulses detected during the QP (Category 1) are suggested to be associated with the electron avalanche/corona process at the tip of an existing negative leader and a space stem. The VHF pulses associated with the microwave pulses are suggested to be emitted by propagating streamers. On the other hand, a single microwave pulse detected during the QP (Category 2) is suggested to be emitted by the electron avalanche/corona process of a space stem. The VHF pulses associated with the microwave pulse are suggested to be emitted by propagating streamers. In both categories, 70% of the microwave radiation pulses have been observed to precede VHF radiation pulses with an average lead time of 0.848 +/- 1.336 mu s. The head-on collision of a downward propagating negative streamer and an upward propagating positive streamer (from space stem) emitted significant microwave radiation. A new negative leader was formed when the head-on collision took place. The microwave radiation pulses emitted by the head-on collision process were observed to precede SLPs with an average lead time of 0.423 +/- 0.378 mu s. Around 80% of the microwave radiation pulses preceded VHF radiation pulses with average lead time of 0.540 +/- 0.596 mu s. Therefore, microwave and VHF radiation pulses are suggested to be emitted by different processes of the electrical breakdown mechanism. The microwave radiation is emitted by electron avalanche/corona/head-on collision while the VHF radiation is emitted by propagating streamers.
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| 10. |
- Khalil, Ibrahim, et al.
(author)
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Burden of Diarrhea in the Eastern Mediterranean Region, 1990-2013 : Findings from the Global Burden of Disease Study 2013
- 2016
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In: American Journal of Tropical Medicine and Hygiene. - : American Society of Tropical Medicine and Hygiene. - 1476-1645 .- 0002-9637. ; 95:6, s. 1319-1329
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Journal article (peer-reviewed)abstract
- Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0-1) in Bahrain and Oman to 471 (95% UI = 245-763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520-989) in Syria to 40,869 (95% UI = 21,540-65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden.
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| 11. |
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| 12. |
- Sabri, Muhammad Haziq Mohammad, et al.
(author)
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Very High Frequency and Microwave Radiation Associated with Initial Breakdown Process in CG Lightning Flashes from Tropical Storms
- 2021
-
In: 2021 35TH INTERNATIONAL CONFERENCE ON LIGHTNING PROTECTION (ICLP) AND XVI INTERNATIONAL SYMPOSIUM ON LIGHTNING PROTECTION (SIPDA). - : Institute of Electrical and Electronics Engineers (IEEE). - 9781665423465
-
Conference paper (peer-reviewed)abstract
- We present the observation of VHF and microwave radiation pulses associated with initial breakdown process of five negative cloud-to-ground (-CG) flashes from two tropical storms. The -CG flashes were detected within and beyond reversal distances with the locations of the first return stroke were less than 10 km. Out of five flashes, only one detected with initial electric field change (IEC) process. Both VHF and microwave pulses were detected before the first classic IB pulse and the first microwave pulses were found to lead the first VHF pulses ranging between 0.03 and 23.9 mu s.
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| 13. |
- Wang, Haidong, et al.
(author)
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Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015 : the Global Burden of Disease Study 2015.
- 2016
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In: The lancet. HIV. - : Elsevier. - 2352-3018. ; 3:8, s. e361-e387
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Journal article (peer-reviewed)abstract
- BACKGROUND: Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015.METHODS: For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification.FINDINGS: Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1-3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5-2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6-40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7-1·9 million) in 2005, to 1·2 million deaths (1·1-1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections.INTERPRETATION: Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030.
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| 14. |
- Wang, Haidong, et al.
(author)
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Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015
- 2016
-
In: The Lancet. - 0140-6736 .- 1474-547X. ; 388:10053, s. 1459-1544
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures.METHODS: We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).FINDINGS: Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4-61·9) in 1980 to 71·8 years (71·5-72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7-17·4), to 62·6 years (56·5-70·2). Total deaths increased by 4·1% (2·6-5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8-18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6-16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9-14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1-44·6), malaria (43·1%, 34·7-51·8), neonatal preterm birth complications (29·8%, 24·8-34·9), and maternal disorders (29·1%, 19·3-37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death.INTERPRETATION: At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems.
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| 15. |
- Baharin, Shamsul Ammar Shamsul, et al.
(author)
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Electromagnetic Interference From Natural Lightning on 4G Communication Links
- 2024
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In: IEEE Access. - : Institute of Electrical and Electronics Engineers (IEEE). - 2169-3536. ; 12, s. 14870-14881
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Journal article (peer-reviewed)abstract
- In this study, microwave radiation pulses emitted from natural lightning have been found to interfere with the Fourth Generation Long Term Evolution (4G LTE) mobile communication data transmission. Two sets of measurement instruments have been synchronized where lightning electric field sensor together with 4G LTE network were evaluated its performance under two conditions namely fair-weather (four cases) and storm (four lightning cases). The microwave radiation emitted from lightning was directly measured without the use of a mixer and down-convertor to ensure the preservation of information such as the number of pulses and amplitude. A client-server architecture has been set up for data transmission utilizing User Datagram Protocol (UDP) where the packets have been generated by using Internet Performance Working Group Third Version (Iperf3) platform. Under fair-weather conditions, the 4G LTE connection at both the client and server nodes demonstrated stability and experienced minimal impact. On the other hand, natural lightning electromagnetic interference disrupted the 4G LTE communication links. Among the four reported storms, three storms have affected the 4G LTE data transmission. The first and fourth storms resulted in a complete connection drop to zero, lasting for 4 minutes and 2 seconds and for 44 seconds, respectively. The observation of hundreds microwave radiation pulses, each characterized by individual oscillating features suggests a potential disruption to packet transmission. Moreover, negative could-to-ground (-CG) and intra-cloud (IC) lightning flashes have been identified as the primary sources of interference to the 4G LTE data transmission. This information could be useful for future studies and for developers working on improving the reliability and performance of 4G LTE networks, particularly in areas prone to thunderstorms.
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| 16. |
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| 17. |
- Griswold, Max G., et al.
(author)
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Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016
- 2018
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In: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 392:10152, s. 1015-1035
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Journal article (peer-reviewed)abstract
- Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week.Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.
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| 18. |
- Hameed, Khurram, et al.
(author)
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Far-Field DOA Estimation of Uncorrelated RADAR Signals through Coprime Arrays in Low SNR Regime by Implementing Cuckoo Search Algorithm
- 2022
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In: Electronics. - : MDPI AG. - 2079-9292. ; 11:4
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Journal article (peer-reviewed)abstract
- For the purpose of attaining a high degree of freedom (DOF) for the direction of arrival (DOA) estimations in radar technology, coprime sensor arrays (CSAs) are evaluated in this paper. In addition, the global and local minima of extremely non-linear functions are investigated, aiming to improve DOF. The optimization features of the cuckoo search (CS) algorithm are utilized for DOA estimation of far-field sources in a low signal-to-noise ratio (SNR) environment. The analytical approach of the proposed CSAs, CS and global and local minima in terms of cumulative distribution function (CDF), fitness function and SNR for DOA accuracy are presented. The parameters like root mean square error (RMSE) for frequency distribution, RMSE variability analysis, estimation accuracy, RMSE for CDF, robustness against snapshots and noise and RMSE for Monte Carlo simulation runs are explored for proposed model performance estimation. In conclusion, the proposed DOA estimation in radar technology through CS and CSA achievements are contrasted with existing tools such as particle swarm optimization (PSO).
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| 19. |
- Kazmi, Bilal, et al.
(author)
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Thermodynamic and economic assessment of cyano functionalized anion based ionic liquid for CO2 removal from natural gas integrated with, single mixed refrigerant liquefaction process for clean energy
- 2022
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In: Energy. - : Pergamon Press. - 0360-5442 .- 1873-6785. ; 239
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Journal article (peer-reviewed)abstract
- The study proposes a novel integrated process in which ionic liquid is utilized to control carbon dioxide (CO2) emissions from the natural gas combined with a single mixed refrigerant-based liquefaction process to assist safe transportation over long distances providing a sustainable and cleaner energy. Commercially amines are utilized for CO2 sequestration, but amines entail energy-intensive regeneration with elevated process costs. The present study offers a solvent screening mechanism based on important parameters such as heat of dissolution, viscosity, selectivity, working capacity, vapor pressure, corrosivity, and toxicity. The selected solvents' performance is computed by sensitivity analysis suggesting imidazolium-based cation 1-hexyl-3-methylimidazolium[Hmim] functionalized with tricyanomethanide(tcm) as anion a potential natural gas sweetening solvent in comparison with commercially used solvent monoethanoloamine(MEA), conventional ILs 1-butyl-3-methylimidazolium hexa-fluorophosphate [Bmim][Pf(6)] and 1-butyl-3-methylimidazolium methyl sulfate [Bmim][MeSO4]. The obtained sweet gas is liquefied using a single mixed refrigerant-based process providing 0.99 mol fraction of liquefied CH4 with less overall specific compression power requirement of 0.41 kW/kg of natural gas. Moreover, an exergy analysis demonstrates that the [Hmim][tcm] based process has lower total exergy destruction of 7.49 x 10(3) kW and is found to utilize less overall specific energy consumption 0.49 kWh/kg of NG in contrast to other studied solvents. Furthermore, a detailed economic analysis establishes [Hmim][tcm]-based CO2 integrated with liquefaction technology offers 50.7%, 74.4%, and 85.8% of total annualized cost (TAC) savings compared with the MEA-amim][Pf(6)]-, and [Bmim][MeSO4], respectively. Hence, [Hmim][tcm] for CO2 removal and integration with liquefaction process will incur unit cost based on the total annualized cost to be $2.2 x 10(4)/kmol of purified NG.
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| 20. |
- Sabri, Muhammad Haziq Mohammad, et al.
(author)
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A study of cloud-to-ground lightning flashes initiated by fast positive breakdown
- 2022
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In: Atmospheric research. - : Elsevier. - 0169-8095 .- 1873-2895. ; 276
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Journal article (peer-reviewed)abstract
- In this paper, we examine the initiation event of two tropical negative cloud to ground (CG) lightning flashes within reversal distance (<8 km) detected on 12 (CG1) and 24 (CG2) November 2019, respectively. The CG flashes were recorded using a fast antenna (FA), slow antenna (SA), magnetic field (B-field), and very high frequency (VHF) sensors located at two observation stations (ST1 and ST2) 13.26 km apart. The key finding is that CG1 flash was initiated by a short VHF pulse followed by a VHF burst (fast positive breakdown) while CG2 flash was initiated by a VHF burst (fast positive breakdown) not preceded by a short VHF pulse. The VHF burst was a precursor for initiation of a narrow bipolar event (NBE)-like pulse and initial electric field changes (IECs). Based on the VHF interferometer map, the VHF sources of NBE-like pulses have been propagated upward predominantly vertical. The initiation altitude, total length of the VHF sources propagation, estimated velocity of NBE-like pulse for CG1 flash were 4.5 +/- 0.5 km, 1.9-3.8 km, and 2.4 x 108 to 4.8 x 108 ms-1, respectively, and for CG2 flash were 5.1 +/- 0.8 km, 0.2-3.0 km, and 2.7 x 107 to 4.1 x 108 ms-1, respectively. It is evident that IECs process has been initiated during fast positive streamers propagation. It can be suggested that the IECs process resulted from charge transfer during a fast positive breakdown. The durations and magnitudes of IECs for CG1 flash were 248.5 mu s and 27.97 V/m, respectively, and for CG2 flash were 265.8 mu s and 2.31 V/m, respectively.
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| 21. |
- Sabri, Muhammad Haziq Mohammad, et al.
(author)
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Microwave Radiation Associated with Lightning Initiation Events of Negative Cloud-to-Ground Flashes
- 2022
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In: Atmosphere. - : MDPI. - 2073-4433. ; 13:9
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Journal article (peer-reviewed)abstract
- In this paper, we examined the initiation events of ten negative cloud-to-ground (CG) flashes detected close to measurement stations on 12 November (CG-1 to CG-5) and 24 November (CG-6 to CG-10), 2019. All CG flashes were accompanied by microwave and very-high frequency (VHF) radiation pulses. We recorded all the CG flashes from two measurement stations (ST1 and ST2), which are separated by 13.3 km and consist of fast and slow antenna (FA and SA) sensors, a magnetic field (B-field) sensor, a VHF sensor (60 MHz), and a microwave sensor (similar to 1 GHz). The key finding is that all of the microwave radiation pulses detected before the onset of initial electric field changes (IECs) preceded all VHF radiation pulses with an average lead time of 1.53 mu s, ranging between 0.3 and 3.0 mu s (for all CG flashes within reversal distance). A total of 50%, 17%, and 33% CG flashes were initiated by a single radiation pulse, two radiation pulses, and three radiation pulses, respectively, and were followed by IECs. Some VHF pulses are classified as short VHF radiation pulses (pulse duration less than 0.5 mu s). The average duration from the first microwave and VHF pulses to the onset of IECs were 53.4 mu s and 32.78 mu s, respectively. The VHF radiation pulses detected before the IECs are suggested to be emitted by short-length positive streamers. Because the microwave radiation pulses were detected earlier (average lead time of 1.53 mu s) than VHF radiation pulses, it is most likely that the microwave pulses were emitted by an electron avalanche process.
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| 22. |
- Sabri, Muhammad Haziq Mohammad, et al.
(author)
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Observation of tropical positive cloud-to-ground flashes accompanied by chaotic and regular pulse trains
- 2024
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In: Journal of Atmospheric and Solar-Terrestrial Physics. - : Elsevier. - 1364-6826 .- 1879-1824. ; 261
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Journal article (peer-reviewed)abstract
- This study investigates the occurrence of chaotic pulse trains (CPTs) and regular pulse trains (RPTs) in tropical positive cloud-to-ground (CG) lightning flashes. These flashes are categorized into four types based on the initial polarity of the initial breakdown (IB) pulses and their relationship to the first return stroke (RS). A total of 71 positive CG flashes from five thunderstorm events were analyzed. The analysis reveals instances of CPTs and RPTs both before and after the first positive RS, along with the occurrence of mixed polarities in RPTs. Variations in IB pulse polarities and the presence of CPTs and RPTs before the first positive RS were observed, contrasting with previous findings in negative CG flashes. All positive CG flashes have been detected when cloud top height occurrences were between 12 and 18 km. In contrast, for negative CG flashes with CPTs and RPTs the cloud top height occurrences were between 5 and 12 km. It is interesting that CPTs and RPTs can be detected during IB process of positive CG flashes at relatively high altitude in the thundercloud. Perhaps due to low pressure at higher altitudes in the cloud, electrical process associated with CPTs and RPTs are easily discharged before the occurrence first positive return stroke. The altitudes of cloud top heights for the inverse polarity of IB pulses were located between 16 and 18 km. This research enhances the understanding of positive CG lightning initiation process and their relationship with CPTs and RPTs, as well as the occurrence of recoil leaders.
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| 23. |
- Ahmed, Ammar, et al.
(author)
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Enhancing wrist abnormality detection with YOLO : Analysis of state-of-the-art single-stage detection models
- 2024
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In: Biomedical Signal Processing and Control. - : Elsevier. - 1746-8094 .- 1746-8108. ; 93
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Journal article (peer-reviewed)abstract
- Diagnosing and treating abnormalities in the wrist, specifically distal radius, and ulna fractures, is a crucial concern among children, adolescents, and young adults, with a higher incidence rate during puberty. However, the scarcity of radiologists and the lack of specialized training among medical professionals pose a significant risk to patient care. This problem is further exacerbated by the rising number of imaging studies and limited access to specialist reporting in certain regions. This highlights the need for innovative solutions to improve the diagnosis and treatment of wrist abnormalities. Automated wrist fracture detection using object detection has shown potential, but current studies mainly use two-stage detection methods with limited evidence for single-stage effectiveness. This study employs state-of-the-art single-stage deep neural network-based detection models YOLOv5, YOLOv6, YOLOv7, and YOLOv8 to detect wrist abnormalities. Through extensive experimentation, we found that these YOLO models outperform the commonly used two-stage detection algorithm, Faster R-CNN, in fracture detection. Additionally, compound-scaled variants of each YOLO model were compared, with YOLOv8 m demonstrating a highest fracture detection sensitivity of 0.92 and mean average precision (mAP) of 0.95. On the other hand, YOLOv6 m achieved the highest sensitivity across all classes at 0.83. Meanwhile, YOLOv8x recorded the highest mAP of 0.77 for all classes on the GRAZPEDWRI-DX pediatric wrist dataset, highlighting the potential of single-stage models for enhancing pediatric wrist imaging.
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| 24. |
- Ahmed, Ammar, et al.
(author)
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Learning from the few : Fine-grained approach to pediatric wrist pathology recognition on a limited dataset
- 2024
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In: Computers in Biology and Medicine. - : Elsevier. - 0010-4825 .- 1879-0534. ; 181
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Journal article (peer-reviewed)abstract
- Wrist pathologies, particularly fractures common among children and adolescents, present a critical diagnostic challenge. While X-ray imaging remains a prevalent diagnostic tool, the increasing misinterpretation rates highlight the need for more accurate analysis, especially considering the lack of specialized training among many surgeons and physicians. Recent advancements in deep convolutional neural networks offer promise in automating pathology detection in trauma X-rays. However, distinguishing subtle variations between pediatric wrist pathologies in X-rays remains challenging. Traditional manual annotation, though effective, is laborious, costly, and requires specialized expertise. In this paper, we address the challenge of pediatric wrist pathology recognition with a fine-grained approach, aimed at automatically identifying discriminative regions in X-rays without manual intervention. We refine our fine-grained architecture through ablation analysis and the integration of LION. Leveraging Grad-CAM, an explainable AI technique, we highlight these regions. Despite using limited data, reflective of real-world medical study constraints, our method consistently outperforms state-of-the-art image recognition models on both augmented and original (challenging) test sets. Our proposed refined architecture achieves an increase in accuracy of 1.06% and 1.25% compared to the baseline method, resulting in accuracies of 86% and 84%, respectively. Moreover, our approach demonstrates the highest fracture sensitivity of 97%, highlighting its potential to enhance wrist pathology recognition.
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| 25. |
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