| 1. |
- Thomas, HS, et al.
(author)
-
- 2019
-
swepub:Mat__t
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- Burstein, R., et al.
(author)
-
Mapping 123 million neonatal, infant and child deaths between 2000 and 2017
- 2019
-
In: Nature. - : Nature Publishing Group. - 0028-0836 .- 1476-4687. ; 574:7778, s. 353-358
-
Journal article (peer-reviewed)abstract
- Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations. © 2019, The Author(s).
|
|
| 5. |
|
|
| 6. |
- Lozano, Rafael, et al.
(author)
-
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
-
In: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
-
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.
|
|
| 7. |
- Stanaway, Jeffrey D., et al.
(author)
-
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
-
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.
|
|
| 8. |
|
|
| 9. |
- Ademuyiwa, Adesoji O., et al.
(author)
-
Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
-
In: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
-
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.
|
|
| 10. |
- Thorgeirsson, T. E., et al.
(author)
-
A rare missense mutation in CHRNA4 associates with smoking behavior and its consequences
- 2016
-
In: Molecular Psychiatry. - : Springer Science and Business Media LLC. - 1359-4184 .- 1476-5578. ; 21:5, s. 594-600
-
Journal article (peer-reviewed)abstract
- Using Icelandic whole-genome sequence data and an imputation approach we searched for rare sequence variants in CHRNA4 and tested them for association with nicotine dependence. We show that carriers of a rare missense variant (allele frequency = 0.24%) within CHRNA4, encoding an R336C substitution, have greater risk of nicotine addiction than non-carriers as assessed by the Fagerstrom Test for Nicotine Dependence (P = 1.2 x 10(-4)). The variant also confers risk of several serious smoking-related diseases previously shown to be associated with the D398N substitution in CHRNA5. We observed odds ratios (ORs) of 1.7-2.3 for lung cancer (LC; P = 4.0 x 10(-4)), chronic obstructive pulmonary disease (COPD; P = 9.3 x 10(-4)), peripheral artery disease (PAD; P = 0.090) and abdominal aortic aneurysms (AAAs; P = 0.12), and the variant associates strongly with the early-onset forms of LC (OR = 4.49, P = 2.2 x 10(-4)), COPD (OR = 3.22, P = 2.9 x 10(-4)), PAD (OR = 3.47, P = 9.2 x 10(-3)) and AAA (OR = 6.44, P = 6.3 x 10(-3)). Joint analysis of the four smoking-related diseases reveals significant association (P = 6.8 x 10(-5)), particularly for early-onset cases (P = 2.1 x 10(-7)). Our results are in agreement with functional studies showing that the human alpha 4 beta 2 isoform of the channel containing R336C has less sensitivity for its agonists than the wild-type form following nicotine incubation.
|
|
| 11. |
- Block, Keith I., et al.
(author)
-
Designing a broad-spectrum integrative approach for cancer prevention and treatment
- 2015
-
In: Seminars in Cancer Biology. - : Academic Press. - 1044-579X .- 1096-3650. ; 35, s. S276-S304
-
Research review (peer-reviewed)abstract
- Targeted therapies and the consequent adoption of "personalized" oncology have achieved notable successes in some cancers; however, significant problems remain with this approach. Many targeted therapies are highly toxic, costs are extremely high, and most patients experience relapse after a few disease-free months. Relapses arise from genetic heterogeneity in tumors, which harbor therapy-resistant immortalized cells that have adopted alternate and compensatory pathways (i.e., pathways that are not reliant upon the same mechanisms as those which have been targeted). To address these limitations, an international task force of 180 scientists was assembled to explore the concept of a low-toxicity "broadspectrum" therapeutic approach that could simultaneously target many key pathways and mechanisms. Using cancer hallmark phenotypes and the tumor microenvironment to account for the various aspects of relevant cancer biology, interdisciplinary teams reviewed each hallmark area and nominated a wide range of high-priority targets (74 in total) that could be modified to improve patient outcomes. For these targets, corresponding low-toxicity therapeutic approaches were then suggested, many of which were phytochemicals. Proposed actions on each target and all of the approaches were further reviewed for known effects on other hallmark areas and the tumor microenvironment Potential contrary or procarcinogenic effects were found for 3.9% of the relationships between targets and hallmarks, and mixed evidence of complementary and contrary relationships was found for 7.1%. Approximately 67% of the relationships revealed potentially complementary effects, and the remainder had no known relationship. Among the approaches, 1.1% had contrary, 2.8% had mixed and 62.1% had complementary relationships. These results suggest that a broad-spectrum approach should be feasible from a safety standpoint. This novel approach has potential to be relatively inexpensive, it should help us address stages and types of cancer that lack conventional treatment, and it may reduce relapse risks. A proposed agenda for future research is offered. (C) 2015 The Authors. Published by Elsevier Ltd.
|
|
| 12. |
- Pelaz, B, et al.
(author)
-
Diverse Applications of Nanomedicine
- 2017
-
In: ACS nano. - : American Chemical Society (ACS). - 1936-086X .- 1936-0851. ; 11:3, s. 2313-2381
-
Journal article (peer-reviewed)
|
|
| 13. |
- Sadovykh, A., et al.
(author)
-
MegaM@Rt2 Project : Mega-Modelling at Runtime - Intermediate Results and Research Challenges
- 2019
-
In: Lect. Notes Comput. Sci.. - Cham : Springer. - 9783030298517 ; , s. 393-405
-
Conference paper (peer-reviewed)abstract
- MegaM@Rt2 Project is a major European effort towards the model-driven engineering of complex Cyber-Physical systems combined with runtime analysis. Both areas are dealt within the same methodology to enjoy the mutual benefits through sharing and tracking various engineering artifacts. The project involves 27 partners that contribute with diverse research and industrial practices addressing real-life case study challenges stemming from 9 application domains. These partners jointly progress towards a common framework to support those application domains with model-driven engineering, verification, and runtime analysis methods. In this paper, we present the motivation for the project, the current approach and the intermediate results in terms of tools, research work and practical evaluation on use cases from the project. We also discuss outstanding challenges and proposed approaches to address them.
|
|
| 14. |
- Saeed, A., et al.
(author)
-
Synthesis, Antibacterial and Antileishmanial Activity, Cytotoxicity, and Molecular Docking of New Heteroleptic Copper(I) Complexes with Thiourea Ligands and Triphenylphosphine
- 2018
-
In: Russian journal of general chemistry. - : MAIK NAUKA/INTERPERIODICA/SPRINGER. - 1070-3632 .- 1608-3350. ; 88:3, s. 541-550
-
Journal article (peer-reviewed)abstract
- A series of copper(I) complexes with triphenylphosphine and N-acyl-N'-arylthioureas were synthesized and characterized by elemental analysis and IR and NMR (H-1, C-13, P-31) spectroscopy. The thiourea ligands and their copper(I) triphenylphosphine complexes were screened for antibacterial and antileishmanial activities and cytotoxicity. The synthesized compounds showed much better activity as compared to glucantime and Kanamycin used as reference drugs. The thiourea ligands showed better activity than their Cu(I) complexes. The molecular docking technique was utilized to ascertain the mechanism of action toward molecular targets (GP63 and 16S-rRNA A-site). It was found that the ligands and complexes were stabilized at the active site by electrostatic and hydrophobic forces, consistent with the corresponding experimental results. The in silico study of the binding pattern predicted that one of the synthesized ligands, N-(5-chloro-2-nitrophenyl)-N'-pentanoylthiourea, can serve as a potential surrogate for hit-to-lead generation and design of novel antibacterial and antileishmanial agents.
|
|
| 15. |
- Vallejo-Vaz, Antonio J., et al.
(author)
-
Overview of the current status of familial hypercholesterolaemia care in over 60 countries - The EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)
- 2018
-
In: Atherosclerosis. - : ELSEVIER IRELAND LTD. - 0021-9150 .- 1879-1484. ; 277, s. 234-255
-
Journal article (peer-reviewed)abstract
- Background and aims: Management of familial hypercholesterolaemia (FH) may vary across different settings due to factors related to population characteristics, practice, resources and/or policies. We conducted a survey among the worldwide network of EAS FHSC Lead Investigators to provide an overview of FH status in different countries. Methods: Lead Investigators from countries formally involved in the EAS FHSC by mid-May 2018 were invited to provide a brief report on FH status in their countries, including available information, programmes, initiatives, and management. Results: 63 countries provided reports. Data on FH prevalence are lacking in most countries. Where available, data tend to align with recent estimates, suggesting a higher frequency than that traditionally considered. Low rates of FH detection are reported across all regions. National registries and education programmes to improve FH awareness/knowledge are a recognised priority, but funding is often lacking. In most countries, diagnosis primarily relies on the Dutch Lipid Clinics Network criteria. Although available in many countries, genetic testing is not widely implemented (frequent cost issues). There are only a few national official government programmes for FH. Under-treatment is an issue. FH therapy is not universally reimbursed. PCSK9-inhibitors are available in similar to 2/3 countries. Lipoprotein-apheresis is offered in similar to 60% countries, although access is limited. Conclusions: FH is a recognised public health concern. Management varies widely across countries, with overall suboptimal identification and under-treatment. Efforts and initiatives to improve FH knowledge and management are underway, including development of national registries, but support, particularly from health authorities, and better funding are greatly needed.
|
|
| 16. |
- El-Sayed, Ashraf S. A., et al.
(author)
-
Aspergillus nidulans thermostable arginine deiminase-Dextran conjugates with enhanced molecular stability, proteolytic resistance, pharmacokinetic properties and anticancer activity
- 2019
-
In: Enzyme and microbial technology. - : Elsevier. - 0141-0229 .- 1879-0909. ; 131
-
Journal article (peer-reviewed)abstract
- The potential anticancer activity of arginine deiminase (ADI) via deimination of L-arginine into citrulline has been extensively verified against various arginine-auxotrophic tumors, however, the higher antigenicity, structural instability and in vivo proteolysis are the major challenges that limit this enzyme from further clinical implementation. Since, this clinically applied enzyme was derived from Mycobacterium spp, thus, searching for ADI from eukaryotic microbes "especially thermophilic fungi" could have a novel biochemical conformational and catalytic properties. Aspergillus nidulans ADI was purified with 5.3 folds, with molecular subunit structure 48 kDa and entire molecular mass 120 kDa, ensuring its homotrimeric identity. The peptide fingerprinting analysis revealing the domain Glu(95)-Gly(96)-Gly(97) as the conserved active site of A. nidulans ADI, with higher proximity to Mycobacterium ADI Glade IV. In an endeavor to fortify the structural stability and anticancer activity of A. nidulans ADI, the enzyme was chemically modified with dextran. The optimal activity of Dextran-ADI conjugates was determined at 0.08:20 M ratio of ADI: Dextran, with an overall increase to ADI molecular subunit mass to (similar to)100 kDa. ADI was conjugated with dextran via the a-amino groups interaction of surface lysine residues of ADI. The resistance of Dextran-ADI conjugate to proteolysis had been increased by 2.5 folds to proteinase K and trypsin, suggesting the shielding of > 50% of ADI surface proteolytic recognition sites. The native and Dextran-ADI conjugates have the same optimum reaction temperature (37 degrees C), reaction pH and pH stability (7.0-8.0) with dependency on K+ ions as a cofactor. Dextran-ADI conjugates exhibited a higher thermal stability by (similar to) 2 folds for all the tested temperatures, ensuring the acquired structural and catalytic stability upon dextran conjugation. Dextran conjugation slightly protect the reactive amino and thiols groups of surface amino acids of ADI from amino acids suicide inhibitors. The affinity of ADI was increased by 5.3 folds to free L-arginine with a dramatic reduction in citrullination of peptidylarginine residues upon dextran conjugation. The anticancer activity of ADI to breast (MCF-7), liver (HepG-2) and colon (HCTB, HT29, DLD1 and LS174 T) cancer cell lines was increased by 1.7 folds with dextran conjugation in vitro. Pharmacokinetically, the half-life time of ADI was increased by 1.7 folds upon dextran conjugation, in vivo. From the biochemical and hematological parameters, ADIs had no signs of toxicity to the experimental animals. In addition to the dramatic reduction of L-arginine in serum, citrulline level was increased by 2.5 folds upon dextran conjugation of ADI. This is first report exploring thermostable ADI from thermophilic A. nidulans with robust structural stability, catalytic efficiency and proteolytic resistance.
|
|
| 17. |
|
|
| 18. |
- Sadovykh, A., et al.
(author)
-
On the Use of Hackathons to Enhance Collaboration in Large Collaborative Projects : - A Preliminary Case Study of the MegaM@Rt2 EU Project - A P
- 2019
-
In: Proceedings of the 2019 Design, Automation and Test in Europe Conference and Exhibition, DATE 2019. - : Institute of Electrical and Electronics Engineers Inc.. - 9783981926323 ; , s. 498-503
-
Conference paper (peer-reviewed)abstract
- In this paper, we present the MegaM@Rt2 ECSEL project and discuss in details our approach for fostering collaboration in this project. We choose to use an internal hackathon approach that focuses on technical collaboration between case study owners and tool/method providers. The novelty of the approach is that we organize the technical workshop at our regular project progress meetings as a challenge-based contest involving all partners in the project. Case study partners submit their challenges related to the project goals and their use cases in advance. These challenges are concise enough to be experimented within approximately 4 hours. Teams are then formed to address those challenges. The teams include tool/method providers, case study owners and researchers/developers from other consortium members. On the hackathon day, partners work together to come with results addressing the challenges that are both interesting to encourage collaboration and convincing to continue further deeper investigations. Obtained results demonstrate that the hackathon approach stimulated knowledge exchanges among project partners and triggered new collaborations, notably between tool providers and use case owners.
|
|
| 19. |
- Abbas, Ashraf H., et al.
(author)
-
Aesthetic Outcome After Reconstruction of Complex SoftTissue Defects with Free Antero-Lateral Thigh Flap UsingSimple Equipment
- 2015
-
In: Journal of surgery. - : Science publishing group. - 2330-0914 .- 2330-0930. ; 3:2-1, s. 36-41
-
Journal article (peer-reviewed)abstract
- Aim: We aimed to assess the aesthetic outcome of surgical reconstruction by free ALT flap using binocular single-refraction magnifying glasses and a modified post- operative surveillance protocol. Methods: 16 patients were operated for free antero-lateral thigh flap to reconstruct complex soft tissue defects with a close clinical follow up protocol for post operative care depending on the attending personnel in the Plastic surgery unit, Suez Canal University hospital, Ismailia, Egypt. Aesthetic outcome was assessed using a questionnaire based on Posch et al. 2005, including the following items colour, contour, presence of hair, overall appearance and donor site scar. Results: The patients’ assessed aesthetic outcome was acceptable in majority of the cases; median score was 4 for all assessed items. Complete flap loss occurred in one case, other complications as arterial thrombosis and hematomas and infection were detected and managed accordingly with flap salvage in the 3 complicated cases. Conclusion: The result suggests that the proposed protocol is sufficient as an alternative. The aesthetic outcome assessed by the patient and the failure rate was in line with other studies.
|
|
| 20. |
- Abd-Ellah, Mahmoud Khaled, et al.
(author)
-
A Review on Brain Tumor Diagnosis from MRI Images : Practical Implications, Key Achievements, and Lessons Learned
- 2019
-
In: Magnetic Resonance Imaging. - : Elsevier. - 0730-725X .- 1873-5894. ; 61, s. 300-318
-
Journal article (peer-reviewed)abstract
- The successful early diagnosis of brain tumors plays a major role in improving the treatment outcomes and thus improving patient survival. Manually evaluating the numerous magnetic resonance imaging (MRI) images produced routinely in the clinic is a difficult process. Thus, there is a crucial need for computer-aided methods with better accuracy for early tumor diagnosis. Computer-aided brain tumor diagnosis from MRI images consists of tumor detection, segmentation, and classification processes. Over the past few years, many studies have focused on traditional or classical machine learning techniques for brain tumor diagnosis. Recently, interest has developed in using deep learning techniques for diagnosing brain tumors with better accuracy and robustness. This study presents a comprehensive review of traditional machine learning techniques and evolving deep learning techniques for brain tumor diagnosis. This review paper identifies the key achievements reflected in the performance measurement metrics of the applied algorithms in the three diagnosis processes. In addition, this study discusses the key findings and draws attention to the lessons learned as a roadmap for future research.
|
|
| 21. |
- Abd-Ellah, Mahmoud Khaled, et al.
(author)
-
Classification of Brain Tumor MRIs Using a Kernel Support Vector Machine
- 2016
-
In: Building Sustainable Health Ecosystems. - Cham : Springer International Publishing. - 9783319446714 - 9783319446721 ; , s. 151-160
-
Conference paper (peer-reviewed)abstract
- The use of medical images has been continuously increasing, which makes manual investigations of every image a difficult task. This study focuses on classifying brain magnetic resonance images (MRIs) as normal, where a brain tumor is absent, or as abnormal, where a brain tumor is present. A hybrid intelligent system for automatic brain tumor detection and MRI classification is proposed. This system assists radiologists in interpreting the MRIs, improves the brain tumor diagnostic accuracy, and directs the focus toward the abnormal images only. The proposed computer-aided diagnosis (CAD) system consists of five steps: MRI preprocessing to remove the background noise, image segmentation by combining Otsu binarization and K-means clustering, feature extraction using the discrete wavelet transform (DWT) approach, and dimensionality reduction of the features by applying the principal component analysis (PCA) method. The major features were submitted to a kernel support vector machine (KSVM) for performing the MRI classification. The performance evaluation of the proposed system measured a maximum classification accuracy of 100 % using an available MRIs database. The processing time for all processes was recorded as 1.23 seconds. The obtained results have demonstrated the superiority of the proposed system.
|
|
| 22. |
- Abd-Ellah, Mahmoud Khaled, et al.
(author)
-
Design and implementation of a computer-aided diagnosis system for brain tumor classification
- 2017
-
In: 2016 28th International Conference on Microelectronics (ICM). - 9781509057214 ; , s. 73-76
-
Conference paper (peer-reviewed)abstract
- Computer-aided diagnosis (CAD) systems have become very important for the medical diagnosis of brain tumors. The systems improve the diagnostic accuracy and reduce the required time. In this paper, a two-stage CAD system has been developed for automatic detection and classification of brain tumor through magnetic resonance images (MRIs). In the first stage, the system classifies brain tumor MRI into normal and abnormal images. In the second stage, the type of tumor is classified as benign (Noncancerous) or malignant (Cancerous) from the abnormal MRIs. The proposed CAD ensembles the following computational methods: MRI image segmentation by K-means clustering, feature extraction using discrete wavelet transform (DWT), feature reduction by applying principal component analysis (PCA). The two-stage classification has been conducted using a support vector machine (SVM). Performance evaluation of the proposed CAD has achieved promising results using a non-standard MRIs database.
|
|
| 23. |
- Abd-Ellah, Mahmoud Khaled, et al.
(author)
-
Parallel Deep CNN Structure for Glioma Detection and Classification via Brain MRI Images
- 2019
-
In: IEEE-ICM 2019 CAIRO-EGYPT. - : IEEE. ; , s. 304-307
-
Conference paper (other academic/artistic)abstract
- Although most brain tumor diagnosis studies have focused on tumor segmentation and localization operations, few studies have focused on tumor detection as a time- and effort-saving process. This study introduces a new network structure for accurate glioma tumor detection and classification using two parallel deep convolutional neural networks (PDCNNs). The proposed structure is designed to identify the presence and absence of a brain tumor in MRI images and classify the type of tumor images as high-grade gliomas (HGGs, i.e., glioblastomas) or low-grade gliomas (LGGs). The introduced PDCNNs structure takes advantage of both global and local features extracted from the two parallel stages. The proposed structure is not only accurate but also efficient, as the convolutional layers are more accurate because they learn spatial features, and they are efficient in the testing phase since they reduce the number of weights, which reduces the memory usage and runtime. Simulation experiments were accomplished using an MRI dataset extracted from the BraTS 2017 database. The obtained results show that the proposed parallel network structure outperforms other detection and classification methods in the literature.
|
|
| 24. |
- Abd-Ellah, Mahmoud Khaled, et al.
(author)
-
TPUAR-Net : Two Parallel U-Net with Asymmetric Residual-Based Deep Convolutional Neural Network for Brain Tumor Segmentation
- 2019
-
In: Image Analysis and Recognition. - Cham : Springer. ; , s. 106-116
-
Conference paper (peer-reviewed)abstract
- The utilization of different types of brain images has been expanding, which makes manually examining each image a labor-intensive task. This study introduces a brain tumor segmentation method that uses two parallel U-Net with an asymmetric residual-based deep convolutional neural network (TPUAR-Net). The proposed method is customized to segment high and low grade glioblastomas identified from magnetic resonance imaging (MRI) data. Varieties of these tumors can appear anywhere in the brain and may have practically any shape, contrast, or size. Thus, this study used deep learning techniques based on adaptive, high-efficiency neural networks in the proposed model structure. In this paper, several high-performance models based on convolutional neural networks (CNNs) have been examined. The proposed TPUAR-Net capitalizes on different levels of global and local features in the upper and lower paths of the proposed model structure. In addition, the proposed method is configured to use the skip connection between layers and residual units to accelerate the training and testing processes. The TPUAR-Net model provides promising segmentation accuracy using MRI images from the BRATS 2017 database, while its parallelized architecture considerably improves the execution speed. The results obtained in terms of Dice, sensitivity, and specificity metrics demonstrate that TPUAR-Net outperforms other methods and achieves the state-of-the-art performance for brain tumor segmentation.
|
|
| 25. |
- Aboelnaga, Ahmed, et al.
(author)
-
Microbial cellulose dressing compared with silver sulphadiazine for the treatment of partial thickness burns: A prospective, randomised, clinical trial
- 2018
-
In: Burns. - : Elsevier. - 0305-4179 .- 1879-1409. ; 44:8, s. 1982-1988
-
Journal article (peer-reviewed)abstract
- BackgroundThe current treatment for partial thickness burns at the trial site is silver sulphadiazine, as it minimises bacterial colonisation of wounds. Its deleterious effect on wound healing, together with the need for repeated, often painful, procedures, has brought about the search for a better treatment. Microbial cellulose has shown promising results that avoid these disadvantages. The aim of this study was therefore to compare microbial cellulose with silver sulphadiazine as a dressing for partial thickness burns.MethodAll patients who presented with partial thickness (superficial and deep dermal) burns from October 2014 to October 2016 were screened for this randomised clinical trial. Twenty patients were included in each group: the cellulose group was treated with microbial cellulose sheets and the control group with silver sulphadiazine cream 10 mg/g. The wound was evaluated every third day. Pain was assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) scale during and after each procedure. Other variables recorded were age, sex, percentage total body surface area burned (TBSA%), clinical signs of infection, time for epithelialisation and hospital stay. Linear multivariable regression was used to analyse the significance of differences between the treatment groups by adjusting for the size and depth of the burn, and the patient’s age.ResultsMedian TBSA% was 9% (IQR 5.5–12.5). The median number of dressing changes was 1 (IQR 1–2) in the cellulose group, which was lower than that in the control group (median 9.5, IQR 6–16) (p < 0.001). Multivariable regression analysis showed that the group treated with microbial cellulose spent 6.3 (95% CI 0.2–12.5) fewer days in hospital (p = 0.04), had a mean score that was 3.4 (95% CI 2.5–4.3) points lower during wound care (p < 0.001), and 2.2 (95% CI 1.6–2.7) afterwards (p < 0.001). Epithelialisation was quicker, but not significantly so.ConclusionThese results suggest that the microbial cellulose dressing is a better first choice for treatment of partial thickness burns than silver sulphadiazine cream. Fewer dressings of the wound were done and, combined with the low pain scores, this is good for both the patients and the health care system. The differences in randomisation of the area of burns is, however, a concern that needs to be included in the interpretation of the results.
|
|
| 26. |
- Arafa, Wael A. A., et al.
(author)
-
ULTRASOUND-MEDIATED THREE-COMPONENT REACTION ON-WATER PROTOCOL FOR THE SYNTHESIS OF NOVEL MONO- AND BIS-1,3-THIAZIN-4-ONE DERIVATIVES
- 2017
-
In: Heterocycles. - 0385-5414 .- 1881-0942. ; 94:8, s. 1439-1455
-
Journal article (peer-reviewed)abstract
- Green synthetic and catalyst-free strategy towards the synthesis of novel mono- and bis-1,3-thiazin-4-one scaffolds through a one pot, reaction of carbon disulfide, monoacetylenic esters and amines under ultrasonication has been reported. The merits of this protocol comprise no need for tedious workup steps and afforded the desired products in excellent yields make this synthetic protocol more efficient and worthy of further attentiveness. Moreover, the method exhibited excellent score in a number of green metrics.
|
|
| 27. |
- Ashraf, A, et al.
(author)
-
Pattern of Altered Plasma Elemental Phosphorus, Calcium, Zinc, and Iron in Alzheimer's Disease
- 2019
-
In: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 9:1, s. 3147-
-
Journal article (peer-reviewed)abstract
- Metal/mineral dyshomeostasis has been implicated in the development of Alzheimer’s disease (AD). The aim of the study was to investigate the difference in absolute and percentage levels of plasma phosphorus, calcium, iron, zinc, copper, selenium in cognitively normal (CN) and AD subjects. Total reflection X-ray fluorescence (TXRF) spectroscopy was used to detect plasma metals/minerals in CN and AD subjects (n = 44 per group). TXRF detected significantly increased plasma levels of phosphorus (p = 1.33 × 10−12) and calcium (p = 0.025) in AD compared to CN subjects, with higher phosphorus/calcium (p = 2.55 × 10−14) ratio in the former. Percentage concentrations calculated for phosphorus, calcium, iron, zinc, copper, selenium by dividing the concentration of each element by the total concentration of these elements and multiplying by 100%, demonstrated phosphorus was higher in AD compared to CN subjects, while calcium, iron, zinc, copper and selenium were lower in AD subjects, with area under the curves as high as 0.937 (p = 6 × 10−5) computed from receiver operating curves. With exclusion of high levels of phosphorus and calcium from percentage calculations, iron levels remained low in AD whereas zinc was higher in AD, and copper and selenium levels were similar. We demonstrate altered distribution of elements in the plasma of AD subjects with high interdependencies between elemental levels and propose the potential of TXRF measurements for disease monitoring.
|
|
| 28. |
|
|
| 29. |
- Ebarasi, Lwaki, et al.
(author)
-
Defects of CRB2 Cause Steroid-Resistant Nephrotic Syndrome
- 2015
-
In: American Journal of Human Genetics. - : Elsevier BV. - 0002-9297 .- 1537-6605. ; 96:1, s. 153-161
-
Journal article (peer-reviewed)abstract
- Nephrotic syndrome (NS), the association of gross proteinuria, hypoalbuminaemia, edema, and hyperlipidemia, can be clinically divided into steroid-sensitive (SSNS) and steroid-resistant (SRNS) forms. SRNS regularly progresses to end-stage renal failure. By homozygosity mapping and whole exome sequencing, we here identify recessive mutations in Crumbs homolog 2 (CRB2) in four different families affected by SRNS. Previously, we established a requirement for zebrafish crb2b, a conserved regulator of epithelial polarity, in podocyte morphogenesis. By characterization of a loss-of-function mutation in zebrafish crb2b, we now show that zebrafish crb2b is required for podocyte foot process arborization, slit diaphragm formation, and proper nephrin trafficking. Furthermore, by complementation experiments in zebrafish, we demonstrate that CRB2 mutations result in loss of function and therefore constitute causative mutations leading to NS in humans. These results implicate defects in podocyte apico-basal polarity in the pathogenesis of NS.
|
|
| 30. |
|
|
| 31. |
- Hasan, A. S. M. Monjurul, et al.
(author)
-
Prospect analysis of biofuel production and usage for transportation in Dhaka city, Bangladesh
- 2015
-
In: 2015 3RD INTERNATIONAL CONFERENCE ON GREEN ENERGY AND TECHNOLOGY (ICGET). - : IEEE. - 9781509001699
-
Conference paper (peer-reviewed)abstract
- World is heading towards the crisis of fossil fuel. Energy crisis is more acute in Bangladesh, as there is no petro-fuel source but only natural gas. It has among the lowest per capita energy (240 kg oil equivalents) consumption in the world and is severely dependent on additional environmentally friendly renewable energy resources in the future. To cope up with present situation and to reduce dependency on imported fuel, Bangladesh government is encouraging the use of renewable energy sources. In this circumstances, biofuel can be a very good alternative fuel for transportation. This paper gives insight into biofuel production feasibility and its usage for road transport can play an important role in the biggest metropolitan city of Bangladesh and contributes to knowledge on how to perform similar studies. Resource-focused assessment including feedstock from the waste sector, agricultural sector, forestry sector and aquatic environments partially considering technological and economic constraints. Sufficient evidence have been found for biofuel production and can met at-least 10% of energy demand for road transport of Dhaka city, Bangladesh. Without compromising with food security the study suggests that it is possible to significantly increase the biofuel production, and to do this as an integrated part of the existing society also contributing with positive societal synergies.
|
|
| 32. |
- Khaled Abd-Ellah, Mahmoud, et al.
(author)
-
Two-phase multi-model automatic brain tumour diagnosis system from magnetic resonance images using convolutional neural networks
- 2018
-
In: EURASIP Journal on Image and Video Processing. - : Springer. - 1687-5176 .- 1687-5281. ; 2018
-
Journal article (peer-reviewed)abstract
- Brain tumour is a serious disease, and the number of people who are dying due to brain tumours is increasing. Manual tumour diagnosis from magnetic resonance images (MRIs) is a time consuming process and is insufficient for accurately detecting, localizing, and classifying the tumour type. This research proposes a novel two-phase multi-model automatic diagnosis system for brain tumour detection and localization. In the first phase, the system structure consists of preprocessing, feature extraction using a convolutional neural network (CNN), and feature classification using the error-correcting output codes support vector machine (ECOC-SVM) approach. The purpose of the first system phase is to detect brain tumour by classifying the MRIs into normal and abnormal images. The aim of the second system phase is to localize the tumour within the abnormal MRIs using a fully designed five-layer region-based convolutional neural network (R-CNN). The performance of the first phase was assessed using three CNN models, namely, AlexNet, Visual Geometry Group (VGG)-16, and VGG-19, and a maximum detection accuracy of 99.55% was achieved with AlexNet using 349 images extracted from the standard Reference Image Database to Evaluate Response (RIDER) Neuro MRI database. The brain tumour localization phase was evaluated using 804 3D MRIs from the Brain Tumor Segmentation (BraTS) 2013 database, and a DICE score of 0.87 was achieved. The empirical work proved the outstanding performance of the proposed deep learning-based system in tumour detection compared to other non-deep-learning approaches in the literature. The obtained results also demonstrate the superiority of the proposed system concerning both tumour detection and localization.
|
|
| 33. |
- Majd, A., et al.
(author)
-
Integrating Learning, Optimization, and Prediction for Efficient Navigation of Swarms of Drones
- 2018
-
In: Proceedings - 26th Euromicro International Conference on Parallel, Distributed, and Network-Based Processing, PDP 2018. - : Institute of Electrical and Electronics Engineers Inc.. - 9781538649756 ; , s. 101-108
-
Conference paper (peer-reviewed)abstract
- Swarms of drones are increasingly been used in a variety of monitoring and surveillance, search and rescue, and photography and filming tasks. However, despite the growing popularity of swarm-based applications of drones, there is still a lack of approaches to generate efficient drone routes while minimizing the risks of drone collisions. In this paper, we present a novel approach that integrates learning, optimization, and prediction for generating efficient and safe routes for swarms of drones. The proposed approach comprises three main components: (1) a high-performance dynamic evolutionary algorithm for optimizing drone routes, (2) a reinforcement learning algorithm for incorporating the feedback and runtime data about the system state, and (3) a prediction approach to predict the movement of drones and moving obstacles in the flying zone. We also present a parallel implementation of the proposed approach and evaluate it against two benchmarks. The results demonstrate that the proposed approach allows to significantly reduce the route lengths and computation overhead while producing efficient and safe routes.
|
|
| 34. |
- Majd, A., et al.
(author)
-
Using Optimization, Learning, and Drone Reflexes to Maximize Safety of Swarms of Drones
- 2018
-
In: 2018 IEEE Congress on Evolutionary Computation, CEC 2018 - Proceedings. - : Institute of Electrical and Electronics Engineers Inc.. - 9781509060177
-
Conference paper (peer-reviewed)abstract
- Despite the growing popularity of swarm-based applications of drones, there is still a lack of approaches to maximize the safety of swarms of drones by minimizing the risks of drone collisions. In this paper, we present an approach that uses optimization, learning, and automatic immediate responses (reflexes) of drones to ensure safe operations of swarms of drones. The proposed approach integrates a high-performance dynamic evolutionary algorithm and a reinforcement learning algorithm to generate safe and efficient drone routes and then augments the generated routes with dynamically computed drone reflexes to prevent collisions with unforeseen obstacles in the flying zone. We also present a parallel implementation of the proposed approach and evaluate it against two benchmarks. The results show that the proposed approach maximizes safety and generates highly efficient drone routes.
|
|
| 35. |
- Ntaios, George, et al.
(author)
-
A tool to identify patients with embolic stroke of undetermined source at high recurrence risk.
- 2019
-
In: Neurology. - 1526-632X. ; 93:23
-
Journal article (peer-reviewed)abstract
- A tool to stratify the risk of stroke recurrence in patients with embolic stroke of undetermined source (ESUS) could be useful in research and clinical practice. We aimed to determine whether a score can be developed and externally validated for the identification of patients with ESUS at high risk for stroke recurrence.We pooled the data of all consecutive patients with ESUS from 11 prospective stroke registries. We performed multivariable Cox regression analysis to identify predictors of stroke recurrence. Based on the coefficient of each covariate of the fitted multivariable model, we generated an integer-based point scoring system. We validated the score externally assessing its discrimination and calibration.In 3 registries (884 patients) that were used as the derivation cohort, age, leukoaraiosis, and multiterritorial infarct were identified as independent predictors of stroke recurrence and were included in the final score, which assigns 1 point per every decade after 35 years of age, 2 points for leukoaraiosis, and 3 points for multiterritorial infarcts (acute or old nonlacunar). The rate of stroke recurrence was 2.1 per 100 patient-years (95% confidence interval [CI] 1.44-3.06) in patients with a score of 0-4 (low risk), 3.74 (95% CI 2.77-5.04) in patients with a score of 5-6 (intermediate risk), and 8.23 (95% CI 5.99-11.3) in patients with a score of 7-12 (high risk). Compared to low-risk patients, the risk of stroke recurrence was significantly higher in intermediate-risk (hazard ratio [HR] 1.78, 95% CI 1.1-2.88) and high-risk patients (HR 4.67, 95% CI 2.83-7.7). The score was well-calibrated in both derivation and external validation cohorts (8 registries, 820 patients) (Hosmer-Lemeshow test χ2: 12.1 [p = 0.357] and χ2: 21.7 [p = 0.753], respectively). The area under the curve of the score was 0.63 (95% CI 0.58-0.68) and 0.60 (95% CI 0.54-0.66), respectively.The proposed score can assist in the identification of patients with ESUS at high risk for stroke recurrence.
|
|
| 36. |
- Abbas, Ghazanfar, et al.
(author)
-
Synthesize and characterization of nanocomposite anodes for low temperature solid oxide fuel cell
- 2015
-
In: International journal of hydrogen energy. - : Elsevier BV. - 0360-3199 .- 1879-3487. ; 40:1, s. 891-897
-
Journal article (peer-reviewed)abstract
- Solid oxide fuel cells have much capability to become an economical alternative energy conversion technology having appropriate materials that can be operated at comparatively low temperature in the range of 400-600 degrees C. The nano-scale engineering has been incorporated to improve the catalytic activity of anode materials for solid oxide fuel cells. Nanostructured Al0.10NixZn0.90-xO oxides were prepared by solid state reaction, which were then mixed with the prepared Gadolinium doped Ceria GDC electrolyte. The crystal structure and surface morphology were characterized by XRD and SEM. The particle size was evaluated by XRD data and found in the range of 20-50 nm, which was then ensured by SEM pictures. The pellets of 13 mm diameter were pressed by dry press technique and electrical conductivities (DC and AC) were determined by four probe techniques and the values have been found to be 10.84 and 4.88 S/cm, respectively at hydrogen atmosphere in the temperature range of 300-600 degrees C. The Electrochemical Impedance Spectroscopy (EIS) analysis exhibits the pure electronic behavior at hydrogen atmosphere. The maximum power density of ANZ-GDC composite anode based solid oxide fuel cell has been achieved 705 mW/cm(2) at 550 degrees C.
|
|
| 37. |
- Dessouky, Ahmed M., et al.
(author)
-
Non-parametric spectral estimation techniques for DNA sequence analysis and exon region prediction
- 2019
-
In: Computers & electrical engineering. - : Elsevier. - 0045-7906 .- 1879-0755. ; 73, s. 334-348
-
Journal article (peer-reviewed)abstract
- Bioinformatics is the analysis of biological information using computers and statistical techniques. This paper presents non-parametric spectral estimation techniques based on the Discrete Fourier Transform (DFT) for the analysis of deoxyribonucleic acid (DNA) sequences. These techniques are efficient frequency-domain signal representation techniques, which improve the analysis of DNA sequences and enable the extraction of some desirable information that cannot be extracted from the time-domain representation of these sequences. The adopted techniques are the periodogram, average periodogram (Bartlett), modified average periodogram (Welch), and Blackman and Tukey spectral estimation techniques. The objective of these spectral estimation techniques is to investigate the locations of exons in DNA sequences for gene prediction. A comparison study is presented in this paper between the suggested spectral estimation techniques from the exon prediction perspective. The methods presented in this paper improve the detectability of peaks representing exon regions.
|
|
| 38. |
- Dessouky, Ahmed M., et al.
(author)
-
Visual representation of DNA sequences for exon detection using non-parametric spectral estimation techniques
- 2019
-
In: Nucleosides, Nucleotides & Nucleic Acids. - : Taylor & Francis Group. - 1525-7770 .- 1532-2335. ; 38:5, s. 321-337
-
Journal article (peer-reviewed)abstract
- This paper presents a new approach for modeling of DNA sequences for the purpose of exon detection. The proposed model adopts the sum-of-sinusoids concept for the representation of DNA sequences. The objective of the modeling process is to represent the DNA sequence with few coefficients. The modeling process can be performed on the DNA signal as a whole or on a segment-by-segment basis. The created models can be used instead of the original sequences in a further spectral estimation process for exon detection. The accuracy of modeling is evaluated evaluated by using the Root Mean Square Error (RMSE) and the R-square metrics. In addition, non-parametric spectral estimation methods are used for estimating the spectral of both original and modeled DNA sequences. The results of exon detection based on original and modeled DNA sequences coincide to a great extent, which ensures the success of the proposed sum-of-sinusoids method for modeling of DNA sequences.
|
|
| 39. |
- Elmasry, Moustafa, et al.
(author)
-
Treatment of Children With Scalds by Xenografts: Report From a Swedish Burn Centre
- 2016
-
In: Journal of Burn Care & Research. - : LIPPINCOTT WILLIAMS & WILKINS. - 1559-047X .- 1559-0488. ; 37:6, s. E586-E591
-
Journal article (peer-reviewed)abstract
- Scalds are the most common type of burn in children, and one way to treat them is with xenografts with no topical antimicrobials in line with the recommendations of a recent review. However, this treatment has not been examined in detail. Our aim was to describe the treatment of such children when biological dressings (xenografts) were used without local antimicrobials. We reviewed the medical records of all children admitted to a Swedish National Burn Centre during the period 2010-2012 with scalds who were treated with xenografts. Percentage TBSA injured, age, length of hospital stay, number of operations, antibiotics given, duration of antibiotic treatment, and pain score during the first 3 days, application of xenografts, and clinical notes of wound infection were recorded. We studied 67 children, (43 of whom were boys), with a median (interquartile range [IQR]) age of 1 (1-2) year and median (IQR) TBSA% 6.2 (4-11). Twenty children (30%) required operation. Twelve (18%) developed a wound infection, 29 (43%) had other infections, and 26 (39%) were free from infection. The median (IQR) duration of systemic antibiotics was 10 (6-13) days. On the day that the xenografts were applied 10 of the children had a Face, Legs, Activity, Cry, and Consolability (FLACC) score between 3 and 7, and during the following 2 days, only four children scored in this range. The remaining 57 children had scores amp;lt;3 on the day that xenografts were applied and on the following 2 days. Median (IQR) length of stay/TBSA% was 0.7 (0.4-1.0). Treatment with xenografts was associated with median length of stay/TBSA% amp;lt; 1 and low pain scores. Despite a high rate of prescription of systemic antibiotics, most were for reasons other than wound infection.
|
|
| 40. |
- Farahbakhsh, A., et al.
(author)
-
60-GHz Groove Gap Waveguide Based Wideband H-Plane Power Dividers and Transitions: For Use in High-Gain Slot Array Antenna
- 2017
-
In: IEEE Transactions on Microwave Theory and Techniques. - 0018-9480 .- 1557-9670. ; 65:11, s. 4111-4121
-
Journal article (peer-reviewed)abstract
- Wideband design of power dividers, T-junctions, and transitions based on groove gap waveguide (GGW) technology is presented in this paper with the goal to use these components in high-gain millimeter-wave antenna array design at 60-GHz frequency range. Since this GGW technology does not require electrical contact between the different metal layers of a complex 3-D waveguide structure, the fabrication cost and mechanical complexity are decreased. The designed T-junctions and different power dividers exhibit wide operational bandwidth and low output power and phase imbalance over the 60-GHz frequency band. Also, two transitions from GGW to a standard rectangular waveguide have been designed. To validate the performance of the designed components, a 64-way power divider in combination with 256 radiating slots is designed, prototyped, and measured at 60-GHz band. Measurement results agree well with the simulated performance of the complete array antenna, and the antenna gain is more than 32.5 dBi. The total radiation efficiency is more than 80% over the operating frequency range from 57 to 67 GHz. Also, the measured sidelobe levels are found to be agreeing well with the simulated level.
|
|
| 41. |
- Farahbakhsh, A., et al.
(author)
-
A wideband high-gain and high-efficiency slot array antenna based on groove gap waveguide
- 2018
-
In: IET Conference Publications. - : Institution of Engineering and Technology. ; 2018:CP741
-
Conference paper (peer-reviewed)abstract
- A groove gap waveguide based wideband high gain and high efficiency 8×8-element slot antenna array has been proposed for mmWave applications. A 16-way power divider based on groove gap waveguide is used as feeding network in this work. The antenna sub-array consists of four radiating slots that are backed by a groove gap cavity layer. The proposed antenna frequency band is from 48.8 GHz to 66.7 GHz and achieved maximum gain is about 27.4 dBi with a total efficiency of about 90 %.
|
|
| 42. |
- Farahbakhsh, A., et al.
(author)
-
Corporate distribution networks for slot array antenna based on groove gap waveguide technology
- 2016
-
In: 10th European Conference on Antennas and Propagation, EuCAP 2016, Davos, Switzerland, 10-15 April 2016. - 2164-3342. ; , s. Art. no. 7481157-
-
Conference paper (peer-reviewed)abstract
- This paper deals with the design of low loss wideband power dividers based on groove gap waveguide (GGW) technology. The advantages of GGW power dividers are low insertion loss, high power handling capacities, ease of fabrication and compatibility with integrated microwave networks. A 64-way power divider is designed and used as the feeding network of a 16×16-element slot antenna array at 60-GHz band. The results show that the gain and total radiation efficiency of the antenna are more than 32.5 dBi and 90% over the desired frequency range from 56 to 66.4 GHz.
|
|
| 43. |
- Farahbakhsh, A., et al.
(author)
-
D-Band Slot Array Antenna Using Combined Ridge and Groove Gap Waveguide Feeding Network
- 2019
-
In: 13th European Conference on Antennas and Propagation, EuCAP 2019.
-
Conference paper (peer-reviewed)abstract
- In this paper, the design of a cavity-backed slot array antenna based on combination of ridge and groove gap waveguide for D-band applications is investigated. The proposed subarray has 2×2 slots with impedance bandwidth of 20 % covering from 127 GHz to 155 GHz. A feeding network combining groove gap waveguide and ridge gap waveguide has been proposed also in this work. The feed network has been designed as a combination of ridge gap waveguide and E-plane groove gap waveguide to reduce the losses in the feed network of a large antenna array, thereby increasing the total efficiency of the array antenna.
|
|
| 44. |
- Farahbakhsh, A., et al.
(author)
-
Ridge gap waveguide slot antenna array with 30% bandwidth for 60-GHz applications
- 2017
-
In: 2017 11th European Conference on Antennas and Propagation, EUCAP 2017. - 2164-3342. ; , s. 3050-3052
-
Conference paper (peer-reviewed)abstract
- This paper presents a wideband high efficiency slot antenna array based on ridge gap waveguide technology at 60 GHz for millimeter-wave applications. The antenna sub-array consists of four radiating slots that are excited by a cavity. Some tuning pins are placed inside the cavity to achieve wideband performance. A 4×4 slots array antenna is designed using 4-ways power divider. The proposed structure exhibits 30% impedance bandwidth (|S11|
|
|
| 45. |
- Ferrando-Rocher, M., et al.
(author)
-
A dual-polarized slotted-waveguide antenna based on gap waveguide technology
- 2017
-
In: 2017 11th European Conference on Antennas and Propagation, EUCAP 2017. ; , s. 3726-3727
-
Conference paper (peer-reviewed)abstract
- Euraap.This paper describes a wide-band dual-polarized slotted-waveguide antenna working at V-band (57-66 GHz) based on Gap Waveguide concept. The antenna has three layers. The first one (feeding-layer 1) is practically identical to the second one (feeding-layer 2). This optimizes the design and facilitates manufacturing. The corporate-feeding networks on the two layers are rotated 90 degrees to each other to get the two orthogonal polarizations. Radiating elements are square apertures located on the top of the antenna. Simulated results show both impedance bandwidth and radiation pattern bandwidth greater than 15% for both polarizations.
|
|
| 46. |
- Ivesono, Timothy, et al.
(author)
-
3-month versus 6-month adjuvant chemotherapy for patients with high-risk stage II and III colorectal cancer : 3-year follow-up of the SCOT non-inferiority RCT
- 2019
-
In: Health Technology Assessment. - : NIHR JOURNALS LIBRARY. - 1366-5278 .- 2046-4924. ; 23:64, s. 1-88
-
Journal article (peer-reviewed)abstract
- Background: Oxaliplatin and fluoropyrimidine chemotherapy administered over 6 months is the standard adjuvant regimen for patients with high-risk stage II or III colorectal cancer. However, the regimen is associated with cumulative toxicity, characterised by chronic and often irreversible neuropathy.Objective: To assess the efficacy of 3-month versus 6-month adjuvant chemotherapy for colorectal cancer and to compare the toxicity, health-related quality of life and cost-effectiveness of the durations.Design: An international, randomised, open-label, non-inferiority, Phase III, parallel-group trial.Setting: A total of 244 oncology clinics from six countries: UK (England, Scotland, Wales and Northern Ireland), Denmark, Spain, Sweden, Australia and New Zealand.Participants: Adults aged >= 18 years who had undergone curative resection for high-risk stage II or III adenocarcinoma of the colon or rectum.Interventions: The adjuvant treatment regimen was either oxaliplatin and 5-fluorouracil or oxaliplatin and capecitabine, randomised to be administered over 3 or 6 months.Main outcomes measures: The primary outcome was disease-free survival. Overall survival, adverse events, neuropathy and health-related quality of life were also assessed. The main cost categories were chemotherapy treatment and hospitalisation. Cost-effectiveness was assessed through incremental cost comparisons and quality-adjusted life-year gains between the options and was reported as net monetary benefit using a willingness-to-pay threshold of 30,000 pound per quality-adjusted life-year per patient.Result: Recruitment is closed. In total, 6088 patients were randomised (3044 per group) between 27 March 2008 and 29 November 2013, with 6065 included in the intention-to-treat analyses (3-month analysis, n = 3035; 6-month analysis, n = 3030). Follow-up for the primary analysis is complete. The 3-year disease-free survival rate in the 3-month treatment group was 76.7% (standard error 0.8%) and in the 6-month treatment group was 77.1% (standard error 0.8%), equating to a hazard ratio of 1.006 (95% confidence interval 0.909 to 1.114; p-value for non-inferiority = 0.012), confirming non-inferiority for 3-month adjuvant chemotherapy. Frequent adverse events (alopecia, anaemia, anorexia, diarrhoea, fatigue, hand-foot syndrome, mucositis, sensory neuropathy, neutropenia, pain, rash, altered taste, thrombocytopenia and watery eye) showed a significant increase in grade with 6-month duration; the greatest difference was for sensory neuropathy (grade >= 3 was 4% for 3-month vs.16% for 6-month duration), for which a higher rate of neuropathy was seen for the 6-month treatment group from month 4 to >= 5 years (p < 0.001). Quality-of-life scores were better in the 3-month treatment group over months 4-6. A cost-effectiveness analysis showed 3-month treatment to cost 4881 pound less over the 8-year analysis period, with an incremental net monetary benefit of 7246 pound per patient.Conclusions: The study achieved its primary end point, showing that 3-month oxaliplatin-containing adjuvant chemotherapy is non-inferior to 6 months of the same regimen; 3-month treatment showed a better safety profile and cost less. For future work, further follow-up will refine long-term estimates of the duration effect on disease-free survival and overall survival. The health economic analysis will be updated to include long-term extrapolation for subgroups. We expect these analyses to be available in 2019-20. The Short Course Oncology Therapy (SCOT) study translational samples may allow the identification of patients who would benefit from longer treatment based on the molecular characteristics of their disease.
|
|
| 47. |
- Jolly, Sanjit S., et al.
(author)
-
Thrombus Aspiration in ST Elevation Myocardial Infarction : An Individual Patient Meta-analysis
- 2017
-
In: Circulation. - 0009-7322. ; 135, s. 143-152
-
Journal article (peer-reviewed)abstract
- BACKGROUND—: Thrombus aspiration during percutaneous coronary intervention (PCI) for the treatment of ST elevation myocardial infarction (STEMI) has been widely used; however, recent trials have questioned its value and safety. In this meta-analysis, we, the trial investigators, aimed to pool the individual patient data from these trials to determine the benefits and risks of thrombus aspiration during PCI in patients with STEMI. METHODS—: Included were large (N≥1000) randomized controlled trials comparing manual thrombectomy vs. PCI alone in patients with STEMI. Individual patient data was provided by the leadership of each trial. The pre-specified primary efficacy outcome was cardiovascular (CV) mortality within 30 days and the primary safety outcome was stroke or transient ischemic attack (TIA) within 30 days. RESULTS—: The 3 eligible randomized trials (TAPAS, TASTE and TOTAL) enrolled 19,047 patients, of whom 18,306 underwent PCI and were included in the primary analysis. CV death at 30 days occurred in 221 (2.4%) of 9155 patients randomized to thrombus aspiration and 262 (2.9%) of 9151 randomized to PCI alone (hazard ratio (HR) 0.84; 95% CI 0.70-1.01, p=0.06). Stroke or TIA occurred in 66 (0.8%) randomized to thrombus aspiration and 46 (0.5%) randomized to PCI alone (odds ratio [OR] 1.43 95% CI 0.98-2.1, p=0.06). There were no significant differences in recurrent myocardial infarction, stent thrombosis, heart failure or target vessel revascularization. In the subgroup with high thrombus burden (TIMI thrombus grade ≥3) thrombus aspiration was associated with less CV death (170 [2.5%] vs. 205 [3.1%] HR 0.80; 95% CI 0.65-0.98, p =0.03), and with more stroke or TIA (55 [0.9%] vs. 34 [0.5%] OR 1.56; 95% CI 1.02-2.42, p=0.04). However, the interaction p-values were 0.32 and 0.34, respectively. CONCLUSIONS—: Routine thrombus aspiration during STEMI PCI did not improve clinical outcomes. In the high thrombus burden subgroup the trends toward reduced CV death and increased stroke or TIA provide a rationale for future trials of improved thrombus aspiration technologies in this high-risk subgroup. CLINICAL TRIAL REGISTRATION—: ClinicalTrials.gov identifier NCT02552407, PROSPERO CRD42015025936
|
|
| 48. |
- Jolly, Sanjit S., et al.
(author)
-
Thrombus Aspiration in ST-Segment-Elevation Myocardial Infarction An Individual Patient Meta-Analysis : Thrombectomy Trialists Collaboration
- 2017
-
In: Circulation. - 0009-7322 .- 1524-4539. ; 135:2, s. 143-
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Thrombus aspiration during percutaneous coronary intervention (PCI) for the treatment of ST-segment-elevation myocardial infarction (STEMI) has been widely used; however, recent trials have questioned its value and safety. In this meta-analysis, we, the trial investigators, aimed to pool the individual patient data from these trials to determine the benefits and risks of thrombus aspiration during PCI in patients with ST-segment-elevation myocardial infarction. METHODS: Included were large (n >= 1000), randomized, controlled trials comparing manual thrombectomy and PCI alone in patients with ST-segment-elevation myocardial infarction. Individual patient data were provided by the leadership of each trial. The prespecified primary efficacy outcome was cardiovascular mortality within 30 days, and the primary safety outcome was stroke or transient ischemic attack within 30 days. RESULTS: The 3 eligible randomized trials (TAPAS [Thrombus Aspiration During Percutaneous Coronary Intervention in Acute Myocardial Infarction], TASTE [Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia], and TOTAL [Trial of Routine Aspiration Thrombectomy With PCI Versus PCI Alone in Patients With STEMI]) enrolled 19 047 patients, of whom 18 306 underwent PCI and were included in the primary analysis. Cardiovascular death at 30 days occurred in 221 of 9155 patients (2.4%) randomized to thrombus aspiration and 262 of 9151 (2.9%) randomized to PCI alone (hazard ratio, 0.84; 95% confidence interval, 0.70-1.01; P=0.06). Stroke or transient ischemic attack occurred in 66 (0.8%) randomized to thrombus aspiration and 46 (0.5%) randomized to PCI alone (odds ratio, 1.43; 95% confidence interval, 0.98-2.10; P=0.06). There were no significant differences in recurrent myocardial infarction, stent thrombosis, heart failure, or target vessel revascularization. In the subgroup with high thrombus burden (TIMI [Thrombolysis in Myocardial Infarction] thrombus grade >= 3), thrombus aspiration was associated with fewer cardiovascular deaths (170 [2.5%] versus 205 [3.1%]; hazard ratio, 0.80; 95% confidence interval, 0.65-0.98; P=0.03) and with more strokes or transient ischemic attacks (55 [0.9%] versus 34 [0.5%]; odds ratio, 1.56; 95% confidence interval, 1.02-2.42, P=0.04). However, the interaction P values were 0.32 and 0.34, respectively. CONCLUSIONS: Routine thrombus aspiration during PCI for ST-segment-elevation myocardial infarction did not improve clinical outcomes. In the high thrombus burden group, the trends toward reduced cardiovascular death and increased stroke or transient ischemic attack provide a rationale for future trials of improved thrombus aspiration technologies in this high-risk subgroup.
|
|
| 49. |
- Mahmoud, Karim D., et al.
(author)
-
Clinical impact of direct stenting and interaction with thrombus aspiration in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention : Thrombectomy Trialists Collaboration
- 2018
-
In: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 39:26, s. 2472-2479
-
Journal article (peer-reviewed)abstract
- Aims: Preliminary studies suggest that direct stenting (DS) during percutaneous coronary intervention (PCI) may reduce microvascular obstruction and improve clinical outcome. Thrombus aspiration may facilitate DS. We assessed the impact of DS on clinical outcome and myocardial reperfusion and its interaction with thrombus aspiration among ST-segment elevation myocardial infarction (STEMI) patients undergoing PCI.Methods and results: Patient-level data from the three largest randomized trials on routine manual thrombus aspiration vs. PCI only were merged. A 1:1 propensity matched population was created to compare DS and conventional stenting. Synergy between DS and thrombus aspiration was assessed with interaction P-values in the final models. In the unmatched population (n= 17329), 32% underwent DS and 68% underwent conventional stenting. Direct stenting rates were higher in patients randomized to thrombus aspiration as compared with PCI only (41% vs. 22%; P < 0.001). Patients undergoing DS required less contrast (162 mL vs. 172 mL; P < 0.001) and had shorter fluoroscopy time (11.1 min vs. 13.3 min; P < 0.001). After propensity matching (n = 10944), no significant differences were seen between DS and conventional stenting with respect to 30-day cardiovascular death [1.7% vs. 1.9%; hazard ratio 0.88, 95% confidence interval (CI) 0.55-1.41; P=0.60; P-interaction = 0.96) and 30-day stroke or transient ischaemic attack (0.6% vs. 0.4%; odds ratio 1.02; 95% CI 0.14-7.54; P= 0.99; P-interaction = 0.81). One-year results were similar. No significant differences were seen in electrocardiographic and angiographic myocardial reperfusion measures.Conclusion: Direct stenting rates were higher in patients randomized to thrombus aspiration. Clinical outcomes and myocardial reperfusion measures did not differ significantly between DS and conventional stenting and there was no interaction with thrombus aspiration.
|
|
| 50. |
|
|
