Learning to rank networked entities

Several algorithms have been proposed to learn to rank entities modeled as feature vectors, based on relevance feedback. However, these algorithms do not model network connections or relations between entities. Meanwhile, Pagerank and variants find the stationary distribution of a reasonable but arbitrary Markov walk over a network, but do not learn from relevance feedback. We present a framework for ranking networked entities based on Markov walks with parameterized conductance values associated with the network edges. We propose two flavors of conductance learning problems in our framework. In the first setting, relevance feedback comparing node-pairs hints that the user has one or more hidden preferred communities with large edge conductance, and the algorithm must discover these communities. We present a constrained maximum entropy network flow formulation whose dual can be solved efficiently using a cutting-plane approach and a quasi-Newton optimizer. In the second setting, edges have types, and relevance feedback hints that each edge type has a potentially different conductance, but this is fixed across the whole network. Our algorithm learns the conductances using an approximate Newton method

Localised melorheostosis

Melorheostosis is a sclerosing bone dysplasia of unknown aetiology. Diagnosis is mainly based on a combination of clinical and imaging studies. The classical dripping candle wax picture on plain radiograph is diagnostic. We report a case of localized melorheostosis of a 14 year old boy on daily analgesics for two years for pain relief. Radiographs showed endosteal bone formation like dripping candle wax. Biopsy and decompression of the hyperostosis was done. However biopsy did not relieve his symptoms. Based on literature survey he was given a single infusion of zoledronic acid. This gave dramatic relief in pain

Functional outcome of tendoachilles following Ponseti’s tenotomy for treatment of congenital talipes equino varus in children older than two years

Background: Long term results of tenotomy and Ponseti technique are established worldwide. However, functions of Tendoachilles following Ponseti’s tenotomy in these cases i.e. idiopathic/neglected/operated/relapsed clubfeet (after casting or surgical correction) are not established. Tendoachilles regeneration after tenotomy has been confirmed on USG and MRI but only a few studies have done functional evaluation of tendoachilles. This study was done to evaluate the functional outcome of tendoachilles after tenotomy in patients older than two years presenting with CTEV. This study also assessed the influence of age and any previous treatment on tenotomy.Methods: In this study, 42 children (68 clubfeet) were seen in the two year study period. Children between 2-13 years coming to the outpatient department for treatment using the Ponseti’s method were followed during and after completion of treatment for 2 years. Patients were divided into two groups-first according to age and second according to previous treatment. Clinical evaluation of tendoachilles regeneration was done by evaluating the child’s ability to stand on tip of toes on single leg and walking ability.Results: The ability to stand on tip of toes after removal of the final cast was delayed maximum in the previously operated patients (9.5 weeks), lesser in patients who were previously treated by casting (7.3 weeks) and least in neglected patients (7 weeks). It also increased as the age increased (2-5 years age group required 7.4 weeks whereas 11-13 years age group required 16 weeks). Neglected patients started walking earlier (4.6 weeks) as compared to patients treated conservatively (4.8 weeks) or operatively (7.2 weeks). Younger children started walking earlier (age 2-5 years required 4.7 weeks whereas 11-13 years age group required 12 weeks). Conclusions: Functional evaluation of tendoachilles showed that all children who had tenotomy could walk and stand on tip of toes irrespective of age and previous treatment. However, older child and children having history of previous treatment, required longer time for recovery

Intra-operative point-of-procedure delineation of oral cancer margins using optical coherence tomography.

ObjectivesSurgical margin status is a significant determinant of treatment outcome in oral cancer. Negative surgical margins can decrease the loco-regional recurrence by five-fold. The current standard of care of intraoperative clinical examination supplemented by histological frozen section, can result in a risk of positive margins from 5 to 17 percent. In this study, we attempted to assess the utility of intraoperative optical coherence tomography (OCT) imaging with automated diagnostic algorithm to improve on the current method of clinical evaluation of surgical margin in oral cancer.Materials and methodsWe have used a modified handheld OCT device with automated algorithm based diagnostic platform for imaging. Intraoperatively, images of 125 sites were captured from multiple zones around the tumor of oral cancer patients (n = 14) and compared with the clinical and pathologic diagnosis.ResultsOCT showed sensitivity and specificity of 100%, equivalent to histological diagnosis (kappa, ĸ = 0.922), in detection of malignancy within tumor and tumor margin areas. In comparison, for dysplastic lesions, OCT-based detection showed a sensitivity of 92.5% and specificity of 68.8% and a moderate concordance with histopathology diagnosis (ĸ = 0.59). Additionally, the OCT scores could significantly differentiate squamous cell carcinoma (SCC) from dysplastic lesions (mild/moderate/severe; p ≤ 0.005) as well as the latter from the non-dysplastic lesions (p ≤ 0.05).ConclusionThe current challenges associated with clinical examination-based margin assessment could be improved with intra-operative OCT imaging. OCT is capable of identifying microscopic tumor at the surgical margins and demonstrated the feasibility of mapping of field cancerization around the tumor

Implementation of a large-scale breast cancer early detection program in a resource-constrained setting: real-world experiences from 2 large states in India

Background: The Breast Health Initiative (BHI) was launched to demonstrate a scalable model to improve access to early diagnosis and treatment of breast cancer. Methods: A package of evidence-based interventions was codesigned and implemented with the stakeholders, as part of the national noncommunicable disease program, through the existing primary health care system. Data from the first 18 months of the BHI are presented. Results: A total of 108,112 women received breast health education; 48% visited the health facilities for clinical breast examination (CBE), 3% had a positive CBE result, and 41% were referred to a diagnostic facility. The concordance of CBE findings between health care providers and adherence to follow-up care improved considerably, with more women visiting the diagnostic facilities and completing diagnostic evaluation within 1 month from initial screening, and with only 9% lost to follow-up. The authors observed a clinically meaningful decrease in time to complete diagnostic evaluation with biopsy, from 37 to 9 days. Conclusions: The results demonstrate the feasibility and effectiveness of implementing a large-scale, decentralized breast cancer early detection program delivered through the existing primary health care system in India

Assessing the feasibility of integrating ecosystem-based with engineered water resource governance and management for water security in semi-arid landscapes: A case study in the Banas catchment, Rajasthan, India

Much of the developing world and areas of the developed world suffer water vulnerability. Engineering solutions enable technically efficient extraction and diversion of water towards areas of demand but, without rebalancing resource regeneration, can generate multiple adverse ecological and human consequences. The Banas River, Rajasthan (India), has been extensively developed for water diversion, particularly from the Bisalpur Dam from which water is appropriated by powerful urban constituencies dispossessing local people. Coincidentally, abandonment of traditional management, including groundwater recharge practices, is leading to increasingly receding and contaminated groundwater. This creates linked vulnerabilities for rural communities, irrigation schemes, urban users, dependent ecosystems and the multiple ecosystem services that they provide, compounded by climate change and population growth. This paper addresses vulnerabilities created by fragmented policy measures between rural development, urban and irrigation water supply and downstream consequences for people and wildlife. Perpetuating narrowly technocentric approaches to resource exploitation is likely only to compound emerging problems. Alternatively, restoration or innovation of groundwater recharge practices, particularly in the upper catchment, can represent a proven, ecosystem-based approach to resource regeneration with linked beneficial socio-ecological benefits. Hybridising an ecosystem-based approach with engineered methods can simultaneously increase the security of rural livelihoods, piped urban and irrigation supplies, and the vitality of river ecosystems and their services to beneficiaries. A renewed policy focus on local-scale water recharge practices balancing water extraction technologies is consistent with emerging Rajasthani policies, particularly Jal Swavlamban Abhiyan (‘water self-reliance mission’). Policy reform emphasising recharge can contribute to water security and yield socio-economic outcomes through a systemic understanding of how the water system functions, and by connecting goals and budgets across multiple, currently fragmented policy areas. The underpinning principles of this necessary paradigm shift are proven and have wider geographic relevance, though context-specific research is required to underpin robust policy and practical implementation

LEARN: A multi-centre, cross-sectional evaluation of Urology teaching in UK medical schools

OBJECTIVE: To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. MATERIALS AND METHODS: LEARN was a national multicentre cross-sectional study. Year 2 to Year 5 medical students and FY1 doctors were invited to complete a survey between 3rd October and 20th December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). RESULTS: 7,063/8,346 (84.6%) responses from all 39 UK medical schools were included; 1,127/7,063 (16.0%) were from Foundation Year (FY) 1 doctors, who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and clinical placements in the later years of medical school. 20.1% of FY1 doctors reported no undergraduate clinical attachment in urology. CONCLUSION: LEARN is the largest ever evaluation of undergraduate urology teaching. In the UK, teaching seemed satisfactory as evaluated by the BAUS undergraduate syllabus. However, many students report having no clinical attachments in Urology and some newly qualified doctors report never having inserted a catheter, which is a GMC mandated requirement. We recommend a greater emphasis on undergraduate clinical exposure to urology and stricter adherence to GMC mandated procedures

Effects of Bristle Hardness & Duration of Manual Tooth brushing on Plaque Control

Background: Oral health is an integral part of general health. Poor oral health can have adverse effect on general health hence a good oral health is very essential, which in turn is achieved by good oral hygiene. Even though, the concept of good oral hygiene evolved 5000 years back, it is only in the beginning of 19th century it gained more importance. (1) Dental caries and periodontal disease are the most commonly occurring diseases affecting mankind. Dental plaque is a very important factor in the causation of both the diseases. (2) Aims & Objectives: To evaluate efficacy of four different types of toothbrushes, with difference in duration of brushing along with different bristle hardness in removal of microbial plaque. Material & Methods: In a randomized controlled trial, four groups with 40 subjects used manual toothbrushes with either hard, medium, soft and ultra-soft bristles. On baseline examination, clinical parameter plaque index (Sillness & Loe, 1964) was recorded. Selected subjects were refrained from all kinds of oral hygiene measures for 24 hrs before clinical appointment. On the day of clinical appointment scores of pre and post brushing were recorded in each patient when brushing time was set for 1 minute and same procedure was repeated after a wash off period of 3 days and similar recordings were made with brushing time of 11/2minute. Primary outcome was measured with differences in the plaque index (Sillness & Loe, 1964) compared to baseline. Results: Significant reduction in mean value of plaque score was observed on comparing pre-brushing and post-brushing data in all the subjects irrespective of bristle hardness in both 1 minute and 11/2 minute groups. On increasing time duration from 1 minute to 11/2 minute intergroup comparison revealed that significant correlation exist in mean plaque score reduction in subjects using medium bristle brush, soft bristle brush, ultra-soft bristle brush. However, no significant reduction in plaque score was observed on increasing duration from 1 minute to 11/2 minute in subjects using hard bristle brush. Conclusion: Manual toothbrushes with hard bristles better remove plaque, but may also cause more soft tissue trauma compared to brushes with softer bristles

Gingival biotype assessment: Variations in gingival thickness with regard to age, gender, and arch location

Background: An adequate width of the attached gingiva helps in maintaining esthetics and proper plaque control. A thin gingiva may lead to recession after trauma or surgical and inflammatory injuries, thus sufficient thickness of the attached gingiva is desirable. Studies have shown considerable intra- and inter-examiner variation in both width and thickness of attached gingiva, which might be due to the presence of different gingival biotypes present in the adult population. By ascertaining gingival thickness, we can diagnose periodontal diseases and plan a proper treatment which is important for a good prognosis. Aims: The aim of the study is to evaluate the variations in the thickness of gingiva with respect to age, gender, and location in the dental arch. Materials and Methods: A total of 90 (45 males and 45 females) periodontally healthy subjects were divided into three different age groups. These individuals were examined for their gingival thickness in the maxillary and mandibular arches. Results: It was observed that the thickness of gingiva significantly decreased with age in both the arches and was significantly higher in females than males. The maxillary arch had thicker gingiva as compared to mandibular arch. Conclusion: In the present study, we concluded that the thickness of the gingiva varies with age, gender, and arch location