Discrete-wavelet-transform recursive inverse algorithm using second-order estimation of the autocorrelation matrix

The recursive-least-squares (RLS) algorithm was introduced as an alternative to LMS algorithm with enhanced performance. Computational complexity and instability in updating the autocolleltion matrix are some of the drawbacks of the RLS algorithm that were among the reasons for the intrduction of the second-order recursive inverse (RI) adaptive algorithm. The 2nd order RI adaptive algorithm suffered from low convergence rate in certain scenarios that required a relatively small initial step-size. In this paper, we propose a newsecond-order RI algorithm that projects the input signal to a new domain namely discrete-wavelet-transform (DWT) as pre step before performing the algorithm. This transformation overcomes the low convergence rate of the second-order RI algorithm by reducing the self-correlation of the input signal in the mentioned scenatios. Expeirments are conducted using the noise cancellation setting. The performance of the proposed algorithm is compared to those of the RI, original second-order RI and RLS algorithms in different Gaussian and impulsive noise environments. Simulations demonstrate the superiority of the proposed algorithm in terms of convergence rate comparedto those algorithms

Discrete wavelet transform-based RI adaptive algorithm for system identification

In this paper, we propose a new adaptive filtering algorithm for system identification. The algorithm is based on the recursive inverse (RI) adaptive algorithm which suffers from low convergence rates in some applications; i.e., the eigenvalue spread of the autocorrelation matrix is relatively high. The proposed algorithm applies discrete-wavelet transform (DWT) to the input signal which, in turn, helps to overcome the low convergence rate of the RI algorithm with relatively small step-size(s). Different scenarios has been investigated in different noise environments in system identification setting. Experiments demonstrate the advantages of the proposed DWT recursive inverse (DWT-RI) filter in terms of convergence rate and mean-square-error (MSE) compared to the RI, discrete cosine transform LMS (DCTLMS), discrete-wavelet transform LMS (DWT-LMS) and recursive-least-squares (RLS) algorithms under same conditions

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy

Background. Gaining percutaneous access during percutaneous nephrolithotomy (PNL) can be complicated with the bowel injury. We report a novel approach of management of duodenal injury complicating percutaneous drainage of infected haematoma after Shock-Wave Lithotripsy (SWL). Case Presentation. A 57-year-old patient with the 15 mm right pelvic kidney stone underwent uneventful SWL. Patient visited emergency department 3 days later with high fever and chills with severe right flank pain. CT urography revealed lower pole kidney injury with signs of infected hematoma due to low attenuation areas but without signs of obstruction or urine leakage. Infected haematoma was drained percutaneously under ultrasound and X-ray control and a pigtail catheter 10 Fr was left beneath the lower pole of the right kidney. Postoperatively duodenal injury was suspected due to amber color, low creatinine, and high bilirubin level in the drainage output. CT demonstrated that the pigtail of the drain had entered the second part of the duodenum. Catheter was withdrawn and defect of the duodenal wall was stapled with four staples endoscopically. After 2 days of fasting patient was allowed to start oral food intake and was discharged on the 5th day. Conclusion. Injury of the duodenum during percutaneous kidney manipulation is an extremely rare complication. Conservative management consisting of endoscopic stapling of the duodenal wall defect is a safe and feasible approach to expediting the recovery of the patient