169 research outputs found

    Vision-based adaptive cruise control using pattern matching

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    Adaptive Cruise Control (ACC) is a relatively new system designed to assist automobile drivers in maintaining a safe following distance. This paper proposes and validates a vision-based ACC system which uses a single camera to obtain the clearance distance between the preceding vehicle and the ACC vehicle. Pattern matching, with the aid of lane detection, is used for vehicle detection. The vehicle and range detection algorithms are validated using real-world data, and then the resulting system performance is shown to be sufficient using a simulation of a basic vehicle model

    Introducing endovenous laser therapy ablation to a national health service vascular surgical unit e the aberdeen experience

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    Objectives: To report early clinical outcomes and learning experience following the introduction of endovenous laser ablation (EVLA) to an NHS vascular unit. Design: Prospective observational study. Results: Between February 2006 and January 2008, 631 consecutive patients underwent EVLA to 704 refluxing truncal veins e 579 GSV, 119 SSV and 6 straight segments of anterior accessory GSV. 275/631 (44%) patients had local anaesthesia (LA) plus sedation, 237 (38%) had LA only and 119 (18%) had general anaesthesia. All were treated using the 810 nm diode laser. Adjuvant procedures on-table included foam sclerotherapy 129/704 (18%), multiple stab avulsions 53/ 704 (8%) and 3 limbs had both. Three-month follow-up with duplex examination is complete in 635/704 limbs (90%). Complete occlusion was noted in 610 veins (96%), 14 (2.2%) were partially occluded and 11 (1.7%) showed no occlusion. 193 (30%) of the 635 limbs seen at follow-up required further treatment for residual varicosities using foam sclerotherapy. There has been one non-fatal pulmonary embolus associated with EVLA and no other complications. Conclusions: EVLA is safe and technically effective. It has a defined learning curve requiring new operator skills which can be readily acquired.peer-reviewe

    A randomized trial comparing treatments for varicose veins

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    Supported by a grant from the Health Technology Assessment Programme of the National Institute for Health Research (06/45/02). The Health Services Research Unit is funded by the Chief Scientist Office of the Scottish Government Health Directorate. We thank Janice Cruden for her secretarial support and data management; Gladys McPherson and the programming team at the Centre for Healthcare Randomised Trials; Tracey Davidson, Lynda Constable, Jackie Ellington, Laura Elliott, and Yvonne Fernie for help with scoring the Aberdeen Varicose Vein Questionnaire; Luke Vale and Laura Ternent, our original economists in the group; members of the Project Management Group for their ongoing advice and support of the trial; members of the study team (Graeme MacLennan, Maria Prior, and Denise Bolsover) who contributed to the behavioral recovery component of the trial; the independent members of the trial steering committee (Alun Davies [chair], Ian Loftus, and Jane Nixon) and the data and safety monitoring committee (Gerry Stansby [chair], Winston Banya, and Marcus Flather); and the staff members at recruitment sites (see the Supplementary Appendix) who facilitated recruitment, treatment, and follow-up of trial participants.Peer reviewedPublisher PD

    Spatiotemporal trends in cetacean strandings and response in the southwestern Indian Ocean : 2000–2020

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    On behalf of SIF, we would like to thank the Seychelles partners (Alphonse Foundation, Desroches Foundation, Island Conservation Society, Farquhar Foundation, Seychelles Islands Foundation, Silhouette Foundation) for providing financial support to acquire and grant use of their data. Collection of data in Reunion was funded by DEAL Reunion and Region-Reunion.The south-western Indian Ocean (SWIO) is a region of global importance for marine mammal biodiversity, but our understanding of most of the species and populations found there is still rudimentary. The Indian Ocean Network for Cetacean Research (IndoCet) was formed in 2014 and is dedicated to the research of all cetacean species across the SWIO. Since 2019, there have been efforts to create a regional network for coordinated response to stranding events as well as training and capacity building in the SWIO region. The present analysis represents a first investigation of stranding data collected by various members and collaborators within the IndoCet network, covering over 14,800km of coastline belonging to nine countries/territories. Between 2000–2020, there were 397 stranding events, representing 1,232 individual animals, 17 genera and 27 species, belonging to six families: four balaenopterids, one balaenid, one physeterid, two kogiids, six ziphiids and 14 delphinids. Seven mass strandings were recorded: two were composed of three to 20 individuals and five composed of > 20 individuals. Spatial analysis of stranding events indicated that local spatio-temporal clusters (excessive number of events in time and geographic space) were present in all countries/territories, except for the Comoros. The only significant cluster was detected on the southwest coast of Mauritius, just west of the village of Souillac. The SWIO region predominantly comprises relatively poor countries/territories, but imminent Ocean Economy developments are prevalent throughout the region. This study highlights the importance of establishing baselines upon which any future potential impact from anthropogenic developments in the region can be measured.Peer reviewe

    Heart rate variability in non-apneic snorers and controls before and after continuous positive airway pressure

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    BACKGROUND: We hypothesized that sympathetic nervous system activity (SNSA) is increased and parasympathetic nervous system activity (PNSA) is decreased during non-rapid eye movement (NREM) sleep in non-apneic, otherwise healthy, snoring individuals compared to control. Moreover, we hypothesized that these alterations in snoring individuals would be more evident during non-snoring than snoring when compared to control. METHODS: To test these hypotheses, heart rate variability was used to measure PNSA and SNSA in 11 normotensive non-apneic snorers and 12 control subjects before and 7-days after adapting to nasal continuous positive airway pressure (nCPAP). RESULTS: Our results showed that SNSA was increased and PNSA was decreased in non-apneic snorers during NREM compared to control. However, these changes were only evident during the study in which snoring was eliminated with nCPAP. Conversely, during periods of snoring SNSA and PNSA were similar to measures obtained from the control group. Additionally, within the control group, SNSA and PNSA did not vary before and after nCPAP application. CONCLUSION: Our findings suggest that long-lasting alterations in autonomic function may exist in snoring subjects that are otherwise healthy. Moreover, we speculate that because of competing inputs (i.e. inhibitory versus excitatory inputs) to the autonomic nervous system during snoring, the full impact of snoring on autonomic function is most evident during non-snoring periods

    Alpha thalassaemia-mental retardation, X linked

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    X-linked alpha thalassaemia mental retardation (ATR-X) syndrome in males is associated with profound developmental delay, facial dysmorphism, genital abnormalities and alpha thalassaemia. Female carriers are usually physically and intellectually normal. So far, 168 patients have been reported. Language is usually very limited. Seizures occur in about one third of the cases. While many patients are affectionate with their caregivers, some exhibit autistic-like behaviour. Patients present with facial hypotonia and a characteristic mouth. Genital abnormalities are observed in 80% of children and range from undescended testes to ambiguous genitalia. Alpha-thalassaemia is not always present. This syndrome is X-linked recessive and results from mutations in the ATRX gene. This gene encodes the widely expressed ATRX protein. ATRX mutations cause diverse changes in the pattern of DNA methylation at heterochromatic loci but it is not yet known whether this is responsible for the clinical phenotype. The diagnosis can be established by detection of alpha thalassaemia, identification of ATRX gene mutations, ATRX protein studies and X-inactivation studies. Genetic counselling can be offered to families. Management is multidisciplinary: young children must be carefully monitored for gastro-oesophageal reflux as it may cause death. A number of individuals with ATR-X are fit and well in their 30s and 40s

    A Drosophila Model for EGFR-Ras and PI3K-Dependent Human Glioma

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    Gliomas, the most common malignant tumors of the nervous system, frequently harbor mutations that activate the epidermal growth factor receptor (EGFR) and phosphatidylinositol-3 kinase (PI3K) signaling pathways. To investigate the genetic basis of this disease, we developed a glioma model in Drosophila. We found that constitutive coactivation of EGFR-Ras and PI3K pathways in Drosophila glia and glial precursors gives rise to neoplastic, invasive glial cells that create transplantable tumor-like growths, mimicking human glioma. Our model represents a robust organotypic and cell-type-specific Drosophila cancer model in which malignant cells are created by mutations in signature genes and pathways thought to be driving forces in a homologous human cancer. Genetic analyses demonstrated that EGFR and PI3K initiate malignant neoplastic transformation via a combinatorial genetic network composed primarily of other pathways commonly mutated or activated in human glioma, including the Tor, Myc, G1 Cyclins-Cdks, and Rb-E2F pathways. This network acts synergistically to coordinately stimulate cell cycle entry and progression, protein translation, and inappropriate cellular growth and migration. In particular, we found that the fly orthologs of CyclinE, Cdc25, and Myc are key rate-limiting genes required for glial neoplasia. Moreover, orthologs of Sin1, Rictor, and Cdk4 are genes required only for abnormal neoplastic glial proliferation but not for glial development. These and other genes within this network may represent important therapeutic targets in human glioma

    The Probable Cell of Origin of NF1- and PDGF-Driven Glioblastomas

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    Primary glioblastomas are subdivided into several molecular subtypes. There is an ongoing debate over the cell of origin for these tumor types where some suggest a progenitor while others argue for a stem cell origin. Even within the same molecular subgroup, and using lineage tracing in mouse models, different groups have reached different conclusions. We addressed this problem from a combined mathematical modeling and experimental standpoint. We designed a novel mathematical framework to identify the most likely cells of origin of two glioma subtypes. Our mathematical model of the unperturbed in vivo system predicts that if a genetic event contributing to tumor initiation imparts symmetric self-renewing cell division (such as PDGF overexpression), then the cell of origin is a transit amplifier. Otherwise, the initiating mutations arise in stem cells. The mathematical framework was validated with the RCAS/tv-a system of somatic gene transfer in mice. We demonstrated that PDGF-induced gliomas can be derived from GFAP-expressing cells of the subventricular zone or the cortex (reactive astrocytes), thus validating the predictions of our mathematical model. This interdisciplinary approach allowed us to determine the likelihood that individual cell types serve as the cells of origin of gliomas in an unperturbed system

    Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins

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    BACKGROUND Endovenous laser ablation and ultrasound-guided foam sclerotherapy are recommended alternatives to surgery for the treatment of primary varicose veins, but their long-term comparative effectiveness remains uncertain. METHODS In a randomized, controlled trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom, we compared the outcomes of laser ablation, foam sclerotherapy, and surgery. Primary outcomes at 5 years were disease-specific quality of life and generic quality of life, as well as cost-effectiveness based on models of expected costs and quality-adjusted life-years (QALYs) gained that used data on participants’ treatment costs and scores on the EuroQol EQ-5D questionnaire. RESULTS Quality-of-life questionnaires were completed by 595 (75%) of the 798 trial participants. After adjustment for baseline scores and other covariates, scores on the Aberdeen Varicose Vein Questionnaire (on which scores range from 0 to 100, with lower scores indicating a better quality of life) were lower among patients who underwent laser ablation or surgery than among those who underwent foam sclerotherapy (effect size [adjusted differences between groups] for laser ablation vs. foam sclerotherapy, βˆ’2.86; 95% confidence interval [CI], βˆ’4.49 to βˆ’1.22; P<0.001; and for surgery vs. foam sclerotherapy, βˆ’2.60; 95% CI, βˆ’3.99 to βˆ’1.22; P<0.001). Generic quality-of-life measures did not differ among treatment groups. At a threshold willingness-to-pay ratio of Β£20,000 (28,433inU.S.dollars)perQALY,77.2CONCLUSIONSInarandomizedtrialoftreatmentsforvaricoseveins,diseaseβˆ’specificqualityoflife5yearsaftertreatmentwasbetterafterlaserablationorsurgerythanafterfoamsclerotherapy.Themajorityoftheprobabilisticcostβˆ’effectivenessmodeliterationsfavoredlaserablationatawillingnessβˆ’toβˆ’payratioofΒ£20,000(28,433 in U.S. dollars) per QALY, 77.2% of the cost-effectiveness model iterations favored laser ablation. In a two-way comparison between foam sclerotherapy and surgery, 54.5% of the model iterations favored surgery. CONCLUSIONS In a randomized trial of treatments for varicose veins, disease-specific quality of life 5 years after treatment was better after laser ablation or surgery than after foam sclerotherapy. The majority of the probabilistic cost-effectiveness model iterations favored laser ablation at a willingness-to-pay ratio of Β£20,000 (28,433) per QALY. (Funded by the National Institute for Health Research; CLASS Current Controlled Trials number, ISRCTN51995477.
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