Hard Decision Cooperative Spectrum Sensing Based on Estimating the Noise Uncertainty Factor

Spectrum Sensing (SS) is one of the most challenging issues in Cognitive Radio (CR) systems. Cooperative Spectrum Sensing (CSS) is proposed to enhance the detection reliability of a Primary User (PU) in fading environments. In this paper, we propose a hard decision based CSS algorithm using energy detection with taking into account the noise uncertainty effect. In the proposed algorithm, two dynamic thresholds are toggled based on predicting the current PU activity, which can be successfully expected using a simple successive averaging process with time. Also, their values are evaluated using an estimated value of the noise uncertainty factor. These dynamic thresholds are used to compensate the noise uncertainty effect and increase (decrease) the probability of detection (false alarm), respectively. Theoretical analysis is performed on the proposed algorithm to deduce its enhanced false alarm and detection probabilities compared to the conventional hard decision CSS. Moreover, simulation analysis is used to confirm the theoretical claims and prove the high performance of the proposed scheme compared to the conventional CSS using different fusion rules.Comment: 5 pages, 4 figures, IEEE International Conference on Computer Engineering and Systems (ICCES 2015). arXiv admin note: text overlap with arXiv:1505.0558

Intraoperative Pontine Infarction: A Hidden Challenge

Apneusis, or apneustic respirations, is characterized by an abnormal breathing pattern involving gasping and the inability to fully expire. A loss of gag reflex and other cranial nerve deficits are also often accompanied with these respiratory changes. In neurological intensive care units (NICUs), these respiratory and airway changes are not uncommon and have been well documented (Lee et al. 1976). These clinical changes are often associated with pontine trauma as it is the core pneumotaxic center in the brain stem. We describe the airway management of a patient with an acute, occult pontine infarct status post craniectomy and cervical laminectomy for decompression of known Chiari malformation in the postanesthesia care unit (PACU)

Soft Decision Cooperative Spectrum Sensing Based Upon Noise Uncertainty Estimation

Spectrum Sensing (SS) constitutes the most critical task i n Cognitive Radio (CR) systems for Primary User (PU) detection. Cooperative Spectrum Sensing (CSS) is introduced to enhance the detection reliability of the PU in fading environments. In this paper, we propose a soft decision based CSS algorithm using energy detection by taking into account the noise uncertainty effect. In the proposed algorithm, two threshold levels are utilized based on predicting the current PU activity, which can be successfully expected using a simple successive averaging process with time. The two threshold levels are evaluated based on estimating the noise uncertainty factor. In addition, they are toggled in a dynamic manner to compensate the noise uncertainty effect and to increase the probability of detection and decrease the probability of false alarm. Theoretical analysis is performed on the proposed algorithm to evaluate its enhanced false alarm and detection probabilities over the conventional soft decision CSS using different combining schemes. In addition, simulation results show the high efficiency of the proposed scheme compared to the conventional soft decision CSS, with high computational complexity enhancements.Comment: 6 Pages, 5 Figures, ICC workshops 201

Co-presentation of Posterior Reversible Encephalopathy Syndrome in a patient with Post Dural Puncture Headache

INTRODUCTION: Post Dural Puncture Headache (PDPH) is a well-known complication of neuraxial anesthesia, however the occurrence of seizures and vision loss within few days after dural puncture could be alarming. Posterior Reversible Encephalopathy Syndrome (PRES) is associated with reversible edema and leukoencephalopathy in the posterior parieto-occipital cortex. We report the co-presentation of PRES and PDPH after labor epidural analgesia. CASE PRESENTATION: 25-year-old multiparous African-American woman was admitted for evaluation of new onset seizures and headache in the postpartum period. She had a recent history of multiple needle insertion attempts and inadvertent dural puncture during epidural analgesia for delivery. Soon after delivery, she was diagnosed with PDPH and was treated with epidural blood patch, with no relief of symptoms. Six days later, she developed sudden onset transient blindness, seizures and altered sensorium and magnetic resonance imaging (MRI) of the brain revealed white matter changes suggestive of PRES. CONCLUSION: PRES is an uncommon complication of cerebrospinal fluid (CSF) leak and intracranial hypotension. We report the occurrence of PRES in a patient with no known risk factors, except a traumatic dural tap. Is it important to expand the differentials for headache after dural puncture to encompass PRES as a possibility, especially in patients with a delayed presentation of seizures and cortical blindness

The Cleveland Clinic Experience with Supraclavicular and Popliteal Ambulatory Nerve Catheters

Continuous peripheral nerve blocks (CPNB) are commonly used for intraoperative and postoperative analgesia. Our study aimed at describing our experience with ambulatory peripheral nerve catheters. After Institutional Review Board approval, records for all patients discharged with supraclavicular or popliteal catheters between January 1, 2009 and December 31, 2011 were reviewed. A licensed practitioner provided verbal and written instructions to the patients prior to discharge. Daily follow-up phone calls were conducted. Patients either removed their catheters at home with real-time simultaneous telephone guidance by a member of the Acute Pain Service or had them removed by the surgeon during a regular office visit. The primary outcome of this analysis was the incidence of complications, categorized as pharmacologic, infectious, or other. The secondary outcome measure was the average daily pain score. Our study included a total of 1059 patients with ambulatory catheters (769 supraclavicular, 290 popliteal). The median infusion duration was 5 days for both groups. Forty-two possible complications were identified: 13 infectious, 23 pharmacologic, and 6 labeled as other. Two patients had retained catheters, 2 had catheter leakage, and 2 had shortness of breath. Our study showed that prolonged use of ambulatory catheters for a median period of 5 days did not lead to an increased incidence of complications

Metal-Bound Methisazone; Novel Drugs Targeting Prophylaxis and Treatment of SARS-CoV-2, a Molecular Docking Study.

SARS-CoV-2 currently lacks effective first-line drug treatment. We present promising data from in silico docking studies of new Methisazone compounds (modified with calcium, Ca; iron, Fe; magnesium, Mg; manganese, Mn; or zinc, Zn) designed to bind more strongly to key proteins involved in replication of SARS-CoV-2. In this in silico molecular docking study, we investigated the inhibiting role of Methisazone and the modified drugs against SARS-CoV-2 proteins: ribonucleic acid (RNA)-dependent RNA polymerase (RdRp), spike protein, papain-like protease (PlPr), and main protease (MPro). We found that the highest binding interactions were found with the spike protein (6VYB), with the highest overall binding being observed with Mn-bound Methisazone at -8.3 kcal/mol, followed by Zn and Ca at -8.0 kcal/mol, and Fe and Mg at -7.9 kcal/mol. We also found that the metal-modified Methisazone had higher affinity for PlPr and MPro. In addition, we identified multiple binding pockets that could be singly or multiply occupied on all proteins tested. The best binding energy was with Mn-Methisazone versus spike protein, and the largest cumulative increases in binding energies were found with PlPr. We suggest that further studies are warranted to identify whether these compounds may be effective for treatment and/or prophylaxis

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020