Iteratively Decoded Irregular Variable Length Coding and Sphere-Packing Modulation-Aided Differential Space-Time Spreading

In this paper we consider serially concatenated and iteratively decoded Irregular Variable Length Coding (IrVLC) combined with precoded Differential Space-Time Spreading (DSTS) aided multidimensional Sphere Packing (SP) modulation designed for near-capacity joint source and channel coding. The IrVLC scheme comprises a number of component Variable Length Coding (VLC) codebooks having different coding rates for the sake of encoding particular fractions of the input source symbol stream. The relative length of these source-stream fractions can be chosen with the aid of EXtrinsic Information Transfer (EXIT) charts in order to shape the EXIT curve of the IrVLC codec, so that an open EXIT chart tunnel may be created even at low Eb/N0 values that are close to the capacity bound of the channel. These schemes are shown to be capable of operating within 0.9 dB of the DSTS-SP channel’s capacity bound using an average interleaver length of 113, 100 bits and an effective bandwidth efficiency of 1 bit/s/Hz, assuming ideal Nyquist filtering. By contrast, the equivalent-rate regular VLC-based benchmarker scheme was found to be capable of operating at 1.4 dB from the capacity bound, which is about 1.56 times the corresponding discrepancy of the proposed IrVLC-aided scheme

Consensus graph and spectral representation for one-step multi-view kernel based clustering

Recently, multi-view clustering has received much attention in the fields of machine learning and pattern recognition. Spectral clustering for single and multiple views has been the common solution. Despite its good clustering performance, it has a major limitation: it requires an extra step of clustering. This extra step, which could be the famous k-means clustering, depends heavily on initialization, which may affect the quality of the clustering result. To overcome this problem, a new method called Multiview Clustering via Consensus Graph Learning and Nonnegative Embedding (MVCGE) is presented in this paper. In the proposed approach, the consensus affinity matrix (graph matrix), consensus representation and cluster index matrix (nonnegative embedding) are learned simultaneously in a unified framework. Our proposed method takes as input the different kernel matrices corresponding to the different views. The proposed learning model integrates two interesting constraints: (i) the cluster indices should be as smooth as possible over the consensus graph and (ii) the cluster indices are set to be as close as possible to the graph convolution of the consensus representation. In this approach, no post-processing such as k-means or spectral rotation is required. Our approach is tested with real and synthetic datasets. The experiments performed show that the proposed method performs well compared to many state-of-the-art approaches

Does Religiosity Affect Stock Investors’ Herding Behaviour? Global Evidence

We investigate if religiosity promotes herding among stock market investors. In a global sample of 21 markets over the period 2006–2018, increasing religiosity fosters herding only when the absolute religiosity level is relatively high. At low levels, an increase in religiosity has the opposite effect, promoting anti-herding. Our finding that changes in religiosity, depending on its level (high versus low), exert opposing effects on herding helps to understand contradictory findings in prior literature. Religiosity further induces more herding when economic freedom is low and the state is either impotent or corrupt, and promotes anti-herding when institutional quality is high

Intrauterine device is embraced by the placenta

The intrauterine device (IUD) is a contraceptive method which are tiny, T-shaped plastic, that is placed within the uterus and left there, is used all throughout the world with more than 99% effectiveness rate. Pregnancy with a levonorgestrel-releasing intrauterine system (LNG-IUS) in situ is very rare. Intracavitary pregnancy with an IUD can lead to a higher risk of infection and preterm birth. We described a case of a live birth with an IUD inserted into the placenta. A 27-year-old Syrian woman in G4P3 with a history of healthy vaginal deliveries arrived in our delivery room at 39+3 weeks gestation complaining of labor pain A vaginal examination revealed bulging membranes and a fully dilated cervix. She delivered a live baby boy, weighing 3100 g and being sent to the nursery with an APGAR score of 9 to 10. When the placenta was examined, a white foreign object that was embedded there was discovered to be an intrauterine device. Although intrauterine pregnancy is a potential problem that must be taken into account, ectopic pregnancy is a reasonably common complication of intrauterine contraceptive devices. Although several studies have shown that term pregnancies with excellent prognoses can occur after the removal of intrauterine devices, close monitoring is necessary to detect misplaced copper-T and prevent undesired births

Treatment of hypertension in rural Cambodia: results of a 6-year programme

This study was aimed to describe the outcomes of a hypertension treatment programme in two outpatient clinics in Cambodia. We determined proportions of patients who met the optimal targets for blood pressure (BP) control and assessed the evolution of mean systolic and diastolic BP (SBP/DBP) over time. Multivariate analyses were used to identify predictors of BP decrease and risk factors for LTFU. A total of 2858 patients were enrolled between March 2002 and June 2008 of whom 69.2% were female, 30.5% were aged >/=64years and 32.6% were diabetic. The median follow-up time was 600 days. By the end of 2008, 1642 (57.4%) were alive-in-care, 8 (0.3%) had died and 1208 (42.3%) were lost to follow-up. On admission, mean SBP and DBP were 162 and 94 mm Hg, respectively. Among the patients treated, a significant SBP reduction of 26.8 mm Hg (95% CI: 28.4-25.3) was observed at 6 months. Overall, 36.5% of patients reached the BP targets at 24 months. The number of young adults, non-overweight patients and non-diabetics reaching the BP targets was more. Older age (>64 years), uncontrolled DBP (>/=90 mm Hg) on last consultation and coming late for the last consultation were associated with LTFU, whereas non-diabetic patients were 1.5 times more likely to default than diabetics (95% CI: 1.3-1.7). Although the definite magnitude of the BP decrease due to antihypertension medication over time cannot be assessed definitely without a control group, our results suggest that BP reduction can be obtained with essential hypertension treatment in a large-scale programme in a resource-limited setting

Further investigation of confirmed urinary tract infection (UTI) in children under five years: a systematic review.

Background: Further investigation of confirmed UTI in children aims to prevent renal scarring and future complications. Methods: We conducted a systematic review to determine the most effective approach to the further investigation of confirmed urinary tract infection (UTI) in children under five years of age. Results: 73 studies were included. Many studies had methodological limitations or were poorly reported. Effectiveness of further investigations: One study found that routine imaging did not lead to a reduction in recurrent UTIs or renal scarring. Diagnostic accuracy: The studies do not support the use of less invasive tests such as ultrasound as an alternative to renal scintigraphy, either to rule out infection of the upper urinary tract (LR- = 0.57, 95%CI: 0.47, 0.68) and thus to exclude patients from further investigation or to detect renal scarring (LR+ = 3.5, 95% CI: 2.5, 4.8). None of the tests investigated can accurately predict the development of renal scarring. The available evidence supports the consideration of contrast-enhanced ultrasound techniques for detecting vesico-ureteric reflux (VUR), as an alternative to micturating cystourethrography (MCUG) (LR+ = 14.1, 95% CI: 9.5, 20.8; LR- = 0.20, 95%CI: 0.13, 0.29); these techniques have the advantage of not requiring exposure to ionising radiation. Conclusion: There is no evidence to support the clinical effectiveness of routine investigation of children with confirmed UTI. Primary research on the effectiveness, in terms of improved patient outcome, of testing at all stages in the investigation of confirmed urinary tract infection is urgently required

On the fatigue response of a bonded repaired aerospace composite using thermography

Lock-in thermography was employed to investigate the repair efficiency of a bonded repaired aerospace composite subjected to step-wise cycling mechanical loading. The studied component (substrate) was artificially damaged with a 5 mm circular notch and subsequently repaired with a tapered bonded patch. Critical and sub-critical damage of the repaired component was monitored via thermography during 5 Hz tension–tension fatigue. The examination of the acquired thermographs enabled the identification of the patch debonding propagation as well as the quantification of the stress magnification at the patch ends and the locus of the circular notch. It was found that fatigue mechanical loading yields both thermoelastic and hysterestic phenomena with the latter being more prominent prior to the failure of the studied repaired component

Natural History of Patients with Ischemia and No Obstructive Coronary Artery Disease: The CIAO-ISCHEMIA Study

Background: Ischemia with no obstructive coronary artery disease (INOCA) is common and has an adverse prognosis. We set out to describe the natural history of symptoms and ischemia in INOCA. Methods: CIAO-ISCHEMIA (Changes in Ischemia and Angina over One year in ISCHEMIA trial screen failures with INOCA) was an international cohort study conducted from 2014-2019 involving angina assessments (Seattle Angina Questionnaire [SAQ]) and stress echocardiograms 1-year apart. This was an ancillary study that included patients with history of angina who were not randomized in the ISCHEMIA trial. Stress-induced wall motion abnormalities were determined by an echocardiographic core laboratory blinded to symptoms, coronary artery disease (CAD) status and test timing. Medical therapy was at the discretion of treating physicians. The primary outcome was the correlation between changes in SAQ Angina Frequency score and change in echocardiographic ischemia. We also analyzed predictors of 1-year changes in both angina and ischemia, and compared CIAO participants with ISCHEMIA participants with obstructive CAD who had stress echocardiography before enrollment, as CIAO participants did. Results: INOCA participants in CIAO were more often female (66% of 208 vs. 26% of 865 ISCHEMIA participants with obstructive CAD, p\u3c0.001), but the magnitude of ischemia was similar (median 4 ischemic segments [IQR 3-5] both groups). Ischemia and angina were not significantly correlated at enrollment in CIAO (p=0.46) or ISCHEMIA stress echocardiography participants (p=0.35). At 1 year, the stress echocardiogram was normal in half of CIAO participants and 23% had moderate or severe ischemia (≥3 ischemic segments). Angina improved in 43% and worsened in 14%. Change in ischemia over one year was not significantly correlated with change in angina (rho=0.029). Conclusions: Improvement in ischemia and improvement in angina were common in INOCA, but not correlated. Our INOCA cohort had a similar degree of inducible wall motion abnormalities to concurrently enrolled ISCHEMIA participants with obstructive CAD. Our results highlight the complex nature of INOCA pathophysiology and the multifactorial nature of angina

How does study quality affect the results of a diagnostic meta-analysis?

Background: The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Although the primary diagnostic literature is extensive, studies are often of low methodological quality or poorly reported. There has been no rigorously evaluated, evidence based tool to assess the methodological quality of diagnostic studies. The primary objective of this study was to determine the extent to which variations in the quality of primary studies impact the results of a diagnostic meta-analysis and whether this differs with diagnostic test type. A secondary objective was to contribute to the evaluation of QUADAS, an evidence-based tool for the assessment of quality in diagnostic accuracy studies. Methods: This study was conducted as part of large systematic review of tests used in the diagnosis and further investigation of urinary tract infection (UTI) in children. All studies included in this review were assessed using QUADAS, an evidence-based tool for the assessment of quality in systematic reviews of diagnostic accuracy studies. The impact of individual components of QUADAS on a summary measure of diagnostic accuracy was investigated using regression analysis. The review divided the diagnosis and further investigation of UTI into the following three clinical stages: diagnosis of UTI, localisation of infection, and further investigation of the UTI. Each stage used different types of diagnostic test, which were considered to involve different quality concerns. Results: Many of the studies included in our review were poorly reported. The proportion of QUADAS items fulfilled was similar for studies in different sections of the review. However, as might be expected, the individual items fulfilled differed between the three clinical stages. Regression analysis found that different items showed a strong association with test performance for the different tests evaluated. These differences were observed both within and between the three clinical stages assessed by the review. The results of regression analyses were also affected by whether or not a weighting (by sample size) was applied. Our analysis was severely limited by the completeness of reporting and the differences between the index tests evaluated and the reference standards used to confirm diagnoses in the primary studies. Few tests were evaluated by sufficient studies to allow meaningful use of meta-analytic pooling and investigation of heterogeneity. This meant that further analysis to investigate heterogeneity could only be undertaken using a subset of studies, and that the findings are open to various interpretations. Conclusion: Further work is needed to investigate the influence of methodological quality on the results of diagnostic meta-analyses. Large data sets of well-reported primary studies are needed to address this question. Without significant improvements in the completeness of reporting of primary studies, progress in this area will be limited