Day case complex devices: the state of the UK.

Objective: Complex cardiac devices including implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy (CRT) devices can safely be implanted as a day case procedure as opposed to overnight stay. We assess how common day case complex device therapy is and the cost implications of more widespread adoption across the UK. Methods: A freedom of information request was sent to all centres performing complex cardiac devices across the UK to assess the adoption of this technique. Cost implications were assessed using Department of Health National Schedule of Reference Costs 2016-2017. Results: 100 UK centres were surveyed, 80% replied. Eighty per cent of UK centres already implant complex cardiac devices as a day case to some extent. 64.06% of centres have a protocol for this. 12.82% of centres do 75% as day case. There was no relationship between centre volume and the proportion of devices done as a day case as opposed to overnight stay. The cost saving of performing a complex device as a day case as opposed to overnight stay was £412 per ICD, £525 per CRT-pacemaker and £2169 per CRT-defibrillator. Conclusions: Day case complex devices are already widespread across the UK, however, there is scope for increase. An increase in proportion of day case devices could translate to £5 583 265 in savings annually for the National Health Service if all centres performed 75% of devices as a day case

Deep Learning Algorithms for the Detection of Suspicious Pigmented Skin Lesions in Primary Care Settings: A Systematic Review and Meta- Analysis

Early detection of suspicious pigmented skin lesions is crucial for improving the outcomes and survival rates of skin cancers. However, the accuracy of clinical diagnosis by primary care physicians (PCPs) is suboptimal, leading to unnecessary referrals and biopsies. In recent years, deep learning (DL) algorithms have shown promising results in the automated detection and classification of skin lesions. This systematic review and meta-analysis aimed to evaluate the diagnostic performance of DL algorithms for the detection of suspicious pigmented skin lesions in primary care settings. A comprehensive literature search was conducted using electronic databases, including PubMed, Scopus, IEEE Xplore, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science. Data from eligible studies were extracted, including study characteristics, sample size, algorithm type, sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and receiver operating characteristic curve analysis. Three studies were included. The results showed that DL algorithms had a high sensitivity (90%, 95% CI: 90-91%) and specificity (85%, 95% CI: 84-86%) for detecting suspicious pigmented skin lesions in primary care settings. Significant heterogeneity was observed in both sensitivity (p = 0.0062, I² = 80.3%) and specificity (p < 0.001, I² = 98.8%). The analysis of DOR and PLR further demonstrated the strong diagnostic performance of DL algorithms. The DOR was 26.39, indicating a strong overall diagnostic performance of DL algorithms. The PLR was 4.30, highlighting the ability of these algorithms to influence diagnostic outcomes positively. The NLR was 0.16, indicating that a negative test result decreased the odds of misdiagnosis. The area under the curve of DL algorithms was 0.95, indicating excellent discriminative ability in distinguishing between benign and malignant pigmented skin lesions. DL algorithms have the potential to significantly improve the detection of suspicious pigmented skin lesions in primary care settings. Our analysis showed that DL exhibited promising performance in the early detection of suspicious pigmented skin lesions. However, further studies are needed

Multiple Reflection Symmetry Detection via Linear-Directional Kernel Density Estimation

Symmetry is an important composition feature by investigating similar sides inside an image plane. It has a crucial effect to recognize man-made or nature objects within the universe. Recent symmetry detection approaches used a smoothing kernel over different voting maps in the polar coordinate system to detect symmetry peaks, which split the regions of symmetry axis candidates in inefficient way. We propose a reliable voting representation based on weighted linear-directional kernel density estimation, to detect multiple symmetries over challenging real-world and synthetic images. Experimental evaluation on two public datasets demonstrates the superior performance of the proposed algorithm to detect global symmetry axes respect to the major image shapes

Ductility considerations in seismic design of reinforced concrete frame buildings according to the Eurocode 8

The Eurocode 8 included three ductility classes: ductility class high (DC H), ductility class medium (DC M) and ductility class low (DC L). The aim of the present work is to give a full analysis of the implication during the design stage of the ductility class for the reinforced concrete frame structures regarding the Eurocode 8. To carry out the proposed study, a regular RC frame building has been designed in different hazard seismic zones for the three ductility classes according to the seismic design rules mentioned in Eurocode 8. In the end, nonlinear pushover analysis was used to assess the design of the frames. The results show that DC M has a high performance close to DC H, even in the high hazard seismic zones, and the cost of DC M frame is close to the costs of DC H frame, which could be less, if the workmanship is included, because DC H will cost more for the workmanship according to its complexity of the detailing.info:eu-repo/semantics/publishedVersio

Prevalence of HCV Infection in Household Contacts of Chronic Liver Diseases Cases in Egypt

Background. Egypt has the highest prevalence of HCV infection worldwide. This project aimed at identifying the role of HCV transmission among household contacts to index cases in the persistent high incidence of HCV infection in Egypt. Methods. This cross-sectional study recruited 70 Egyptian cases with chronic liver diseases and their household contacts (140 contacts) from Qalubeyia Governorate. An interview questionnaire was used to collect information on sociodemographic characteristics and risk factors to HCV infection. HCV-RNA was tested using real-time polymerase chain reaction (PCR). Univariate and multivariate analyses were carried out to estimate the risk of HCV infection among contacts. Results. HCV viremia was detected in 85.7% of cases and 20% of contacts. HCV-RNA was detected in higher proportion of household contacts to cases than the general population. Contacts to HCV-positive cases were unlikely exposed to used syringe (P=0.02) and unlikely to have history of Bilharziasis (P=0.001) compared to contacts to HCV-negative cases. HCV-positive contacts were more likely older (P<0.001) and married (P=0.008) and had higher crowding index (P=0.04) than HCV-negative contacts. Also, HCV-positive contacts were more likely exposed to blood transfusion (P=0.008) and shaving at community barber (P=0.04) and had history of Bilharziasis (P=0.01). The strongest predictors for HCV infection among contacts were old age (OR, 95% CI: 1.08, 1.02 to 1.15; P=0.01) and blood transfusion (8.08, 1.75 to 37.3; P=0.007). Conclusion. Nonetheless, household contacts to HCV cases are exposed to increased risk of HCV infection, and environmental exposure particularly blood transfusion remained a major source of HCV infection

Does vitamin C have the ability to augment the therapeutic effect of bone marrow-derived mesenchymal stem cells on spinal cord injury?

Methylprednisolone (MP) is currently the only drug confirmed to exhibit a neuroprotective effect on acute spinal cord injury (SCI). Vitamin C (VC) is a natural water-soluble antioxidant that exerts neuroprotective effects through eliminating free radical damage to nerve cells. Bone marrow mesenchymal stem cells (BMMSCs), as multipotent stem cells, are promising candidates in SCI repair. To evaluate the therapeutic effects of MP, VC and BMMSCs on traumatic SCI, 80 adult male rats were randomly divided into seven groups: control, SCI (SCI induction by weight-drop method), MP (SCI induction, followed by administration of 30 mg/kg MP via the tail vein, once every other 6 hours, for five times), VC (SCI induction, followed by intraperitoneal administration of 100 mg/kg VC once a day, for 28 days), MP + VC (SCI induction, followed by administration of MP and VC as the former), BMMSCs (SCI induction, followed by injection of 3 × 106 BMMSCs at the injury site), and BMMSCs + VC (SCI induction, followed by BMMSCs injection and VC administration as the former). Locomotor recovery was assessed using the Basso Mouse Scale. Injured spinal cord tissue was evaluated using hematoxylin-eosin staining and immunohistochemical staining. Expression of transforming growth factor-beta, tumor necrosis factor-alpha, and matrix metalloproteinase-2 genes was determined using real-time quantitative PCR. BMMSCs intervention better promoted recovery of nerve function of rats with SCI, mitigated nerve cell damage, and decreased expression of transforming growth factor-beta, tumor necrosis factor-alpha, and matrix metalloproteinase-2 genes than MP and/or VC. More importantly, BMMSCs in combination with VC induced more obvious improvements. These results suggest that VC can enhance the neuroprotective effects of BMMSCs against SCI

Is multiple tracts percutaneous nephrolithotomy (PCNL) safe modality in management of complex renal stones? A prospective study: Single center experience

Objectives : To evaluate and analyze the efficacy and the safety of multiple tracts PCNL in management of complex renal calculi.Patients and Methods : The study was conducted during the period between March 2016 till January 2017 on 265 patients with complex renal stones, all patients underwent multiple tracts PCNL, either with double or triple punctures, preoperative and postoperative laboratory and radiological results were compared together in correlation to the stone size, shape and site.Results: The results of our study have shown that increased size and complexity of stones is associated with increased number of punctures needed to achieve stone clearance, and the aggressive approach to complex renal calculi using multiple tracts PCNL is a safe and effective modality in management of complex renal calculi with acceptable complications.Conclusion: Number of percutaneous tracts needed for stone clearance was increased with the increase in stone size and complexity. Surgeon experience, accurate choosing puncture site and carefully performed multiple tracts will decrease the intra-operative and postoperative complications or transfusion requirements

منع تاكل الألومنيوم في حمض الهيدروكلوريك

The inhibitive effect of oximes, P-diketones and hydrazides, on the corrosion of aluminium in 2M HC1 has been investigated galvanostatically. The results suggest that, in presence of inhibitors, the anode is preferentially polarized under the influence of an external current. The order of decreasing inhibition efficiency among the three groups of compounds is: oximes > P-diketones > hydrazides. The inhibitors appear to function through a Temkin adsorption isotherm. The free energy of adsorption AG°a is.also computed and discussed.تم دراسة تأثير بعض مشتقات الاكزيم ، بيتا ثنائي الكيتون والهيدرازيد كموانع لتآكل الالمنيوم في محلول 2 عياري من حمض الهيدروكلوريك وذلك بالطريقة الجلفانوستاتيكية ومن الواضح أن هذه المواد تعمل خلال الادمصاص الكيميائي الضعيف تابعة أيزوثرم تمكن . كما تم التوصل إلى كفاءة استخدام هذه المواد كمثبطات للتأكل تزداد في الاتجاه : مشتقات الاكزيم > بيتا ثنائي الكيتون > الهيدرازيد . ومن نتائج هذه الطريقة يتبين أن هذه المواد تؤثر على التفاعل المصعدي وذلك تحت تأثير التيار الخارجي . وقد حسبت ونوقشت الطاقة الحرة القياسية للادمصاص