An agent based architecture for cognitive spectrum management

In the recent years, wireless technologies and devices have progressed dramatically that has augmented the demand for electromagnetic spectrum. Some research work showed that spectrum access and provision to user is not possible due to shortage of spectrum but federal communication commission refused to accept this theory and indicated that the spectrum is available since most of the frequency bands are underutilized. In order to allow the use of these frequency bands without interference, cognitive radio was proposed that characterizes the growing intelligence of radio systems can adapt to the radio environment, allowing opportunistic usage and sharing with the existing uses of spectrum. To take this concept a step further, we propose to use intelligent agent for spectrum management in the context of cognitive radio in this paper. In our proposed architecture, agents are embedded in the radio devices that coordinate their operations to benefit from network and avoid interference with the primary user. Agents carry a set of modules to gather information about the terminal status and the radio environment and act accordingly to the constraints of the user application

Assessing emergency medical care in low income countries: A pilot study from Pakistan

Background: Emergency Medical Care is an important component of health care system. Unfortunately it is however, ignored in many low income countries. We assessed the availability and quality of facility-based emergency medical care in the government health care system at district level in a low income country - Pakistan. Methods: We did a quantitative pilot study of a convenience sample of 22 rural and 20 urban health facilities in 2 districts - Faisalabad and Peshawar - in Pakistan. The study consisted of three separate cross-sectional assessments of selected community leaders, health care providers, and health care facilities. Three data collection instruments were created with input from existing models for facility assessment such as those used by the Joint Commission of Accreditation of Hospitals and the National Center for Health Statistics in USA and the Medical Research Council in Pakistan. Results: The majority of respondents 43/44(98%), in community survey were not satisfied with the emergency care provided. Most participants 36/44(82%) mentioned that they will not call an ambulance in health related emergency because it does not function properly in the government system. The expenses on emergency care for the last experience were reported to be less than 5,000 Pakistani Rupees (equivalent to US$ 83) for 19/29(66%) respondents. Most health care providers 43/44(98%) were of the opinion that their facilities were inadequately equipped to treat emergencies. The majority of facilities 31/42(74%) had no budget allocated for emergency care. A review of medications and equipment available showed that many critical supplies needed in an emergency were not found in these facilities. Conclusion: Assessment of emergency care should be part of health systems analysis in Pakistan. Multiple deficiencies in emergency care at the district level in Pakistan were noted in our study. Priority should be given to make emergency care responsive to needs in Pakistan. Specific efforts should be directed to equip emergency care at district facilities and to organize an ambulance network

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Fault detection and remote monitoring of robotic manipulator using Internet of Things (IoT)

Abstract Remote monitoring of industrial machines is important in order to have high productivity continuous process control. New emerging technologies such as Internet of Things (IoT), are facilitating the process of automation and remote controlling in multiple ways. In this research work, a robotic manipulator based on PUMA robot structure and an intelligent remote maintenance system is developed aimed to ensure the continual accurate operation of a robotic manipulator. Entire manipulator is designed from different types of motors like DC motors, stepper motors and servo motors along with their motor drivers. Various types of sensors like Tachometer, DHT11 Temperature and Humidity sensor, Capacitance meter and EMF Detector are also designed and interfaced with the manipulator for identification of different faults. Android App and Wi-Fi module are used for the remote-controlled automation purposes. The authors were succeeded in detecting various faults in the robotic manipulator and notifying the operator in real-time

Triphasic Helical CT Scan :Value of Arterial Phase Acquisition in Detection of Focal Lesion in Cirrhotic Liver

Background: To determine the value of triple phaseCT scan and the phase acquisition in which maximumtumour conspicuity can be obtained, in a population ofpatients with chronic liver disease.Methods: In this descriptive study tripahsic CT scan of50 chronic liver disease patients who presented withsonographic suspicion of space occupying lesion, wereevaluated. CT scan appearances of different focal liverlesions , in arterial and portal venous phases, wereevaluated . Tumour conspicuity was assessed on differentphases of CT acquisition to determine the phase whichprovided maximum tumour to parenchymal difference,while using multidetector CT with fixed timing delay.Results: Focal hepatic lesion was found to be present in41 out of 50 patients. 24 patients had morphologicalcharacteristics of hepatocellular carcinoma(HCC). Tumourwas found to be most conspicuous in late arterial phase ofacquisition in 30 patientsConclusion: Triphasic helical CT of liver, using early,late arterial and portal venous phases with fixed timingdelays is quick, easy and non-invasive useful imagingmodality in detection and characterization of focal lesionsand especially diagnosis of HCC in cirrhotic patients

An agent based architecture for cognitive spectrum management

In the recent years, wireless technologies and devices have progressed dramatically that has augmented the demand for electromagnetic spectrum. Some research work showed that spectrum access and provision to user is not possible due to shortage of spectrum but federal communication commission refused to accept this theory and indicated that the spectrum is available since most of the frequency bands are underutilized. In order to allow the use of these frequency bands without interference, cognitive radio was proposed that characterizes the growing intelligence of radio systems can adapt to the radio environment, allowing opportunistic usage and sharing with the existing uses of spectrum. To take this concept a step further, we propose to use intelligent agent for spectrum management in the context of cognitive radio in this paper. In our proposed architecture, agents are embedded in the radio devices that coordinate their operations to benefit from network and avoid interference with the primary user. Agents carry a set of modules to gather information about the terminal status and the radio environment and act accordingly to the constraints of the user application

Surgical rescue of embolized amplatzer devices.

Background and Aim: Transcatheter closure of atrial septal defect (ASD) and patent ductus arteriosus (PDA) with Amplatzer septal/duct occluder (ASO/ADO) is an established, safe, and efficient procedure with high success. However, device embolization remains a major complication requiring immediate intervention (either percutaneous or surgical) for retrieval and correction of the heart defect. The aim of this study is to share the experience of managing embolized ASO/ADO. Methods: Of the 284 cases of device closure performed from October 2002 to December 2010, four Patients (1.4%) had device embolization requiring immediate surgical retrieval. Two adult female Patients with secundum ASD had ASO device implanted. One embolized to the right ventricle and the other into the ascending aorta. An eight-month-old boy and a four-year-old girl with hypertensive PDA had device closure. Device embolization occurred into the descending aorta and right pulmonary artery, respectively. Results: All four devices were retrieved and the defects closed successfully with a low morbidity and no mortality. Conclusion: Careful consideration should be given to surgical or transcatheter closure of a heart defect. Life-threatening complications although rare can occur. Our experience strongly suggests that these devices should only be inserted in facilities where cardiac surgical support is immediately available

Accompanying effects of sewage sludge and pine needle biochar with selected organic additives on the soil and plant variables

The effects of synthetic fertilizer and nutrient leaching are causing serious problems impacting soil function and its fertility. Mitigation of nutrient leaching and use of chemical fertilizer is crucial as fertile land adds up sustainability to climate changes. Biochar produced from agricultural bio-waste and municipal solid waste has been used for crop production and when applied in combination with organic nutrients may support mitigation of nutrient loss and adverse effects of chemical fertilizers. Different types of biochar and their application for soil enhancement have been observed, pine needle and sewage sludge derived low-temperature biochar along with compost, organic fertilizer in the form of manure and microalgal biomass may interact with soil chemistry and plant growth to impact nutrient loss and compensate the hazardous effect of chemical fertilizer, but it has not been investigated yet. This present study elaborates application of sewage sludge and pine needle biochar produced at 400 °C in an application rate of 5 % w/w and 10 t h-1 in combination with compost, manure and microalgal biomasses of Closteriopsis acicularis (BM1) and Tetradesmus nygaardi (BM2) on the growth of Chickpea (Cicer arietinum) and Fenugreek (Trigonella foenum-graecum) crop assessed in a pot experiment over a two crop (Chickpea - Fenugreek) cycle in Pakistan. Results depict that the pine needle biochar with additives has increased plant height by 104.1 ± 2.76 cm and fresh biomass by 49.9 ± 1.02 g, buffered the soil pH to 6.5 for optimum growth of crops and enhance carbon retention by 36 %. This study highlights the valorization of sewage sludge and pine needle into biochar and the effect of biochar augmentation, its impact on soil nutrients and plant biomass enhancement. The greener approach also mitigates and helps in the sustainable management of solid wastes

Empiric Combination Antibiotic Therapy Is Associated with Improved Outcome against Sepsis Due to Gram-Negative Bacteria: a Retrospective Analysis ▿

The optimal approach for empirical antibiotic therapy in patients with severe sepsis and septic shock remains controversial. A retrospective cohort study was conducted in the intensive care units of a university hospital. The data from 760 patients with severe sepsis or septic shock associated with Gram-negative bacteremia was analyzed. Among this cohort, 238 (31.3%) patients received inappropriate initial antimicrobial therapy (IIAT). The hospital mortality rate was statistically greater among patients receiving IIAT compared to those initially treated with an appropriate antibiotic regimen (51.7% versus 36.4%; P < 0.001). Patients treated with an empirical combination antibiotic regimen directed against Gram-negative bacteria (i.e., β-lactam plus aminoglycoside or fluoroquinolone) were less likely to receive IIAT compared to monotherapy (22.2% versus 36.0%; P < 0.001). The addition of an aminoglycoside to a carbapenem would have increased appropriate initial therapy from 89.7 to 94.2%. Similarly, the addition of an aminoglycoside would have increased the appropriate initial therapy for cefepime (83.4 to 89.9%) and piperacillin-tazobactam (79.6 to 91.4%). Logistic regression analysis identified IIAT (adjusted odds ratio [AOR], 2.30; 95% confidence interval [CI] = 1.89 to 2.80) and increasing Apache II scores (1-point increments) (AOR, 1.11; 95% CI = 1.09 to 1.13) as independent predictors for hospital mortality. In conclusion, combination empirical antimicrobial therapy directed against Gram-negative bacteria was associated with greater initial appropriate therapy compared to monotherapy in patients with severe sepsis and septic shock. Our experience suggests that aminoglycosides offer broader coverage than fluoroquinolones as combination agents for patients with this serious infection