Differential Image Compression for Telemedicine: A Novel Approach

Telemedicine is one of the most emerging technologies of applied medical sciences. Medical information related to patients is transmitted and stored for references and consultations. Medical images occupy huge space; in order to transmit these images may delay the process of image transmission in critical times. Image compression techniques provide a better solution to combat bandwidth scarcity problems, and transmit same image in a much lower bandwidth requirements, more faster and at the same time maintain quality. In this paper a differential image compression method is developed in which medical images are taken from a wounded patient and are compressed to reduce the bit rate of these images. Results indicate that on average 25% compression on images is achieved with 3.5 MOS taken from medical doctors and other paramedical staff the ultimately user of the images

Study of Influence of Formulation Variables on Drug Release: Optimization of Sustained Release Matrix Tablets of Metoclopramide HCl Using Central Composite Experimental Design

Metoclopramide Hydrochloride (MCP), has a short half-life. In order to maintain therapeutic levels in blood, it administered in dose of 10-15 mg four times a day. Fluctuation in plasma concentration of drug is commonly observed for drugs that are rapidly absorbed and eliminated when used in long term therapy. This attribute makes metoclopramide a suitable candidate for controlled release delivery. In this work HPMC K4M was used as release rate controlling polymer for the development of controlled release tablet formulation. Experimental Design using CCRD was utilized to determine the influence of varying the concentration of different variables such as polymer and diluents on the release behavior of the drug from matrix tablets and optimization of formulation. Different SR formulation prepared were designed and optimized with the help of software Design Expert® version 10. Using Central Composite Rotatable Design (CCRD), fifteen formulations were selected and prepared using HPMC K4M, Avicel PH-102 and Lactose DC as variables. All the trial formulations were evaluated using different pharmacotechnical tests including hardness, friability, disintegration, dissolution. Online Dissolution apparatus type II and 900 ml different dissolution media in the pH range 1-6.8 and distilled water for dissolution. The drug release was studied by applying the dissolution models by DDSolver® software. Hixson-Crowell model was best fit to the F13 SR formulation. The CCRD experimental design was successfully used in optimization of sustained release Metoclopramide HCl formulation

A Finite-Time Robust Distributed Cooperative Secondary Control Protocol for Droop-Based Islanded AC Microgrids

In this research work, a resilient finite-time consensus-based distributed secondary control protocol is presented for droop-based distributed generating (DG) units of an islanded AC microgrid (MG). Through a multi-agent control structure, the DG units of the microgrid adjust their active power outputs so that they reach an agreed-upon value in a finite time. Concurrently, all the DG units are forced to operate with their frequencies regulated to the reference MG frequency in a finite time, despite time-varying load perturbations. Each DG unit is provided with a hierarchical control architecture, where the primary control is achieved using the droop control method, while the secondary control is established through the proposed distributed control protocol. The communication between DG units takes place over a sparse communication network. The proposed control protocol is robust to both small and sufficiently large communication latencies and it supports the plug-and-play feature of DG units. Different time-domain-based numerical simulations are carried out on a small as well as large microgrid testbenches in Matlab/Simulink and demonstrate the correctness and effectiveness of the proposed distributed control protocol. A comparative study is also presented with the existing distributed control protocol, and it is found that the proposed strategy is superior in its performance

Rearing of Rhipicephalus annulatus ticks on rabbits for the biological transmission of Anaplasma marginale

Background and Aim: Anaplasma marginale is an obligate intraerythrocytic rickettsial parasite that infects cattle in tropical and subtropical regions. There is no evidence that A. marginale inoculation can be used to culture Rhipicephalus annulatus in rabbits. This study aimed to determine the molting of R. annulatus larvae, nymphs, and adults on rabbits as well as nymphs and adults of R. annulatus on calves with or without A. marginale. Transstadial, horizontal, and transovarial transmissions of A. marginale in R. annulatus reared on rabbits and calves were evaluated. Materials and Methods: Engorged female ticks were collected from field samples of A. marginale-infected and non-infected cattle. We divided the eight rabbits into two groups: A and B. Group A rabbits were infected with A. marginale through parenteral inoculation, whereas Group B rabbits were kept as a control. The “clean rabbits” in Group B were observed for tick rearing without A. marginale. Polymerase chain reaction was used to screen A. marginale in rabbits and stages of tick. The complete life cycle of R. annulatus with or without A. marginale was observed on rabbits. Results: A 6.5-day longer life cycle was observed in ticks harboring A. marginale than in ticks without A. marginale. To observe transstadial transmission, transstadial, horizontal, and transovarial transmissions of A. marginale in R. annulatus ticks were experimentally observed in one clean calf fed separately with infected nymphs and female adult ticks. Conclusion: We experimentally observed transovarian, transstadial, and transovarial transmission of A. marginale in R. annulatus ticks as a biological vector reared on calves and rabbits. We used rabbits as a model animal for rearing R. annulatus ticks and culture of A. marginale. Keywords: Anaplasma marginale, horizontal, rabbits, Rhipicephalus annulatus, transovarial, transstadial

Mapping Pediatric Oncology Clinical Trial Collaborative Groups on the Global Stage

The global pediatric oncology clinical research landscape, particularly in Central and South America, Africa, and Asia, which bear the highest burden of global childhood cancer cases, is less characterized in the literature. Review of how existing pediatric cancer clinical trial groups internationally have been formed and how their research goals have been pursued is critical for building global collaborative research and data-sharing efforts, in line with the WHO Global Initiative for Childhood Cancer. METHODS: A narrative literature review of collaborative groups performing pediatric cancer clinical research in each continent was conducted. An inventory of research groups was assembled and reviewed by current pediatric cancer regional and continental leaders. Each group was narratively described with identification of common structural and research themes among consortia. RESULTS: There is wide variability in the structure, history, and goals of pediatric cancer clinical trial collaborative groups internationally. Several continental regions have longstanding endogenously-formed clinical trial groups that have developed and published numerous adapted treatment regimens to improve outcomes, whereas other regions have consortia focused on developing foundational database registry infrastructure supported by large multinational organizations or twinning relationships. CONCLUSION: There cannot be a one-size-fits-all approach to increasing collaboration between international pediatric cancer clinical trial groups, as this requires a nuanced understanding of local stakeholders and resources necessary to form partnerships. Needs assessments, performed either by local consortia or in conjunction with international partners, have generated productive clinical trial infrastructure. To achieve the goals of the Global Initiative for Childhood Cancer, global partnerships must be sufficiently granular to account for the distinct needs of each collaborating group and should incorporate grassroots approaches, robust twinning relationships, and implementation science

Hepatoprotective effects of methanol extract of Carissa opaca leaves on CCl4-induced damage in rat

<p>Abstract</p> <p>Background</p> <p><it>Carissa opaca </it>(Apocynaceae) leaves possess antioxidant activity and hepatoprotective effects, and so may provide a possible therapeutic alternative in hepatic disorders. The effect produced by methanolic extract of <it>Carissa opaca </it>leaves (MCL) was investigated on CCl₄-induced liver damages in rat.</p> <p>Methods</p> <p>30 rats were divided into five groups of six animals of each, having free access to food and water <it>ad libitum</it>. Group I (control) was given olive oil and DMSO, while group II, III and IV were injected intraperitoneally with CCl₄(0.5 ml/kg) as a 20% (v/v) solution in olive oil twice a week for 8 weeks. Animals of group II received only CCl₄. Rats of group III were given MCL intragastrically at a dose of 200 mg/kg bw while that of group IV received silymarin at a dose of 50 mg/kg bw twice a week for 8 weeks. However, animals of group V received MCL only at a dose of 200 mg/kg bw twice a week for 8 weeks. The activities of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and γ-glutamyltransferase (γ-GT) were determined in serum. Catalase (CAT), peroxidase (POD), superoxide dismutase (SOD), glutathione-S-transferase (GST), glutathione peroxidase (GSH-Px), glutathione reductase (GSR) and quinone reductase (QR) activity was measured in liver homogenates. Lipid peroxidation (thiobarbituric acid reactive substances; TBARS), glutathione (GSH) and hydrogen peroxide (H₂O₂) concentration was also assessed in liver homogenates. Phytochemicals in MCL were determined through qualitative and high performance liquid chromatography (HPLC) analysis.</p> <p>Results</p> <p>Hepatotoxicity induced with CCl₄was evidenced by significant increase in lipid peroxidation (TBARS) and H₂O₂level, serum activities of AST, ALT, ALP, LDH and γ-GT. Level of GSH determined in liver was significantly reduced, as were the activities of antioxidant enzymes; CAT, POD, SOD, GSH-Px, GSR, GST and QR. On cirrhotic animals treated with CCl₄, histological studies showed centrilobular necrosis and infiltration of lymphocytes. MCL (200 mg/kg bw) and silymarin (50 mg/kg bw) co-treatment prevented all the changes observed with CCl₄-treated rats. The phytochemical analysis of MCL indicated the presence of flavonoids, tannins, alkaloids, phlobatannins, terpenoids, coumarins, anthraquinones, and cardiac glycosides. Isoquercetin, hyperoside, vitexin, myricetin and kaempherol was determined in MCL.</p> <p>Conclusion</p> <p>These results indicate that MCL has a significant protective effect against CCl₄induced hepatotoxicity in rat, which may be due to its antioxidant and membrane stabilizing properties.</p

The Global COVID-19 Observatory and Resource Center for Childhood Cancer: A response for the pediatric oncology community by SIOP and St. Jude Global

The COVID-19 pandemic quickly led to an abundance of publications and recommendations, despite a paucity of information on how COVID-19 affects children with cancer. This created a dire need for a trusted resource with curated information and a space for the pediatric oncology community to share experiences. The Global COVID-19 Observatory and Resource Center for Childhood Cancer was developed, launched, and maintained by the International Society of Pediatric Oncology and St. Jude Children's Research Hospital. The three components (Resource Library, Global Registry, and Collaboration Space) complement each other, establishing a mechanism to generate and transfer knowledge rapidly throughout the community.Fil: Moreira, Daniel C.. St. Jude Children's Research Hospital; Estados UnidosFil: Sniderman, Elizabeth. St. Jude Children's Research Hospital; Estados UnidosFil: Mukkada, Sheena. St. Jude Children's Research Hospital; Estados UnidosFil: Chantada, Guillermo Luis. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; ArgentinaFil: Bhakta, Nickhill. St. Jude Children's Research Hospital; Estados UnidosFil: Foster, Whitney. St. Jude Children's Research Hospital; Estados UnidosFil: Avula, Meghana. St. Jude Children's Research Hospital; Estados UnidosFil: Homsi, Maysam R.. St. Jude Children's Research Hospital; Estados UnidosFil: Faughnan, Lane. St. Jude Children's Research Hospital; Estados UnidosFil: Happ, Brooke. St. Jude Children's Research Hospital; Estados UnidosFil: Andujar, Allyson. St. Jude Children's Research Hospital; Estados UnidosFil: Sonnenfelt, Jason. St. Jude Children's Research Hospital; Estados UnidosFil: Dalvi, Rashmi. Bombay Hospital And Medical Research Centre; IndiaFil: Frazier, A. Lindsay. No especifíca;Fil: Hessissen, Laila. Universite Mohammed V. Rabat; Otros paises de ÁfricaFil: Kearns, Pamela R.. No especifíca;Fil: Luna Fineman, Sandra. No especifíca;Fil: Moreno, Arturo. Hospital Universitario de Puebla; MéxicoFil: Saghir Khan, Muhammad. No especifíca;Fil: Sullivan, Michael. Royal Children's Hospital, Melbourne; AustraliaFil: Devidas, Meenakshi. St. Jude Children's Research Hospital; Estados UnidosFil: Santana, Victor. St. Jude Children's Research Hospital; Estados UnidosFil: Caniza, Miguela. St. Jude Children's Research Hospital; Estados UnidosFil: Pritchard Jones, Kathy. University College London; Estados UnidosFil: Rodriguez Galindo, Carlos. St. Jude Children's Research Hospital; Estados Unido

Outcomes of obstructed abdominal wall hernia: results from the UK national small bowel obstruction audit

Background: Abdominal wall hernia is a common surgical condition. Patients may present in an emergency with bowel obstruction, incarceration or strangulation. Small bowel obstruction (SBO) is a serious surgical condition associated with significant morbidity. The aim of this study was to describe current management and outcomes of patients with obstructed hernia in the UK as identified in the National Audit of Small Bowel Obstruction (NASBO). Methods: NASBO collated data on adults treated for SBO at 131 UK hospitals between January and March 2017. Those with obstruction due to abdominal wall hernia were included in this study. Demographics, co-morbidity, imaging, operative treatment, and in-hospital outcomes were recorded. Modelling for factors associated with mortality and complications was undertaken using Cox proportional hazards and multivariable regression modelling. Results: NASBO included 2341 patients, of whom 415 (17·7 per cent) had SBO due to hernia. Surgery was performed in 312 (75·2 per cent) of the 415 patients; small bowel resection was required in 198 (63·5 per cent) of these operations. Non-operative management was reported in 35 (54 per cent) of 65 patients with a parastomal hernia and in 34 (32·1 per cent) of 106 patients with an incisional hernia. The in-hospital mortality rate was 9·4 per cent (39 of 415), and was highest in patients with a groin hernia (11·1 per cent, 17 of 153). Complications were common, including lower respiratory tract infection in 16·3 per cent of patients with a groin hernia. Increased age was associated with an increased risk of death (hazard ratio 1·05, 95 per cent c.i. 1·01 to 1·10; P = 0·009) and complications (odds ratio 1·05, 95 per cent c.i. 1·02 to 1·09; P = 0·001). Conclusion: NASBO has highlighted poor outcomes for patients with SBO due to hernia, highlighting the need for quality improvement initiatives in this group

National prospective cohort study of the burden of acute small bowel obstruction

Background Small bowel obstruction is a common surgical emergency, and is associated with high levels of morbidity and mortality across the world. The literature provides little information on the conservatively managed group. The aim of this study was to describe the burden of small bowel obstruction in the UK. Methods This prospective cohort study was conducted in 131 acute hospitals in the UK between January and April 2017, delivered by trainee research collaboratives. Adult patients with a diagnosis of mechanical small bowel obstruction were included. The primary outcome was in‐hospital mortality. Secondary outcomes included complications, unplanned intensive care admission and readmission within 30 days of discharge. Practice measures, including use of radiological investigations, water soluble contrast, operative and nutritional interventions, were collected. Results Of 2341 patients identified, 693 (29·6 per cent) underwent immediate surgery (within 24 h of admission), 500 (21·4 per cent) had delayed surgery after initial conservative management, and 1148 (49·0 per cent) were managed non‐operatively. The mortality rate was 6·6 per cent (6·4 per cent for non‐operative management, 6·8 per cent for immediate surgery, 6·8 per cent for delayed surgery; P = 0·911). The major complication rate was 14·4 per cent overall, affecting 19·0 per cent in the immediate surgery, 23·6 per cent in the delayed surgery and 7·7 per cent in the non‐operative management groups (P < 0·001). Cox regression found hernia or malignant aetiology and malnutrition to be associated with higher rates of death. Malignant aetiology, operative intervention, acute kidney injury and malnutrition were associated with increased risk of major complication. Conclusion Small bowel obstruction represents a significant healthcare burden. Patient‐level factors such as timing of surgery, acute kidney injury and nutritional status are factors that might be modified to improve outcomes

Outcomes following small bowel obstruction due to malignancy in the national audit of small bowel obstruction

Introduction Patients with cancer who develop small bowel obstruction are at high risk of malnutrition and morbidity following compromise of gastrointestinal tract continuity. This study aimed to characterise current management and outcomes following malignant small bowel obstruction. Methods A prospective, multicentre cohort study of patients with small bowel obstruction who presented to UK hospitals between 16th January and 13th March 2017. Patients who presented with small bowel obstruction due to primary tumours of the intestine (excluding left-sided colonic tumours) or disseminated intra-abdominal malignancy were included. Outcomes included 30-day mortality and in-hospital complications. Cox-proportional hazards models were used to generate adjusted effects estimates, which are presented as hazard ratios (HR) alongside the corresponding 95% confidence interval (95% CI). The threshold for statistical significance was set at the level of P ≤ 0.05 a-priori. Results 205 patients with malignant small bowel obstruction presented to emergency surgery services during the study period. Of these patients, 50 had obstruction due to right sided colon cancer, 143 due to disseminated intraabdominal malignancy, 10 had primary tumours of the small bowel and 2 patients had gastrointestinal stromal tumours. In total 100 out of 205 patients underwent a surgical intervention for obstruction. 30-day in-hospital mortality rate was 11.3% for those with primary tumours and 19.6% for those with disseminated malignancy. Severe risk of malnutrition was an independent predictor for poor mortality in this cohort (adjusted HR 16.18, 95% CI 1.86 to 140.84, p = 0.012). Patients with right-sided colon cancer had high rates of morbidity. Conclusions Mortality rates were high in patients with disseminated malignancy and in those with right sided colon cancer. Further research should identify optimal management strategy to reduce morbidity for these patient groups