Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)

Architecture And Logic Design Of A Discrete Wavelet Transform Processor

Since the advent of wavelets in the 1980s, wavelet analysis has been applied to many different applications, such as video and image compression, digital communications, biomedical signal processing, medical imaging, matrix computation, digital signal processing, and video-conferencing. In this thesis, we propose a dedicated VLSI architecture for implementing the discrete wavelet transform (DWT). In this architecture, a wavelet processor based on a generic reduced-instruction-set-computing (RISC) architecture is designed and optimised for the DWT

VLSI Design of a Wavelet Processing Core

A processing core architecture for the implementation of the discrete wavelet transform (DWT), optimized for throughput, scalability and programmability is proposed. The architecture is based on the RISC architecture with an instruction set specifically designed to facilitate the implementation of wavelet-based applications and a memory controller optimized for the memory access pattern of DWT processing

Implementation of speaker identification system by means of personal computer

Speech processing systems are highly complex and teaching students in this subject matter with the underlying technologies can be a challenging task. The aim of this work was to give a hands-on experience via a development of speech processing system based on the hidden Markov model (HMM) as a teaching aid. A method for implementing the speaker recognition system using our toolkit was developed as a dedicated laboratory environment for students. For speaker recognition, experiments were performed to evaluate the performance of the system with 30 speakers (22 impostors and 8 clients). The identification error was 2%, the false acceptance rate was 28% and the false rejection rate was 1%. The Teaching Module Speech Recognition (TMSR) toolkit was used in the lab which was part of the courses on digital signal processing (DSP) technology given by the Computer Engineering and Microelectronics Department. Students are given some initial guidance on how to use the toolkit and instructions to carry out the speaker identification experiments. Overall, the laboratory system was a success and plans are taken in the coming academic years to improve and extend the capability of the syste

Speaker recognition based on Hidden Markov Model

In this paper, a method for implementing speaker recognition system using the discrete Hidden Markov Model. This method uses a statistical approach in characterizing speech. The speech utterance is fit into a probabilistic framework, which consist of transition of states and discrete observable sequences. The system is then applied to recognition of isolated Bahasa Melayu digits, that is 'kosong', 'satu', 'dua', 'tiga', 'empat', 'lima', 'enam', 'tujuh', 'lapan', and ·sembilan'. Experiments were done to evaluate the system's perfomance on speaker recognition. which can be further divided into speaker identification and speaker verification. Speaker recognition, experiments were performed to evaluate the performance of the system with 30 speakers (22 impostors and 8 clients). The identification error was 2%, the false acceptance rate was 28% and the false rejection rate was 1%

An Enhanced Memory Address Mapping Scheme for Improved Memory Access Performance of 2-D DWT Processing Systems

The implementation of the memory for storing image and transform coefficients in 2-D DWT processing systems using the more cost-effective external memory module such as DDR DRAM is shown to suffer from effective memory bandwidth which is significantly lower than the memory system peak bandwidth if the conventional direct logical-to-physical memory address mapping is adopted. The low effective memory bandwidth is caused by the high level of memory overhead cycle occurrence which is in turn is closely related to the logical memory access patterns of 2-D DWT processes. The problem becomes even more severe for the 2-D DWT processing of video. An analysis on the logical memory access patterns of multi-level 2-D DWT is carried out and an enhanced logical-to-physical memory mapping scheme which minimizes the occurrence of memory overhead cycles is proposed. The proposed scheme is simulated and its performance in terms of effective memory access bandwidth is evaluated and compared with the conventional direct mapping scheme

SMG1 heterozygosity exacerbates haematopoietic cancer development in Atm null mice by increasing persistent DNA damage and oxidative stress

Suppressor of morphogenesis in genitalia 1 (SMG1) and ataxia telangiectasia mutated (ATM) are members of the PI3‐kinase like–kinase (PIKK) family of proteins. ATM is a well‐established tumour suppressor. Loss of one or both alleles of ATM results in an increased risk of cancer development, particularly haematopoietic cancer and breast cancer in both humans and mouse models. In mice, total loss of SMG1 is embryonic lethal and loss of a single allele results in an increased rate of cancer development, particularly haematopoietic cancers and lung cancer. In this study, we generated mice deficient in Atm and lacking one allele of Smg1, Atm−/−Smg1gt/+ mice. These mice developed cancers more rapidly than either of the parental genotypes, and all cancers were haematopoietic in origin. The combined loss of Smg1 and Atm resulted in a higher level of basal DNA damage and oxidative stress in tissues than loss of either gene alone. Furthermore, Atm−/−Smg1gt/+ mice displayed increased cytokine levels in haematopoietic tissues compared with wild‐type animals indicating the development of low‐level inflammation and a pro‐tumour microenvironment. Overall, our data demonstrated that combined loss of Atm expression and decreased Smg1 expression increases haematopoietic cancer development

Unmanned systems in integrating cross-domain naval fires

Systems Engineering Capstone Project ReportThe ability to communicate and transmit targeting data via the electromagnetic spectrum is crucial to the Navy's ability to fight. However, in recent years, potential adversaries have significantly advanced their electronic warfare capabilities, obtaining an ability to interfere with the Navy's use of the electromagnetic spectrum during operations in contested environments. SEA23 investigates concepts of operation focusing on future potential electromagnetic-spectrum warfighting capabilities in the 2025Ð2030 timeframe. Specifically, we explore these capabilities using modular unmanned and manned platforms capable of carrying communications and data suites to enable cross-domain targeting information in support of tactical offensive operations in a contested, denied, degraded, intermittent, and limited-bandwidth environment. This project focuses on developing a system-of-systems architecture and analyzing alternatives to provide potential solutions while developing the associated concepts of operation. We recommend an architecture based on Link 16 and organic rotary-wing unmanned aerial vehicles to transfer sensor to shooter data in demanding and contested environments.http://archive.org/details/unmannedsystemsi1094549381Approved for public release; distribution is unlimited

A rat model of ataxia-telangiectasia: evidence for a neurodegenerative phenotype

Ataxia-telangiectasia (A-T), an autosomal recessive disease caused by mutations in the ATM gene is characterised by cerebellar atrophy and progressive neurodegeneration which has been poorly recapitulated in Atm mutant mice. Consequently, pathways leading to neurodegeneration in A-T are poorly understood. We describe here the generation of an Atm knockout rat model that does not display cerebellar atrophy but instead paralysis and spinal cord atrophy, reminiscent of that seen in older patients and milder forms of the disorder. Loss of Atm in neurons and glia leads to accumulation of cytosolic DNA, increased cytokine production and constitutive activation of microglia consistent with a neuroinflammatory phenotype. Rats lacking ATM had significant loss of motor neurons and microgliosis in the spinal cord, consistent with onset of paralysis. Since short term treatment with steroids has been shown to improve the neurological signs in A-T patients we determined if that was also the case for Atm-deficient rats. Betamethasone treatment extended the lifespan of Atm knockout rats, prevented microglial activation and significantly decreased neuroinflammatory changes and motor neuron loss. These results point to unrepaired damage to DNA leading to significant levels of cytosolic DNA in Atm-deficient neurons and microglia and as a consequence activation of the cGAS-STING pathway and cytokine production. This in turn would increase the inflammatory microenvironment leading to dysfunction and death of neurons. Thus the rat model represents a suitable one for studying neurodegeneration in A-T and adds support for the use of anti-inflammatory drugs for the treatment of neurodegeneration in A-T patients

SYNAPSE: An international roadmap to large brain imaging

10.1016/j.physrep.2022.11.003PHYSICS REPORTS-REVIEW SECTION OF PHYSICS LETTERS9991-6