Modeling of Neuropathic Bladder Lesions Diagnosis Using Neural Network Algorithm.

The urinary bladder is probably the only visceral smooth-muscle organ that is under complete voluntary control from the cerebral cortex. Normal bladder function requires interaction of sensory and motor components of both the somatic and autonomic nervous system. Recent advances in the understanding of neural pathways and neurotransmitters have shown that most levels of the nervous system are involved in the regulation of voiding function. Therefore many neuralgic diseases causes changes in the bladder function [1]. In this paper, Number of patients selected from Ibn-Alkiff hospital (for treatment and rehabilitation of Spinal cord injuries), in Baghdad, who were referred to the urology department for complains of some urinary symptoms, and examined by cystometry in the urology out patient and/or inpatient department. These cases were selected randomly who already consult these departments and were followed up and managed by the expert urosurgeons. They were adults complaining of general neuropathic bladder disorder symptoms like frequency, urgency, dysuria, urinary incontinence and were diagnosed as having neuropathic bladder disease, whether: Upper motor neuropathic bladder lesions. Lower motor neuropathic bladder lesions. And finally they were examined by cystometry. The collections of data from patients were about: Accommodation (compliance). • Bladder capacity. • Contractility. • Sensation. • Voluntary control. These data with the final definition diagnosis about the neuropathic bladder lesion were processed to 3- layers Neural Network algorithm that was constructed in a matlab computer package. Consequently after all data processing, the neural network model was tested by its capability of processing an already diagnosed neuropathic bladder case and its accuracy in explaining the real neurological bladder behavior of that selected patien

Magnetic resonance imaging of the left wrist: assessment of the bone age in a sample of healthy Iraqi adolescent males

Background: Use of magnetic resonance imaging (MRI) to calculate skeletal age is a novel idea. MRI provides excellent soft-tissue contrast and multiplanar cross-sectional imaging capability. It could be used as an alternative method of skeletal age determination. Objectives: To study the value of MRI in estimating the age of healthy Iraqi adolescent males and to compare the obtained results with other countries records. Population and methods: This cross sectional study was applied on 179 healthy adolescent males between the ages of 13 to18 years in MRI unit at radiology institute in medical city, Baghdad – Iraq. This study was carried out from November 2011 to December 2012. Magnetic resonance imaging of the left wrist was performed by using a 1.5Tesla machine with surface coil. The sequence used was coronal T1weighted images (WI). The degree of fusion of the left distal radial physis was determined by a newly developed grading system. Results: There is high correlation between chronological age and degree of fusion of distal radius within the participant population. Most adolescent boys in the age group between 13 and 14 years presented as grade I and II, while the complete fusion was found at the age of 17and18 years, the mean age of participants was 17.5 years. Degree of fusion of the distal radius in the sample of the study was almost approaching the obtained values in the Algeria and Malaysia as comparative countries. Conclusion: MRI offers an alternative; non-invasive method of examination of the epiphysial fusion, which eliminates any risk associated with standard radiographic rating. The grading system can accurately identify the variable degrees of epiphysial fusion in an objective teachable manner

Abdominal computed tomography findings in patients with exudative ascites

Background: peritoneal cavity can be involved in inflammatory and malignant diseases and using computed tomography (CT) findings of exudative ascites may help in the differentiation. Objectives: 1-Describe CT features in patients with exudative ascites.2-Obtain useful CT findings to differentiate between tuberculous (TB) peritonitis and peritoneal carcinomatosis. Patients &methods: A cross sectional study conducted in Medical City Teaching Complex from September 2009 to September 2010 studied patients with exudative ascites using CT scan and confirmed later with histopathology examination. CT scan results were presented according to cytology examination and biochemical analysis. Results: 35 patients with exudative ascites were studied, including 19 males &16 females, age varied from 20 to73 years. While the amount of ascites(large or small) did not show statistically significant association with malignant disease, the density of ascitic fluid was slightly higher in TB[range(18-22)Hounsfield Unit(HU),mean is 20HU]compared to malignant ascites [range(15-20)HU ,mean is 18HU].Right subphrenic ascitic collections are associated with malignant disease (12 or 60% compared to 2 or 13.3% in TB) and pelvic ascitic collections were associated with TB disease (8 or 53.3% compared to 3 or 15% in malignant disease). Conclusion: In addition to omental cake &thickened bowel wall, malignant exudative ascites on CT scan is likely to have lower density, located in the right subphrenic space than in the pelvic region compared to benign (tuberculous) exudative ascites المقدمة :هذه الدراسة للتفريق بين مسببات الاستسقاء النضحي الحميدة والخبيثة باستخدام المفراس الحلزوني. الاهداف: وصف مشاهدات المفراس الحلزوني في الاستسقاء النضحي، استخدام مشاهدات المفراس الحلزوني للتفريق بين مسببات الاستسقاء النضحي الحميدة والخبيثة المرضى والطرائق: لقد تم دراسة 35 مريض يعانون من استسقاء البطن عن طريق الاختيار العشوائي للمرضى في وحدة المفراس لمستشفيات مدينة الطب التعليمية للفترة من ايلول 2009 الى ايلول 2010, وتم تأكيد النتيجة من الفحص المختبري,هؤلاء المرضى مكونين من 19 ذكر و16 أنثى .وكانت أعمار المرضى تتراوح بين 20-73. النتائج: وجدنا ان كثافة سائل الاستسقاء كانت مرتفعة عند مرضى التدرن البريتوني (20 وحدة هاونسفيلد) بالمقارنة مع المسسببات الخبيثة للاستسقاء النضحي (15 وحدة هاونسفيلد) يكون تجمع الاستسقاء في الناحية تحت الحجاب اليمنى في المسببات الخبيثة (12 او 60% بالمقارنة مع 2 او 13.3% في المسببات الحميدة ) والتجمع في الناحية الحوضية اكثر في مرضى التدرن (8 او 53.3% بالمقارنة مع 3 او 15 % في المسببات الخبيثة). الاستنتاج: اضافة الى الكعكة الثربية والتثخن في جدار الامعاء, يكون الاستسقاء النضحي ذو المسببات الخبيثة بكثافة اقل ويكثر تواجده في الناحية تحت الحجاب اليمنى بالمقارنة مع المسببات الحميدة للاستسقا

Low temperature decreases bone mass in mice: Implications for humans

ObjectivesHumans exhibit significant ecogeographic variation in bone size and shape. However, it is unclear how significantly environmental temperature influences cortical and trabecular bone, making it difficult to recognize adaptation versus acclimatization in past populations. There is some evidence that cold‐induced bone loss results from sympathetic nervous system activation and can be reduced by nonshivering thermogenesis (NST) via uncoupling protein (UCP1) in brown adipose tissue (BAT). Here we test two hypotheses: (1) low temperature induces impaired cortical and trabecular bone acquisition and (2) UCP1, a marker of NST in BAT, increases in proportion to degree of low‐temperature exposure.MethodsWe housed wildtype C57BL/6J male mice in pairs at 26 °C (thermoneutrality), 22 °C (standard), and 20 °C (cool) from 3 weeks to 6 or 12 weeks of age with access to food and water ad libitum (N = 8/group).ResultsCool housed mice ate more but had lower body fat at 20 °C versus 26 °C. Mice at 20 °C had markedly lower distal femur trabecular bone volume fraction, thickness, and connectivity density and lower midshaft femur cortical bone area fraction versus mice at 26 °C (p < .05 for all). UCP1 expression in BAT was inversely related to temperature.DiscussionThese results support the hypothesis that low temperature was detrimental to bone mass acquisition. Nonshivering thermogenesis in brown adipose tissue increased in proportion to low‐temperature exposure but was insufficient to prevent bone loss. These data show that chronic exposure to low temperature impairs bone architecture, suggesting climate may contribute to phenotypic variation in humans and other hominins.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146428/1/ajpa23684.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146428/2/ajpa23684_am.pd

Tulosperusteiset rahoitusmallit kalastonhoidon vauhdittajina

Ympäristöhaasteiden ratkaiseminen vaatii systeemisiä muutoksia ja rahallisia panostuksia. Samaan aikaan julkisen sektorin kyvykkyys rahoittaa vaadittavia toimenpiteitä on heikentynyt julkisen talouden kasvavan kestävyysvajeen vuoksi. On tärkeää kehittää aktiivisesti uusia rahoitustapoja, jotka tehostavat julkisen rahan vaikuttavuutta sekä perustuvat malleihin, joilla yksityistä sijoituspääomaa pystytään hyödyntämään ympäristötavoitteiden edistämisessä nykyistä enemmän. Uudet tulosperusteiset rahoitusmallit siirtävät tarkastelun tarkkaan rajattujen suoritteiden tai toimien hankinnasta tulosten ja vaikutusten perusteella tapahtuviin maksuihin ja muuttavat nykyiset ympäristöhaasteet sijoituskohteiksi. Kalavarojen tilan parantaminen on tärkeä yhteiskunnallinen tavoite, jonka saavuttaminen edellyttää onnistumisia mm. kalastuksen säätelyssä, vaellusreittien avaamisessa ja veden tilan parantamisessa. Esiselvityksessä tarkastellaan minkälaisiin tavoitteisiin ja toimenpiteisiin tulosperusteiset rahoitus- ja hankintamallit voisivat soveltua kalavarojen tilaa parantavien toimien osalta. Lisäksi työssä arvioidaan uudenlaisten rahastomallien mahdollisuuksia lisätä yksityistä rahoitusta tai sijoituspääomaa kalataloudellisten kunnostusten toteuttamiseen. Selvitystyön perusteella tavoitteena on käynnistää pilotointityö tulosperusteisista rahoitusmalleista kalataloudellisissa kunnostuksissa

Seniors' experiences of living in special housing accommodation

This article presents a hermeneutic phenomenological analysis of interview material in which 12 seniors living in Special Housing Accommodation (SHA) facilities reflect on the experience of living in such facilities. Of particular interest in the analysis is living in a SHA as a phenomenon. The finding shows that the phenomenon of lived experience in a SHA seems to be a state of ambiguity regarding one's existence, which is made up of several constituents (elements of meaning). The analysis contributes to the understanding of how the phenomenon of SHA living is coming into existence as a need, due to an individual's failing health; however, the SHA is not considered to be a true home. Accordingly, this has consequences to the subject position for the seniors in that they have to navigate between existing and not existing. The seniors learn to cope with living in the SHA by lowering their expectations of life and existence while the SHA provides the prerequisites for their existence. An implication for promoting care is to support the seniors to enable a full existence of life within SHA living

Scenario trees and policy selection for multistage stochastic programming using machine learning

We propose a hybrid algorithmic strategy for complex stochastic optimization problems, which combines the use of scenario trees from multistage stochastic programming with machine learning techniques for learning a policy in the form of a statistical model, in the context of constrained vector-valued decisions. Such a policy allows one to run out-of-sample simulations over a large number of independent scenarios, and obtain a signal on the quality of the approximation scheme used to solve the multistage stochastic program. We propose to apply this fast simulation technique to choose the best tree from a set of scenario trees. A solution scheme is introduced, where several scenario trees with random branching structure are solved in parallel, and where the tree from which the best policy for the true problem could be learned is ultimately retained. Numerical tests show that excellent trade-offs can be achieved between run times and solution quality

Home: The place the older adult can not imagine living without

<p>Abstract</p> <p>Background</p> <p>Rapidly aging populations with an increased desire to remain at home and changes in health policy that promote the transfer of health care from formal places, as hospitals and institutions, to the more informal setting of one's home support the need for further research that is designed specifically to understand the experience of home among older adults. Yet, little is known among health care providers about the older adult's experience of home. The aim of this study was to understand the experience of home as experienced by older adults living in a rural community in Sweden.</p> <p>Methods</p> <p>Hermeneutical interpretation, as developed by von Post and Eriksson and based on Gadamer's philosophical hermeneutics, was used to interpret interviews with six older adults. The interpretation included a self examination of the researcher's experiences and prejudices and proceeded through several readings which integrated the text with the reader, allowed new questions to emerge, fused the horizons, summarized main and sub-themes and allowed a new understanding to emerge.</p> <p>Results</p> <p>Two main and six sub-themes emerged. Home was experienced as the place the older adult could not imagine living without but also as the place one might be forced to leave. The older adult's thoughts vacillated between the well known present and all its comforts and the unknown future with all its questions and fears, including the underlying threat of loosing one's home.</p> <p>Conclusions</p> <p>Home has become so integral to life itself and such an intimate part of the older adult's being that when older adults lose their home, they also loose the place closest to their heart, the place where they are at home and can maintain their identity, integrity and way of living. Additional effort needs to be made to understand the older adult's experience of home within home health care in order to minimize intrusion and maximize care. There is a need to more fully explore the older adult's experience with health care providers in the home and its impact on the older adult's sense of "being at home" and their health and overall well-being.</p