Secure and Efficient Video Transmission in VANET

Currently, vehicular communications have become a reality used by various applications, especially applications that broadcast video in real time. However, the video quality received is penalized by the poor characteristics of the transmission channel (availability, non-stationarity, the ration of signal-to-noise, etc.). To improve and ensure minimum video quality at reception, we propose in this work a mechanism entitled “Secure and Efficient Transmission of Videos in VANET (SETV)”. It's based on the "Quality of Experience (QoE)" and using hierarchical packet management. This last is based on the importance of the images of the stream video. To this end, the use of transmission error correction with uneven error protection has proven to be effective in delivering high quality videos with low network overhead. This is done based on the specific details of video encoding and actual network conditions such as signal to noise ratio, network density, vehicle position and current packet loss rate (PLR) not to mention the prediction of the future DPP.Machine learning models were developed on our work to estimate perceived audio-visual quality. The protocol previously gathers information about its neighbouring vehicles to perform distributed jump reinforcement learning. The simulation results obtained for several types of realistic vehicular scenarios show that our proposed mechanism offers significant improvements in terms of video quality on reception and end-to-end delay compared to conventional schemes. The results prove that the proposed mechanism has showed 11% to 18% improvement in video quality and 9% load gain compared to ShieldHEVC

Machbarkeit und Sicherheit einer kombinierten Therapie mittels transarterieller Chemoembolisation mit Irinotecan beladenen Mikrosphären (DEBIRI-TACE) und CT- gesteuerter Hochdosis-Brachytherapie (CT-HDRBT) zur Behandlung von großen, nicht resektablen kolorektalen Lebermetastasen

Background: Globally, colorectal cancer is the third most common type of cancer and the incidence is constantly increasing. The presence of liver metastases is related to a poor outcome, especially if there are no surgical options for the removal of the metastases, due to their size or unfavorable anatomical location. Interventional therapies are therefore being increasingly used in palliative settings. Purpose: This prospective trial evaluated feasibility and safety of combined irinotecan Chemoembolization (DEBIRI-TACE) and CT-guided high-dose-rate brachytherapy (CT- HDRBT) in patients with unresectable colorectal liver metastases > 3 cm in diameter. Materials and Methods: 23 patients (age: 70 years ± 11.3) with 47 colorectal liver metastases (size: 62 mm ± 18.7) were recruited in the trial between December 2015 and December 2017. Catheter-related adverse events were reported per Society of Interventional Radiology classification, and treatment toxicities were reported per Common Terminology Criteria for Adverse Events. Liver blood tests before and after intervention were compared using Wilcoxon test, considering results with p < 0.05 as significant. Time to local tumor progression, progression-free survival (PFS), and overall survival (OS) were estimated by Kaplan–Meier method. Results: No catheter-related major or minor complications were recorded. The periinterventioal mortality was zero. There were significant differences in baseline vs. follow-up levels of aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT); both p < 0.001, gamma-glutamyltransferase (GGT; p = 0.013), and hemoglobin (p = 0.014). After therapy, 12 of 23 patients (52,1%) presented with new grade I/II toxicities (bilirubin, n = 3 [13%]; ASAT, n = 16 [70%]; ALAT, n = 18 [78%]; ALP, n = 12 [52%] and hemoglobin, n = 15 [65%]). Moreover, grade III/IV toxicities developed in 10 (43.5%; 1 grade IV): ASAT, n = 6 (26%), grade III, n = 5; grade IV, n = 1; ALAT, n = 3 (13%); GGT, n = 7 (30%); and hemoglobin, n = 1 (4%). However, all new toxicities resolved within 3 months after therapy without additional treatment. Median local tumor control, PFS, and OS were 6, 4, and 8 months, respectively. Conclusion: DEBIRI-TACE and HDRBT is safe and shows low incidence of toxicities, which were self-resolving.Das kolorektale Karzinom ist die dritthäufigste maligne Erkrankung weltweit und die Inzidenz zeigt eine steigende Tendenz. Hepatisch metastasierte kolorektale Karzinome gehen mit einer ungünstigen Prognose einher, da die Lebermetastasen aufgrund ihrer Anzahl, Größe oder anatomischen Lage oft nicht resektabel sind. Aus diesem Grund werden minimal invasive Therapieverfahren zunehmend im Rahmen von multidisziplinären Therapiekonzepten eingesetzt. Fragestellung: Die vorliegende prospektive Studie untersuchte die Machbarkeit und Sicherheit der Kombination einer transarteriellen Chemoembolisation mit Irinotecan beladenen Mikrosphären (DEBIRI-TACE) und einer CT-gesteuerten Hochdosis- Brachytherapie (CT-HDRBT) bei Patienten mit nicht-resektablen kolorektalen Lebermetastasen mit einem Durchmesser > 3 cm. Material und Methodik: 23 Patienten (70 Jahre ± 11.3) mit insgesamt 47 kolorektale Lebermetastasen (62 mm ± 18.7) erhielten im Zeitraum zwischen Dezember 2015 und Dezember 2017 die oben genannte Kombinationstherapie. Die Therapie-assoziierten Komplikationen wurden nach der Klassifikation der Society of Interventional Radiology erfasst, und die Therapietoxizität nach den Kriterien "Common Terminology Criteria for Adverse Events (CTCAE) version 4.0“ eingestuft. Die prä- und postinterventionellen Leberfunktionsparameter wurden mittels Wilcoxon-Tests verglichen und p < 0.05 als Signifikanzniveau festgelegt. Die sekundären Endpunkte (lokale Tumorkontrolle (LTC), progressionsfreies Überleben (PFS) und Gesamtüberleben (OS)) wurden anhand der Kaplan-Meier Methode analysiert. Ergebnisse: Bei keinem der Patienten wurden milde oder schwerwiegende periinterventionelle Komplikationen festgestellt. Es wurden signifikante Unterschiede einzelner Blutwerte prä- und postinterventionell beobachtet: Aspartat-Aminotransferase (ASAT, p < 0.001), Alanin-Aminotransferase (ALAT, p < 0.001), Gamma- Glutamytransferase (GGT, p = 0.013) sowie Hämoglobin (Hb, p = 0.014). Nach dem Kombinationsverfahren zeigte sich bei 12 Patienten (52.1%) eine Lebertoxizität ersten und zweiten Grades (Bilirubin, n = 3 [13%]; ASAT, n = 16 [70%]; ALA T, n = 18 [78 %]; AP, n = 12 [52%] und Hämoglobin, n = 15 [65%]), bei 9 Patienten (43.5%) eine Lebertoxizität dritten Grades, und ausschließlich bei einem Patienten eine Lebertoxizität vierten Grades (ASAT, n = 6 (26%), Grad III, n = 5; Grad IV, n = 1; ALAT, n = 3 (13%); GGT, n = 7 (30%); Hb, n = 1 (4%)). Bei allen Patienten zeigte sich die Lebertoxizität nach drei Monaten vollständig regredient ohne spezifische Therapie. Lokale Tumorkontrolle, progressionsfreies Überleben, sowie Gesamtüberleben betrugen durchschnittlich jeweils 6, 4 und 8 Monate. Schlussfolgerung: Das Kombinationsverfahren mittels transarterieller Chemoembolisation mit Irinotecan beladenen Mikrosphären und CT-gesteuerter Hochdosis-Brachytherapie ist ein sicheres Verfahren. Die Therapie-assoziierte Toxizität ist gering und selbstlimitierend

The uterine choriocarcinoma in postmenopausal women: specificities of diagnosis and treatment

Choriocarcinoma is a gestational trophoblastic tumor that mainly affects women of childbearing age. Cases of choriocarcinoma in postmenopausal women are exceptional. Through an observation and literature review, we propose to study the specific diagnosis and treatment features of this tumor in menopausal women. We report the observation of a pure uterine choriocarcinoma, which occurred in post-menopause. The diagnosis was made on the analysis of surgical specimens confirmed by measurement of hCG. Chemotherapy was started after a total hysterectomy and bilateral salpingo-oophorectomy first. The improvement was dramatic after 3 courses of chemotherapy and the patient is in complete remission after five years of monitoring. The primitive forms of pure choriocarcinoma in postmenopausal women are exceptional. Their etiology is poorly understood and their treatment based on chemotherapy.Key words: Uterine choriocarcinoma; post menopause; gestational trophoblastic tumo

Mammary-like adenocarcinoma of the vulva associated to Paget’s disease: a case report

Mammary-like adenocarcinoma of the vulva associated to Paget's disease is exceedingly rare. So, it is very important to perform all the pathological and immunohistochemical investigations to achieve differential  diagnosis from both a metastatic lesion from an orthotopic breast cancer and a vulvar adnexal tumor. This report describes a case of vulvar Paget's disease associated with underlying mammary-like adenocarcinoma diagnosed in the Department of Obstetrics and Gynecology of Farhat Hached university hospital of Sousse in Tunisia. We also review previously reported cases of primary breast-like carcinoma of the vulva with or without Paget's diseaseKey words: Mammary-like adenocarcinoma, vulva, Paget´s diseas

Pulmonary Barotrauma Including Huge Pulmonary Interstitial Emphysema in an Adult with Status Asthmaticus: Diagnostic and Therapeutic Challenges

Introduction: Pulmonary interstitial emphysema is a rare finding defined as abnormal air collection inside the lung interstitial tissues. Described more frequently in ventilated new-borns, pulmonary interstitial emphysema is an uncommon barotrauma-related complication in adults. Management and clinical sequelae are poorly described. Patient: We describe the case of a 64-year-old man who presented with huge pulmonary interstitial emphysema together with simultaneous pulmonary barotrauma in status asthmaticus requiring invasive ventilation. Discussion: There are no guidelines for the management of such complications and their possible sequelae but conservative treatment seems to be effective. The treatment of our patient is described

Treatment of Acute Promyelocytic Leukemia with AIDA Based Regimen. Update of a Tunisian Single Center Study

In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two regimens combining ATRA and an anthracycline with cytarabine (APL93), and without cytarabine (LPA99). From 2004, 51 patients with confirmed APL either by t(15;17) or PML/RARA were treated according to the PETHEMA LPA 99 trial. Forty three patients achieved CR (86%). The remaining seven patients had early death (one died before treatment onset): four caused by differentiation syndrome (DS) and three died from central nervous system hemorrhage. Multivariate analysis revealed that female gender (P=0.045), baseline WBC> 10 G/L (P=0.041) and serum creatinine > 1.4mg/dl (P=0.021) were predictive of mortality during induction. DS was observed in 16 patients (32%) after a median onset time of 15 days from treatment onset (range, 2–29). Body mass index ≥ 30 (P=0.01) remained independent predictor of DS. Occurrence of hypertensive peaks significantly predicted occurrence of DS (P=0.011) and was significantly associated with high BMI (p=0.003). With a median follow-up of 50 months, 5 year cumulative incidence of relapse, event free and overall survival were 4.7%, 74% and 78%, respectively

Genetic Control of Canine Leishmaniasis: Genome-Wide Association Study and Genomic Selection Analysis

Background: the current disease model for leishmaniasis suggests that only a proportion of infected individuals develop clinical disease, while others are asymptomatically infected due to immune control of infection. The factors that determine whether individuals progress to clinical disease following Leishmania infection are unclear, although previous studies suggest a role for host genetics. Our hypothesis was that canine leishmaniasis is a complex disease with multiple loci responsible for the progression of the disease from Leishmania infection. Methodology/Principal Findings: genome-wide association and genomic selection approaches were applied to a population-based case-control dataset of 219 dogs from a single breed (Boxer) genotyped for ~170,000 SNPs. Firstly, we aimed to identify individual disease loci; secondly, we quantified the genetic component of the observed phenotypic variance; and thirdly, we tested whether genome-wide SNP data could accurately predict the disease. Conclusions/Significance: we estimated that a substantial proportion of the genome is affecting the trait and that its heritability could be as high as 60%. Using the genome-wide association approach, the strongest associations were on chromosomes 1, 4 and 20, although none of these were statistically significant at a genome-wide level and after correcting for genetic stratification and lifestyle. Amongst these associations, chromosome 4: 61.2-76.9 Mb maps to a locus that has previously been associated with host susceptibility to human and murine leishmaniasis, and genomic selection estimated markers in this region to have the greatest effect on the phenotype. We therefore propose these regions as candidates for replication studies. An important finding of this study was the significant predictive value from using the genomic information. We found that the phenotype could be predicted with an accuracy of ~0.29 in new samples and that the affection status was correctly predicted in 60% of dogs, significantly higher than expected by chance, and with satisfactory sensitivity-specificity values (AUC = 0.63)

Grand Challenges in global eye health: a global prioritisation process using Delphi method

Background: We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods: Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings: Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation: This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges. Funding: The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission. Translations: For the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section