Retinopathy of prematurity in infants with birth weight above 1500 grams

Objective: To identify the rate and prognosis of retinopathy of prematurity (ROP) among newborn infants of birthweight of above 1500 grams, and the possible risk factors associated with the disease.Design: A prospective cohort study.Setting: Neonatal unit at Maternity Hospital, Kuwait city, Kuwait.Methods: All low birth weight infants were examined for the presence of ROP in the period between January 1996 to December 1997. Prospective collection of data on babies who were above 1500 grams was done to find an association between the disease in these babies and some of the maternal and neonatal risk factors.Results: A total of 68 babies of birth weight above 1500 grams were screened for ROP out of which 13 (19.1%) had different stages of the disease. None of the patients had threshold disease requiring surgery. Among the risk factors chosen, oxygen therapy, presence ofhypotension at birth and the non-use of surfactant were the only risk factors to be associated with disease. However, with logistic regression analysis, none of these were independently associated with ROP.Conclusion: ROP may occur in newborn infants of larger birthweight but with good prognosis, and oxygen therapy seems to predispose to the disease

The intelligent cities conversion process based on AI and technologies integration: a systematic literature review

The vision of an intelligent city remains ambiguous, with multiple concepts indicating a gradual alignment over time between the ideas of a smart city and a sustainable city. Intelligent cities are considered an evolved concept of urban development, as they combine artificial intelligence and machine learning to form systems that can learn, adapt, and make decisions. A systematic literature review methodology is utilised to define the theoretical scope and to answer the research question. The analysis targeted comprehensive literature covering published topics on intelligent cities over the past twenty years, employing a reproducible and straightforward method to reduce bias by providing verifiable data processing details. The methodology includes identifying studies, explaining the selection process, conducting analysis and synthesis, and deriving conclusions. Eighty-six "intelligent city" papers were analysed by theme, methodology, and results. The literature on intelligent cities covers various topics, such as urban mobility, infrastructure development, risk management, AI integration, sustainability, ecosystems, community involvement, challenges, technological innovations, and inclusive governmental changes

THE INFLUENCE OF RESIN MODIFIERS ON THE PERFORMANCE OF HOT MIX ASPHALT

ABSTRACT In order to study the influence of resin modifiers materials on the performance of hot mix asphalts (HMA), two types of resin modifiers were selected. One was anUnsaturated Polyester Resin (UPR) and the other was an Epoxy Resin (ER). Also, unsaturated polyester resin mixed with 3% epoxy resin (UPRER) was used according to test results, which gave preference to 3% additions. Marshal test was conducted to study the stability, flow, bulk density, air voids (AV), voids in mineral aggregate (VMA) and voids filled with bitumen (VFA) for controlled hot asphalt mixtures and resin: modified mixtures at various resin modifiers contents. A computer program named BISAR was also used to determine the total stress, strain and displacement in x-y, and z-direction for flexible pavements constructed with these hot mix asphalts modified with resin additives.Experimental results showed that all resin-modified asphalt mixtures have higher flow, bulk density and VFA compared with control mixture. The stability of asphalt mixtures with UPPER was always higher than the control mixture. Unlike, for type ER and UPR the stability was lower than the control mixture up to 1% and 2% respectively then they increase. The UPRER gave higher stability, flow, AV and VMA than the other types. Moreover, the UPR gave the highest value of bulk density and VFA. The maximum stability occurs at 3% resin modifiers content for all types. The total stress and strain relatively increase with the increase of mix depth till 10 cm, then they decrease for all types of resin modifiers. The maximum total stresses and strain in case of UPRER are higher values than those achieved by ER and UPR respectively. The total displacement in case of UPRER is higher than that achieved by ER and UPR respectively. As resin modifiers can improve the field performance of asphalt mixes comprehensively, they will be of great benefit to the engineering field

Retinal Optic Disc Segmentation using Conditional Generative Adversarial Network

This paper proposed a retinal image segmentation method based on conditional Generative Adversarial Network (cGAN) to segment optic disc. The proposed model consists of two successive networks: generator and discriminator. The generator learns to map information from the observing input (i.e., retinal fundus color image), to the output (i.e., binary mask). Then, the discriminator learns as a loss function to train this mapping by comparing the ground-truth and the predicted output with observing the input image as a condition.Experiments were performed on two publicly available dataset; DRISHTI GS1 and RIM-ONE. The proposed model outperformed state-of-the-art-methods by achieving around 0.96% and 0.98% of Jaccard and Dice coefficients, respectively. Moreover, an image segmentation is performed in less than a second on recent GPU.Comment: 8 pages, Submitted to 21st International Conference of the Catalan Association for Artificial Intelligence (CCIA 2018

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Greedy Growing Enables High-Resolution Pixel-Based Diffusion Models

We address the long-standing problem of how to learn effective pixel-based image diffusion models at scale, introducing a remarkably simple greedy growing method for stable training of large-scale, high-resolution models. without the needs for cascaded super-resolution components. The key insight stems from careful pre-training of core components, namely, those responsible for text-to-image alignment {\it vs.} high-resolution rendering. We first demonstrate the benefits of scaling a {\it Shallow UNet}, with no down(up)-sampling enc(dec)oder. Scaling its deep core layers is shown to improve alignment, object structure, and composition. Building on this core model, we propose a greedy algorithm that grows the architecture into high-resolution end-to-end models, while preserving the integrity of the pre-trained representation, stabilizing training, and reducing the need for large high-resolution datasets. This enables a single stage model capable of generating high-resolution images without the need of a super-resolution cascade. Our key results rely on public datasets and show that we are able to train non-cascaded models up to 8B parameters with no further regularization schemes. Vermeer, our full pipeline model trained with internal datasets to produce 1024x1024 images, without cascades, is preferred by 44.0% vs. 21.4% human evaluators over SDXL

Knowledge of dental academics about the COVID-19 pandemic: a multi-country online survey

Background: COVID-19 is a global pandemic affecting all aspects of life in all countries. We assessed COVID-19 knowledge and associated factors among dental academics in 26 countries. Methods: We invited dental academics to participate in a cross-sectional, multi-country, online survey from March to April 2020. The survey collected data on knowledge of COVID-19 regarding the mode of transmission, symptoms, diagnosis, treatment, protection, and dental treatment precautions as well as participants’ background variables. Multilevel linear models were used to assess the association between dental academics’ knowledge of COVID-19 and individual level (personal and professional) and country-level (number of COVID-19 cases/ million population) factors accounting for random variation among countries. Results: Two thousand forty-five academics participated in the survey (response rate 14.3%, with 54.7% female and 67% younger than 46 years of age). The mean (SD) knowledge percent score was 73.2 (11.2) %, and the score of knowledge of symptoms was significantly lower than the score of knowledge of diagnostic methods (53.1 and 85.4%, P &lt; 0.0001). Knowledge score was significantly higher among those living with a partner/spouse than among those living alone (regression coefficient (B) = 0.48); higher among those with PhD degrees than among those with Bachelor of Dental Science degrees (B = 0.48); higher among those seeing 21 to 30 patients daily than among those seeing no patients (B = 0.65); and higher among those from countries with a higher number of COVID-19 cases/million population (B = 0.0007). Conclusions: Dental academics had poorer knowledge of COVID-19 symptoms than of COVID-19 diagnostic methods. Living arrangements, academic degrees, patient load, and magnitude of the epidemic in the country were associated with COVD-19 knowledge among dental academics. Training of dental academics on COVID-19 can be designed using these findings to recruit those with the greatest need

Knowledge of dental academics about the COVID-19 pandemic: a multi-country online survey.

BACKGROUND: COVID-19 is a global pandemic affecting all aspects of life in all countries. We assessed COVID-19 knowledge and associated factors among dental academics in 26 countries. METHODS: We invited dental academics to participate in a cross-sectional, multi-country, online survey from March to April 2020. The survey collected data on knowledge of COVID-19 regarding the mode of transmission, symptoms, diagnosis, treatment, protection, and dental treatment precautions as well as participants' background variables. Multilevel linear models were used to assess the association between dental academics' knowledge of COVID-19 and individual level (personal and professional) and country-level (number of COVID-19 cases/ million population) factors accounting for random variation among countries. RESULTS: Two thousand forty-five academics participated in the survey (response rate 14.3%, with 54.7% female and 67% younger than 46 years of age). The mean (SD) knowledge percent score was 73.2 (11.2) %, and the score of knowledge of symptoms was significantly lower than the score of knowledge of diagnostic methods (53.1 and 85.4%, P <  0.0001). Knowledge score was significantly higher among those living with a partner/spouse than among those living alone (regression coefficient (B) = 0.48); higher among those with PhD degrees than among those with Bachelor of Dental Science degrees (B = 0.48); higher among those seeing 21 to 30 patients daily than among those seeing no patients (B = 0.65); and higher among those from countries with a higher number of COVID-19 cases/million population (B = 0.0007). CONCLUSIONS: Dental academics had poorer knowledge of COVID-19 symptoms than of COVID-19 diagnostic methods. Living arrangements, academic degrees, patient load, and magnitude of the epidemic in the country were associated with COVD-19 knowledge among dental academics. Training of dental academics on COVID-19 can be designed using these findings to recruit those with the greatest need

Perceived preparedness of dental academic institutions to cope with the COVID-19 pandemic: a multi-country survey

Dental academic institutions are affected by COVID-19. We assessed the perceived COVID19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics’ and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics’ and institutions’ attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = −1.31, p = 0.006) and upper-middle income (UMICs) (B = −0.98, p = 0.02) countries than in high-income countries (HICs), in teaching only (B = −0.55, p &lt; 0.0001) and in research only (B = −1.22, p = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving &gt;100 patients (B = −0.38, p &lt; 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, p &lt; 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care

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

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 middle-income 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 low-income 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 low-income, 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