On the Transmission of Colour Image Over Double Generalized Gamma FSO Channel

In this paper performance analysis of colour image Free Space Optics (FSO) transmission over Double Generalized Gamma (DGG) turbulence communication channel is carried out. At the reception side, we have used an average bit error rate (ABER) for reconstructed image performance measure, as the function of FSO link transmission parameters, such as propagation distance, Rytov variance and turbulence shaping and severity parameters (γ1, γ2, m1, m2). Obtained results cover a large number of colour image FSO transmission scenarios, for Gamma-Gamma, Double-Weibull and K turbulence models channels considered as special cases

Pancreatic Cancer Malnutrition and Pancreatic Exocrine Insufficiency in the Course of Chemotherapy in Unresectable Pancreatic Cancer

Background: Malnutrition and cachexia are common in patients with advanced pancreatic ductal adenocarcinoma (PDAC) and have a significant influence on the tolerance and response to treatments. If timely identified, malnourished PDAC patients could be treated to increase their capacity to complete the planned treatments and, therefore, possibly, improve their efficacy. Aims: The aim of this study is to assess the impact of nutritional status, pancreatic exocrine insufficiency (PEI), and other clinical factors on patient outcomes in patients with advanced PDAC. Methods: PAncreatic Cancer MAlnutrition and Pancreatic Exocrine INsufficiency in the Course of Chemotherapy in Unresectable Pancreatic Cancer (PAC-MAIN) is an international multicenter prospective observational cohort study. The nutritional status will be determined by means of Mini-Nutritional Assessment score and laboratory blood tests. PEI will be defined by reduced fecal elastase levels. MAIN OUTCOME: adherence to planned chemotherapy in the first 12 weeks following the diagnosis, according to patients' baseline nutritional status and quantified and reported as "percent of standard chemotherapy dose delivered." SECONDARY OUTCOMES: rate of chemotherapy-related toxicity, progression-free survival, survival at 6 months, overall survival, quality of life, and the number of hospitalizations. ANALYSIS: chemotherapy dosing over the first 12 weeks of therapy (i.e., percent of chemotherapy received in the first 12 weeks, as defined above) will be compared between well-nourished and malnourished patients. SAMPLE SIZE: based on an expected percentage of chemotherapy delivered of 70% in well-nourished patients, with a type I error of 0.05 and a type II error of 0.20, a sample size of 93 patients per group will be required in case of a percentage difference of chemotherapy delivered of 20% between well-nourished and malnourished patients, 163 patients per group in case of a difference of 15% between the groups, and 356 patients per group in case of a 10% difference. Centers from Russia, Romania, Turkey, Spain, Serbia, and Italy will participate in the study upon Local Ethics Committee approval. Discussion: PAC-MAIN will provide insights into the role of malnutrition and PEI in the outcomes of PDAC. The study protocol was registered at clinicaltrials.gov as NCT04112836

PERFORMANCE OF MACRO DIVERSITY WIRELESS COMMUNICATION SYSTEM OPERATING IN WEIBUL MULTIPATH FADING ENVIRONMENT

In this paper, we consider wireless mobile radio communication system with macro diversity reception. Signal is subject to Weibull small scale fading and Gamma large scale fading resulting in system performance degradation. Receiver uses macro diversity selection combining (SC) technique in order to reduce the impact of long term fading effects, and two micro diversity SC branches are used to mitigate Weibull short term fading effects on system performance. Probability density function (PDF), and cumulative distribution function (CDF), as well as level crossing rate (LCR) and average fade duration (AFD) of the SC receiver output signal envelope are evaluated. The obtained expressions converge rapidly for all considered values of Weibull fading parameter and Gamma shadowing severity parameter. Mathematical results are studied in order to analyze the influence of Weibull fading parameter and Gamma shadowing severity parameter on statistical properties of the SC receiver output signal

CHANNEL CAPACITY OF THE MACRO-DIVERSITY SC SYSTEM IN THE PRESENCE OF KAPPA-MU FADING AND CORRELATED SLOW GAMMA FADING

In this paper macrodiversity system consisting of two microdiversity SC (Selection Combiner) receivers and one macrodiversity SC receiver are analyzed. Independent κ-μ fading and correlated slow Gamma fading are present at the inputs to the microdiversity SC receivers. For this system model, analytical expression for the probability density of the signal at the output of the macrodiversity receiver SC, and the output capacity of the macrodiversity SC receiver are calculated. The obtained results are graphically presented to show the impact of Rician κ factor, the shading severity of the channel c, the number of clusters µ and correlation coefficient ρ on the probability density of the signal at the output of the macrodiversity system and channel capacity at the output of the macrodiversity system. Based on the obtained results it is possible to analyze the real behavior of the macrodiversity system in the presence of  κ-μ fading

Metabolic maturation in the first 2 years of life in resource-constrained settings and its association with postnatal growths

Funding Information: The Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) is carried out as a collaborative project supported by the Bill & Melinda Gates Foundation (BMGF 47075), the Foundation for the National Institutes of Health, and the National Institutes of Health, Fogarty International Center, while additional support was obtained from BMGF for the examination of host innate factors on enteric disease risk and enteropathy (grants OPP1066146 and OPP1152146 to M.N.K.). Additional funding was obtained from the Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases of the Johns Hopkins School of Medicine (to M.N.K.). Publisher Copyright: Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution License 4.0 (CC BY).Peer reviewedPublisher PD

Detection of Significant Prostate Cancer Using Target Saturation in Transperineal Magnetic Resonance Imaging/Transrectal Ultrasonography-fusion Biopsy

BACKGROUND: Multiparametric magnetic resonance imaging (mpMRI) and targeted biopsies (TBs) facilitate accurate detection of significant prostate cancer (sPC). However, it remains unclear how many cores should be applied per target. OBJECTIVE: To assess sPC detection rates of two different target-dependent magnetic resonance imaging (MRI)/transrectal ultrasonography (TRUS)-fusion biopsy approaches (TB and target saturation [TS]) compared with extended systematic biopsies (SBs). DESIGN, SETTING, AND PARTICIPANTS: Retrospective single-centre outcome of transperineal MRI/TRUS-fusion biopsies of 213 men was evaluated. All men underwent TB with a median of four cores per MRI lesion, followed by a median of 24 SBs, performed by experienced urologists. Cancer and sPC (International Society of Urological Pathology grade group ≥2) detection rates were analysed. TB was compared with SB and TS, with nine cores per target, calculated by the Ginsburg scheme and using individual cores of the lesion and its "penumbra". OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Cancer detection rates were calculated for TS, TB, and SB at both lesion and patient level. Combination of SB + TB served as a reference. Statistical differences in prostate cancer (PC) detection between groups were calculated using McNemar's tests with confidence intervals. RESULTS AND LIMITATIONS: TS detected 99% of 134 sPC lesions, which was significantly higher than the detection by TB (87%, p = 0.001) and SB (82%, p < 0.001). SB detected significantly more of the 72 low-risk PC lesions than TB (99% vs 68%, p < 0.001) and 10% (p = 0.15) more than that detected by TS. At a per-patient level, 99% of men harbouring sPC were detected by TS. This was significantly higher than that by TB and SB (89%, p = 0.03 and 81%, p = 0.001, respectively). Limitations include limited generalisability, as a transperineal biopsy route was used. CONCLUSIONS: TS detected significantly more cases of sPC than TB and extended SB. Given that both 99% of sPC lesions and men harbouring sPC were identified by TS, the results suggest that this approach allows to omit SB cores without compromising sPC detection. PATIENT SUMMARY: Target saturation of magnetic resonance imaging-suspicious prostate lesions provides excellent cancer detection and finds fewer low-risk tumours than the current gold standard combination of targeted and systematic biopsies

“I’m Not Waving, I’m Drowning”: An Autoethnographical Exploration of Biographical Disruption and Reconstruction During Recovery From Prescribed Benzodiazepine Use

Benzodiazepines are group of drugs used mainly as sedatives, hypnotics, muscle relaxants, and anti-epileptics. Tapering off benzodiazepines is, for some users, a painful, traumatic, and protracted process. In this article, I use an autoethnographic approach, adopting the metaphor of water, to examine heuristically my experience of iatrogenic illness and recovery. I draw on personal journals and blog entries and former users’ narratives to consider the particular form of biographical disruption associated with benzodiazepines and the processes involved in identity reconstruction. I emphasize the role of the online community in providing benzodiazepine users such as myself with a co-cultural community through which to share a voice and make sense of our experiences. I explain how the success stories of former users provided me with the hope that I, the “medical victim,” could become the “victor” and in the process construct a new life and fresh identity

Orally active antischistosomal early leads identified from the open access malaria box.

BACKGROUND: Worldwide hundreds of millions of schistosomiasis patients rely on treatment with a single drug, praziquantel. Therapeutic limitations and the threat of praziquantel resistance underline the need to discover and develop next generation drugs. METHODOLOGY: We studied the antischistosomal properties of the Medicines for Malaria Venture (MMV) malaria box containing 200 diverse drug-like and 200 probe-like compounds with confirmed in vitro activity against Plasmodium falciparum. Compounds were tested against schistosomula and adult Schistosoma mansoni in vitro. Based on in vitro performance, available pharmacokinetic profiles and toxicity data, selected compounds were investigated in vivo. PRINCIPAL FINDINGS: Promising antischistosomal activity (IC50: 1.4-9.5 µM) was observed for 34 compounds against schistosomula. Three compounds presented IC50 values between 0.8 and 1.3 µM against adult S. mansoni. Two promising early leads were identified, namely a N,N'-diarylurea and a 2,3-dianilinoquinoxaline. Treatment of S. mansoni infected mice with a single oral 400 mg/kg dose of these drugs resulted in significant worm burden reductions of 52.5% and 40.8%, respectively. CONCLUSIONS/SIGNIFICANCE: The two candidates identified by investigating the MMV malaria box are characterized by good pharmacokinetic profiles, low cytotoxic potential and easy chemistry and therefore offer an excellent starting point for antischistosomal drug discovery and development

Constraining the Gap Size in the Disk around HD 100546 in the Mid-infrared

We refine the gap size measurements of the disk surrounding the Herbig Ae star HD 100546 in the N band. Our new mid-infrared interferometric (MIDI) data have been taken with the UT baselines and span the full range of orientations. The correlated fluxes show a wavy pattern in which the minima separation links to a geometrical structure in the disk. We fit each correlated flux measurement with a spline function, deriving the corresponding spatial scale, while assuming that the pattern arises interferometrically due to the bright emission from the inner disk and the opposing sides of the wall of the outer disk. We then fit an ellipse to the derived separations at their corresponding position angles, thereby using the observations to constrain the disk inclination to i = 47° ± 1° and the disk position angle to PA = 135⁰0 ± 2⁰5 east of north, both of which are consistent with the estimated values in previous studies. We also derive the radius of the ellipse to 15.7 ± 0.8 au. To confirm that the minima separations translate to a geometrical structure in the disk, we model the disk of HD 100546 using a semianalytical approach taking into account the temperature and optical depth gradients. Using this model, we simultaneously reproduce the level and the minima of the correlated fluxes and constrain the gap size of the disk for each observation. The values obtained for the projected gap size in different orientations are consistent with the separation found by the geometrical model