Endoscopic Management of Gastric Polyp with Outlet Obstruction without Polypectomy

Although gastric polyp is usually an incidental endoscopic finding, large-sized polyps can cause symptoms ranging from epigastralgia to bleeding from ulcerated polyps and gastric outlet obstruction. Although the gold standard of treatment is removal of the polyp either through endoscopic polypectomy or surgical excision, complications associated with these procedures cannot be ignored. The risk becomes a major concern for patients at high risk for surgery when complications arise. We describe a debilitated 74-year-old woman who presented with early satiety, intermittent postprandial nausea and vomiting for three months. Upper endoscopy revealed a 2.5 cm pedunculated polyp over the gastric antrum causing intermittent obstruction. Considering her high risk for polypectomy, detachable snaring was performed without polypectomy in an outpatient setting. The patient was complication-free with complete relief of obstructive symptoms one week after the procedure. Subsequent follow-ups showed satisfactory healing without signs of mucosal disruption or recurrence. The results suggest that detachable snaring without polypectomy may be a therapeutic option for high-risk patients with benign symptomatic gastric polyps

Multicore and FPGA implementations of emotional-based agent architectures

The final publication is available at Springer via http://dx.doi.org/10.1007/s11227-014-1307-6.Control architectures based on Emotions are becoming promising solutions for the implementation of future robotic agents. The basic controllers of the architecture are the emotional processes that decide which behaviors of the robot must activate to fulfill the objectives. The number of emotional processes increases (hundreds of millions/s) with the complexity level of the application, reducing the processing capacity of the main processor to solve complex problems (millions of decisions in a given instant). However, the potential parallelism of the emotional processes permits their execution in parallel on FPGAs or Multicores, thus enabling slack computing in the main processor to tackle more complex dynamic problems. In this paper, an emotional architecture for mobile robotic agents is presented. The workload of the emotional processes is evaluated. Then, the main processor is extended with FPGA co-processors through Ethernet link. The FPGAs will be in charge of the execution of the emotional processes in parallel. Different Stratix FPGAs are compared to analyze their suitability to cope with the proposed mobile robotic agent applications. The applications are set up taking into account different environmental conditions, robot dynamics and emotional states. Moreover, the applications are run also on Multicore processors to compare their performance in relation to the FPGAs. Experimental results show that Stratix IV FPGA increases the performance in about one order of magnitude over the main processor and solves all the considered problems. Quad-Core increases the performance in 3.64 times, allowing to tackle about 89 % of the considered problems. Quad-Core has a lower cost than a Stratix IV, so more adequate solution but not for the most complex application. Stratix III could be applied to solve problems with around the double of the requirements that the main processor could support. Finally, a Dual-Core provides slightly better performance than stratix III and it is relatively cheaper.This work was supported in part under Spanish Grant PAID/2012/325 of "Programa de Apoyo a la Investigacion y Desarrollo. Proyectos multidisciplinares", Universitat Politecnica de Valencia, Spain.Domínguez Montagud, CP.; Hassan Mohamed, H.; Crespo, A.; Albaladejo Meroño, J. (2015). Multicore and FPGA implementations of emotional-based agent architectures. Journal of Supercomputing. 71(2):479-507. https://doi.org/10.1007/s11227-014-1307-6S479507712Malfaz M, Salichs MA (2010) Using MUDs as an experimental platform for testing a decision making system for self-motivated autonomous agents. Artif Intell Simul Behav J 2(1):21–44Damiano L, Cañamero L (2010) Constructing emotions. Epistemological groundings and applications in robotics for a synthetic approach to emotions. In: Proceedings of international symposium on aI-inspired biology, The Society for the Study of Artificial Intelligence, pp 20–28Hawes N, Wyatt J, Sloman A (2009) Exploring design space for an integrated intelligent system. Knowl Based Syst 22(7):509–515Sloman A (2009) Some requirements for human-like robots: why the recent over-emphasis on embodiment has held up progress. Creat Brain Like Intell 2009:248–277Arkin RC, Ulam P, Wagner AR (2012) Moral decision-making in autonomous systems: enforcement, moral emotions, dignity, trust and deception. In: Proceedings of the IEEE, Mar 2012, vol 100, no 3, pp 571–589iRobot industrial robots website. http://www.irobot.com/gi/ground/ . Accessed 22 Sept 2014Moravec H (2009) Rise of the robots: the future of artificial intelligence. Scientific American, March 2009. http://www.scientificamerican.com/article/rise-of-the-robots/ . 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Proc IEEE 100(3):571–589Salichs MA, Malfaz M (2012) A new approach to modeling emotions and their use on a decision-making system for artificial agents. Affect Comput IEEE Trans 3(1):56–68Altera Corporation (2011) Stratix III device handbook, vol 1–2, version 2.2. http://www.altera.com/literature/lit-stx3.jsp . Accessed 14 Oct 2014.Altera Corporation (2014) Stratix IV device handbook, vol 1–4, version 5.9. http://www.altera.com/literature/lit-stratix-iv.jsp . Accessed 14 Oct 2014.Naouar MW, Monmasson E, Naassani AA, Slama-Belkhodja I, Patin N (2007) FPGA-based current controllers for AC machine drives: a review. IEEE Trans Ind Electr 54(4):1907–1925Intel Corporation (2014) Desktop 4th generation Intel Core Processor Family, Desktop Intel Pentium Processor Family, and Desktop Intel Celeron Processor Family, Datasheet, vol 1, 2March JL, Sahuquillo J, Hassan H, Petit S, Duato J (2011) A new energy-aware dynamic task set partitioning algorithm for soft and hard embedded real-time systems. 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In: Proceedings of international joint conference on neural networks, IEEE (IJCNN’2013)IBM Cognitive Computing and Neurosynaptic chips website. http://www.research.ibm.com/cognitive-computing/neurosynaptic-chips.shtml . Accessed 22 Sept 2014Seo E, Jeong J, Park S, Lee J (2008) Energy efficient scheduling of real-time tasks on multicore processors. IEEE Trans Parallel Distrib Syst 19(11):1540–1552Lehoczky J, Sha L, Ding Y (1989) The rate monotonic scheduling algorithm: exact characterization and average case behavior. In: Proceedings of real time systems symposium, IEEE 1989, pp 166–171Ng-Thow-Hing V, Lim J, Wormer J, Sarvadevabhatla RK, Rocha C, Fujimura K, Sakagami Y (2008) The memory game: creating a human-robot interactive scenario for ASIMO. In: Proceedings of intelligent robots and systems, 2008, IROS 2008, IEEE/RSJ international conference, pp 779–78

In vivo biocompatibility assessment of (PTFE–PVDF–PP) terpolymer-based membrane with potential application for glaucoma treatment

The aim of the work was to evaluate the in vivo biological behaviour of polymeric membrane materials for glaucoma implants. The base material was biostable synthetic terpolymer (PTFE–PVDF–PP) with proved biocompability (PN-EN ISO 10993). The samples manufactured in the form a membrane were subjected to chemical and physical treatment to create an open pore system within the polymer matrix. As a porogenic phase biodegradable natrium alginate in a fibrous form was employed. The non-perforating deep sclerectomy technique was performed in a rabbit model. The clinical observations were made after 14 and 30 days. During the study clinical symptoms of a moderate degree were observed, and histopathological changes were typical for foreign body implantation. At the end stage of the study no significant difference in histopathological assessment was found between control and experimental group. Similarities observed in both groups and relatively mild histopathological changes in the tissue surrounding the implant indicate that the observed symptoms come from a deep scleral trauma caused by surgery, and not by the presence of the implant itself

Midwall Fibrosis Is an Independent Predictor of Mortality in Patients With Aortic Stenosis

ObjectivesThe goal of this study was to assess the prognostic significance of midwall and infarct patterns of late gadolinium enhancement (LGE) in aortic stenosis.BackgroundMyocardial fibrosis occurs in aortic stenosis as part of the hypertrophic response. It can be detected by LGE, which is associated with an adverse prognosis in a range of other cardiac conditions.MethodsBetween January 2003 and October 2008, consecutive patients with moderate or severe aortic stenosis undergoing cardiovascular magnetic resonance with administration of gadolinium contrast were enrolled into a registry. Patients were categorized into absent, midwall, or infarct patterns of LGE by blinded independent observers. Patient follow-up was completed using patient questionnaires, source record data, and the National Strategic Tracing Service.ResultsA total of 143 patients (age 68 ± 14 years; 97 male) were followed up for 2.0 ± 1.4 years. Seventy-two underwent aortic valve replacement, and 27 died (24 cardiac, 3 sudden cardiac deaths). Compared with those with no LGE (n = 49), univariate analysis revealed that patients with midwall fibrosis (n = 54) had an 8-fold increase in all-cause mortality despite similar aortic stenosis severity and coronary artery disease burden. Patients with an infarct pattern (n = 40) had a 6-fold increase. Midwall fibrosis (hazard ratio: 5.35; 95% confidence interval: 1.16 to 24.56; p = 0.03) and ejection fraction (hazard ratio: 0.96; 95% confidence interval: 0.94 to 0.99; p = 0.01) were independent predictors of all-cause mortality by multivariate analysis.ConclusionsMidwall fibrosis was an independent predictor of mortality in patients with moderate and severe aortic stenosis. It has incremental prognostic value to ejection fraction and may provide a useful method of risk stratification. (The Prognostic Significance of Fibrosis Detection in Cardiomyopathy; NCT00930735

A Step Forward in Molecular Diagnostics of Lyssaviruses – Results of a Ring Trial among European Laboratories

Rabies is a lethal and notifiable zoonotic disease for which diagnostics have to meet the highest standards. In recent years, an evolution was especially seen in molecular diagnostics with a wide variety of different detection methods published. Therefore, a first international ring trial specifically designed on the use of reverse transcription polymerase chain reaction (RT-PCR) for detection of lyssavirus genomic RNA was organized. The trial focussed on assessment and comparison of the performance of conventional and real-time assays. In total, 16 European laboratories participated. All participants were asked to investigate a panel of defined lyssavirus RNAs, consisting of Rabies virus (RABV) and European bat lyssavirus 1 and 2 (EBLV-1 and -2) RNA samples, with systems available in their laboratory. The ring trial allowed the important conclusion that conventional RT-PCR assays were really robust assays tested with a high concordance between different laboratories and assays. The real-time RT-PCR system by Wakeley et al. (2005) in combination with an intercalating dye, and the combined version by Hoffmann and co-workers (2010) showed good sensitivity for the detection of all RABV samples included in this test panel. Furthermore, all used EBLV-specific assays, real-time RT-PCRs as well as conventional RT-PCR systems, were shown to be suitable for a reliable detection of EBLVs. It has to be mentioned that differences were seen in the performance between both the individual RT-PCR systems and the laboratories. Laboratories which used more than one molecular assay for testing the sample panel always concluded a correct sample result. Due to the markedly high genetic diversity of lyssaviruses, the application of different assays in diagnostics is needed to achieve a maximum of diagnostic accuracy. To improve the knowledge about the diagnostic performance proficiency testing at an international level is recommended before using lyssavirus molecular diagnostics e.g. for confirmatory testing