Throughput, Spectral, and Energy Efficiency of 5G Massive MIMO Applications Using Different Linear Precoding Schemes

— A promising massive multiple input multiple output (M-MIMO) system is required to meet the growing need for highly traffic data, highly-resolution of streaming video, and intelligent communication on the fifth-generation wireless networks (5G). M-MIMO systems are essential for the optimization of the trade between energy efficiency (EE), throughput (R), and spectral _efficiency (SE) in wireless 5G networks. M-MIMO system architecture is proposed in this paper to enhance the trade-off between energy efficiency and uplink and downlink throughput at the optimum EE. Furthermore, using linear precoding techniques such as M MMSE, RZF, ZF, and MR, the EE-SE trade-off is optimized for uplink and downlink (M-MIMO) systems. The analysis of simulation results proved that throughput (R) is enhanced by increasing the number of antennas at optimum EE. After that, the proposed trading scheme is optimized and improved using M_MMSE compared to RZF, ZF. Finally, the results prove that M_MMSE gives the optimum trade-off between EE and R at the proved optimum ratio between the number of active antennas and the number of active users UE

Libyan Experience in Congenital Heart Disease Interventions in Eastern region of Libya at National Heart Center Benghazi,2022.

ABSTRACT: Background: Interventional cardiology procedures are constantly increasing in management of structure heart disease in developing countries. Percutaneous catheterization   plays an important role in diagnosis and treatment of pediatric and adult with CHD included Trans catheter device, balloon angioplasty and valvoplasty, atrial septostomy. Aim of study: 1. To recognize the Libyan Experience in Congenital Heart Intervention in Eastern region of Libya. 2. To evaluate outcome of the non-surgical intervention in treatment of structure heart disease. Methods: Retrospective study was done include 192 of children and adult undergoing Percutaneous diagnostic and intervention catheterization at NHC in a period between 2011 and 2020. Patients were analysis according to type of catheterization either diagnostic or interventional and type of congenital heart disease. Result: Revealed that Diagnostic were 68 patients (35.4%) and 124 interventional patients (64.5%). (47.9%) were male and (52%) were female ,42 patients (21.8%) underwent ASDs, PFO Transcatheter closure, 37 patients (19.2%) were Transcatheter closure of PDA, 27 patients (14%) were pulmonary balloon valvuloplasty, (11) patients (5.7%) were coronary angiography, (5) patients (2.6%) were atrial septostomy and (2) patients (1%) ballowen angio to COA stent. Complication in 2 patients (1%), failure in 2 patients (1%) and no death.Conclusion: - Transcatheter intervention is an alternative to surgical intervention to repair certain types of congenital heart disease (CHD) with less morbidity and mortality than the surgical method of treatment.Key words: -NHC: National Heart Center NHC, CHD: Congenital Heart Disease, ASD: Atrial Septal Defect, PFO: Patent Foramen Ovale. PDA: Patent Ducts Arteriosus.  TGA: Transposition of great artery, PS: pulmonary stenosis, TCC:   Transcatheter closure, BPV: Balloon pulmonary Valvuloplasty, COA: coarctation of the aorta

Isolation of antibiotic-resistant pathogenic and potentially pathogenic bacteria from carpets of mosques in Tripoli, Libya

Objective: Isolation of potentially pathogenic bacteria from carpets in hospitals has been reported earlier, but not from carpets in mosques. The aim of the present study is to determine the pathogenic and potentially pathogenic bacteria that may exist on the carpets of mosques in Tripoli, Libya. Methods: Dust samples from carpets were collected from 57 mosques in Tripoli. Samples were examined for pathogenic bacteria using standard bacteriological procedures. Susceptibility of isolated bacteria to antimicrobial agents was determined by the disc-diffusion method.Results: Of dust samples examined, Salmonella spp. was detected in two samples (3.5%, 1 in group B and 1 in group C1), Escherichia coli in 16 samples (28.1%), Aeromonas spp. in one sample (1.8%), and Staphylococcus aureus in 12 samples (21.1%). Multiple drug resistance was observed in >16.7% of E. coli and in 25% of S. aureus. Conclusion: Contamination of carpets in mosques of Tripoli with antibiotic-resistant pathogenic and potentially pathogenic bacteria may pose a health risk to worshipers, particularly, the very young, the old and the immunecompromised. Worshipers are encouraged to use personal praying mats when praying in mosques.Keywords: pathogenic bacteria; antibiotic resistance; carpets; mosques; Tripoli; Liby

cardiotoxicity with immune system targeting drugs a meta analysis of anti pd pd l1 immunotherapy randomized clinical trials

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Disagreement Between Randomized and Observational Evidence on the Use of Bilateral Internal Thoracic Artery Grafting:A Meta-Analytic Approach

Background The ART (Arterial Revascularization Trial) showed no difference in survival at 10 years between patients assigned to the single versus bilateral internal thoracic artery grafting strategies. This finding is in contrast with the results of most observational studies, where the use of 2 internal thoracic arteries has been associated with improved survival. Methods and Results We selected propensity-matched studies from the most comprehensive observational meta-analysis on the long-term outcomes of patients receiving 1 versus 2 internal thoracic arteries. Individual participant survival data from each study and the ART were reconstructed using an iterative algorithm that was applied to solve the Kaplan-Meier equations. The reconstructed individual participant survival data were aggregated to obtain combined survival curves and Cox regression hazard ratios with 95% CIs. Individual participant survival data were obtained from 14 matched observational studies (24 123 patients) and the ART. The 10-year survival of the control group of ART was significantly higher than that of the matched observational studies (hazard ratio, 0.86; 95% CI, 0.80-0.93). The 10-year survival of the experimental group of ART was significantly lower than that of the bilateral internal thoracic artery group of the observational studies (hazard ratio, 1.11; 95% CI, 1.03-1.20). Conclusions Both the improved outcome of the control arm and the lower beneficial effect of the intervention had played a role in the difference between observational evidence and ART

Intraoperative Graft Flow Profiles in Coronary Artery Bypass Surgery: a Meta-Analysis

Background: Conduits used in coronary artery bypass artery grafting (CABG) have different properties and flow profiles. We compared intraoperative mean graft flow (MGF) between arterial and venous conduits, off-pump CABG (OPCABG) and on-pump CABG (ONCABG) procedures, skeletonized and pedicled internal mammary artery (IMA) grafts, and pulsatility index (PI) between OPCABG and ONCABG, in pairwise meta-analyses. Methods: Following a systematic literature search, all studies comparing MGF in arterial and venous grafts, were included. The primary endpoint was comparison of pooled MGF between arterial and venous grafts. Secondary endpoints were comparisons of pooled MGF in OPCABG vs ONCABG, anastomosed skeletonized vs pedicled IMA grafts, free skeletonized vs pedicled IMA grafts and PI in OPCABG versus ONCABG. Results: A total of 25 studies with 4443 patients were included. Compared with venous grafts, arterial grafts had lower MGF (standardized mean difference [SMD], -0.28; 95% confidence interval [CI, -0.34; -0.22]; P < .001). OPCABG was associated with significantly lower MGF compared to ONCABG (SMD, -0.29; 95%CI, -0.50; -0.08]; P = .01). No differences were found in MGF between skeletonized vs pedicled IMA after anastomosis (SMD, 0.32; 95%CI [-0.08; 0.71]; P = .11) or in free flow (SMD, 0.76; 95%CI [-0.14; 1.65]; P = .10). No difference was found in PI between OPCABG and ONCABG. At meta-regression, age was associated with higher MGF, while OPCABG was associated with lower MGF. Conclusions: Intraoperative flow of venous conduits is higher than that of arterial grafts. Compared to OPCABG surgery, graft flow is higher in ONCABG. In skeletonized and pedicled IMA conduits, no difference in flow profiles was found.info:eu-repo/semantics/publishedVersio

Thorax support vest to prevent sternal wound infections in cardiac surgery patients—a systematic review and meta-analysis

OBJECTIVES: Midline sternotomy is the main surgical access for cardiac surgeries. The most prominent complication of sternotomy is sternal wound infection (SWI). The use of a thorax support vest (TSV) that limits thorax movement and ensures sternal stability has been suggested to prevent postoperative SWI. METHODS: We performed a meta-analysis to evaluate differences in clinical outcomes with and without the use of TSV after cardiac surgery in randomized trials. The primary outcome was deep SWI (DSWI). Secondary outcomes were superficial SWI, sternal wound dehiscence, and hospital length of stay (LOS). A trial sequential analysis was performed. Fixed (F) and random effects (R) models were calculated. RESULTS: A total of 4 studies (3820 patients) were included. Patients who wore the TSV had lower incidence of DSWI [odds ratio (OR) = F: 0.24, 95% confidence interval (CI), 0.13–0.43, P < 0.01; R: 0.24, 0.04–1.59, P = 0.08], sternal wound dehiscence (OR = F: 0.08, 95% CI, 0.02–0.27, P < 0.01; R: 0.10, 0.00–2.20, P = 0.08) and shorter hospital LOS (standardized mean difference = F: −0.30, −0.37 to −0.24, P < 0.01; R: −0.63, −1.29 to 0.02, P = 0.15). There was no difference regarding the incidence of superficial SWI (OR = F: 0.71, 95% CI, 0.34–1.47, P = 0.35; R: 0.64, 0.10, 4.26, P = 0.42). The trial sequential analysis, however, showed that the observed decrease in DSWI in the TSV arm cannot be considered conclusive based on the existing evidence. CONCLUSIONS: This meta-analysis suggests that the use of a TSV after cardiac surgery could potentially be associated with a reduction in sternal wound complications. However, despite the significant treatment effect in the available studies, the evidence is not solid enough to provide strong practice recommendations