Multi-Scale Convolutional Neural Network for Accurate Corneal Segmentation in Early Detection of Fungal Keratitis.

Microbial keratitis is an infection of the cornea of the eye that is commonly caused by prolonged contact lens wear, corneal trauma, pre-existing systemic disorders and other ocular surface disorders. It can result in severe visual impairment if improperly managed. According to the latest World Vision Report, at least 4.2 million people worldwide suffer from corneal opacities caused by infectious agents such as fungi, bacteria, protozoa and viruses. In patients with fungal keratitis (FK), often overt symptoms are not evident, until an advanced stage. Furthermore, it has been reported that clear discrimination between bacterial keratitis and FK is a challenging process even for trained corneal experts and is often misdiagnosed in more than 30% of the cases. However, if diagnosed early, vision impairment can be prevented through early cost-effective interventions. In this work, we propose a multi-scale convolutional neural network (MS-CNN) for accurate segmentation of the corneal region to enable early FK diagnosis. The proposed approach consists of a deep neural pipeline for corneal region segmentation followed by a ResNeXt model to differentiate between FK and non-FK classes. The model trained on the segmented images in the region of interest, achieved a diagnostic accuracy of 88.96%. The features learnt by the model emphasize that it can correctly identify dominant corneal lesions for detecting FK

Isgur-Wise Function for Heavy Light Mesons in D dimensional Potential Model

We report results of a potential model for mesons in D space-time dimension developed by considering the quark-antiquark potential of Nambu-Goto strings. With this wave function, we have studied Isgur-Wise function for heavy-light mesons and its derivatives like slope and curvature. The dimensional dependence of our results and a comparative study with the results of 3+1 dimensional QCD are also reported.Comment: 11 pages, 4 figure

Nurses in advanced roles as a strategy for equitable access to healthcare in the WHO Western Pacific region: a mixed methods study

BackgroundThe Western Pacific region constitutes one-quarter of the world's population and has diverse health needs. While dialogue on and promotion of advanced practice nurses are ongoing, this study investigated the current responsibilities of nurses in advanced roles, future healthcare needs, and the implications of these components for nurses' professional development within the Western Pacific region.MethodsThis study employed three phases, a descriptive survey on the current status of nurses in advanced roles in the Western Pacific region, followed by a Delphi survey, and exploratory interviews. A total of 55 national experts with clinical, academic, and/or government-related backgrounds from 18 countries participated from December 2017 - December 2018. The descriptive survey via email to identify the status of nurses in advanced roles and a working definition was developed. This formed the basis for the Delphi survey, which identified key barriers and challenges for enhancing the development of nurses in advanced roles within the country (round 1) and for the region (rounds 2 and 3). Lastly, semi-structured individual interviews were conducted to identify strategies for establishing nurses in advanced roles to improve equitable access to healthcare.ResultsThirty-seven roles and characteristics were identified and categorized for nurses performing advanced roles. Emergency care, critical care, elderly health, child health, and rural/remote communities were identified as fields with particular need for nurses in advanced roles in the Western Pacific region. Providing effective services, influencing government leadership, and advocating for health system sustainability were deemed necessary to improve equitable healthcare access. We found that nurses in advanced roles are not limited to clinical tasks within the hospital but are poised for active participation in primary healthcare, education/teaching, professional leadership, quality management, and research.ConclusionsDemand for nurses in advanced roles is high in the Western Pacific region and 15 items were identified across five core strategic areas to enhance development of nurses in advanced roles. Governmental-level recommendations include establishing legislative protection, improving systems for remuneration, strengthening supportive channels, and conducting national needs assessments

An adverbial approach for the formal specification of topological constraints involving regions with broad boundaries

Topological integrity constraints control the topological properties of spatial objects and the validity of their topological relationships in spatial databases. These constraints can be specified by using formal languages such as the spatial extension of the Object Constraint Language (OCL). Spatial OCL allows the expression of topological constraints involving crisp spatial objects. However, topological constraints involving spatial objects with vague shapes (e.g., regions with broad boundaries) are not supported by this language. Shape vagueness requires using appropriate topological operators (e.g., strongly Disjoint, fairly Meet) to specify valid relations between these objects; otherwise, the constraints cannot be respected. This paper addresses the problem of the lack of terminology to express topological constraints involving regions with broad boundaries. We propose an extension of Spatial OCL based on a geometric model for objects with vague shapes and an adverbial approach for topological relations between regions with broad boundaries. This extension of Spatial OCL is then tested on an agricultural database

Modal Logics of Topological Relations

Logical formalisms for reasoning about relations between spatial regions play a fundamental role in geographical information systems, spatial and constraint databases, and spatial reasoning in AI. In analogy with Halpern and Shoham's modal logic of time intervals based on the Allen relations, we introduce a family of modal logics equipped with eight modal operators that are interpreted by the Egenhofer-Franzosa (or RCC8) relations between regions in topological spaces such as the real plane. We investigate the expressive power and computational complexity of logics obtained in this way. It turns out that our modal logics have the same expressive power as the two-variable fragment of first-order logic, but are exponentially less succinct. The complexity ranges from (undecidable and) recursively enumerable to highly undecidable, where the recursively enumerable logics are obtained by considering substructures of structures induced by topological spaces. As our undecidability results also capture logics based on the real line, they improve upon undecidability results for interval temporal logics by Halpern and Shoham. We also analyze modal logics based on the five RCC5 relations, with similar results regarding the expressive power, but weaker results regarding the complexity

Treatment of hypertension in rural Cambodia: results of a 6-year programme

This study was aimed to describe the outcomes of a hypertension treatment programme in two outpatient clinics in Cambodia. We determined proportions of patients who met the optimal targets for blood pressure (BP) control and assessed the evolution of mean systolic and diastolic BP (SBP/DBP) over time. Multivariate analyses were used to identify predictors of BP decrease and risk factors for LTFU. A total of 2858 patients were enrolled between March 2002 and June 2008 of whom 69.2% were female, 30.5% were aged >/=64years and 32.6% were diabetic. The median follow-up time was 600 days. By the end of 2008, 1642 (57.4%) were alive-in-care, 8 (0.3%) had died and 1208 (42.3%) were lost to follow-up. On admission, mean SBP and DBP were 162 and 94 mm Hg, respectively. Among the patients treated, a significant SBP reduction of 26.8 mm Hg (95% CI: 28.4-25.3) was observed at 6 months. Overall, 36.5% of patients reached the BP targets at 24 months. The number of young adults, non-overweight patients and non-diabetics reaching the BP targets was more. Older age (>64 years), uncontrolled DBP (>/=90 mm Hg) on last consultation and coming late for the last consultation were associated with LTFU, whereas non-diabetic patients were 1.5 times more likely to default than diabetics (95% CI: 1.3-1.7). Although the definite magnitude of the BP decrease due to antihypertension medication over time cannot be assessed definitely without a control group, our results suggest that BP reduction can be obtained with essential hypertension treatment in a large-scale programme in a resource-limited setting

Isolation and characterization of Shiga toxigenic Escherichia coli of animal and bird origin by multiplex polymerase chain reaction

Abstract Aim: The purpose of this study was to determine the virulence genes and serotype of Shiga toxin producing Escherichia coli (STEC) strains isolated from animals and birds. Materials and Methods: A total of 226 different samples viz., fecal, intestinal content, rectal swab and heart blood were collected from different clinically affected/healthy animals and birds and were streaked on McConkeys' lactose agar and eosin methylene blue agar for isolation of E. coli, confirmed by staining characteristics and biochemical tests. By polymerase chain reaction (PCR) all the E. coli isolates were screened for certain virulence genes, viz., Shiga toxin 1 (stx1), stx2 and eae and enterohemolytic (Ehly) phenotype was observed in washed sheep blood agar plate. All the isolated E. coli strains were forwarded to the National Salmonella and Escherichia Centre, Central Research Institute, Kasauli (Himachal Pradesh) for serotyping. Results: Out of 226 samples 138 yielded E. coli. All the isolates were screened for molecular detection of different virulent genes, viz. stx1, stx2 and eae, based on which 36 (26.08%) were identified as STEC. Among those STEC isolates, 15 (41.67%), 14 (38.89%), 1 (2.78%) exhibited eae, stx2, stx1 alone, respectively, whereas 4 (11.11%) and 2 (5.56%) carried both stx1 and stx2, stx2 and eae, respectively. Among the STEC isolates 22 were belonged to 15 different sero-groups, viz., O2, O20, O22, O25, O43, O60, O69, O90, O91, O95, O106, O118, O130, O162 and O170 and others were untypable. Ehly phenotype was observed in 10 (27.78%) the STEC isolates. Conclusion: The present study concluded that STEC could be isolated from both clinically affected as well as healthy animals and birds. Regular monitoring of more samples from animal and bird origin is important to identify natural reservoir of STEC to prevent zoonotic infection

Identification of the initial molecular changes in response to circulating angiogenic cells-mediated therapy in critical limb ischemia

BackgroundCritical limb ischemia (CLI) constitutes the most aggressive form of peripheral arterial occlusive disease, characterized by the blockade of arteries supplying blood to the lower extremities, significantly diminishing oxygen and nutrient supply. CLI patients usually undergo amputation of fingers, feet, or extremities, with a high risk of mortality due to associated comorbidities.Circulating angiogenic cells (CACs), also known as early endothelial progenitor cells, constitute promising candidates for cell therapy in CLI due to their assigned vascular regenerative properties. Preclinical and clinical assays with CACs have shown promising results. A better understanding of how these cells participate in vascular regeneration would significantly help to potentiate their role in revascularization.Herein, we analyzed the initial molecular mechanisms triggered by human CACs after being administered to a murine model of CLI, in order to understand how these cells promote angiogenesis within the ischemic tissues.MethodsBalb-c nude mice (n:24) were distributed in four different groups: healthy controls (C, n:4), shams (SH, n:4), and ischemic mice (after femoral ligation) that received either 50 mu l physiological serum (SC, n:8) or 5x10(5) human CACs (SE, n:8). Ischemic mice were sacrificed on days 2 and 4 (n:4/group/day), and immunohistochemistry assays and qPCR amplification of Alu-human-specific sequences were carried out for cell detection and vascular density measurements. Additionally, a label-free MS-based quantitative approach was performed to identify protein changes related.ResultsAdministration of CACs induced in the ischemic tissues an increase in the number of blood vessels as well as the diameter size compared to ischemic, non-treated mice, although the number of CACs decreased within time. The initial protein changes taking place in response to ischemia and more importantly, right after administration of CACs to CLI mice, are shown.ConclusionsOur results indicate that CACs migrate to the injured area; moreover, they trigger protein changes correlated with cell migration, cell death, angiogenesis, and arteriogenesis in the host. These changes indicate that CACs promote from the beginning an increase in the number of vessels as well as the development of an appropriate vascular network.Institute of Health Carlos III, ISCIII; Junta de Andaluci

Tractable Fragments of Temporal Sequences of Topological Information

In this paper, we focus on qualitative temporal sequences of topological information. We firstly consider the context of topological temporal sequences of length greater than 3 describing the evolution of regions at consecutive time points. We show that there is no Cartesian subclass containing all the basic relations and the universal relation for which the algebraic closure decides satisfiability. However, we identify some tractable subclasses, by giving up the relations containing the non-tangential proper part relation and not containing the tangential proper part relation. We then formalize an alternative semantics for temporal sequences. We place ourselves in the context of the topological temporal sequences describing the evolution of regions on a partition of time (i.e. an alternation of instants and intervals). In this context, we identify large tractable fragments

A global reference database of crowdsourced cropland data collected using the Geo-Wiki platform

A global reference data set on cropland was collected through a crowdsourcing campaign using the Geo-Wiki crowdsourcing tool. The campaign lasted three weeks, with over 80 participants from around the world reviewing almost 36,000 sample units, focussing on cropland identification. For quality assessment purposes, two additional data sets are provided. The first is a control set of 1,793 sample locations validated by students trained in satellite image interpretation. This data set was used to assess the quality of the crowd as the campaign progressed. The second data set contains 60 expert validations for additional evaluation of the quality of the contributions. All data sets are split into two parts: the first part shows all areas classified as cropland and the second part shows cropland average per location and user. After further processing, the data presented here might be suitable to validate and compare medium and high resolution cropland maps generated using remote sensing. These could also be used to train classification algorithms for developing new maps of land cover and cropland extent