Gastric Outlet Obstruction at Bugando Medical Centre in Northwestern Tanzania: A Prospective Review of 184 Cases.

Gastric outlet obstruction poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. There is a paucity of published data on this subject in our setting. This study was undertaken to highlight the etiological spectrum and treatment outcome of gastric outlet obstruction in our setting and to identify prognostic factors for morbidity and mortality. This was a descriptive prospective study which was conducted at Bugando Medical Centre between March 2009 and February 2013. All patients with a clinical diagnosis of gastric outlet obstruction were, after informed consent for the study, consecutively enrolled into the study. Statistical data analysis was done using SPSS computer software version 17.0. A total of 184 patients were studied. More than two-third of patients were males. Patients with malignant gastric outlet obstruction were older than those of benign type. This difference was statistically significant (p < 0.001). Gastric cancer was the commonest malignant cause of gastric outlet obstruction where as peptic ulcer disease was the commonest benign cause. In children, the commonest cause of gastric outlet obstruction was congenital pyloric stenosis (13.0%). Non-bilious vomiting (100%) and weight loss (93.5%) were the most frequent symptoms. Eighteen (9.8%) patients were HIV positive with the median CD 4+ count of 282 cells/μl. A total of 168 (91.3%) patients underwent surgery. Of these, gastro-jejunostomy (61.9%) was the most common surgical procedure performed. The complication rate was 32.1 % mainly surgical site infections (38.2%). The median hospital stay and mortality rate were 14 days and 18.5% respectively. The presence of postoperative complication was the main predictor of hospital stay (p = 0.002), whereas the age > 60 years, co-existing medical illness, malignant cause, HIV positivity, low CD 4 count (<200 cells/μl), high ASA class and presence of surgical site infection significantly predicted mortality ( p< 0.001). The follow up of patients was generally poor as more than 60% of patients were lost to follow up. Gastric outlet obstruction in our setting is more prevalent in males and the cause is mostly malignant. The majority of patients present late with poor general condition. Early recognition of the diagnosis, aggressive resuscitation and early institution of surgical management is of paramount importance if morbidity and mortality associated with gastric outlet obstruction are to be avoided

Mucinous cystic neoplasm of the pancreas in a male patient

Mucinous cystic neoplasms (MCNs) make up a morphologic family of similar appearing tumors arising in the ovary and various extraovarian organs such as pancreas, hepatobiliary tract and mesentery. MCNs of the pancreas occur almost exclusively in women. Here, we report a rare case of MCN in a male patient. A 39-year-old man was admitted to our hospital with the chief complaint of back pain. Abdominal computed tomography revealed a multilocular cyctic mass 6.3 cm in diameter in the pancreatic tail. In addition, the outer wall and septae with calcification were demonstrated in the cystic lesion. On magnetic resonance imaging , the cystic fluid had low intensity on T1-weighted imaging and high intensity on T2-weighted imaging. Endoscopic retrograde cholangio-pancreatography (ERCP) showed neither communication between the cystic lesion and the main pancreatic duct nor encasement of the main pancreatic duct. Endoscopic ultrasonography revealed neither solid component nor thickness of the septae in the cystic lesion. Consequently, we performed distal pancreatectomy with splenectomy under the diagnosis of cystic neoplasia of the pancreas. Histopathologically, the cystic lesion showed two distinct component: an inner epithelial layer and an outer densely cellular ovarian-type stromal layer. Based on these findings, the cystic lesion was diagnosed as MCN

Community, Family, and Partner-Related Stigma Experienced by Pregnant and Postpartum Women with HIV in Ho Chi Minh City, Vietnam

Pregnant and postpartum women with HIV often face stigma and discrimination at home and in the community. In Vietnam, associations between HIV and the “social evils” of drug use and sex work contribute to stigmatization of people with HIV. We conducted a qualitative study to explore discrimination experienced by HIV-positive pregnant and postpartum women in Ho Chi Minh City at home and in the community. We conducted 20 in-depth interviews and two focus group discussions. Participants described managing disclosure of their HIV infection because of fear of stigma and discrimination, particularly to the wider community. In cases where their HIV status was disclosed, women experienced both discrimination and support. The findings highlight the need for targeted interventions to support pregnant and postpartum women with HIV, particularly during this period when they are connected to the healthcare system and more readily available for counseling

SVCEval-RA: an evaluation framework for adaptive scalable video streaming

[EN] Multimedia content adaption strategies are becoming increasingly important for effective video streaming over the actual heterogeneous networks. Thus, evaluation frameworks for adaptive video play an important role in the designing and deploying process of adaptive multimedia streaming systems. This paper describes a novel simulation framework for rate-adaptive video transmission using the Scalable Video Coding standard (H.264/SVC). Our approach uses feedback information about the available bandwidth to allow the video source to select the most suitable combination of SVC layers for the transmission of a video sequence. The proposed solution has been integrated into the network simulator NS-2 in order to support realistic network simulations. To demonstrate the usefulness of the proposed solution we perform a simulation study where a video sequence was transmitted over a three network scenarios. The experimental results show that the Adaptive SVC scheme implemented in our framework provides an efficient alternative that helps to avoid an increase in the network congestion in resource-constrained networks. Improvements in video quality, in terms of PSNR (Peak Signal to Noise Ratio) and SSIM (Structural Similarity Index) are also obtained.Castellanos Hernández, WE.; Guerri Cebollada, JC.; Arce Vila, P. (2017). SVCEval-RA: an evaluation framework for adaptive scalable video streaming. Multimedia Tools and Applications. 76(1):437-461. doi:10.1007/s11042-015-3046-yS437461761Akhshabi S, Begen AC, Dovrolis C (2011) An experimental evaluation of rate-adaptation algorithms in adaptive streaming over HTTP. In: Proceedings of the second annual ACM conference on Multimedia systems. ACM, pp 157–168Alabdulkarim MN, Rikli N-E (2012) QoS Provisioning for H.264/SVC Streams over Ad-Hoc ZigBee Networks Using Cross-Layer Design. In: 8th International Conference on Wireless Communications, Networking and Mobile Computing (WiCOM). pp 1–8Birkos K, Tselios C, Dagiuklas T, Kotsopoulos S (2013) Peer selection and scheduling of H. 264 SVC video over wireless networks. In: Wireless Communications and Networking Conference (WCNC), 2013 IEEE. pp 1633–1638Castellanos W (2014) SVCEval-RA - An Evaluation Framework for Adaptive Scalable Video Streaming. In: SourceForge Project. http://sourceforge.net/projects/svceval-ra/ . Accessed 1 May 2015Castellanos W, Guerri JC, Arce P (2015) A QoS-aware routing protocol with adaptive feedback scheme for video streaming for mobile networks. Comput Commun. http://dx.doi.org/10.1016/j.comcom.2015.08.012Castellanos W, Arce P, Acelas P, Guerri JC (2012) Route Recovery Algorithm for QoS-Aware Routing in MANETs. Springer Berlin Heidelberg, Bilbao, pp. 81–93Chikkerur S, Sundaram V, Reisslein M, Karam LJ (2011) Objective video quality assessment methods: A classification, review, and performance comparison. Broadcast, IEEE Trans on 57:165–182Choupani R, Wong S, Tolun M (2014) Multiple description coding for SNR scalable video transmission over unreliable networks. Multimed Tools Appl 69:843–858. doi: 10.1007/s11042-012-1150-9CISCO Corp. (2014) Cisco Visual Networking Index Forecast and Methodology. In: White Paper. http://www.cisco.com/c/en/us/solutions/collateral/service-provider/ip-ngn-ip-next-generation-network/white_paper_c11-481360.pdf.Dai M, Zhang Y, Loguinov D (2009) A unified traffic model for MPEG-4 and H. 264 video traces. IEEE Trans Multimedia 11:1010–1023Detti A, Bianchi G, Pisa C, et al. (2009) SVEF: an open-source experimental evaluation framework for H.264 scalable video streaming. In: IEEE Symposium on Computers and Communications. pp 36–41Espina F, Morato D, Izal M, Magaña E (2014) Analytical model for MPEG video frame loss rates and playback interruptions on packet networks. Multimed Tools Appl 72:361–383. doi: 10.1007/s11042-012-1344-1Fiems D, Steyaert B, Bruneel H (2012) A genetic approach to Markovian characterisation of H.264 scalable video. Multimedia Tools Appl 58:125–146Floyd S, Handley M, Kohler E Datagram Congestion Control Protocol (DCCP). http://tools.ietf.org/html/rfc4340 . Accessed 17 Feb 2014Floyd S, Padhye J, Widmer J TCP Friendly Rate Control (TFRC): Protocol Specification. http://tools.ietf.org/html/rfc5348 . Accessed 17 Feb 2014Fraz M, Malkani YA, Elahi MA (2009) Design and implementation of real time video streaming and ROI transmission system using RTP on an embedded digital signal processing (DSP) platform. In: 2nd International Conference on Computer, Control and Communication, 2009. IC4 2009. pp 1–6ISO/IEC (2014) Information technology - Dynamic adaptive streaming over HTTP (DASH) - Part 1: Media presentation description and segment formats.ITU-T (2013) Rec. H.264 & ISO/IEC 14496-10 AVC. Advanced Video Coding for Generic Audiovisual Services.Ivrlač MT, Choi LU, Steinbach E, Nossek JA (2009) Models and analysis of streaming video transmission over wireless fading channels. Signal Process Image Commun 24:651–665. doi: 10.1016/j.image.2009.04.005Karki R, Seenivasan T, Claypool M, Kinicki R (2010) Performance Analysis of Home Streaming Video Using Orb. In: Proceedings of the 20th International Workshop on Network and Operating Systems Support for Digital Audio and Video. ACM, New York, NY, USA, pp 111–116Ke C-H (2012) myEvalSVC-an Integrated Simulation Framework for Evaluation of H. 264/SVC Transmission. KSII Trans Internet Inf Syst (TIIS) 6:377–392. doi: 10.3837/tiis.2012.01.021Ke C-H, Shieh C-K, Hwang W-S, Ziviani A (2008) An Evaluation Framework for More Realistic Simulations of MPEG Video Transmission. J Inf Sci Eng 24:425–440Klaue J, Rathke B, Wolisz A (2003) Evalvid–A framework for video transmission and quality evaluation. In: Computer Performance Evaluation. Modelling Techniques and Tools. Springer, pp 255–272Le TA, Nguyen H (2014) End-to-end transmission of scalable video contents: performance evaluation over EvalSVC—a new open-source evaluation platform. Multimed Tools Appl 72:1239–1256. doi: 10.1007/s11042-013-1444-6Lie A, Klaue J (2008) Evalvid-RA: trace driven simulation of rate adaptive MPEG-4 VBR video. Multimedia Systems 14:33–50. doi: 10.1007/s00530-007-0110-0Moving Pictures Experts Group and ITU-T Video Coding Experts Group (2011) H. 264/SVC reference software (JSVM 9.19.14) and Manual.Nightingale J, Wang Q, Grecos C (2014) Empirical evaluation of H.264/SVC streaming in resource-constrained multihomed mobile networks. Multimed Tools Appl 70:2011–2035. doi: 10.1007/s11042-012-1219-5Parmar H, Thornburgh M (2012) Real-Time Messaging Protocol (RTMP) Specification. AdobePolitis I, Dounis L, Dagiuklas T (2012) H. 264/SVC vs. H. 264/AVC video quality comparison under QoE-driven seamless handoff. Signal Process Image Commun 27:814–826Pozueco L, Pañeda XG, García R, et al. (2013) Adaptable system based on Scalable Video Coding for high-quality video service. Comput Electr Eng 39:775–789. doi: 10.1016/j.compeleceng.2013.01.015Pozueco L, Pañeda XG, García R, et al. (2014) Adaptation engine for a streaming service based on MPEG-DASH. Multimed Tools Appl 1–20. doi: 10.1007/s11042-014-2034-ySchwarz H, Marpe D, Wiegand T (2007) Overview of the Scalable Video Coding Extension of the H.264/AVC Standard. IEEE Trans Circ Syst Video Technol 17:1103–1120. doi: 10.1109/TCSVT.2007.905532Seo H-Y (2013) An Efficient Transmission Scheme of MPEG2-TS over RTP for a Hybrid DMB System. ETRI J 35:655–665. doi: 10.4218/etrij.13.0112.0124Sohn H, Yoo H, De Neve W, et al. (2010) Full-Reference Video Quality Metric for Fully Scalable and Mobile SVC Content. IEEE Trans Broadcast 56:269–280. doi: 10.1109/TBC.2010.2050628Sousa-Vieira M-E (2011) Suitability of the M/G/∞ process for modeling scalable H.264 video traffic. In: Analytical and Stochastic Modeling Techniques and Applications. Springer, pp 149–158Tanwir S, Perros H (2013) A Survey of VBR Video Traffic Models. IEEE Commun Surv Tutor 15:1778–1802. doi: 10.1109/SURV.2013.010413.00071Tanwir S, Perros HG (2014) VBR Video Traffic Models. Wiley, HobokenThe Network Simulator (NS-2). http://www.isi.edu/nsnam/ns . Accessed 6 Feb 2015Unanue I, Urteaga I, Husemann R, et al. (2011) A Tutorial on H. 264/SVC Scalable Video Coding and its Tradeoff between Quality, Coding Efficiency and Performance. Recent Advances on Video Coding 1–24.Van der Auwera G, David PT, Reisslein M, Karam LJ (2008) Traffic and quality characterization of the H. 264/AVC scalable video coding extension. Adv Multimedia 2008:1Wang Y, Claypool M (2005) RealTracer—Tools for Measuring the Performance of RealVideo on the Internet. Multimed Tools Appl 27:411–430. doi: 10.1007/s11042-005-3757-6Wang Z, Lu L, Bovik AC (2004) Video quality assessment based on structural distortion measurement. Signal Process Image Commun 19:121–132. doi: 10.1016/S0923-5965(03)00076–6Wien M, Schwarz H, Oelbaum T (2007) Performance Analysis of SVC. IEEE Trans Circ Syst for Video Technol 17:1194–1203. doi: 10.1109/TCSVT.2007.905530YUV video repository. ftp://ftp.tnt.uni-hannover.de/pub/svc/testsequences/ . Accessed 10 Jan 201