Fault tolerant Medical Network (MEDNET)

This investigation describes the development of a new fault tolerant Medical Network (MEDNET) model based on the existing Public Switch Telephone Network (PSTN), Integrated Services Digital Network (ISDN) and Intemetworking (Internet). This research includes the original design, development and testing of the required hardware and software interfaces to provide a complete Medical Network model. MEDNET ties the Doctor, the Patient, the Hospital, the Medical Lab, and the Pharmacy for near real time and fault tolerant exchange of medical information. The MEDNET model includes the following modules: 1 Central Database Server, 2. Remote Client Access, and 3. Communication Interface. This work proves that medical images and data can be exchanged between healthcare providers which are not geographically adjacent, in a cost effective, timely, and secure manne

Comparison of Three Different Techniques of Inverted Internal Limiting Membrane Flap in Treatment of Large Idiopathic Full-Thickness Macular Hole.

Purpose: To evaluate and compare three different techniques of inverted internal limiting membrane (ILM) flap in the treatment of large idiopathic full-thickness macular hole. Methods: In a comparative interventional case series, 72 eyes from 72 patients with large (\u3e 400 µm) full-thickness macular hole were randomly enrolled into three different groups: group A - hemicircular ILM peel with temporally hinged inverted flap; group B - circular ILM peel with temporally hinged inverted flap; and group C - circular ILM peel with superior inverted flap. Best-corrected visual acuity (BCVA), anatomical closure rate, and ellipsoid zone (EZ) or external limiting membrane (ELM) defects were evaluated preoperatively, at week 1, and months 1, 3 and 6 after surgery. Results: There were 24 eyes in group A, 23 in group B, and 25 in group C. In all three groups, larger diameter macular hole was associated with worse preoperative visual acuity (r=0.625, P\u3c0.001). Mean BCVA improved significantly in all three groups 6 months after surgery (0.91vs 0.55, p\u3c0.001). 6 months after surgery, mean BCVA improved from 0.91 logMAR to 0.52±0.06 in group A, 0.90 to 0.53±0.06 in group B, and 0.91 to 0.55±0.11 in group C. In group A vs. B vs. C, improvement of BCVA was 0.380±0.04 vs. 0.383±0.04 vs. 0.368±0.11 logMAR, with no statistically significant difference between groups (P=0.660). The rate of successful hole closure was 87.5% vs. 91.3% vs. 100%. Although the closure rate was 100% in Group C (circular ILM peel with superiorly hinged inverted flap), this difference was not statistically significant (P=0.115). Conclusion: ILM peel with an inverted flap is a highly effective procedure for the treatment of large, full-thickness macular hole. Different flap techniques have comparable results, indicating that the technique can be chosen based on surgeon preference

The Reduced Profiteering Quality as a Cause of Sanction in the Airline Companies of Iran (The Case of Zagros Airline Company)

AbstractThe main purpose of the current study was to investigate the factors effective in the service quality of airline companies ba sed on the SERVQUAL Scale. Further, the relationships among service quality, satisfaction, trust and loyalty will be also studied. To achieve the purposes of the research, a field study was conducted on 259 passengers of Zagros Airline Company. The convenience-sampling plan was used to collect the data. The descriptive statistics, the confirmatory factor analysis, Pearson's correlation test and the structural equation modeling were used for data analysis. SPSS and AMOS Software were used for data analysis. The findings show that the service quality has a significant effect on the customer's satisfaction. Customer's satisfaction has also a significant effect on customer's trust, word of mouth (WOM) and the retention intention. In addition, WOM has a positive significant effect on the retention intention of the customers. However, no significant relationship was observed between the trust and the retention intention of the customers

Aging with GRACE: Lifelong Model Editing with Discrete Key-Value Adaptors

Large pre-trained models decay over long-term deployment as input distributions shift, user requirements change, or crucial knowledge gaps are discovered. Recently, model editors have been proposed to modify a model's behavior by adjusting its weights during deployment. However, when editing the same model multiple times, these approaches quickly decay a model's performance on upstream data and forget how to fix previous errors. We propose and study a novel Lifelong Model Editing setting, where streaming errors are identified for a deployed model and we update the model to correct its predictions without influencing unrelated inputs without access to training edits, exogenous datasets, or any upstream data for the edited model. To approach this problem, we introduce General Retrieval Adaptors for Continual Editing, or GRACE, which learns to cache a chosen layer's activations in an adaptive codebook as edits stream in, leaving original model weights frozen. GRACE can thus edit models thousands of times in a row using only streaming errors, while minimally influencing unrelated inputs. Experimentally, we show that GRACE improves over recent model editors and generalizes to unseen inputs. Our code is available at https://www.github.com/thartvigsen/grace

Salt overly sensitive 1 (SOS1) gene expression can be regulated via Azospirillum brasilense Sp7 in wheat seedlings under saline condition

Salinity stress reduces plant growth via failure of physiological processes mainly due to the abundance of Na+ ion. Salt overly sensitive (SOS) signaling pathway is considered as an important component of Na+/K+ homeostasis system in plants, especially under saline condition. Moreover, it is reported that wheat-Azospirillum associated has resulted in an enhanced salinity tolerance. To evaluate involvement of Azospirillum species in regulation of SOS signaling pathway, inoculated and none-inoculated wheat seedlings with Azospirillum brasilense Sp7 were grown for five days. Then uniform seedlings were transferred into saline hydroponic media with and without 200 mM NaCl. The relative expression of TaSOS1 of root, sheath, and blade as well as Na+/K+ ratio was measured after 6, 24 and 48 hours since inoculated and non-inoculated seedling were transferred to NaCl media. Simultaneously Ca, Fe, proline content, root and shoot dry mass and soluble sugars were measured at 72 hour after application of NaCl. Result showed that salinity increased TaSOS1 gene expression, Na+, prolin and Na+/K+ ratio but Ca and Fe were decreased in root and shoot of wheat seedlings. Although A. brasilense Sp7 could improve salinity tolerance in wheat via reduction of Na uptake and upregulation of TaSOS1 expression, but do not have any effect in sodium distribution within plant parts. Therefore, salinity could increase TaSOS1 expression in the root, sheath and blade and A. brasilense Sp7 also could reduce the adverse effect of salinity via addition of over expression of TaSOS1.</p

Intraocular Injection of Stivant® (A Biosimilar to Bevacizumab): A Case Series

Purpose: To report the results of intravitreal injection of a bevacizumab biosimilar called Stivant®. Methods: This prospective interventional case series was conducted on eyes with neovascular age-related macular degeneration (nAMD), retinal vein occlusion (RVO), and diabetic macular edema (DME). Stivant® was injected in three consecutive months and changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline and monthly up to one month after the third injection. Results: Three hundred and eighty-five eyes with DME (234 eyes, 61%), nAMD (87 eyes, 22%), and macular edema secondary to RVO (64 eyes, 17%) were enrolled. The mean ± standard deviation age of the patients was 61.7 ± 7.20 years. The mean BCVA and CMT changed from 0.63 ± 0.3 to 0.51 ± 0.3 LogMAR (P = 0.12 ) and from 420.4 ± 47.3μm at baseline to 316.7 ± 50.6 μm (P &lt; 0.001) in the DME group; from 0.79 ± 0.3 to 0.68 ± 0.3 LogMAR (P = 0.19) and from 376.1 ± 31.7 μm to 303 ± 31.3 μm (P = 0.019) in the nAMD group; and from 0.81 ± 0.4 to 0.63 ± 0.4 LogMAR (P = 0.05) and from 424.21 ± 18 μm to 303.4 ± 18.8 μm (P &lt; 0.001) in the RVO group, respectively. Conclusion: Our limited experience showed that the intravitreal injection of Stivant® was well tolerated. Although the results of this case series showed relative improvement in CMT one month after the last injection of Stivant®, BCVA improvement was statistically significant only in the RVO group. This would be essential to design a randomized clinical trial to evaluate the non-inferiority of Stivant® in comparison to bevacizumab

Dosimetric Investigation of Six Ru-106 Eye Plaques by EBT3 Radiochromic Films and Monte Carlo Simulation

Background: Ophthalmic brachytherapy using radioactive plaques is an effective technique for the treatment of uveal melanoma. Ru-106 eye plaques are considered as interesting issue due to their steep gradient dose. The pre-planning evaluation of dosimetric parameters is essential for the treatment planning system.Objective: The current study aims at providing dose distributions of six Ru-106 eye plaques (CCA, CCB, CGD, CIB, COB and COD) using radiochromic EBT3 film, Geant4 Monte Carlo toolkit and the treatment planning software (Plaque Simulator).Material and Methods: In this experimental study, an in-house phantom was employed for depth dose measurements with EBT3 films. Also, Geant4.10.5 scoring mesh was implemented to obtain the 2D dose distribution of the plaques. The results were compared with Plaque Simulator software and the manufacturer’s (BEBIG) data. The gamma index criterion (3%/3 mm) was used to evaluate dose distributions obtained by the film measurements and Geant4 simulation.Results: A good agreement was achieved between simulation and experimental results. Gamma index passing rate was 94.2%, 89.3%, 88.2%, 82.2%, 92.2% and 90.1% for CCA, CCB, CGD, CIB, COB and COD plaques, respectively. Absolute dose rate (mGy/min) obtained by EBT3 film at the depth of 2 mm was 79.4 mGy/min, 81.0 mGy/min, 78.6 mGy/min, 62.2 mGy/min, 75.2 mGy/min and 81.2 mGy/min for CCA, CCB, CGD, CIB, COB and COD plaques, respectively.  Conclusion: The measured dose distributions and lateral dose profiles may be utilized in the treatment planning system to cover clinical volumes such as the clinical target volume and the gross tumor volume

Massive Uveal Relapse of Retinoblastoma Presumed to Be Choroidal Tumorous Involvement: Case Series

We report the choroidal and ciliary body invasion by retinoblastoma (RB) in a salvaged eye after complete and successful primary treatment. Case 1: A 25-month-old boy was referred due to group B RB lesions based on the International Classification of RB (ICRB; groups A–E) in the right eye (OD). His left eye (OS) was enucleated because of advanced group E RB. After 47 months of uneventful follow-up (F/U), a new lesion recurred and was treated with transpupillary thermotherapy. Four months later, a fast-growing pigmented subretinal mass was detected that was treated by brachytherapy with the apical dose of 80 Gy. Three weeks later, the lesion regressed completely, and no recurrence happened after 6 years of F/U. Case 2: A 4-month-old girl with a deletion in chromosome 13 was referred for bilateral RB. OD was enucleated because of unresponsive RB and anterior segment involvement. In OS, group B lesions had multiple recurrences after systemic chemotherapy. After a while, a single mass appeared in the nasal periphery which was controlled well with brachytherapy. Four months later, AC involvement was controlled with IAC, intravitreal, and intracameral chemotherapy, but posterior synechia and cataract appeared later. One year after the last treatment, UBM showed a ring-shaped ciliary body mass. Her parents refused enucleation again, and she received intravenous chemotherapy. Two years later, magnetic resonance imaging showed orbital and optic canal involvement with a deformed globe. In conclusion, RB recurrence can appear as local choroidal and ciliary body involvement even after a time of complete remission. The role of B-scan and UBM in early diagnosis and successful treatment is valuable

Automated Diagnosis of Cardiovascular Diseases from Cardiac Magnetic Resonance Imaging Using Deep Learning Models: A Review

In recent years, cardiovascular diseases (CVDs) have become one of the leading causes of mortality globally. CVDs appear with minor symptoms and progressively get worse. The majority of people experience symptoms such as exhaustion, shortness of breath, ankle swelling, fluid retention, and other symptoms when starting CVD. Coronary artery disease (CAD), arrhythmia, cardiomyopathy, congenital heart defect (CHD), mitral regurgitation, and angina are the most common CVDs. Clinical methods such as blood tests, electrocardiography (ECG) signals, and medical imaging are the most effective methods used for the detection of CVDs. Among the diagnostic methods, cardiac magnetic resonance imaging (CMR) is increasingly used to diagnose, monitor the disease, plan treatment and predict CVDs. Coupled with all the advantages of CMR data, CVDs diagnosis is challenging for physicians due to many slices of data, low contrast, etc. To address these issues, deep learning (DL) techniques have been employed to the diagnosis of CVDs using CMR data, and much research is currently being conducted in this field. This review provides an overview of the studies performed in CVDs detection using CMR images and DL techniques. The introduction section examined CVDs types, diagnostic methods, and the most important medical imaging techniques. In the following, investigations to detect CVDs using CMR images and the most significant DL methods are presented. Another section discussed the challenges in diagnosing CVDs from CMR data. Next, the discussion section discusses the results of this review, and future work in CVDs diagnosis from CMR images and DL techniques are outlined. The most important findings of this study are presented in the conclusion section