COMPARISON OF MAMMOGRAPHY AND ULTRASOUND COMBINED VERSUS ULTRASOUND ALONE IN EARLY EVALUATION OF SYMPTOMATIC BREAST CANCERS IN PAKISTAN

Purpose: The purpose of this study was to detect diagnostic accuracy of mammography and ultrasound combined versus ultrasound alone in early evaluation of symptomatic breast lesions.Materials and Methods: All new patients who presented to the breast clinic with symptomatic breast lesions, during the year 2012, were included in the study. A total of 695 patients were registered. Their clinical findings, mammogram, ultrasound and histopathology were reviewed.Results: Mammogram and ultrasound combined detected 693 (99.71%) lesions in total. Mammogram failed to detect lesions in 1.43% of patients, whereas the failure rate of ultrasound was 0.43%. The incidence of microcalcifications on mammogram was 19.13%.Conclusion: Ultrasound is a useful tool in the initial evaluation of symptomatic breasts. For places such as Pakistan where mammogram is not available at every centre, ultrasound can be used as an effective alternative for the assessment of symptomatic breast lesions.Key words: Breast cancer, mammography, ultrasoun

Smoking prevalence, knowledge and attitudes among medical students in Karachi, Pakistan

A survey of smoking prevalence and attitudes was made among medical students randomly selected from classes at the Aga Khan University, Karachi, Pakistan. Of 271 respondents, 14.4% were current smokers (22.0% male and 3.8% females) and 3.3% ex-smokers. A majority of students recognized the dangers associated with active as well as passive smoking although only 55% of current smokers planned to quit in the near future. Most smokers (96%) believed that they as well as other health professionals needed training on smoking cessation and 95% of all students believed that doctors should play a role model in smoking cessation by not smoking themselves. Specific training and counselling should be a part of the required curriculum at medical schools

An Internet of Things based bed-egress alerting paradigm using wearable sensors in elderly care environment

The lack of healthcare staff and increasing proportions of elderly population is alarming. The traditional means to look after elderly has resulted in 255,000 reported falls (only within UK). This not only resulted in extensive aftercare needs and surgeries (summing up to £4.4 billion) but also in added suffering and increased mortality. In such circumstances, the technology can greatly assist by offering automated solutions for the problem at hand. The proposed work offers an Internet of things (IoT) based patient bed-exit monitoring system in clinical settings, capable of generating a timely response to alert the healthcare workers and elderly by analyzing the wireless data streams, acquired through wearable sensors. This work analyzes two different datasets obtained from divergent families of sensing technologies, i.e., smartphone-based accelerometer and radio frequency identification (RFID) based accelerometer. The findings of the proposed system show good efficacy in monitoring the bed-exit and discriminate other ambulating activities. Furthermore, the proposed work manages to keep the average end-to-end system delay (i.e., communications of sensed data to Data Sink (DS)/Control Center (CC) + machine-based feature extraction and class identification + feedback communications to a relevant healthcare worker/elderly) below 1 10 th of a second

Energy-Efficient Resource Allocation for 6G Backscatter-Enabled NOMA IoV Networks

The integration of Ambient Backscatter Communication (AmBC) with Non-Orthogonal Multiple Access (NOMA) is expected to support connectivity of low-powered Internet-of-Vehicles (IoVs) in the upcoming Sixth-Generation (6G) transportation systems. This paper proposes an energy-efficient resource allocation framework for the AmBC-enabled NOMA IoV network under imperfect Successive Interference Cancellation (SIC) decoding. In particular, multiple Road-Side Units (RSUs) transmit superimposed signals to their associated IoVs utilizing downlink NOMA transmission. Meanwhile, the Backscatter Tags (BackTags) also transmit data symbols towards nearby IoVs by reflecting the superimposed signals of RSUs. Thus, the objective is to maximize the total energy efficiency of the NOMA IoV network subject to the minimum data rate of all IoVs. A joint problem that simultaneously optimizes the total power budget of each RSU, power allocation coefficient of IoVs and reflection power of BackTags under imperfect SIC decoding is formulated. A Dinkelbach approach is first adopted to transform the optimization problem and then the transformed problem is decoupled into two subproblems for optimal transmit power at RSUs and efficient reflection power at BackTags, respectively. To solve the problems efficiently, dual theory and Karush-Kuhn-Tucker conditions are exploited, where the Lagrangian dual variables are iteratively calculated using the subgradient method. To check the performance of the proposed framework, a benchmark optimization without AmBC is also provided. Numerical results demonstrate the superiority of the proposed AmBC-enabled NOMA IoV framework over the benchmark conventional IoV framework

Mucinous carcinoma of breast: A rare tumour with favorable prognosis - 10 years experience from a single center

Purpose: The purpose of this study was to describe the biological behaviour of mucinous breast carcinoma (MBC) regarding their clinical presentations, pathological features, prognosis and survival.Methodology: We conducted this retrospective study from 2006 to 2015 (10-year duration) and included all the patients who presented with mucinous carcinoma of the breast at any age. We excluded all the patients who presented with invasive ductal carcinoma or other rare breast tumours. Each patient with mucinous carcinoma breast was categorised in terms of diagnosis, surgery, chemotherapy and outcome. For categorical variables, Chi-square test was used. Kaplan–Meier curves were used to determine estimated overall survival. Data analysis was carried out using the SPSS 20.Results: In total, 8841 patients with breast carcinoma presented during the study period. Of these, 74 patients were diagnosed as cases of MBC, constituting <1%. Family history of breast carcinoma was positive in 20% of patients. Most of the women were postmenopausal (66.2%) falling in BIRADS Category 4 and 5 (32.4% each). Considering laterality tumours had almost equal distribution between the right and left side. Breast-conserving surgery was performed in 47.3% of women as compare to modified radicle mastectomy in 52.7% of women. Most of the patients had pathological T2 (51.4%), N0 (81.1%) and moderately differentiated (69%) mucinous carcinoma. ER was positive in 85% of patients, PR in 80% and H2N in 74.6% of patients. Neoadjuvant chemotherapy was given to 20 patients (27%) and adjuvant chemoradiotherapy was given to 51 patients (69%). Metastasis occurred in 12 (16.2%) of our patients while 62 (83.8%) were metastasis free on long-term follow-up, with bones being the most common site of metastasis, occurring in 6 patients (8.1%) followed by lungs, occurring in 4 patients (5.4%). A total of 32 (43.2%) patients are alive, and on regular follow-up, 3 (4.1%) died during the course of follow-up and 39 (52.7%) are lost to follow-up with a median survival of 60 months and an overall 5-year survival rate of >95%.Conclusion: Mucinous carcinoma is a rare breast carcinoma with a good prognosis.Key words: Breast cancer, mucinous carcinoma, prognosi

Enabling Design and Simulation of Massive Parallel Nanoarchitectures

A common element in emerging nanotechnologies is the increasing complex- ity of the problems to face when attempting the design phase, because issues related to technology, specific application and architecture must be evalu- ated simultaneously. In several cases faced problems are known, but require a fresh re-think on the basis of different constraints not enforced by standard design tools. Among the emerging nanotechnologies, the two-dimensional structures based on nanowire arrays is promising in particular for massively parallel architec- tures. Several studies have been proposed on the exploration of the space of architectural solutions, but only a few derived high-level information from the results of an extended and reliable characterization of low-level structures. The tool we present is of aid in the design of circuits based on nanotech- nologies, here discussed in the specific case of nanowire arrays, as best candi- date for massively parallel architectures. It enables the designer to start from a standard High-level Description Languages (HDL), inherits constraints at physical level and applies them when organizing the physical implementation of the circuit elements and of their connections. It provides a complete simu- lation environment with two levels of refinement. One for DC analysis using a fast engine based on a simple switch level model. The other for obtaining transient performance based on automatic extraction of circuit parasitics, on detailed device (nanowire-FET) information derived by experiments or by existing accurate models, and on spice-level modeling of the nanoarray. Re- sults about the method used for the design and simulation of circuits based on nanowire-FET and nanoarray will be presente

An integrated antenna system for 4G and millimeter-wave 5G future handheld devices

In this work, an integrated antenna system with Defected Ground Structure (DGS) is presented for Fourth Generation (4G) and millimeter (mm)-wave Fifth Generation (5G) wireless applications and handheld devices. The proposed design with overall dimensions of 110 mm × 75 mm is modeled on 0.508 mm thick Rogers RT/Duroid 5880 substrate. Radiating structure consists of antenna arrays excited by the T-shape 1 × 2 power divider/combiner. Dual bands for 4G centered at 3.8 GHz and 5.5 GHz are attained, whereas the 10-dB impedance bandwidth of 24.4 - 29.3 GHz is achieved for the 5G antenna array. In addition, a peak gain of 5.41 dBi is demonstrated across the operating bandwidth of the 4G antenna array. Similarly, for the 5G mm-wave configuration the attained peak gain is 10.29 dBi. Moreover, significant isolation is obtained between the two antenna modules ensuring efficient dual-frequency band operation using a single integrated solution. To endorse the concept, antenna prototype is fabricated and far-field measurements are procured. Simulated and measured results exhibit coherence. Also the proposed design is investigated for the beam steering capability of the mm-wave 5G antenna array using CST®MWS®. The demonstrated structure offers various advantages including compactness, wide bandwidth, high gain, and planar configuration. Hence, the attained radiation characteristics prove the suitability of the proposed design for the current and future wireless handheld devices

A quantitative study of the impact of organizational culture, communication management, and clarity in project scope on constructions’ project success with moderating role of project manager’s competencies to enhance constructions management practices

The construction industry is considered a driver of economic growth, especially in developing countries. However, the successful completion of construction projects is a major challenge, due to the lack of competencies. The current study explores the effects of communication management practices, clarity in the scope of the construction project, and organizational culture to enhance project success. A project manager is essential in running a project smoothly and according to the schedule. Keeping in view the predominant role of the project manager, this study aims to find the moderating impact of manager competencies to improve the construction project routine and generate successful projects. A questionnaire survey was conducted to collect the data and determine how these variables influence construction project progress. The current research results show an ex-cellent association between a construction project’s success and the discussed independent variables. Additionally, it was found that a competent project manager can play a better role in preventing the uncomfortable influences of independent variables on the dependent variable. The obtained outcomes highlight the importance of adequately handling organizational culture, communication management, and clarity to achieve project success. These outcomes are helpful for the professionals working in the construction sector to raise the project success rate and enhance their construction management capabilities

Eimeria species occurrence varies between geographic regions and poultry production systems and may influence parasite genetic diversity

Coccidiosis is one of the biggest challenges faced by the global poultry industry. Recent studies have highlighted the ubiquitous distribution of all Eimeria species which can cause this disease in chickens, but intriguingly revealed a regional divide in genetic diversity and population structure for at least one species, Eimeria tenella. The drivers associated with such distinct geographic variation are unclear, but may impact on the occurrence and extent of resistance to anticoccidial drugs and future subunit vaccines. India is one of the largest poultry producers in the world and includes a transition between E. tenella populations defined by high and low genetic diversity. The aim of this study was to identify risk factors associated with the prevalence of Eimeria species defined by high and low pathogenicity in northern and southern states of India, and seek to understand factors which vary between the regions as possible drivers for differential genetic variation. Faecal samples and data relating to farm characteristics and management were collected from 107 farms from northern India and 133 farms from southern India. Faecal samples were analysed using microscopy and PCR to identify Eimeria occurrence. Multiple correspondence analysis was applied to transform correlated putative risk factors into a smaller number of synthetic uncorrelated factors. Hierarchical cluster analysis was used to identify poultry farm typologies, revealing three distinct clusters in the studied regions. The association between clusters and presence of Eimeria species was assessed by logistic regression. The study found that large-scale broiler farms in the north were at greatest risk of harbouring any Eimeria species and a larger proportion of such farms were positive for E. necatrix, the most pathogenic species. Comparison revealed a more even distribution for E. tenella across production systems in south India, but with a lower overall occurrence. Such a polarised region- and system-specific distribution may contribute to the different levels of genetic diversity observed previously in India and may influence parasite population structure across much of Asia and Africa. The findings of the study can be used to prioritise target farms to launch and optimise appropriate anticoccidial strategies for long-term control