3,501 research outputs found

    Pancreato-Biliary Cancers – Diagnosis and Management

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    Learning and detecting activities from movement trajectories using the hierarchical hidden Markov model

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    Directly modeling the inherent hierarchy and shared structures of human behaviors, we present an application of the hierarchical hidden Markov model (HHMM) for the problem of activity recognition. We argue that to robustly model and recognize complex human activities, it is crucial to exploit both the natural hierarchical decomposition and shared semantics embedded in the movement trajectories. To this end, we propose the use of the HHMM, a rich stochastic model that has been recently extended to handle shared structures, for representing and recognizing a set of complex indoor activities. Furthermore, in the need of real-time recognition, we propose a Rao-Blackwellised particle filter (RBPF) that efficiently computes the filtering distribution at a constant time complexity for each new observation arrival. The main contributions of this paper lie in the application of the shared-structure HHMM, the estimation of the model\u27s parameters at all levels simultaneously, and a construction of an RBPF approximate inference scheme. The experimental results in a real-world environment have confirmed our belief that directly modeling shared structures not only reduces computational cost, but also improves recognition accuracy when compared with the tree HHMM and the flat HMM.<br /

    An Efficient Precoder Design for Multiuser MIMO Cognitive Radio Networks with Interference Constraints

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    We consider a linear precoder design for an underlay cognitive radio multiple-input multiple-output broadcast channel, where the secondary system consisting of a secondary base-station (BS) and a group of secondary users (SUs) is allowed to share the same spectrum with the primary system. All the transceivers are equipped with multiple antennas, each of which has its own maximum power constraint. Assuming zero-forcing method to eliminate the multiuser interference, we study the sum rate maximization problem for the secondary system subject to both per-antenna power constraints at the secondary BS and the interference power constraints at the primary users. The problem of interest differs from the ones studied previously that often assumed a sum power constraint and/or single antenna employed at either both the primary and secondary receivers or the primary receivers. To develop an efficient numerical algorithm, we first invoke the rank relaxation method to transform the considered problem into a convex-concave problem based on a downlink-uplink result. We then propose a barrier interior-point method to solve the resulting saddle point problem. In particular, in each iteration of the proposed method we find the Newton step by solving a system of discrete-time Sylvester equations, which help reduce the complexity significantly, compared to the conventional method. Simulation results are provided to demonstrate fast convergence and effectiveness of the proposed algorithm.Comment: Accepted to appear in IEEE Trans. Vehicular Technology, 13 pages, 8 figure

    The impact of admission diagnosis on gastric emptying in critically ill patients

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    Introduction Disturbed gastric emptying (GE) occurs commonly in critically ill patients. Admission diagnoses are believed to influence the incidence of delayed GE and subsequent feed intolerance. Although patients with burns and head injury are considered to be at greater risk, the true incidence has not been determined by examination of patient groups of sufficient number. This study aimed to evaluate the impact of admission diagnosis on GE in critically ill patients. Methods A retrospective review of patient demographics, diagnosis, intensive care unit (ICU) admission details, GE, and enteral feeding was performed on an unselected cohort of 132 mechanically ventilated patients (94 males, 38 females; age 54 ± 1.2 years; admission Acute Physiology and Chronic Health Evaluation II [APACHE II] score of 22 ± 1) who had undergone GE assessment by 13C-octanoic acid breath test. Delayed GE was defined as GE coefficient (GEC) of less than 3.20 and/or gastric half-emptying time (t50) of more than 140 minutes. Results Overall, 60% of the patients had delayed GE and a mean GEC of 2.9 ± 0.1 and t50 of 163 ± 7 minutes. On univariate analysis, GE correlated significantly with older age, higher admission APACHE II scores, longer length of stay in ICU prior to GE measurement, higher respiratory rate, higher FiO2 (fraction of inspired oxygen), and higher serum creatinine. After these factors were controlled for, there was a modest relationship between admission diagnosis and GE (r = 0.48; P = 0.02). The highest occurrence of delayed GE was observed in patients with head injuries, burns, multi-system trauma, and sepsis. Delayed GE was least common in patients with myocardial injury and non-gastrointestinal post-operative respiratory failure. Patients with delayed GE received fewer feeds and stayed longer in ICU and hospital compared to those with normal GE. Conclusion Admission diagnosis has a modest impact on GE in critically ill patients, even after controlling for factors such as age, illness severity, and medication, which are known to influence this function.Nam Q Nguyen, Mei P Ng, Marianne Chapman, Robert J Fraser and Richard H Hollowa

    Cognitive full-duplex relay networks under the peak interference power constraint of multiple primary users

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    Abstract This paper investigates the outage performance of cognitive spectrum-sharing multi-relay networks in which the relays operate in a full-duplex (FD) mode and employ the decode-and-forward (DF) protocol. Two relay selection schemes, i.e., partial relay selection (PRS) and optimal relay selection (ORS), are considered to enhance the system performance. New exact expressions for the outage probability (OP) in both schemes are derived based on which an asymptotic analysis is carried out. The results show that the ORS strategy outperforms PRS in terms of OP, and increasing the number of FD relays can significantly improve the system performance. Moreover, novel analytical results provide additional insights for system design. In particular, from the viewpoint of FD concept, the primary network parameters (i.e., peak interference at the primary receivers, number of primary receivers, and their locations) should be carefully considered since they significantly affect the secondary network performance

    Fasting and nutrient-stimulated plasma peptide-YY levels are elevated in critical illness and associated with feed intolerance: an observational, controlled study

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    INTRODUCTION: Delayed gastric emptying and feed intolerance occur frequently in the critically ill. In these patients, gastric motor responses to nutrients are disturbed. Peptide YY (PYY) slows gastric emptying. The aim of this study was to determine fasting and nutrient-stimulated plasma PYY concentrations and their relationship to cholecystokinin (CCK) in critically ill patients. METHODS: Studies were performed in 19 unselected mechanically ventilated critically ill patients (12 males; 48 ± 7 years old) in a randomised, single-blind fashion. Subjects received a 60-minute duodenal infusion of Ensure(® )at either 1 or 2 kcal/minute. Blood samples were collected at baseline and at 20, 40, 60, and 180 minutes following commencement of the nutrient infusion for the measurement of plasma PYY and CCK concentrations (using radioimmunoassay). Patient data were compared to 24 healthy subjects (17 males; 43 ± 2 years old). RESULTS: Fasting PYY concentration was higher in patients (P < 0.05), particularly in those with feed intolerance (P < 0.05). Plasma PYY concentrations were higher in patients during nutrient infusion (area under the curve [AUC] at 1 kcal/minute: 2,265 ± 718 versus 1,125 ± 138 pmol/l.min, P < 0.05; at 2 kcal/minute: 2,276 ± 303 versus 1,378 ± 210 pmol/l.min, P = 0.01) compared to healthy subjects. The magnitude of PYY elevation was greater in patients during the 1 kcal/minute infusion (AUC: 441 ± 153 versus 186 ± 58 pmol/l.min, P < 0.05), but not the 2 kcal/minute infusion. Fasting and nutrient-stimulated plasma CCK concentrations were higher in patients (P < 0.05). There was a relationship between plasma PYY and CCK concentrations during fasting (r = 0.52, P < 0.05) and nutrient infusion (r = 0.98, P < 0.0001). CONCLUSION: In critical illness, both fasting and nutrient-stimulated plasma PYY concentrations are elevated, particularly in patients with feed intolerance, in conjunction with increased CCK concentrations

    Geometric properties of boundary sections of solutions to the Monge--Amp\`ere equation and applications

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    In this paper, we establish several geometric properties of boundary sections of convex solutions to the Monge-Amp\`ere equations: the engulfing and separating properties and volume estimates. As applications, we prove a covering lemma of Besicovitch type, a covering theorem and a strong type p−pp-p estimate for the maximal function corresponding to boundary sections. Moreover, we show that the Monge-Amp\`ere setting forms a space of homogeneous type.Comment: 24 page

    The relationship between gastric emptying, plasma cholecystokinin, and peptide YY in critically ill patients

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    © 2007 Nguyen et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background Cholecystokinin (CCK) and peptide YY (PYY) are released in response to intestinal nutrients and play an important physiological role in regulation of gastric emptying (GE). Plasma CCK and PYY concentrations are elevated in critically ill patients, particularly in those with a history of feed intolerance. This study aimed to evaluate the relationship between CCK and PYY concentrations and GE in critical illness. Methods GE of 100 mL of Ensure® meal (106 kcal, 21% fat) was measured using a 13C-octanoate breath test in 39 mechanically ventilated, critically ill patients (24 males; 55.8 ± 2.7 years old). Breath samples for 13CO2 levels were collected over the course of 4 hours, and the GE coefficient (GEC) (normal = 3.2 to 3.8) was calculated. Measurements of plasma CCK, PYY, and glucose concentrations were obtained immediately before and at 60 and 120 minutes after administration of Ensure. Results GE was delayed in 64% (25/39) of the patients. Baseline plasma CCK (8.5 ± 1.0 versus 6.1 ± 0.4 pmol/L; P = 0.045) and PYY (22.8 ± 2.2 versus 15.6 ± 1.3 pmol/L; P = 0.03) concentrations were higher in patients with delayed GE and were inversely correlated with GEC (CCK: r = -0.33, P = 0.04, and PYY: r = -0.36, P = 0.02). After gastric Ensure, while both plasma CCK (P = 0.03) and PYY (P = 0.02) concentrations were higher in patients with delayed GE, there was a direct relationship between the rise in plasma CCK (r = 0.40, P = 0.01) and PYY (r = 0.42, P < 0.01) from baseline at 60 minutes after the meal and the GEC. Conclusion In critical illness, there is a complex interaction between plasma CCK, PYY, and GE. Whilst plasma CCK and PYY correlated moderately with impaired GE, the pathogenetic role of these gut hormones in delayed GE requires further evaluation with specific antagonists.Nam Q Nguyen, Robert J Fraser, Laura K Bryant, Marianne J Chapman, Judith Wishart, Richard H Holloway, Ross Butler, and Michael Horowit
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