40 research outputs found
Whole Business Securitization: Secured Lending Repackaged?: A Comment on Hill
We study certain generalized Cauchy integral formulas for gradients of solutions to second order divergence form elliptic systems, which appeared in recent work by P. Auscher and A. Rosén. These are constructed through functional calculus and are in general beyond the scope of singular integrals. More precisely, we establish such Cauchy formulas for solutions u with gradient in weighted L_2(\R^{1+n}_+, t^{\alpha}dtdx) also in the case |\alpha|<1. In the end point cases \alpha= \pm 1, we show how to apply Carleson duality results by T. Hytönen and A. Rosén to establish such Cauchy formulas
Data Uncertainty Guided Noise-aware Preprocessing Of Fingerprints
The effectiveness of fingerprint-based authentication systems on good quality
fingerprints is established long back. However, the performance of standard
fingerprint matching systems on noisy and poor quality fingerprints is far from
satisfactory. Towards this, we propose a data uncertainty-based framework which
enables the state-of-the-art fingerprint preprocessing models to quantify noise
present in the input image and identify fingerprint regions with background
noise and poor ridge clarity. Quantification of noise helps the model two
folds: firstly, it makes the objective function adaptive to the noise in a
particular input fingerprint and consequently, helps to achieve robust
performance on noisy and distorted fingerprint regions. Secondly, it provides a
noise variance map which indicates noisy pixels in the input fingerprint image.
The predicted noise variance map enables the end-users to understand erroneous
predictions due to noise present in the input image. Extensive experimental
evaluation on 13 publicly available fingerprint databases, across different
architectural choices and two fingerprint processing tasks demonstrate
effectiveness of the proposed framework.Comment: IJCNN 2021 (Accepted
Sensor-invariant Fingerprint ROI Segmentation Using Recurrent Adversarial Learning
A fingerprint region of interest (roi) segmentation algorithm is designed to
separate the foreground fingerprint from the background noise. All the learning
based state-of-the-art fingerprint roi segmentation algorithms proposed in the
literature are benchmarked on scenarios when both training and testing
databases consist of fingerprint images acquired from the same sensors.
However, when testing is conducted on a different sensor, the segmentation
performance obtained is often unsatisfactory. As a result, every time a new
fingerprint sensor is used for testing, the fingerprint roi segmentation model
needs to be re-trained with the fingerprint image acquired from the new sensor
and its corresponding manually marked ROI. Manually marking fingerprint ROI is
expensive because firstly, it is time consuming and more importantly, requires
domain expertise. In order to save the human effort in generating annotations
required by state-of-the-art, we propose a fingerprint roi segmentation model
which aligns the features of fingerprint images derived from the unseen sensor
such that they are similar to the ones obtained from the fingerprints whose
ground truth roi masks are available for training. Specifically, we propose a
recurrent adversarial learning based feature alignment network that helps the
fingerprint roi segmentation model to learn sensor-invariant features.
Consequently, sensor-invariant features learnt by the proposed roi segmentation
model help it to achieve improved segmentation performance on fingerprints
acquired from the new sensor. Experiments on publicly available FVC databases
demonstrate the efficacy of the proposed work.Comment: IJCNN 2021 (Accepted
The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study
Background:
Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy.
Methods:
Consecutive women undergoing mastectomyâ±âIBR for breast cancer JulyâDecember, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomyâ±âIBR were compared and risk factors associated with delays explored.
Results:
A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [nâ=â675, 26.6%]; pedicled flaps [nâ=â105,4.1%] and free-flaps [nâ=â228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays.
Conclusions:
IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients
Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990â2021: a systematic analysis for the Global Burden of Disease Study 2021
Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 riskâoutcome pairs. Pairs were included on the basis of data-driven determination of a riskâoutcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each riskâoutcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of riskâoutcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7â9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4â9·2]), smoking (5·7% [4·7â6·8]), low birthweight and short gestation (5·6% [4·8â6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8â6·0]). For younger demographics (ie, those aged 0â4 years and 5â14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9â27·7]) and environmental and occupational risks (decrease of 22·0% [15·5â28·8]), coupled with a 49·4% (42·3â56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9â21·7] for high BMI and 7·9% [3·3â12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6â1·9) for high BMI and 1·3% (1·1â1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4â78·8) for child growth failure and 66·3% (60·2â72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions
Does varicocele repair improve conventional semen parameters? A meta-analytic study of before-after data
Purpose The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles. Materials and Methods The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies). Results Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129â0.278; p<0.001; I2=83.62%, Eggerâs p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474â1.706; p<0.001; I2=97.86%, Eggerâs p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526â2.121; p<0.001; I2=97.88%, Eggerâs p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318â1.968; p<0.001; I2=98.65%, Eggerâs p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%â2.153%; p<0.001; I2=98.97%, Eggerâs p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%â1.759%; p<0.001; l2=97.98%, Eggerâs p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%â1.211%; p<0.001; I2=97.87%, Eggerâs p=0.1864. Conclusions The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele. Keywords Controlled before-after studies; Infertility, male; Meta-analysis; Varicocel
Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK âAlert Level 4â phase of the B-MaP-C study
Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated âstandardâ or âCOVID-alteredâ, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had âCOVID-alteredâ management. âBridgingâ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2â9%) using âNHS Predictâ. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of âCOVID-alteredâ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown