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Cardiac manifestations in multisystem inflammatory syndrome in children (MIS-C) can include coronary artery aneurysms, left ventricular systolic dysfunction, and electrocardiographic disturbances. We report the clinical course of three children with MIS-C while focusing on the unique considerations for managing atrioventricular conduction abnormalities. All initially had normal electrocardiograms but developed bradycardia followed by either PR prolongation or QTc elongation. Two had mild left ventricular ejection fraction dysfunction prior to developing third-degree heart block and/or a junctional escape rhythm; one had moderate left ventricular systolic dysfunction that normalized before developing a prolonged QTc. On average, our patients presented to the hospital 4 days after onset of illness. Common presenting symptoms included fevers, abdominal pain, nausea, and vomiting. Inflammatory and coagulation factors were their highest early on, and troponin peaked the highest within the first two days; meanwhile, peak brain-natriuretic peptide occurred at hospital days 3-4. The patient’s lowest left ventricular ejection fraction occurred at days 5-6 of illness. Initial electrocardiograms were benign with PR intervals below 200 milliseconds (ms); however, collectively the length of time from initial symptom presentation till when electrocardiographic abnormalities began was approximately days 8-9. When comparing the timing of electrocardiogram changes with trends in c-reactive protein and brain-natriuretic peptide, it appeared that the PR and QTc elongation patterns occurred after the initial hyperinflammatory response. This goes in line with the proposed mechanism that such conduction abnormalities occur secondary to inflammation and edema of the conduction tissue as part of a widespread global myocardial injury process. Based on this syndrome being a hyperinflammatory response likely affecting conduction tissue, our group was treated with different regimens of intravenous immunoglobulin, steroids, anakinra, and/or tocilizumab. These medications were successful in treating third-degree heart block, prolonged QTc, and a junctional ectopic rhythm.

The characterization of interstellar chemical inventories provides valuable insight into the chemical and physical processes in astrophysical sources. The discovery of new interstellar molecules becomes increasingly difficult as the number of viable species grows combinatorially, even when considering only the most thermodynamically stable. In this work, we present a novel approach for understanding and modeling interstellar chemical inventories by combining methodologies from cheminformatics and machine learning. Using multidimensional vector representations of molecules obtained through unsupervised machine learning, we show that identification of candidates for astrochemical study can be achieved through quantitative measures of chemical similarity in this vector space, highlighting molecules that are most similar to those already known in the interstellar medium. Furthermore, we show that simple, supervised learning regressors are capable of reproducing the abundances of entire chemical inventories, and predict the abundance of not yet seen molecules. As a proof-of-concept, we have developed and applied this discovery pipeline to the chemical inventory of a well-known dark molecular cloud, the Taurus Molecular Cloud 1 (TMC-1); one of the most chemically rich regions of space known to date. In this paper, we discuss the implications and new insights machine learning explorations of chemical space can provide in astrochemistry., 20 pages; 8 figures, 2 tables in the main text. 6 figures, 2 tables in the appendix. Accepted for publication in The Astrophysical Journal Letters. Molecule recommendations for TMC-1 can be found in the Zenodo repository: https://zenodo.org/record/5146276

E-wallet was an innovative payment instrument that arises under financial technology. E-wallet helps to ease the user’s daily life, in which users can make their daily transactions without using the notes or coins. Indirectly, E-wallet also helps to reduce the risk of cash being stolen. Undeniably, E-wallet brings more benefits than disadvantages. The primary aim of this study is to examine the factors affecting the adoption of E-wallet services in Sarawak. The questionnaire, which consisted of 26 questions were distributed to the respondents and successfully collected 450 feedbacks. Firstly, this study applied factor analysis to construct all the variables. Also, Cronbach’s α coefficient was computed to determine internal consistency reliabilities. Then, this study used regression analysis to test the relationship between the variables. The results of the regression analysis showed that the users would adopt E-wallet when they perceive that the E-wallet is useful and easy to be used. Meanwhile, the findings of this study also showed that rewards tend to attract users to use E-wallet. Besides that, this study also found that higher perceived risk may act as a barrier to stop users from using E-wallet. These results help the E-wallet service providers to identify the significant factors that influence the user’s intention to use E-wallet services. Lastly, this study recommended the E-wallet service providers to take the security systems and rewards into consideration for the enhancement of their payment system.

International audience; Nuclear structure data plays an important role in nuclear physics studies and applications such as nuclear power generation. This article presents evaluations of a mean-field approach to describe two nuclear structure quantities namely the electric and magnetic moments. The Hartree-Fock-plus-pairing approach was employed with pairing correlations treated within the Bardeen-Cooper-Schrieffer (BCS) framework. The Skyrme SIII parametrization and seniority force are chosen to approximate the effective nucleon-nucleon and pairing interactions, respectively. Calculated results show that the self-consistent blocking procedure which takes into account time-reversal symmetry breaking is important to reproduce experimental magnetic moment

A proof-of-concept framework for identifying molecules of unknown elemental composition and structure using experimental rotational data and probabilistic deep learning is presented. Using a minimal set of input data determined experimentally, we describe four neural network architectures that yield information to assist in the identification of an unknown molecule. The first architecture translates spectroscopic parameters into Coulomb matrix eigenspectra, as a method of recovering chemical and structural information encoded in the rotational spectrum. The eigenspectrum is subsequently used by three deep learning networks to constrain the range of stoichiometries, generate SMILES strings, and predict the most likely functional groups present in the molecule. In each model, we utilize dropout layers as an approximation to Bayesian sampling, which subsequently generates probabilistic predictions from otherwise deterministic models. These models are trained on a modestly sized theoretical dataset comprising ${\sim}$83,000 unique organic molecules (between 18 and 180 amu) optimized at the $\omega$B97X-D/6-31+G(d) level of theory where the theoretical uncertainty of the spectroscopic constants are well understood and used to further augment training. Since chemical and structural properties depend highly on molecular composition, we divided the dataset into four groups corresponding to pure hydrocarbons, oxygen-bearing, nitrogen-bearing, and both oxygen- and nitrogen-bearing species, training each type of network with one of these categories thus creating "experts" within each domain of molecules. We demonstrate how these models can then be used for practical inference on four molecules, and discuss both the strengths and shortcomings of our approach, and the future directions these architectures can take., Comment: 48 pages, 13 figures, 6 tables. Accepted for publication in JPCA Special Issue: Machine Learning in Physical Chemistry. Code for models available at https://github.com/laserkelvin/rotconml. Corrected details about the optimizer and weight decay

Unlike traditional bus fleets, autonomous mobility services are naturally amenable to dynamic, demand-responsive adaptation of itinerary. Accurate prediction of demand for such services can thus improve their utilization and decrease their operational costs. Although demand for transit services is inherently stochastic, models of demand often reduce its distribution to point estimates, thus losing useful information for subsequent decision making. In this paper, we advocate for preserving the full predictive distribution through quantile regression, so that the structure of uncertainty in future demand is preserved. To demonstrate our approach, we present a real-world case study of an autonomous shuttle service in a Danish university campus, for which we have several weeks of crowd movement counts, as reconstructed from campus WiFi records. We devise several types of quantile regression models for demand prediction, analyze their performance, and discuss their applicability to the case study. Our modeling methodology can be extended to autonomous fleets of higher scale, thus promoting sustainable shared mobility.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden. The ERIC-PPCI trial was funded by a British Heart Foundation clinical study grant (grant number CS/14/3/31002) and a University College London Hospitals/University College London Biomedical Research Centre clinical research grant. The CONDI-2 trial was funded by Danish Innovation Foundation grants (grant numbers 11-108354 and 11-115818), Novo Nordisk Foundation (grant number NNF13OC0007447), and TrygFonden (grant number 109624). DJH was supported by the British Heart Foundation (grant number FS/10/039/28270), the National Institute for Health Research (NIHR) Biomedical Research Centre at University College London Hospitals, the Duke-National University Singapore Medical School, the Singapore Ministry of Health’s National Medical Research Council under its Clinician Scientist-Senior Investigator scheme (grant number NMRC/CSA-SI/0011/2017) and its Collaborative Centre Grant scheme (grant number NMRC/CGAug16C006), and the Singapore Ministry of Education Academic Research Fund Tier 2 (grant number MOE2016-T2-2-021). HEB was supported by the Novo Nordisk Foundation (grant numbers NNF14OC0013337, NNF15OC0016674). RKK is supported by the Oxford NIHR Biomedical Centre. The research was also supported by the NIHR infrastructure at Leeds. The views expressed are those of the author(s) and not necessarily those of the National Health Service, the NIHR, or the Department of Health. This article is based on the work of COST Action EU-CARDIOPROTECTION (CA16225) and supported by COST (European Cooperation in Science and Technology). We thank all study personnel for their invaluable assistance. Sí

Summary Background Lenalidomide and dexamethasone has been a standard of care in transplant-ineligible patients with newly diagnosed multiple myeloma. The addition of a third drug to the combination is likely to improve treatment efficacy. KEYNOTE-185 assessed the efficacy and safety of lenalidomide and dexamethasone with and without pembrolizumab in patients with previously untreated multiple myeloma. Here, we present the results of an unplanned interim analysis done to assess the benefit–risk of the combination at the request of the US Food and Drug Administration (FDA). Methods KEYNOTE-185 was a randomised, open-label, phase 3 trial done at 95 medical centres across 15 countries (Australia, Canada, France, Germany, Ireland, Israel, Italy, Japan, New Zealand, Norway, Russia, South Africa, Spain, UK, and USA). Transplantation-ineligible patients aged 18 years and older with newly diagnosed multiple myeloma, Eastern Cooperative Oncology Group performance status of 0 or 1, and who were treatment naive were enrolled, and randomly assigned 1:1 to receive either pembrolizumab plus lenalidomide and dexamethasone or lenalidomide and dexamethasone alone using an interactive voice or integrated web response system. Patients received oral lenalidomide 25 mg on days 1–21 and oral dexamethasone 40 mg on days 1, 8, 15, and 22 of repeated 28-day cycles, with or without intravenous pembrolizumab 200 mg every 3 weeks. The primary endpoint was progression-free survival, which was investigator-assessed because of early trial termination. Efficacy was analysed in all randomly assigned patients and safety was analysed in all patients who received at least one dose of study drug. This trial is registered at ClinicalTrials.gov , number NCT02579863 , and it is closed for accrual. Findings Between Jan 7, 2016, and June 9, 2017, 301 patients were randomly assigned to the pembrolizumab plus lenalidomide and dexamethasone group (n=151) or the lenalidomide and dexamethasone group (n=150). On July 3, 2017, the FDA decided to halt the study because of the imbalance in the proportion of death between groups. At database cutoff (June 2, 2017), with a median follow-up of 6·6 months (IQR 3·4–9·6), 149 patients in the pembrolizumab plus lenalidomide and dexamethasone group and 145 in the lenalidomide and dexamethasone group had received their assigned study drug. Median progression-free survival was not reached in either group; progression-free survival estimates at 6-months were 82·0% (95% CI 73·2–88·1) versus 85·0% (76·8–90·5; hazard ratio [HR] 1·22; 95% CI 0·67–2·22; p=0·75). Serious adverse events were reported in 81 (54%) patients in the pembrolizumab plus lenalidomide and dexamethasone group versus 57 (39%) patients in the lenalidomide and dexamethasone group; the most common serious adverse events were pneumonia (nine [6%]) and pyrexia (seven [5%]) in the pembrolizumab plus lenalidomide and dexamethasone group and pneumonia (eight [6%]) and sepsis (two [1%]) in the lenalidomide and dexamethasone group. Six (4%) treatment-related deaths occurred in the pembrolizumab plus lenalidomide and dexamethasone group (cardiac arrest, cardiac failure, myocarditis, large intestine perforation, pneumonia, and pulmonary embolism) and two (1%) in the lenalidomide and dexamethasone group (upper gastrointestinal haemorrhage and respiratory failure). Interpretation The results from this unplanned, FDA-requested, interim analysis showed that the benefit–risk profile of pembrolizumab plus lenalidomide and dexamethasone is unfavourable for patients with newly diagnosed, previously untreated multiple myeloma. Long-term safety and survival follow-up is ongoing. Funding Merck Sharp & Dohme, a subsidiary of Merck & Co, Inc (Kenilworth, NJ, USA).

This paper examines the relationship between credit risk and profitability of Malaysian local commercial banks which consist of eight banks they are Maybank, CIMB Bank, Hong Leong Bank, Public Bank, RHB Bank, AmBank, Alliance Bank, and Affin Bank. For the purpose of analysis this study covers a period of eight years from 2005 to 2012. The empirical tests employed in this study are Pooled Ordinary Least Square (OLS) and Panel regression. Based on the findings of this study its shows that the non-performing loan to total loan ratio (NPL/LA) and the ratio of loan loss provision to total loan (LLP/LA) have a negative effect on profitability meanwhile the total loan to total deposit ratio (LA/TD) found to have a positive effect on the return on asset (ROA). Overall the results of this study concluded that to some degree, Malaysia’s commercial banks have a very good credit risk policy.

Leaves of the Epimedium plant are traditionally consumed for bone health and other indications. The aim of this study was to establish the safety and pharmacokinetics of the metabolites of prenylflavonoids (icariin, icariside I, icariside II, icaritin, and desmethylicaritin) following single doses of a defined Epimedium prenylflavonoid extract in humans. A single oral dose of 370, 740, or 1110 mg of a standardized Epimedium prenylflavonoid extract was administered to 30 healthy male subjects in a randomized, placebo-controlled trial. Serum samples were collected over a 48-h period and analyzed by liquid chromatography-tandem mass spectrometry and non-compartmental pharmacokinetic modelling. Epimedium prenylflavonoid extracts were well tolerated and no adverse effects were observed. The principle metabolites detected in the serum were icariside II and desmethylicaritin. Icariside II had a T max of between 4.1 – 4.3 h, reaching a maximum AUC0→∞ of 23.0 (17.5, 29.9) h×ng/mL (median [IQR: interquartile range]) with the highest dose of the Epimedium prenylflavonoid. On the other hand, desmethylicaritin had a delayed T max of 24.1 – 24.4 h and reached a maximum AUC0→∞ of 126.1 (62.4, 202.9) h×ng/mL. The median maximum plasma concentration and AUC0→∞ of desmethyliciaritin showed an increase with higher doses of the Epimedium prenylflavonoid (p

OBJECTIVES: The authors sought to evaluate the accuracy of instantaneous wave-Free Ratio (iFR) pullback measurements to predict post-percutaneous coronary intervention (PCI) physiological outcomes, and to quantify how often iFR pullback alters PCI strategy in real-world clinical settings.\ud \ud BACKGROUND: In tandem and diffuse disease, offline analysis of continuous iFR pullback measurement has previously been demonstrated to accurately predict the physiological outcome of revascularization. However, the accuracy of the online analysis approach (iFR pullback) remains untested.\ud \ud METHODS: Angiographically intermediate tandem and/or diffuse lesions were entered into the international, multi-center iFR GRADIENT (Single instantaneous wave-Free Ratio Pullback Pre-Angioplasty Predicts Hemodynamic Outcome Without Wedge Pressure in Human Coronary Artery Disease) registry. Operators were asked to submit their procedural strategy after angiography alone and then after iFR-pullback measurement incorporating virtual PCI and post-PCI iFR prediction. PCI was performed according to standard clinical practice. Following PCI, repeat iFR assessment was performed and the actual versus predicted post-PCI iFR values compared.\ud \ud RESULTS: Mean age was 67+/-12 years (81% male). Paired pre-and post-PCI iFR were measured in 128 patients (134 vessels). The predicted post-PCI iFR calculated online was 0.93+/-0.05; observed actual iFR was 0.92+/-0.06. iFR pullback predicted the post-PCI iFR outcome with 1.4+/-0.5% error. In comparison to angiography-based decision making, after iFR pullback, decision making was changed in 52 (31%) of vessels; with a reduction in lesion number (-0.18+/-0.05 lesion/vessel; p = 0.0001) and length (-4.4+/-1.0 mm/vessel; p < 0.0001).\ud \ud CONCLUSIONS: In tandem and diffuse coronary disease, iFR pullback predicted the physiological outcome of PCI with a high degree of accuracy. Compared with angiography alone, availability of iFR pullback altered revascularization procedural planning in nearly one-third of patients.

This paper describes a study conducted to evaluate the use of concrete containing up to 100% recycled concrete aggregate (RCA) for the construction of a commercial building known as the Samwoh Eco-Green Building in Singapore. The study is a continuation of research which established that concrete produced with RCA can achieve strength comparable to that of normal concrete produced with natural aggregate for structural applications by using a rational mix design approach. The present study was carried out to evaluate the effects of RCA on other engineering and durability properties of concrete, including compressive strength, flexural strength, tensile splitting strength, creep strain, water permeability, initial surface absorption, chloride ingress and sulfate resistance. With normal concrete serving as the basis for comparison, the experimental data showed that comparable compressive strength, flexural strength and tensile splitting strength were attainable for concrete containing up to 100% RCA. Although concrete with 100% RCA exhibited higher creep strain and initial surface absorption rate as well as lower resistance to water permeability, chloride ingress and external sulfate attack, the effects on the concrete performance are insignificant. On the whole, the research study suggests that RCA concrete can be designed to meet the specifications for structural applications, which led to the successful completion of the Samwoh Eco-Green Building.

Traditionally travel time estimation is performed through data from loop detectors. However, this solution is not truly scalable because of the high cost associated with the installation and maintenance of loop detectors in large transportation networks. As GPS-equipped devices become increasingly common, it proves to be a more viable alternative data source for travel time estimation. Previous studies have successfully estimated travel time with good accuracy either from loop detectors data or GPS data. In this paper, we present a nearest-neighbor method for estimating travel time with partial information, using a distance measure derived from analytical models of the relationship between travel time and trip features. Our method is compared to a baseline nearest-neighbor method using generic Euclidean distance as its distance metric. We tested both methods on 1 million taxi trips and found that our method has successfully reduced the mean absolute percentage error (MAPE) value to 22.29% which is a 16% improvement over the baseline method.

This paper describes a study that was carried to investigate the use of recycled concrete aggregate (RCA) in aircraft stand rigid pavement at the Singapore Changi Airport. The study aimed to recycle the concrete waste generated from the demolition of the existing aircraft stand rigid pavement to reconstruct the aircraft stand rigid pavement. The study was a continuation of a previous work in which 20% of RCA was used in the rigid pavement. In this study, laboratory tests were carried out to evaluate the use of up to 100% of RCA in rigid pavement. The test properties that were evaluated include compressive strength, flexural strength, drying shrinkage and resistance to chloride ingress. The study showed that it is viable to incorporate high RCA content in concrete.

In Singapore, the applications of recycled concrete aggregate (RCA) are limited to nonstructural concrete, road construction, and backfilling. To realize the beneficial use of RCA, an in-depth study was conducted to evaluate its use in structural concrete. This paper reports the test results of a study that is part of extensive research intended to evaluate the properties of RCA concrete produced by a proposed rational approach in concrete mix design. The key parameters studied include compressive strength, elastic modulus, and drying shrinkage. The results showed that the RCA concrete can be designed to achieve comparable compressive strength and elastic modulus, relative to the corresponding properties of concrete containing natural coarse aggregate (NCA). RCA concrete tends to exhibit higher drying shrinkage strains relative to NCA concrete, but the values are within the recommended limits.

Novel agents have demonstrated enhanced efficacy when combined with other antimyeloma agents especially dexamethasone. The steroid doses employed in myeloma regimens are often poorly tolerated. Therefore, in a phase II clinical trial we investigated the efficacy of a steroid-free combination including bortezomib, pegylated liposomal doxorubicin and thalidomide (VDT regimen). Twenty-three patients with relapsed or refractory myeloma or other plasma cell cancers were treated with the VDT regimen. Patient had a median of five prior therapies and 65.2% were refractory to their last regimen. The overall response rates were 55.5% and 22%, respectively. The median progression free survival was 10.9 months (95% CI: 7.3-15.8) and the median overall survival was 15.7 months (95% CI: 9.1-not reached). Fatigue and sensory neuropathy were the most common side effects noted. We observe that VDT is an effective steroid-free regimen with ability to induce durable remission even in patients with refractory myeloma.

Multiple myeloma patients with plasmablastic morphology of tumor cells and extramedullary presentation of disease often have an aggressive clinical course and resistance to chemotherapy. We describe a case of an elderly patient who presented with extramedullary, IgA-λ—secreting multiple myeloma with plasmablastic features who demonstrated impressive clinical response to single-agent lenalidomide. This is the first description of a plasmablastic variety of multiple myeloma successfully treated with lenalidomide alone.

An endoscopic method of malar arch repair without a bicoronal incision has been recently described. To determine the effectiveness of this new technique, a cadaver study was performed to evaluate the capacity of this technique to (1) restore the anatomic position of a fractured malar arch, (2) rigidly fixate the arch, and (3) avoid injury to the frontal branch of the facial nerve. The technique of endoscopically assisted fracture repair was then applied to a clinical series of consecutive patients presenting with displaced zygomatic fractures with comminution at the malar arch. All cadaveric specimens repaired with this endoscopic technique demonstrated anatomic reduction and rigid fixation of the arch without disruption of the frontal branch of the facial nerve. In all clinical cases, four-point rigid plate fixation (zygomaticofrontal, infraorbital, malar arch, and zygomaticomaxillary buttress) was achieved endoscopically with limited access incisions. All clinical cases demonstrated excellent skeletal restoration of the zygoma on postoperative computed tomography scans. On clinical examination, facial symmetry and normal facial nerve function were observed in all patients after operation.

We demonstrate a field-portable upright and inverted microscope that can image specimens in both reflection and transmission modes. This compact and cost-effective dual-mode microscope weighs only ∼135 grams (

Pedestrian detection is one of the most popular research areas in video processing and it is vital for video surveillance systems. In this paper, we present a real-time pedestrian detection system based on Dalal and Triggs's human detection framework with the use of image segmentation and virtual mask. Image segmentation enables the system to focus only on the region of interest whereas the virtual mask reduces noise and unnecessary processing. The system has high computational speed while it retains the discriminative power of Histogram of Oriented Gradient (HOG) features for pedestrian detection. It is tested with videos captured in a single task environment and in various lengths. The experimental results showed that most of the pedestrians in the videos are correctly detected, achieving an overall accuracy of 83.29% with low amount of computational time, which implies the effectiveness in detecting pedestrians and the real-time property of the proposed system.

Recent research has been devoted to detecting people in images and videos. In this paper, a human detection method based on Histogram of Oriented Gradients (HoG) features and human body ratio estimation is presented. We utilized the discriminative power of HoG features for human detection, and implemented motion detection and local regions sliding window classifier, to obtain a rich descriptor set. Our human detection system consists of two stages. The initial stage involves image preprocessing and image segmentation, whereas the second stage classifies the integral image as human or non-human using human body ratio estimation, local region sliding window method and HoG Human Descriptor. Subsequently, it increases the detection rate and reduces the false alarm by deducting the overlapping window. In our experiments, DaimlerChrysler pedestrian benchmark data set is used to train a standard descriptor and the results showed an overall detection rate of 80% above.

We present a novel probe-based portable clinical system for early detection and margin demarcation of melanoma and non-melanoma skin cancers. The system collects both white light reflectance and fluorescence from tissue in real time. We use gated detection to eliminate effects of room lights and make the system clinically compatible. Instrument control and spectral calibration is automated using a personal computer. The total acquisition time for data collection is less than a second. We use a spectrally-constrained inverse model for our probe geometry to fit the diffuse reflectance and extract hemoglobin content, oxygen saturation, tissue micro-architecture and melanin content. We demonstrate system performance and present results from tissue simulating phantoms. The mean rms errors in estimating scattering and absorption coefficients in tissue phantoms over a physiologically relevant range were 9.8% and 11.8% respectively. Using a photon migration model and least-squares regression we were able to extract the intrinsic fluorescence line shapes and estimate fluorophore concentrations from measured fluorescence spectra with an rms error of less than 10%.

The wavelength of a semiconductor laser diode (LD) is modulated using the self-mixing effect to create the undulation wave. In order to determine the direction of a moving target, the number of undulations is added to the undulations of detected Doppler frequency shift. These modulated undulations are generated through the difference between the rising and falling counts of a triangular modulated current waveform of LD. A theoretical model is proposed to relate the wavelength modulation and current modulation of LD to predict the number of undulations so that the direction of a moving target can be determined.

A novel sustain driver is proposed to drive a plasma display panel (PDP) while minimizing circuit complexity compared with prior approaches. The presented driver uses an inductor to resonate with the equivalent intrinsic capacitance of the PDP so that abrupt charging/discharging operation is avoided. The energy loss due to conventional hard switching driving is mainly recovered. All active switches are operated with zero voltage switching and all diodes are turned off naturally without the problem of reverse recovery.

Traditional radiofrequency devices use extreme heat (400-600 °C) to abruptly vaporize intracellular and extracellular fluids, causing tissue desiccation. On a new front, Coblation presents a unique method of delivering radiofrequency energy for soft tissue removal applications in medicine, including ENT surgery. Coblation involves energizing the ions in conductive fluid (saline), via a bipolar wand, to form a plasma field. The plasma has enough energy to break the tissue’s molecular bonds, creating an ablative path while resulting in minimal thermal penetration (70-90 °C) into surrounding tissue. Epithelial destruction, collateral tissue damage, and wound healing were observed in a rat tongue model. Coblation treated animals had significantly less epithelial destruction and collateral tissue damage, which resulted in less granulation tissue and faster wound healing. Clinical experience with coblation in otolaryngology has been very promising in a variety of situations. Specifically, coblation has been used for tonsillar surgery for total tonsillar excision, subtotal ablation and tonsil channeling with subsequent volume reduction . Clinical studies have shown that coblation has offered significant advantages compared to tradition techniques in each of these applications. In many cases patients operated on using coblation had a reduction of pain and a more rapid return to normal diet and activity. The blend of effective tissue ablation and hemostasis for bleeding that coblation offers may make it useful for most procedures that utilize electrocautery devices at this time.

An endoscopic method of mandibular subcondylar fracture repair has been described recently. To determine the effectiveness of this new technique, we longitudinally studied functional, aesthetic, and radiographic parameters following endoscopic repair of 22 subcondylar frac-tures in 20 patients. Restoration of mandibular function was achieved without postoperative maxillomandibular fixation. Premorbid occlusion was restored. Clinical jaw motion was found to progressively increase with a mean interincisal jaw opening of 43 mm achieved after the eighth postoperative week. Patients were pleased with the aesthetic restoration of their chin projection, jaw line, and the symmetric midline movement of the chin point on jaw opening. Anatomic fracture reduction with rigid plate fixation was confirmed on early postsurgical radiographs. Late radiographs showed fracture union without remodeling of the condylar head. Endoscopic subcondylar fracture repair was efficacious at functional, aesthetic, and radiographic restoration of the mandible.

Objective To describe the design and ventilatory characteristics of a new mode of ventilation (pressurized injection/suction ventilation). Design Descriptive and analytical laboratory study. Setting Laboratory study. Subjects Simulated lung model and dogs. Interventions We tested the ability to maintain ventilation through a 2.5-mm internal diameter ventilating stylet in the setting of simulated complete airway occlusion. A microprocessor-controlled ventilator mode was used wherein injection of oxygen under high pressure (flow rate 95 L/min) alternates with suction of expired gas (flow rate 18 L/min) through the ventilating stylet. Measurements and main results In a lung model, we achieved a maximum minute ventilation of 12.9 L/min. In two dogs, we maintained stable oxygenation (mean PaO2 603 +/- 47 torr [80.4 +/- 6.3 kPa]) and ventilation (mean PaCO2 19 +/- 3 torr [2.5 +/- 0.4 kPa]) for 15 mins at maximum minute ventilation settings. No clinically important deleterious effects on the tracheal mucosa were observed. The ventilator system's safety-abort feature prevented overinflation or excessive deflation of the dogs' lungs in every test of simulated malfunction of the pressure-monitoring mechanism. Conclusions Pressurized injection/suction ventilation can maintain adequate gas exchange in an animal model with near-complete airway obstruction. Further work is needed to develop the safety and clinical applications of pressurized injection/suction ventilation in the management of patients with near-complete airway occlusion.

We report a probe-based portable and clinically compatible instrument for the spectral diagnosis of melanoma and nonmelanoma skin cancers. The instrument combines two modalities--diffuse reflectance and intrinsic fluorescence spectroscopy--to provide complementary information regarding tissue morphology, function, and biochemical composition. The instrument provides a good signal-to-noise ratio for the collected reflectance and laser-induced fluorescence spectra. Validation experiments on tissue phantoms over a physiologically relevant range of albedos (0.35-0.99) demonstrate an accuracy of close to 10% in determining scattering, absorption and fluorescence characteristics. We also demonstrate the ability of our instrument to collect in vivo diffuse reflectance and fluorescence measurements from clinically normal skin, dysplastic nevus, and malignant nonmelanoma skin cancer.

We have previously shown that plasma from patients with idiopathic as well as HIV and thienopyridine-linked TTP induces apoptosis of microvascular endothelial cells (MVEC) in vitro, with specific sparing of large vessel and pulmonary MVEC, consistent with the clinical syndrome. This correlates with in vivo measures of apoptosis in splenic tissue of TTP patients. We found that osteoprotegrin (OPG), an inhibitor of multiple inducers of MVEC apoptosis, could block TTP plasma-mediated MVEC injury. Utilizing OPG affinity-binding columns and MS-TOFI analysis of column eluates, we subsequently identified complement (C) components and C-regulatory factors as potentially involved in TTP plasma-mediated EC injury. Building on the observation that familial TTP syndromes have been linked to genetic deficiencies of the C-regulatory factors Factor H and MCP, and three cases of sporadic HUS in children have been accompanied by autoantibodies to factor H, we hypothesized that the C-system plays an important role in TTP-induced MVEC injury, facilitated by autoantibody-mediated suppression of C-regulatory proteins. To evaluate the role of the complement system we looked at: IFA staining of splenic tissue from TTP patients versus controls for C-components in conjunction with CD34+ indentification of MVEC. ELISA-based assays of complement activation/deposition on MVEC exposed to TTP vs. control plasma. Ability of anti-C agents to block TTP plasma-mediated MVEC apoptosis. DNA microarray analysis of TTP plasma MVEC exposed to TTP vs. control plasma. ELISA-based search for autoantibodies against C-regulatory proteins in TTP plasma. IFA staining demonstrated increased deposition of C-components on MVEC in vivo on splenic tissue of TTP vs. control patients (4/5 TTP, 0/3 control). Increased C-activation was demonstrated on MVEC exposed to plasmas of TTP patients in vitro as evidenced by decreased C3b (p=0.002) and C4d (p=0.0002) deposition. Microarray data revealed increased expression of C-regulatory factors in resistant vs. susceptible MVEC exposed to TTP plasma. C-inhibtion resulted in prevention of TTP-plasma induced MVEC apoptosis by annexin-V staining (P

The purpose of this paper is to empirically examine the effect of internet users' general attitude towards internet advertising and level of product involvement on their attitudes and behaviour. In this study, three banner advertisements and corporate websites of varying creative content and message appeal were used. Data was gathered through an online survey with a sample size of 245 respondents. The Covariance Structural Modelling results show that general attitude towards internet advertising and level of product involvement has a positive impact on users' attitudes (site and brand) and behavioural intention. The results show that the extent to which users perceive a corporate website is customised from information derived from their individual-level differences and is influenced by their general attitude towards internet advertising and level of involvement. Copyright © 2006 Inderscience Enterprises Ltd.