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BackgroundLeptospirosis is the most common anthropozoonosis worldwide and imposes a major public health problem in many tropical countries. It is a leading cause of disease burden in form of mortality, morbidity and hospital admission. Identifying patients at high risk for mortality or for prolonged hospitalization may save lives and preserve economy. The aim of the current study is to identify significant factors associated with disease mortality and prolonged hospitalization.DesignCress-sectional retrospective study.SettingsTertiary care teaching hospitals in Kelantan, Peninsular Malaysia.ParticipantsAdult patients proven to have leptospirosis depending on IgM ELISA were classified into two classes depending on prolonged hospitalization (>7 days or ≤ 7 days) and mortality (fatal cases or non-fatal cases). Patients' clinico-laboratory data were compared according to these two outcomes using the appropriate statistical test.ResultsOf the 525 patients enrolled, 136 (25.9%) had prolonged hospitalization. The mean length of stay was 6.77 ± 5.68 days. Logistic regression analysis identified acute kidney injury (AKI) (OR 2.3), Jaundice (OR 2.7), elevated alanine aminotransferase (ALT) (OR 2), and prolonged prothrombin time (PT) (OR 1.9) independently associated with prolonged hospitalization. Case fatality rate was 6.48% and around one third of fatal cases had prolonged hospitalization of more than seven days. Factors associated with leptospirosis mortality included age >40 years (p < 0.001), patients presented with tachypnea (p = 0.002), pulmonary infiltrate (p < 0.001), T-wave changes (p < 0.001), atrial fibrillation (p = 0.013), conducting abnormality (p < 0.001), chronic kidney diseases (p < 0.001), multiple organ dysfunctions (p < 0.0010), respiratory failure (p < 0.001), pneumonia (p < 0.001), sepsis (p = 0.004), low venous PH (p = 0.042), AKI (P < 0.001), elevated AST (p < 0.001) or ALT (p = 0.004), hypoalbuminemia (p < 0.001), rhabdomyolysis (p < 0.001), severe thrombocytopenia (p = 0.042), prolonged PT (p < 0.001) or prolonged aPTT (p < 0.017).ConclusionsSignificant proportion of leptospirosis patients (25.9%) had prolonged hospital stay and less proportion died (6.48%). Early identifying patients with factors associated with prolonged hospitalization and death will positively impact practitioners' decisions regarding the proper and fast course of management including ICU admission.

A cross-sectional study was carried out from November, 2015 to April, 2018 to determine the prevalence and identify the risk factors of BTB using the comparative intradermal tuberculin (CIDT) test on 5327 dairy cattle in 16 dairy herds in mid-delta, Alexandria Road and Upper Egypt districts. Questionnaires used to collect data on herd size and management. The herd and individual animal prevalence at cut-off ≥4mm were 68.75% (95%, CI: 46 to 91.4) and1.67% (95%, CI: 1.3to 2.1) respectively. The individual prevalence was significantly associated with age, breed and different location of farms and density of cattle in yard. On herd level, history of BTB in the farm, management practices, raising of different species in the same facility and newly purchased cattle are important risk factors for BTB. The postmortem examination of positive reactors revealed 66 (85.71%) out of 77slaughtered cattle with visible lesions and 11(14.29%) with non-visible lesions. Bacteriological examination revealed 74.24% (49/66) from visible lesions and 9.09% (1/11) from non-visible lesions were Mycobacterium bovis. The indirect enzyme linked immunosorbent assay (IELISA) results revealed 31(40.26%) showed positive result including 29 (93.6%) visible lesions and 2(6.4%) nonvisible lesions. In conclusion, the prevalence high in herds with poor management condition, raised different species in the same facility, had previous history of BTB infection and purchased new animals. At animal level Holstein breed, 3-6 years age, kept in high density and located in mid- delta district were at higher risk to be reactor to comparative intradermal tuberculin (CIDT) test.

Leptospirosis is the most widely spread zoonosis and Leptospirosis Associated Acute Kidney Injury (LAKI) is common and fatal if not properly and swiftly treated. The aim of this review is to evaluate the mortality of LAKI and to identify the risk factors for its development. An electronic search was performed to identify the studies included LAKI patients series. Only studies which investigated mortality or risk factors for LAKI development in adults were included. Twenty-three studies with 24 patients series were included in the final analysis and included 1698 patients. The median series mortality was 10.05% (range 0–33.3%) with a total of 223 death. Only four studies identified the independent risk factors for LAKI development which were oliguria, jaundice, arrhythmia, crackles, elevated direct bilirubin level, elevated activated prothrombin time, hyperbilirubinemia and leukocytosis. Although the mortality of LAKI is high, its predictors are not studied enough in literature. Keywords: Leptospirosis associated acute kidney injury, Predictors, Mortality, Clinical characters, Adults, Systematic review

Abstract Monitoring of ingestive activities is critically important for managing the health and wellness of individuals with various health conditions, including the elderly, diabetics, and individuals seeking better weight control. Monitoring swallowing events can be an ideal surrogate for developing streamlined methods for effective monitoring and quantification of eating or drinking events. Swallowing is an essential process for maintaining life. This seemingly simple process is the result of coordinated actions of several muscles and nerves in a complex fashion. In this study, we introduce automated methods for the detection and quantification of various eating and drinking activities. Wireless surface electromyography (sEMG) was used to detect chewing and swallowing from sEMG signals obtained from the sternocleidomastoid muscle, in addition to signals obtained from a wrist-mounted IMU sensor. A total of 4675 swallows were collected from 55 participants in the study. Multiple methods were employed to estimate bolus volumes in the case of fluid intake, including regression and classification models. Among the tested models, neural networks-based regression achieved an R 2 of 0.88 and a root mean squared error of 0.2 (minimum bolus volume was 10 ml). Convolutional neural networks-based classification (when considering each bolus volume as a separate class) achieved an accuracy of over 99% using random cross-validation and around 66% using cross-subject validation. Multiple classification methods were also used for solid bolus type detection, including SVM and decision trees (DT), which achieved an accuracy above 99% with random validation and above 94% in cross-subject validation. Finally, regression models with both random and cross-subject validation were used for estimating the solid bolus volume with an R 2 value that approached 1 and root mean squared error values as low as 0.00037 (minimum solid bolus weight was 3 gm). These reported results lay the foundation for a cost-effective and non-invasive method for monitoring swallowing activities which can be extremely beneficial in managing various chronic health conditions, such as diabetes and obesity.

Abstract Disparities in premature cardiovascular mortality (PCVM) have been associated with socioeconomic, behavioral, and environmental risk factors. Understanding the “phenotypes”, or combinations of characteristics associated with the highest risk of PCVM, and the geographic distributions of these phenotypes is critical to targeting PCVM interventions. This study applied the classification and regression tree (CART) to identify county phenotypes of PCVM and geographic information systems to examine the distributions of identified phenotypes. Random forest analysis was applied to evaluate the relative importance of risk factors associated with PCVM. The CART analysis identified seven county phenotypes of PCVM, where high-risk phenotypes were characterized by having greater percentages of people with lower income, higher physical inactivity, and higher food insecurity. These high-risk phenotypes were mostly concentrated in the Black Belt of the American South and the Appalachian region. The random forest analysis identified additional important risk factors associated with PCVM, including broadband access, smoking, receipt of Supplemental Nutrition Assistance Program benefits, and educational attainment. Our study demonstrates the use of machine learning approaches in characterizing community-level phenotypes of PCVM. Interventions to reduce PCVM should be tailored according to these phenotypes in corresponding geographic areas.

Objective: Dysphagia management relies on the evaluation of the temporospatial kinematic events of swallowing performed in videofluoroscopy (VF) by trained clinicians. The upper esophageal sphincter (UES) opening distension represents one of the important kinematic events that contribute to healthy swallowing. Insufficient distension of UES opening can lead to an accumulation of pharyngeal residue and subsequent aspiration which in turn can lead to adverse outcomes such as pneumonia. VF is usually used for the temporal and spatial evaluation of the UES opening; however, VF is not available in all clinical settings and may be inappropriate or undesirable for some patients. High resolution cervical auscultation (HRCA) is a noninvasive technology that uses neck-attached sensors and machine learning to characterize swallowing physiology by analyzing the swallow-induced vibrations/sounds in the anterior neck region. We investigated the ability of HRCA to noninvasively estimate the maximal distension of anterior-posterior (A-P) UES opening as accurately as the measurements performed by human judges from VF images. Methods and procedures: Trained judges performed the kinematic measurement of UES opening duration and A-P UES opening maximal distension on 434 swallows collected from 133 patients. We used a hybrid convolutional recurrent neural network supported by attention mechanisms which takes HRCA raw signals as input and estimates the value of the A-P UES opening maximal distension as output. Results: The proposed network estimated the A-P UES opening maximal distension with an absolute percentage error of 30% or less for more than 64.14% of the swallows in the dataset. Conclusion: This study provides substantial evidence for the feasibility of using HRCA to estimate one of the key spatial kinematic measurements used for dysphagia characterization and management. Clinical and Translational Impact Statement: The findings in this study have a direct impact on dysphagia diagnosis and management through providing a non-invasive and cheap way to estimate one of the most important swallowing kinematics, the UES opening distension, that contributes to safe swallowing. This study, along with other studies that utilize HRCA for swallowing kinematic analysis, paves the way for developing a widely available and easy-to-use tool for dysphagia diagnosis and management.

Dysphagia, commonly referred to as abnormal swallowing, affects millions of people annually. If not diagnosed expeditiously, dysphagia can lead to more severe complications, such as pneumonia, nutritional deficiency, and dehydration. Bedside screening is the first step of dysphagia characterization and is usually based on pass/fail tests in which a nurse observes the patient performing water swallows to look for dysphagia overt signs such as coughing. Though quick and convenient, bedside screening only provides low-level judgment of impairment, lacks standardization, and suffers from subjectivity. Recently, high resolution cervical auscultation (HRCA) has been investigated as a less expensive and non-invasive method to diagnose dysphagia. It has shown strong preliminary evidence of its effectiveness in penetration-aspiration detection as well as multiple swallow kinematics. HRCA signals have traditionally been collected and investigated in conjunction with videofluoroscopy exams which are performed using barium boluses including thin liquid. An HRCA-based bedside screening is highly desirable to expedite the initial dysphagia diagnosis and overcome all the drawbacks of the current pass/fail screening tests. However, all research conducted for using HRCA in dysphagia is based on thin liquid barium boluses and thus not guaranteed to provide valid results for water boluses used in bedside screening. If HRCA signals show no significant differences between water and thin liquid barium boluses, then the same algorithms developed on thin liquid barium boluses used in diagnostic imaging studies, it can be then directly used with water boluses. This study investigates the similarities and differences between HRCA signals from thin liquid barium swallows compared to those signals from water swallows. Multiple features from the time, frequency, time-frequency, and information-theoretic domain were extracted from each type of swallow and a group of linear mixed models was tested to determine the significance of differences. Machine learning classifiers were fit to the data as well to determine if the swallowed material (thin liquid barium or water) can be correctly predicted from an unlabeled set of HRCA signals. The results demonstrated that there is no systematic difference between the HRCA signals of thin liquid barium swallows and water swallows. While no systematic difference was discovered, the evidence of complete conformity between HRCA signals of both materials was inconclusive. These results must be validated further to confirm conformity between the HRCA signals of thin liquid barium swallows and water swallows.

The implementation of RFID technology has globally impacted several industries and this revolution has improved the aspects of service delivery in many sectors, such as logistics, supply chain visibility, access control, military, and agri-food sector. RFID provides several security services to protect the data transmitted between a tag and a reader in the IoT environment. However, these advantages do not prevent an attacker to access this communication and remaining various security and privacy issues in these systems. Furthermore, with the rapid growth of IoT, there is an urgent need of security authentication and confidential data protection. Authentication protocols based on cryptographic primitives were widely investigated and implemented to guarantee protection against various attacks that can suffer an RFID system. Among those cryptosystems is the Elliptic Curve Integrated Encryption Scheme (ECIES), which can be found in several cryptographic standards. It offers mutual authentication and data integrity that has become highly employed in RFID applications. In this paper, we present a novel secure ECC-based RFID authentication protocol that meets the security needs of existing published protocols and ensures data confidentiality and privacy. Beforehand, we present an overview of some ECC-based RFID authentication protocols and highlight their security weaknesses against server spoofing, tracking, and impersonation attacks. After that, a comparative study with existing protocols in terms of computational performance and security strength is performed. Finally, our protocol is analyzed and verified with the Automated Validation of Internet Security Protocols and Applications (AVISPA) analysis tool after being modeled in High Level Protocol Specification Language (HLPSL).

Investigates the secondary emission yield, physical density and electrical resistivity of SnO[subx] conductor films. Information on secondary electron emission yield of thin films; Measurement of values of SnO[subx] films as a function of primary electron energy; Result of electron diffraction and electron microscopy analyses.

Lane departure warning systems have gained considerable research interest in the past decade for its promising usage in automotive, where lane detection and tracking is applied. However, it is a challenging task to improve the robustness of lane detection due to environmental factors, such as perspective effect, possible low visibility of lanes, and partial occlusions. To deal with these issues, we propose a reliable vision-based real-time lane markings detection and tracking system that can adapt to various environmental conditions. The lane detection is composed of three stages: pre-processing, Adaptive Region of Interest (AROI) setting, and lane marking detection and tracking. In the pre-processing stage, smoothing and edge detection operators are applied on input frames to automatically obtain binary images, then, lane markings segmentation are carried out. After that, An Adaptive Region of Interest is extracted to reduce the computational complexity. In the subsequent detection stages, Kalman filter is employed to track road boundaries detected in the AROI using Progressive Probabilistic Hough Transform (PPHT) in the next frame. Based on road boundaries and the vehicle's position, the proposed algorithm decides if the vehicle has drifted off the lane. For the performance evaluation of lane detection and tracking, real-life datasets for both urban roads and highways in various lighting conditions are used. Applying our method to Catltech dataset, the average correct detection rate is 93.82%. In addition, the proposed method outperforms that of the state-of-the-art methods in processing time (21.54ms/frame).

The interleukin-1 family has multifaceted roles in men٫s reproductive syste. Out of these is interleukin-1 receptor antagonist (IL-1RN) which exists in men gonads, and in case of infection and inflammatory process, its activity is increased. The current study aims to verify a possible linkage of Variable Number Tandem Repeat (VNTR) polymorphism of the IL-1RN gene with human men infertility. The study groups enrolled included 100 infertile men and 100 fertile and healthy men. Their seminal fluids were subjected to analysis. Also peripheral blood samples were collected for the assessment or detection of polymorphic Variable Number Tandem Repeats (VNTR) polymorphism of interleukin-1 receptor antagonist gene (IL-1RN). Two alleles, namely IL-1RN1 allele corresponding to 410bp fragment and IL-11RN2 that corresponding to 240bp fragments, are a marker for human men infertility, detected by PCR technique. The results delineated a high frequency of IL-1RN2 allelic gene variants (26%), and two VNTR allelic gene variants carriers IL-1RN1 and IL-1RN2 (16%) among infertile men with significant impacts on sperm motility and morphology (P< 0.000-0.002) respectively. This prospective study inKurdistan region (Erbil –Iraq) defined a significant impact of VNTR polymorphism of IL-1RN gene in the etiology of men infertility especially on sperm motility and morphology; particularly carriers of IL-1RN2 allelic variants

Millions of people across the globe suffer from swallowing difficulties, known as dysphagia, which can lead to malnutrition, pneumonia, and even death. Swallowing cervical auscultation, which has been suggested as a noninvasive screening method for dysphagia, has not been associated yet with any physical events. In this paper, we have compared the hyoid bone displacement extracted from the videofluoroscopy images of 31 swallows to the signal features extracted from the cervical auscultation recordings captured with a tri-axial accelerometer and a microphone. First, the vertical displacement of the anterior part of the hyoid bone is related to the entropy rate of the superior–inferior swallowing vibrations and to the kurtosis of the swallowing sounds. Second, the vertical displacement of the posterior part of the hyoid bone is related to the bandwidth of the medial–lateral swallowing vibrations. Third, the horizontal displacements of the posterior and anterior parts of the hyoid bone are related to the spectral centroid of the superior–inferior swallowing vibrations and to the peak frequency of the medial–lateral swallowing vibrations, respectively. At last, the airway protection scores and the command characteristics were associated with the vertical and horizontal displacements, respectively, of the posterior part of the hyoid bone. Additional associations between the patients’ characteristics and auscultations’ signals were also observed. The hyoid bone maximal displacement is a cause of swallowing vibrations and sounds. High-resolution cervical auscultation may offer a noninvasive alternative for dysphagia screening and additional diagnostic information.

A high demand for mineral resources observed in recent decades has led to an expansion in production in the mining industry. Different process alternatives have been proposed for selective separation between apatite and contaminants (carbonates and silicates) present in phosphate ores. Magnetic separation, calcinations and gravity separation processes are methods that present low efficiency and high cost. Flotation is the most common process; however the selectivity is hampered by the superficial similarity of the chemical composition of phosphates and carbonates, high surface activity of the collectors used, interactions between dissolved ionic species of certain mineral with another and also interactions between dissolved ionic species and reagents. So, selective adsorption and surface modification of minerals by surfactants is the primarily step in the process of separating certain minerals with similar physical and chemical characteristics in the flotation process. In Egypt phosphate rock present in three main regions Nile valley, new valley in western desert, and in the Eastern desert along the red sea coast. The ore was pretreated through grinding, sorting and discarding slimes. The effect on flotation of pH, collector concentration, and particle size and flotation time was then analyzed. The results achieved show that a neutral or slightly alkaline pH and short flotation times promote the concentration of sedimentary phosphorite a concentrate contain with 29.5% P2O5 & 7.65%A.I with a recovery of about 68.06%. [ABSTRACT FROM AUTHOR]