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Recently, substantial development is observed in the area of Internet of Vehicles owing to the application of wireless communication technologies. Majority of these technologies are based on radio frequency (RF); however, RF spectra are overly congested and regulated, and hence, insufficient to support massive data traffic in the future. In recent times, optical camera communication (OCC) that uses a light-emitting diode (LED) as a transmitter and a camera as a receiver has been deemed an excellent solution for future intelligent transportation systems. As a communication medium, OCC mostly uses visible light, the spectrum of which is vast, completely free, and unregulated. The current outdoor environment is heavily crammed with LED infrastructures, and most vehicles have built-in cameras, rendering OCC immensely promising. OCC is highly secured, supports mobility, and can achieve an excellent bit-error rate. However, the data rate obtained using OCC is not as high as that obtained using other RF-based systems; therefore, its reliability in fast-changing channels is still under research. This review article discusses the applications of the OCC system in vehicle-to-vehicle and vehicle-to-infrastructure (or vice versa) networks; to the best of our knowledge, this is the first extensive review dedicated to the above topic. Herein, we provide a general overview of OCC standardization in IEEE and ISO in recent years. Then, we explain the general principles of OCC, including channel characteristics, region of interest signaling, and modulation schemes particularly considered in vehicular communications. Additionally, we present a comprehensive overview of the effects of mobility, noise, and interference in OCC. Finally, the challenges and future opportunities in OCC are outlined.

Moyamoya syndrome (MMS) associated with hyperthyroidism, such as Graves’ disease, is a rare condition that causes ischemic stroke with thyrotoxicity. A 43-year-old woman with symptoms of right hemiparesis was admitted. Brain magnetic resonance imaging revealed a small cerebral infarction in the left frontal lobe. Cerebral angiography revealed multi-vessel intracranial occlusive disease. Several days later, neurologic deterioration and aggravation of cerebral infarction developed due to a thyroid storm. A thyroid function test revealed the following: thyroid-stimulating hormone (TSH) ＜0.01 μunits/mL (reference range, 0.55–4.78 μunits/mL); triiodo-thyronine ＞8.0 ng/mL (reference range, 0.77–1.81 ng/mL); free thyroxine (T4) of 9.47 pmol/L (reference range, 11.4–22.6 pmol/L); and TSH receptor antibody of 37.10 U/L (reference range, 0–10 U/L). For thyroid storm management, we initiated treatment with methimazole, Gemstein’s solution, and hydrocortisone. Finally, the thyroid disease was controlled, and neurologic deficits improved. We describe a case of acute cerebral infarction combined with a thyroid storm in a patient with Moyamoya syndrome and Graves’ disease. Hyperthyroidism such as Graves’ disease should be considered in the differential diagnosis for patho-etiologic mechanisms associated with MMS. A cerebrovascular disease with a thyroid storm can lead to severe mortality and morbidity. Prompt diagnosis and strict treatment are important.

Background: There have been some cases where abnormal histopathologic findings could not be found in the kidney could even with proper specimen collection through percutaneous renal biopsy (PRB) in accordance with its indication. We analyzed the incidence and clinical outcomes of children who showed normal histopathological findings in their PRBs.Methods: The medical records of 552 pediatric subjects who underwent PRB between 2005 and 2016 were reviewed. Twenty-six subjects were excluded because allograft biopsy was performed in nine subjects, and the age at biopsy was greater than 18 years in 17 subjects. Finally, 526 subjects were enrolled in this study.Results: Of the 526 pediatric patients, 32 (6.1%) showed no histopathological abnormalities in their PRBs. The male-to-female ratio of the patients was 1.9:1, and the mean ages at the first visit and at biopsy were 10.6 ± 4.1 and 11.4 ± 3.8 years, respectively. In accordance with the biopsy indications, recurrent gross hematuria showed the highest incidence rate, but combined hematuria and proteinuria had the lowest incidence rate regarding normal renal histopathology among all the subjects. At a mean follow-up of 35.5 ± 23.6 months, urinary abnormalities had improved in more than 50% of the subjects with normal renal histopathology, and none of the patients showed progression to end-stage renal disease or required rebiopsy due to symptom worsening during the follow-up period.Conclusion: The clinical outcomes of children with normal PRB histopathologic findings are generally good. Further studies to evaluate their long-term outcomes are needed.

This technical paper proposes an instrumentation valve (IV) status monitoring system based on optical camera communication (OCC). A transmitter circuit equipped with a temperature sensor is integrated into each IV. Each transmitter also includes two light-emitting diodes (LEDs) forming an LED group, where one of the LEDs is used to transmit the data. During the reception process, each LED group is recognized and classified using a neural network. Then, the LEDs are individually identified using the region-of-interest detection mechanism. A close circuit television camera is employed to receive the data, which are henceforth stored in a cloud server for further monitoring. An angle measurement algorithm capable of determining the angle generated due to unwanted failure related to the proper closing or opening of the IV is proposed. Additionally, a neural blind deconvolution algorithm is proposed to alleviate the blur effect in the received images. In short, the data transmitted by the LED contain information including valve ID, temperature, and the amount of inflection produced by the IV. The entire OCC system is implemented, and its performance is evaluated using Python 3.7. Data with blurry images are successfully received up to a communication distance of 10 m, whereas the lowest BER is achieved at a communication distance of 2 m.

Although the current guidelines recommend bridging thrombolysis (BT) therapy, which is intravenous thrombolysis (IVT) followed by endovascular thrombectomy (EVT), for patients with acute ischemic stroke from large vessel occlusion (AIS-LVO), the effectiveness and safety of IVT remain controversial. We performed a meta-analysis to demonstrate the non-inferiority of direct EVT alone (DEVT) compared to BT for the efficacy and safety in patients with AIS-LVO who were eligible for IVT. The literature was searched in big databases between 1 January 1990 and 1 April 2021. The search included both randomized clinical trials (RCTs) and nonrandomized studies (NRSs) that compared DEVT with BT for patients with AIS-LVO who were eligible for IVT (time from stroke onset ≤ 4.5 h). Only NRSs with good intergroup variable matching were included in the study. Outcomes measured included 90-day functional independence, mortality, symptomatic intracranial hemorrhage (sICH), and successful recanalization. The noninferiority margin for risk difference was set at 5% from the literature review. Three RCTs (n = 1094) and four NRSs (n = 1366) were included in the meta-analysis. There were 1227 patients (49.9%) in the DEVT group and 1233 patients (50.1%) in the BT group. A statistically significant noninferiority of DEVT compared to BT was concluded in 90-day functional independence, mortality and successful reperfusion. Even in the sICH rate, DEVT group showed a superiority (risk difference, −2%; 95% confidence interval, −4 to −0.002%). Evidence from RCTs and observational NRSs supports the use of DEVT (without IVT) as the first choice for treatment of patients with AIS-LVO within a time span of 4.5 h or less from stroke onset.

Visible light communication (VLC) is an emerging technology that provides ubiquitous connectivity by complementing radio frequency communication for the fifth-generation (5G) wireless communication and beyond. However, inadequacies in modulation bandwidth of light-emitting diode (LED) reduce the achievable data rate for image sensor-based VLC, also known as optical camera communication (OCC). Hence, for densely deployed OCC networks, multiple channel access is a major challenge faced when supporting large numbers of users. This article proposes an optical nonorthogonal multiple access based OCC (NOMA-OCC) system, where each LED can transmit two separate signals of two different power levels by superimposing them into one signal. An image sensor based receiver system is designed to separate these two signals supporting two users by implying an intensity threshold. The distinct channel capacities for both the users as well as the sum rate of the LED access point were analyzed. In order to validate the proposed NOMA-OCC scheme, the bit error rate performance of the system is also investigated through simulation for both channels and then compared with the conventional frequency shift on–off keying scheme.

This study was performed to evaluate the effect of intra‐abdominal pressure (IAP) on intraocular pressure (IOP) in conscious dog models using a balloon technique to generate intra‐abdominal hypertension. Six healthy dogs without ocular abnormalities were evaluated in this study. A balloon device was placed in the intra‐abdominal cavity. The abdomen was insufflated to IAP levels of 15 and 25 mmHg using the balloon device. Intraocular pressure was measured at baseline, at IAP levels of 15 and 25 mmHg, and after decompression. In comparison with the mean baseline IOP (15.1 ± 2.0 mmHg), there was a significant increase in IOP at IAP levels of 15 mmHg (20.0 ± 2.1 mmHg) and 25 mmHg (19.9 ± 2.2 mmHg), corresponding to a 32.4% and 31.7% increase from baseline IOP, respectively. The mean IOP after decompression (14.8 ± 1.7 mmHg) was significantly lower compared to those at IAP levels of 15 and 25 mmHg. The present findings demonstrate that increased IAP has a clinically significant effect on IOP in dogs under conscious conditions. Although more research is needed to determine of increased IAP on IOP, these findings suggest that increased IAP leads to mild and reversible increase in IOP.

This study was performed to identify the effect of synovium graft on conjunctiva in rabbits after dry eye induction. Six New Zealand White rabbits were used as dry eye models. Both eyes were divided to two groups as control and synovium graft group. The synovium graft was performed in fourth week after dry eye modeling. Quantitative change of tears through Schirmer tear test (STT), qualitative change of tear film through tear film break up time (TFBUT), and damage of cornea through fluorescein staining were observed for 10 weeks at intervals of two weeks. Histological examination was performed to evaluate cornea and conjunctiva at tenth week. In both groups, STT and TFBUT were significantly decreased in 4 weeks after modeling compared to 0 weeks (p < 0.05) . After synovium graft, there were increases in STT value at 4 weeks and TFBUT at 4 and 6 weeks in graft group (p < 0.05). Corneal fluorescein staining showed no significant difference between the two groups. In histopathological examination, grafted synovium was detected as round to ovoid ingression folds, well attached to grafted regions with 0.11 ± 0.04 mm2 (range, 0.05- 0.16 mm2). These results indicated that the synovium graft on the conjunctiva had an effect on the qualitative and quantitative improvement of the tear film even though there was no histological change.

Recent advances in the engineering or strategy of materials and device design have established ultrathin, soft, lightweight, and skin-conformable characteristics in wearable/implantable electronic ...

Objective To describe an approach for ethmoidal nerve block (EBLOCK) and to compare the effects of a maxillary nerve block (MBLOCK), EBLOCK and their combination (M-EBLOCK) on heart rate (HR), systolic (SAP), mean (MAP), diastolic (DAP) arterial pressures and respiratory rate (fR) during nasal stimulation in dogs. Study design Prospective, blinded, randomized, crossover placebo-controlled study. Animals Beagle dogs (five cadavers, nine live dogs), with a median (interquartile range) weight of 10.5 (10.3–11.0) kg. Methods The accuracy of iohexol injections (each 1 mL) at the maxillary and ethmoidal foramina in cadavers was evaluated using computed tomography. Then, anesthetized dogs were administered four bilateral treatments separated by 1 week, saline or 2% lidocaine 1 mL per injection: injections of saline at the maxillary and ethmoidal foramina (Control), injections of lidocaine at the maxillary foramina and saline at the ethmoidal foramina (MBLOCK), injections of saline at the maxillary foramina and lidocaine at the ethmoidal foramina (EBLOCK) and injections of lidocaine at all foramina (M-EBLOCK). The ventral nasal meatus was bilaterally stimulated using cotton swabs, and HR, SAP, MAP, DAP and fR were continuously recorded. Values for each variable were compared before and after stimulation using Wilcoxon signed-rank test. Changes in variables among treatments were analyzed using Mann–Whitney U and Kruskal–Wallis tests (p ≤ 0.05). Results Computed tomography revealed iohexol distribution around the openings of the target foramina in all cadavers. In living dogs, HR, SAP, MAP, DAP and fR significantly increased after stimulation within each treatment (p Conclusions and clinical relevance Concurrent injections of lidocaine at the maxillary and ethmoidal foramina attenuated HR, arterial pressure and fR responses to nasal stimulation in Beagle dogs.

In clinical studies, the effect of heart rate (HR) alone as feedback for maintaining homeostasis cannot be observed. Therefore, in this study, the effect of HR on pulse wave velocity (PWV) was investigated using a simulator without feedback. This was achieved via a one-tube model that simplifies the human arterial system and an arterial tree model similar to the human body, using a cardiovascular simulator. The one-tube model measured the pressure waveform at two measuring points 1.2 m apart, while the arterial tree model measured the pressure waveform in the carotid and femoral arteries. In the one-tube experiment, the effects of HR, mean pressure (MP), and stroke volume (SV) on PWV were independently investigated. PWV was found to increase as HR increased, but was not affected when MP and SV were changed. Further, in the arterial tree model experiment, it was observed that the PWV increased with an increase in HR. The results of this study showed that even in a simulator containing a human arterial model made of silicone material with no human feedback action, changes in HR alone affect the PWV.

Currently, various radio frequency (RF) technologies are used to transfer medical data in healthcare applications. The electromagnetic interference caused by RF can critically affect the performance of medical devices. The main goal of this article, thus, is to provide reliable and low-latency fifth-generation (5G) electronic health (eHealth) solutions for monitoring patients at home, hospitals, ambulances, intensive care units, and outdoors. This monitoring is based on optical camera communication (OCC). In our proposal, the OCC system is used to receive the monitored data from wearable sensors/patches. OCC systems are connected to 5G access networks or wired networks to be linked with the core network. The proposed system is able to provide fast and secure connectivity for simultaneous monitoring of multiple patients. The monitored information is forwarded to hospitals, medical servers, doctors, cloud, and mobile systems for remote monitoring purposes. In this study, we provide a novel technical solution for monitoring patients remotely. A robot system with OCC is also proposed to monitor the health data of multiple patients in hospital. We provide several eHealth solution scenarios for better understanding of the proposed eHealth architecture.

This technical paper presents an optical camera communication system by using data as input collected from a sensor that continuously garners humidity and temperature information from the environment. A small light-emitting diode (LED) and an LED array are used as a transmitter and a low-speed rolling-shutter camera as a receiver. A modulation scheme standardized in IEEE 802.15.7, referred to as variable pulse-width modulation, is used to encode the data bits. The proposed scheme is flicker-free in different frequencies and applicable in both static and mobile scenarios. A neural network is designed for LED detection and improving the bit-error-rate in mobile scenarios. A new method based on the region-wise comparison and an existing method is used to remove the interference and noise generated from the neighboring light sources, respectively. The decoding procedure is performed and analyzed in Python 3.7. A data rate of 1.02 kbps is achieved using the single LED, which is further augmented to 64 kbps by using an $8\times 8$ LED dot matrix.

Objective This study aimed to assess the relationship between increased intracranial pressure (ICP) and mastoid effusions (ME). Methods Between January 2015 and October 2018, patients who underwent intracranial surgery and had ICP monitoring catheters placed were enrolled. ICP was recorded hourly for at least 3 days. ME was determined by the emergence of opacification in mastoid air cells on follow-up brain imaging. C-reactive protein (CRP) levels, presence of endotracheal tube (ETT) and nasogastric tube (NGT), duration of intensive care unit (ICU) stay, duration of mechanical ventilator application, diagnosis, surgical modalities, and presence of sinusitis were recorded. Each factor's effect on the occurrence of ME was analyzed by binary logistic regression analyses. To analyze the independent effects of ICP as a predictor of ME a multivariable logistic regression analysis was performed. Results Total of 61 (53%) out of 115 patients had ME. Among the patients who had unilateral brain lesions, 94% of subject (43/50) revealed the ipsilateral development of ME. ME developed at a mean of 11.1±6.2 days. The variables including mean ICP, peak ICP, age, trauma, CRP, ICU stays, application of mechanical ventilators and presence of ETT and NGT showed statistically significant difference between ME groups and non-ME groups in univariate analysis. Sex and the occurrence of sinusitis did not differ between two groups. Adding the ICP variables significantly improved the prediction of ME in multivariable logistic regression analysis. Conclusion While multiple factors affect ME, this study demonstrates that ICP and ME are probably related. Further studies are needed to determine the mechanistic relationship between ICP and middle ear pressure.

The belief propagation (BP) decoding of short low-density parity check codes suffers from short cycles and trapping sets. A number of perturbation schemes have been proposed to overcome the limitation. This letter presents a generalized framework for multi-round BP decoding with input perturbation and proposes an improved perturbation scheme. In particular, the impulsive perturbation which is applied to only a few symbols is proposed, along with a new space selection criterion. The proposed scheme performs better than existing schemes for short codes at lower complexity and supports a parallel implementation.

CASE DESCRIPTION A 10-year-old 7-kg (15.4-lb) neutered male Shih Tzu was referred for evaluation because of a sudden onset of dullness and intermittent vomiting of 1 to 2 weeks’ duration. Two days prior to evaluation, clinical signs had worsened and 1 seizure was reported. CLINICAL FINDINGS A 3.5 × 2.5-cm soft, dome-shaped mass of the right occipital region of the head was noted on physical examination. Radiography and CT confirmed the presence of the mass and indicated its intra- and extracranial expansion. The MRI images showed compression of the cerebellum by the mass, with distinct margins of hypointensity on both T1- and T2-weighted images. TREATMENT AND OUTCOME Surgery was performed, and the mass was completely excised. The dog had mild ataxia, hypermetria, and head tremors after surgery. Histologic examination of the mass yielded a diagnosis of intradiploic epidermoid cyst. On examination 3 weeks after surgery, the previous neurologic signs had resolved. On examination 25 months after surgery, the dog remained free of clinical signs. CLINICAL RELEVANCE The present report described the clinical signs, diagnostic imaging results, and successful surgical removal of an intradiploic epidermoid cyst in a dog. Long-term prognosis may be good with complete removal of intradiploic epidermoid cysts in dogs.

Deep learning (DL) is a kind of machine learning technique that uses artificial intelligence to identify the characteristics of given data and efficiently analyze large amounts of information to perform tasks such as classification and prediction. In the field of neuroimaging of neurodevelopmental disorders, various biomarkers for diagnosis, classification, prognosis prediction, and treatment response prediction have been examined; however, they have not been efficiently combined to produce meaningful results. DL can be applied to overcome these limitations and produce clinically helpful results. Here, we review studies that combine neurodevelopmental disorder neuroimaging and DL techniques to explore the strengths, limitations, and future directions of this research area.

WHAT IS KNOWN AND OBJECTIVE We evaluated the effect of the proportion of time maintained within the target international normalized ratio (INR) postoperatively in hospitalized patients who underwent On-X mechanical heart valve replacement on warfarin therapy after discharge. METHODS Inclusion was patients who were ≥18 years, received warfarin for a minimum of 10 days without any interruptions during hospitalization and followed by the anticoagulation service (ACS) clinic after discharge between June 2006 and June 2016. Patients were excluded if they had incomplete medical records, INR goal changes, known as warfarin resistance, transferred to another facility or expired during the study. The patients were divided into 3 groups according to the proportion of time maintained within therapeutic INR range (TTR) from day 4 to 10 of warfarin initiation (low

Background Although Thrombolysis in Cerebral Infarction (TICI) grade 2B or 3 is considered successful after endovascular thrombectomy (EVT) for acute ischemic stroke, TICI 2B was found to be associated with poorer outcomes than was 3. Furthermore, the newly proposed TICI 2C grade seems to be clinically equivalent to TICI 3 rather than to 2B. This network meta-analysis aimed to assess the differences in clinical outcomes between TICI grades and redefine successful reperfusion. Methods PubMed, Embase, and Cochrane Central Register were queried. A random-effect model with frequentist framework was applied to evaluate outcomes using odds ratios (ORs) and 95% confidence intervals (CIs). Using surface under the cumulative ranking curve (SUCRA), the hierarchy of TICI grades was indicated. Results Analysis of 12 studies, with 2084 patients, indicated that TICI 2C (OR, 2.28; 95% CI, 1.65–3.13) and 3 (OR, 2.40; 95% CI, 1.74–3.30) were significantly more associated with favorable 90-day clinical outcomes than were 2B; there was no significant difference between TICI 2C and 3 (OR, 1.05; 95% CI, 0.76–1.46). Based on the SUCRA, TICI 2C and 3 were considered as more effective reperfusion end points than was 2B (TICI 3, 80.8%; 2C, 69.2%; 2B, 0.0%) and showed significant association with lower rates of mortality and symptomatic intracranial hemorrhage. Conclusions Patients with TICI 2C grade would be distinguished from those with 2B, because 2C is clinically equivalent to 3 and has a better outcome than 2B. Therefore, achieving 2C or 3 is likely to be closer to the successful aim of endovascular thrombectomy in acute ischemic stroke than achieving 2B.

Background: Acute kidney injury (AKI) is one of the most significant postoperative complications of pediatric cardiac surgery. Because serum creatinine has limitations as a diagnostic marker of AKI, new biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are being evaluated to overcome these limitations and detect AKI at an early stage after cardiac surgery.Purpose: This study aimed to investigate the clinical usefulness of these biomarkers in young children.Methods: Thirty patients with congenital heart diseases who underwent cardiac surgery using cardiopulmonary bypass (CPB) were selected, and their urine and blood samples were collected at baseline and 6, 24, and 48 hours after surgery. Serum creatinine and blood urea nitrogen levels as well as NGAL, KIM-1, and IL-18 levels in urine samples were measured, and clinical parameters were evaluated.Results: Of the 30 patients, 12 developed AKI within 48 hours after cardiac surgery. In the AKI group, 8 of 12 (66.6%) met AKI criteria after 24 hours, and urine KIM-1/creatinine (Cr) level (with adjustment of urine creatinine) peaked at 24 hours with significant difference from baseline level. Additionally, urine KIM-1/Cr level in the AKI group was significantly higher than in the non-AKI group at 6 hours. However, urine NGAL/Cr and IL-18/Cr levels showed no specific trend with time for 48 hours after cardiac surgery.Conclusion: It is suggested that urine KIM-1/Cr concentration could be considered a good biomarker for early AKI prediction after open cardiac surgery using CPB in young children with congenital heart diseases.

In recent times, the electric power management based on customers' demand has drawn significant attention of smart-grid (SG) governors. The SG requires real-time management of dynamic load to maintain the quality of service (i.e., balance between supply and demand) by interfacing with users. In this paper, we propose an approach to respond to the active demand (AD) based on user-defined energy-management policy. An algorithm is also proposed for the smart-controller device (SCD) modeled with the load aggregator and connected to the customers. The total contracted load and the user ADs are determined based on area, load, and phase classification, which specify the individual energy consumption. The proposed scheme is implemented in MATLAB/Simulink using the load-information of the IEEE 30-bus system, and the feasibility is assessed in IEEE 13 and IEEE 34 node test feeder systems. By applying the customer's controlled SCD device both the deficiency and redundancy of generation in terms of grid controllable load have been improved that lead the maximization of generation and distribution services. The voltage regulation and power factor of the particular area have been enhanced by integrating appropriate distributed generation and power factor improvement devices. The results garnered from the performance analysis show that the proposed scheme can optimize power generation based on the user-defined demand.

Optical wireless communication (OWC) is an excellent complementary solution to its radio frequency (RF) counterpart. OWC technologies have been demonstrated to be able to support high traffic generated by massive connectivity of the Internet of Things (IoT) and upcoming 5th generation (5G) wireless communication systems. As the characteristics of OWC and RF are complementary, a combined application is regarded as a promising approach to support 5G and beyond communication systems. Hybrid RF/optical and optical/optical wireless systems offer an excellent solution for recovering the limitations of individual systems as well as for providing positive features of each of the technologies. An RF/optical wireless hybrid system consists both RF and optical-based wireless technologies, whereas an optical/optical wireless hybrid system consists two or more types of OWC technologies. The co-deployment of wireless systems can improve system performance in terms of throughput, reliability, and energy efficiency of individual networks. This study surveys the state of the art and key research directions regarding optical wireless hybrid networks, being the first extensive survey dedicated to this topic. We provide a technology overview of existing literature on optical wireless hybrid networks, such as RF/optical and optical/optical systems. We consider the RF-based macrocell, small cell, wireless fidelity, and Bluetooth, as well as optical-based visible light communication, light fidelity, optical camera communication, and free-space optical communication technologies for different combinations of hybrid systems. Moreover, we consider underwater acoustic communication for hybrid acoustic/optical systems. The opportunities brought by hybrid systems are presented in detail. We outline important challenges that need to be addressed for successful deployment of optical wireless hybrid network systems for 5G and IoT paradigms.

In this paper, an area-time efficient hardware implementation of modular multiplication over five National Institute of Standard and Technology (NIST)-recommended prime fields is proposed for lightweight elliptic curve cryptography (ECC). A modified radix-2 interleaved algorithm is proposed to reduce the time complexity of conventional interleaved modular multiplication. The proposed multiplication algorithm is designed in hardware and separately implemented on Xilinx Virtex-7, Virtex-6, Virtex-5, and Virtex-4 field-programmable gate array (FPGA) platforms. On the Virtex-7 FPGA, the proposed design occupies only 1151, 1409, 1491, 2355, and 2496 look up tables (LUTs) and performs single modular multiplication in 0.93 μs, 1.18 μs, 1.45 μs, 2.80 μs, and 4.69 μs with maximum clock frequencies of 207.1 MHz, 190.7 MHz, 177.3 MHz, 137.6 MHz, and 111.2 MHz over five NIST prime fields of size 192, 224, 256, 384, and 521 bits, respectively. The hardware implementations on the Virtex-6, Virtex-5, and Virtex-4 FPGAs also show that the proposed design is highly efficient in terms of hardware resource utilization and area-delay product compared with other designs for modular multiplication.

In this letter, a hybrid-encoding scheme is developed for an integrated optical camera communication (OCC)/light-fidelity (LiFi) system. A single multilevel light-emitting diode (LED) is used for transmitting both OCC and LiFi data. Two data streams are transmitted, where each stream is intended for LiFi and OCC. The first stream is transmitted at a very high frequency using the LED. The LED flickers in two different power levels creating consecutive sequences. A smartphone camera receives the sequences as binary successions, wherein the second data stream is modulated. The modulation is referred to as intensity-shift keying. A testbed prototype is implemented to demonstrate the proof-of-concept, which is also used to show the bit-error-rate performance of the proposed scheme.

This research investigates how the display locations of regular and sale prices in comparative price advertising impact perceived quality, deal attractiveness, and purchase intention. Based on the ...

Objectives To determine whether the probability of target attainment over 72 hours of initial therapy with beta-lactam (cefepime, ceftazidime, piperacillin/tazobactam) and carbapenem (imipenem, meropenem) antibiotics were substantially influenced between intensive and less-intensive continuous renal replacement therapy groups in the Acute Renal Failure Trial Network trial and The RENAL Replacement Therapy Study trial. Design The probability of target attainment was calculated using pharmacodynamic targets of percentage of time that free serum concentrations (fT): 1) were above the target organism's minimum inhibitory concentration (≥ fT > 1 × minimum inhibitory concentration); 2) were above four times the minimum inhibitory concentration (≥ % fT > 4 × minimum inhibitory concentration); and 3) were always above the minimum inhibitory concentration (≥ 100% fT > minimum inhibitory concentration) for the first 72 hours of antibiotic therapy. Demographic data and effluent rates from the Acute Renal Failure Trial Network and RENAL Replacement Therapy Study trials were used. Optimal doses were defined as the dose achieving greater than or equal to 90% probability of target attainment. Setting Monte Carlo simulations using demographic data from Acute Renal Failure Trial Network and RENAL Replacement Therapy Study trials. Patients Virtual critically ill patients requiring continuous renal replacement therapy. Interventions None. Measurements and main results The pharmacodynamic target of fT greater than 1 × minimum inhibitory concentration led to similarly high rates of predicted response with antibiotic doses often used in continuous renal replacement therapy. Achieving 100% fT greater than minimum inhibitory concentration is a more stringent benchmark compared with T greater than 4 × minimum inhibitory concentration with standard antibiotic dosing. The intensity of effluent flow rates (less intensive vs intensive) did not substantially influence the probability of target attainment of antibiotic dosing regimens regardless of pharmacodynamic target. Conclusions Antibiotic pharmacodynamic target attainment rates likely were not meaningfully different in the low- and high-intensity treatment arms of the Acute Renal Failure Trial Network and RENAL Replacement Therapy Study Investigators trials.

Gut dysbiosis is closely associated with the occurrence of inflammatory bowel disease (IBD) and psychiatric disorder. Here, to understand the difference of gut microbiota composition and physiological effect between IBD patients with (IBD/D+) or without depression (IBD/D−), we analyzed the fecal microbiota composition of patients with IBD with (/D+) or without depression (/D−) and healthy volunteers (HVs) and examined the effects of these fecal microbiota transplantations (FMTs) on the occurrence of systemic inflammation and anxiety/depression in mice. FMTs from patients with IBD/D+ or IBD/D− caused IBD-like colitis in the transplanted mice: they increased the myeloperoxidase activity, IL-1β and IL-6 expression, and NF-κB+/CD11c+ cell population in the colon. Transplantation of the IBD/D+ patient feces (IBD/D+-F) caused IBD-like colitis more strongly than that of IBD/D−-F. FMTs from patients with IBD/D+ also caused anxiety-/depression-like behaviors, increased the NF-κB+/Iba1+ and lipopolysaccharide (LPS)+/Iba1+ cell populations, and decreased the BDNF+/NeuN+ cell population in the hippocampus. They increased LPS levels in the blood. FMTs from patients with IBD/D− caused anxiety-like, but not depression-like, behaviors. α-/β-diversities and composition of gut microbiota in IBD-F were different from those of HV feces (HV-F). The Enterobacteriaceae and Enterococcaceae populations and LPS levels were higher in the IBD-F than in the HV-F. The Enterococcaceae population was higher in IBD/D+-F vs. IBD/D−-F. However, the transplantation of HV-F into mice previously transplanted with IBD/D+-F significantly reduced depression-like behaviors, NF-κB+/Iba1+ and LPS+/Iba1+ cell populations in the hippocampus, LPS levels in the feces and blood, and IL-1β expression in the colon. These findings suggest that the outbreak of depression/anxiety may be dependent on the systemic inflammation with a leaky gut through the gut dysbiosis-attributable overproduction of bacterial LPS and suppression of tight junction protein expression in patients with IBD.

(1) Purpose of this study: To determine whether patient weight influences the probability of target attainment (PTA) over 72 h of initial therapy with beta-lactam (cefepime, ceftazidime, piperacillin/tazobactam) and carbapenem (imipenem, ertapenem, meropenem) antibiotics in the critical care setting. This is the first paper to address the question of whether patient size affects antibiotic PTA in the ICU. (2) Methods: We performed a post hoc analysis of Monte Carlo simulations conducted in virtual critically ill patients receiving antibiotics and continuous renal replacement therapy. The PTA was calculated for each antibiotic on the following pharmacodynamic (PD) targets: (a) were above the target organism’s minimum inhibitory concentration (≥%fT≥1×MIC), (b) were above four times the MIC (≥%fT≥4×MIC), and (c) were always above the MIC (≥100%fT≥MIC) for the first 72 h of antibiotic therapy. The PTA was analyzed in patient weight quartiles [Q1 (lightest)-Q4 (heaviest)]. Optimal doses were defined as the lowest dose achieving ≥90% PTA. (3) Results: The PTA for fT≥1×MIC led to similarly high rates regardless of weight quartiles. Yet, patient weight influenced the PTA for higher PD targets (100%fT≥MIC and fT≥4×MIC) with commonly used beta-lactams and carbapenems. Reaching the optimal PTA was more difficult with a PD target of 100%fT≥MIC compared to fT≥4×MIC. (4) Conclusions: The Monte Carlo simulations showed patients in lower weight quartiles tended to achieve higher antibiotic pharmacodynamic target attainment compared to heavier patients.

There are few studies between postoperative neutrophil to lymphocyte ratio (NLR) and survival in cervical cancer. We compared postoperative changes in NLR according to surgical methods and analyzed the effect of these changes on 5-year mortality of cervical cancer patients. A total of 929 patients were assigned to either the laparoscopic radical hysterectomy (LRH) (n = 721) or open radical hysterectomy (ORH) (n = 208) group. Propensity score matching analysis compared the postoperative NLR changes between the two groups, and multivariate logistic regression analysis evaluated the association between NLR changes and 5-year mortality. Surgical outcomes between the two groups were also compared. In the LRH group, NLR changes at postoperative day (POD) 0 and POD 1 were significantly lower than in the ORH group after matching (NLR change at POD 0, 10.4 vs. 14.3, p &lt, 0.001, NLR change at POD 1, 3.5 vs. 5.4, p &lt, 0.001). In multivariate logistic regression analysis, postoperative NLR change was not associated with 5-year mortality (2nd quartile: OR 1.55, 95% CI 0.56–4.29, p = 0.401, 3rd quartile: OR 0.90, 95% CI 0.29–2.82, p = 0.869, 4th quartile: OR 1.40, 95% CI 0.48–3.61, p = 0.598), whereas preoperative NLR was associated with 5-year mortality (OR 1.23, 95% CI 1.06–1.43, p = 0.005). After matching, there were no significant differences in surgical outcomes between the two groups. There were significantly fewer postoperative changes of NLR in the LRH group. However, the extent of these NLR changes was not associated with 5-year mortality. By contrast, preoperative NLR was associated with 5-year mortality.

Recently, Cooperative massive multiple-input multiple-output and non-orthogonal multiple access (mMIMO-NOMA) has been considered as a promising solution that can significantly improve the system capacity and the spectral efficiency of the sixth-generation (6G) high frequency spectrum such as Millimeter Wave and Terahertz networks. In this paper, we consider a mMIMO-NOMA enabled base station that can support a number of single antenna users in different clusters. Cooperative use of NOMA can support the users in a cluster by sharing the same frequency and time resources. However, in 6G the networks will be congested with ultra-massive interconnected users and that arises challenges in clustering the users efficiently. Therefore. we briefly summarize the studies about user clustering solutions in mMIMO-NOMA systems and divided them into two categories; resource aware user clustering (RAUC) and learning assisted user clustering (LAUC) approaches. A comparison among those techniques has been tabulated considering the computational complexities. The result depicts that the RAUC demonstrates a polynomial complexity function while that for the LAUC is comparatively low.

The integration of artificial intelligence with home energy management systems (HEMS) due to the development of advanced metering infrastructure is a promising scheme to improve the usage of renewable energy in a residential application. In the paper, energy management among multiple co-operative households with PV-Storage integrated generation system in a home micro-grid in the presence of short-term prediction of power generation and consumption is studied. In such a home microgrid system, the central energy storage system (C.ESS) is considered that is connected with multiple household and PV panels. The key parameters that are responsible for optimum scheduling of C.ESS are forecasted PV power generation, forecasted household energy consumption, dynamic state of charge (SOC), and base level of energy consumption. In this paper, firstly, the prediction of short-term generation and consumption based on the long short-term memory (LSTM) algorithm is done. Then, this forecasted data is used as the constraint to the control algorithm for optimum scheduling. Therefore, the amount of power that will be supplied from C.ESS is also determined for properly utilizing the stored energy. The simulation results of the proposed scheme show the robustness and effectiveness in the home microgrid environment.

In the era of Industry 4.0, the vast development of Smart Factory is always followed by the advancement of Deep Learning technology. To avoid the smart factory system from unwanted losses because of defects in its output production in the steel factory, defect classification on steel sheets based on Deep Learning should be developed precisely. This paper explains how the Deep Learning technique was used to implement defect detection in a smart factory. For this study, we used an open dataset of steel defects. The result of the Deep Learning method for the defect detection system generates 96% accuracy, 0.95 recall, and a precision of 0.97 on the training process. This research goal may contribute to enhancing efficiency and cost reduction in the smart steel factory environment.

(1) Purpose of this study: determination of adsorption and transmembrane clearances (CLTM) of imipenem and relebactam in ex vivo continuous hemofiltration (CH) and continuous hemodialysis (CHD) models. These clearances were incorporated into a Monte Carlo Simulation (MCS), to develop drug dosing recommendations for critically ill patients requiring continuous renal replacement therapy (CRRT), (2) Methods: A validated ex vivo bovine blood CH and CHD model using two hemodiafilters. Imipenem/relebactam and urea CLTM at different ultrafiltrate/dialysate flow rates were evaluated in both CH and CHD. MCS was performed to determine dose recommendations for patients receiving CRRT, (3) Results: Neither imipenem nor relebactam adsorbed to the CRRT apparatus. The CLTM of imipenem, relebactam, and urea approximated the effluent rates (ultrafiltrate/dialysate flow rates). The types of hemodiafilter and effluent rates did not influence CLTM except in a dialysis flow rate of 1 L/h and 6 L/h in the CHD with relebactam (p &lt, 0.05). Imipenem and relebactam 200 mg/100 mg every 6 h were sufficient to meet the standard time above the MIC pharmacodynamic targets in the modeled CRRT regimen of 25 kg/mL/h. (4) Conclusions: Imipenem and relebactam are not removed by adsorption to the CRRT apparatus, but readily cross the hemodiafilter membrane in CH and CHD. Dosage adjustment of imipenem/relebactam is likely required for critically ill patients receiving CRRT.

Purpose: This randomized noninferiority trial aimed to evaluate whether combined suprascapular, axillary nerve, and the articular branch of lateral pectoral nerve block (3NB) is noninferior to interscalene nerve block (ISB) for pain control after arthroscopic rotator cuff repair (ASRCR). Materials and Methods: Eighty-five patients undergoing ASRCR were randomized to either 3NB (n = 43) or ISB (n = 42) group. We used 5 and 15 ml of 0.2% ropivacaine for each nerve in the 3NB and ISB groups, respectively. The primary outcome was the visual analog scale (VAS) pain score at 4 h postoperatively measured assessed on an 11-point scale (ranging from 0 = no pain to 10 = worst pain) that was analyzed using noninferiority testing. The secondary outcome was VAS pain scores in the recovery room and at 8, 12, 24, 36, 48, and 72 h postoperatively. Rebound pain, IV-PCA usage during 48 h, dyspnea, muscle weakness, and satisfaction were evaluated. Results: Regarding the primary outcome, the mean difference in VAS pain scores between the 3NB (2.5 ± 1.6) and ISB (2.2 ± 2.3) groups at 4 h postoperatively was 0.3, with a 95% confidence interval (CI) of −0.56 to 1.11. The upper limit of 95% CI is lower than the noninferiority margin of 1.3 ( p < 0.001). At all other time points, except in the recovery room, 3NB showed noninferior to ISB. Rebound pain, IV-PCA usage during the second 24 h, and muscle weakness were lower in the 3NB group (all p < 0.005). The satisfaction was similar in both groups ( p = 0.815). Conclusion: Combined 3NB is noninferior to ISB in terms of pain control after ASRCR; and is associated with low levels of rebound pain, IV-PCA usage, and muscle weakness. Level of evidence: Randomized controlled trial, Level I.