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There are certain lesions in the liver, where biopsy is contraindicated, for example Hemangiomas. In such scenarios, we rely on imaging to give diagnosis to clinicians and also provide a roadmap. A rare scenario like peliosis hepatis has grave prognosis. The etiology is still under consideration. Our main aim through this rare case report is to create awareness amongst clinicians and radiologists since it initially closely resembled hepatocellular carcinoma and atypical hemangiomas. It was through our close analysis and detailed literature review that we came to close diagnosis.

Although prisoners are considered a vulnerable population, no data repository currently exists to monitor the COVID-19 incidence in Nigerian prisons. To better understand the impact of COVID-19 within the Nigerian prison system, prisons should develop detailed COVID-19 response protocols, implement enhanced point-of-care testing, and initiate contact tracing with meticulous data collection.

Gait impairment in Multiple Sclerosis (MS) can result from muscle weakness, physical fatigue, lack of coordination, and other symptoms. Walking speed, as measured by a number of clinician-administered walking tests, is the primary measure of gait impairment used by clinical researchers, but inertial gait features from body-worn sensors have been proven to add clinical value. This paper seeks to understand and differentiate the physiological significance of four such features with proven value in MS to facilitate adoption by clinical researchers and incorporation in gait monitoring and analysis systems. In addition, this information can be used to select features which might be appropriate in other forms of disability. Two of the four features are computed using the dynamic time warping (DTW) algorithm: the “DTW Score” is based on the usual DTW distance, and the “Warp Score” is based on the warping length. The third feature, based on kernel density estimation (KDE), is the “KDE Peak” value. Finally, the “Causality Index” is based on the phase slope index between inertial signals from different body parts. Relationships between these measures and the aforementioned gait-related symptoms are determined by applying factor analysis to three common, clinical walking outcomes, then correlating the inertial measures as well as walking speed to each extracted factor. Statistically significant differences in correlation coefficients to the three extracted clinical factors support their distinct physiological meaning and suggest they may have complimentary roles in the analysis of MS-related walking disability.

To characterize growth trajectories of children who develop multiple sclerosis compared to typically developing, regional peers and Centers for Disease Control (CDC) normative values.This case-control study collected weight, height, and body mass index (BMI) in 40 consecutive pediatric patients with multiple sclerosis (28 females, 12 males), in addition to 120 typically developing peers (84 females, 36 males), identified and matched for year of birth, sex, ethnicity, and socio-economic status. BMI values were converted to z-scores based on CDC reference values and were compared with respect to age between our two cohorts and by years relative to multiple sclerosis onset for cases.Median age for the clinical onset of multiple sclerosis was 15 years. BMI z-scores are significantly higher for patients with multiple sclerosis compared to typically developing, demographically-matched peers and CDC standards. These significant differences in BMI are noted from 4 years of age and onward. Height trajectories were similar among case and control individuals and CDC normative values.BMI in pediatric multiple sclerosis is markedly higher, beginning in early childhood, years before the clinical-onset of the disease.Children with multiple sclerosis are significantly more overweight than typically developing peers at the time of diagnosis. Body mass index trajectories are significantly higher years before the clinical manifestation(s) of multiple sclerosis.TRAYECTORIAS DEL ÍNDICE DE MASA CORPORAL EN ESCLEROSIS MÚLTIPLE PEDIÁTRICA: OBJETIVO: Caracterizar las trayectorias de crecimiento de los niños que desarrollan esclerosis múltiple en comparación con los valores normativos de desarrollo típico, los pares regionales y los Centros para el Control de Enfermedades (CDC). MÉTODO: Este estudio de casos y controles recopiló el peso, la estatura y el índice de masa corporal (IMC) en 40 pacientes pediátricos consecutivos con esclerosis múltiple (28 mujeres, 12 varones), además de 120 compañeros con desarrollo típico (84 mujeres, 36 varones), identificados y emparejados por año de nacimiento, sexo, etnia y estatus socioeconómico. Los valores de IMC se convirtieron en puntuaciones z basándose en los valores de referencia de los CDC y se compararon con respecto a la edad entre nuestras dos cohortes y por años en relación con el inicio de esclerosis múltiple para los casos. RESULTADOS: La edad media para el inicio clínico de la esclerosis múltiple fue de 15 años. Las puntuaciones z de IMC son significativamente más altas para los pacientes con esclerosis múltiple en comparación con los pares con desarrollo demográfico y estándares CDC. Estas diferencias significativas en el IMC se observan a partir de los 4 años de edad. Las trayectorias de altura fueron similares entre los individuos de casos y controles y los valores normativos de los CDC. INTERPRETACIÓN: El IMC en la esclerosis múltiple pediátrica es notablemente más alto, comenzando en la primera infancia, años antes del inicio clínico de la enfermedad.TRAJETÓRIAS DO ÍNDICE DE MASSA CORPORAL EM ESCLEROSE MÚLTIPLA PEDIÁTRICA: OBJETIVO: Caracterizar as trajetórias de crescimento de crianças que desenvolvem esclerose múltipla comparadas com pares regionais que se desenvolvem tipicamente e valores normativos do Centro para Controle de Doenças (CDC). MÉTODO: Este estudo de caso-controle coletou peso, altura e índice de massa corporal (IMC) em 40 pacientes pediátricos consecutivos com esclerose múltipla (28 do sexo feminino, 12 do sexo masculino), além de 120 pares com desenvolvimento típico (84 do sexo feminino, 36 do sexo masculino), pareados para ano de nascimento, sexo, etnia, e nível sócio-econômico. Os valores de IMC foram convertidos para escores z com base nos valores de referência do CDC e comparados com relação à idade entre as duas coortes, e por anos com relação ao início da esclerose múltipla para os casos. RESULTADOS: A idade mediana para o início clínico da esclerose múltipla foi 15 anos. Os escores z do IMC foram significativamente mais altos para os pacientes com esclerose múltipla comparados aos pares com desenvolvimento típico e demograficamente pareados, e aos padrões do CDC. Estas diferenças significativas no IMC são notadas a partir dos 4 anos de idade. As trajetórias de altura foram similares entre casos, controles e valores normativos do CDC. INTERPRETAÇÃO: O IMC em esclerose múltipla pediátrica é marcadamente mais alto, iniciando cedo na infância, anos antes do início clínico da doença.

Tyrosinemia is a rare metabolic disease showing autosomal recessive inheritance associated with a deficiency of the enzyme fumarylacetoacetate hydrolase. Absence of this enzyme results in the accumulation of succinylacetone in the tissues which predominantly results in liver injury, renal tubular damage, and neurological manifestation resembling porphyrias. The complications that can develop without appropriate treatment include renal tubular dysfunction, growth failure, rickets, neurological crises, hepatomegaly, and possible hepatocellular carcinoma. We describe a case of 18-month-old child who presents with fever and gradually progressive abdominal distension. Laboratory and radiological investigations were done that lead to the diagnosis of this rare entity.

Multiple sclerosis (MS) is a neurological disorder which interrupts the communication between the brain and other parts of the body resulting in neurologic and physical and functional limitations. Gait deterioration is one of the most common problems and hence assessments of walking quality is a crucial part of MS diagnosis. In-clinic evaluations use physical examinations and an expanded disability status scale (EDSS) to label MS subjects into various disability groups such as mild, moderate, etc. Current research in MS focuses on leveraging the inertial data for accurate gait assessments to overcome the shortcomings of qualitative methods and enhancing the separability performance between MS and control subjects. However, MS symptoms vary among individuals. In [1], we showed that the inertial gait density estimates can be used to identify the multiple types of walk within each disability group. In this work, we show that the peak value of the inertial gait density estimate correlates significantly to distance covered in six minutes (r = −0.8028, p < 0.0001), making it clinically meaningful. The peak values also correlate with other related subjective data discussed in the paper. Thus the gait density of an MS subject can be evaluated to objectively assess the impact of MS on his/her functional capacities. We believe that we are supplementing existing information with a new, high-precision objective anchor to help reduce dependence on subjective and burdensome questionnaires.

In each of 2015 and 2016, a “pitching research” competition was held at the University of Queensland, sponsored by the UQ Association of Postgraduate Students (UQuAPS). The UQuAPS events are truly comprehensive – they capture the full spectrum of academic discipline areas: from mechanical engineering to…tourism to…virology in 2015 and from human movements to…chemistry to…medicine in 2016. But what have we learned over these two editions? How can we make the 2017 event even bigger and better?

Business intelligence (BI) has been successful in eliminating the traditional decision support systems at Gulf Shores Company (GSC) to improve efficiency and effectiveness in service delivery and eliminate human errors. Such improved organizations are better prepared to respond quickly to threats and opportunities. Artificial intelligence (AI) supports an organization’s BI process by simplifying them and making them more cost-effective so that, under certain conditions, automated decisions and alerts can be used. Introducing AI into GSC processes would also give them the capability of making decisions in real time. GSC could implement the BI/AI combination in complex settings to address a wide range of risks specific to their industry. The case study describes the logic for implementing AI in petroleum industries, based on an intelligent system that helps offshore platforms start up, and explains how it can be applied in other industries such as medical billing.

Improving Energy Supply at El Crucero is an extended version of a paper titled “El Crucero Pilot Program One IPad2 per Child” presented at the CICE-2012 conference [4]. The previous paper conducted an advanced action research process in generating an innovative pilot program, providing an iPad2 for every child in El Crucero School and the students are making solar panels for profit. The project presented here is intended to improve the current energy supply at El Crucero by implementing a renewable hybrid system using both wind and solar energy power, along with use of Distributed Generation generator sources. Improving the current Internet speed from 2034 to 5034 kb is also possible by implementation of an artificial intelligence adaptive network based fuzzy inference system.

Most multiple sclerosis (MS) patients eventually suffer from mobility impairment, and thus it is critical that walking disability in MS be accurately assessed. The six-minute walk test (6MWT), a reliable MS measure, is traditionally used to determine the distance covered in six minutes using a standard protocol. With the availability of body sensor networks (BSNs), researchers are interested in leveraging BSN data for finding new gait assessment anchors for improved separability performance. Further, current methods for gait assessments are insufficient since assessments are absolute, performed by comparing outcomes to the statistical norms established from diverse patient data despite natural inter-patient variability. For example, walking at a slower pace may be a personal trait rather than a fatigue-induced impact in MS. Thus instead of using actual values, changes in gait features during a 6MWT can be used to draw clinical conclusions and remove inter-subject variability. We use 6MWT gait time series BSN data of MS subjects to determine changes in their gait speed and gait cycle length variance over six minutes. We also determine the relationships between these variables and three subjective assessments, namely functional systems scores, modified fatigue impact scale, and multiple sclerosis walking scale. These relationships are important in order to validate features and make them clinically meaningful for a doctor. In MS, feelings of fatigue can occur more often, and have a greater impact on a subject's daily life. The results show that MS patients who reported high motor-related fatigue slowed down and had high gait cycle length variance in the last minute of the test, in contrast to those on whom fatigue had minimal impact, enhancing the separability between MS subjects of varied disabilities based on their scores. It is also observed that FSS components related to coordination, balance, and physical activities show strong correlation with gait parameters.

Multiple sclerosis (MS) is a neurological disorder that disrupts the communication within the brain, and between the brain and body. MS symptoms may vary over time. So we propose to do longitudinal assessments of a patient's gait characteristics using inertial data, in order to evaluate his/her gait for an extended period of time.

Approximately 50% of infant and toddler long bone fractures are attributed to non-accidental trauma; however, differentiating from benign mechanisms is subjective, due to an absence of evidence-based diagnostic tools. Previous studies investigated small ranges of rotational velocities in animal long bone models, although did not report the variation in the spiral fracture angle. This study considered the fracture angle as a potential clinical measure, correlating this data with a wider range of rotational velocities. The spiral fracture angle was measured relative to the long axis, whilst noting the narrowest diaphysial diameter, location of the fracture, and the extent of comminution and periosteal disruption. Twenty-six bones failed in spiral fracture, with the potting material failing in the remaining tests. All spiral fractures centred on the narrowest diaphysial diameter. Slower rotational velocities caused fracture angles approaching 45°, whereas fractures at greater velocities caused fracture angles nearer 30°. A relatively strong trend (R (2) = 0.78) is reported when the normalised fracture angle (against the narrowest diaphysial dimension) was plotted against the rotational rate. A relationship has been identified between the angle of spiral fracture and the rotational velocity using the immature bovine metatarsal model. This trend forms a scientific foundation from which to explore developing a diagnostic, evidence-based tool that may ultimately serve to assist differentiating between accidental and non-accidental injury.

The Empirical Mode Decomposition (EMD) algorithm was introduced as the first step of the Hilbert-Huang Transform, proposed by Huang et al. (1998). EMD decomposes a signal into so-called Intrinsic Mode Functions (IMFs) in a systematic way. Since then, various versions of EMD have been developed, addressing weaknesses of the original EMD procedure and aiming to optimize the original algorithm in a number of ways. This paper proposes to use selective extrema analysis while generating IMFs with two goals. One is to reduce/control the number of IMFs a signal is decomposed into with a small decomposition error, and second is to make EMD insensitive to small variations in the analyzed signal. The proposed algorithm is applied to a gait signal and shown to consistently yield two IMFs, even in the presence of small disturbances.

We consider a real-time streaming system where messages created at regular time intervals at a source are encoded for transmission to a receiver over a packet erasure link; the receiver must subsequently decode each message within a given delay from its creation time. We study a bursty erasure model in which all erasure patterns containing erasure bursts of a limited length are admissible. For certain classes of parameter values, we provide code constructions that asymptotically achieve the maximum message size among all codes that allow decoding under all admissible erasure patterns. We also study an i.i.d. erasure model in which each transmitted packet is erased independently with the same probability; the objective is to maximize the decoding probability for a given message size. We derive an upper bound on the decoding probability for any time-invariant code, and show that the gap between this bound and the performance of a family of time-invariant intrasession codes is small in the high reliability regime.

Anterior crown fractures are a common form of injury that mainly affects children and adolescents due to their position in the oral cavity especially in the maxillary arch. Reattachment of original tooth fragment to the fractured tooth forms a relatively quick, biologic and esthetic restoration. A 28 years old male reported to the Department of conservative dentistry&endodontics with a complex crown fracture of 21 and 22 one day after the trauma had occurred. Following endodontic treatment, a glass fibre post was used to increase retention and distribute stresses along the tooth. The dental restoration was completed using the original fragment and a dual cure resin composite. Clinical and radiographic examination at 3, 6&11 months recall showed the glass fiber post and restoration was in place, indicating the success of the treatment in maintaining the fractured tooth.

Explanted hearts from patients with chronic left ventricular assist device (LVAD) support have shown the presence of aortic cusp fusion, which results in valvular stenosis and may complicate weaning of a LVAD. This is the first report of aortic cusp fusion diagnosed solely by transesophageal echocardiography (TEE) in vivo in a patient on chronic LVAD support. Under intraoperative TEE guidance, a 41-year-old woman underwent an attempted explantation of a LVAD, which had been implanted 8 months before for dilated cardiomyopathy. When LVAD support was discontinued, previously normal left ventricular function deteriorated, and aortic stenosis from aortic valve cusp fusion was documented by TEE. The explantation procedure was abandoned. This case demonstrates the utility of intraoperative TEE in the evaluation of aortic valvular anatomy and function in patients wtih chronic LVAD support.