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Image enhancement of low light images is an important research area in computer vision and image processing. In recent years, deep learning has emerged as a powerful tool for enhancing low light images, with convolutional neural networks (CNNs) being the most used architecture. In this study, we propose a deep learning approach for enhancing low light images using a modified CNN. Our approach involves training the network on a large dataset of low light images and their corresponding enhanced images and using the trained model to enhance new low light images. We also propose a new loss function that encourages the network to enhance details and reduce noise in the images. Our experiments show that our approach outperforms existing state-of-the-art methods in terms of both objective metrics and visual quality, making it a promising technique for real-world low light image enhancement applications

Objective: The main objective of this study is to assess the feasibility in replacing the portfolio in a low resource setting and its acceptance amongst the students and staff. Synopsis: The objective for the study with regards to using portfolios: is it feasible for the 2 month professorial appointment in a low resource setting and its acceptance amongst the students and staff. Methods: The study was conducted on 259 final year medical students for a period of two years from 2016 to 2018, using the student portfolio maintained by them during their professorial gynaecology and obstetrics appointment which is of 8 weeks duration, and the feedbacks provided by students and staff. Results: Around 2 mini clinical evaluation exercise (CEX) were completed for gynaecology and obstetrics and 1 OSAT each was completed of the five different technical skills by all students. All of them completed the objective structured assessment of technical skills (OSATS) in episiotomy suturing, urine catherization and cannulation, 96% of the students were assessed on their skills for artificial rupture of membrane (ARM) and in setting up as an intravenous drip. Students managed to obtain feedback from patients, peers and nursing officers.100% positive feedback was given by the patients, 97% from peers and 92% from the nursing officers. 80% of all the logs in the portfolio were completed by the students. On an average 2 reflective writings were completed per student. 97% of the students found it as a useful tool and 97% stated that it can be easily completed. Conclusion: Introduction of a portfolio for the obstetrics and gynaecology professorial appointment for medical students is possible, with good student satisfaction despite higher number of student: staff ratios.

Bladder endometriosis is uncommon yet a cause of cyclical disabling urinary symptoms. Surgical excision of the bladder endometriotic nodule using combined cystoscopic and laparoscopic approach (“light to light technique”) remains the best approach where surgery is deemed the mode of treatment. A 31-year-old infertile woman underwent resection of endometriosis of the bladder by this method. The main surgical steps included ureteric stenting, bladder mobilization, marking the endometriotic nodule cystoscopically, cystoscopic transillumination, completion of the bladder nodule excision laparoscopically and bladder repair.

The use of tail chalk and estrus/heat expression scores (HEATSC) evaluation is instrumental in identifying cows with greater estrus expression and greater artificial insemination pregnancy rates (P/AI) in cows submitted to timed artificial insemination (TAI), and cows with low or no estrus expression present lower P/AI. It was intended in this study to improve the pregnancy rates in TAI for Bos indicus beef cows, and gonadotrophin-releasing hormone (GnRH) injection was hypothesized to increase pregnancy rates in a TAI program for cows submitted to progesterone–estradiol-based protocols with low or no estrus expression, evaluated by HEATSC. Cows (n= 2284) received a progesterone device and 2 mg estradiol benzoate, after 8 days the device was removed and 1 mg estradiol cypionate, 150 μg of d-cloprostenol and 300 IU equine chorionic gonadotropin was administered. All cows were marked with chalk and HEATSC evaluated (scales 1 to 3) at TAI performed on day 10. Animals with HEATSC1 and HEATSC2 (n= 937) received 100 μg de gonadorelin (GNRH group; n= 470), or 1 ml saline (Control group; n= 467), and cows with HEATSC3 (named HEAT group; n= 1347) received no additional treatment. The larger dominant follicle, evaluated on day 8and at TAI (day 10), was greater in HEAT group (P= 0.0145 and P

Expression of estrus near timed artificial insemination (TAI) is associated with greater fertility, and estrus detection could improve TAI fertility or direct TAI management, although accurate estrus detection can be difficult and time-consuming using traditional methods. The aim of this study is to evaluate influence of estrus on pregnancy (artificial insemination pregnancy rates (P/AI)) and to validate an alternative method to classify estrus/heat expression using tail chalking (HEATSC) in postpartum Bos indicus cows subjected to TAI in progesterone–estrogen-based protocols. In experiment 1 (Exp. 1), cows (5491) were subjected to visual observation of estrus after progesterone device removal, before TAI, and P/AI was evaluated according to estrus and body condition score (BCS). Cows received a progesterone device and 2 mg estradiol benzoate (EB). After 8 days, the device was removed and 150 μg of d-cloprostenol and 300 IU equine chorionic gonadotrophin was given. Later, animals in Exp. 1 received 1 mg EB and TAI 44 to 48 h. In the Exp. 2 – 3830 cows using similar protocol, received different ovulation inducers: 1 mg EB (n=1624) or 1 mg estradiol cypionate (EC; n=2206) on day 8 (D8). Cows were then marked with chalk, and HEATSC evaluated at TAI on D10 (HEATSC1 – no chalk removal=no estrus expression; HEATSC2 – partial chalk removal=low estrus expression; HEATSC3 – near complete/complete chalk removal=high estrus expression). In Exp. 1, cows showing estrus presented greater P/AI (48.4% v. 40.2%, P

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide medical challenge due to the scarcity of proper information and remedial resources. The ability to efficiently avoid a further SARS-CoV-2 pandemic will, therefore, depend on understanding several factors which include host immunity, virus behavior, prevention measures, and new therapies. This is a multi-phase observatory study conducted in the SG Moscati Hospital of Taranto in Italy that was converted into COVID-19 Special Care Unit for SARS-Co-V2 risk management. Patients were admitted to the 118 Emergency Pre-Hospital and Emergency Department based on two diagnostic criteria, the nasopharyngeal swab assessed by reverse-transcriptase-polymerase-chain-reaction (RT-PCR) and CT-scan image characterized by ground glass opacity. Patients were divided into four groups, positive-positive (ER-PP), negative-positive (ER-NP), negative-negative (ER-NN) and a group admitted to the ICU (ER-IC). A further control group was added when the T and B lymphocyte subsets were analyzed. Data included gender, age, vital signs, arterial blood gas analysis (ABG), extensive laboratory results with microbiology and bronchoalveolar lavage fluid (BALF) which were analyzed and compared. Fundamental differences were reported among the groups. Males were significantly higher in PP, ICU, and NP groups, from 2 to 4-fold higher than females, while in the NN group, the number of females was mildly higher than males; the PP patients showed a marked alkalotic, hypoxic, hypocapnia ABG profile with hyperventilation at the time of admission; finally, the laboratory and microbiology results showed lymphopenia, fibrinogen, ESR, CRP, and eGFR were markedly anomalous. The total number of CD4+ and CD8+ T cells was dramatically reduced in COVID-19 patients with levels lower than the normal range delimited by 400/μL and 800/μL, respectively, and were negatively correlated with blood inflammatory responses.

OBJECTIVE: The clinical use of mesenchymal stem cells (MSCs) in regenerative medicine either in tissue repair or tissue reconstruction has given highly interesting results thanks to their particular nature. Sources that have attracted the attention of medical scientists from where stem cells (SCs) in adults could be obtained are different and, dental tissues have certainly become an optimal source of MSCs. Dental tissue is a main reservoir of two types of MSCs dental bud (DBSCs) that constitute the immature precursor of the tooth and dental pulp (DPSCs) that are derived from dental inner pulp and partly from dental follicle tissue and can differentiate into several cell phenotypes as osteoblast, chondrocyte, hepatocytes, cardiomyocytes, neuron and beta cells.PATIENTS AND METHODS: Normal impacted third molars and tooth buds were collected from adults and adolescents underwent to extractions for orthodontic reasons. The expression of the five sternness genes Nanog, OCT4, Sox2, c-Myc and Klf4 were investigated by qRTPCR in two different dental stem/progenitor cells: dental pulp stem cells (DPSCs) and stem cells from dental bud (DBSCs), differentiated toward osteoblastic phenotype and not.RESULTS: Both DPSCs and DBSCs are easy to access and we found their expression of the typical mesenchymal sternness makers and osteogenic capacity due to the effective presence of embryonic gene regulators like Nanog, OCT4, Sox2, c-Myc and Klf4. Both DBSCs and DPSCs could represent a valid tool in regenerative medicine and translational applications.CONCLUSIONS: The results depicted here provide, for the first time to our knowledge, a comparative outcome about the stemness properties generated from accessible tissues such as DPSCs and DBSCs. These two types of SCs showed few different distinctive genetic traits supposedly in relation to their origin, location and stage of maturation. Certainly these SCs reserve solid potential for human clinical application in autologous procedure for bone, hard tissue and soft tissue regeneration, easy to isolate, ready availability, high-biocompatibility and safety and no ethical restrictions.

A new pandemic coronavirus causing coronavirus disease-2019 (COVID-19), initially called 2019-nCoV and successively named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The COVID-19 refers to the disease while the SARS-CoV-2 refers to the virus and is characterized by a rapid contagious capacity able to spread worldwide in a very short time. The rise in the number of infected patients and deaths is of great concern especially because symptoms are vague and similar to other forms of flu infection and corona syndrome infections characterized by fever, fatigue, dry cough, and dyspnea. According to the latest guidelines published by the World Health Organization (WHO), the diagnosis of COVID-19 must be confirmed by quantitative reverse transcription polymerase chain reaction (rRT-PCR) or gene sequencing of specimen obtained from throat, sputum and blood samples. However, the limitations due to logistics, as well as low sensitivity and specificity diagnostic tools currently available have been reported as the main cause of high incidence of either false-negative or positive results.The purpose of the present translational research protocol is to discuss and present the original findings from our research team on new diagnostic technique to detect four Coronaviridae family members (SARS-CoV-2, SARS-CoV, HCoV and MERS-CoV), highlighting the methodology, the procedure and the possible advantages. Moreover, the authors review the current epidemiology, precautions and safety measures for health personnel to manage patients with known or suspected COVID-19 infection.Implementation of an effective and rapid plan of diagnosing, screening and checking is a key factor to reduce and prevent further transmission. This procedure based on rRT-PCR could be of great help to decisively validate the results obtained from more conventional diagnostic procedures such as chest computed tomography (CT) imaging and chest ultrasound.This translational diagnostic tool will assist emergency and primary care clinicians, as well as out-of-hospital providers, in effectively managing people with suspected or confirmed SARS-CoV-2.

Osseo-degeneration is a disorder related to several factors, that may lead to the disruption of several skeletal regions providing support, such as the femur head, the vertebrae and the alveolar bone. The functional condition can be restored by means of grafting procedures, using different materials: calcium powder, xenografts, ceramics and metals. Such procedures aim at reforming an adequate bone volume and strength, that is necessary to support loading forces. Bone regeneration requires that the basic biological principles of osteogenesis, osteoinduction, osteoconduction and biocompatibility are followed. The success of regenerative procedures may depend on the inner structural, mechanical and metabolic condition of the host's bone on which implants should be inserted, on the surgical technique, and on the biomaterial used. Among these, the aging process of the patient appears to be relevant. It can be associated with metabolic disease leading to systemic functional decay, which involves a gradual steady decline of hormonal, immune function and osteo-metabolic activity. The latter can affect the positive outcomes of bone reconstruction and implant therapy. This review will analyze the biological and physiological factors involved in the bone tissue break-down, such as the influences from gut microbiome unbalance and the consequent metabolic, endocrine, immune dysfunctions, the surgery procedures and the quality of the grafting material used. The decline of bone architecture and strength should be corrected by using an appropriate clinical regenerative approach, based on a bio-endocrine, metabolic and immunologic know-how. The final characteristics of the regenerated bone must be able to support the loading forces transmitted by the implants, independent of the body location, and should be individualized according to the different condition of each patient.

Persistent trigeminal artery (PTA) originates from the posterior bend or lateral wall of the intra-cavernous carotid artery and is the most common occurring type of remnant primitive fetal arteries. In literature, there is limited number of reports on migraine-cephalgia (MC) associated with coexisting PTA. The primitive anastomose arteries that fully belong to the intracranial arterial vascular system are not supposed to perform any supportive functional activity; usually they are subjected to normal biological decay caused by the aging process and metabolic dysfunctions. The hypothesis suggests that these primitive fetal arteries such as PTA may not undergo a fast and structural deterioration but they might be active contributors to a series of mechanisms that can cause a variety of idiopathic complaints. Consequently this would bring a different therapeutic approach other than their surgical removal, which is the accepted option today as a solution for these problems. In this case report, a chronic unilateral MC due to coexisting PTA adjacent to trigeminal nerve is presented. The caliber and location of the PTA was confirmed by a CT-Angiography. The MC treatment was achieved by administration of bio-identical testosterone, human placenta extract (HPE), b-nicotinamide adenine dinucleotide (NADH) and low dose amlopidine.

The rarely diagnosed persistent trigeminal artery (PTA) originates from the posterior bend or lateral wall of the intracavernous carotid artery and is the most common occurring type of remnant primitive fetal arteries. Even if PTA is uncommon, information and awareness about it could be of great help for clinicians dealing with cranial vascular imaging and operating this region. In addition, it could give a supporting response to the presence of a wide range of idiopathic and unresponsive disturbs that sometimes are erroneously interpreted and treated. There are very few published scientific reports of coexisting PTA and unilateral trigeminal neuralgia and migraine-cephalgia (MC). In this review we describe few reported and unreported cases regarding the manifestation of unresponsive trigeminal neuralgia and migraine due to the presence of PTA. Patients usually present with a clinical symptomatology with unstable blood hypertension, pain of typical trigeminal neuralgia and MC that cover unilaterally the occipital area over the second and third divisions of the nerve. The outbreaks may often become more severe during physical exertion, stress and hypertension. Angio-MRI may reveal the PTA with an occasional occurrence of parietal cavernoma. We also describe a case of chronic left MC case associated with an adjacent PTA close to the trigeminal nerve position. The size and location of the PTA was confirmed by a CT-Angiography. The MC was safely treated by bio-identical testosterone, human placenta extract (HPE), b-nicotinamide adenine dinucleotide (NADH) and low dose amlopidine. It is hypothesized that these types of primitive anastomose arteries that fully belong to the intracranial arterial vascular system do not perform any supportive functional activity. Nevertheless, they undergo the normal biological decay caused by the aging process and metabolic dysfunctions. Therefore, such primitive fetal arteries as PTA might be subjected not only to a faster structural deterioration but they would actively contribute to a series of mechanisms causing a variety of idiopathic intracranial vascular and structural symptoms. Consequently, this would change the primary therapeutic approach to solve this problem, today represented by surgical removal. Anatomic implications related to treatment procedure are also discussed.

Ultrafiltration clarifies fruit juices, in the food industry, but generates retentive, recalcitrant wastewater, which, by its organic nature, may present a potential for biodegradation and methane production. This study aimed to evaluate the biochemical methane potential (BMP) in wastewater from the processing of unripe green acerola, obtaining the mass balance and the speed of organic load removal in COD terms. The BMP assays followed the German Guidelines VDI 4630, by applying three COD loads per liter of reactor vial (0.86 g CODappliedL −1 R, 1.5 g CODappliedL−1R, and 2.0 g CODappliedL−1R), in batches, inoculated with the anaerobics ludge from reactors treating domestic sewage, at 30 ◦C. The pH, COD, and methane production were evaluated every 48 hours. The biodegradability and the decay rate constant of the COD (Kd) were determined, thus obtaining the methanized COD, the COD for the formation of new cells, and the COD present in the wastewater, in the form of volatile acids. The best BMP was 0.100 L CH4 g −1 CODremoved, the percentages of methanization were above 62 %, and the highest Kd occurred for the lowest load applied. The anaerobic digestion of the wastewater proved viable for in full-scale, with its application being suggested at a pilot scale. Made available in DSpace on 2020-12-19T09:04:04Z (GMT). No. of bitstreams: 1 Biochemical-potential-of-methane-of-wastewater-2020.pdf: 190064 bytes, checksum: ddf02438073ec6af011c5178cc6d9843 (MD5) Previous issue date: 2020

In patients presenting with transient ischaemic attacks and acute minor noncardioembolic ischemic strokes (NIHSS score ≤3) who did not receive intravenous alteplase, treatment with dual antiplatelet therapy with aspirin and clopidogrel, started within 24 hours of symptom onset and continued for 21 days is effective in reducing a recurrent ischemic stroke up to 90 days from the symptom onset. However, as the long-term risk of major disabling bleeding with aspirin-based antiplatelet treatment is higher in patients aged 75 years or older, routine co-prescription of proton pump inhibitor should be encouraged.

Background: Auto erotic asphyxia (AEA) is described as an activity where persons intentionally induces hypoxia in order to increase the sexual excitement. This could be a group or solitary activity, observed commonly in adolescents or yo ung adult males. According to available literature deaths due to autoerotic asphyxia has not been reported in Sri Lanka. This is a case report on the death of a young adult male due to incomplete hanging with sexual paraphernalia. Case description: A 22 year old male was found partially hanging in his bed room with the door closed. The lower half of the body was naked and he was in an upright kneeling position with a ligature around his neck. The ligature was a cotton sheet with a slipped noose on the right side of the neck and tied a wooden bar under the roof. There was a mobile phone, pieces of a shattered mirror and a chair on the floor close to the body. There was dried seminal fluid on the left hand and on the floor close to the body. Conclusion: The state of partial hanging was used to reach the state of asphyxia. Prolonged compression of neck or failure to adopt self-rescue mechanisms may have led to death. The findings at the scene correspond to what is reported in the literature on auto erotic asphyxia. This case report highlights the importance of scene visit, in determining manner of death.

A transient ischaemic attack (TIA) is a major warning of an impending stroke. The risk of recurrent TIA or stroke is highest during the first 24 hours. 80% of recurrence risk is reduced with early initiation of effective treatment. Many things have changed regarding TIAs over the last decade. The definition of TIA has changed from a time-based to a tissue-based one. Strategies for investigation and treatment have changed, with specialist evaluation and management recommended for all TIAs within 24 hours of symptom onset. Dedicated TIA clinics have revolutionized the approach to TIA management. Improving awareness on early recognition and establishing pathways for rapid delivery of optimal care for TIAs will go a long way in minimizing the burden of stroke in Sri Lanka.