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Discover the techniques of analog filter designs and their utilization in a large number of practical applications such as audio/video signal processing, biomedical instrumentation and antialiasing/reconstruction filters. Covering high frequency filter design like active R and active C filters, the author tries to present the subject in a simpler way as a base material for analog filter designs, as well as, for advanced study of continuous-time filter designs, and allied filter design areas of current-mode (CM) and switched capacitor filters. With updated basic analog filter design approaches, the book will provide a better choice to select appropriate design technique for a specific application. Focussing mainly on continuous time domain techniques, which forms the base of all other techniques, this is an essential reading for undergraduate students. Numerous solved examples, practical applications and case studies on audio/video devices, medical instrumentation, control and antialiasing/reconstruction filters, shall provide ample motivation to readers.
You have just encountered a possible stroke patient. You ask yourself: what should I do first? How do I know it is a stroke? Is it too late to reverse the damage? This book provides integral assistance in answering these critical questions. All content is arranged in chronological order, covering all considerations in assessing and treating patients in the emergency room, stroke unit, and rehabilitation facilities. This new edition offers readers the latest information on stroke treatment, and features brand new chapters on stroke radiology, endovascular therapy, the uncommon causes of stroke, cerebral venous thrombosis, stroke prevention, and the transition to outpatient care. The comprehensive set of appendices contains useful reference information, including dosage algorithms, conversion factors, and stroke scales.
The current study was carried out to determine whether Dietary insulin index (DII) and Dietary insulin load (DIL) are related to psychological disorders in a cross-sectional study among adults. A total of 3172 Iranian adults (age range of 18-55 years) were included. Data on dietary intakes were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire. DII and DIL were calculated using food insulin index values published earlier. To assess depression and anxiety, Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was used. Furthermore, psychological distress was examined using the General Health Questionnaire (GHQ). Among women, a significant positive association was seen; such that women in the highest quartile of DIL had higher odds of depression than those in the lowest quartile (OR: 1.84; 95% CI: 1.14-2.96). In terms of DII, in the fully adjusted model, women in the top quartile of DII were more likely to be depressed compared with those in the bottom quartile (OR: 1.65; 95% CI: 1.05-2.58). In conclusion, we found a significant positive association between DIL and DII and odds of depression among women, but not in men. However, such findings were not seen for anxiety and psychological distress.
Cysticercus tenuicollis as metacestode of Taenia hydatigena is the most prevalent taeniid species in livestock. Eighty-eight C. tenuicollis samples were collected from sheep (n = 44) and goats (n = 44) of the northern Iran from 2015 to 2016. The isolated parasites were characterized by morphometric keys. The DNA of the larval stage was extracted, amplified and sequenced targeting mitochondrial 12S rRNA and Cox 1 markers. A significant difference in larval rostellar hook length was observed in 12S rRNA haplotypes. Analysis of molecular variance of 12S rRNA indicated a moderate genetic diversity in the C. tenuicollis isolates. The pairwise sequence distance of C. tenuicollis showed an intra-species diversity of 0.3–0.5% and identity of 99.5–100%. Using the 12S rRNA sequence data we found a moderate genetic difference (Fst; 0.05421) in C. tenucollis isolates collected from livestock of the northern and southeastern regions of Iran. We concluded that the genetic variants of C. tenuicollis are being undoubtedly distributing mostly in different parts of Iran. Further studies with a larger number of T. hydatigena isolates collected from various intermediate and definitive hosts are needed to study this evolutionary assumption and also to determine the apparent genetic differences observed in the studied regions.
The purpose of this study is to investigate quantitatively the correlation of displacement vector fields (DVFs) from different deformable image registration (DIR) algorithms to register images from helical computed tomography (HCT), axial computed tomography (ACT) and cone beam computed tomography (CBCT) with motion parameters.
Materials and methods:
CT images obtained from scanning of the mobile phantom were registered with the stationary CT images using four DIR algorithms from the DIRART software: Demons, Fast-Demons, Horn–Schunck and Lucas–Kanade. HCT, ACT and CBCT imaging techniques were used to image a mobile phantom, which included three targets with different sizes (small, medium and large) that were manufactured from a water-equivalent material and embedded in low-density foam to simulate lung lesions. The phantom was moved with controlled cyclic motion patterns where a range of motion amplitudes (0–20 mm) and frequencies (0·125–0·5 Hz) were used.
The DVF obtained from different algorithms correlated well with motion amplitudes applied on the mobile phantom for CBCT and HCT, where the maximal DVF increased linearly with the motion amplitudes of the mobile phantom. In ACT, the DVF correlated less with motion amplitudes where motion-induced strong image artefacts and the DIR algorithms were not able to deform the ACT image of the mobile targets to the stationary targets. Three DIR algorithms produce comparable values and patterns of the DVF for certain CT imaging modality. However, DVF from Fast-Demons deviated strongly from other algorithms at large motion amplitudes.
The local DVFs provide direct quantitative values for the actual internal tumour shifts that can be used to determine margins for the internal target volume that consider tumour motion during treatment planning. Furthermore, the DVF distributions can be used to extract motion parameters such as motion amplitude that can be extracted from the maximal or minimal DVF calculated by the different DIR algorithms and used in the management of the patient motion.
Chickpea is one of the most important nutritious grain legume crops in the world. There is limited information available on micro- and macro-nutrients in chickpea. Therefore, an effort was made to evaluate a set of 40 chickpea genotypes belonging to all the gene pools including cultivated (Cicer arietinum) as well as wild, Cicer reticulatum from the primary gene pool, Cicer echinospermum from the secondary gene pool and Cicer microphyllum from the tertiary gene pools. Concentration in the seed of the micro- (Zn, Fe, Cu and Mn) and macro-nutrients (Ca, Mg and K) was studied. Substantial variation was observed among different gene pools for the concentration of all the nutrients. The cultivated chickpea exhibited higher seed Cu, Mn, Mg and Ca than wilds indicating positive domestication effect, whereas wild crop relatives were found to have higher levels than cultivated chickpeas for seed Zn, Fe and K concentrations. While comparing desi-type chickpeas with Kabulis, it was revealed that desi types possessed more Zn, Cu, Ca and Mg than Kabulis but reverse was true for seed Fe, Mn and K. Among different desi types (desi brown, desi green and desi black), desi brown types were generally associated with higher mineral nutrient levels. The present study led to the identification of most promising genotypes for different seed micro- and macro-nutrients. These promising lines may serve as genetic resources useful in gene discovery programmes and for alleviating malnutrition or hidden hunger in the developing world.
The environmental and economic realities of Arctic climate change present novel problems for international law. Arctic warming and pollution raise important questions about responsibilities and accountabilities across borders, as they result from anthropogenic activities both within and outside the Arctic region, from the Global North and the Global South. Environmental interdependencies and economic development prospects connect in a nexus of risk and opportunity that raises difficult normative questions pertaining to Arctic governance and sovereignty. This article looks at how the Arctic has been produced in international legal spaces. It addresses the implication of states and Indigenous peoples in processes of Arctic governance. Looking at specific international legal instruments relevant to Arctic climate change and development, the author attempts to tease out the relationship between the concepts of Indigenous rights and state sovereignty that underlie these international legal realms. What do these international legal regimes tell us with respect to the role of Arctic Indigenous peoples and the role of states in governing the ‘global’ Arctic? It is argued that while international law has come a long way in recognizing the special status of Indigenous peoples in the international system, it still hesitates to recognize Indigenous groups as international law makers. Comparing the status of Indigenous peoples under specific international regimes to their role within the Arctic Council, it becomes evident that more participatory forms of global governance are entirely possible and long overdue.
Falls are a major health concern in older adults. Falls lead to mortality, immobility and high costs to social and health care services. Early detection and classification of falls is imperative for timely and appropriate medical aid response. Traditional machine learning models have been explored for fall classification. While newly developed deep learning techniques have the ability to potentially extract high-level features from raw sensor data providing high accuracy and robustness to variations in sensor position, orientation and diversity of work environments that may skew traditional classification models. However, frequently used deep learning models like Convolutional Neural Networks (CNN) are computationally intensive. To the best of our knowledge, we present the first instance of a Hybrid Multichannel Random Neural Network (HMCRNN) architecture for fall detection and classification. The proposed architecture provides the highest accuracy of 92.23% with dropout regularization, compared to other deep learning implementations. The performance of the proposed technique is approximately comparable to a CNN yet requires only half the computation cost of the CNN-based implementation. Furthermore, the proposed HMCRNN architecture provides 34.12% improvement in accuracy on average than a Multilayer Perceptron.
In assisted reproductive technology (ART) programmes, approximately 10% of infertile patients have at least two or three repeated implantation failures (RIFs) after an in vitro fertilization (IVF) protocol. Successful implantation mainly depends on local immune tolerance mechanisms involving a spectrum of cytokines, interleukins and growth factors. The latter have played pivotal roles in the recruitment of immune cells (and notably T-lymphocyte cells). In total, 250 couples participating in frozen–thawed embryo transfer programme were incorporated in a randomized clinical trial (peripheral blood mononuclear cells (PBMC) subgroup: n=122; control subgroup: n=128). In the PBMC group, a blood sample was collected 5 days before the scheduled frozen–thawed embryo transfer; PBMCs were isolated using Ficoll separation and then cultured for 72 h. Two days prior to embryo transfer, 0.4 ml of cultured PBMCs were transferred into the patient’s uterus. Although the clinical pregnancy rate was higher in the PBMC group (34.4%) than in the control group (23.4%), this difference was not statistically significant (P=0.05 in a chi-squared test). Nevertheless, when we limited the analysis to patients with ≥3 RIFs (n=138), there was a significant difference in the clinical pregnancy rate between the PBMC group (38.6%) and the control group (19.7%; P=0.01). Our results imply that PBMC transfer can be part of effective fertility treatment for patients with RIF.
Prehospital identification of large vessel occlusion (LVO) stroke may expedite treatment by direct transport to comprehensive stroke centers (CSCs) with endovascular capabilities. The Cincinnati Prehospital Stroke Scale (CPSS) is commonly used for prehospital stroke detection. We aimed to assess whether (1) a high CPSS score can identify LVO and (2) an Emergency Medical Service (EMS) redirection protocol based on high CPSS accelerated endovascular treatment (EVT).
A retrospective comparison of patients transported by EMSs for suspected stroke to a high-volume CSC over a 16-month period, before and after implementation of an EMS redirection protocol based on high CPSS score (3/3). Charts were reviewed to determine the presence of LVO. Time to EVT and 3-month outcomes were compared before and after implementation.
A prehospital CPSS 3/3 score was found in 223 (59%) patients, demonstrating positive and negative predictive values for LVO of 29% and 94%, respectively. CPSS-based EMS redirection increased the proportion of EVT performed after direct transport to CSC [before: 21 (36%), after: 45 (63%), p < 0.01] and decreased median first door-to-groin puncture time by 28 minutes [109 (interquartile range (IQR) 64–116) versus 81 (IQR 56–130), p = 0.03]. At 3 months, the proportion of patients achieving functional independence (modified Rankin score 0–2) went from 20/57 (35%) to 29/68 (43%) (p = 0.39) following implementation.
CPSS-based EMS redirection accelerated identification of LVO strokes in the out-of-hospital setting and decreased time to EVT. Nevertheless, this protocol was also associated with high rates of non-LVO stroke. Impact on clinical outcomes should be evaluated in a larger cohort.
This study examined the role of social support in managing worry among a sample of Malaysian adults. An online questionnaire was completed by 136 participants (age M = 34, SD = 7.65; 71% female, 29% male). Each wrote open-ended, essay-type descriptions of their experiences with social support in relation to worry, as well as completing measures of pathological worry (Penn State Worry Questionnaire), normal worry (Worry Domains Questionnaire), and perceived social support (Multidimensional Scale of Perceived Social Support). Results indicated that young adults experienced a higher degree of normal worry compared to older adults, but pathological worry was not significantly different between the two groups. No significant differences in worry were found in relation to gender, ethnicity or marital status. Perceived social support was negatively related to levels of both normal and pathological worry. Qualitative analyses pointed towards four important roles for social support: providing a sense of belonging and security, providing emotional relief or catharsis, helping to reappraise situations, and facilitating problem-solving and decision-making. The role of social support as a secure base that facilitates emotion management and helps to ground thinking is discussed.
Volumetric modulated arc therapy (VMAT), an extension of intensity modulated radiation therapy (IMRT), employs modifications in gantry rotation speed, machine dose rate and multi-leaf collimator motion to deliver a three-dimensional dose distribution. This study compared VMAT to IMRT for patients with anal carcinoma.
Materials and Methods:
Sixteen patients previously treated with IMRT were retrospectively selected. Each patient received a total dose of 57·6–63·0 Gy in 1·8 Gy fractions. A single- or double-isocenter multi-arc VMAT treatment plan was generated using Eclipse RapidArc system with the same computed tomography image sets and optimisation constraints used for IMRT. Dose–volume histograms (DVHs) for planning target volumes (PTVs) and organs at risk (OARs), and monitor units (MUs) and beam on times (BOTs) were used for comparison.
IMRT and VMAT plans showed insignificant differences in PTV homogeneity and conformity and sparing hips and bowel. VMAT required fewer mean MU and shorter BOT per plan (1,597 MU, 2·66 min) compared to IMRT (2,571 MU, 4·29 min) with p < 0·0001.
Fewer MU and shorter BOT for VMAT may decrease the damage from secondary radiation and treatment delivery uncertainty due to intra-fraction tumour motion, leading to higher machine throughput and improving patient comfort, with less treatment time.
The objective of the present study was to investigate the effect of curcumin on insulin resistance (IR) and hepatic lipid accumulation in intra-uterine growth restriction (IUGR). Rats with a normal birth weight (NBW) or IUGR were fed basic diets (NBW and IUGR groups) or basic diets supplemented with curcumin (NBW-C and IUGR-C groups) from 6 to 12 weeks. Rats in the IUGR group showed higher levels of glucose and homeostasis model assessment for insulin resistance index (HOMA-IR) (P < 0·05) than in the NBW group. The livers of IUGR rats exhibited higher (P < 0·05) concentration of TAG and lower (P < 0·05) activities of lipolysis enzymes compared with the normal rats. In response to dietary curcumin supplementation, concentrations of serum insulin, glucose and HOMA-IR, pyruvate, TAG, total cholesterol and NEFA in the liver were decreased (P < 0·05). The concentrations of glycogen and activities of lipolysis enzymes in the liver were increased (P < 0·05) in the IUGR-C group compared with the IUGR group. These results were associated with lower (P < 0·05) phosphorylated insulin receptor substrate 1, protein kinase B or Akt, glycogen synthase kinase 3β and expressions of sterol regulatory element binding protein 1 and fatty acid synthase (FASN); decreased expressions for Cd36, sterol regulatory element binding protein 1c (Srebf1) and Fasn; increased (P < 0·05) expression of PPARα; and expressions for Ppara and hormone-sensitive lipase in the liver of IUGR-C rats than the IUGR rats. Maternal malnutrition caused IR and lipid accumulation in the liver. Curcumin supplementation prevented IR by regulating insulin signalling pathways and attenuated hepatic lipid accumulation.
No study is available that has assessed the association of dietary diversity score (DDS) and alternative healthy eating index (AHEI) with glioma. The present study aimed to assess this association in Iranian adults. Overall, 128 pathologically confirmed cases of glioma were enrolled from hospitals and 256 age- and sex-matched controls were recruited from other wards of the hospital between 2009 and 2011. Dietary assessment was done using a validated block-format 123-item semi-quantitative FFQ. Dietary indices including DDS and AHEI-2010 were constructed according to standard methods. After controlling for potential confounders, a significant inverse association was found between DDS and risk of glioma (OR 0·42, 95 % CI 0·19, 0·94). Such finding was also seen when further adjustment was made for BMI; such that participants in the highest quartile of DDS were 56 % less likely to have glioma compared with those in the lowest quartile (OR 0·44, 95 % CI, 0·20, 0·97). In addition, a significant inverse association was found between adherence to AHEI and glioma; such that in the fully adjusted model, participants in the fourth quartile of AHEI had 74 % lower risk of glioma compared with those in the first quartile (OR 0·26, 95 % CI 0·12, 0·56). In conclusion, we found that greater adherence to the healthy, as measured by AHEI, and diverse, as measured by DDS, diets was associated with decreased odds of glioma.
Auto-biological beliefs—beliefs about one’s own biology—are an understudied component of personal identity. Research participants who are led to believe they are biologically vulnerable to affective disorders report more symptoms and less ability to control their mood; however, little is known about the impact of self-originating beliefs about risk for psychopathology, and whether such beliefs correspond to empirically derived estimates of actual vulnerability. Participants in a neuroimaging study (n = 1256) completed self-report measures of affective symptoms, perceived stress, and neuroticism, and an emotional face processing task in the scanner designed to elicit threat responses from the amygdala. A subsample (n = 63) additionally rated their own perceived neural response to threat (i.e., amygdala activity) compared to peers. Self-ratings of neural threat response were uncorrelated with actual threat-related amygdala activity measured via BOLD fMRI. However, self-ratings predicted subjective distress across a variety of self-report measures. In contrast, in the full sample, threat-related amygdala activity was uncorrelated with self-report measures of affective distress. These findings suggest that beliefs about one’s own biological threat response—while unrelated to measured neural activation—may be informative indicators of psychological functioning.
Childhood maltreatment is robustly associated with increased risk of poor mental health outcome and changes in brain function. The authors investigated whether childhood experience of abuse (e.g. physical, emotional and sexual abuse) and neglect (physical and emotional deprivation) was differentially associated with neural reactivity to threat.
Participants were drawn from an existing study and allocated to one of four groups based on self-report of childhood maltreatment experience: individuals with childhood abuse experiences (n = 70); individuals with childhood neglect experiences (n = 87); individuals with combined experience of childhood abuse and neglect (n = 50); and non-maltreated individuals (n = 207) propensity score matched (PSM) on gender, age, IQ, psychopathology and SES. Neural reactivity to facial cues signalling threat was compared across groups, allowing the differential effects associated with particular forms of maltreatment experience to be isolated.
Brain imaging analyses indicated that while childhood abuse was associated with heightened localised threat reactivity in ventral amygdala, experiences of neglect were associated with heightened reactivity in a distributed cortical fronto-parietal network supporting complex social and cognitive processing as well as in the dorsal amygdala. Unexpectedly, combined experiences of abuse and neglect were associated with hypo-activation in several higher-order cortical regions as well as the amygdala.
Different forms of childhood maltreatment exert differential effects in neural threat reactivity: while the effects of abuse are more focal, the effects of neglect and combined experiences of abuse are more distributed. These findings are relevant for understanding the range of psychiatric outcomes following childhood maltreatment and have implications for intervention.