A Survey of Human Activity Recognition in Smart Homes Based on IoT Sensors Algorithms: Taxonomies, Challenges, and Opportunities with Deep Learning.

Recent advances in Internet of Things (IoT) technologies and the reduction in the cost of sensors have encouraged the development of smart environments, such as smart homes. Smart homes can offer home assistance services to improve the quality of life, autonomy, and health of their residents, especially for the elderly and dependent. To provide such services, a smart home must be able to understand the daily activities of its residents. Techniques for recognizing human activity in smart homes are advancing daily. However, new challenges are emerging every day. In this paper, we present recent algorithms, works, challenges, and taxonomy of the field of human activity recognition in a smart home through ambient sensors. Moreover, since activity recognition in smart homes is a young field, we raise specific problems, as well as missing and needed contributions. However, we also propose directions, research opportunities, and solutions to accelerate advances in this field.

A comprehensive study of class incremental learning algorithms for visual tasks.

The ability of artificial agents to increment their capabilities when confronted with new data is an open challenge in artificial intelligence. The main challenge faced in such cases is catastrophic forgetting, i.e., the tendency of neural networks to underfit past data when new ones are ingested. A first group of approaches tackles forgetting by increasing deep model capacity to accommodate new knowledge. A second type of approaches fix the deep model size and introduce a mechanism whose objective is to ensure a good compromise between stability and plasticity of the model. While the first type of algorithms were compared thoroughly, this is not the case for methods which exploit a fixed size model. Here, we focus on the latter, place them in a common conceptual and experimental framework and propose the following contributions: (1) define six desirable properties of incremental learning algorithms and analyze them according to these properties, (2) introduce a unified formalization of the class-incremental learning problem, (3) propose a common evaluation framework which is more thorough than existing ones in terms of number of datasets, size of datasets, size of bounded memory and number of incremental states, (4) investigate the usefulness of herding for past exemplars selection, (5) provide experimental evidence that it is possible to obtain competitive performance without the use of knowledge distillation to tackle catastrophic forgetting and (6) facilitate reproducibility by integrating all tested methods in a common open-source repository. The main experimental finding is that none of the existing algorithms achieves the best results in all evaluated settings. Important differences arise notably if a bounded memory of past classes is allowed or not.

Laparoscopic resection of large pelvic lipoma causing obstructive uropathy in a 66 year old female - A case report from Greece.

Lipomas are benign, usually asymptomatic, tumours and pelvic lipomas are extremely rare. We describe the case of a giant pelvic lipoma causing obstructive uropathy to a 66-year-old morbidly obese female treated in the 4th Surgical Department of the Medical School of Aristotle University of Thessaloniki in General Hospital "G. Papanikolaou" in March 2016. The patient presented with a history of nocturia and frequent daytime urination for 1 year. Her medical history included diffuse lipomatosis. Computer tomography revealed a giant pelvic mass which lead to left side hydronephrosis, hydrouterer and a pear-shaped bladder, with the differential diagnosis including pelvic lipoma or liposarcoma. An ultrasound guided biopsy excluded the diagnosis of liposarcoma. The patient was submitted to laparoscopic resection of the pelvic lipoma, with complete remission of urinary symptoms. The key-point is to consider the possibility that the pelvic mass is a well-differentiated liposarcoma and to manage it adequately and thus, we recommend intact excision of the mass through a wound protector, and extreme caution to avoid any rupture of the capsule.

Laparoscopic Resection of Desmoid Type Fibromatosis of the Splenic Hilum Mimicking a Greater Curvature Gastric GIST.

Desmoid tumor, recently renamed as desmoid type fibromatosis, is an uncommon neoplasm. The mesentery is the usual origin of intra-abdominal desmoid-type fibromatosis and despite the fact there is no metastatic potential, it can infiltrate adjacent organs. There etiology remains unknown, preoperative diagnosis is difficult and differential diagnosis includes among other gastrointestinal stromal tumor (GIST). In resectable tumors, the mainstay of treatment is surgical resection with at least clean microscopic margins. We present a case of a 51-year lady who presented with a 6.2 x 4.5 x 3.3 cm neoplasm in the anatomic area of the greater gastric curvature, the splenic hilum and the tail of the pancreas that was diagnosed as GIST on the CT scan. The patient was submitted to laparoscopic excision of the tumor and histopathological examination revealed desmoid type fibromatosis of the splenic hilum infiltrating the spleen, pancreatic tale and greater gastric curvature. According to the authors' knowledge, this is the first reported case of a sporadic splenic desmoid tumor, which has been treated successfully by laparoscopic en block resection.

Atypical anastomotic malignancies of small bowel after subtotal gastrectomy with Billorth II gastroenterostomy for peptic ulcer: Report of three cases and review of the literature.

AIM: To present patients who developed small-bowel malignancy at the level of the gastrointestinal anastomosis decades after a subtotal gastrectomy for ulcer, to review relevant literature, and to attempt to interpret the reasons those cancers developed to these postsurgical non-gastric sights. METHODS: For the current retrospective study and review of literature, the surgical and histopathological records dated from January 1, 1993 to December 31, 2017 of our department were examined, searching for patients who have undergone surgical treatment of small-bowel malignancy to identify those who have undergone subtotal gastrectomy for benign peptic ulcer. A systematic literature search was also conducted using PubMed, EMBASE, and Cochrane Library to identify similar cases. RESULTS: We identified three patients who had developed small-intestine malignancy at the level of the gastrointestinal anastomosis decades after a subtotal gastrectomy with Billroth II gastroenterostomy for benign peptic ulcer-two patients with adenocarcinoma originated in the Braun anastomosis and one patient with lymphoma of the efferent loop. All three patients were submitted to surgical resection of the tumor with Roux-en-Y reconstruction of the digestive tract. In the literature review, we only found one case of primary small-intestinal cancer that originated in the efferent loop after Billroth II gastrectomy because of duodenal ulcer but none reporting Braun anastomosis adenocarcinoma following partial gastrectomy for benign disease. We also did not find any case of efferent loop lymphoma following gastrectomy. CONCLUSION: Anastomotic gastric cancer following distal gastrectomy for peptic ulcer is a well-established clinical entity. However, malignancies of the afferent or efferent loop of the gastrointestinal anastomosis are extremely uncommon. The substantial diversion of the potent carcinogenic pancreaticobiliary secretions through the Braun anastomosis and the stomach hypochlorhydria, allowing the formation of carcinogenic factors from food, are the two most prominent pathogenetic mechanisms for those tumors.

Our 20-year experience with experimental colonic anastomotic healing.

Aim: To present our experience with experimental colonic anastomoses and compare it with the results of other experienced researchers. Materials and Method: The published experimental studies of our research group up to 1996, as well as results of other researchers in this field, are demonstrated and discussed. Different actions of administered substances on the anastomotic healing were compared and represented. Various chemotherapeutic agents were evaluated in experimental models without colorectal cancer as independent risk factors for the anastomotic healing. Moreover, numerous pharmaceutical agents such as steroids, immunomodulators, vasodilators and the use of fibrin glue are also assessed in detail. Results: Cytostatics, as well as steroids, impair the colonic anastomotic healing, but the combined administration of other agents can reverse this negative effect. Fibrin glue seems to protect the colonic anastomosis, while iloprost could be a potential candidate for further exploration in patient trials. Tacrolimus, despite its immunosuppressive action, seems to promote the anastomotic healing. This observation could be useful for patients with inflammatory bowel disease under tacrolimus therapy, who undergo a non-elective colectomy. Obstructive conditions predispose to anastomotic insufficiency, and therefore, substances to avoid this threatening complication are also assessed. Tacrolimus and iloprost showed a remarkable action against anastomotic leakage under artificially obstructive conditions. Conclusion: Further studies, especially in forms of clinical protocols, are necessary in order for these results to find their place in safe daily practice.

Heterotopic mesenteric ossification of ileostomy - "intraabdominal myositis ossificans".

UNLABELLED: Heterotopic mesenteric ossification is a rare clinical entity with less than 40 reported cases. Moreover, heterotopic mesenteric ossification around a stoma is described in fewer cases. CASE PRESENTATION: An 81-year-old male patient, who underwent a sigmoidectomy two years ago for a sigmoid colon cancer, was admitted in our Department in order to be investigated for a local recurrence of his disease. Because of unresectable pelvic lesions, the patient was taken in the operating room for a palliative double barrel ileostomy. The patient presented two weeks after the ileostomy clinical signs suggesting its obstruction. A revision of the ileostomy is performed. Macroscopically, the end part of the ileostomy was inflamed and resected. Histological findings revealed heterotopic ossification of the mesentery. CONCLUSIONS: The surgeon should be alert to the possibility of heterotopic ossification, especially within a previously operated wound and be prepared for the difficulties it may cause during reopening of an incision, during the operation itself, at closure of the wound and, if not removed, also in the postoperative setting.

Massive Localized Lymphedema in the Morbidly Obese Patient: A Clinical Entity Mimicking Lymphosarcoma.

Massive localized lymphedema (MLL) is a rare benign soft tissue lesion that develops in morbidly obese patients, most commonly on the medial thigh (though other locations have also been described). The cause of MLL remains unknown, but the common denominator in all reported cases is obesity. The diagnosis of MLL is usually made based on clinical history and presentation but it is believed to be underdiagnosed due to a lack of awareness of this distinct entity. When left untreated, MLL can degenerate into angiosarcoma. This report describes a case of MLL of the right lower abdominal wall in an obese 61-year-old female (BMI = 42 kg/m(2)).

Adrenal Gland Lymphangiomas.

Lymphangiomas of the adrenal glands (ALs) are benign vascular lesions. Approximately, 53 cases have been reported in the literature. The current study reviews and analyzes the clinical and pathologic features of all reported ALs and additionally illustrates a typical case of adrenal lymphangioma (AL). In order to perform the review analysis, a search of the international literature for ALs in adults was conducted. Thirty-eight related articles were found. Clinical and pathological information were obtained for all the reported cases and a database was created. ALs were detected more frequently in women than men. The mean age of occurrence was 39.5 years, while their mean size was 8.86 cm. Fifty-nine percent of ALs were right-sided. Size and localization were responsible for the presenting symptoms, though 30.4 % were asymptomatic. Diagnosis was made postoperatively in all cases by histological results. ALs are rare and benign lesions. They usually present as an incidental finding after abdominal imaging. The diagnosis is made after the surgical removal by histological and immunohistochemical examinations.

Primary squamous cell carcinoma of the thyroid gland.

Primary squamous cell carcinoma (SCC) of the thyroid gland is a very rare entity representing <1% of all primary carcinomas of the thyroid gland with a very poor prognosis. We report a rare case of a 65-year-old woman with SCC of the thyroid gland, emphasizing the postoperative complications and poor prognosis of these patients. Surgical excision of primary SCC of the thyroid gland when possible is the optimal therapy. Chemo- and radiotherapy rarely have place in its treatment as this malignancy has a poor response to chemotherapy and in many cases is radio-resistant. Median survival of these patients is around 6 months.

Neuroendocrine tumors of extrahepatic biliary tract.

Neuroendocrine tumors of the extrahepatic bile ducts (EBNETs) are very rare. The aim of the present review is to elucidate the characteristics of EBNETs, their treatment and prognosis. An exhaustive systematic review of the literature was performed from 1959 up-to-date. One hundred articles, describing 150 cases were collected. Each article was carefully analyzed and a database was created. The most common symptoms were jaundice (60.3 %) and pruritus (19.2 %). Cholelithiasis co-existed in 15 cases (19.2 %). Hormone- and vasoactive peptide- related symptoms were present in only 7 cases (9 %). The most frequent sites were found to be the common hepatic duct and the proximal common bile duct (19.2 %). Surgical management was considered the main treatment for EBNETs, while excision of extrahepatic biliary tree (62.82 %) with portal vein lymphadenectomy (43.6 %) was the most popular procedure. EBNETs are extremely rare. Their rarity makes their characterization particularly difficult. Up to date the final diagnosis is made after surgery by pathology and immunohistochemistry findings. The present analysis of the existing published cases elucidates many aspects of these tumours, giving complete clinicopathological documentation.

The effects of iloprost on colonic anastomotic healing in rats under obstructive ileus conditions.

BACKGROUND: The aim of this study was to investigate the effects of iloprost, on colonic anastomotic healing in rats, under obstructive ileus conditions. MATERIALS AND METHODS: Eighty male Albino rats were randomized into four groups of 20 animals each. They underwent colonic resection followed by an inverted anastomosis. The rats of group 1 (control) and group 2 (ileus) received 3 mL of saline 0.9% intraperitoneally and those of group 3 (iloprost), and group 4 (ileus + iloprost) iloprost (2 µg/kg of body weight), immediately postoperatively and daily until the day of sacrifice. Each group was further divided into two equal subgroups, depending on the day of sacrifice. The animals of subgroup "a" were sacrificed on the fourth postoperative day, whereas those of "b" on the eighth day. Macroscopic and histologic assessment was performed, whereas anastomotic bursting pressures and the tissue concentrations in hydroxyproline and collagenase I were evaluated. RESULTS: Means of bursting pressure, neoangiogenesis, fibroblast activity, and hydroxyproline concentration were significantly increased in group 4 compared with group 2. In addition, on the fourth postoperative day, the inflammatory cell infiltration and the collagenase I concentration were significantly decreased in group 4 compared with group 2. Moreover, on the eighth postoperative day, collagen deposition was significantly increased in group 4 compared with group 2. CONCLUSIONS: Iloprost after intraperitoneal administration reverses the negative effect of obstructive ileus. It promotes not only the angiogenic activity but also collagen formation, resulting in increased bursting pressures on the fourth and eighth postoperative days.

Endoscopic application of n-butyl-2-cyanoacrylate on esophagojejunal anastomotic leak: a case report.

INTRODUCTION: This case report describes an esophagojejunal anastomotic leak following total gastrectomy for gastric cancer. The leak was treated successfully with endoscopic application of n-butyl-2-cyanoacrylate. This is the first case report on the endoscopic application of cyanoacrylate alone for the treatment of an anastomotic leak. CASE PRESENTATION: This report describes a case of a 68-year-old Caucasian man who underwent surgery for gastric cancer. He underwent total gastrectomy and esophagojejunal anastomosis with Roux-en-Y anastomosis plus transverse colectomy. An anastomotic leak was treated conservatively at first for a total of three weeks. However, the leak persisted; therefore, the decision was made to apply topical endoscopic n-butyl-2-cyanoacrylate. CONCLUSION: The endoscopic application of n-butyl-2-cyanoacrylate alone can be used successfully to treat esophagojejunal anastomotic leakage.

Surgical treatment of hepatic metastases from colorectal cancer.

Colorectal carcinoma is one of the most frequent cancers in Western societies with an incidence of around 700 per million people. About half of the patients develop metastases from the primary tumor and liver is the primary metastatic site. Improved survival rates after hepatectomy for metastatic colorectal cancer have been reported in the last few years and these may be the result of a variety of factors, such as advances in systemic chemotherapy, radiographic imaging techniques that permit more accurate determination of the extent and location of the metastatic burden, local ablation methods, and in surgical techniques of hepatic resection. These have led to a more aggressive approach towards liver metastatic disease, resulting in longer survival. The goal of this paper is to review the role of various forms of surgery in the treatment of hepatic metastases from colorectal cancer.

Brucella liver abscess; imaging approach, differential diagnosis, and therapeutic management: a case report.

We report a new case of a brucellar liver abscess (brucelloma) in a young woman without previous remote brucellosis who presented with pronounced systemic and mild local symptoms. Brucelloma is the result of calcification of a granoulomatous reaction induced by persistent Brucella in macrophages. It represents a rare manifestation that follows previously undetected brucellosis. We describe the findings in plain radiograph, ultrasound, computed tomography, and magnetic resonance images. Together with the positive serology, imaging yielded important elements supporting the diagnosis. Modern radiological techniques also contributed to the final therapeutic management, preventing unnecessary laparotomy. Sequencing confirmed the definite diagnosis of Brucella melitensis as the causative factor.