Direct mapping from PET coincidence data to proton-dose and positron activity using a deep learning approach.

Objective. Obtaining the intrinsic dose distributions in particle therapy is a challenging problem that needs to be addressed by imaging algorithms to take advantage of secondary particle detectors. In this work, we investigate the utility of deep learning methods for achieving direct mapping from detector data to the intrinsic dose distribution.Approach. We performed Monte Carlo simulations using GATE/Geant4 10.4 simulation toolkits to generate a dataset using human CT phantom irradiated with high-energy protons and imaged with compact in-beam PET for realistic beam delivery in a single-fraction (∼2 Gy). We developed a neural network model based on conditional generative adversarial networks to generate dose maps conditioned on coincidence distributions in the detector. The model performance is evaluated by the mean relative error, absolute dose fraction difference, and shift in Bragg peak position.Main results. The relative deviation in the dose and range of the distributions predicted by the model from the true values for mono-energetic irradiation between 50 and 122 MeV lie within 1% and 2%, respectively. This was achieved using 105coincidences acquired five minutes after irradiation. The relative deviation in the dose and range for spread-out Bragg peak distributions were within 1% and 2.6% uncertainties, respectively.Significance. An important aspect of this study is the demonstration of a method for direct mapping from detector counts to dose domain using the low count data of compact detectors suited for practical implementation in particle therapy. Including additional prior information in the future can further expand the scope of our model and also extend its application to other areas of medical imaging.

Using demand mapping to assess the benefits of urban green and blue space in cities from four continents.

The benefits of urban green and blue infrastructure (UGI) are widely discussed, but rarely take into account local conditions or contexts. Although assessments increasingly consider the demand for the ecosystem services that UGI provides, they tend to only map the spatial pattern of pressures such as heat, or air pollution, and lack a wider understanding of where the beneficiaries are located and who will benefit most. We assess UGI in five cities from four continents with contrasting climate, socio-political context, and size. For three example services (air pollution removal, heat mitigation, accessible greenspace), we run an assessment that takes into account spatial patterns in the socio-economic demand for ecosystem services and develops metrics that reflect local context, drawing on the principles of vulnerability assessment. Despite similar overall levels of UGI (from 35 to 50% of urban footprint), the amount of service provided differs substantially between cities. Aggregate cooling ranged from 0.44 °C (Leicester) to 0.98 °C (Medellin), while pollution removal ranged from 488 kg PM2.5/yr (Zomba) to 48,400 kg PM2.5/yr (Dhaka). Percentage population with access to nearby greenspace ranged from 82% (Dhaka) to 100% (Zomba). The spatial patterns of pressure, of ecosystem service, and of maximum benefit within a city do not necessarily match, and this has implications for planning optimum locations for UGI in cities.

Oxidative Desulfurization of Petroleum Distillate Fractions Using Manganese Dioxide Supported on Magnetic Reduced Graphene Oxide as Catalyst.

In this study, oxidative desulfurization (ODS) of modeled and real oil samples was investigated using manganese-dioxide-supported, magnetic-reduced graphene oxide nanocomposite (MnO2/MrGO) as a catalyst in the presence of an H2O2/HCOOH oxidation system. MnO2/MrGO composite was synthesized and characterized by scanning electron microscope (SEM), energy dispersive X-ray spectroscopy (EDX), Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD) analyses. The optimal conditions for maximum removal of dibenzothiophene (DBT) from modeled oil samples were found to be efficient at 40 °C temperature, 60 min reaction time, 0.08 g catalyst dose/10 mL, and 2 mL of H2O2/formic acid, under which MnO2/MrGO exhibited intense desulfurization activity of up to 80%. Under the same set of conditions, the removal of only 41% DBT was observed in the presence of graphene oxide (GO) as the catalyst, which clearly indicated the advantage of MrGO in the composite catalyst. Under optimized conditions, sulfur removal in real oil samples, including diesel oil, gasoline, and kerosene, was found to be 67.8%, 59.5%, and 51.9%, respectively. The present approach is credited to cost-effectiveness, environmental benignity, and ease of preparation, envisioning great prospects for desulfurization of fuel oils on a commercial level.

LCSS-Based Algorithm for Computing Multivariate Data Set Similarity: A Case Study of Real-Time WSN Data.

Multivariate data sets are common in various application areas, such as wireless sensor networks (WSNs) and DNA analysis. A robust mechanism is required to compute their similarity indexes regardless of the environment and problem domain. This study describes the usefulness of a non-metric-based approach (i.e., longest common subsequence) in computing similarity indexes. Several non-metric-based algorithms are available in the literature, the most robust and reliable one is the dynamic programming-based technique. However, dynamic programming-based techniques are considered inefficient, particularly in the context of multivariate data sets. Furthermore, the classical approaches are not powerful enough in scenarios with multivariate data sets, sensor data or when the similarity indexes are extremely high or low. To address this issue, we propose an efficient algorithm to measure the similarity indexes of multivariate data sets using a non-metric-based methodology. The proposed algorithm performs exceptionally well on numerous multivariate data sets compared with the classical dynamic programming-based algorithms. The performance of the algorithms is evaluated on the basis of several benchmark data sets and a dynamic multivariate data set, which is obtained from a WSN deployed in the Ghulam Ishaq Khan (GIK) Institute of Engineering Sciences and Technology. Our evaluation suggests that the proposed algorithm can be approximately 39.9% more efficient than its counterparts for various data sets in terms of computational time.

Routing Protocols for Underwater Wireless Sensor Networks: Taxonomy, Research Challenges, Routing Strategies and Future Directions.

Recent research in underwater wireless sensor networks (UWSNs) has gained the attention of researchers in academia and industry for a number of applications. They include disaster and earthquake prediction, water quality and environment monitoring, leakage and mine detection, military surveillance and underwater navigation. However, the aquatic medium is associated with a number of limitations and challenges: long multipath delay, high interference and noise, harsh environment, low bandwidth and limited battery life of the sensor nodes. These challenges demand research techniques and strategies to be overcome in an efficient and effective fashion. The design of routing protocols for UWSNs is one of the promising solutions to cope with these challenges. This paper presents a survey of the routing protocols for UWSNs. For the ease of description, the addressed routing protocols are classified into two groups: localization-based and localization-free protocols. These groups are further subdivided according to the problems they address or the major parameters they consider during routing. Unlike the existing surveys, this survey considers only the latest and state-of-the-art routing protocols. In addition, every protocol is described in terms of its routing strategy and the problem it addresses and solves. The merit(s) of each protocol is (are) highlighted along with the cost. A description of the protocols in this fashion has a number of advantages for researchers, as compared to the existing surveys. Firstly, the description of the routing strategy of each protocol makes its routing operation easily understandable. Secondly, the demerit(s) of a protocol provides (provide) insight into overcoming its flaw(s) in future investigation. This, in turn, leads to the foundation of new protocols that are more intelligent, robust and efficient with respect to the desired parameters. Thirdly, a protocol can be selected for the appropriate application based on its described merit(s). Finally, open challenges and research directions are presented for future investigation.

Pharmacological rational of dry ripe fruit of Aegle marmelos L. as an anti-nociceptive agent in different painful conditions.

The aim of study is to investigate central and peripheral analgesic effects of methanolic extract of dry ripe fruit of Aegle marmelos Linn. Corea (Am. Cr) by two methods, tail flick test and acetic acid induced writhing test at 100, 250 and 500mg/kg doses in animal models. Analgesic activity against tail flick test revealed that Am. Cr induced significant increase in latency period in dose dependent manner i.e. 65.38% at 100mg/kg, 395.37% at 250mg/kg (p<0.01) and 459.25% at 500mg/kg (p<0.01) body weight at 1hr after drug delivery while at 2hr effect decreased i.e. 61.53% at 100mg/kg, 161.11% (p<0.01) at 250mg/kg and 165.74% (p<0.01) at 500mg/kg but interestingly again there is an elongation in latency period at 3hr i.e. 106.15% at 100mg/kg dose, 251.85% (p<0.01) at 250mg/kg and 293.51% (p<0.05) at 500mg/kg respectively. The standard drug Diclofenac sodium at the dose of 5mg/kg continuously increased the latency period but less significantly as compared to the test substance i.e. 79.43%, 113.08% and 222.42% (p<0.05) respectively. Acetic acid induced writhing test produced highest significant activity at the dose of 100mg/kg i.e. 89.83% (p<0.01) as compared to Diclofenic sodium (standard drug) at a dose of 5mg/kg body weight i.e 63.63% (p<0.01). It is concluded that dry ripe fruit of A. marmelos possesses significant dual analgesic activities i.e. central and peripheral.

Salinity in drinking water and the risk of (pre)eclampsia and gestational hypertension in coastal Bangladesh: a case-control study.

BACKGROUND: Hypertensive disorders in pregnancy are among the leading causes of maternal and perinatal death in low-income countries, but the aetiology remains unclear. We investigated the relationship between salinity in drinking water and the risk of (pre)eclampsia and gestational hypertension in a coastal community. METHODS: A population-based case-control study was conducted in Dacope, Bangladesh among 202 pregnant women with (pre)eclampsia or gestational hypertension, enrolled from the community served by the Upazilla Health Complex, Dacope and 1,006 matched controls from the same area. Epidemiological and clinical data were obtained from all participants. Urinary sodium and sodium levels in drinking water were measured. Logistic regression was used to calculate odds ratios, and 95% confidence intervals. FINDINGS: Drinking water sources had exceptionally high sodium levels (mean 516.6 mg/L, S.D 524.2). Women consuming tube-well (groundwater) were at a higher disease risk than rainwater users (p<0.001). Adjusted risks for (pre)eclampsia and gestational hypertension considered together increased in a dose-response manner for increasing sodium concentrations (300.01-600 mg/L, 600.1-900 mg/L, >900.01 mg/L, compared to <300 mg/L) in drinking water (ORs 3.30 [95% CI 2.00-5.51], 4.40 [2.70-7.25] and 5.48 [3.30-9.11] (p-trend<0.001). Significant associations were seen for both (pre)eclampsia and gestational hypertension separately. INTERPRETATION: Salinity in drinking water is associated with increased risk of (pre)eclampsia and gestational hypertension in this population. Given that coastal populations in countries such as Bangladesh are confronted with high salinity exposure, which is predicted to further increase as a result of sea level rise and other environmental influences, it is imperative to develop and evaluate affordable approaches to providing water with low salt content.

A mysterious gram-positive rods.

We encountered a patient with a history of intravenous drug use presenting with fever, malaise and nausea who was found to have cavitary lung lesions. Unexpectedly, gram positive rods grew out on day five on multiple blood cultures, which were later identified as Mycobacterium fortuitum. The patient underwent transesophageal echocardiogram, which showed aortic and tricuspid valve vegetations. Liver biopsy demonstrated granulomatous hepatitis. Interestingly, serum alkaline phosphatase level fell with antibiotic treatment. Mycobacterium fortuitum is ubiquitous worldwide, being found in tap water, and soil. M. fortuitum is usually considered as a contaminant. Disseminated infection caused by this bacterium in an immunocompetent host is extremely rare. Most of the disseminated infections have been reported in immune-deficient patients. In immunocompetent people, M. fortuitum causes human infection primarily by direct inoculation, including localized post-traumatic and surgical wound infections, and catheter-related sepsis. Our patient, an HIV-negative intravenous drug user, had Mycobacterium fortuitum sepsis associated with infective endocarditis, septic pulmonary emboli, and granulomatous hepatitis. Interestingly, the patient admitted using tap water occasionally for mixing heroin when her sterile water ran out, which we thought was the likely source of M. fortuitum.

Is resection equivalent to transplantation for early cirrhotic patients with hepatocellular carcinoma? A meta-analysis.

BACKGROUND: Whether liver resection or liver transplantation is optimal therapy for patients with hepatocellular carcinoma (HCC) remains undefined. A meta-analysis was conducted to answer this question. STUDY DESIGN: This study performed a systematic review of the published literature between January 2000 and April 2012. RESULTS: Nine retrospective studies, totaling 2,279 patients (989 resected and 1,290 transplanted), met the selection criteria. Older patients with larger tumors and less severe cirrhosis were identified in the resection group. At 1 year, resection demonstrated significantly higher overall [odds ratio (OR) = 1.54; 95 % confidence interval (CI), 1.19-1.98; p = 0.001], but equivalent disease-free survival (OR = 0.93; 95 % CI, 0.53-1.63; p = 0.80). At 5 years, there was no difference in overall survival (OR = 0.86; 95 % CI, 0.61-1.21; p = 0.38), but a higher disease-free survival in transplanted patients was observed (OR = 0.39; 95 % CI, 0.24-0.63; p < 0.001). When limiting our analysis to studies conducted in an intent-to-treat fashion, there was no difference in 5 year overall survival (OR = 1.18; 95 % CI, 0.92-1.51; p = 0.19), but a significantly higher disease-free survival (OR = 0.76; 95 % CI, 0.57-1.00; p = 0.05) in transplanted patients. At 10 years, transplantation had higher overall and disease-free survival rates. CONCLUSION: Liver transplantation in patients with HCC results in increased late disease-free and overall survival when compared with liver resection. Nonetheless, the benefit of liver transplantation is offset by higher short-term mortality, donor organ availability, and long transplant wait times associated with more patient deaths. Understanding these differences in survival is helpful in guiding treatment. However, a properly controlled prospective trial is needed to define how best to treat HCC patients who are candidates for either therapy.

Drinking Water Salinity and Maternal Health in Coastal Bangladesh: Implications of Climate Change.

Background: Drinking water from natural sources in coastal Bangladesh has become contaminated by varying degrees of salinity due to saltwater intrusion from rising sea levels, cyclone and storm surges and upstream withdrawal of freshwater. Objective: Our objective was to estimate salt intake from drinking water sources and examine environmental factors that may explain a seasonal excess of hypertension in pregnancy. Methods: Water salinity data (1998-2000) for Dacope, in rural coastal Bangladesh, were obtained from the Centre for Environment and Geographic Information System. Information on drinking water sources, 24-hour urine samples and blood pressure were obtained from 343 pregnant Dacope women during the dry season (October 2009 - March 2010). The hospital-based prevalence of hypertension in pregnancy was determined for 969 pregnant women (July 2008 - March 2010). Results: Average estimated sodium intakes from drinking water ranged from 5 to 16 g/day in the dry season, compared to 0.6 - 1.2 g/day in the rainy season. Average daily sodium excretion in urine was 3.4 g/day (range 0.4 - 7.7 g/d). Women who drank shallow tubewell water were more likely to have urine sodium > 100 mmol/d than women who drank rainwater (OR=2.05, 95% CI: 1.11 - 3.80). The annual hospital prevalence of hypertension in pregnancy was higher in the dry season (12.2%, 95% CI: 9.5 - 14.8) than the rainy season (5.1%, 95% CI: 2.91 - 7.26). Conclusions: The estimated salt intake from drinking water in this population exceeded recommended limits. The problem of saline intrusion into drinking water has multiple causes and is likely to be exacerbated by climate change induced sea-level rise.

Assessing dangerous climate change through an update of the Intergovernmental Panel on Climate Change (IPCC) "reasons for concern".

Article 2 of the United Nations Framework Convention on Climate Change [United Nations (1992) http://unfccc.int/resource/docs/convkp/conveng.pdf. Accessed February 9, 2009] commits signatory nations to stabilizing greenhouse gas concentrations in the atmosphere at a level that "would prevent dangerous anthropogenic interference (DAI) with the climate system." In an effort to provide some insight into impacts of climate change that might be considered DAI, authors of the Third Assessment Report (TAR) of the Intergovernmental Panel on Climate Change (IPCC) identified 5 "reasons for concern" (RFCs). Relationships between various impacts reflected in each RFC and increases in global mean temperature (GMT) were portrayed in what has come to be called the "burning embers diagram." In presenting the "embers" in the TAR, IPCC authors did not assess whether any single RFC was more important than any other; nor did they conclude what level of impacts or what atmospheric concentrations of greenhouse gases would constitute DAI, a value judgment that would be policy prescriptive. Here, we describe revisions of the sensitivities of the RFCs to increases in GMT and a more thorough understanding of the concept of vulnerability that has evolved over the past 8 years. This is based on our expert judgment about new findings in the growing literature since the publication of the TAR in 2001, including literature that was assessed in the IPCC Fourth Assessment Report (AR4), as well as additional research published since AR4. Compared with results reported in the TAR, smaller increases in GMT are now estimated to lead to significant or substantial consequences in the framework of the 5 "reasons for concern."

Cognitive performance and plasma levels of homocysteine, vitamin B12, folate and lipids in patients with Alzheimer disease.

BACKGROUND: Conflicting results have been reported on the association of plasma total homocysteine (tHcy) and cholesterol levels in Alzheimer disease (AD). The objective of this study was to determine the relationship between cognitive performance and plasma levels of tHcy and its biological determinants folate and vitamin B(12), and lipids in clinically diagnosed AD patients. METHODS: A cross-sectional database review was performed on two separate groups of patients (n = 191). Mini-Mental State Exam (MMSE) scores, plasma levels of tHcy, vitamin B(12), folate, cholesterol, and triglycerides were analyzed. RESULTS: The MMSE scores were inversely correlated with age, plasma levels of tHcy and LDL cholesterol. However, only the inverse relationship between MMSE scores and LDL cholesterol levels persisted after adjustment for age, sex, and status of statin treatment. Plasma tHcy levels increased significantly with age and were inversely related to vitamin B(12) and folate levels, which modified the relationship between MMSE scores and plasma tHcy levels. CONCLUSIONS: The plasma tHcy levels appeared to relate more to aging than to cognition. Cognitive performance was inversely associated with plasma LDL cholesterol levels in AD patients. Our findings provide further evidence that high LDL cholesterol levels may play a role in the pathogenesis of AD.

Validity of self-reports of reasons for hospitalization by young adults and risk factors for discordance with medical records: the Coronary Artery Risk Development in Young Adults (CARDIA) Study.

This research focused on the validity of young adults' (mean age=33 years; standard deviation, 3.9) self-reports of reasons for hospitalization and factors affecting validity in a longitudinal cohort study of over 5,000 young adults in four US cities (1985-1998). Self-reported reasons were considered discordant if they differed from those in medical records. Of the 321 self-reported hospitalizations, overall concordance was 92.5%; concordance ranged from 80% for infections to 100% for injuries/fractures and procedures/surgeries. There were no significant differences among mail, telephone, or face-to-face methods of collecting self-reports. In generalized estimating equations analyses, Black race (odds ratio=4.23, 95% confidence interval: 1.72, 10.40; p=0.002) and intravenous drug use (odds ratio=6.06, 95% confidence interval: 1.17, 31.22; p=0.03) were positively associated with discordance. Nonetheless, self-reports by Blacks were 90.0% concordant. Self-reports by Whites were 95.7% concordant. These results suggest that young adults' self-reported reasons for hospitalization are overwhelmingly concordant with medical records. This has important implications, since obtaining medical records has become more costly and logistically difficult.

The potential risks of commonly prescribed antipsychotics: during pregnancy and lactation.

Chlorpromazine, haloperidol, fluphenazine, clozapine, risperidone, quetiapine, olanzapine, ziprasidone, and aripiprazole are antipsychotics commonly used in psychiatric medicine. Approximately one third of pregnant women with psychotic symptoms use antipsychotics at least once. This review will discuss the effects of antipsychotic use during pregnancy and lactation on the fetus and infant.Although adequate and well-controlled studies have not been done in any one of these antipsychotic drugs, animal studies have revealed evidence of teratogenic or embryo/fetotoxic effects in all of them. Toxicities include skeletal malformations, central nervous system (CNS) defects, cleft palate, cardiac abnormalities, decreased fetal growth, and fetal death. For example, in pregnant women, congenital malformations and perinatal death have been reported with chlorpromazine use. Both chlorpromazine and fluphenazine in monotherapy have been shown to cause extrapyramidal symptoms and respiratory distress in infants born to mothers treated with these medications. Haloperidol use during pregnancy has been linked to severe limb reduction defects.Effects of antipsychotic use in lactating mothers are mostly unknown. However, the use of chlorpromazine has been reported to result in drowsiness and lethargy in breastfed infants. Additionally, clozapine has been reported to cause sedation, decreased suckling, restlessness, irritability, seizures, and cardiovascular instability of infants were also reported with clozapine use in lactating mother. Use of antipsychotic drugs by pregnant and lactating mother may only be justified if the potential benefit outweighs the potential risk to the fetus.

Residency training in public psychiatry: a review of literature.

BACKGROUND: Training of psychiatry residents in a conmmunity setting has been emerging as a more rational and reasonable choice for psychiatry residency training, considering the shift of reliance in the recent years for psychiatric services from inpatient care in hospitals to outpatient care in the community. METHODS: A literature review regarding residency training in community psychiatry was performed using the Medline databases. Seven residency training programs' curricula were included in this review. The curriculum of each of these seven programs was also obtained from their respective Internet home pages. The authors describe the community psychiatry training curriculum of their affiliated program, the University of Alabama at Birmingham. RESULTS: A brief description of community training curricula of these eight programs is provided. These curricula, especially their unique characteristics, are then compared in a table. DISCUSSION: The psychiatry training programs differ in many noteworthy ways while providing their residents with "community psychiatry experience." The table provides a quick comparison and highlights the differences of these programs. The authors emphasize the need for a "model curriculum," taking into consideration various factors including the local resources available where the residents could rotate for their community psychiatry experience. CONCLUSION: The authors concluded that psychiatry residency training programs need to publish their curricula, so that other programs can modify their own curricula, if needed, and hence provide an excellent experience in community psychiatry to their residents and future psychiatrists.

Clozapine: a clinical review of adverse effects and management.

Clozapine (Clozaril) is a novel and unique prototype atypical, tricyclic, dibenzodiazepine-derivative, antipsychotic agent. It has been proven effective and significantly superior to placebo, as well as to conventional neuroleptics, in several placebo-controlled, double-blind studies in treatment-resistant schizophrenia. It has also been found to produce an incidence of extrapyramidal symptoms (EPS) as low as that found with placebo. Approximately 30-60% of all schizophrenic patients who fail to respond to typical antipsychotics may respond to clozapine. It was the first major advance that marked a turning point in the treatment of schizophrenia and other psychotic disorders since the introduction of the typical antipsychotic agents, i.e., chlorpromazine and haloperidol in the 1950s and 1960s, respectively. After its introduction in clinical studies in the United States in the early 1970s, it was withdrawn in 1974, and was not approved for clinical use in the United States until February 1990, because of the risk of agranulocytosis. Its novel pharmacological profile, lack of propensity to cause EPS in both short- and long-term uses, lack of effects on serum prolactin, and ameliorative effects on tardive dyskinesia have resulted in the expansion of its use from refractory schizophrenia to schizoaffective disorders, affective disorders, some neurological disorders, aggression, as well as psychosis in patients with dementia and parkinsonism. This review covers the history, pharmacology, management of side effects, and fetal and neonatal effects of clozapine.