Efficient Spectrum Occupancy Prediction Exploiting Multidimensional Correlations through Composite 2D-LSTM Models.

In cognitive radio systems, identifying spectrum opportunities is fundamental to efficiently use the spectrum. Spectrum occupancy prediction is a convenient way of revealing opportunities based on previous occupancies. Studies have demonstrated that usage of the spectrum has a high correlation over multidimensions, which includes time, frequency, and space. Accordingly, recent literature uses tensor-based methods to exploit the multidimensional spectrum correlation. However, these methods share two main drawbacks. First, they are computationally complex. Second, they need to re-train the overall model when no information is received from any base station for any reason. Different than the existing works, this paper proposes a method for dividing the multidimensional correlation exploitation problem into a set of smaller sub-problems. This division is achieved through composite two-dimensional (2D)-long short-term memory (LSTM) models. Extensive experimental results reveal a high detection performance with more robustness and less complexity attained by the proposed method. The real-world measurements provided by one of the leading mobile network operators in Turkey validate these results.

Management options of chronic low back pain. A randomized blinded clinical trial.

OBJECTIVE: To compare efficacies of 2 active programs in the management of chronic low back pain (CLBP). METHODS: This prospective, stratified, randomized single-blinded controlled study was conducted in the Department of Rehabilitation Medicine, King Abdullah University Hospital, Irbid, Jordan, between February and December 2010. A total of 100 patients were randomized to either 6-weeks of multidisciplinary rehabilitation (group A) or therapist-assisted exercise (group B). At baseline and 6 weeks, the visual analogue scale (VAS) pain score was estimated, as a primary outcome measure. McGill pain score, Oswestry Disability Index (ODI), trunk forward flexion and extension, left and right lateral bending, were applied before and after treatment and were employed as secondary outcome measures. RESULTS: All outcome measures significantly improved in group A after treatment, compared with group B. The VAS, McGill, ODI scores, left and right lateral bending decreased significantly, whereas forward and backward bending increased. A significant number of patients returned to work in group A at the end of 6 weeks, compared with group B. These effects were maintained over 12 and 24 weeks of follow-up. CONCLUSION: Multidisciplinary rehabilitation improved functional indices and pain scale scores in group A compared with B. This would be an effective strategy in CLBP management.

"Vitamin E" fortified parenteral lipid emulsions: Plackett-Burman screening of primary process and composition parameters.

The objective of this study was to screen the effect of eight formulations and process parameters on the physical attributes and stability of "Vitamin E"-rich parenteral lipid emulsions. Screening was performed using a 12-run, 8-factor, 2-level Plackett-Burman design. This design was employed to construct polynomial equations that identified the magnitude and direction of the linear effect of homogenization pressure, number of homogenization cycles, primary and secondary emulsifiers, pre-homogenization temperature, oil loading, and ratio of vitamin E to medium-chain triglycerides (MCT) in the oil phase on particle size, polydispersity index, short-term stability, and outlet temperature of manufactured emulsions. The viscosity of vitamin E was reduced from 3700 (100%) to 64 mPa.s (30%) by MCT addition. As viscosity is critical for efficient emulsification, vitamin/MCT ratio was the most significant contributor for the stability of emulsions. Particle size increased from 236 to 388 nm, and percentage vitamin remaining emulsified after 48 h dropped from 100 to 73% with increase in vitamin/MCT ratio from 30/70 to 70/30. Significant decrease in particle size and PI, and an increase in outlet temperature were also observed with increase in homogenization pressure and number of homogenization cycles. Emulsifiers and oil loading, however, had insignificant effect on the responses. Overall, stable submicron emulsions at vitamin/MCT ratio of 30/70 could be prepared at 25,000 psi and 25 cycles in ambient conditions. The identification of these parameters by a well-constructed design demonstrated the utility of screening studies in the "Quality by Design" approach to pharmaceutical product development.

The clinical and nonclinical values of nonexercise estimation of cardiovascular endurance in young asymptomatic individuals.

Exercise testing is associated with barriers prevent using cardiovascular (CV) endurance (CVE) measure frequently. A recent nonexercise model (NM) is alleged to estimate CVE without exercise. This study examined CVE relationships, using the NM model, with measures of obesity, physical fitness (PF), blood glucose and lipid, and circulation in 188 asymptomatic young (18-40 years) adults. Estimated CVE correlated favorably with measures of PF (r = 0.4 - 0.5) including handgrip strength, distance in 6 munities walking test, and shoulder press, and leg extension strengths, obesity (r = 0.2 - 0.7) including % body fat, body water content, fat mass, muscle mass, BMI, waist and hip circumferences and waist/hip ratio, and circulation (r = 0.2 - 0.3) including blood pressures, blood flow, vascular resistance, and blood (r = 0.2 - 0.5) profile including glucose, total cholesterol, LDL-C, HDL-C, and triglycerides. Additionally, differences (P < 0.05) in examined measures were found between the high, average, and low estimated CVE groups. Obviously the majority of these measures are CV disease risk factors and metabolic syndrome components. These results enhance the NM scientific value, and thus, can be further used in clinical and nonclinical settings.

Relationship between improvements in physical measures and patient satisfaction in rehabilitation after total knee arthroplasty.

The aim of this study was to examine patient satisfaction with rehabilitation after total knee arthroplasty (TKA). Fifty-six patients, aged 45-77 years, were enrolled in a post-TKA comprehensive therapy program focusing on knee strengthening and functional activities. The program lasted 3 months and was conducted for 1 h, twice a day, 5 days per week. Pain scores, number of steps climbed (STp), and maximum walked distance (MWD) were determined before the operation and 3 months after cessation of the rehabilitation program. In addition, knee-flexion range of motion (ROM) was measured before the surgery and immediately, 2 weeks and 3 months after the surgery. Pain decreased whereas MWD and STp increased at 3 months postoperation. In addition, the magnitude of improvement in STp correlated positively with the magnitude of change in MWD and pain. There was a significant increase in knee-flexion ROM at 2 weeks and 3 months postoperation compared with preoperation. The patient age also correlated positively with the magnitude of improvement in knee-flexion ROM after 2 weeks and 3 months of therapy. Improvements in MWD and STp were greater and pain was less, among the satisfied patients compared with unsatisfied ones. The results of this study further confirm the importance of therapy for osteoarthritis patients after TKA. In addition, as older patients are less conditioned, they seem to be more inclined to improvement in functionality with rehabilitation. Satisfied patients seem to achieve larger improvements in functional capacity and pain measures.

Effectiveness of constraint-induced movement therapy (CIMT) as home-based therapy on Barthel Index in patients with chronic stroke.

OBJECTIVE: The goal of this study is to investigate the effectiveness of constraint-induced movement therapy (CIMT) on the Barthel Index (BI) scores in persons with stroke to assess dependency in survivers of stroke and to investigate the long-term effects of CIMT on dependency needs as measured by the BI, based on the hypothesis that CIMT as home-based therapy would be of significant benefit in stroke rehabilitation. METHODS: Twenty-seven participants, 16 men with a mean age of 58 (+/- 10.8) and 4 women with a mean age of 60 (+/- 6.3), participated in the study as an experimental group, and 17 participants, 12 men with a mean age of 58 (+/- 9.7) and 5 women with a mean age of 55 (+/-11.8), participated as a control group. The experimental/treatment group received traditional therapy with the CIMT where the intact contralateral upper limb was placed in a removable cast for 6 hours a day during waking hours for 4 weeks. The control group received traditional therapy only. Both groups were assessed using the BI on admission and on discharge from rehabilitation. In addition, 18 participants (14 male and 4 female), 64% of the experimental group, were reevaluated using the BI for the long-term benefits of CIMT on dependency. RESULTS: Using unpaired t test (SPSS version 15), statistically significant improvement was noted in the BI for the experimental group compared to the control group. After 6 months follow-up, BI was 96.3 +/- 2.7, indicating that the obtained gains were maintained at 6 months post discharge, compared to their BI score at 4 weeks (68.2 +/- 3.8) post CIMT (p value < .005). CONCLUSION: Following stroke, patients who received CIMT every day for 4 weeks in conjunction with traditional rehabilitation therapy showed significant changes in the BI upon discharge and this positive outcome was preserved after 6 months follow-up. This improvement indicates an overall significant improvement in ADL status for patients who received CIMT and has implications for future use in stroke rehabilitation as home-based therapy for stroke rehabilitation.

Acute ischemic stroke: relationship of brain lesion location & functional outcome.

PURPOSE: To establish, using brain spiral computerised tomography (SCT) and modified Barthel index (MBI), whether the location of cerebral infarction could be correlated with functional outcome in acute ischemic stroke patients who undergo early intensive rehabilitation. METHODS: Observational cohort, assessor blinded and correlational prospective 12-weeks study that included 111 acute ischemic stroke patients, admitted consecutively to an early intensive inpatient rehabilitation programme (5 days a week, 3-5 h a day) during 2003. Confirmation of diagnosis and stratification was done by brain SCT. Brain lesion locations were correlated to motor performance and functional outcome, on admission and discharge, using MBI. RESULTS: Statistical analysis demonstrated a significant correlation between motor performance, functional outcome and brain lesion locations. The groups with deep, combined deep and large superficial, small superficial and large superficial infarcts showed the most consistent improvement in that order of frequency. Normal brain SCT group did not reach statistical significance (p = 0.051) while the bi-hemispheric infarcts group did not show any change. The inter and intra group differences were highly significant (p < 0.05). CONCLUSIONS: Immediate non-contrasted brain SCT may act as an independent predictor of final functional outcome in acute ischemic stroke. It may provide clinicians with an opportunity to offer realistic expectations to stroke patients and their relatives.

Association between the functional independence measure and Glasgow coma scale regarding the rehabilitation outcomes of traumatic brain injury.

OBJECTIVE: To evaluate the outcomes of early comprehensive rehabilitation protocols for traumatic brain injury (TBI) using the functional independence measure (FIM), and to study the relationship between FIM and Glasgow coma scale (GCS) variables to determine which patients will be best served by rehabilitation therapies. METHODS: Fifty-one subjects with diagnosed TBI receiving treatment at a single inpatient rehabilitation facility at Jordan University of Science and Technology, Teaching Hospital, Irbid, Jordan were enrolled in this experimental study between August 2006 and February 2008. Of the enrolled subjects, 47 completed the study. The mean age of the participants was 33 years (8 females and 39 males). Glasgow coma scale was measured on admission. Functional independence measure score was measured on admission and on discharge. According to the GCS, the participants were divided into 3 groups as severe injury (GCS: 3-8 [n=24]), moderate injury (GCS: 9-12 [n=12]), and mild or no injury (GCS: 13-15 [n=11]). The FIM score and CGS and their relation were evaluated. RESULTS: Evaluation outcomes revealed a significant improvement in FIM scores after rehabilitation compared to the FIM admission (p=0.00006) in severe TBI. In moderate TBI, the FIM scores were significantly improved (p=0.0004) after rehabilitation. However, with minimal injury, the FIM scores were not significantly improved (p=0.15). CONCLUSION: Early rehabilitation interventions significantly improved the FIM scores in moderate and severe TBI patients. ERRATUM NOTICE PUBLISHED IN NEUROSCIENCES 2009; 14: 306.

Comparison between lipolysis and compendial dissolution as alternative techniques for the in vitro characterization of alpha-tocopherol self-emulsified drug delivery systems (SEDDS).

In vitro characterization of alpha-tocopherol SEDDS formulations was performed by (1) lipolysis in bio-relevant media, and (2) physical assessment by dissolution, particle size, and turbidity analyses. Both methods were statistically correlated using a 25-run, five-factor multiple-level d-optimal mixture design. Independent variables were SEDDS composition [vitamin E (12.5-25%), Tween 80 (10-40%), labrasol (0-10%), alcohol (0-10%), and captex 355 (20-50%)]. Measured responses were percent lipolysis, percent vitamin E retained in the aqueous layer of the digestion medium, and percent vitamin E dissolved in the dissolution medium. Percent lipolysis ranged from 0% to 66.3%. Percent vitamin E retrieved in the aqueous layer of the digestion and dissolution media ranged from 3% to 29.3% and from 25.9% to 101.7%, respectively. Turbidity ranged from 28 to 403JTU and the average droplet size was >1.0 microm. All formulation ingredients had significant (p<0.05) effect on percent lipolysis. Only two factors, Tween and vitamin E had significant effect on vitamin retention in the aqueous layer post-lipolysis. Tween, labrasol, and captex 355 had significant effect on vitamin E dissolution. Poor correlation was observed between the responses. Formulation ingredients influenced each response differently; and therefore, each method can only reveal distinctive characteristics of the SEDDS formulation and may not be used interchangeably.

A novel texture-probe for the simultaneous and real-time measurement of swelling and erosion rates of matrix tablets.

In this note, a novel probe fitted to a texture analyzer was described. This probe has the ability to simultaneously measure, in real-time, dimensional changes in the swollen layer and the glassy core of hydrophilic matrices when exposed to aqueous dissolution media. The utility of this probe was demonstrated on directly compressed tablets containing polymer blends, a water soluble additive, and theophylline as a model drug. Both the erosion and swelling fronts were measured for the same tablet every hour for 12 h. The probe provided accurate thickness data of the swollen region and the glassy core, and was able to demonstrate the swelling and subsequent erosion of the tablet with time. With this method, it is possible to simultaneously measure the swelling rate of the rubbery region and the erosion rate of the glassy core without operator intervention, which provides many advantages over the conventional approaches frequently reported in the literature.

Effect of risk factors on functional outcome after stroke rehabilitation.

OBJECTIVE: The incidence of stroke and the demand for rehabilitation services continues to increase. Risk factors may act as stroke outcome predictors and hence determine the type and intensity of rehabilitation. Our aim is to investigate stroke outcome predictors that will define groups with maximal or minimal benefit from rehabilitation after stroke. METHODS: Our longitudinal prospective study included 111 ischemic stroke patients, admitted consecutively to the Rehabilitation Department, Hamad Medical Corporation, Qatar, during 2000-2001. We analyzed the influence of modifiable risk factors: diabetes mellitus (DM), hypertension (HTN), ischemic heart disease (IHD) and non-modifiable factors: age, gender, race and side of lesion on stroke outcome. All patients received regular rehabilitation and underwent an evaluation on admission and discharge, using the Modified Barthel Index. RESULTS: Statistical analysis demonstrated that the group of patients with IHD showed greatest improvement after 3 months of rehabilitation. The group without co-morbidities followed this, and then the HTN, DM, combined DM and HTN and combined HTN and IHD groups. The group that suffered from combined DM, HTN, and IHD did not show improvement. Non-modifiable risk factors showed no significant differences. However, younger patients showed a tendency for better improvement. CONCLUSION: Those patients with modifiable risk factors had significant impact on rehabilitation outcome (p-value = 0.009). Those with one or 2 co-morbidities had the highest score of improvement after rehabilitation while the group of patients with more than 2 co-morbidities did not show improvement. However, non-modifiable risk factors did not play a significant role in stroke outcome.

Homocystinemia and stroke in vegetarians.

Homocysteine is a sulfurated amino acid with a central role in the metabolism of thiol compounds. Homocystinemia is a recognized independent potentially remediable risk factor for vascular disease. It is associated with both macro and micro vascular ischemic stroke. It can often be normalized by polyvitamin therapy. This inexpensive and well-tolerated treatment is considered effective in decreasing the incidence of stroke. We report 2 young strict vegetarians with no known vascular risk factors. The first suffered a left middle cerebral artery infarct, and the second multiple bilateral small cerebral infarctions. Extensive investigations showed moderately elevated homocysteine and low serum B12 levels, suggesting that these are most probably the underlying etiology. We believe that a high index of suspicion is needed, particularly in younger people with a potential underlying cause for B12 deficiency and no identifiable stroke risk factor.