Diabetic Retinopathy Improved Detection Using Deep Learning

Diabetes is a disease that occurs when the body presents an uncontrolled level of glucose that is capable of damaging the retina, leading to permanent damage of the eyes or vision loss. When diabetes affects the eyes, it is known as diabetic retinopathy, which became a global medical problem among elderly people. The fundus oculi technique involves observing the eyeball to diagnose or check the pathology evolution. In this work, we implement a convolutional neural network model to process a fundus oculi image to recognize the eyeball structure and determine the presence of diabetic retinopathy. The model’s parameters are optimized using the transfer-learning methodology for mapping an image with the corresponding label. The model training and testing are performed with a dataset of medical fundus oculi images and a pathology severity scale present in the eyeball as labels. The severity scale separates the images into five classes, from a healthy eyeball to a proliferative diabetic retinopathy presence. The latter is probably a blind patient. Our proposal presented an accuracy of 97.78%, allowing for the confident prediction of diabetic retinopathy in fundus oculi images.

Nonlinear dynamics of proton beams with hollow electron lens in the CERN high-luminosity LHC

The design stored beam energy in the CERN high-luminosity large hadron collider (HL-LHC) upgrade is about 700 MJ, with about 36 MJ in the beam tails, according to estimates based on scaling considerations from measurements at the LHC. Such a large amount of stored energy in the beam tails poses serious challenges on its control and safe disposal. In particular, orbit jitters can cause significant losses on primary collimators, which can lead to accidental beam dumps, magnet quenches, or even permanent damage to collimators and other accelerator elements. Thus, active control of the diffusion speed of halo particles is necessary and the use of hollow electron lenses (HELs) represents the most promising approach to handle overpopulated tails at the HL-LHC. HEL is a very powerful and advanced tool that can be used for controlled depletion of beam tails, thus enhancing the performance of beam halo collimation. For these reasons, HELs have been recently included in the HL-LHC baseline. In this paper, we present detailed beam dynamics calculations performed with the goal of defining HEL specifications and operational scenarios for HL-LHC. The prospects for effective halo control in HL-LHC are presented.

Excel’s Calculation of Basic Assets Amortisation Values

For Excel’s calculation of basic (fixed) assets amortisation values, the investigated economic and mathematical foundation with required values and their relations were used. The investigated and introduced theory is adapted to Excel calculations of fixed assets amortisation based on today’s needs. All values for Excel’s calculations are sorted into input and output values, and input to main and nested calculations. Two methods for calculating fixed assets amortisation were introduced using Excel. The first method is based on a linear decreasing function, G(t) = G0 (1-pt), which presents the simple interest calculation of the reduced equities for equal periodic amortisation values. The second method is based on the exponential degrading function, G(t) = G0qt, which presents a complex interest calculation of the reduced equities for periodic amortisation amounts in a descending sequence. The continuity of the introduced functions results from the continuity of: the life of the fixed asset, periodic amortisation, accumulated amortisation and non-amortized amount (residual value) of the fixed asset. It is particularly important to introduce dates with the exact time, for the beginning and the end of each amortisation period of the fixed asset. The theory for Excel’s calculation of the fixed asset output values for an arbitrary (planned or unplanned) term has also been explored and introduced. Such calculations relate mainly to terms of alienation, permanent damage, permanent loss of the process function of a fixed asset and periodic accounting reporting.

The anesthesiologist and Covid-19 endocrinopathies

Covid-19 disease created a havoc since 2019, affected large number of number of people over worldwide. As the second wave is receding, we will be receiving patients with the long-term effects of Covid-19 for the surgeries either for their primary disease or for the complications arising from the Covid-19. Primarily, the Covid-19 is a disease affecting the pulmonary and cardiac system, many other systems including renal, hematology, central nervous, endocrine etc. also damaged with the same. Various endocrine glands are being involved in Covid-19 disease like pancreas, thyroid, pituitary, adrenals, reproductive system etc. as they are highly expressed with ACE. This may even lead to the permanent damage. Because of the unfamiliarity with the disease, plausible impact on the endocrine functions is still unclear. This article elaborates various endocrine manifestations of SARS Cov and SARS Cov-2 for better understanding and management of Covid-19 recovered patients.

Debonding Techniques - A Review

BACKGROUND The overall success of orthodontic treatment depends on both bonding as well as debonding techniques. The debonding procedure in orthodontics consists of removal of the attachments (brackets, bondable tubes & buttons) as well as all the adhesive resin from the teeth without causing any permanent damage and to restore the teeth to their pre-treatment stage. The demand for more aesthetic appliance led to the introduction of direct bonding techniques and has made banded attachments almost obsolete in present-day orthodontics. These procedures should not be painful to the patient or damaging to enamel and to obtain these objectives a correct debonding technique is of fundamental importance. The debonding procedure is as essential as bonding for the overall success of the orthodontic treatment. In an attempt to increase the bond strength of orthodontic appliances, we have neglected the fact that these appliances have to be debonded at the end of the treatment. In orthodontics debonding refers to debracketing that is removal of brackets, bondable tubes, buttons, and the adhesive used to bond as well as to restore the form and surface of tooth to its best possible original form by avoiding any type of iatrogenic damage. For achieving such objectives, an accurate debonding procedure is of utmost importance, else it could be needlessly lengthy and painful to the patient and damaging to the enamel. Many researches have been carried out to conclude the best techniques for debonding which will give an ideal finish for the tooth when treatment is terminated. The debonding procedure is mostly done by mechanical means, but its technique should be varied according to the bracket material and type. KEY WORDS Debonding Techniques, Metal Brackets, Ceramic Brackets, Enamel Damage

The basics of radiation damage in crystalline silicon networks by NIEL

Basically, radiation can cause two effects on materials: ionization and non-ionization. This work presented the theory involved in defects caused by non-ionization, known as NIEL, with a focus on silicon materials. When energy is transferred directly to the atoms in the crystalline lattice, it can either be dissipated in the form of vibrations or be large enough to pull atoms out of that lattice. This weakens the lattice, causing measurement errors that can lead to permanent damage. This study is extremely important because silicon materials are used in radiation detectors. These detectors cannot return false measurements, especially in dangerous situations, such as in nuclear reactor monitoring. After presenting the theory involved, examples are shown. Failures of up to 30% were found by the researchers.

Association between bleeding volume with heme oxygenase-1 and malondialdehyde levels in patients of acute intracerebral hemorrhage

Background: Oxidative stress plays an important role in secondary brain damage after a stroke of intracerebral hemorrhage because it causes permanent damage to grey matter, white matter taken by brain blood barrier disorders, and brain edema with brain cells. This study aimed to determine the correlation between bleeding volume and heme oxygenase-1 (HO-1) and malondialdehyde (MDA) levels in stroke patients with acute intracerebral hemorrhage at Dr. Soetomo Hospital, Surabaya.

Local Gaussian Distribution Fitting Boundary Image Segmentation Algorithm for Ultrasound Images in Avoiding Recurrent Laryngeal Nerve Injury during Thyroid Nodules Treatment

This work aimed to analyze the effect of the boundary segmentation algorithm in thyroid nodules image segmentation and the influence of its adoption in avoiding recurrent laryngeal nerve (RLN) injury during treatment of thyroid nodules. The nodule boundary was extracted aided by the local Gaussian distribution fitting energy (LGDF) segmentation algorithm, which was compared with the normalized cut (Ncut) algorithm and the Canny algorithm. Then, 51 patients treated with microwave ablation for thyroid nodules were taken as a test group, and 51 patients treated with surgical resection were taken as a control group. The incidence of RLN injury and the levels of free triiodothyronine (FT3), free thyroid hormone (FT4), and thyroid-stimulating hormone (TSH) were compared between the two groups before and after treatment. The results showed that the true positive fraction (TPF) of the LGDF segmentation algorithm was 69.45%, the TPF of the Ncut algorithm and the Canny algorithm were 58.65% and 52.37%, respectively. The TPF of LGDF algorithm was higher than that of the Ncut algorithm and Canny algorithm, with notable differences ( P < 0.05 ). In the control group, there were 10 cases of temporary and permanent damage to the RLN after operation, and the total incidence was 19.61%. In the test group, there were 3 cases of temporary and permanent damage to the RLN after operation, and the total incidence was 5.88%, which was lower than that of the control group ( P < 0.05 ). No evident differences were shown in the levels of FT3, FT4, and TSH between the two groups before treatment ( P > 0.05 ). However, after treatment, the TSH level of the test group (4.58 ± 0.79) was higher than that of the control group (3.19 ± 0.17), and the levels of FT3 and FT4 in the test group were lower than those in the control group, and the differences were remarkable ( P < 0.05 ). In short, the LGDF algorithm had more ideal segmentation effect. In addition, ultrasound-guided microwave ablation was effective in treating benign thyroid nodules, which could reduce damage to the RLN and maintain normal thyroid function.

Compression neuropathies of the forearm: anatomy, clinical features and management

The upper limb consists of four major parts: a girdle formed by the clavicle and scapula, the arm, the forearm and the hand. Peripheral nerve lesions of the upper limb are divided into lesions of the brachial plexus or the nerves arising from it. Lesions of the nerves arising from the brachial plexus are further divided into upper (proximal) or lower (distal) lesions based on their location. Peripheral nerves in the forearm can be compressed in various locations and by a wide range of pathologies. A thorough understanding of the anatomy and clinical presentations of these compression neuropathies can lead to prompt diagnosis and management, preventing possible permanent damage. This article discusses the aetiology, anatomy, clinical presentation and surgical management of compressive neuropathies of the upper limb.

The role of LigaSure™ and Harmonic Scalpel in the preservation of recurrent laryngeal nerve during thyroidectomy

INTRODUCTION Transient or permanent damage to the recurrent laryngeal nerve (RLN) during thyroidectomy is of paramount importance for patient quality of life. The aim of this study is to systematically review the literature concerning the role of the most popular energy-based vessel-sealing devices (LigaSure™ (LS) and Harmonic Scalpel (HS)) in preservation of the RLN during thyroidectomy. The safety and inferiority or superiority of LS and HS compared with conventional haemostatic techniques are highlighted. METHODS A systematic search of the literature was performed. Clinical trials, prospective and retrospective studies that significantly compared the use of LS and HS with conventional haemostasis regarding the postoperative incidence of RLN palsy were included. FINDINGS The search resulted in 43 studies, including 17,953 patients treated using energy-based devices or conventional haemostatic methods. Concerning the incidence of RLN palsy, 40 studies showed no significant difference between the energy-based device and conventional groups, whereas two studies demonstrated a significant superiority in performance for LS and HS compared with conventional haemostasis. Only one study exhibited significant inferiority of LS and HS compared with conventional methods. No statistical relationship was observed between energy-based devices and conventional techniques regarding permanent damage to the RLN. CONCLUSION The performance of both LS and HS shows no inferiority compared with conventional haemostatic techniques, regarding damage to the laryngeal nerve. Further well-designed studies are needed to investigate their potential benefit in preservation of the RLN.