2D Wavelet Tree Ordering Based Localized Total Variation Model for Efficient Image Restoration

The degraded image during the process of image analysis needs more number of iterations to restore it. These iterations take long waiting time and slow scanning, resulting in inefficient image restoration. A few numbers of measurements are enough to recuperate an image with good condition. Due to tree sparsity, a 2D wavelet tree reduces the number of coefficients and iterations to restore the degraded image. All the wavelet coefficients are extracted with overlaps as low and high sub-band space and ordered them such that they are decomposed in the tree ordering structured path. Some articles have addressed the problems with tree sparsity and total variation (TV), but few authors endorsed the benefits of tree sparsity. In this paper, a spatial variation regularization algorithm based on tree order is implemented to change the window size and variation estimators to reduce the loss of image information and to solve the problem of image smoothing operation. The acceptance rate of the tree-structured path relies on local variation estimators to regularize the performance parameters and update them to restore the image. For this, the Localized Total Variation (LTV) method is proposed and implemented on a 2D wavelet tree ordering structured path based on the proposed image smooth adjustment scheme. In the end, a reliable reordering algorithm proposed to reorder the set of pixels and to increase the reliability of the restored image. Simulation results clearly show that the proposed method improved the performance compared to existing methods of image restoration.

The Analysis of Quality of Work Life and Work Achievement in Department of Agriculture Simalungun Regency

In fact, the work performance of employees does not match the expectations of an agency, and they still encounter low employee performance. As a result of low employee performance, the impact on agency productivity decreases and cannot meet the targets set by the agency, so that the agency suffers losses and experiences obstacles in its development. Meanwhile, for employees who have low work performance, it will hinder the career development and income of the employee.Descriptive analysis is a research method that provides an overview regarding situations and events so that this method intends to Base data accumulation applies.From the results of the analysis with the number of respondents as many as 63 people, the following conclusions are drawn: 1) Job satisfaction has a positive and significant effect on employee performance in Simalungun Regency Agriculture Office. 2) Leaders are expected to improve the promotion appraisal system based on performance and work results. 3) Maintaining the current good condition of employees, who are able to work hard to get awards, a well-developed family atmosphere and an interesting and challenging work atmosphere has been created.

Nontypical presentation of a common disease: a case report

Background Kawasaki disease is an idiopathic medium-sized vasculitis that occurs primarily in infants and children younger than 5 years of age. Atypical Kawasaki disease applies to patients who do not fulfill the complete criteria of fever of 5 days or more with at least four of five features: bilateral conjunctival injection, changes in the lips and oral cavity, cervical lymphadenopathy, extremity changes, and polymorphous rash. Acute kidney injury is defined as a sudden decline in kidney function within hours, including structural injuries and loss of function. Acute kidney injury is extremely common in hospitalized pediatric patients. However, it is rarely documented in Kawasaki disease. Acute kidney injury is underestimated in Kawasaki disease due to the lack of a clear definition of age-specific normal serum creatinine levels and routine renal functions. This report describes a case who presented with clinical features suggestive of atypical Kawasaki disease and developed acute kidney injury. Case presentation A 2-year-old Saudi girl had a history of high-grade fever for 5 days, moderate dehydration, dry cracked lips, poor appetite, and generalized erythematous rash; therefore, she was diagnosed to have incomplete Kawasaki disease. Laboratory investigations revealed normochromic normocytic anemia, leukocytosis, thrombocytosis, high inflammatory markers, and acute kidney injury stage III. An echocardiogram showed a 4-mm dilatation on the left main coronary artery and a 3-mm dilatation on the right. A renal biopsy was not performed to identify the cause of the injury as it showed improvements after the start of the specific therapy for Kawasaki disease; intravenous immune globulin at a dose of 2 g/kg, aspirin at a high dosage of 80 mg/kg/day, and prednisolone at 2 mg/kg. In addition to the acute kidney injury management, normal saline boluses were followed by furosemide at a 2 mg/kg dose. Her urine output increased, and her renal functions normalized. She was discharged in good condition after 10 days. Conclusions It is valuable to check renal function tests in a confirmed case of Kawasaki disease to reduce the negative consequences of late acute kidney injury discovery. Early detection and intervention make a substantial difference in acute kidney injury management.

Case Report: First Case of Consolidation Immunotherapy After Definitive Chemoradiotherapy in Mediastinal Lymph Node Metastatic Sarcomatoid Carcinoma

Sarcomatoid carcinoma (SC) is a rare lung cancer subtype with poor prognosis and lack of effective treatment regimens. Studies concerning SC indicated common programmed death ligand-1 (PD-L1) overexpression and higher tumor mutational burden, leading to potential benefits from immunotherapy. The present case is the first report employing PD-L1 inhibitor durvalumab following definitive concurrent chemoradiotherapy (cCRT) in a patient with mediastinal lymph node metastatic SC, which was considered as a high probability of pulmonary origin but unclear primary lesion. After the 19-month follow-up, there was neither local recurrence nor distant metastasis. The patient was in a good condition, with the thoracic lesion controlled at Partial response-Response Evaluation Criteria in Solid Tumors (PR-RECIST). Except for grade 2 esophagitis, none of the other adverse events was observed. Our first attempt to adopt the consolidation immunotherapy after cCRT in unresectable locally advanced mediastinal SC exhibited improved local control, manageable safety, and potential survival benefits, representing a novel and promising therapeutic option for SC and encouraging further research exploration of this regimen in the future.

Bilateral Optic Neuritis Caused by Meningococcal Meningoencephalitis

In this article, we described a case of pathogen-induced bilateral optic neuritis accompanying meningococcal meningoencephalitis in an adolescent male. A 15-year-old boy presented to our emergency room due to progressive severe headache, stiff neck, diffuse extremity pain, fever, and nausea concerning meningoencephalitis. Intravenous ceftriaxone, metamizole, and ondansetron were started immediately. Due to acute autonomic dysregulation and development of petechiae, he was transferred to the pediatric intensive care unit. Next morning, the patient developed severe visual impairment. Investigations revealed elevated C-reactive protein, procalcitonin and leucocyte count, decreased platelet count, and clotting activation. Cerebrospinal fluid (CSF) analysis revealed increased leucocyte count, protein, and decreased glucose concentration with pathological CSF cytology. Brain magnetic resonance imaging revealed an increased contrast enhancement in the optic nerve sheath, consistent with acute bilateral optic neuritis. He was started on high-dose intravenous pulse methylprednisolone therapy. After treatment with ceftriaxone und pulse steroids, the patient was discharged in good condition without any visual sequel.

Lung Stereotactic Radiation Therapy: Intercomparison of Several Irradiation Devices in Terms of Outcome and Predictive Factors

Background: Stereotactic body radiotherapy (SBRT) is recommended for the treatment of inoperable early stage non-small-cell lung cancer and lung oligometastases. The radiation oncology department of the Lausanne University Hospital (CHUV) gathers three different radiotherapy devices able to treat pulmonary lesions in SBRT conditions: CyberKnife® (CK), Helical Tomotherapy® (HT), and volumetric modulated arc therapy (VMAT). The aim of this study is to define the patients’ outcome in terms of irradiation efficacy and toxicities after lung SBRT depending of the choice of the SBRT technique.Methods: We retrospectively analyzed the clinical, radiological, and dosimetric data of patients with primary lung tumor or pulmonary oligometastases treated with SBRT between January 2016 and February 2020. We analyzed descriptive data using the Chi-2 test for proportions and the T-test for means comparisons, survival data by the Kaplan-Meier method and comparisons between groups by the Log-rank test and Cox-regression.Results: We identified 111 patients mostly in good condition (82.9% PS 0-1) with a median age of 71.4 years. One hundred forty-two lesions were treated with a typical fractionation of 55 Gy in 5 fractions, delivered by CK (59.9%), VMAT (38.0%), or HT (2.1%). Compared to other techniques, CK technique allowed to treat comparable gross tumor volume (GTV; 2.1 vs 1.4cc, p = 0.84) with smaller planning treatment volume (PTV; 12.3 vs 21.9 cc, p = 0.013), and was associated with a lower mean lung dose (MLD; 2.6 vs 4.1 Gy, p < 0.001), a lower V5 (13.5 vs 19.9 cc, p = 0.002) and a lower V20 (2.3 vs 5.4 cc, p < 0.001). Local control rates at 2 years were not different depending on the irradiation device, respectively of 96.2% (range, 90.8-100) and 98.1% (range, 94.4-100), p = 0.68. Toxicity incidence was significantly increased with V5 value > 17.2% (56.0 vs 77.4%, p = 0.021). Conclusions: Compared to other SBRT techniques, CK treatments permitted to treat comparable GTV with reduced PTV, MLD, V20, and V5. The dosimetric benefit of CK SBRT was not associated with a clear clinical benefit, with comparable outcome in terms of control rates and toxicity. Toxicity incidence was less frequent when reducing the V5. The use of CK is particularly attractive in case of multiple courses of lung SBRT or in case of local relapse requiring lung re-irradiation.Trial registration: Registered on February 24th 2021, ID 2021-00267, with the authorization of the CER-VD ethics committee (Switzerland).

Case Report: A Novel Non-Reciprocal ALK Fusion: ALK-GCA and EML4-ALK Were Identified in Lung Adenocarcinoma, Which May Respond to Alectinib Adjuvant-Targeted Therapy

Anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancers (NSCLCs) have favorable and impressive response to ALK tyrosine kinase inhibitors (TKIs). However, ALK rearrangement had approximately 90 distinct fusion partners. Patients with different ALK fusions might have distinct responses to different-generation ALK-TKIs. In this case report, we identified a novel non-reciprocal ALK fusion: ALK-grancalcin (GCA) (A19: intragenic) and EML4-ALK (E20: A20) by next-generation sequencing (NGS) in a male lung adenocarcinoma patient who was staged as IIIB-N2 after surgery. After a multidisciplinary discussion, the patient received alectinib adjuvant targeted therapy and postoperative radiotherapy (PORT). He is currently in good condition, and disease-free survival (DFS) has been 20 months so far, which has been longer than the median survival time of IIIB NSCLC patients. Our study extended the spectrum of ALK fusion partners in ALK + NSCLC, and we reported a new ALK fusion: ALK-GCA and EML4-ALK and its sensitivity to alectinib firstly in lung cancer. It is vital for clinicians to detect fusion mutations of patients and report timely the newfound fusions and their response to guide treatment.

A large undifferentiated sarcoma of the liver in a 13-year-old girl treated with anatomical resection: a case report and review of the literature

Background Undifferentiated embryonal sarcoma of the liver (UESL) is a rare liver tumor accounting for 6–13% of primary liver tumors. Accurate preoperative diagnosis is difficult, with a rather high misdiagnosis rate. Herein, we reported a very large UESL treated with anatomical resection. Our case is amongst the largest pediatric UESLs in the literature. Case presentation Herein, we report a 13-year-old girl presenting with right upper quadrant abdominal pain, postprandial vomiting, and abdominal distention, in which radiographic imaging demonstrated a huge UESL (28 × 20 × 12 cm). The patient was treated with partial hepatectomy and the 5 kg tumor was removed. The patient was discharged in good condition, with no significant complaints in her follow-up. Conclusions Although different treatment strategies have been reported for UESL cases, anatomical resection is still the main treatment approach, especially for large tumors.

Analysis of Soil Primary Macro Nutrient Status in Agricultural Land, Tabundung District, East Sumba Regency

Agricultural land is land that can affect agricultural productivity. Land, which is part of land resources, is the main component in the production of agricultural commodities. In supporting the productivity of agricultural commodities, there must be sufficient nutrients in the soil. Tabundung sub-regency is a producer of food crops, livestock and fisheries. As the main producer in the agricultural sector, the production of agricultural crops is not proportional to the total area of harvested land, meaning that the productivity of agricultural crops is not optimal if it is based on harvested area. The study was conducted in Tarimbang Village, Proud Watu and Tapil Regency of Tabundung. The method used in this research was survey technique and soil sampling was carried out in a composite manner. Soil samples were analyzed at the Nusa Cendana University Laboratory, Kupang. Primary data analyzed were elements of nitrogen (N), phosphorus (P), potassium (K), organic carbon (C), cation exchange capacity (CEC), and pH. The results showed that the overall nutrient status of N, P, and K were in the medium, high and very high categories, but there were some sample points that were in the low category for macronutrients N and P. While the concentrations of organic C, CEC and pH were overall generally in pretty good condition. This condition indicates that the research area provides sufficient nutrients for plant cultivation during the growth and yield of plants, but improvements are needed to overcome macronutrient deficiencies in several observation locations.

Condition Assessment Using None Destructive Tests at Montauk Bridge Deck

Ground penetrating radar (GPR) and portable seismic property analyzer (PSPA), was used in concrete structures for monitoring, quantifying, and mapping the deterioration of bridge decks. The Montauk Bridge deck was assessed based on PSPA and GPR data. Based on the analysis of the PSPA data, it was determined that over 65% of bridge conditions were rated serious to poor condition with an average compressive strength of less than 2500 psi; less than 35% of bridge deck conditions were rated fair to good with an average compressive strength over 2500 psi. Based on GPR data, it was determined that 72% of the bridge deck was in serious to poor condition, and only 28% of the bridge deck was in fair to good condition. Additionally, the analyses of the ground penetrating radar data indicated possible rebar corrosion in places. For these reasons, it is recommended that the Montauk bridge’s deck be completely replaced. Keywords: Condition assessment, NDT, GPR, PSPA, bridge deck