Background: Fever is a common cause of pediatric consultation in the emergency department. However, identifying the source of infection in many febrile infants is challenging because of insufficient presentation of signs and symptoms. Meningitis is a critical cause of fever in infants, and its diagnosis is confirmed invasively by lumbar puncture. This study aimed to evaluate potential laboratory markers for meningitis in febrile infants. Methods: We retrospectively analyzed infants aged <3 months who visited the emergency department of our hospital between May 2012 and May 2017 because of fever of unknown etiology. Clinical information and laboratory data were evaluated. Receiver operating characteristic (ROC) curves were constructed. Results: In total, 145 febrile infants aged <3 months who underwent lumbar punctures were evaluated retrospectively. The mean C-reactive protein (CRP) level was significantly higher in the meningitis group than in the non-meningitis group, whereas the mean white blood cell count or absolute neutrophil count (ANC) did not significantly differ between groups. The area under the ROC curve (AUC) for CRP was 0.779 (95% confidence interval [CI], 0.701-0.858). The AUC for the leukocyte count was 0.455 (95% CI, 0.360-0.550) and that for ANC was 0.453 (95% CI, 0.359-0.547). The CRP cut-off value of 10 mg/L was optimal for identifying possible meningitis. Conclusion: CRP has an intrinsic predictive value for meningitis in febrile infants aged <3 months. Despite its invasiveness, a lumbar puncture may be recommended to diagnose meningitis in young, febrile infants with a CRP level >10 mg/L.
Objective: This study aimed to investigate sperm motility and its changes after preparation as predictors of pregnancy in intrauterine insemination (IUI) cycles. Methods: In total, 297 IUI cycles from January 2012 to December 2017 at a single tertiary hospital were retrospectively analyzed. Patient and cycle characteristics, and sperm motility characteristics before and after processing were compared according to clinical pregnancy or live birth as outcomes. Results: The overall clinical pregnancy rate per cycle was 14.5% (43/297) and the live birth rate was 10.4% (30/289). Patient and cycle characteristics were similar between pregnant and non-pregnant groups. Sperm motility after preparation and the total motile sperm count before and after processing were comparable in terms of pregnancy outcomes. Pre-preparation sperm motility was significantly higher in groups with clinical pregnancy and live birth than in cycles not resulting in pregnancy (71.4%±10.9% vs. 67.2%±11.7%, p=0.020 and 71.6% ±12.6% vs. 67.3%±11.7%, p=0.030, respectively). The change in sperm motility after processing was significantly fewer in the non-pregnant cycles, both when the comparison was conducted by subtraction (post-pre) and division (post/pre). These relationships remained significant after adjusting for the female partner's age, anti-Müllerian hormone level, and number of pre-ovulatory follicles. According to a receiver operating characteristic curve analysis, an initial sperm motility of ≥72.5% was the optimal threshold value for predicting live birth after IUI. Conclusion: Initial sperm motility, rather than the motility of processed sperm or the degree of change after preparation, predicted live birth after IUI procedures.
Kim, Won-Ki;Bae, Ho Seuk;Son, Su-Uk;Hahn, Jooyeong;Park, Joung-Soo
Journal of the Korea Institute of Military Science and Technology
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v.24
no.5
/
pp.482-491
/
2021
It is obvious that understanding the effects of shallow water environment of Korea is very important to guarantee the optimal performance of active sonar such as monostatic and bistatic sonar. For this reason, in this paper, we analyzed the detection performance characteristics for various depth deployments of sonar in summer, winter and water temperature inversion environments, which environments are frequently observed in shallow water of Korea such as the Yellow sea. To analyze only effects of water temperature structures on target detection performance, we applied range independent conditions for bottom, sea surface and water temperature characteristics. To understand the characteristics of detection performance, we conducted transmission loss and signal excess modeling. From the results, we were able to confirm the characteristics of detection performance of active sonar. In addition, we verified that operation depth of transmitter and receiver affects the detection performance. Especially in the water temperature inversion environment, it was confirmed that the shadow zone could be minimized and the detection range could be increased through bistatic operation.
Purpose: Necrotizing enterocolitis (NEC) is one of the most serious complications of prematurity. Many risk factors can contribute to the development of NEC. The epidermal growth factor (EGF) plays a major role in intestinal barrier function, increases intestinal enzyme activity, and improves nutrient transport. The aim of this study was to assess the role of epidermal growth factor in the development of NEC in preterm neonates. Methods: In this study, 130 preterm neonates were included and divided into 3 groups, as follows: group 1, 40 preterm neonates with NEC; group 2, 50 preterm neonates with sepsis; and group 3, 40 healthy preterm neonates as controls. The NEC group was then subdivided into medical and surgical NEC subgroups. The serum EGF level was measured using enzyme-linked immunosorbent assay. Results: Serum EGF levels (pg/dL) were significantly lower in the NEC group (median [interquartile range, IQR], 9.6 [2-14]) than in the sepsis (10.1 [8-14]) and control groups (11.2 [8-14], P<0.001), with no significant difference between the sepsis and control groups, and were positively correlated with gestational age (r=0.7, P<0.001). A binary logistic regression test revealed that low EGF levels and gestational ages could significantly predict the development of NEC. The receiver-operating characteristic curve for EGF showed an optimal cutoff value of 8 pg/mL, with 73.3% sensitivity, 98% specificity, and an area under the curve of 0.92. Conclusion: The patients with NEC in this study had significantly lower serum EGF levels (P<0.001), which indicated that EGF could be a reliable marker of NEC in preterm neonates.
Bawaneh, Mohammed J.;Al-Shalabi, Emad Fawzi;Al-Hazaimeh, Obaida M.
International Journal of Computer Science & Network Security
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v.21
no.1
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pp.143-151
/
2021
The enormous prevalence of transferring official confidential digital documents via the Internet shows the urgent need to deliver confidential messages to the recipient without letting any unauthorized person to know contents of the secret messages or detect there existence . Several Steganography techniques such as the least significant Bit (LSB), Secure Cover Selection (SCS), Discrete Cosine Transform (DCT) and Palette Based (PB) were applied to prevent any intruder from analyzing and getting the secret transferred message. The utilized steganography methods should defiance the challenges of Steganalysis techniques in term of analysis and detection. This paper presents a novel and robust framework for color image steganography that combines Linear Congruential Generator (LCG), simulated annealing (SA), Cesar cryptography and LSB substitution method in one system in order to reduce the objection of Steganalysis and deliver data securely to their destination. SA with the support of LCG finds out the optimal minimum sniffing path inside a cover color image (RGB) then the confidential message will be encrypt and embedded within the RGB image path as a host medium by using Cesar and LSB procedures. Embedding and extraction processes of secret message require a common knowledge between sender and receiver; that knowledge are represented by SA initialization parameters, LCG seed, Cesar key agreement and secret message length. Steganalysis intruder will not understand or detect the secret message inside the host image without the correct knowledge about the manipulation process. The constructed system satisfies the main requirements of image steganography in term of robustness against confidential message extraction, high quality visual appearance, little mean square error (MSE) and high peak signal noise ratio (PSNR).
Kim, Chun-Won;An, Na-Gyun;Kim, Dong-Hyun;Cho, Byung-Lok
Journal of the Korean Society for Aeronautical & Space Sciences
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v.50
no.9
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pp.657-662
/
2022
In this paper, the calculation using simulation and two measurement methods for G/T of the telemetry are analyzed. Antenna gain and noise temperature are calculated by using ICARA and Antenna Noise Temperature Calculator. System G/T were calculated by using Antenna gain/noise temperature, LNA gain/noise temperature, cable loss. The first G/T measurement method is Y-factor measurement method, which is to calculate G/T by comparing LNA noise temperature and a signal level difference when an antenna and a 50ohm termination are respectively connected to an LNA input terminal Second method is Solar calibration measurement method that is to calculate G/T by comparing noise level difference when looking at the sun and lowest level point. Finally, the accuracy was reviewed by comparing the G/T calculation results with the two measurement methods, and the optimal measurement method according to antenna performance and operating environment was presented.
Typical anti-jamming technologies based on array antennas, Space Time Adaptive Process (STAP) & Space Frequency Adaptive Process (SFAP), are very effective algorithms to perform nulling and beamforming. However, it does not perform equally well for all types of jamming signals. If the anti-jamming algorithm is not optimized for each signal type, anti-jamming performance deteriorates and the operation stability of the system become worse by unnecessary computation. Therefore, jamming classification technique is required to obtain optimal anti-jamming performance. Machine learning, which has recently been in the spotlight, can be considered to classify jamming signal. In general, performing supervised learning for classification requires a huge amount of data and new learning for unfamiliar signal. In the case of jamming signal classification, it is difficult to obtain large amount of data because outdoor jamming signal reception environment is difficult to configure and the signal type of attacker is unknown. Therefore, this paper proposes few-shot jamming signal classification technique using meta-learning and transfer-learning to train the model using a small amount of data. A training dataset is constructed by anti-jamming algorithm input data within the GNSS receiver when jamming signals are applied. For meta-learning, Model-Agnostic Meta-Learning (MAML) algorithm with a general Convolution Neural Networks (CNN) model is used, and the same CNN model is used for transfer-learning. They are trained through episodic training using training datasets on developed our Python-based simulator. The results show both algorithms can be trained with less data and immediately respond to new signal types. Also, the performances of two algorithms are compared to determine which algorithm is more suitable for classifying jamming signals.
Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.
BACKGROUND: Right ventricular (RV) dysfunction is a significant risk of major adverse cardiac events in patients with acute heart failure (AHF). In this study, we evaluated RV-pulmonary artery (PA) coupling, assessed by tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and assessed its prognostic significance, in AHF patients. METHODS: We measured the TAPSE/PASP ratio and analyzed its correlations with other echocardiographic parameters. Additionally, we assessed its prognostic role in AHF patients. RESULTS: A total of 1147 patients were included in the analysis (575 men, aged 70.81 ± 13.56 years). TAPSE/PASP ratio exhibited significant correlations with left ventricular (LV) ejection fraction(r = 0.243, p < 0.001), left atrial (LA) diameter(r = -0.320, p < 0.001), left atrial global longitudinal strain (LAGLS, r = 0.496, p < 0.001), mitral E/E' ratio(r = -0.337, p < 0.001), and right ventricular fractional area change (RVFAC, r = 0.496, p < 0.001). During the median follow-up duration of 29.0 months, a total of 387 patients (33.7%) died. In the univariate analysis, PASP, TAPSE, and TAPSE/PASP ratio were significant predictors of mortality. After the multivariate analysis, TAPSE/PASP ratio remained a statistically significant parameter for all-cause mortality (hazard ratio [HR], 0.453; p = 0.037) after adjusting for other parameters. In the receiver operating curve analysis, the optimal cut-off level of TAPSE/PASP ratio for predicting mortality was 0.33 (area under the curve = 0.576, p < 0.001), with a sensitivity of 65% and a specificity of 47%. TAPSE/PASP ratio < 0.33 was associated with an increased risk of mortality after adjusting for other variables (HR, 1.306; p = 0.025). CONCLUSIONS: In AHF patients, TAPSE/PASP ratio demonstrated significant associations with RVFAC, LA diameter and LAGLS. Moreover, a decreased TAPSE/PASP ratio < 0.33 was identified as a poor prognostic factor for mortality.
Tae-Hyung Kim;Sungmin Woo;Sangwon Han;Chong Hyun Suh;Soleen Ghafoor;Hedvig Hricak;Hebert Alberto Vargas
Korean Journal of Radiology
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v.21
no.6
/
pp.684-694
/
2020
Objective: The purpose was to review the diagnostic performance of the length of tumor capsular contact (LCC) on magnetic resonance imaging (MRI) for detecting prostate cancer extraprostatic extension (EPE). Materials and Methods: PubMed and EMBASE databases were searched up to March 24, 2019. We included diagnostic accuracy studies that evaluated LCC on MRI for EPE detection using radical prostatectomy specimen histopathology as the reference standard. Quality of studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and graphically presented using hierarchical summary receiver operating characteristic (HSROC) plots. Meta-regression and subgroup analyses were conducted to explore heterogeneity. Results: Thirteen articles with 2136 patients were included. Study quality was generally good. Summary sensitivity and specificity were 0.79 (95% confidence interval [CI] 0.73-0.83) and 0.67 (95% CI 0.60-0.74), respectively. Area under the HSROC was 0.81 (95% CI 0.77-0.84). Substantial heterogeneity was present among the included studies according to Cochran's Q-test (p < 0.01) and Higgins I2 (62% and 86% for sensitivity and specificity, respectively). In terms of heterogeneity, measurement method (curvilinear vs. linear), prevalence of Gleason score ≥ 7, MRI readers' experience, and endorectal coils were significant factors (p ≤ 0.01), whereas method to determine the LCC threshold, cutoff value, magnet strength, and publication year were not (p = 0.14-0.93). Diagnostic test accuracy estimates were comparable across all assessed MRI sequences. Conclusion: Greater LCC on MRI is associated with a higher probability of prostate cancer EPE. Due to heterogeneity among the studies, further investigation is needed to establish the optimal cutoff value for each clinical setting.
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