Necrotizing enterocolitis (NEC) is a common condition in preterm infants. The risk factors that contribute to NEC include asphyxia, apnea, hypotension, sepsis, and congenital heart diseases (CHD). ...The objective of this study was to evaluate the association between the treatment (surgery or drainage) and unfavorable outcomes in neonates with NEC and congenital heart diseases (NEC + CHD). A 19-year retrospective cohort study was conducted (2000-2019). Inclusion criterion was NEC Bell II stage. Exclusion criteria were associated malformation or genetic syndrome and those who did not undergo echocardiography or had a Bell I diagnosis. We included 100 neonates: NEC (n=52) and NEC + CHD (n=48). The groups were subdivided into NEC patients undergoing surgery (NECS, n=31), NEC patients undergoing peritoneal drainage (NECD, n=19), NEC + CHD patients undergoing surgery (NECCAS, n=21), and NEC + CHD patients who were drained (NECCAD, n=29). Multivariate analysis was performed to estimate the relative risk of death and the length of stay. Covariates were birth weight and gestational age. The group characteristics were similar. The adjusted relative risk of death was higher in the drainage groups NECD (Adj RR=2.70 (95%CI: 1.47; 4.97) and NECCAD (Adj RR=1.97 (95%CI: 1.08; 3.61), and they had the shortest time to death: NECD=8.72 (95%CI: 3.10; 24.54) and NECCAD=5.32 (95%CI: 1.95; 14.44). We concluded that performing primary peritoneal drainage in neonates with or without CHD did not improve the number of days of life, did not decrease the risk of death, and was associated with a higher mortality in newborns with NEC and clinical instability. Key words: Necrotizing enterocolitis; Peritoneal drainage; Congenital heart diseases
Software engineering effort estimation plays a significant role in managing project cost, quality, and time and creating software. Researchers have been paying close attention to software estimation ...during the past few decades, and a great amount of work has been done utilizing a variety of machine-learning techniques and algorithms. In order to better effectively evaluate predictions, this study recommends various machine learning algorithms for estimating, including k-nearest neighbor regression, support vector regression, and decision trees. These methods are now used by the software development industry for software estimating with the goal of overcoming the limitations of parametric and conventional estimation techniques and advancing projects. Our dataset, which was created by a software company called Edusoft Consulted LTD, was used to assess the effectiveness of the established method. The three commonly used performance evaluation measures, mean absolute error (MAE), mean squared error (MSE), and R square error, represent the base for these. Comparative experimental results demonstrate that decision trees perform better at predicting effort than other techniques.
To compare the effectiveness of tibial nerve transcutaneous electrical nerve stimulation (TENS) for an overactive bladder, considering the sites of application and frequency of attendance.
This ...multi-arm randomized controlled trial enrolled 137 adult women (61.0±9.0 years) with overactive bladder from a university hospital. They underwent 12 sessions of 30-min TENS application and were assigned to five groups: one leg, once a week (n=26); one leg, twice a week (n=27); two legs, once a week (n=26); two legs, twice a week (n=28); and placebo (n=30). Symptoms of overactive bladder and its impact on quality of life were evaluated before and after 6 or 12 weeks of treatment using the Overactive Bladder Questionnaire-V8 and voiding diary. ClinicalTrials.gov: NCT01912885.
The use of one leg, once a week TENS application reduced the frequency of urgency episodes compared with the placebo (1.0±1.6 vs. 1.4±1.9; p=0.046) and frequency of incontinence episodes compared with the placebo (0.7±1.4 vs.1.4±2.2; p<0.0001). The one-leg, twice a week protocol decreased the urinary frequency compared with the two legs, once a week protocol (8.2±3.5 vs. 9.0±5.1; p=0.026) and placebo (8.2±3.5 vs. 7.9±2.7; p=0.02). Nocturia improved using the two legs, once a week protocol (1.5±1.8) when compared with the one leg, twice a week protocol (1.9±2.0) and placebo (1.7±1.6) (p=0.005 and p=0.027, respectively). Nocturia also improved using the two legs, twice a week protocol when compared with the one leg, twice a week protocol (1.3±1.2 vs.1.9±2.0; p=0.011).
One-leg stimulation improved the daily urinary frequency, urgency, and incontinence, and the two-leg stimulation once and twice weekly improved nocturia.
There are no data in the literature regarding aortic arch mechanics assessed with 2D speckle tracking (2D-ST) echocardiography.
Purpose
To study the feasibility of measuring vascular mechanics in the ...aortic arch with 2D-ST echocardiography and to define normal values.
Methods
We recruited 54 healthy volunteers and performed a complete echocardiographic exam. We included in the analysis a short axis view of the aortic arch, after the emergence of the brachiocephalic artery. The 2D-ST methodology was used to off-line calculate aortic arch mechanics (EchoPAQ, GE Healthcare®). The analysis was performed for circumferential aortic strain (CAS) and for early circumferential aortic strain rate (eCASR). We assessed the aortic pulse wave velocity (PVW) with the Complior®. Kolmogorov-Smirnov test was used for normality assessment.
Results
We included 50 controls with a gender balance and a mean age of 33±9 years. Of the total 300 aortic wall segments, 278 had adequate waveforms for analysis. Global CAS had a normal distribution (p = 0.20); the mean and median CAS were 11.3±3.2% and 11.5% (8.4–13.7) respectively. Global eCASRalso had a normal distribution (p = 0.10); the mean and median eCASR were 1.5±0.4 s-1 and 1.6 s-1 (1.3–1.7), respectively. There was a significant negative correlation between CAS, age (r=-0.46, p<0.01), pulse pressure (r=-0.40, p<0.01), PWV (r=-0.52, p = 0.03) and the vascular augmentation index (r=-0.60, p = 0.01). A similar association was identified for eCARS.
Conclusion
2D-ST is a feasible methodology for the analysis of the aortic arch mechanics; in this study, we obtained reference values and normal distributions.
Loss Data Analysis Gzyl, Henryk; Mayoral, Silvia; Gomes-Gonçalves, Erika
2018, 2018-02-05
eBook
This volume deals with two complementary topics. On one hand the book deals with the problem of determining the the probability distribution of a positive compound random variable, a problem which ...appears in the banking and insurance industries, in many areas of operational research and in reliability problems in the engineering sciences. On the other hand, the methodology proposed to solve such problems, which is based on an application of the maximum entropy method to invert the Laplace transform of the distributions, can be applied to many other problems. The book contains applications to a large variety of problems, including the problem of dependence of the sample data used to estimate empirically the Laplace transform of the random variable.
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