The objective of the treatment of cervical intraepithelial neoplasia (CIN) is the prevention of invasive carcinoma of the cervix, which still remains the most common cancer in Zimbabwean women, as in ...most other low-resource countries where screening facilities are grossly inadequate. We conducted a randomised prospective study to compare CIN treatment outcome after cryotherapy and loop electrosurgical excision procedure (LEEP) in 400 women with histologically confirmed high grade squamous intra-epithelial lesions (HGSIL). Treatment outcome measures were immediate complications, persistent disease and recurrent disease evaluated at follow-up visits. Eighty-two per cent of the women (159 cryotherapy, 168 LEEP) completed their 6-month and 12-month follow-up visits. LEEP had a significantly higher overall cure rate of 96·4% (absence of persistant or recurrent disease) compared to 88·3% cryotherapy ( P =0·026). Although cryotherapy was not superior to LEEP, its cure rate (88·3%) is acceptable and therefore provides a viable treatment option for low resource countries such as Zimbabwe where the majority of women at risk for cervical cancer reside in rural areas.
To document the socio-demographic profile, presenting symptoms, disease stage and treatment modality offered to all women attending Harare and Parirenyatwa Hospitals with a histological diagnosis of ...invasive cervical cancer in 1998.
A cross sectional study.
Parirenyatwa Hospital and Harare Central Hospital.
All women with a histological diagnosis of cervical cancer admitted between 11 January 1998 and 14 December 1998 were recruited into the study.
A total of 196 patients, with a median age of 47 years (range 24 to 80 years) were recruited into the study. A high proportion (63.3%) of the women were from rural areas. The mean age at first pregnancy was 17.9 years (SD 2.8) and 112 (63.3%) first sought treatment at the primary health care centre. Persistent vaginal discharge was the most frequent (69.4%) presenting complaint. One hundred and ninety five patients (99.5%) had histological confirmation of invasive cervical cancer (91.8% squamous cell carcinoma, 7.7% adenocarcinoma). Clinical staging by The International Federation of Gynaecology and Obstetrics (FIGO) classification confirmed that the majority (80.3%) of the cancers had spread from the cervix into the parametrium and beyond (stage 2b and above) at the time of presentation. Radiation therapy was the most commonly used (77.0%) treatment modality.
This study demonstrates that the burden of cervical cancer occurs around the peak age of 47 years and that the majority of women present with advanced disease. None of the women had ever been screened for cervical cancer. The planned introduction of a cervical cancer screening programme by visual inspection of the cervix with acetic acid (VIA), together with a health education campaign may result in a shift towards more women presenting with early curable cervical cancer cases.
A study was carried out to determine the prevalence of cervical intra-epithelial neoplasia (CIN) among women referred to Harare Hospital Colposcopy Clinic with a history of an abnormal smear. During ...the period, 132 patients were seen and 79 (60 pc) had colposcopic findings suggestive of CIN and 17 (13 pc) had inflammatory changes and 36 (27 pc) had normal findings. Electrocautery was used to treat low grade CIN lesions, cone biopsy was performed for higher grades of CIN and a selected group underwent hysterectomy.
Red cell and white cell parameters were determined in 600 (310 male and 290 female) normal Black Zimbabwean neonates with a mean +/- sd birth weight of 3.0 +/- 0.4 (range 2.04 to 4.50, median 3.0) kg ...using a Coulter Counter Model S Plus. Cord anaemia (cord Hb < 13.5 gdl-1) was detected in 60 (10 pc) of the neonates. Although the male babies were significantly heavier than the females (p = 0.004), there were no significant differences (p > 0.05) in the red cell and white cell indices between the two sexes. When the haematological parameters of the 540 (90 pc) non-anaemic (cord Hb > or = 13.5 gdl-1) neonates were analysed, the mean +/- sd values which may serve as local reference standards were: Hb 15.2 +/- 1.8 (range 13.5 to 19.4) gdl-1, Hct 47.3 4.9 (range 38.6 to 60.3) pc, MCV 107.8 +/- 9.4 (range 88.8 to 134.3) fl, MCH 31.9 +/- 3.4 (range 25.2 to 45.2) pg, MCHC 32.9 +/- 1.3 (range 30.0 to 38.3) gdl-1, nucleated red blood cells 6.1 +/- 5.9 (range 0 to 55) per 100 white blood cells, reticulocyte count 5.0 +/- 1.9 (range 0 to 24.0) pc, total leucocyte count 13.8 +/- 4.4 (range 4.6 to 132.8) x 10(9)l-1; differential count: neutrophils 7.30 +/- 2.90 (range 1.72 to 18.02) x 10(9) l-1, lymphocytes 5.67 +/- 2.47 (range 0.98 to 16.14) x 10(9) l-1, monocytes 0.81 +/- 0.83 (range 0 to 5.58) x 10(9) l-1, 1 and eosinophils 0.08 +/- 0.13 (range 0 to 0.72) x 10(9)l-1.
Platelet parameters were determined in 600 full term healthy Zimbabwean neonates using a Coulter Counter Model S Plus. The mean +/- s.d. values obtained with ranges were: Platelet count 235 +/- 67 ...(range 100-410) x 10(9) l-1; Mean Platelet Volume (MPV) 9.5 +/- 1.0 (range 7.1-13.9) fl; Plateletcrit (PCT) 0.269 +/- 0.058 (range 0.142-0.524) and Platelet Distribution Width (PDW) 16.8 +/- 1.0 (range 12.2-19.8). Although platelet counts in this study were comparable to those established by others in both Black and Caucasian infants, the female Zimbabwean neonates had significantly higher counts than the males (p < 0.001). An inverse relationship between the number of circulating platelets and their MPV was also observed. Further studies are needed to delineate the range of normality of these platelet measurements in the African neonate so that abnormal cases can be adequately screened, investigated and appropriately treated.
We investigate modulation schemes optimized for two-way wireless relaying systems, for which network coding is employed at the physical layer. We consider network coding based on denoise-and-forward ...(DNF) protocol, which consists of two stages: multiple access (MA) stage, where two terminals transmit simultaneously towards a relay, and broadcast (BC) stage, where the relay transmits towards the both terminals. We introduce a design principle of modulation and network coding, considering the superposed constellations during the MA stage. For the case of QPSK modulations at the MA stage, we show that QPSK constellations with an exclusive-or (XOR) network coding do not always offer the best transmission for the BC stage, and that there are several channel conditions in which unconventional 5-ary constellations lead to a better throughput performance. Through the use of sphere packing, we optimize the constellation for such an irregular network coding. We further discuss the design issue of the modulation in the case when the relay exploits diversity receptions such as multiple-antenna diversity and path diversity in frequency-selective fading. In addition, we apply our design strategy to a relaying system using higher-level modulations of 16QAM in the MA stage. Performance evaluations confirm that the proposed scheme can significantly improve end-to-end throughput for two-way relaying systems.
The objective of this study was to compare image quality and clinically significant lesion detection on deep learning reconstruction (DLR) and iterative reconstruction (IR) images of submillisievert ...chest and abdominopelvic CT.
Our prospective multiinstitutional study included 59 adult patients (33 women, 26 men; mean age ± SD, 65 ± 12 years old; mean body mass index weight in kilograms divided by the square of height in meters = 27 ± 5) who underwent routine chest (
= 22; 16 women, six men) and abdominopelvic (
= 37; 17 women, 20 men) CT on a 640-MDCT scanner (Aquilion ONE, Canon Medical Systems). All patients gave written informed consent for the acquisition of low-dose (LD) CT (LDCT) after a clinically indicated standard-dose (SD) CT (SDCT). The SDCT series (120 kVp, 164-644 mA) were reconstructed with interactive reconstruction (IR) (adaptive iterative dose reduction AIDR 3D, Canon Medical Systems), and the LDCT (100 kVp, 120 kVp; 30-50 mA) were reconstructed with filtered back-projection (FBP), IR (AIDR 3D and forward-projected model-based iterative reconstruction solution FIRST, Canon Medical Systems), and deep learning reconstruction (DLR) (Advanced Intelligent Clear-IQ Engine AiCE, Canon Medical Systems). Four subspecialty-trained radiologists first read all LD image sets and then compared them side-by-side with SD AIDR 3D images in an independent, randomized, and blinded fashion. Subspecialty radiologists assessed image quality of LDCT images on a 3-point scale (1 = unacceptable, 2 = suboptimal, 3 = optimal). Descriptive statistics were obtained, and the Wilcoxon sign rank test was performed.
Mean volume CT dose index and dose-length product for LDCT (2.1 ± 0.8 mGy, 49 ± 13mGy·cm) were lower than those for SDCT (13 ± 4.4 mGy, 567 ± 249 mGy·cm) (
< 0.0001). All 31 clinically significant abdominal lesions were seen on SD AIDR 3D and LD DLR images. Twenty-five, 18, and seven lesions were detected on LD AIDR 3D, LD FIRST, and LD FBP images, respectively. All 39 pulmonary nodules detected on SD AIDR 3D images were also noted on LD DLR images. LD DLR images were deemed acceptable for interpretation in 97% (35/37) of abdominal and 95-100% (21-22/22) of chest LDCT studies (
= 0.2-0.99). The LD FIRST, LD AIDR 3D, and LD FBP images had inferior image quality compared with SD AIDR 3D images (
< 0.0001).
At submillisievert chest and abdominopelvic CT doses, DLR enables image quality and lesion detection superior to commercial IR and FBP images.
We describe in detail the recently proposed four-dimensional modulation format family based on 2-ary amplitude 8-ary phase-shift keying (2A8PSK), supporting spectral efficiencies of 5, 6, and 7 ...bits/symbol. These formats nicely fill the spectral efficiency gap between the dual-polarization (DP) quadrature PSK (QPSK) and DP 16-ary quadrature-amplitude modulation (16QAM), with excellent linear and nonlinear performance. Since these modulation formats just use different parity bit expressions in the same constellation, similar digital signal processing can be seamlessly used for different spectral efficiency. A series of nonlinear transmission simulation results shows that this modulation format family outperforms the conventional modulation formats at the corresponding spectral efficiency. We also investigate the adaptive equalizer for these modulation formats.
Existing fingerprint-based indoor localization uses either fine-grained channel state information (CSI) from the physical layer or coarse-grained received signal strength indicator (RSSI) ...measurements. In this paper, we propose to use a mid-grained intermediate-level channel measurement - spatial beam signal-to-noise ratios (SNRs) that are inherently available and defined in the IEEE 802.11ad/ay standards - to construct the fingerprinting database. These intermediate channel measurements are further utilized by a deep learning approach for multiple purposes: 1) location-only classification; 2) simultaneous location-and-orientation classification; and 3) direct coordinate estimation. Furthermore, the effectiveness of the framework is thoroughly validated by an in-house experimental platform consisting of 3 access points using commercial-off-the-shelf millimeter-wave WiFi routers. The results show a 100% accuracy if the location is only interested, about 99% for simultaneous location-and-orientations classification, and an averaged root mean-square error (RMSE) of 11.1 cm and an average median error of 9.5 cm for direct coordinate estimate, greater than 2-fold improvements over the RMSE of 28.7 cm and median error of 23.6 cm for RSSI-like single SNR-based localization.
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