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Sensors (Basel, Switzerland) Jul 2022The spectrum allocation in any auctioned wireless service primarily depends upon the necessity and the usage of licensed primary users (PUs) of a certain band of...
The spectrum allocation in any auctioned wireless service primarily depends upon the necessity and the usage of licensed primary users (PUs) of a certain band of frequencies. These frequencies are utilized by the PUs as per their needs and requirements. When the allocated spectrum is not being utilized in the full efficient manner, the unused spectrum is treated by the PUs as white space without believing much in the concept of spectrum scarcity. There are techniques invented and incorporated by many researchers, such as cognitive radio technology, which involves software-defined radio with reconfigurable antennas tuned to particular frequencies at different times. Cognitive radio (CR) technology realizes the logic of the utility factor of the PUs and the requirements of the secondary users (SU) who are in queue to utilize the unused spectrum, which is the white space. The CR technology is enriched with different frequency allocation engines and with different strategies in different parts of the world, complying with the regulatory standards of the FCC and ITU. Based on the frequency allocation made globally, the existing CR technology understands the nuances of static and dynamic spectrum allocation and also embraces the intelligence in time allocation by scheduling the SUs whenever the PUs are not using the spectrum, and when the PUs pitch in the SUs have to leave the band without time. This paper identifies a few of the research gaps existing in the earlier literature. The behavioral aspects of the PUs and SUs have been analyzed for a period of 90 days with some specific spectrum ranges of usage in India. The communal habits of utilizing the spectrum, not utilizing the spectrum as white space, different time zones, the requisites of the SUs, the necessity of the applications, and the improvement of the utility factor of the entire spectrum have been considered along with static and dynamic spectrum usage, the development of the spectrum policy engine aligned with cooperative and opportunistic spectrum sensing, and access techniques indulging in artificial intelligence (AI). This will lead to fine-tuning the PU and SU channel mapping without being hindered by predefined policies. We identify the cognitive radio transmitter and receiver parameters, and resort to the same in a proposed channel adaption algorithm. We also analyze the white spaces offered by spectrum ranges of VHF, GSM-900, and GSM-1800 by a real-time survey with a spectrum analyzer. The identified parameters and white spaces are mapped with the help of a swotting algorithm. A sample policy has been stated for ISM band 2.4 GHz where such policies can be excited in a policy server. The policy engine is suggested to be configured over the 5G CORE spectrum management function.
Topics: Artificial Intelligence; Cognition; Computer Communication Networks; Humans; Policy; Suppuration; Technology; Wireless Technology
PubMed: 35808505
DOI: 10.3390/s22135011 -
International Journal of Infectious... Mar 2021Sex differences in adult cellulitis, a frequent cause of hospitalization, have not been analyzed. These differences were investigated in a large cellulitis series.
OBJECTIVES
Sex differences in adult cellulitis, a frequent cause of hospitalization, have not been analyzed. These differences were investigated in a large cellulitis series.
METHODS
This was a prospective observational study of 606 Spanish hospitalized cellulitis patients. Different comorbidities, clinical, diagnostic, and treatment data were compared between the sexes. Multiple logistic regression modeling was performed to determine the variables independently associated with sex.
RESULTS
Overall 606 adult cellulitis patients were enrolled; 314 (51.8%) were male and 292 (48.2%) were female. Females were older (mean age 68.8 vs 58.9 years, p < 0.0001), less likely to have prior wounds (p = 0.02), and more likely to have venous insufficiency (p = 0.0002) and edema/lymphedema (p = 0.0003) than males. The location of the infection differed between the sexes (p = 0.02). Males were more likely to have positive pus cultures (p = 0.0008), the causing agent identified (p = 0.04), and higher rates of Staphylococcus aureus infection (p = 0.04) and received longer antibiotic treatment (p = 0.03). Factors independently associated with female sex in the multivariate analysis were older age (p < 0.0001), prior cellulitis (p = 0.01), presence of edema/lymphedema as the predisposing factor (p = 0.004), negative versus positive pus culture (p = 0.0002), and location of cellulitis other than in the lower extremities (p = 0.035).
CONCLUSIONS
Differences between male and female patients with cellulitis were age, recurrence, presence of edema/lymphedema, positivity of pus culture, and topography of the infection.
Topics: Adult; Aged; Anti-Bacterial Agents; Cellulitis; Edema; Female; Hospitalization; Humans; Logistic Models; Male; Middle Aged; Prospective Studies; Recurrence; Risk Factors; Sex Characteristics; Staphylococcal Infections; Young Adult
PubMed: 33508477
DOI: 10.1016/j.ijid.2021.01.044 -
Indian Pediatrics Jul 2007An 18-day-old neonate presented with fever and abdominal distension. Renal subcapsular abscess was diagnosed with sonography and CT scan. Percutaneous drainage resulted...
An 18-day-old neonate presented with fever and abdominal distension. Renal subcapsular abscess was diagnosed with sonography and CT scan. Percutaneous drainage resulted in aspiration of 20 mL of pus, which grew Staphylococcus aureus.
Topics: Abscess; Drainage; Humans; Infant, Newborn; Kidney Diseases; Staphylococcal Infections; Staphylococcus aureus; Treatment Outcome
PubMed: 17684309
DOI: No ID Found -
Frontiers in Cellular and Infection... 2022Spinal infection is a rarely occurred pathology, whose diagnosis remains a major challenge due to the low sensitivity of culturing techniques. Metagenomic...
Spinal infection is a rarely occurred pathology, whose diagnosis remains a major challenge due to the low sensitivity of culturing techniques. Metagenomic next-generation sequencing (mNGS) is a novel approach to identify the pathogenic organisms in infectious diseases. In this study, mNGS technology was adopted for pathogenic detection in spinal infection from the tissue and pus samples. Additionally, the diagnostic performance of mNGS for spinal infection was evaluated, by comparing it with that of the conventional microbial culture, with the histopathological results as the gold standard. Overall, 56 samples from 38 patients were enrolled for mNGS testing, and 69 samples were included for microbial culture. 30 patients (78.95%) were identified to be positive by the mNGS method, which was higher than that of microbial culture (17, 44.74%). The sensitivity and specificity of mNGS with pus samples were 84.2% and 100.0%, respectively, which outperformed those of microbial culture (42.1% and 100.0%). The pathogen identification results were applied to medication guidance, and all 38 patients experienced favorable outcomes at three months, followed-up post-treatment, without any adverse effects. These findings proved that mNGS was superior to microbial culture in pathogenic identification of the spinal infection, thereby showing great promise in guiding drug administration and improving clinical outcomes.
Topics: Humans; Metagenomics; Metagenome; High-Throughput Nucleotide Sequencing; Sensitivity and Specificity; Suppuration
PubMed: 36389162
DOI: 10.3389/fcimb.2022.967584 -
The British Journal of Radiology Sep 2014The incidence of spinal infections has increased in the past two decades, owing to the increasing number of elderly patients, immunocompromised conditions, spinal...
The incidence of spinal infections has increased in the past two decades, owing to the increasing number of elderly patients, immunocompromised conditions, spinal surgery and instrumentation, vascular access and intravenous drug use. Conventional MRI is the gold standard for diagnostic imaging; however, there are still a significant number of misdiagnosed cases. Diffusion-weighted imaging (DWI) with a b-value of 1000 and apparent diffusion coefficient (ADC) maps provide early and accurate detection of abscess and pus collection. Pyogenic infections are classified into four types of extension based on MRI and DWI findings: (1) epidural/paraspinal abscess with spondylodiscitis, (2) epidural/paraspinal abscess with facet joint infection, (3) epidural/paraspinal abscess without concomitant spondylodiscitis or facet joint infection and (4) intradural abscess (subdural abscess, purulent meningitis and spinal cord abscess). DWI easily detects abscesses and demonstrates the extension, multiplicity and remote disseminated infection. DWI is often a key image in the differential diagnosis. Important differential diagnoses include epidural, subdural or subarachnoid haemorrhage, cerebrospinal fluid leak, disc herniation, synovial cyst, granulation tissue, intra- or extradural tumour and post-surgical fluid collections. DWI and the ADC values are affected by susceptibility artefacts, incomplete fat suppression and volume-averaging artefacts. Recognition of artefacts is essential when interpreting DWI of spinal and paraspinal infections. DWI is not only useful for the diagnosis but also for the treatment planning of pyogenic and non-pyogenic spinal infections.
Topics: Abscess; Aged; Decompression, Surgical; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Discitis; Epidural Abscess; Female; Humans; Joint Diseases; Magnetic Resonance Imaging; Male; Middle Aged; Spinal Cord Diseases; Suppuration; Zygapophyseal Joint
PubMed: 24999081
DOI: 10.1259/bjr.20140011 -
Archives of Disease in Childhood. Fetal... Mar 2006In developing countries, newborn omphalitis contributes significantly to morbidity and mortality. Community based identification and management of omphalitis will...
BACKGROUND
In developing countries, newborn omphalitis contributes significantly to morbidity and mortality. Community based identification and management of omphalitis will require standardised clinical sign based definitions.
OBJECTIVE
To identify optimal sign based algorithms to define omphalitis in the community and to evaluate the reliability and validity of cord assessments by non-specialist health workers for clinical signs of omphalitis.
DESIGN
Within a trial of the impact of topical antiseptics on umbilical cord infection in rural Nepal, digital images of the umbilical cord were collected. Workers responsible for in-home examinations of the umbilical cord evaluated the images for signs of infection (pus, redness, swelling). Intraworker and interworker agreement was evaluated, and sensitivity and specificity compared with a physician generated gold standard ranking were estimated.
RESULTS
Sensitivity and specificity of worker evaluations were high for pus (90% and 96% respectively) and moderate for redness (57% and 95% respectively). Swelling was the least reliably identified sign. Measures of observer agreement were similar to that previously recorded between experts evaluating subjective skin conditions. A composite definition for omphalitis that combined pus and redness without regard to swelling was the most sensitive and specific.
CONCLUSIONS
Two sign based algorithms for defining omphalitis are recommended for use in the community. Focusing on redness extending to the skin around the base of the stump will identify cases of moderate and high severity. Requiring both the presence of pus and redness will result in a definition with very high specificity and moderate to high sensitivity.
Topics: Algorithms; Bacterial Infections; Community Health Services; Community Health Workers; Developing Countries; Erythema; Humans; Infant, Newborn; Nepal; Observer Variation; Photography; Rural Health Services; Sensitivity and Specificity; Severity of Illness Index; Suppuration; Umbilical Cord
PubMed: 16223755
DOI: 10.1136/adc.2005.080093 -
Langenbeck's Archives of Surgery Sep 2022Pyogenic liver abscess (PLA) is a collection of pus in the liver, often without a known direct cause. There is discord on the best diagnostic and therapeutic strategy....
PURPOSE
Pyogenic liver abscess (PLA) is a collection of pus in the liver, often without a known direct cause. There is discord on the best diagnostic and therapeutic strategy. We aimed to examine these questions in our patient cohort.
METHODS
A total of 66 out of 309 patients with PLA at our tertiary referral center between 2012 and 2020 had a primarily unknown cause. We analyzed PLA configuration, comorbidities, and whether an underlying cause could be found later. Therapy was sorted by antibiotics alone, percutaneous drainage, and primary surgery. Success was assessed by a change of initial therapy, in-hospital mortality, and mean hospital stay.
RESULTS
Overall mortality was 18%; in 55%, a causative condition could be found. CRP, GGT, size, and multiple localization go along with higher mortality. Antibiotics alone had a failure rate of 82%. Percutaneous drainage was successful in 70% of cases. Surgery was mainly reserved for failed previous non-surgical treatment and had in-hospital mortality of 12%.
CONCLUSIONS
PLA goes along with high mortality. In the majority of all patients, a causative condition can be identified by detailed diagnostics. Percutaneous drainage together with antibiotics is the therapy of choice and is successful in 70% of cases. If drainage is insufficient or impossible, surgery is an effective alternative.
Topics: Anti-Bacterial Agents; Drainage; Humans; Liver Abscess, Pyogenic; Retrospective Studies
PubMed: 35635587
DOI: 10.1007/s00423-022-02535-3 -
Taiwanese Journal of Obstetrics &... Sep 2022To present a rare case of xanthogranulomatous inflammation (XI) mimicking a uterine sarcoma and invading the ureter and colon. (Review)
Review
Xanthogranulomatous inflammation caused by K. pneumonia and nocardiosis mimicking a uterine tumor and invading the ureter and colon: A case report and review of the literature.
OBJECTIVE
To present a rare case of xanthogranulomatous inflammation (XI) mimicking a uterine sarcoma and invading the ureter and colon.
CASE REPORT
A 66-year-old woman presented with lower abdominal pain. Pelvic examination showed tenderness over the lower abdominal region without cervical discharge. Per-rectal examination showed a hard tumor on the posterior uterine wall, while ultrasonography showed a tumor-like mass extending from the posterior uterine wall to the rectum. Magnetic resonance imaging showed signs of endometrial cancer invading the rectum. However, the tumor markers carbohydrate antigen (CA) 125, CA199, and carcinoembryonic antigen were in the normal range. Cystoscopy, panendoscopy, and colonoscopy showed no significant findings. On performing exploratory laparotomy, we observed pus and severe adhesion on the posterior uterine wall and rectum. Hysterectomy, bilateral adnexectomy, colectomy, and partial left ureter resection were performed. The final pathology showed XI. The pus culture revealed Klebsiella pneumonia and PCR revealed nocardiosis. The patient received 2 weeks of antibiotic treatment and was discharged thereafter.
CONCLUSION
XI in elderly women is rare, and hence, differential diagnoses should be carefully considered.
Topics: Aged; Colon; Female; Humans; Inflammation; Nocardia Infections; Pneumonia; Suppuration; Ureter; Uterine Neoplasms
PubMed: 36088063
DOI: 10.1016/j.tjog.2021.12.006 -
Journal of Clinical Microbiology Dec 2000The algorithm for a new identification system was designed on the basis of colony color and morphology on CHROMagar Orientation medium in conjunction with simple...
Cost-effective and rapid presumptive identification of gram-negative bacilli in routine urine, pus, and stool cultures: evaluation of the use of CHROMagar orientation medium in conjunction with simple biochemical tests.
The algorithm for a new identification system was designed on the basis of colony color and morphology on CHROMagar Orientation medium in conjunction with simple biochemical tests such as indole (IND), lysine decarboxylase (LDC), and ornithine decarboxylase (ODC) utilization tests with gram-negative bacilli isolated from urine samples as well as pus, stool, and other clinical specimens by the following colony characteristics, biochemical reactions, and serological results: pinkish to red, IND positive (IND(+)), Escherichia coli; metallic blue, IND(+), LDC(+), and ODC negative (ODC(-)), Klebsiella oxytoca; IND(+), LDC(-), and ODC(+), Citrobacter diversus; IND(+) or IND(-), LDC(-), and ODC(-), Citrobacter freundii; IND(-), LDC(+), and ODC(+), Enterobacter aerogenes; IND(-), LDC(-), and ODC(+), Enterobacter cloacae; IND(-), LDC(+), and ODC(-), Klebsiella pneumoniae; diffuse brown and IND(+), Morganella morganii; IND(-), Proteus mirabilis; aqua blue, Serratia marcescens; bluish green and IND(+), Proteus vulgaris; transparent yellow-green, serology positive, Pseudomonas aeruginosa; clear and serology positive, Salmonella sp.; other colors and reactions, the organism was identified by the full identification methods. The accuracy and cost-effectiveness of this new system were prospectively evaluated. During an 8-month period, a total of 345 specimens yielded one or more gram-negative bacilli. A total of 472 gram-negative bacillus isolates were detected on CHROMagar Orientation medium. For 466 of the isolates (98.7%), no discrepancies in the results were obtained on the basis of the identification algorithm. The cost of identification of gram-negative bacilli during this period was reduced by about 70%. The results of this trial for the differentiation of the most commonly encountered gram-negative pathogens in clinical specimens with the new algorithm were favourable in that it permitted reliable detection and presumptive identification. In addition, this rapid identification system not only significantly reduced costs but it also improved the daily work flow within the clinical microbiology laboratory.
Topics: Agar; Algorithms; Cost-Benefit Analysis; Culture Media; Feces; Gram-Negative Bacteria; Humans; Suppuration; Urine
PubMed: 11101600
DOI: 10.1128/JCM.38.12.4586-4592.2000 -
Nutrients Jul 2023Preliminary evidence in the literature suggests a high prevalence of malnutrition (undernutrition) in patients with severe acquired brain injuries (sABI), with an...
Relationship between Nutritional Risk, Clinical and Demographic Characteristics, and Pressure Ulcers in Patients with Severe Acquired Brain Injuries Attending a Rehabilitative Program.
Preliminary evidence in the literature suggests a high prevalence of malnutrition (undernutrition) in patients with severe acquired brain injuries (sABI), with an expected negative impact on clinical outcomes and pressure ulcers (PUs) in particular. In a retrospective cohort study on patients discharged from intensive care units (ICU) and admitted to an intensive rehabilitation unit (IRU), the risk of malnutrition was systematically assessed, in addition to standard clinical procedures (including PUs evaluation), using two different tools: the Malnutrition Universal Screening Tool (MUST) and the Controlling Nutritional Status (CONUT) tool. Eighty-eight patients were included in the analysis. A high proportion (79.5%) of patients with sABI suffered from PUs, being older and more frequently men, with a longer ICU stay between the event and admission to IRU, and a greater MUST score. At discharge, when compared to patients whose PUs had healed, those with persisting PUs were more often men and had the worst cognitive performance at admission. As for nutritional risk, the baseline CONUT score was identified as an independent negative predictor of PUs at discharge by the logistic regression model. In conclusion, the assessment of nutritional risk using simple standard tools may be useful in the clinical evaluation of sABI patients with PUs.
Topics: Male; Humans; Retrospective Studies; Pressure Ulcer; Nutritional Status; Malnutrition; Brain Injuries; Suppuration; Nutrition Assessment
PubMed: 37571274
DOI: 10.3390/nu15153336