Analysis of Data Reception in the Communication Layer Applied to an Architecture of Mobile Sensor Networks in Marine Environments.

This paper is focused on the use of radio frequency identification (RFID) technology operating at 125 kHz in a communication layer for a network of mobile and static nodes in marine environments, with a specific focus on the Underwater Internet of Things (UIoT). The analysis is divided into two main sections: characterizing the penetration depth at different frequencies and evaluating the probabilities of data reception between antennas of static nodes and a terrestrial antenna considering the line of sight (LoS) between antennas. The results indicate that the use of RFID technology at 125 kHz allows for data reception with a penetration depth of 0.6116 dB/m, demonstrating its suitability for data communication in marine environments. In the second part of the analysis, we examine the probabilities of data reception between static-node antennas at different heights and a terrestrial antenna at a specific height. Wave samples recorded in Playa Sisal, Yucatan, Mexico, are used for this analysis. The findings show a maximum reception probability of 94.5% between static nodes with an antenna at a height of 0 m and a 100% data reception probability between a static node and the terrestrial antenna when the static-node antennas are optimally positioned at a height of 1 m above sea level. Overall, this paper provides valuable insights into the application of RFID technology in marine environments for the UIoT, considering the minimization of impacts on marine fauna. The results suggest that by adjusting the characteristics of the RFID system, the proposed architecture can be effectively implemented to expand the monitoring area, considering variables both underwater and on the surface of the marine environment.

Enhancing Image Quality via Robust Noise Filtering Using Redescending M-Estimators.

In the field of image processing, noise represents an unwanted component that can occur during signal acquisition, transmission, and storage. In this paper, we introduce an efficient method that incorporates redescending M-estimators within the framework of Wiener estimation. The proposed approach effectively suppresses impulsive, additive, and multiplicative noise across varied densities. Our proposed filter operates on both grayscale and color images; it uses local information obtained from the Wiener filter and robust outlier rejection based on Insha and Hampel's tripartite redescending influence functions. The effectiveness of the proposed method is verified through qualitative and quantitative results, using metrics such as PSNR, MAE, and SSIM.

Denoising Vanilla Autoencoder for RGB and GS Images with Gaussian Noise.

Noise suppression algorithms have been used in various tasks such as computer vision, industrial inspection, and video surveillance, among others. The robust image processing systems need to be fed with images closer to a real scene; however, sometimes, due to external factors, the data that represent the image captured are altered, which is translated into a loss of information. In this way, there are required procedures to recover data information closest to the real scene. This research project proposes a Denoising Vanilla Autoencoding (DVA) architecture by means of unsupervised neural networks for Gaussian denoising in color and grayscale images. The methodology improves other state-of-the-art architectures by means of objective numerical results. Additionally, a validation set and a high-resolution noisy image set are used, which reveal that our proposal outperforms other types of neural networks responsible for suppressing noise in images.

Efficient System for Delimitation of Benign and Malignant Breast Masses.

In this study, a high-performing scheme is introduced to delimit benign and malignant masses in breast ultrasound images. The proposal is built upon by the Nonlocal Means filter for image quality improvement, an Intuitionistic Fuzzy C-Means local clustering algorithm for superpixel generation with high adherence to the edges, and the DBSCAN algorithm for the global clustering of those superpixels in order to delimit masses' regions. The empirical study was performed using two datasets, both with benign and malignant breast tumors. The quantitative results with respect to the BUSI dataset were JSC≥0.907, DM≥0.913, HD≥7.025, and MCR≤6.431 for benign masses and JSC≥0.897, DM≥0.900, HD≥8.666, and MCR≤8.016 for malignant ones, while the MID dataset resulted in JSC≥0.890, DM≥0.905, HD≥8.370, and MCR≤7.241 along with JSC≥0.881, DM≥0.898, HD≥8.865, and MCR≤7.808 for benign and malignant masses, respectively. These numerical results revealed that our proposal outperformed all the evaluated comparative state-of-the-art methods in mass delimitation. This is confirmed by the visual results since the segmented regions had a better edge delimitation.

Rician Denoising Based on Correlated Local Features LMMSE Approach.

In this study we propose a novel correction scheme that filters Magnetic Resonance Images data, by using a modified Linear Minimum Mean Square Error (LMMSE) estimator which takes into account the joint information of the local features. A closed-form analytical solution for our estimator is presented and it proves to make the filtering process far simpler and faster than other estimation techniques that rely on iterative optimization scheme and require multiple data samples. An experimental validation of our correction scheme was carried out through large scale experiments using both clinical and synthetic MR images, artificially corrupted with rician noise of σ varying from 1 to 40. These noisy images were filtered using our proposed method against the classical LMMSE, the Non-Local Means filter and the Nonlocality-Reinforced Convolutional Neural Networks (NRCNN) techniques. The results show an outstanding performance of our proposed method, given the fact that from σ ≈ 12 onwards, the proposed method outperforms all other methods. Another attention-grabbing feature of our method is that its Structural Similarity does not vary sharply [0.87, 0.95] across the σ spectrum as the other three techniques, which implies that this method can work on a wider range of deteriorated images than the rest of the techniques.

Increased Doses Lead to Higher Drug Exposures of Levofloxacin for Treatment of Tuberculosis.

Patients with multidrug-resistant tuberculosis in Peru and South Africa were randomized to a weight-banded nominal dose of 11, 14, 17, or 20 mg/kg/day levofloxacin (minimum, 750 mg) in combination with other second-line agents. A total of 101 patients were included in noncompartmental pharmacokinetic analyses. Respective median areas under the concentration-time curve from 0 to 24 h (AUC0-24) were 109.49, 97.86, 145.33, and 207.04 µg · h/ml. Median maximum plasma concentration (Cmax) were 11.90, 12.02, 14.86, and 19.17 µg/ml, respectively. Higher levofloxacin doses, up to 1,500 mg daily, resulted in higher exposures. (This study has been registered at ClinicalTrials.gov under identifier NCT01918397.).

Effectiveness of a bedaquiline, linezolid, clofazimine "core" for multidrug-resistant tuberculosis.

Rationale: Treatment outcomes may be compromised among patients with multidrug- or rifampicin-resistant tuberculosis with additional fluoroquinolone resistance. Evidence is needed to inform optimal treatment for these patients. Objectives: We compared the effectiveness of longer individualized regimens comprised of bedaquiline for 5 to 8 months, linezolid, and clofazimine to those reinforced with at least 1 third-tier drug and/or longer duration of bedaquiline. Methods: We emulated a target trial to compare the effectiveness of initiating and remaining on the core regimen to one of five regimens reinforced with (1) bedaquiline for ≥9 months, (2) bedaquiline for ≥9 months and delamanid, (3) imipenem, (4) a second-line injectable, or (5) delamanid and imipenem. We included patients in whom a fluoroquinolone was unlikely to be effective based on drug susceptibility testing and/or prior exposure. Our analysis consisted of cloning, censoring, and inverse-probability weighting to estimate the probability of successful treatment. Measurements and Main Results: Adjusted probabilities of successful treatment were high across regimens, ranging from 0.75 (95%CI:0.61, 0.89) to 0.84 (95%CI:0.76, 0.91). We found no substantial evidence that any of the reinforced regimens improved effectiveness of the core regimen, with ratios of treatment success ranging from 1.01 for regimens reinforced with bedaquiline ≥9 months (95%CI:0.79, 1.28) and bedaquiline ≥9 months plus delamanid (95%CI:0.81, 1.31) to 1.11 for regimens reinforced by a second-line injectable (95%CI:0.92, 1.39) and delamanid and imipenem (95%CI:0.90, 1.41). Conclusions: High treatment success underscores the effectiveness of regimens comprised of bedaquiline, linezolid, and clofazimine, highlighting the need for expanded access to these drugs.

Algorithm for the diagnosis of smear-negative pulmonary tuberculosis in high-incidence resource-constrained settings.

OBJECTIVES: Diagnosis of smear-negative pulmonary tuberculosis (SNPT) remains a challenge, particularly in resource-constrained settings. We evaluated a diagnostic algorithm that combines affordable laboratory tools and a clinical prediction rule (CPR). METHODS: We derived, based on published evidence, a diagnostic algorithm for SNPT. Sputum concentration constitutes its first step. In suspects with negative results, SNPT probability is classified with a CPR as low (excluded), high (confirmed) or intermediate. For intermediate patients, sputum Middlebrook 7H9 liquid culture is performed, and they are assessed after 2 weeks. If clinically deteriorated, with still negative liquid culture, bronchoscopy is offered. Otherwise, results of Middlebrook 7H9 culture are awaited. We prospectively evaluated this algorithm against a reference standard of solid and liquid cultures in two reference hospitals in Lima, Peru. RESULTS: 670 SNPT suspects were included from September 2005 to March 2008. The prevalence of SNPT was 27% according to the reference standard. The algorithm's overall accuracy was 0.94 (95% CI 0.91-0.95), its sensitivity was 0.88 (95% CI 0.82-0.92) and its specificity, 0.96 (95% CI 0.94-0.98). Sputum concentration, the CPR, Middlebrook 7H9 sputum culture and bronchoscopic samples defined a diagnosis of SNPT according to the algorithm in 57 (37%), 25 (16%), 63 (41%) and 8(5%) of patients, respectively. 65% of patients were diagnosed within 3 weeks. CONCLUSIONS: The algorithm was accurate for SNPT diagnosis. Sputum concentration, CPR and selective Middlebrook 7H9 culture are essential components.

FAST tuberculosis transmission control strategy speeds the start of tuberculosis treatment at a general hospital in Lima, Peru.

OBJECTIVE: To evaluate the effect of the FAST (Find cases Actively, Separate safely, Treat effectively) strategy on time to tuberculosis diagnosis and treatment for patients at a general hospital in a tuberculosis-endemic setting. DESIGN: Prospective cohort study with historical controls. PARTICIPANTS: Patients diagnosed with pulmonary tuberculosis during hospitalization at Hospital Nacional Hipolito Unanue in Lima, Peru. METHODS: The FAST strategy was implemented from July 24, 2016, to December 31, 2019. We compared the proportion of patients with drug susceptibility testing and tuberculosis treatment during FAST to the 6-month period prior to FAST. Times to diagnosis and tuberculosis treatment were also compared using Kaplan-Meier plots and Cox regressions. RESULTS: We analyzed 75 patients diagnosed with pulmonary tuberculosis through FAST. The historical cohort comprised 76 patients. More FAST patients underwent drug susceptibility testing (98.7% vs 57.8%; OR, 53.8; P < .001), which led to the diagnosis of drug-resistant tuberculosis in 18 (24.3%) of 74 of the prospective cohort and 4 (9%) of 44 of the historical cohort (OR, 3.2; P = .03). Overall, 55 FAST patients (73.3%) started tuberculosis treatment during hospitalization compared to 39 (51.3%) controls (OR, 2.44; P = .012). FAST reduced the time from hospital admission to the start of TB treatment (HR, 2.11; 95% CI, 1.39-3.21; P < .001). CONCLUSIONS: Using the FAST strategy improved the diagnosis of drug-resistant tuberculosis and the likelihood and speed of starting treatment among patients with pulmonary tuberculosis at a general hospital in a tuberculosis-endemic setting. In these settings, the FAST strategy should be considered to reduce tuberculosis transmission while simultaneously improving the quality of care.

Performance of an algorithm based on WHO recommendations for the diagnosis of smear-negative pulmonary tuberculosis in patients without HIV infection.

OBJECTIVE: To evaluate the performance of an algorithm based on WHO recommendations for diagnosis of smear-negative pulmonary tuberculosis in HIV-negative patients. METHODS: We recruited HIV-negative patients with clinical suspicion of tuberculosis who had had three negative sputum smears in Lima, Peru. All included subjects underwent a complete anamnesis, physical examination and chest X-ray, and had a sputum specimen cultured in Ogawa, Middlebrook 7H9 media and MGIT®. We applied an algorithm based on WHO recommendations to classify patients as having tuberculosis or not. The diagnostic performance of the algorithm was evaluated comparing its results against the reference standard of a positive culture for M. tuberculosis in either of the media used. RESULTS: A total of 264 of the 285 patients included (92.6%) completed evaluation and follow up. Of these, 70 (26.5%) had a positive culture for M. tuberculosis. Clinical response to a broad spectrum course of antibiotics was good in 32 of these 70 patients (45.7; 95%CI 34.0-57.4%). Overall, the algorithm attained a sensitivity of 22.9% (95% CI 13.1-32.7%) and a specificity of 95.4 % (95% CI 92.4-98.3%) compared to culture results. The positive likelihood ratio was 4.93 and the negative likelihood ratio was 0.81. CONCLUSIONS: The sensitivity and negative likelihood ratio of the algorithm is poor. It should be re-evaluated, and possibly adapted to local circumstances before further use. The clinical response to an antibiotic trial is the most important component to reassess. We also suggest considering performing chest X-ray earlier in the diagnostic work-up.

PhotoId-Whale: Blue whale dorsal fin classification for mobile devices.

Photo-identification (photo-id) is a method used in field studies by biologists to monitor animals according to their density, movement patterns and behavior, with the aim of predicting and preventing ecological risks. However, these methods can introduce subjectivity when manually classifying an individual animal, creating uncertainty or inaccuracy in the data as a result of the human criteria involved. One of the main objectives in photo-id is to implement an automated mechanism that is free of biases, portable, and easy to use. The main aim of this work is to develop an autonomous and portable photo-id system through the optimization of image classification algorithms that have high statistical dependence, with the goal of classifying dorsal fin images of the blue whale through offline information processing on a mobile platform. The new proposed methodology is based on the Scale Invariant Feature Transform (SIFT) that, in conjunction with statistical discriminators such as the variance and the standard deviation, fits the extracted data and selects the closest pixels that comprise the edges of the dorsal fin of the blue whale. In this way, we ensure the elimination of the most common external factors that could affect the quality of the image, thus avoiding the elimination of relevant sections of the dorsal fin. The photo-id method presented in this work has been developed using blue whale images collected off the coast of Baja California Sur. The results shown have qualitatively and quantitatively validated the method in terms of its sensitivity, specificity and accuracy on the Jetson Tegra TK1 mobile platform. The solution optimizes classic SIFT, balancing the results obtained with the computational cost, provides a more economical form of processing and obtains a portable system that could be beneficial for field studies through mobile platforms, making it available to scientists, government and the general public.

Medical Imaging Lesion Detection Based on Unified Gravitational Fuzzy Clustering.

We develop a swift, robust, and practical tool for detecting brain lesions with minimal user intervention to assist clinicians and researchers in the diagnosis process, radiosurgery planning, and assessment of the patient's response to the therapy. We propose a unified gravitational fuzzy clustering-based segmentation algorithm, which integrates the Newtonian concept of gravity into fuzzy clustering. We first perform fuzzy rule-based image enhancement on our database which is comprised of T1/T2 weighted magnetic resonance (MR) and fluid-attenuated inversion recovery (FLAIR) images to facilitate a smoother segmentation. The scalar output obtained is fed into a gravitational fuzzy clustering algorithm, which separates healthy structures from the unhealthy. Finally, the lesion contour is automatically outlined through the initialization-free level set evolution method. An advantage of this lesion detection algorithm is its precision and its simultaneous use of features computed from the intensity properties of the MR scan in a cascading pattern, which makes the computation fast, robust, and self-contained. Furthermore, we validate our algorithm with large-scale experiments using clinical and synthetic brain lesion datasets. As a result, an 84%-93% overlap performance is obtained, with an emphasis on robustness with respect to different and heterogeneous types of lesion and a swift computation time.

An optimized background regimen design to evaluate the contribution of levofloxacin to multidrug-resistant tuberculosis treatment regimens: study protocol for a randomized controlled trial.

BACKGROUND: Current guidelines for treatment of multidrug-resistant tuberculosis (MDR-TB) are largely based on expert opinion and observational data. Fluoroquinolones remain an essential part of MDR-TB treatment, but the optimal dose of fluoroquinolones as part of the regimen has not been defined. METHODS/DESIGN: We designed a randomized, blinded, phase II trial in MDR-TB patients comparing across levofloxacin doses of 11, 14, 17 and 20 mg/kg/day, all within an optimized background regimen. We assess pharmacokinetics, efficacy, safety and tolerability of regimens containing each of these doses. The primary efficacy outcome is time to culture conversion over the first 6 months of treatment. The study aims to determine the area under the curve (AUC) of the levofloxacin serum concentration in the 24 hours after dosing divided by the minimal inhibitory concentration of the patient's Mycobacterium tuberculosis isolate that inhibits > 90% of organisms (AUC/MIC) that maximizes efficacy and the AUC that maximizes safety and tolerability in the context of an MDR-TB treatment regimen. DISCUSSION: Fluoroquinolones are an integral part of recommended MDR-TB regimens. Little is known about how to optimize dosing for efficacy while maintaining acceptable toxicity. This study will provide evidence to support revised dosing guidelines for the use of levofloxacin as part of combination regimens for treatment of MDR-TB. The novel methodology can be adapted to elucidate the effect of other single agents in multidrug antibiotic treatment regimens. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01918397 . Registered on 5 August 2013.

The validity of cerebrospinal fluid parameters for the diagnosis of tuberculous meningitis.

OBJECTIVES: To assess the diagnostic validity of laboratory cerebrospinal fluid (CSF) parameters for discriminating between tuberculous meningitis (TBM) and other causes of meningeal syndrome in high tuberculosis incidence settings. METHODS: From November 2009 to November 2011, we included patients with a clinical suspicion of meningitis attending two hospitals in Lima, Peru. Using a composite reference standard, we classified them as definite TBM, probable TBM, and non-TBM cases. We assessed the validity of four CSF parameters, in isolation and in different combinations, for diagnosing TBM: adenosine deaminase activity (ADA), protein level, glucose level, and lymphocytic pleocytosis. RESULTS: One hundred and fifty-seven patients were included; 59 had a final diagnosis of TBM (18 confirmed and 41 probable). ADA was the best performing parameter. It attained a specificity of 95%, a positive likelihood ratio of 10.7, and an area under the receiver operating characteristics curve of 82.1%, but had a low sensitivity (55%). None of the combinations of CSF parameters achieved a fair performance for 'ruling out' TBM. CONCLUSIONS: Finding CSF ADA greater than 6 U/l in patients with a meningeal syndrome strongly supports a diagnosis of TBM and permits the commencement of anti-tuberculous treatment.