Chronic diseases present a significant challenge to 21st century global health policy. In developing nations, the growing prevalence of chronic diseases such as chronic kidney disease has severe implications on health and economic output. The rapid rise of common risk factors such as diabetes, hypertension, and obesity, especially among the poor, will result in even greater and more profound burdens that developing nations are not equipped to handle. Attention to chronic diseases, chronic kidney disease in particular, has been lacking, largely due to the global health community’s focus on infectious diseases and lack of awareness. There is a critical need for funding in and to developing countries to implement more comprehensive, cost-effective, and preventative interventions against chronic diseases. This paper examines the epidemiology of chronic diseases, the growing prevalence of chronic kidney disease and its implications for global public health, and the associated health and economic burdens. Finally, a summary review of cost-effective interventions and funding needs is provided.
This paper presents the evaluation results of the methods submitted to Challenge US: Biometric Measurements from Fetal Ultrasound Images, a segmentation challenge held at the IEEE International Symposium on Biomedical Imaging 2012. The challenge was set to compare and evaluate current fetal ultrasound image segmentation methods. It consisted of automatically segmenting fetal anatomical structures to measure standard obstetric biometric parameters, from 2D fetal ultrasound images taken on fetuses at different gestational ages (21 weeks, 28 weeks, and 33 weeks) and with varying image quality to reflect data encountered in real clinical environments. Four independent sub-challenges were proposed, according to the objects of interest measured in clinical practice: abdomen, head, femur, and whole fetus. Five teams participated in the head sub-challenge and two teams in the femur sub-challenge, including one team who tackled both. Nobody attempted the abdomen and whole fetus sub-challenges. The challenge goals were two-fold and the participants were asked to submit the segmentation results as well as the measurements derived from the segmented objects. Extensive quantitative (region-based, distance-based, and Bland-Altman measurements) and qualitative evaluation was performed to compare the results from a representative selection of current methods submitted to the challenge. Several experts (three for the head sub-challenge and two for the femur sub-challenge), with different degrees of expertise, manually delineated the objects of interest to define the ground truth used within the evaluation framework. For the head sub-challenge, several groups produced results that could be potentially used in clinical settings, with comparable performance to manual delineations. The femur sub-challenge had inferior performance to the head sub-challenge due to the fact that it is a harder segmentation problem and that the techniques presented relied more on the femur's appearance.
Meticulous standardisation and ongoing monitoring of adherence to measurement protocols during data collection are essential to ensure consistency and to minimise systematic error in multicentre studies. Strict ultrasound fetal biometric measurement protocols are used in the st Project so that data of the highest quality from different centres can be compared and potentially pooled. A central Ultrasound Quality Unit (USQU) has been set up to oversee this process. After initial training and standardisation, the USQU monitors the performance of all ultrasonographers involved in the project by continuously assessing the quality of the images and the consistency of the measurements produced. Ultrasonographers are identified when they exceed preset maximum allowable differences. Corrective action is then taken in the form of retraining or simply advice regarding changes in practice. This paper describes the procedures used, which can form a model for research settings involving ultrasound measurements.
The positional accuracy of Global Positioning System (GPS) and Navigation with Indian Constellation (NavIC) are affected by errors, one of the predominant errors is instrumental delay. This delay distorts the satellite signal and effect the position accuracy. To counter this problem, efficient models shall be used. In this paper, satellites' and receivers' instrumental bias is estimated using a modified Fitted Receiver Bias (FRB) method, Singular Value Decomposition (SVD) technique and Self-Calibration of Pseudo Range Error (SCORE) model. The FRB method is based on the minimization of standard deviation of vertical Total Electron Content (TEC) computed from different satellites. The SVD based Least Mean Square (LMS) algorithm uses the values of one-day period corresponding to four GPS and NavIC stations. It uses data from dual frequency GPS receivers. To derive the instrumental bias errors the SCORE technique uses a self-consistency constraint on the receiver's measurements of ionospheric delay.
Evidence of horseshoe kidney in Indian population is 1 in 600-800 individuals. Horseshoe kidney is predisposed to complications by virtue of its ectopic position, malrotation and associated vascular and ureteral anomalies. Incidence of Renal Cell Carcinoma (RCC) in a horseshoe kidney is same as that in general population. Other pelvic tumours, transitional tumours, Wilms tumour and carcinoids show a greater frequency. High grade urothelial carcinomas are quite rare with a few case reports available. An index case of 75 yeal old male presented with renal mass in an incidentally diagnosed horseshoe kidney on radiologic imaging. The case has been highlighted due to its poorly differentiated tumour morphology and aggressive nature. Further, immunohistochemistry was done to arrive at a correct diagnosis for appropriate treatment. The tumour cells showed positivity for Cytokeratin 7 (CK 7) and CK 5/6. They were negative for p63, PAX-8 (Paired-box gene 8). Also, it is technically difficult to excise large-sized renal mass in an anomalous kidney.
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