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Navigational Note: Skin papilloma Asymptomatic; intervention Intervention initiated not indicated Definition:A disorder characterized by the presence of one or more warts medications you can buy in mexico purchase 100mg cordarone amex. Navigational Note: Tumor hemorrhage Mild symptoms; intervention Moderate symptoms; Transfusion indicated; Life-threatening Death not indicated intervention indicated invasive intervention consequences; urgent indicated; hospitalization intervention indicated Definition:A disorder characterized by bleeding in a tumor medicine 4212 order cordarone cheap online. Navigational Note: Anosmia Present Definition:A disorder characterized by a change in the sense of smell medicine 5658 discount cordarone 250mg fast delivery. Navigational Note:Also consider Olfactory nerve disorder Aphonia Voicelessness; unable to speak Definition:A disorder characterized by the inability to speak symptoms after conception discount cordarone 250 mg free shipping. Navigational Note: Cognitive disturbance Mild cognitive disability; not Moderate cognitive disability; Severe cognitive disability; interfering with interfering with significant impairment of work/school/life work/school/life performance work/school/life performance performance; specialized but capable of independent educational services/devices living; specialized resources not indicated on part time basis indicated Definition:A disorder characterized by a conspicuous change in cognitive function medications in spanish cheap cordarone 100 mg with amex. Navigational Note: Dysphasia Awareness of receptive or Moderate receptive or Severe receptive or expressive expressive characteristics; not expressive characteristics; characteristics; impairing impairing ability to impairing ability to ability to read medications lisinopril 200mg cordarone sale, write or communicate communicate spontaneously communicate intelligibly Definition:A disorder characterized by impairment of verbal communication skills, often resulting from brain damage. Navigational Note: Edema cerebral New onset; worsening from Life-threatening Death baseline consequences; urgent intervention indicated Definition:A disorder characterized by swelling due to an excessive accumulation of fluid in the brain. Navigational Note: Ischemia cerebrovascular Asymptomatic; clinical or Moderate symptoms diagnostic observations only; intervention not indicated Definition:A disorder characterized by a decrease or absence of blood supply to the brain caused by obstruction (thrombosis or embolism) of an artery resulting in neurological damage. Navigational Note: Tendon reflex decreased Ankle reflex reduced Ankle reflex absent; other Absence of all reflexes reflexes reduced Definition:A disorder characterized by less than normal deep tendon reflexes. Typically, viability is achievable between the twentieth and thirty-seventh week of gestation. Navigational Note: Delayed orgasm Delay in achieving orgasm not Delay in achieving orgasm adversely affecting adversely affecting relationship relationship Definition:A disorder characterized by sexual dysfunction characterized by a delay in climax. Navigational Note: Delusions Moderate delusional Severe delusional symptoms; Life-threatening Death symptoms hospitalization not indicated; consequences, threats of new onset harm to self or others; hospitalization indicated Definition:A disorder characterized by false personal beliefs held contrary to reality, despite contradictory evidence and common sense. Navigational Note: Euphoria Mild mood elevation Moderate mood elevation Severe mood elevation. Navigational Note: Libido decreased Decrease in sexual interest Decrease in sexual interest not adversely affecting adversely affecting relationship relationship Definition:A disorder characterized by a decrease in sexual desire. Navigational Note: Psychosis Mild psychotic symptoms Moderate psychotic Severe psychotic symptoms Life-threatening Death symptoms. Navigational Note:Also consider Investigations: Creatinine increased Bladder perforation Invasive intervention not Invasive intervention Life-threatening Death indicated indicated consequences; organ failure; urgent operative intervention indicated Definition:A disorder characterized by a rupture in the bladder wall. Navigational Note: Hemoglobinuria Asymptomatic; clinical or diagnostic observations only; intervention not indicated Definition:A disorder characterized by laboratory test results that indicate the presence of free hemoglobin in the urine. Navigational Note: Proteinuria 1+ proteinuria; urinary protein Adult:2+ and 3+ proteinuria; Adult:Urinary protein >=3. Navigational Note: Urinary fistula Symptomatic, invasive Invasive intervention Life-threatening Death intervention not indicated indicated consequences; urgent invasive intervention indicated Definition:A disorder characterized by an abnormal communication between any part of the urinary system and another organ or anatomic site. Navigational Note: Dyspareunia Mild discomfort or pain Moderate discomfort or pain Severe discomfort or pain associated with vaginal associated with vaginal associated with vaginal penetration; discomfort penetration; discomfort or penetration; discomfort or relieved with use of vaginal pain partially relieved with pain unrelieved by vaginal lubricants or estrogen use of vaginal lubricants or lubricants or estrogen estrogen Definition:A disorder characterized by painful or difficult coitus. Navigational Note: Fallopian tube obstruction Asymptomatic; clinical or Symptomatic; elective Severe symptoms; invasive diagnostic observations only; intervention indicated intervention indicated intervention not indicated Definition:A disorder characterized by blockage of the normal flow of the contents in the fallopian tube. Navigational Note: Nipple deformity Asymptomatic; asymmetry Symptomatic; asymmetry of with slight retraction and/or nipple areolar complex with thickening of the nipple moderate retraction and/or areolar complex thickening of the nipple areolar complex Definition:A disorder characterized by a malformation of the nipple. Navigational Note: Ovarian hemorrhage Mild symptoms; intervention Moderate symptoms; Transfusion indicated; Life-threatening Death not indicated intervention indicated invasive intervention consequences; urgent indicated; hospitalization intervention indicated Definition:A disorder characterized by bleeding from the ovary. Navigational Note: Ovulation pain Present Definition:A disorder characterized by a sensation of marked discomfort in one side of the abdomen between menstrual cycles, around the time of the discharge of the ovum from the ovarian follicle. Symptoms may include hot flashes, night sweats, mood swings, and a decrease in sex drive. Navigational Note: Vaginal stricture Asymptomatic; mild vaginal Vaginal narrowing and/or Vaginal narrowing and/or Death shortening or narrowing shortening not interfering shortening interfering with with physical examination the use of tampons, sexual activity or physical examination Definition:A disorder characterized by a narrowing of the vaginal canal. Navigational Note: Bronchial fistula Asymptomatic Symptomatic, invasive Invasive intervention Life-threatening Death intervention not indicated indicated consequences; urgent intervention indicated Definition:A disorder characterized by an abnormal communication between the bronchus and another organ or anatomic site. Navigational Note: Bronchial stricture Asymptomatic; clinical or Symptomatic. Navigational Note: Hoarseness Mild or intermittent voice Moderate or persistent voice Severe voice changes change; fully understandable; changes; may require including predominantly self-resolves occasional repetition but whispered speech understandable on telephone; medical evaluation indicated Definition:A disorder characterized by harsh and raspy voice arising from or spreading to the larynx. Navigational Note: Laryngeal edema Asymptomatic; clinical or Symptomatic; medical Stridor; respiratory distress; Life-threatening airway Death diagnostic observations only; intervention indicated. Navigational Note: Laryngeal fistula Asymptomatic Symptomatic, invasive Invasive intervention Life-threatening Death intervention not indicated indicated consequences; urgent intervention indicated Definition:A disorder characterized by an abnormal communication between the larynx and another organ or anatomic site. Navigational Note: Mediastinal hemorrhage Mild symptoms; intervention Moderate symptoms; Transfusion indicated; Life-threatening Death not indicated; radiologic intervention indicated invasive intervention consequences; urgent evidence only indicated; hospitalization intervention indicated Definition:A disorder characterized by bleeding from the mediastinum. Navigational Note: Pharyngeal fistula Asymptomatic Symptomatic, invasive Invasive intervention Life-threatening Death intervention not indicated indicated consequences; urgent intervention indicated Definition:A disorder characterized by an abnormal communication between the pharynx and another organ or anatomic site. Navigational Note: Pharyngeal hemorrhage Mild symptoms; intervention Moderate symptoms; Transfusion indicated; Life-threatening Death not indicated intervention indicated invasive intervention consequences; intubation or indicated; hospitalization urgent intervention indicated Definition:A disorder characterized by bleeding from the pharynx. Navigational Note: Voice alteration Mild or intermittent change Moderate or persistent Severe voice changes from normal voice change from normal voice; including predominantly still understandable whispered speech; may require frequent repetition or face-to-face contact for understandability; may require assistive technology Definition:A disorder characterized by a change in the sound and/or speed of the voice. Navigational Note: Body odor Mild odor; physician Pronounced odor; intervention not indicated; psychosocial impact; patient self care interventions seeks medical intervention Definition:A disorder characterized by an abnormal body smell resulting from the growth of bacteria on the body. Navigational Note:If infectious, consider Infections and infestations: Rash pustular or other site-specific Infections and infestations term. Navigational Note: Nail changes Present Definition:A disorder characterized by a change in the nails. Navigational Note: Nail ridging Asymptomatic; clinical or diagnostic observations only; intervention not indicated Definition:A disorder characterized by vertical or horizontal ridges on the nails. Older lesions are usually a darker purple color and eventually become a brownish-yellow color. Navigational Note: Lymphocele Asymptomatic; clinical or Symptomatic; medical Severe symptoms; invasive diagnostic observations only; intervention indicated intervention indicated intervention not indicated Definition:A disorder characterized by a cystic lesion containing lymph. Navigational Note: Phlebitis Present Definition:A disorder characterized by inflammation of the wall of a vein. The goal of the collaborative project is to improve the quality of pain management in health care organizations. This monograph is designed for informational purposes only and is not intended as a substitute for medical or professional advice. Readers are urged to consult a qualified health care professional before making decisions on any specific matter, particularly if it involves clinical practice. The inclusion of any reference in this monograph should not be construed as an endorsement of any of the treatments, programs or other information discussed therein. After years of neglect, issues of pain assessment the undertreatment of pain is not a new prob and management have captured the attention of lem. The Agency for Health Care Policy and both health care professionals and the public. The authors of this guideline acknowl pain is undertreated, and a growing awareness of edged the prior efforts of multiple health care dis the adverse consequences of inadequately man ciplines. About 9 in 10 Americans Pain Society, International Association for the regularly suffer from pain,1 and pain is the most 13 Study of Pain) to address this situation. Sufficient knowledge and resources and complexity of the subject matter, a compre exist to manage pain in an estimated 90% of indi hensive discussion of all aspects of pain assess viduals with acute or cancer pain. Data graph emphasizes practical knowledge that from a 1999 survey suggest that only 1 in 4 indi will facilitate diagnosis and/or the selection viduals with pain receive appropriate therapy. Inadequate pain management has adverse s Controversy exists over how both pain and consequences. Poorly man graph reviews only a few of the many classi aged acute pain may cause serious medical com fication systems. Thus, undertreated pain National Pharmaceutical Council 3 Section I: Background and Significance assessment. This monograph provides an s Definitions and causes of some clinical pain overview of pain assessment, but primarily states focuses on the initial assessment. In 1968, McCaffery defined pain as whatever Coverage of treatment issues relevant to the experiencing person says it is, existing when special populations. It also stresses that the emphasizes: 1) the major classes of drugs patient, not clinician, is the authority on the used for pain management; 2) examples and pain and that his or her self-report is the most salient features of these drugs; and 3) some 13 reliable indicator of pain. In 1979, the means of ensuring the safe, strategic, and International Association for the Study of Pain effective use of these agents. It s Transduction: the conversion of the energy also reviews a pain classification system based on from a noxious thermal, mechanical, or underlying pathophysiology. The goal is to pro chemical stimulus into electrical energy vide practical information that will facilitate (nerve impulses) by sensory receptors called pain assessment and management. A question nociceptors and-answer format is used to provide informa s Transmission: the transmission of these neu tion about the following: ral signals from the site of transduction s the definition of pain (periphery) to the spinal cord and brain s the process by which noxious stimuli gener s Perception: the appreciation of signals arriv ate neural signals and the transmission of ing in higher structures as pain these signals to higher centers (nociception) s Modulation: descending inhibitory and facili s the role of inflammatory mediators, neuro tory input from the brain that influences transmitters, and neuropeptides in these (modulates) nociceptive transmission at the processes. Nociceptor activation and sensitization tor) sensitization amplifies signal transmission Nociceptors are sensory receptors that are and thereby contributes to central sensitization preferentially sensitive to tissue trauma or a 28 and clinical pain states (see I. Peripheral neuropathic pain afferent) nerve fibers distributed throughout the Not all pain that originates in the periphery is periphery (Figure 1). Some neuropathic pain is tors travel primarily along two fiber types: slowly caused by injury or dysfunction of the peripheral conducting unmyelinated C-fibers and small, nervous system. Injury to tissue causes cells to break down and release various tissue byproducts and mediators of c. The functioning of nociceptors depends upon the electrophysiological ics) block or modulate channels, thus inhibiting properties of the tissues, co-factors, and cytokines. Noxious signaling may result from either abnormal firing patterns due to damage or disease in the peripheral nerves or stimulation of nociceptors (free nerve endings due to tissue trauma). Inflammation in injured or diseased tissue sensitizes nociceptors, lowering their firing thresholds. Some clinical pain states have no peripheral origin, arising from disorders of brain function. Spinal interneurons release Nerve impulses generated in the periphery are inhibitory amino acids. Descending Signals ascend Tissue trauma to higher levels modulation of the central nervous system Posterior division Anterior root Injury signals Sympathetic ganglion enter the dorsal horn Viscera < la. Afferents Receptions in skin conveying noxious signaling from the periphery enter the Muscle dorsal horn of the spinal cord, where they synapse with dorsal spindle horn neurons. This generates nerve impulses that exit the cord ipsilaterally through motor and sympathetic efferents. A simplified schema of a spinal nerve and the different Inhibitory influences include certain spinal interneurons and types of fibers contained therein. Pain: Current Understanding of Assessment, Management, and Treatments 6 Section I: Background and Significance Figure 4. Multiple pathways of nociceptive transmission for the spinal cord to central structures. There are four major pathways the A: spinoreticular; B: spinothalamic; C: spinomesencephalic; and D: spinohypothalamic tracts. For example, opioid analgesics bind to opi other nociceptive input to the limbic system. The perception of pain is an uncomfortable awareness of some part of the body, characterized a. Descending pathways by a distinctly unpleasant sensation and negative Modulation of nociceptive transmission occurs emotion best described as threat. Melzack and contralateral somatosensory cortex39 (Figure 4), Walls Gate Control Theory brought this notion where input is somatotopically mapped to pre to the forefront in 1965. National Pharmaceutical Council 7 Section I: Background and Significance Multiple brain regions contribute to descend temporal summation-refers to a progressive ing inhibitory pathways. For example, some antidepressants interfere with the reuptake of manifest as: 1) an increased response to a nox serotonin and norepinephrine at synapses, ious stimulus (hyperalgesia), 2) a painful increasing their relative interstitial concentra response to a normally innocuous stimulus (allo tion (availability)52-53 and the activity of dynia), 3) prolonged pain after a transient stim endogenous pain-modulating pathways. Clinical implications Inflammatory mediators, intense, repeated, or Sensitization is likely responsible for most of prolonged noxious stimulation, or both can sensi 26,54-55 the continuing pain and hyperalgesia after an tize nociceptors. In other words, they or abnormal input from injured nerves or gan generate nerve impulses more readily and more glia. That is, the hyperalgesia and an important role in central sensitization and clin allodynia encourage protection of the injury dur ical pain states such as hyperalgesia (increased ing the healing phase. However, these processes response to a painful stimulus) and allodynia (pain 58-59 can persist long after healing of the injury in the caused by a normally innocuous stimulus). Central sensitization plays a key role in some chronic pain, especially pain induced by nerve injury or dysfunction. Pain: Current Understanding of Assessment, Management, and Treatments 8 Section I: Background and Significance difficult to suppress than acute pain. Pain that is classified on the basis of its pre sumed underlying pathophysiology is broadly categorized as nociceptive or neuropathic pain. Pain arising from visceral organs is called visceral pain, whereas that arising from nervous system injury or impairment. Common tissues such as skin, muscle, joint capsules, and causes of neuropathic pain include trauma, inflam bone is called somatic pain. Generally, there is a close corre may contribute to neuropathic pain: 1) generation of spontaneous ectopic activity, 2) loss of normal inhibitory mechanisms in the dor spondence between pain perception and stimulus sal horn. Differences in how stim nerve impulse firing and/or abnormal signal amplification. Examples and Characteristics of Nociceptive Pain Superficial Somatic Pain Deep Somatic Pain Visceral Pain Nociceptor location Skin, subcutaneous tissue, Muscles, tendons, joints, Visceral organsa and mucous membranes fasciae, and bones Potential stimuli External mechanical, Overuse strain, mechanical Organ distension, muscle spasm, chemical, or thermal events injury, cramping, ischemia, traction, ischemia, inflammation Dermatologic disorders inflammation Localization Well localized Localized or diffuse and Well or poorly localized radiating Quality Sharp, pricking, or burning Usually dull or aching, Deep aching or sharp stabbing sensation cramping pain, which is often referred to cutaneous sites Associated symptoms Cutaneous tenderness, Tenderness, reflex muscle Malaise, nausea, vomiting, and signs hyperalgesia hyperesthesia, spasm, and sympathetic sweating, tenderness, reflex muscle allodynia hyperactivityb spasm Clinical examples Sunburn, chemical or Arthritis pain, tendonitis, Colic, appendicitis, pancreatitis, thermal burns, cuts and myofascial pain peptic ulcer disease, bladder contusions of the skin distension Sources: References 22-24 and 88-89. National Pharmaceutical Council 9 Section I: Background and Significance in origin. Neuropathic pain is sometimes called patho logic pain because it serves no purpose. These include allodynia) or occurs when no identifiable stimu multidimensional classification systems, such as lus exists.

Human cancer cells are then separated according to three categories: necrotic symptoms 6 weeks buy cordarone canada, early apoptotic symptoms vitamin b deficiency purchase 200 mg cordarone with mastercard, or late apoptotic treatment modalities cordarone 200 mg fast delivery. The results are compiled for two variables medications hyperthyroidism order cordarone 100mg without a prescription, magnetic field and oxygen medications definitions generic 250 mg cordarone, in 16 different situations (Transitions) likely to occur in the human body under present living conditions treatment dvt buy cordarone from india. We find that magnetic fields 22 are a more powerful determinant of cell death than oxygen, and induce death by different mechanisms. This has important implications for the reproducibility of in vitro biological experiments focusing on cell survival or metabolism, and for public health. The rate and mechanisms of cell death are critical to many chronic human ailments such as cancer, neurological diseases, and diabetes. The effects of this exposure at plant community level are unknown and difficult to assess in a scientifically appropriate manner. Such an assessment can be scientifically adequate if a studied plant community is completely new and control-impact radiation treatment is used. This plant community can be represented by mesic meadow, ruderal or arable weed community, or other herbaceous, moderately productive vegetation type. The group of canopy parameters includes mean height, vertical vegetation structure and dry 23 weight of above-ground standing phytomass. Plant characteristics requiring biometric sampling in the field are plant height, the number of fruits and seeds, as well as seed viability. The group of non-plant indicators includes primarily the frequency of flower visits by beetles, wasps, hoverflies, and bees that have their nests over ground. Abstract For centuries, humans have been fascinated by how migratory animals find their way over thousands of kilometres. Here, I review the mechanisms used in animal orientation and navigation with a particular focus on long-distance migrants and magnetoreception. I contend that any long-distance navigational task consists of three phases and that no single cue or mechanism will enable animals to navigate with pinpoint accuracy over thousands of kilometres. I conclude by raising twenty important mechanistic questions related to long-distance animal navigation that should be solved over the next twenty years. Exposure Effects of Terahertz Waves on Primary Neurons and Neuron-like Cells Under Nonthermal Conditions. Behavioral evidence for geomagnetic imprinting and transgenerational inheritance in fruit flies. Abstract Certain long-distance migratory animals, such as salmon and sea turtles, are thought to imprint on the magnetic field of their natal area and to use this information to help them return as adults. Despite a growing body of indirect support for such imprinting, direct experimental evidence thereof remains elusive. Here, using the fruit fly as a magnetoreceptive model organism, we demonstrate that exposure to a specific geographic magnetic field during a critical period of early development affected responses to a matching magnetic field gradient later in life. Specifically, hungry flies that had imprinted on a specific magnetic field from 1 of 3 widely separated geographic locations responded to the imprinted field, but not other magnetic fields, by moving downward, a geotactic behavior associated with foraging. This same behavior occurred spontaneously in the progeny of the next generation: female progeny moved downward in response to the field on which their parents had imprinted, whereas male progeny did so only in the presence of these females. These results represent experimental evidence that organisms can learn and remember a magnetic field to which they were exposed during a critical period of development. Although the function of the behavior is not known, one possibility is that imprinting on the magnetic field of a natal area assists flies and their offspring in recognizing locations likely to be favorable for foraging and reproduction. As stated previously, the lowest rate was seen in the concurrent control group (63%). Moreover, the increase in malignant tumor-like hyperplasia in the adrenal gland of female rats was significantly higher at 6 W/kg, relative to the concurrent controls (p <0. A particular perspective to keep in mind is that, with the induction of cancer by a carcinogen, an agent is typically considered carcinogenic if it induces a significant response in a specific tissue. Moskowitz, National toxicology program publishes final cell phone radiation study reports, Electromagn. Evaluation of the genotoxicity of cell phone radiofrequency radiation in male and female rats and mice following subchronic exposure. Female rats exhibited malignant schwannomas of the heart and malignant gliomas, but incidences of these tumors were considered equivocal. The gliomas and schwannomas observed in rats are similar to the tumor types reported in some epidemiology studies to be associated with cell phone use. The highest exposure of 6 W/kg in rats and 10 W/kg in mice, for a total of 9 h 10 min a day (achieved by cycling for 10 min on, 10 min off over 18 h 20 min), produced higher exposures than experienced by humans under normal cellular phone use conditions. Abstract this monograph identifies adverse effects of wireless radiation as reported in the premier biomedical literature. It also presents evidence that the nascent 5G mobile 28 networking technology will affect not only the skin and eyes, as commonly believed, but will have systemic adverse effects as well. Abstract With the rapid advances in technology, extensive use of mobile phones has increased the risk of health problems. This study was performed to find out the effect of mobile phone frequency on male Wistar rats. Exposure of microwave radiation frequency showed significant alterations in cholinesterase activity, muscular strength, learning ability and anxiety. This study may reveal a platform to understand its toxic effect and can further be used for amendment in current guidelines of mobile radiation. While the authors confirm the role of genetic risk factors and ionizing radiation exposures, they claimed that no firm conclusion could be drawn about the role of exposure to non-ionizing radiation. Radiofrequency electromagnetic field exposure assessment: a pilot study on mobile phone signal strength and transmitted power levels. An often-overlooked aspect is received signal strength levels from base stations and its correlation with mobile phone transmit (Tx) power. The Qualipoc android phone is a tool that provides information on both signal strength and Tx power. Measurements taken in the greater Melbourne area found a wide range of signal strength levels. Variations in Tx power over categorical levels of signal strength were quantified and showed large increases in Tx power as signal level decreased. Conclusions this study has demonstrated the use of the Qualipoc handheld android phone to assess the correlations between multiple signal strength indicators and Tx power on the 3G and 4G networks in the greater Melbourne area. The phones provided objective measurements of exposure rather than self-reported estimates from surveys. It found Tx power from a mobile phone device varied greatly depending on signal strength level, with exposure differing by orders of magnitude between poor and excellent signal strength levels. As Tx power is difficult to measure and costly with the Qualipoc android device, it is recommended that future epidemiological studies control for signal strength as a proxy due to the strong correlations found between signal strength and Tx power. Factors influencing signal strength, such as distance from base station 30 or base station concentration, line of site, vegetation, building materials, and service provider provide measures to control for signal strength. Furthermore, we compared the profiles of these limitations between studies with positive and negative results. Strengths and limitations in design, conduct and analysis of individual studies were assessed using a customized rating tool. In many studies, both with positive and negative results, we identified methodological limitations that might have either fostered false or masked real effects of exposure. The most common limitations were related to the selection of study participants, the counterbalancing of the exposure sequence and the effectiveness of blinding. If further experimental studies are conducted, they should preferably be performed at the individual level. In particular, to increase the likelihood of detecting hypersensitive individuals, if they exist, we encourage researchers to achieve a high credibility of the results by minimizing sources of risk of bias and imprecision. In order to increase the likelihood of detecting hypersensitive individuals, if they exist, we encourage researchers to achieve a high credibility of the results by minimizing of sources of risk of bias and imprecision. Measurement and mapping of the electromagnetic radiation in the urban environment. Abstract People are increasingly exposed to electromagnetic radiation with the rapid development of technologies such as broadcasting and mobile communication system. There is a concern that long-term exposure at low levels may be associated with various non-specific physical symptoms and ecological effects on animals and plants. It is extremely important to measure and analyze the electromagnetic radiation levels in order to protect people from the possible effects of electromagnetic radiation. A large-scale assessment of the effects of electromagnetic radiation on health or on ecology requires the ambient electromagnetic radiation levels over areas too vast to cover with conventional measurement methods. In this article, detailed information about the measurement tools and measurement method are given. The electromagnetic radiation exposure levels were measured on the main streets in the dense urban areas of Beijing, the capital of China. We apply ordinary kriging as an interpolation technique to assess the electromagnetic radiation exposure in large outdoor areas based on car-mounted measurements along the surrounding roads. The electromagnetic radiation exposure levels for larger areas can be investigated visually on the electromagnetic pollution map, which can assist decision makers by identifying the hotspots. Many studies have already reported genotoxic effects on a variety of organisms and cell/tissue types. Lymphocytes exposed during the G2 phase of the cell division cycle and observed at metaphase, exhibited chromatid-type aberrations (gaps and breaks) at highly significant percentages up to 275% compared to the control (sham-exposed) samples. Moreover, the percentages of aberrations in the control samples among subjects were different due to genetic and environmental factors. All measurements were carried out separately from the exposures in order to have the measuring devices at exactly the same position with the samples during the exposures. Long term persistence of this phenomenon is connected to a variety of health problems such as depression, sleep disorders, impulsivity, mania, metabolic syndrome, cardiovascular disease, and increased cancer risk (Panagopoulos and Chrousos 2019). Finally, the responsible public health authorities should take into account the results of the present study as well as the results of hundreds of other peer-reviewed published studies (Panagopoulos 2019) and establish much stringer exposure limits than the existing ones. Further studies are needed to elucidate which molecular mechanisms could be involved. Abstract Exposure to electromagnetic field in long-term use of cell phones has increased concerns about serious health 34 problems. Our aim was to survey the possible effects of electromagnetic field radiation (60 min/day for 28 days) on the spinal cords of 12 weeks old rats. Further, we investigated whether the administration of thymoquinone (10 mg/kg/day) would protect the spinal cord tissue against the adverse effects of electromagnetic field or not. Twenty-four adult male Wistar albino rats were assigned randomly into four groups: control, electromagnetic field, thymoquinone and electromagnetic field + thymoquinone. The cervical spinal cords of all rats was evaluated using the stereological, biochemical and histological methods. The number of motor neurons were reduced in the electromagnetic field group compared to the control group (p < 0. Superoxide dismutase level was higher in the electromagnetic field group compared to the control group (p < 0. In the electromagnetic field + thymoquinone group, we found an increase in the number of motor neurons and decrease in superoxide dismutase activity compared to the electromagnetic field group (p < 0. We speculated that electromagnetic field radiation induced the morphological and biochemical damage to the spinal cord tissue of rats. Administration of antioxidant, thymoquinone, also ameliorated such complications caused by electromagnetic field. The Effect of Radiation Emitted by Cell Phone on the Gelatinolytic Activity of Matrix Metalloproteinase-2 and 9 of Mouse Pre-Antral Follicles during In Vitro Culture. This study was designed to investigate the effects of exposure to the cell phone on the gelatinolytic activity of in vitro cultured mouse pre-antral follicle. Materials and Methods: In this experimental study, pre-antral follicles were isolated from ovaries of immature mice (n=16) and cultured with or without exposure to the cell phone in talking mode for 60 minutes. Results: the maturation parameters of the cell phone-exposed pre-antral follicles were significantly lower compared with the control group (P<0. The gelatinolytic activity was significantly decreased in the cell phone-exposed preantral follicles compared with the control group (P<0. Throughout a 90 day experiment, no application was performed on the control group. Subcutaneous melatonin injection was applied 40 minutes before radiation and then the fourth group was exposed to radiation for 30 minutes. At the end of the experiment, brain (cerebrum and cerebellum) tissues were taken from the subjects. Histochemical, immunohistochemical, ultrastructural and Western blot analyses were applied. Pre-increased protein synthesis before apoptosis was identified by electron microscopy. Uncertainty Analysis of Mobile Phone Use and Its Effect on Cognitive Function: the Application of 36 Monte Carlo Simulation in a Cohort of Australian Primary School Children. Abstract Previous epidemiological studies on health effects of radiation exposure from mobile phones have produced inconsistent results. This may be due to experimental difficulties and various sources of uncertainty, such as statistical variability, measurement errors, and model uncertainty. An analytical technique known as the Monte Carlo simulation provides an additional approach to analysis by addressing uncertainty in model inputs using error probability distributions, rather than point-source data. Data were collected twice, approximately one year apart (between 2011 and 2013) for 412 primary school participants in Australia. Monte Carlo simulation was used to estimate output uncertainty in the model due to uncertainties in the call exposure data. Multiple linear regression models evaluated associations between mobile phone calls with cognitive function and found weak evidence of an association. Similar to previous longitudinal analysis, associations were found for the Go/No Go and Groton maze learning tasks, and a Stroop time ratio.

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Observed irrigation efficiencies ranged between 70 and 85% for both microirrigation and furrow irrigation symptoms of diabetes buy discount cordarone 100 mg on-line. It is worth noting that actual efficiencies may be below or above this range treatment ingrown toenail order cordarone 250 mg online, and that changes in management practice may have improved to capture the technical advantage of pressurized systems in the 16 years since this study was published symptoms inner ear infection buy cordarone no prescription. At least one study suggests that variance in efficiency may not have increased despite the recent use of more sophisticated equipment medicine reminder order online cordarone. When irrigation performance was measured on nine drip irrigated celery fields in the Salinas Valley medicine cups buy cordarone 250 mg on-line, performance was low symptoms constipation order online cordarone. Celery may not be representative of other cropping systems less sensitive to water stress; however, the results illustrate the potential for current irrigation system mismanagement even with advanced technology. Though the ability to apply the desired amount of water with each application is limited by the configuration of the irrigation system and hence uniformity and efficiency are somewhat predetermined, there are many practices growers can use to optimize water delivery systems (Dzurella et al. Although the drainage volume is the most significant predictor of nitrate leaching, the volume of leachate is only half of the equation. In other words, as N is applied in increasing quantities, the potential for leaching loss also increases (Figure 24). This can simply be explained by the fact that leaching represents the greatest fraction of N loss from croplands, and thus increases with fertilizer use. The recognized objective of N fertilizer management is therefore straightforward: match the supply of nitrogen as closely as possible to the amount demanded by the cropping system (Cassman et al. Synchronization of soil-N supply with plant-N demand results in low levels of residual inorganic N, high efficiency, and low potential for pollution. In practice, nitrogen fluxes in agricultural systems are a function of a multitude of biological and chemical processes whose rates vary across space (fields, farms, and landscapes) and time (days, months, years), and are subject to a series of constraints ranging from climate to cultivars to soil type to cultural practices. Thus, a grower is faced with balancing complex and variable relationships within and Technical Report 2: Nitrogen Sources and Loading to Groundwater 80 between biology and technology. While difficult, the main principles of improving system performance relative to N leaching have been successfully demonstrated in monitoring systems operating under various water quality permits, and can therefore be emulated. Note: four outliers of high N inputs (> 1000 kg/ha) and high N leached (> 700 kg/ha) were omitted. Nitrate leaching losses appear to be low if N fertilizer use does not exceed crop demand; whereas, once N uptake is exceeded, leaching potential increases exponentially (Broadbent & Rauschkolb 1977). Although N uptake is not the only determining factor in appropriate fertilization, this finding suggests that minimizing the amount of surplus N application is critical to controlling leaching loss. Fruits and vegetables, many of which receive the most N per unit area, often recovered the least amount of N fertilizer. While the actual amount assimilated by a given crop will be a function of specific site and cropping system peculiarities, the exponential increase in leaching losses beyond crop demand thresholds presents growers and water quality managers an important point of reference from which to minimize nitrate leaching. It is important to note that perfectly matching N supply and demand is technically and biologically impossible. Under nearly all circumstances, even with best management practices, the amount of N assimilated by a crop will always be somewhat smaller than the amount of N (from all sources) applied to the field due to the constraints of farming (economics, infrastructure, labor, etc), the variability of soil and climate, and the complexity of N dynamics in the root zone, which cannot be perfectly predicted. This is in part because of the difficulty in estimating leaching losses and partially because of the economic drivers of agricultural research; development of nutrient management practices to reduce nitrate leaching has focused on productivity and N use efficiency and not on directly quantifying leaching loss or remediation. Correlations between soil N surplus and leaching loss make the indirect approach informative. But the result is that only a small set of literature is available directly measuring leaching losses under California conditions. Much of the research was performed in the 1970s and 1980s with few measurements having been made since. Data collected during early studies represent N loading rates without changes in cropping, irrigation, and fertility practices and therefore remain uncertain. As suggested by the preceding section, measuring nitrate leaching requires estimates of two factors: the volume of water moving beyond the root zone during a given period of time and the concentration of nitrate in that water. Gaining reliable measurement of either factor is not a trivial task as they occur well below soil surface and are highly variable within any given field, due to the intrinsic heterogeneity of soils and sediments. A number of methods to estimate or directly measure each factor have been developed over the last 30 years. The appropriate choice of monitoring tools depends on the goals of the research or the monitoring program. Seminal studies on leaching largely used soil cores to depths of 15 m and estimated leaching rates over more than 5 years. Descriptions of techniques used to estimate nitrate leaching and their advantages and disadvantages can be found elsewhere (Webster et al. Estimates of nitrate leaching will partially be a function of the method used to measure it. In general, the accuracy of a given method in predicting nitrate loss is inversely related to its cost and complexity. Broadbent and Carlton (1980) compared the results of soil coring with in situ extraction of soil solution using porous ceramic cups in corn fields on a Yolo loam soil in California with N fertilization rates of 90, 180, and 360 kg per ha, but both methods displayed considerable variability (F. Conversely, estimates derived from soil cores were generally lower and demonstrate significantly different seasonal patterns than the other methods calling into question their accuracy. Such results are concerning given many of the early estimates of leaching in California used deep soil cores to estimate nitrate leaching rates and transit to aquifers (Adriano, Pratt, et al. Because of the variability among methods, and variability of soil-nitrogen-water systems, estimates of nitrate leaching derived from relatively few measurements along a crop, soil, and management continuum must be interpreted with caution. Technical Report 2: Nitrogen Sources and Loading to Groundwater 82 200 150 100 50 0 0 50 100 150 200 Suction lysimeter (kg N/ha) Figure 25. Comparison of nitrate leaching estimates measured by soil sampling and suction lysimeters on a fine sandy loam in California. By tabulating estimates reported in text or tables (but not including 1 1 figures) within these published studies, a median of 78 kg ha yr was determined to be leached each year, which is equal to 30. The similarity between these leaching rates was unexpected because of the intense irrigated cropping systems in California, many of which utilize drip and micro-irrigation. It is likely that the median value reflects a bias towards measurements being made in the 1970s and 1980s, prior to widespread adoption of improved irrigation technology. This analysis also determined that reported nitrate leaching losses in California irrigated cropland varied significantly, even when the same amount of N was applied. Estimated nitrate leaching losses depend on crop investigated, irrigation technology used, and length of measurements taken. Differential management creates various leaching potentials by altering the mineral N applied and potentially influencing irrigation technology and management. Cropping patterns reflect the relationship between specific crops, and inherent nutrient demands, and fidelity to specific soil types; thus, each combination of crop and soil may have inherently different nitrate leaching potentials (see Technical Report 3, Dzurella et al. As discussed previously, irrigation management can have a significant impact on nitrate leaching loss by decreasing the residence time of nitrate in areas of greatest root activity and movement of nitrate downward through the soil profile. Nitrate leaching in lettuce fields has been estimated to range from 3 to 79% of N applied (Cahn unpublished, Jackson et al. The difference in the measurements seems to result from the period of observations. The results demonstrate that with low N inputs (< 125 kg N per ha) and strict water management (< 1. However, when complete cropping considerations are taken into account (double cropping and overwinter fallow periods) nitrate leaching losses increased considerably. Increased nitrate leaching resulted from the mineralization of soil N from soil organic matter and crop residues between cropping events, and over the winter months when precipitation likely contributed to uncontrolled soil moisture percolation to below the root zone. At the higher application rate, the amount of nitrate leached increased 3 fold and was equal to double the relative percent (18% vs. Their measurements largely taken from fields of vegetable crops suggest an average groundwater leaching rate of 34% of applied N from these systems. Collection of effluent allowed Letey and others to calculate concentrations of nitrate N. It is worth mentioning that measuring nitrate in tile drains as a proxy for leaching can distort leaching estimates, because tile drains change the matric potential of soils and may alter the observed estimates by increasing downward movement of water towards the drain. Therefore the accuracy of applying these estimates to non-tile drained fields remains uncertain. This may be partially explained by the coarse soil textures found at the study sites. Tulare County sites showed low mass nitrate leaching losses (< 7% of N applied) while Fresno County sites appeared to leach more nitrate than N applied in three of the four sites studied. The latter findings of a net negative balance might have resulted from mineralization of N from soil organic matter or the mobilization of geologic nitrate (see Section 2. Information gleaned from historical leaching studies must be interpreted with caution when extrapolating to estimate current and future leaching losses. Yields, soil, water, and irrigation management as well as cropping practices are dynamic. That is obviously the case in the fairly widespread shift to orchard crops, but it is also true that even annual cropping systems (for which most of the early studies on leaching were conducted) have changed. Nitrogen and irrigation management methods have improved in response to Technical Report 2: Nitrogen Sources and Loading to Groundwater 84 research by the University of California, and others. Examples of such technologies that have improved N efficiency include irrigation scheduling, splitting of N applications, and drip irrigation (see Technical Report 3, Dzurella et al. With few exceptions, much of past leaching measurement has centered on annual cropping systems. Many early studies also do not delineate which crops were being grown during a particular season (Adriano, Pratt, et al. The narrow breadth of crop diversity in these studies is problematic when one considers the large diversity of crops in California, and the diversity in irrigation, soil, and fertility management across fields and farms, between crops and even among fields of the same crops. The mass balance approach quantifies the relative magnitude of N flows through the study system, and is akin to balancing a checkbook. Nitrogen mass balances have been applied at a variety of scales in California from the field or ranch to watershed to the entire state (Adriano, Pratt, et al. Performing the mass balance approach for cropland requires three pieces of information that are specific to the particular crop grown on a field: (1) knowledge of the location at which each specific crop is grown, (2) the typical amount of N fertilizer applied, by crop type, and (3) the amount of N harvested (removed) from a field, by crop type. Methods of deriving historical, current, and future estimates of these elements of the cropland mass balance are described in this section. Nitrate in water supply wells of the study area have been lost from the root zone of a field, or from other sources, years and decades ago, when crop patterns and farm practices were considerably different. Similarly, nitrate loading from cropland today will affect groundwater concentrations in the foreseeable future. The Technical Report 2: Nitrogen Sources and Loading to Groundwater 85 pattern of nitrogen loading across the study area is inherently a spatial issue, as different land uses will result in varying concentrations of surficial nitrogen at different locations from varying sources. In other words, mapping different land cover types enables modeling of nitrate loading, which, when integrated over space and time in a groundwater flow and transport model, can be used to compute well nitrate concentrations (Boyle et al. Spatial components to nitrogen loading include the locations of different crop types with varying fertilization regimes, dairy sites, the locations of septic systems and wastewater treatment plants, as well as fertilized lawns and turfgrass in urban areas, as described in other sections. Because nitrogen loading to groundwater is cumulative over time, we developed land cover maps for several periods at approximately 15 year intervals over the past 60 years, as well as a current (circa 2005) land use map and two future land use projections. We also provide a projected land cover map for the 2050 time frame based upon combining the current land use map with the results from an urban growth model. In the context of this project, the statewide view was necessary because it served as an input for a parallel project developing a nitrogen budget for the entire state of 17 California. A raster representation was chosen for later ease of analysis and processing: for instance, the spatial backcasting algorithm for 17 nitrogen. These different data sources all have varying spatial resolutions, are in both raster and vector formats, and have varying levels of detail in the characteristics of land uses that they map. These have been compiled on a county-by county basis with a return interval of about seven years. The dates of the surveys for the counties in our study region range from 1997 to 2006. This layer combines the best regional vegetation maps into a single statewide raster map at a 100 m resolution. The land cover classes use the California Wildlife Habitat Relationships system, which is organized around differentiating habitat types for wildlife. We used the most recent maps for each county, specifically 1997 for Monterey, 1999 for Tulare, 2000 for Fresno, 2003 for Kings, and 2006 for Kern County. These agricultural classes are further subdivided into 89 subclasses (coded as "subclass1" in the attribute tables) that are mostly individual crop types. However, for the grain and hay class, the miscellaneous category accounts for a large fraction of the acreage because subclasses were not assigned. Because the information on agricultural types was contained in two columns in this database table (both the "class1" column and the "subclass1" column), it was necessary to perform a relational database join across these two columns to convert them to a single integer coded table of land cover types. We then exported this Technical Report 2: Nitrogen Sources and Loading to Groundwater 88 table in the spatial database to another shapefile which was then rasterized at 50 m resolution with integer-formatted values for the different land cover classifications (see Appendix Table 2) for the coding of the different land cover type). As a requirement of pesticide permits, farmers record application locations and dates with their county agricultural commissioner, who in turn reports these data to the Department of Pesticide Regulation. The table was referenced spatially to a public land survey system layer for the state. These identify a number of different categories of lands, such as prime farmlands, locally important farmlands, grazing lands and so on for most counties in the state.

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Similarly symptoms in spanish buy cheap cordarone 100mg, since the appear ance of the necrotic and the non-enhancing tumor core is typically hypo-intense in T1-Gd when compared to T1 medications canada order genuine cordarone on-line, we extract necrotic and the non-enhancing tu mor related features from segmented sub-region of T1Gd scan medicine venlafaxine order cordarone 250mg with mastercard. The values of these features were normalized by removing the mean and scaling to unit variance medicine kim leoni buy cordarone visa. More specically treatment mononucleosis buy cordarone 250mg visa, we re move the features whose weights in cost function are less than 0 treatment cervical cancer purchase 250mg cordarone free shipping. All the images were skull-striped and re sampled to an isotropic 1mm3 resolution, and the four sequences of the same patient had been co-registered. The evaluation result of segmentation on training set and validation set are listed as follows: Table 1. Survival prediction evaluation result Phase mean squared error median squared error Validation 199476. Our proposed network architecture for segmentation in corporates multi-view fusion, multi-scale prediction as well as skip connection. For survival prediction, we extract the radiomic features from the segmented brain tumor sub-regions. In the future, we will explore dierent network architecture and training strategy to further improve our result. We will also design new features and optimize our feature selection methods for survival prediction. In: International Conference on Medical image computing and computer-assisted intervention. End-to-end deep learning for regression tasks on medical imaging data shows promising results. The progress in the elds of automated tumor segmentation and radiomics have led to many dierent approaches to predict the survival time of high-grade glioma patients. Deep features: Neural networks are used to extract features, which are subse quently fed into a classical regression method such as Logistic Regression. We believe that a thorough comparison and discussion will provide a good baseline for future investigations of survival prediction tasks. We only present experiments for the survival prediction challenge and rely on an established tumor segmentation method (see below). All images in the datasets are resampled to istotropic voxel size (111 mm), size-adapted to 2403 240155 mm, and skull-stripped. To obtain the required segmentations, we thus employ the method presented by Wang et al. Feature Extraction We extract 4465 survival features from the computed segmentation together with the four sequences. A majority of the features (4451 out of 4465) are obtained by the open-source pyra diomics2 python package [8] and include various shape, gray-level, gray-tone, and rst-order intensity features for all tumor sub-compartments. The remaining features consist of 12 additional enhancing tumor shape features previously used as predictors for survival [9,15]. These features are the rim with of the enhancing tumor, geometric heterogeneity, and combinations of rim width quartiles. Feature Selection Since the number of features is much higher than the avail able samples, a subset of features is used. Apart from being necessary for many machine learning methods, a reduction of the feature space improves the in terpretability of possible markers regarding survival. Based on a step wise for ward/backward selection [7] with a linear model, we selected the feature set listed in table 1. Feature Contrast-enhancing tumor T1c log-sigma-3-0-mm-3D gldm DependenceNonUniformity T2 original gldm HighGrayLevelEmphasis T2 log-sigma-1-0-mm-3DglcmCorrelation Flair log-sigma-1-0-mm-3D glszm SmallAreaLowGrayLevelEmphasis T1c log-sigma-5-0-mm-3D glcm ClusterShade Edema T1c log-sigma-3-0-mm-3D gldm DependenceNonUniformity T2 original gldm HighGrayLevelEmphasis T2 log-sigma-1-0-mm-3D glcmCorrelation Flair log-sigma-1-0-mm-3D glszm SmallAreaLowGrayLevelEmphasis T1c log-sigma-5-0-mm-3D glcm ClusterShade Necrosis and non-enhancing tumor T1c log-sigma-3-0-mm-3D gldm DependenceNonUniformity T2 original gldm HighGrayLevelEmphasis T2 log-sigma-1-0-mm-3D glcm Correlation Flair log-sigma-1-0-mm-3D glszm SmallAreaLowGrayLevelEmphasis T1c log-sigma-5-0-mm-3D glcm ClusterShade Subject Information Age or demographic information, features may be appended to the rst fully con nected layer. These blocks are again connected to two fully connected layers in front of the output. The regression output was subsequently thresholded to classify each subject as short, medium or long survivor, with survival times of less than ten, between ten and 15, and longer than 15 months respectively. Model selection dur ing training was therefore a challenge, since the accuracy and Spearmans rank coecient were very unstable as well. Adding age and resection status to the fully connected layer led to a faster convergence during training, but not to a better nal accuracy. Including hand crafted features showed lower accuracy in preliminary experiments. For this seemingly easier task, no higher or more stable accuracy could be achieved. Using classical regression techniques with hand-crafted features has the ad vantage of better interpretability. Models with fewer learnable parameters, such as the classical regression methods tested and FeatNet achieve more robust re sults on unseen data when only few training samples are available. A robust stopping criterion during training with a small validation set poses a challenge. More research should go into the combination of deep features and classi cal hand-crafted features. We handle the imbalance problem with cascade model architecture and further use focal loss to fo cus on dicult region. Recently, deep learning based on convolutional neural network achieved huge success. Inspired by [17] and [9], we use 3D convolutional network with a cascade and multi-stage framework to alleviate class imbalance which is the main diculty in brain tumor segmentation. We used the three stages for segmenting whole, core and enhancing tumor region into one cascade structure. This cascade framework for semantic segmentation was originally proposed by [9] but they use diculty to separate stage2 while we use the structure of the tumor. To directly combine three network and maintain the necessary network capacity can caused signicant memory usage. To alleviate this problem, we use anisotropic convolutional network suggested by [17]. With the observation in [9], the diculty in each voxel is dierent and learn ing those dicult voxels is important to improve semantic segmentation result. In brain tumor segmentation, the healthy tissue and background take more than 80% of the volume which can be easily classied while the contour of core and enhancing tumor is much harder. Since we choose to use tumor structure in stead of diculty to separate the cascade layer, we opt to use loss function to address this problem. In this way, both local features as well as more global contextual features can be learned despite the input patch size is small. In addition, they also explore a cascade architec ture in which the output of a rst network is treated as input for subsequent networks. Two parallel pathways with small 3D kernel and residual connection that take down-sampled context as input to avoid to computation on large 3D volumes at full resolution. Dice loss and its variant is commonly used in biomedical segmentation task such as [5] [16]. Triple Cascaded Framework [17] use three networks target for three dierent regions where whole tumor, core tumor and enhancing tumor. Since tumor core is contained in the whole tumor region and enhancing tumor is contained in core region by denition, we can segment each part in a cascade manner. They also trained three network for dierent orthogonal view and fuse them together to better leveraging contextual information of 3D volume. The annotation was annotated manually by one to four raters and all segmentations were approved by expert raters. The annotations separate the brain tumor into four dierent labels: Background and healthy tissue, Non-Enhancing tumor, Edema and Enhancing tumor. We normalize each modality of each case individually, with the mean and standard deviation of the brain intensities. The design of [17] has great advantages but separate training is time-consuming and end-to-end training allows subsequent networks to provide more information. The three networks are trained together and produce three predictions and uses three loss function to supervise (see. Note that in down-sampling layer we follow the same design choice as [17] which maintain the stride of depth dimension to one. In the following stages, we maintain the feature map resolution to preserve structure informations and used dilated con volution to increase eective receptive eld instead as in [18] [17]. The prediction is produced by two consecutive convolution transpose operations to restore the original resolution (the green part in. The easy examples will occupy the total loss causing the dicult examples such as enhancing tumor hard to learn. We penalize the easy example which classied with very high probability as Equation. The evaluation system separates the tumor structure into three regions due to practical clinical applications. It considers all tumor areas and evaluates all labels 1, 2, 4 (1 for non-enhancing core, 2 for edema and 4 for enhancing core). The Dice-Coecient is the main metric and commonly used in biomedical image segmentation. Sensitivity indicates the ratio between correct predicted voxels and true positive voxels. These metrics can help us to determine whether our method is over-segmenting or under-segmenting of the tumor regions. Hausdordistance measures how far two subsets (our prediction and ground truth) of a metric space are from each other. We build 3D-Unet with 2 down-sampling layer and 2 up-sampling layer which is an popular design choice (see. For [17], we preserve the default parameters since the training and testing data is similar. Noted that We use the focal loss parameter gamma equals to 2 in all experiments (following [10]). Unet3D is based on our own implementation trained with Dice loss [13] as an baseline. We also used the Cascade [17] with their ocial released code to train and test since it is the most relevant work to ours. Our approach is fast to train and test although the tumor core performance is worse than [17]. We further experimented focal loss function to better handle the imbalance problem. One possible solution is to increase the receptive eld of second stage network since that in [17], the network for core region uses more dilation operations. Another possibility is that our network is over-tting since the total training iterations are more than [17] (joint training plus separate training). With the preliminary results, we will further investigate the better training strategy and parameter tuning to verity our assumption. In this paper, we have presented preliminary results in the Brats2018 Vali dation set which shows great eciency and achieve competitive results. The extraction of brain tumor tissues in 3D Brain Magnetic Resonance Imaging plays an important role in diagnosis gliomas. In this paper, we use clinical data to develop an approach to segment Enhancing Tumor, Tumor Core, and Whole Tumor which are the sub-regions of glioma. Our method starts with Bit-plane to get the most significant and least significant bits which can cluster and generate more images. Among many types of brain tumor, Gliomas are the most common primary brain malignancies, with different degrees of aggressiveness, variable prognosis and various heterogeneous histological sub-regions. In this paper, we focus on Enhancing Tumor, Tumor Core, and Whole Tumor segmentation which are the sub-regions of gliomas segmentation. In this study, we combine the Bit-plane [7] and U-Net [8] method for tumor seg mentation. First, we use Bit-plane to divide images into many images by determining significant bits. Second, the images with the significant bits can be used to segment the object boundary. Finally, original images and images with least significant bits can be used to determine tissues inside the boundary. There are three main stages: Preprocess, Ob ject boundary segmentation and Tissues segmentation. Here, we cropped the image size from (256,256) to (176,176) Majority of the volumes in the dataset were acquired along the axial plane and hence had the highest resolution this plane. After the prepro cessing stage, all the 2D slices is from (155,256,256) to (100,176,176) with value range (0-255) 2. The intensities of an image are based on the Eq (1): a 2m-1 + a 2m-2 + + a 21 + a 20 (1) m-1 m-2 1 0 We realize that the final plane contains the most significant bit. We eliminate the last 6 bits to remove the noise and only used the first 2 bits to keep the significant data to generate images for training to detect the object boundary. In Table 1, we show the average performance for each label and score for all the validation patients. In this paper, we propose using Bit-plane to generate more image but still remains the significant features. The result is evaluated without additional data and is shown with a promising perfor mance. Despite getting the good result, we need to process the boundary after the final segmentation as the post-processing.

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