Although atrial fibrillation (AF) Arrhythmia is highly prevalent within a wide range of populations with major associated risks and due to its episodic occurrence, its recognition remains a challenge for doctors. This paper aims to present and experimentally validate a new efficient approach for the detection and classification of this cardiac anomaly using multiple Electrocardiogram (ECG) signals. This work consists of applying Stockwell transform (ST) with compact support kernel (ST-CSK) for ECG time-frequency analysis. The estimation of the atrial activity (AA) is then achieved after analyzing P-waves of the ECG signals for each heartbeat. ECG signals segmentation allows characterizing the AA by making use of its (t, f) flatness, (t, f) flux, energy concentration and heart rate variability. The features matrix is employed as an input of the support vector machines (SVM) working in binary and asymmetrical mode with an embedded reject option. The proposed algorithm is trained and then tested using different ECG sources namely two databases provided by PhysionNet (MIT-BIH Arrhythmia, MIT-BIH Atrial Fibrillation) and recorded ECG signals using MySignals HW development platform with raspberry Pi 3 model B[Formula see text]. The used method has achieved [Formula see text] and [Formula see text] as sensitivity and specificity, respectively. The obtained results confirm that the proposed approach represents a promising tool for Atrial Fibrillation Episodes (AFE) recognition with significant separability between Normal atrial activity and atrial activity with AF even under real and clinical conditions.Despite existing evidence-based practice guidelines for the management of biliary acute pancreatitis (AP), the clinical compliance with recommendations is overall poor. Studies in this field have identified significant discrepancies between evidence-based recommendations and daily clinical practice. The most commonly reported gaps between clinical practice and AP guidelines include the indications for CT scan, need and timing of artificial nutritional support, indications for antibiotics, and surgical/endoscopic management of biliary AP. The MANCTRA-1 (coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis) study is aiming to identify the areas for quality improvement that will require new implementation strategies. The study primary objective is to evaluate which items of the current AP guidelines are commonly disregarded and if they correlate with negative clinical outcomes according to the different clinical presentations of the disease. We attempt to summarize the main areas of sub-optimal care due to the lack of compliance with current guidelines to provide the basis for introducing a number of bundles in AP patients’ management to be implemented during the next years. 666-15 inhibitor cell line The MANCTRA-1 study is an international multicenter, retrospective cohort study with the purpose to assess the outcomes of patients admitted to hospital with a diagnosis of biliary AP and the compliance of surgeons worldwide to the most up-to-dated international guidelines on biliary AP. ClinicalTrials.Gov ID Number NCT04747990, Date February 23, 2021. Protocol Version V2.2.

We sought to evaluate the effect of age on postoperative outcomes among patients undergoing major liver surgery for perihilar cholangiocarcinoma (PHCC).

77 patients were included. Patients were categorized into two groups the “< 70-year-olds” group (n = 54) and the “≥ 70-year-olds” group (n = 23).

Median LOS was 19 both for < 70-year-old group and ≥ 70-year-old group (P = 0.72). No differences in terms of severe complication were detected (44.4% Clavien-Dindo 3-4-5 in < 70-year-old group vs 47.8% in ≥ 70-year-old group, P = 0.60). Within 90 postoperative days, 11 patients died, 6 in < 70-year-old group (11.3%) and 5 in ≥ 70-year-old group (21.7%), P = 0.29. The median follow-up was 20months. The death rate was 72.2% and 78.3% among patients < 70years old and ≥ 70years old. The OS at 2 and 5years was significantly higher among the < 70years old (57.0% and 27.7%) compared to the ≥ 70years old (27.1% and 13.6%), P = 0.043. Adjusting for hypertension and Charlson comorbidity index in a multivariate analysis, the HR for age was 1.93 (95% CI 0.84-4.44), P = 0.12. Relapse occurred in 43 (81.1%) patients in the < 70-year-old group and in 19 (82.6%) patients in the ≥ 70-year-old group. DFS at 12, 24, and 36months was, respectively, 59.6, 34.2, and 23.2 for the < 70 -year-old group and 32.5, 20.3, and 13.5 for the ≥ 70-year-old group (P = 0.26). Adjusting for hypertension and Charlson comorbidity index in a Cox model, the HR for age was 1.52 (95% CI 0.67-3.46), with P = 0.32.

 ≥ 70-year-old patients with PHCC can still be eligible for major liver resection with acceptable complication rates and should not be precluded a priori from a radical treatment.

 ≥ 70-year-old patients with PHCC can still be eligible for major liver resection with acceptable complication rates and should not be precluded a priori from a radical treatment.

Diabetes Mellitus (DM) plays an important role in aortic remodeling and alters the wall mechanics. The purpose of this study is to investigate and compare multi-directional failure properties of healthy and diabetic thoracic aortas.

Thirty adult rabbits (1.6-2.2 kg) were collected and type 1 diabetic rabbit model was induced by injection of alloxan. A total of 10 control and 20 diabetic (with different time exposure to diabetic condition) rabbit descending thoracic aortas were harvested. Uniaxial tensile (UT) and radial tension (RT) tests were performed to determine circumferential, axial and radial failure stresses of the control and diabetic aortas, which were further correlated with mass fractions (MFs) of collagen.

Throughout the UT test, there was a clear indication of anisotropic mechanical responses for some diabetic aorta specimens in the high loading domain. There was a trend towards an increase in the mean circumferential and axial failure stresses for the diabetic aortas when compared to the control aortas.