• Nyborg Spence posted an update 6 months ago

    Finally the simulation results demonstrate the high efficiency and strong robustness of our method.As a typical frequency-domain analysis method, quaternion discrete Fourier transform (QDFT) has been widely used in information hiding in color images. However, due to the sensitivity of QDFT to geometric attacks, existing QDFT-based information hiding schemes have limited ability in resisting geometric attacks. In this study, a kind of novel geometrically resilient polar QDFT (PQDFT) is constructed and the properties of the proposed PQDFT are analyzed. read more Subsequently, a PQDFT-based color image zero-hiding scheme robust to geometric attacks is proposed for lossless copyright protection of color images, which experimentally shows reasonable resistance against geometric and common attacks, indicating better robustness compared with the existing QDFT-based information hiding schemes and other leading-edge zero-hiding schemes.

    The Enhanced Recovery Program after surgery is a multimodal, evidence-based protocol of care developed to minimize the response to surgical stress. Data on the influence of ERP on outcomes, particularly according to the complexity of liver surgery, are lacking.

    A prospective multicenter cohort of patients undergoing liver surgery and exposed to Enhanced Recovery Program from 2016 to 2020 in France was analyzed. High Enhanced Recovery Program compliance was defined as more than 70% of items (15 out of 21). The outcomes were the rate of complications, length of stay, and functional recovery according to Enhanced Recovery Program compliance.

    A total of 297 patients were included in the study, and they had 61.9% overall compliance (median= 13 items, interquartile range 11-15). Complications were observed in 32.2% (n= 95) of cases, and the mean length of hospital stay was 7.28 (±7.15) days overall. A longer duration of liver surgery was associated with an increase in the complication rate, while high compliance was independently associated with a reduced risk of complications in the multivariable analysis.

    High Enhanced Recovery Program compliance was associated with a lower rate of postoperative complexity.

    High Enhanced Recovery Program compliance was associated with a lower rate of postoperative complexity.

    The Emergency Surgery Score was recently validated in a prospective multicenter study as an accurate predictor of mortality in emergency general surgery patients. The Emergency Surgery Score is easily calculated using multiple demographic, comorbidity, laboratory, and acuity of disease variables. We aimed to investigate whether the Emergency Surgery Score can predict 30-day postoperative mortality across patients undergoing emergency surgery in multiple surgical specialties.

    Our study is a retrospective cohort study using data from the national American College of Surgeons National Surgical Quality Improvement Program database (2007-2017). We included patients that underwent emergency gynecologic, urologic, thoracic, neurosurgical, orthopedic, vascular, cardiac, and general surgical procedures. The Emergency Surgery Score was calculated for each patient, and the correlation between the Emergency Surgery Score and 30-day mortality was assessed for each specialty using the c-statistics methodology.

    Of 6,4edicts mortality across patients undergoing emergency surgery in multiple surgical specialties, especially general, gynecologic, and urologic surgery. The Emergency Surgery Score can prove useful for perioperative patient counseling and for benchmarking the quality of surgical care.

    To validate the Institut Mutualiste Montsouris classification as a difficulty scoring system applicable to laparoscopic repeat liver resections and identify risk-factors of unexpected difficulty.

    From a prospectively collected database between 2000 and 2019, patients undergoing laparoscopic repeat liver resections were classified according to the Institut Mutualiste Montsouris classification. Doubly robust estimators (weighted regressions) were used to assess the effect of factors on intra- and postoperative outcomes and allowed for strong adjustment on age, body mass index, American Society of Anesthesiologists, carcinoembryonic antigen, number, and size of lesions. Unexpected difficulty was defined as a composite indicator which included substantial blood loss and/or substantial operative time and/or conversion.

    Of 205 laparoscopic repeat liver resections patients, 87, 25, and 93 procedures were classified as grade 1, 2, and 3 laparoscopic repeat liver resections, respectively. After doubly robust adjn and presence of sinusoidal obstruction syndrome are likely to jeopardize the outcomes.

    The Institut Mutualiste Montsouris classification is a valuable difficulty scoring system for laparoscopic repeat liver resections procedures, while previous major resection and presence of sinusoidal obstruction syndrome are likely to jeopardize the outcomes.Low-risk individuals still experience adverse cardiac events. We sought to evaluate long-term cardiac events and predictors for subclinical coronary atherosclerosis in subjects without indication for statin therapy. We analyzed 3,272 individuals without indication for statin therapy who voluntarily underwent coronary computed tomography angiography as part of a general health examination. A cardiac event was defined as a composite of cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, or late coronary revascularization. The prevalence of normal coronary arteries, nonobstructive coronary artery disease (CAD) (diameter stenosis less then 50%), and obstructive CAD (diameter stenosis ≥50%) was 2,338 (71.5%), 809 (24.7%), and 125 (3.8%), respectively. During the follow-up period (median 5.3 years), the 6-year event-free survival rates were 99.2%±0.2% in subjects with normal coronary arteries, 98.2%±0.6% in those with nonobstructive CAD, and 90.2%±2.7% in those with obstructive CAD (log-rank p less then 0.001). Multivariable regression analysis showed that low-density lipoprotein cholesterol (LDL-C, odds ratio 1.012; 95% confidence interval (CI) 1.005-1.019) and high-density lipoprotein cholesterol (HDL-C, OR 0.968; 95% CI 0.952-0.984) levels were associated with subclinical obstructive CAD, together with age (OR 1.080; 95% CI 1.040-1.121) and male sex (OR 3.102; 95% CI 1.866-5.155) (all p less then 0.05). In conclusion, LDL-C and HDL-C are significantly associated with the presence of subclinical obstructive CAD with a worse prognosis in subjects without indication for statin therapy. These findings suggest that stricter control of LDL-C and HDL-C levels may be necessary for primary prevention even in a relatively low-risk population.

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