Recipient Side Research Articles

Evaluation of trabecular bone healing using fractal dimension analysis after augmentation of alveolar crests with autogenous bone grafts: a preliminary study.

The aim of this study is to evaluate bone remodeling after alveolar crest augmentation with autogenous bone grafts. 50 patients who were applied augmentation due to alveolar deficiency were included in this study. Fractal dimensions were measured on the radiographs in the preoperative, postoperative, follow-up periods. The ROI was selected specific to each patient, but repeated in a standardized manner on subsequent radiographs. A total of 50 patients were included in the study; There were 31 females and 19 males. Implants were placed in all patients without any complications. The mean fractal dimensions on the graft recipient side were statistically higher in the postoperative 5th month compared to the postoperative 1st week (p = 0.002). The mean fractal dimensions on the donor side were statistically higher in the preoperative and postoperative 5th month compared to the postoperative 1st week (p < 0.001). Any clinical imaging method cannot fully reflect the histological microstructures of the bone. Evaluating the fractal analysis together with the clinical results can demonstrate adequate bone healing and quality prior to implant placement. Fractal analysis is a non-invasive, reproducible, method but further, prospective, randomized, controlled clinical studies are needed to estimate bone quality prior to implant placement.

The Evolving Role of Ex Vivo Lung Perfusion during the COVID-19 Pandemic

PurposeThe novel coronavirus (COVID-19) pandemic presented unique challenges to lung transplant (LTx) programs. On the donor side, infection concerns resulted in a dramatic reduction in donor lung offers and raised the specter of viral transmission to procurement team members. On the recipient side, the need for pre-transplant COVID-19 testing and COVID free patient care units presented unprecedented logistical challenges. New indications for ex vivo lung perfusion (EVLP) also emerged, including logistics (e.g. providing adequate time for recipient COVID testing), and donor lung evaluation following 3rd party procurement. In this study, we defined the novel roles of EVLP that our LTx program developed during the COVI-19 pandemic.MethodsRetrospective analysis of adult LTx procedures performed at our institute from March 17th (when COVID restrictions began at our institute) through May 31st 2020, compared to LTx performed during the same period in 2019.ResultsDuring the study period, 17 LTx were performed. Eight of 17 were performed after EVLP evaluation, and 6 with EVLP back-up. Notably, the number of LTx after EVLP doubled vs. the same period in 2019, and the number of LTx cases with EVLP backup tripled (Figure 1A). Indications for EVLP in 4 LTx cases and 4 cases with EVLP backup were unique to pandemic conditions (Figure 1B). To date, no patients transplanted during this period, or team members tested positive for COVID-19, or are suspected of COVID infection post-LTx. 30-day survival was 100%, and incidence of primary graft dysfunction grades 0, 1, 2, and 3 at 72 hours post-transplant were 39%, 52%, 4%, and 4%, respectively. Median ventilation duration was 1 day.ConclusionMaintaining LTx activity with EVLP was feasible in the early phases of the COVID-19 pandemic. EVLP enabled our team to solve challenges with donor evaluation and logistics. By enabling donor assessment after local procurement, EVLP also increased the procurement team's safety. In the future, these newer EVLP indications may be applicable beyond the COVID-19 pandemic.

Brokering science, blaming culture: The US-South Korea ecological survey in the Demilitarized Zone, 1963-8.

This paper examines the planning, execution, and closure of the US-Korea Cooperative Ecological Survey project in the Korean Demilitarized Zone (DMZ) in the 1960s. In this period, the U.S. National Academy of Sciences (NAS) initiated bilateral scientific cooperation between the NAS and similar organizations in developing countries along the line of the developmental turn of U.S. foreign assistance. Working closely with the NAS, U.S. conservationists used this scheme to introduce nature conservation practices and the discipline of ecosystem ecology to developing countries. In this context, by way of the NAS's Pacific Science Board, two countries' biologists initiated the preliminary cooperative project in the DMZ in 1966. Korean and U.S. scientists soon began to realize that their collaboration was marked by dissonance. The U.S. side attributed the cooperation failure to Korean culture while the Korean side criticized the unequal structure of their cooperation. Joining the global historiography of Cold War scientific collaboration, this paper pays particular attention to the intermediaries of the collaborative project and their rivalry. It argues that political struggles revolving around the position of go-betweens - as what I call knowledge brokers - on the recipient side provoked contestation between American and Korean scientists. The contention between the two sides played out in the collaboration coming to an end, albeit partially. Throughout this analysis, this study suggests paying more serious attention to the politics of scientific exchange among actors on the recipient side as an outset from which to analyze the heterogeneity of the Korean side without losing sight of their active role in the building process of American hegemony.

Reversible Information Hiding Algorithm Based on Multikey Encryption

This paper proposes a scheme of reversible data hiding in encrypted images based on multikey encryption. There are only two parties that are involved in this framework, including the content owner and the recipient. The content owner encrypts the original image with a key set which is composed by a selection method according to the additional message. Thus, the image can be encrypted and embedded at the same time. Additional message can be extracted given that the recipient side could perform decryption strategy by exploiting spatial correlation; then, original image can be recovered without any loss. Compare with other current information hiding mechanism, the proposed approach provides higher embedding capacity and is also able to perfectly reconstruct the original image as well as the embedded message. Rate distortion of the proposed method outperforms the previously published ones.

Ethical Decision Diagrams on Donation After Cardiocirculatory Death Heart Transplantation Considering Organ Preservation Techniques.

Background.To overcome organ shortage, some centers accept hearts from cardiocirculatory determined death (DCD) donors for heart transplantation (HTx). DCD-HTx is attached with special ethical conflicts on the donor, family, and recipient side. Ethically motivated decisions also have to be made considering organ preservation techniques. However, ethical decision diagrams, which can be applied to find a final answer on the complex field of ethical questions, have not been developed yet.Methods.In an interdisciplinary group of clinical ethicists, transplantation surgeons, transplantation researchers, and perfusionists, after review of relevant literature, we focused on crucial ethical aspects on DCD-HTx in general and separated ethical conflicts with regard to the individual perspective of the donor, family, and recipient.Results.The leading aspect of discussion in the donor perspective mainly deals with the standoff period and with the definition of death. The perspective of recipients focuses on the wish to say farewell after the patient is deceased. In the recipient perspective ethical questions regarding organ procurement techniques occur.Conclusions.Ethical decision-making on DCD-HTx is complex, but it can be processed in a structured way by applying the decision diagrams that we have developed.

Backlash against naming and shaming: The politics of status and emotion

The most prominent approach to promoting human rights features the naming and shaming of perpetrators of abuses and those who abet them, including the tactic of ranking non-compliant states relative to their peers to undermine their international status. Neither activists nor the scholars who study them have paid much attention to the emotional dynamics of the targeted group, and in particular to the emotions of shame and shaming, nor to the sociological mechanisms that underpin the politics of status and status competition. This article draws upon relatively ignored, yet mainstream theoretical literatures in psychology, social psychology, and sociology in arguing that naming and shaming tactics often lead to backlash by those who are targeted. Transnational human rights advocacy commonly appeals to the norms of exporting society. On the recipient side, this external outrage plays into the hands of elites in a traditional power structure, drawing energy from outrage at loss of status in a way that motivates widespread popular backlash. The backlash narrative alters public discourse, reinvigorates and reshapes traditional institutions, and in these ways locks in and perpetuates patterns that leave the progressive namers and shamers farther from their goals. Beyond arguing that this is a common pattern, I will also investigate the conditions and tactics that are less likely to spur counterproductive backlash.

Twin anemia–polycythemia sequence in sex‐discordant monochorionic dizygotic twins

The possibility of monochorionic (MC) dizygotic (DZ) twins was first raised in 1970. As MC sex-discordant twins are rarely observed, MCDZ twins are seldom recognized clinically. Conception by assisted reproductive technology (ART) is associated with an increased frequency of MC diamniotic (DA) twins, with more than 50% of reported MCDZ twins conceived by ART1. With the increased use of ART, it is therefore reasonable to expect that the incidence of MCDZ twins may increase. MC twins share a single placenta and are connected by the placental circulation. They are at risk of transfusion imbalance in this circulation, which may lead to twin–twin transfusion syndrome (TTTS) or twin anemia–polycythemia sequence (TAPS). The diagnosis of TTTS at an early stage is based on discordant amniotic fluid volume. Currently, the diagnosis of TAPS is based on increased middle cerebral artery peak systolic velocity (MCA-PSV) in the donor twin (> 1.5 MoM) and decreased MCA-PSV in the recipient twin (< 1 MoM)2. Postnatally, TAPS can be diagnosed based on an intertwin hemoglobin difference of > 8 g/dL and at least one of the following criteria: (1) reticulocyte count ratio > 1.7; and (2) presence of only small vascular anastomoses on placental examination3. We report a case of TAPS diagnosed prenatally in a MCDZ twin pregnancy. A 32-year-old woman with a spontaneously conceived pregnancy was diagnosed with a MCDA twin gestation at 14 weeks by ultrasound. Sex discordance was noted on the fetal anatomy survey and was suggested on cell-free fetal DNA screening. Sex discordance was confirmed postnatally. A diagnosis of TAPS was suspected at 28 + 6 weeks based on MCA-PSV (1.65 MoM in the donor and 0.48 MoM in the recipient), and worsening of TAPS, with a new finding of placental echogenicity discordance between the donor and recipient sides, was suspected at 30 + 6 weeks (Figure 1). The patient was delivered at 31 + 2 weeks, following administration of corticosteroids and magnesium sulfate for neuroprotection, due to worsening of TAPS. TAPS was confirmed postnatally. Hemoglobin was 25.2 g/dL in the recipient twin and 7.5 g/dL in the donor twin. Reticulocyte count ratio (donor/recipient twin) was 14.7. Monochorionicity was confirmed by pathological examination. In TAPS, the placenta may have a discordant ultrasound appearance (hyperechoic on the donor twin side and hypoechoic on the recipient twin side) and a color difference on gross examination (pale appearance on the donor twin side and dark purple appearance on the recipient twin side)4. The current case demonstrated these findings (Figures 1 and 2). Although a case of TAPS in MCDZ twins was reported recently in a spontaneously delivered pregnancy in which the diagnosis was made postnatally5, we report what we believe to be the first case of TAPS in MCDZ twins that was diagnosed prenatally. Our report demonstrates that discordant MCA-PSV measurements and placental echogenicity differences in MC twin pregnancy are objective ultrasound findings that may indicate a developing and worsening status of TAPS in MCDZ twins. It is important to recognize that MCDZ twin gestations exist. Early determination of chorionicity during the first trimester with confirmation of fetal sex in the second trimester is the key in identifying a MCDZ twin gestation.

RETRACTED ARTICLE: A stable image steganography: a novel approach based on modified RSA algorithm and 2–4 least significant bit (LSB) technique

Nowadays, due to the rapid technological growth of information technology billions of data transferred through the network around the world in a fraction of seconds. To protect the transferred information from unauthorized access, security mechanism is required. At this point, significant role is performed by a technology called information security. So, to provide security, various techniques have been evolved such as cryptography, steganography and digital watermarking. Cryptography converts the message into scrambled format whereas in steganography the secret message is buried in the digital media. In this paper, both cryptography and steganography is combined to safeguard the information. First, the message is encrypted with the help of revised RSA algorithm to convert the message into secret message. Second, the cover image is segmented into edge and non-edge pixels using Canny edge detection technique and then N1(two) and N2 (four) bits of the secret messages are buried into the edge and non-edge pixel areas using LSB technique. Finally, the essential parameters like N1, N2 and the length values are implanted into the last four pixels of the cover-image to obtain the stego-image. At the recipient side, the hidden data are extracted from the stego-image after extracting N1, N2 and length information. Then, the extracted secret data is decrypted using revised RSA algorithm. Modified RSA algorithm improves the security by using two pairs of keys. At last, the various performance metrics parameters such as entropy, MSE, peak signal to noise ratio and histogram are measured. It is observed that the proposed system attains improved efficiency, security and imperceptibility properties of information hiding from the results.

Redefining the Supply Chain Model on the Milicz Carp Market

The growing demand for cheap food is a key factor in maintaining long supply chains. Increasing the distance between the producer and the consumer results not only in certain problems in maintaining profitability by small, local producers, but also in a threat to food safety. One way to counteract these adverse effects is to sell food through short supply chains. They shape the market in the direction of maintaining care for the sustainable development of all food production, but above all, maintaining and strengthening the production capacity ensuring the transparency of the high-quality food production process from an identifiable source of origin. The purpose of this article is to indicate the conditions on the side of both carp producers and consumers, conducive to building short supply chains, and determine whether they can be an effective alternative sales model in Polish conditions. The article focuses on the possibilities of developing short supply chains on the carp market in the Barycz Valley, concentrating the largest area of carp ponds in Europe. The research (surveys) included the five largest fishing farms and, on the recipient side, individual consumers and restaurants located in the Barycz Valley and Wrocław, and agritourism facilities in the researched area. The obtained results confirmed that short supply chains in the area of Polish aquaculture are characterized by high implementation potential. However, it is necessary to modify the current sales model so that the producers’ expectations regarding the sales volume and the obtained price are balanced with the expectations of consumers articulating the will to buy fish at a given time, place, and price. This, in turn, will ensure the high economic efficiency of fishing farms, and consumers will have access to a high-quality product.

Trans-regional power trading optimization for promoting clean energy accommodation

A trading decision-making method that uses electricity market means to promote clean energy accommodation is proposed. Making Ml use of load difference, peak-to-valley difference and time difference, a joint optimization model of clean energy purchasing-selling-transmission is established to promote clean energy accommodation, which considers the willingness of the recipient side, and satisfies the physical operation constraints of DC line. The model can set the power curve shape, in order to realize the lean decision of cross-regional trading power, and propose a practical accommodation plan. Based on the calculation of cross-regional power transactions between two regions in China, the validity of the model and scheme is verified.

Implementation Processes of Social Protection Policy in Indonesia: Study of Prakerja Card Program

In recent decades, in Indonesia, there have been many social protection policies as social and political agendas that are not public knowledge in the form of “Kartu Sakti”. One of the magic cards that are very popular during the COVID-19 pandemic is the Prakerja card. The purpose of this paper is to analyze the process of implementing the Grindle theory (2017) involving interest actors. The research method was carried out qualitatively by using secondary data which was analyzed in depth. The results show that the grindle theory includes Content of Policy and Content of Implementation in the social protection policy implementation process of the Prakerja card program, there are problems and are difficult to implement properly by the implementers, this causes the real purpose of social protection policies has not shown the impact on community welfare during the COVID -19 pandemic compared to other social protection policy programs on target. in addition, the actors of the Prakerja card program have different interests and goals from both the implementor and the recipient side. The Indonesian government is obliged to evaluate and take strategic and regulatory action in the form of pra Kerja program innovation as a long-term priority scale to avoid any gap in the process of implementing social protection policies that adversely affect the welfare of the Indonesian community.

Secured Video Transmission Using Encryption by MD5

Advances in computerized substance transmission have expanded in the previous couple of years. Be that as it may, Security and protection issues of the transmitted information have turned into an imperative worry in mixed media innovation. The paper displays a computationally capable and secure video encryption approach with usage of appropriated and parallel condition. The paper expects to make secure video encryption practical for constant applications with no additional committed equipment at recipient side. Verifying is a major testing assignment especially with respect to affirmation of privacy, confirmation and uprightness. Writing indicates utilization of cryptography and steganography to verify distinctive types of computerized information. The wide utilization of correspondence utilizing Internet has encouraged sharing of content as well as sound and video posts in a less difficult way. A standard encryption calculation is particularly material for content and twofold information yet neglects to deal with voluminous video information. An endeavor has been made in the paper to verify recordings utilizing keyed hash calculations. Experimentation unmistakably uncovered the advantages of the proposed plan regarding guaranteeing trustworthiness and realness without trade off in nature of the video.

Supporting Policy Reform from the Outside

AbstractSound economic and social policies are important if countries wish to prosper and achieve sustainable development. It is far from guaranteed, however, that policymakers select and implement good policies, which provides a rationale for external policy support. Indeed, many organizations are engaged in supporting policy reform processes in recipient countries. This study investigates the limits and opportunities of supporting policy reform by focusing on four dimensions of support: conditional financing, policy dialogue, technical evidence and political institutions. Four findings follow from a review of the literature. First, without commitment on the recipient side, conditional financing is unlikely to induce policy reform. Second, when external actors acquire a seat at the policy dialogue table, it is important to detect (and influence) the beliefs policymakers hold. Third, outside parties should bring sound evidence to the table about the costs, benefits, and effectiveness of their policy proposals. Finally, supporting changes in political institutions without considering general equilibrium effects can be counterproductive. The study concludes with a discussion and some avenues for future research in this field.

Speech Recognition Bot

Voice Controlled Bot (VCB) is a flexible bot whose gesture can be supervised by the authority using specific voice instructions. An Android device is used as a microphone. A Speech to Text conversion application for the recognition of voice signal is developed. This app is connected to the Bluetooth module contained in the bot. The Bluetooth module sends the command message to the robot’s microcontroller. The microcontroller inspects the message and takes suitable actions. The aim is to implement a bot which is controlled by servo motors. The Speech Recognition Unit in the application converts the voice commands into digital signals. These text instructions are transmitted to the bot. On the recipient side, the Bluetooth module receives the command from the transmitter side and then carries out the respective functions. The Hardware microcontroller employed here is AT89s52. The voice recognition unit performs alone without the intelligence of the bot. The best part is that, it does not involve bot's main intelligence power. The software work is done in Keil software using Embedded C.

Robust digital watermarking for color images in combined DFT and DT-CWT domains.

Image watermarking focuses on hiding secret data into the cover image imperceptibly to protect the copyright of the original image. In this paper, we propose a new framework of robust digital watermarking for color images using combined embedding techniques of Discrete Fourier Transform (DFT) and Dual Tree Complex Wavelet Transform (DTCWT). The cover image is first divided into Y, U and V channels. The Y channel is then transformed by DFT and partitioned into the ring shapes. With an embedding key, we generate pseudo-random patterns to represent the watermark. These patterns are also transformed and partitioned. The watermark represented by the selection of patterns is then embedded into the rings of the DFT coefficients. We further embed a rectification watermark into the U channel, in which DTCWT is applied to achieve a capability of geometric distortion resilience. On the recipient's side, the detection and extraction of watermark can be successfully done. Compared with previous schemes, the proposed method is better on preserving the image quality. Meanwhile, the robustness against typical attacks is also stronger.

Reversible Data Hiding With Image Enhancement Using Histogram Shifting

Traditional reversible data hiding (RDH) focuses on enlarging the embedding payloads while minimizing the distortion with a criterion of mean square error (MSE). Since imperceptibility can also be achieved via image processing, we propose a novel method of RDH with contrast enhancement (RDH-CE) using histogram shifting. Instead of minimizing the MSE, the proposed method generates marked images with good quality with the sense of structural similarity. The proposed method contains two parts: the baseline embedding and the extensive embedding. In the baseline part, we first merge the least significant bins to reserve spare bins and then embed additional data by a histogram shifting approach using arithmetic encoding. During histogram shifting, we propose to construct the transfer matrix by maximizing the entropy of the histogram. After embedding, the marked image containing additional data has a larger contrast than the original image. In the extensive embedding part, we further propose to concatenate the baseline embedding with an MSE-based embedding. On the recipient side, the additional data can be extracted exactly, and the original image can be recovered losslessly. Comparing with existing RDH-CE approaches, the proposed method can achieve a better embedding payload.

Living donor liver transplantation using left trisection graft with caudate lobe

Summary Background: Due to small remnant volume or anatomical variation, a right liver graft may be precluded in adult living donor liver transplantation (LDLT). Right posterior section, right anterior section graft, or dual donor grafts have been proposed as alternative grafts of right and left liver grafts. Here, we report a case of LDLT using left trisection graft with caudate lobe. Methods: The recipient was a 55-years old female with hepatitis B virus associated liver cirrhosis. The donor had a type III portal vein (PV) anomaly. Donor’s right hepatic artery (HA) was extrahepatically divided into right anterior and posterior HA and left HA was originated from left gastric artery. Preoperative cholangiography showed trifurcation of bile duct. Left trisection graft with caudate lobe was measured 620 gram that was 0.88% of graft to recipient weight ratio. Results: With J shaped incision, hilar dissection of the donor was performed to isolate the left and right anterior and posterior branches of the HA and PV. Then, the liver was transected in a plane that was demarcated on the liver surface, temporarily occluding the right posterior branch of the HA and PV. We encountered 1 PV opening, 1 hepatic vein opening, 3 HAs, and 3 bile duct openings in the left trisection graft with caudate lobe that were safely anastomosed in the recipient. There was no complication in donor and recipient side after operation. Conclusions: Although it was a complex operation, left trisection graft with caudate lobe might be a feasible option for special situations involving donors unsuitable for right liver donation.

Separable Reversible Data Hiding in Encrypted JPEG Bitstreams

While most techniques of reversible data hiding in encrypted images (RDH-EI) are developed for uncompressed images, this paper provides a separable reversible data hiding protocol for encrypted JPEG bitstreams. We first propose a JPEG encryption algorithm, which enciphers an image to a smaller size and keeps the format compliant to JPEG decoder. After a content owner uploads the encrypted JPEG bitstream to a remote server, a data hider embeds an additional message into the encrypted copy without changing the bitstream size. On the recipient side, the original bitstream can be reconstructed losslessly using an iterative recovery algorithm based on the blocking artifact. Since message extraction and image recovery are separable, anyone who has the embedding key can extract the message from the marked encrypted copy. Experimental results show that the proposed method outperforms a previous work in terms of separation capability, embedding capacity and security.

Extraluminal Recanalization of Bile Duct Anastomosis Obstruction after Liver Transplantation

This report describes extraluminal recanalization of bile duct anastomosis obstruction after living donor liver transplantation. The procedure was performed in 5 patients in whom negotiation of the biliary anastomotic obstruction by retrograde endoscopic approach and percutaneous intraluminal recanalization had failed. Extraluminal puncture from the donor bile duct to the recipient side bile duct was made with the stiff back end of a 0.035-inch hydrophilic guide wire. After recanalization, a percutaneous transhepatic biliary drainage catheter was placed through the created tract. In all 5 patients, extraluminal recanalization was achieved without major complication, and endoscopic plastic stents were subsequently placed along the tract.

Causes of Ineligibility for Recipients in Living Kidney Transplantation

BackgroundEven if a living donor candidate exists, there are some cases that do not result in kidney transplantation (KTx) due to problems on the recipient side. The aim of this study was to clarify causes of ineligibility for KTx in these cases, so as to make RTx more applicable for patients. MethodsWe targeted 470 patients with end-stage renal disease who applied for the primary kidney KTx from 2010 to 2012. Then we selected those who were not applicable for KTx and investigated recipient causes of ineligibility for KTx or not receiving KTx. ResultsThe average age of recipients was 47.6 ± 12.9 (7–82) years. A majority of the 470 patients were male (n = 305, 64.9%). Two hundred ninety-seven patients intended to receive a living donor KTx and the others hoped for a deceased donor KTx. Of the 297 patients, 207 (70.0%) underwent KTx and 9 (1.9%) were being prepared for KTx at the time of the survey. Eighty-three patients (27.9%) did not receive a living KTx, with 59 of these due to recipient-related problems and 30 due to donor-related problems. We further classified the reasons for these 59 recipients not undergoing KTx as follows: (1) unclear reasons (35.6%); (2) insufficient intention to receive transplant (13.6%); (3) heart disease (10.2%); (4) malignancy (8.5%); (5) immunologic risks (5.1%); (6) death during the waiting period (5.1%); (7) cerebrovascular events (5.1%); (8) cardiovascular problems (5.1%); (9) psychiatric disorders (3.4%); and (10) infections (3.4%). ConclusionNearly 50% of the reasons for ineligibility as a recipient were related to their intention to receive KTx, with 94.9% of the nontransplanted cases due to nonimmunologic reasons. Thanks to the recent advances in immunosuppressive therapy, there were only 3 patients who could not undergo KTx due to immunologic risks. Based on these results, transplant surgeons should not only emphasize physical evaluation but should also pay careful attention to the recipient's intention to receive KTx.