The Experts below are selected from a list of 17205 Experts worldwide ranked by ideXlab platform
Shaheen Hamdy - One of the best experts on this subject based on the ideXlab platform.
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oropharyngeal dysphagia manifestations and diagnosis
Nature Reviews Gastroenterology & Hepatology, 2016Co-Authors: Nathalie Rommel, Shaheen HamdyAbstract:Swallowing disorders (dysphagia) have been recognized by the WHO as a medical disability associated with increased morbidity, mortality and costs of care. With increasing survival rates and ageing of the population, swallowing disorders and their role in causing pulmonary and nutritional pathologies are becoming exceedingly important. Over the past two decades, the study of oropharyngeal dysphagia has been approached from various disciplines with considerable progress in understanding its pathophysiology. This Review describes the most frequent manifestations of oropharyngeal dysphagia and the clinical as well as instrumental techniques that are available to diagnose patients with dysphagia. However, the clinical value of these diagnostic tests and their sensitivity to predict outcomes is limited. Despite considerable clinical research efforts, conventional diagnostic methods for oropharyngeal dysphagia have limited proven accuracy in predicting aspiration and respiratory disease. We contend that incorporation of Measurable Objective assessments into clinical diagnosis is needed and might be key in developing novel therapeutic strategies.
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Oropharyngeal dysphagia: manifestations and diagnosis
Nature Reviews Gastroenterology & Hepatology, 2016Co-Authors: Nathalie Rommel, Shaheen HamdyAbstract:Swallowing disorders (dysphagia) have been recognized by the WHO as a medical disability associated with increased morbidity, mortality and costs of care. With increasing survival rates and ageing of the population, swallowing disorders and their role in causing pulmonary and nutritional pathologies are becoming exceedingly important. Over the past two decades, the study of oropharyngeal dysphagia has been approached from various disciplines with considerable progress in understanding its pathophysiology. This Review describes the most frequent manifestations of oropharyngeal dysphagia and the clinical as well as instrumental techniques that are available to diagnose patients with dysphagia. However, the clinical value of these diagnostic tests and their sensitivity to predict outcomes is limited. Despite considerable clinical research efforts, conventional diagnostic methods for oropharyngeal dysphagia have limited proven accuracy in predicting aspiration and respiratory disease. We contend that incorporation of Measurable Objective assessments into clinical diagnosis is needed and might be key in developing novel therapeutic strategies. Oropharyngeal dysphagia is a common disability that can manifest in a variety of ways Respiratory complications and psychosocial issues are often unrecognized in patients with oropharyngeal dysphagia Videofluoroscopy and fibreoptic endoscopic evaluation of swallowing are the current gold-standard investigations for oropharyngeal dysphagia Despite considerable effort, these conventional diagnostic methods have limited proven accuracy in predicting aspiration and respiratory disease Emerging evidence shows that novel techniques such as high-resolution manometry with impedance, functional lumen imaging probe and accelerometry could have a role in the diagnosis of oropharyngeal dysphagia Incorporation of Measurable Objective assessments into clinical diagnosis is needed and could reveal subtle abnormalities that are key to distinguish pathology of oropharyngeal dysphagia and develop new therapeutic strategies Oropharyngeal dysphagia is a common swallowing disorder. In this Review, Rommel and Hamdy describe the most frequent manifestations of oropharyngeal dysphagia, including potential causes and complications. They also provide a comprehensive overview of the techniques available to diagnose this condition.
Nathalie Rommel - One of the best experts on this subject based on the ideXlab platform.
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oropharyngeal dysphagia manifestations and diagnosis
Nature Reviews Gastroenterology & Hepatology, 2016Co-Authors: Nathalie Rommel, Shaheen HamdyAbstract:Swallowing disorders (dysphagia) have been recognized by the WHO as a medical disability associated with increased morbidity, mortality and costs of care. With increasing survival rates and ageing of the population, swallowing disorders and their role in causing pulmonary and nutritional pathologies are becoming exceedingly important. Over the past two decades, the study of oropharyngeal dysphagia has been approached from various disciplines with considerable progress in understanding its pathophysiology. This Review describes the most frequent manifestations of oropharyngeal dysphagia and the clinical as well as instrumental techniques that are available to diagnose patients with dysphagia. However, the clinical value of these diagnostic tests and their sensitivity to predict outcomes is limited. Despite considerable clinical research efforts, conventional diagnostic methods for oropharyngeal dysphagia have limited proven accuracy in predicting aspiration and respiratory disease. We contend that incorporation of Measurable Objective assessments into clinical diagnosis is needed and might be key in developing novel therapeutic strategies.
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Oropharyngeal dysphagia: manifestations and diagnosis
Nature Reviews Gastroenterology & Hepatology, 2016Co-Authors: Nathalie Rommel, Shaheen HamdyAbstract:Swallowing disorders (dysphagia) have been recognized by the WHO as a medical disability associated with increased morbidity, mortality and costs of care. With increasing survival rates and ageing of the population, swallowing disorders and their role in causing pulmonary and nutritional pathologies are becoming exceedingly important. Over the past two decades, the study of oropharyngeal dysphagia has been approached from various disciplines with considerable progress in understanding its pathophysiology. This Review describes the most frequent manifestations of oropharyngeal dysphagia and the clinical as well as instrumental techniques that are available to diagnose patients with dysphagia. However, the clinical value of these diagnostic tests and their sensitivity to predict outcomes is limited. Despite considerable clinical research efforts, conventional diagnostic methods for oropharyngeal dysphagia have limited proven accuracy in predicting aspiration and respiratory disease. We contend that incorporation of Measurable Objective assessments into clinical diagnosis is needed and might be key in developing novel therapeutic strategies. Oropharyngeal dysphagia is a common disability that can manifest in a variety of ways Respiratory complications and psychosocial issues are often unrecognized in patients with oropharyngeal dysphagia Videofluoroscopy and fibreoptic endoscopic evaluation of swallowing are the current gold-standard investigations for oropharyngeal dysphagia Despite considerable effort, these conventional diagnostic methods have limited proven accuracy in predicting aspiration and respiratory disease Emerging evidence shows that novel techniques such as high-resolution manometry with impedance, functional lumen imaging probe and accelerometry could have a role in the diagnosis of oropharyngeal dysphagia Incorporation of Measurable Objective assessments into clinical diagnosis is needed and could reveal subtle abnormalities that are key to distinguish pathology of oropharyngeal dysphagia and develop new therapeutic strategies Oropharyngeal dysphagia is a common swallowing disorder. In this Review, Rommel and Hamdy describe the most frequent manifestations of oropharyngeal dysphagia, including potential causes and complications. They also provide a comprehensive overview of the techniques available to diagnose this condition.
Simon M. Lucas - One of the best experts on this subject based on the ideXlab platform.
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CIG - Ms Pac-Man versus ghost-team competition
2009 IEEE Symposium on Computational Intelligence and Games, 2009Co-Authors: Simon M. LucasAbstract:Ms. Pac-Man is a challenging and interesting game that is usually viewed form the perspective of the Ms. Pac-Man agent. The game is also provides an excellent environment for testing multi-agent strategies for controlling the team of ghosts, with the aim either of optimising the playability of the game, or simply to minimise the score obtained by the agent. It is this latter more Measurable Objective that provides the focus of this competition. For this purpose an efficient simulator of the game has been developed with simple software interfaces with which to connect your controllers. The screenshot below shows a game in progress on the simulator. You can enter an agent controller or a ghost-team controller (or even both). The aim of the Ms. Pac-Man agent is to score as many points as possible. The aim of the ghost team controller is to prevent this!
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CIG - Screen-capture Ms Pac-Man
2009 IEEE Symposium on Computational Intelligence and Games, 2009Co-Authors: Simon M. LucasAbstract:Ms. Pac-Man is a challenging and interesting game that is usually viewed form the perspective of the Ms. Pac-Man agent. The game also provides an excellent environment for testing multi-agent strategies for controlling the team of ghosts, with the aim either of optimising the playability of the game, or simply to minimise the score obtained by the agent. It is this latter more Measurable Objective that provides the focus for this competition. For this purpose an efficient simulator of the game has been developed with simple software interfaces with which to connect your controllers. The screenshot below shows a game in progress on the simulator. You can enter an agent controller or a ghost-team controller (or even both). The aim of the Ms. Pac-Man agent is to score as many points as possible. The aim of the ghost team controller is to prevent this!
Babita Thapa - One of the best experts on this subject based on the ideXlab platform.
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Status of Scar in Repeat Cesarean Section in a Tertiary Hospital
Journal of Lumbini Medical College, 2016Co-Authors: Subha Shrestha, Raju Prasad Shakya, Buddhi Kumar Shrestha, Narinder Kaur, Babita ThapaAbstract:Introduction: In modern Obstetrics, with rising trends of primary cesarean section (CS) for fetal and maternal interests, pregnancy over the scarred uterus is a challenge to all treating obstetricians. Despite the method of suturing of the cesarean scar, its fate in next pregnancy is still not Measurable. Objective of this study was to evaluate the status of previous cesarean scar during repeat cesarean section (RCS) and calculate the maternal morbidity in those cases in a tertiary hospital. Methods: It was a descriptive, retrospective study conducted at department of Obstetrics of Lumbini Medical College Teaching Hospital. The study was conducted from 15th July 2014 to 14thJuly 2015. The data were retrieved from the department of Medical Records. Women undergoing RCS were enrolled. The status of scar was evaluated in terms of intact scar, scar rupture, scar dehiscence, thin lower uterine segment, scar placenta previa, and adhesions as indicator of scar integrity. Results: There were 534 (25.4%) CS among 2,098 deliveries during the study period. Ninety one (17.04%) of them were RCS. Elective RCS were 73.6% (n=67), and emergency RCS were 26.4% (n=24). Eighty two (90.1%) women had RCS once and nine (9.9%) had RCS for second time. Scar was intact in 22 (91.6%), scar dehiscence in one (8.3%), scar with adhesions in one (8.3%) among emergency RCS and intact in 53 (91.3%) and scar with adhesions in five (8.7%) among elective RCS. There was no scar dehiscence and no scar rupture in two RCS women. Adhesions were documented twice higher in women whose primary CS was undertaken outside our hospital. Placenta previa and placenta accreta each were found in two cases. Conclusion : Most of the scars of repeat cesarean section were healthy with no scar rupture. We can consider trial of labor for scarred uterus with strict vigilance and in need, CS is always an option. DOI: https://doi.org/10.22502/jlmc.v4i1.84 J. Lumbini. Med. Coll. Vol 4, No 1, Jan-June 2016, page: 42-45
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Status of Scar in Repeat Cesarean Section in a Tertiary Hospital
Lumbini Medical College, 2016Co-Authors: Subha Shrestha, Buddhi Kumar Shrestha, Narinder Kaur, Raju Shakya, Babita ThapaAbstract:Introduction: In modern Obstetrics, with rising trends of primary Cesarean section (CS) for fetal and maternal interests, pregnancy over the scarred uterus is a challenge to all treating obstetricians. How better the cesarean scar is sutured, its exact fate in next pregnancy is still not Measurable. Objective of this study was to evaluate the status of previous cesarean scar during repeat cesarean section (RCS) and calculate the maternal morbidity in those cases in a tertiary hospital. Methods: It was a descriptive, retrospective study conducted at department of Obstetrics of Lumbini Medical College Teaching Hospital. The study was conducted from 15th July 2014 to 14th July 2015. The data were retrieved from the department of Medical Records. Women undergoing RCS were enrolled. The status of scar was evaluated in terms of intact scar, scar rupture, scar dehiscence, thin lower uterine segment, scar placenta previa, and adhesions as indicator of scar integrity. Results: There were 534 (25.4%) CS among 2,098 deliveries during the study period. Ninety one (17.04%) of them were RCS. Elective RCS were 73.6% (n=67), and emergency RCS were 26.4% (n=24). Eighty two (90.1%) women had RCS once and 9 (9.9%) had RCS for second time. Scar was intact in 22 (91.6%), scar dehiscence in 1 (8.3%), scar with adhesions in 1 (8.3%) among emergency RCS and intact in 53 (91.3%) and scar with adhesions in 5 (8.7%) among elective RCS. Among nine women of two RCS, three (37.5%) had thin scar, five (62.5%) had well formed scar, seven (87.5%) had intact scar, and one (12.5%) had scar with adhesion. There was no scar dehiscence and no scar rupture in two RCS women. Adhesions were documented twice higher in women whose primary CS was undertaken outside our hospital. Placenta previa and placenta accreta each were found in two cases. Conclusion: Most of the scars of repeat Cesarean section were healthy with no scar rupture. We can consider trial of labor for scarred uterus with strict vigilance and in need, CS is always at option
Jesper Madsen - One of the best experts on this subject based on the ideXlab platform.
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Stakeholder Perspectives and Values when Setting Waterbird Population Targets: Implications for Flyway Management Planning in a European Context
PloS one, 2013Co-Authors: James Williams, Jesper MadsenAbstract:Managing and controlling wildlife species within Europe is an acknowledged part of conservation management, yet deciding and setting a population target in order to control a population is perceived to be conceptually very challenging. We interviewed stakeholders, within a variety of governmental and non-governmental organizations, to evaluate their perspectives about setting population targets as part of waterbird management for controlling population sizes. We conclude that the setting of a quantifiable population target is beneficial as a Measurable Objective for monitoring and evaluating management actions. However, it must be recognised as just one possible Measurable Objective and there may well be multiple supporting Objectives that encapsulate the management aims of different stakeholders. When considering wide-scale control of waterbirds species, where it is likely that population size matters, any population target should be coupled to the issues being addressed. We highlight that it is important to actively engage with stakeholders as part of the decision-making process, not only to gain consensus but to share knowledge. A clear understanding of the context and the rationale for controlling a waterbird species is needed to align the interests of diverse stakeholders. The provision of scientific data and the continuous monitoring of management actions is viewed as beneficial and demanded by stakeholders, as part of any decision-making process when setting population targets. This facilitates effective evaluation of management actions, helping managers make wise decisions as well as enabling the continued development of management plans.