Search results for: Median

Authors: H. Bonakdari, I. Ebtehaj

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The prediction of scour depth around bridge piers is frequently considered in river engineering. One of the key aspects in efficient and optimum bridge structure design is considered to be scour depth estimation around bridge piers. In this study, scour depth around bridge piers is estimated using two methods, namely the Adaptive Neuro-Fuzzy Inference System (ANFIS) and Artificial Neural Network (ANN). Therefore, the effective parameters in scour depth prediction are determined using the ANN and ANFIS methods via dimensional analysis, and subsequently, the parameters are predicted. In the current study, the methods’ performances are compared with the nonlinear regression (NLR) method. The results show that both methods presented in this study outperform existing methods. Moreover, using the ratio of pier length to flow depth, ratio of median diameter of particles to flow depth, ratio of pier width to flow depth, the Froude number and standard deviation of bed grain size parameters leads to optimal performance in scour depth estimation.

Keywords: adaptive neuro-fuzzy inference system (ANFIS), artificial neural network (ANN), bridge pier, scour depth, nonlinear regression (NLR)

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Authors: J. Punj, R. K. Pandey, V. Darlong, K. Thangavel

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Background: Dural puncture epidural (DPE) technique has been introduced recently for labour analgesia however, no study has compared ropivacaine and levobupivacaine for the same. Methods: The primary aim of the study was to compare time to onset of the Numerical Pain Rating Score (NPRS) ≤ 1 in labour analgesia with both drugs. After obtaining ethics and patient consent, ASA I and ASA II parturient with single foetus in vertex presentation and cervical dilatation <5.0 cm were included. DPE was performed with 16/ 26 G combined spinal epidural (CSE) technique, and parturients randomized into two groups. In Group R ( Ropivacaine) 20 ml 0.125% ropivacaine+ fentanyl 2µg/ml was injected to a maximum of 20 ml in 20 minutes and in Group L (Levobupivacaine), 20 ml 0.125% levobupivacaine + fentanyl 2µg/ml was injected. Outcomes were assessed at 0.5,2,4,6,8,10,12,14,16,18,20 and 30 minutes, then every 90 minutes until delivery. Appropriate statistical analysis was done, and p value of <0.05 was considered statistically significant. Results: The median time to onset of NPRS ≤1 in both groups was comparable (group R= 16 minutes vs group L= 18 minutes (p = 0.076). Volume of drug for NPR ≤1 in both groups was also comparable (Group R 15.95± 2.03 ml vs Group L 16.35 ± 1.34 ml (p=0.47). Conclusion: DPE with 16 G epidural needle and 26 gauge spinal needle with both 0.125% ropivacaine and 0.125% levobupivacaine results in similar efficacy of labour analgesia.

Keywords: dural puncture epidural, labour analgesia, obstetric analgesia, hypotension

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Authors: Elsyed Fath Khalifa, Samer Mohamed Daghash

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The present study was carried out to investigate the structure of the masseter muscle of camel and its attachments to the skull as well as the relationships with its arterial blood supply. Fourteen heads of clinically healthy camels of different ages and sexes were used in the present investigation. The both common carotid arteries of six specimens were cannulated and flushed with warm normal saline solution (0.9%) then injected with red colored neoprine (60%) latex in order to study the pattern of the blood supply to the masseter muscle. Two heads were injected with an eventually mixture of 75gm red lead oxide in 150cc latex and preserved in a cold room for 3-4 days then divided sagittaly along the median plane to avoid super imposition of the arteries. The arteries of the masseter muscle of each half were radiographed. Four heads were used in manual dissection to describe the laminar arrangement of the masseter muscle. The masseter muscle of the camel was very tendinous and was situated far caudally, which enable the camel to open its jaw very wide. In the camel, the masseter muscle was recognized into proper and improper masseter groups. The proper group included the first, second superficial, intermediate and deep masseter layers. The improper group consisted of maxillo-mandibularis and zygomatico-mandibularis. The remaining two heads were used for clearance.

Keywords: anatomy, camel, masseter, lamination, blood supply

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Authors: Dzatur Rizqi Fathienah Syarifuddin, Isharyah Sunarno, Eddy Hartono, Siti Maisuri T. Chalid

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Introduction: The potential impact of coronavirus disease 2019 (COVID-19) on the health of expectant mothers and fetuses has strained attention. Pregnant women are considered a vulnerable category to respiratory infections. Moreover, several inflammatory cytokines are 2-100 times more abundant in COVID-19 with cytokine storms than in normal individuals; interleukin 6 (IL-6) exhibits much higher elevations. Investigating potential relationships between IL-6 serum levels and the severity of COVID-19 symptoms in pregnant women is the aim of this study. Material and Methods: Sixty-two eligible pregnant women were divided into a positive COVID-19 group (n=31) and a negative COVID-19 group (n=31) in this cross-sectional study. The research subjects were selected using consecutive sampling. The IL-6 was measured from a vein blood specimen using ELISA methods. Results: The COVID-19 positive group had a higher median IL-6 serum level (45.35 (35.15- 153.99) vs. 38.86 ± 11.43 (15.02-59.52), p=0.03) than the negative group. On the other hand, the IL-6 serum level had comparable value according to the COVID-19 symptoms severity (88.35 ± 36.14 ng/mL vs. 51.09 ± 25.48 ng/mL vs. 56.02 ± 33.20 ng/mL in moderate symptoms, mild symptoms, and asymptomatic, respectively; p=0.152). Conclusion: Although the IL-6 serum levels are not related to COVID-19 symptoms severity, an elevated of this biomarker was found in pregnant women with affected diagnoses.

Keywords: interleukin-6, pregnancy, COVID-19, several inflammatory

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Authors: Alyaa M. Younes, Nermine Harraz, Mohammad H. Elwany

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Lithium ion batteries are currently used for many applications including satellites, electric vehicles and mobile electronics. Their ability to store relatively large amount of energy in a limited space make them most appropriate for critical applications. Evaluation of the life of these batteries and their reliability becomes crucial to the systems they support. Reliability of Li-Ion batteries has been mainly considered based on its lifetime. However, another important factor that can be considered critical in many applications such as in electric vehicles is the cycle duration. The present work presents the results of an experimental investigation on the degradation behavior of a Laptop Li-ion battery (type TKV2V) and the effect of applied load on the battery cycle time. The reliability was evaluated using an accelerated life test. Least squares linear regression with median rank estimation was used to estimate the Weibull distribution parameters needed for the reliability functions estimation. The probability density function, failure rate and reliability function under each of the applied loads were evaluated and compared. An inverse power model is introduced that can predict cycle time at any stress level given.

Keywords: accelerated life test, inverse power law, lithium-ion battery, reliability evaluation, Weibull distribution

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Authors: Anasuya Ghosh, Subhramoy Chaudhury

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During routine cadaveric dissection at gross anatomy lab of our institution, a radial artery was found with unusual origin and superficial course. Normally the radial artery takes its origin as one of the terminal branches of brachial artery at the level of the neck of radius. It usually lies along the lateral border of fore arm deep to the brachioradialis muscle. While dissecting a 72-year-old Caucasian female cadaver, it was found that the right sided radial artery originated from the upper part of brachial artery of arm, 2 cm below the lower border of teres major muscle, from the lateral aspect of brachial artery. Then the radial artery superficially crossed the brachial artery and median nerve from lateral to medial direction and rested superficially at the cubital fossa. Embryologically, it can be explained as a failure of disappearance, or abnormal persistence of some insignificant embryonic vessels may give rise to this kind of vascular anomalies. As radial artery is one of the most important upper limb arteries, its variation and related complications are clinically significant. This unusual origin and course of radial artery should be kept in mind by all healthcare providers including surgeons and radiologists during routine venipuncture, orthopedic and plastic surgeries of arm, coronary angiographic procedures in radial approach etc. to prevent unwanted complications.

Keywords: brachial artery anomalies, brachio-radial artery, high origin radial artery, superficial radial artery

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Authors: S. Saju, G. Thirugnanam

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In this paper, a medical image watermarking algorithm based on contourlet is proposed. Medical image watermarking is a special subcategory of image watermarking in the sense that images have special requirements. Watermarked medical images should not differ perceptually from their original counterparts because clinical reading of images must not be affected. Watermarking techniques based on wavelet transform are reported in many literatures but robustness and security using contourlet are better when compared to wavelet transform. The main challenge in exploring geometry in images comes from the discrete nature of the data. In this paper, original image is decomposed to two level using contourlet and the watermark is embedded in the resultant sub-bands. Sub-band selection is based on the value of Peak Signal to Noise Ratio (PSNR) that is calculated between watermarked and original image. To extract the watermark, Kernel ICA is used and it has a novel characteristic is that it does not require the transformation process to extract the watermark. Simulation results show that proposed scheme is robust against attacks such as Salt and Pepper noise, Median filtering and rotation. The performance measures like PSNR and Similarity measure are evaluated and compared with Discrete Wavelet Transform (DWT) to prove the robustness of the scheme. Simulations are carried out using Matlab Software.

Keywords: digital watermarking, independent component analysis, wavelet transform, contourlet

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Authors: F. Haddadj, F. Acheuk, S. Hamdi, S. Zenia, A. Smai, H. Saadi, B. Doumandji-Mitiche

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Locust is causing significant losses in agricultural production in the countries concerned by the invasion. Up to the present control strategy has consisted only of the spreaders chemicals; they have proven harmful to the environment and. For this, a new control method appeared it comes to the biological control based mostly by using microorganism. It is in that sense is we've made our contribution by the use of a biopesticide which is entomopathogenic fungus Metarhizium anisopliae var acridium "Green Muscle" on part of the cuticule the larval of fifth instar locust Schistocerca gregaria (Forskål, 1775). Preliminary test on the study of the pathogenicity of M. anisopliae var acridium biocontrol agent, was conducted in the laboratory on L5 S. gregaria, on which we inoculated treatment in the digestive tract and it administrant 20μl of entomopathogenic solution orally at a dose DL50 = 3.25 x107 sp./ ml (median lethal dose estimated at earlier), 5 days after treatment individuals are sacrificed. After dissection cuticles are recovered and then subjected to histological sections. The histological technique followed is that of Martoja Martoja-Pierson (1967). Microscopic observation revealed alterations in the architecture of the cuticule which leads to disorganization of cell layers.

Keywords: biopesticide, cuticle, desert locust, toxicity

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Authors: Ryan J. Trefethen, Vincent H. Smith

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This study explores the relationship between national spending on the Medicaid program, and total Medicaid spending and enrollment in Montana, a state that ranks thirty-third in per capita income and thirty-seventh in median household income in the United States. The purpose of the research is to estimate the potential effects that specific changes to national healthcare policy would likely have on funding for the Montana Medicaid Program and enrollees in the program, members of families in poverty whose incomes are low, even though in many cases they have steady jobs. A particular concern is the effect on access to care for children in poverty who tend to be food insecure and, therefore, especially in need of access to health care. The research uses data collected from a variety of government publications, including the Medicaid Financial Management Report, the Medicaid Managed Care Enrollment Report, and the Centers for Medicare and Medicaid Services MSIS State Summaries for fiscal years 2000-2015. These data were examined using econometric analysis, to assess these impacts. The evidence indicates that the changes included in recent congressional legislative initiatives would potentially leave an additional 50,000 to 60,000 Montana residents, five to six percent of the state’s population, in poverty without access to health care. Impacts on children in poverty would potentially be substantial.

Keywords: children, healthcare, medicaid, montana, poverty

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Authors: Öykü Barutçu, Mehmet Özgür Kuzdan

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Aim: Laparoscopy is very risky in patients undergoing, multiple open abdominal surgeries. The aim of this study, to define a safe method for the first trocar placement in children with a history of multiple open abdominal surgeries. Methods: Children who underwent laparoscopic surgery between March 2019 and April 2020 with a history of three or more open abdominal surgeries were included in the retrospective study. Patient information was obtained from the hospital automation system. Ultrasonography was used to determine the location of adhesions preoperatively. The first trocar was placed according to ultrasonography findings, using the Hasson technique to create an air pocket with finger dissection. The patient's preoperative, perioperative, and postoperative findings are reported. Results: A total of 10 patients were included in the study. The median number of operations before laparoscopy was three. The most common site for the first trocar entry was Palmer's point (40%). No mortality or morbidity was observed amongst any patients. The average number of adhesions detected by USG and observed on laparoscopy were significantly positively correlated. Conclusion: In children with a history of multiple abdominal surgeries, abdominal wall ultrasonography for visualization of adhesions and finger dissection for the formation of an air pocket appears to be a safe method for the first trocar insertion.

Keywords: abdominal wall, child, laparoscopy, ultrasonography

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Authors: Mohammad Jalali Varnamkhasti

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The genetic algorithms have been very successful in handling difficult optimization problems. The fundamental problem in genetic algorithms is premature convergence. This paper, present a new fuzzy genetic algorithm based on chaotic values instead of the random values in genetic algorithm processes. In this algorithm, for initial population is used chaotic sequences and then a new sexual selection proposed for selection mechanism. In this technique, the population is divided such that the male and female would be selected in an alternate way. The layout of the male and female chromosomes in each generation is different. A female chromosome is selected by tournament selection size from the female group. Then, the male chromosome is selected, in order of preference based on the maximum Hamming distance between the male chromosome and the female chromosome or The highest fitness value of male chromosome (if more than one male chromosome is having the maximum Hamming distance existed), or Random selection. The selections of crossover and mutation operators are achieved by running the fuzzy logic controllers, the crossover and mutation probabilities are varied on the basis of the phenotype and genotype characteristics of the chromosome population. Computational experiments are conducted on the proposed techniques and the results are compared with some other operators, heuristic and local search algorithms commonly used for solving p-median problems published in the literature.

Keywords: genetic algorithm, fuzzy system, chaos, sexual selection

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Authors: M. Abdullah Al Faruque, Ram Balachandar

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An experimental study with four different types of bed conditions was carried out to understand the effect of roughness in open channel flow at two different Reynolds numbers. The bed conditions include a smooth surface and three different roughness conditions which were generated using sand grains with a median diameter of 2.46 mm. The three rough conditions include a surface with distributed roughness, a surface with continuously distributed roughness and a sand bed with a permeable interface. A commercial two-component fibre-optic LDA system was used to conduct the velocity measurements. The variables of interest include the mean velocity, turbulence intensity, the correlation between the streamwise and the wall normal turbulence, Reynolds shear stress and velocity triple products. Quadrant decomposition was used to extract the magnitude of the Reynolds shear stress of the turbulent bursting events. The effect of roughness was evident throughout the flow depth. The results show that distributed roughness has the greatest roughness effect followed by the sand bed and the continuous roughness. Compared to the smooth bed, the streamwise turbulence intensity reduces but the vertical turbulence intensity increases at a location very close to the bed due to the introduction of roughness. Although the same sand grain is used to create the three different rough bed conditions, the difference in the turbulence intensity is an indication that the specific geometry of the roughness has an influence on turbulence structure.

Keywords: open channel flow, smooth and rough bed, Reynolds number, turbulence

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Authors: Muhamad Syafiq Hakimi Kamaruddin, Norhidayah Suleiman

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Ginger extracts (Zingiber officinale Rosc.) have been attributed therapeutic properties primarily as antioxidant, anticancer, and anti-inflammatory properties. Conventional extractions including Soxhlet and maceration are commonly used to extract the bioactive compounds from plant material. Nevertheless, high energy consumption and being non-environmentally friendly are the predominant limitations of the conventional extractions method. Herein, green technology, namely supercritical carbon dioxide (scCO2) extraction, is used to study process variables' effects on extract yields. Herein, green technology, namely supercritical carbon dioxide (scCO2) extraction, is used to study process variables' effects on extract yields. A pressure (10-30 MPa), temperature (40-60 °C), and median particle size (300-600 µm) were conducted at a CO2 flow rate of 0.9 ± 0.2 g/min for 120 mins. The highest overall yield was 4.58% obtained by the scCO2 extraction conditions of 300 bar and 60 °C with 300µm of ginger powder for 120 mins. In comparison, the yield of the extract was increased considerably within a short extraction time. The results show that scCO2 has a remarkable ability over ginger extract and is a promising technology for extracting bioactive compounds from plant material.

Keywords: conventional, ginger, non-environmentally, supercritical carbon dioxide, technology

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Authors: Yu-Chih Wang, Chia-Yu Lai, Hsiao-Tien Liu, Yi-Ju Chen, Shao-Bin Cheng

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Liver transplant has been one of the curative treatment options for hepatocellular carcinomaunder certain oncological conditions. Two of the most validated criteria are from Milan in1996 and USCF in 2001, suggesting number and size limits of tumor without vascularinvasion or distant metastasis. We performed a retrospective cohort study of hepatocellular carcinoma patients undergoing livertransplant between August 2003 and December 2020 in our institute. Clinical andpathological characteristic, survival outcome, and recurrent pattern were analysed.UCSF criteria was applied for living donor transplantation, and Milan criteria was applied for deceased donor transplantation. Of 180 total patients, 52 cases(28.8%) with diagnosis of hepatocellular carcinoma, including26 living donor(LD) and 26 deceased donor(DD) liver transplant. Complete pathologicalremission was significantly more in the DD group(p=0.009). Pathological reports showed that30.8% of DD group exceeded Milan criteria, and 19.2% of LD group exceeded UCSFcriteria.After a median follow-up of 52.2 months, the 1-year, 3-year and 5-year overall survival was 87.6%, 74.1%, and 71.8%, respectively.Meanwhile, progression-free survival was 93.1%, 85.7%, and 81.6% for 1, 3, and 5-year, respectively, similar to that in Mazzaferro et al, 1996. We concluded that Liver transplant could be applied cautiously in expanded criteria for patent withhepatocellular carcinoma.

Keywords: liver transplant, milan criteria, UCSF criteria, living donor transplantation, deceased donor transplantation

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Authors: Kejal Joshi Reddy, Sirimavo Nair

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Micronutrient malnutrition affects pregnant women and children extremely with reference to growth manifestations in gestation as well as after birth. Early fetal development affected by iodine and iron deficiency leads to poor life quality. Various researchers have found interesting interrelations between iron and iodine. A few studies on impact assessment of DFS supplementation during pregnancy have been reported in India. Aim To provide meaningful contribution by assessing the efficacy of DFS supplementation on iodine and iron status of pregnant women. Design An interventional study. Setting A semi government hospital of urban Vadodara. Subjects Pregnant women (n=150) enrolled during first trimester (< 12 weeks) and followed up till the end of gestation, n=75 were divided in experimental (DFS supplemented) and control (Non supplemented) group. Results Impact on iron and iodine status was assessed by Hb concentration and UIE respectively. Mean Hb improved significantly (p < 0.001) (+0.42 g/dl) in experimental group and reduced non significantly (-0.20 g/dl) in control group at the end, since DFS provided additional 93 mg of iron within 6 months. Median UIE improved non significantly (278.6 to 299.01µg/L) in experimental group and decreased significantly (p < 0.05) (376.59 to 288.66 µg/L) in control group. Conclusion DFS could improve iron and iodine status of experimental group compared to control group. It is an effective measure to control two essential micronutrient deficiencies together.

Keywords: DFS supplementation, anemia, pregnancy, iodine deficiency, iron

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Authors: Anas El Amraoui, Abdelkhalek Cheddadi, Mohammed Touhami Ouazzani

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Laminar natural convection in a cylindrical annular cavity filled with air and provided with two fins is studied numerically using the discretization of the governing equations with the Centered Finite Difference method based on the Alternating Direction Implicit (ADI) scheme. The fins are attached to the inner cylinder of radius r_i (hot wall of temperature T_i). The outer cylinder of radius r_o is maintained at a temperature T_o (T_o < T_i). Two values of the dimensionless thickness of the fins are considered: 0.015 and 0.203. We consider a low fin height equal to 0.078 and medium fin heights equal to 0.093 and 0.203. The position of the fin is 0.82π and the radius ratio is equal to 2. The effect of Rayleigh number, Ra, on the flow structure and heat transfer is analyzed for a range of Ra from 10³ to 10⁴. The results for established flow structures and heat transfer at low height indicate that the flow regime that occurs is unicellular for all Ra and fin thickness; in addition, the heat transfer rate increases with increasing Rayleigh number and is the same for both thicknesses. At median fin heights 0.093 and 0.203, the increase of Rayleigh number leads to transitions of flow structure which correspond to significant variations of the heat transfer. The critical Rayleigh numbers, Ra_c.app and Ra_c.disp corresponding to the appearance of the bicellular flow regime and its disappearance, are determined and their influence on the change of heat transfer rate is analyzed.

Keywords: natural convection, fins, critical Rayleigh number, heat transfer, fluid flow regime, horizontal annulus

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Authors: Daniel Fundi Murithi

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Missing data is a real bane in many surveys. To overcome the problems caused by missing data, partial deletion, and single imputation methods, among others, have been proposed. However, problems such as discarding usable data and inaccuracy in reproducing known population parameters and standard errors are associated with them. For regression and stochastic imputation, it is assumed that there is a variable with complete cases to be used as a predictor in estimating missing values in the other variable, and the relationship between the two variables is linear, which might not be realistic in practice. In this project, we estimate population total in presence of missing values in two-phase sampling. Instead of regression or stochastic models, non-parametric model based regression model is used in imputing missing values. Empirical study showed that nonparametric model-based regression imputation is better in reproducing variance of population total estimate obtained when there were no missing values compared to mean, median, regression, and stochastic imputation methods. Although regression and stochastic imputation were better than nonparametric model-based imputation in reproducing population total estimates obtained when there were no missing values in one of the sample sizes considered, nonparametric model-based imputation may be used when the relationship between outcome and predictor variables is not linear.

Keywords: finite population total, missing data, model-based imputation, two-phase sampling

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Authors: Muhammad Faizan Butt, Maria Ambreen Tahir, Joshua James Pilkington, A. A. Warsi

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Background: Total parenteral nutrition (TPN) use within the NHS is crucial in the prevention of malnourishment. TPN prescriptions are tailored to an individual patient’s needs. TPN bags come in fixed sizes, and minimizing wastage has financial and sustainability implications for the health service. The aim of the study is to assess current prescribing practices, look at the volume of TPN wastage and identify reasons for it. Methodology: A retrospective cohort study on TPN prescriptions over a period of 1 year (Jan-Dec 2022) was performed. All patients prescribed TPN that had been admitted under a general surgery consultant in a small district hospital were included. Data were extracted from hospital electronic records and dietician charts. Data were described, and reasons for TPN wastage were explored. Results: 49 patients were identified. The average length of TPN prescription was 8 days (median). This totaled 608 prescriptions. Of the bags prescribed, 258, 169, and 181 were 10g (2500ml), 14g (2000ml), and 18g (2000ml), respectively. The mean volume wasted from each type of bag was 634ml, 634ml, and 648ml, respectively. Reasons for TPN wastage identified were: no loss (25%), smaller bags not available (53.6%), step-down regime (8.1%), and other (12.2%). Conclusion: This study has identified that the current stocking and prescribing of TPN within a district general hospital leads to a significant wastage of 638.2ml (average). The commonest reason for wastage is the non-availability of a more appropriate sized bag.

Keywords: general surgery, TPN, sustainability, wastage

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Authors: Osama Shakeel

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The objective of the paper is to study the clinic-pathological factors, survival analyses, recurrence rate, metastatic rate, risk factors and the management of cutaneous malignant melanoma at Shaukat Khanum Memorial Cancer Hospital and Research Center. Methodology: From 2014 to 2017, all patients with a diagnosis of cutaneous malignant melanoma (CMM) were included in the study. Demographic variables were collected. Short and long term oncological outcomes were recorded. All data were entered and analyzed in SPSS version 21. Results: A total of 28 patients were included in the study. Median age was 46.5 +/-15.9 years. There were 16 male and 12 female patients. The family history of melanoma was present in 7.1% (n=2) of the patients. All patients had a mean survival of 13.43+/- 9.09 months. Lower limb was the commonest site among all which constitutes 46.4%(n=13). On histopathological analyses, ulceration was seen in 53.6% (n=15) patients. Unclassified tumor type was present in 75%(n=21) of the patients followed by nodular 21.4% (n=6) and superficial spreading 3.5%(n=1). Clark level IV was the commonest presentation constituting 46.4%(n=13). Metastases were seen in 50%(n=14) of the patients. Local recurrence was observed in 60.7%(n=17). 64.3%(n=18) lived after one year of treatment. Conclusion: CMM is a fatal disease. Although its disease of fair skin individuals, however, the incidence of CMM is also rising in this part of the world. Management includes early diagnoses and prompt management. However, mortality associated with this disease is still not favorable.

Keywords: malignant cancer of skin, cutaneous malignant melanoma, skin cancer, survival analyses

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Authors: S. alireza Mirghasemi, Shervin Rashidinia, Mohammadsaleh Sadeghi, Mohsen Talebizadeh, Narges Rahimi Gabaran, S. Shahin Eftekhari, Sara Shahmoradi

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Purpose: There are various pin-in-plaster methods for treating distal radius fractures. This study is meant to introduce a modified technique of pin-in-plaster. Materials and methods: Fifty-four patients with distal radius fractures were followed up for one year. Patients were excluded if they had type B fractures according to AO classification, multiple injuries or pathological fractures, and were treated more than 7 days after injury. Range of motion and functional results were evaluated. Radiographic parameters including radial inclination, tilt, and height, were measured preoperatively and postoperatively. Results: The average radial tilt was 10.6° and radial height was 10.2 mm at the sixth month postoperatively. Three cases of pin tract infection were recorded, who were treated totally with oral antibiotics. There was no case of pin loosening. Of total 73 patients underwent surgery, three cases of radial nerve irritation were recorded at the time of cast removal. All of them resolved at the 6th month follow up. No median nerve compression and carpal tunnel syndrome have found. We also had no case of tendon injury. Conclusion: Our modified technique is effective to restore anatomic congruity and maintain reduction.

Keywords: distal radius fracture, percutaneous pinning, pin-in-plaster, modified method of pin-in-plaster, operative treatment

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Authors: Sally Shepherd, Jessica Wong, David Read

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Traumatic brachiocephalic artery aneurysm is a rare injury that typically occurs as a result of a blunt chest injury. A 19-year-old female sustained a head-on, high speed motor vehicle crash into a tree. Upon release after 45 minutes of entrapment, she was tachycardic but normotensive, with a significant seatbelt sign across her chest and open deformed right thigh with weak pulses in bilateral lower limbs. A chest XR showed mild upper mediastinal widening. A CT trauma series plus gated CT chest revealed a grade 3a aortic arch transection with brachiocephalic pseudoaneurysm. Endovascular repair of the brachiocephalic artery was attempted post-presentation but was unsuccessful as the first stent migrated to the infrarenal abdominal aorta and the second stent across the brachiocephalic artery origin had a persistent leak at the base. She was transferred to Intensive Care for strict blood pressure control. She returned to theatre 5 hours later for a median sternotomy, aortic arch repair with an 8mm graft extraction, and excision of the innominate artery pseudoaneurysm. She had an uncomplicated post-operative recovery. This case highlights that brachiocephalic artery injury is a rare but potentially lethal injury as a result of blunt chest trauma. Safe management requires a combined Vascular and Cardiothoracic team approach, as stenting alone may be insufficient.

Keywords: blunt chest injury, Brachiocephalic aneurysm, innominate artery, trauma

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Authors: Y. Suchitra Devi, L. Hemchandra Singh

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Background: Because of its geographical location, Manipur lies in the conventional goiter endemic belt. During the post salt iodization period, endemic goiter was prevalent in the valley districts of Manipur without iodine deficiency. Objectives: The present study aim at the prevalence of goiter among school children (6-12 years) and women of reproductive age group (above 20 years) of Andro Assembly Constituency, Imphal- East, Manipur, India. Method: A total of 3992 individuals were clinically examined for thyroid enlargement. Hormones like TSH, FT₄, FT₃, and Anti-TPO, Anti-Tg were tested, UIC, USCN, testing of iodine in water and salt. Result: Total goiter prevalence was found to be 13.98%, median urinary iodine level was 166.0 µg/l, mean urinary thiocyanate concentration was 0.726 ± 0.408, mean water iodine concentration was 3.843 ± 2.291, and all the salt samples were above 15ppm. 6 out of 41 children and 93 out of 176 women were auto antibody positive. 41 children and 176 women were tested for TSH, FT₄, and FT₃, which shows disturbance in hormone level. Conclusion: The present study showed that the region is mildly goiter endemic without biochemical iodine deficiency.

Keywords: goiter, TSH, FT₄, FT₃, anti-TPO, anti-Tg, UIC, USCN, school children and women of reproductive age

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Authors: Vladimir Siska, Lukas Kober

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Introduction: The research deals with the work satisfaction of nurses working in healthcare institutions in the Slovak Republic, and factors influencing it. Employers should create working conditions that are consonant with the requirements of their employees and make the most of motivation strategies to help them answer to the employess' needs in concordance with various needs and motivation process theories. Methodology: In our research, we aimed to investigate the level of work satisfaction in nurses by carrying out a quantitative analysis using the standardized McCloskey/Mueller Satisfaction scale questionnaire. We used the descriptive positioning characteristics (average, median and variability, standard deviation, minimum and maximum) to process the collected data and, to verify our hypotheses; we employed the double-selection Student T-test, Mann-Whitney U test, and a one-way analysis of variance (One-way ANOVA). Results: Nurses´satisfaction with external rewards is influenced by their age, years of experience, and level of completed education, with all of the abovementioned factors also impacting on the nurses' satisfaction with their work schedule. The type of founding authority of the healthcare institution also constitutes an influence on the nurses' satisfaction concerning relationships in the workplace. Conclusion: The feelling of work dissatisfaction can influence employees in many ways, e.g., it can take the form of burn-out syndrome, absenteeism, or increased fluctuation. Therefore, it is important to pay increased attention to all employees of an organisation, regardless of their position.

Keywords: motivation, nurse, work satisfaction, McCloskey/Mueller satisfaction scale

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Authors: Wanhyun Cho, Seongchae Seo, Soonja Kang

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In this work, we propose a variational technique for image contrast enhancement which utilizes global and local information around each pixel. The energy functional is defined by a weighted linear combination of three terms which are called on a local, a global contrast term and dispersion term. The first one is a local contrast term that can lead to improve the contrast of an input image by increasing the grey-level differences between each pixel and its neighboring to utilize contextual information around each pixel. The second one is global contrast term, which can lead to enhance a contrast of image by minimizing the difference between its empirical distribution function and a cumulative distribution function to make the probability distribution of pixel values becoming a symmetric distribution about median. The third one is a dispersion term that controls the departure between new pixel value and pixel value of original image while preserving original image characteristics as well as possible. Second, we derive the Euler-Lagrange equation for true image that can achieve the minimum of a proposed functional by using the fundamental lemma for the calculus of variations. And, we considered the procedure that this equation can be solved by using a gradient decent method, which is one of the dynamic approximation techniques. Finally, by conducting various experiments, we can demonstrate that the proposed method can enhance the contrast of colour images better than existing techniques.

Keywords: color image, contrast enhancement technique, variational approach, Euler-Lagrang equation, dynamic approximation method, EME measure

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Authors: Adam Chlapecka, Anna Kagstrom, Pavla Cermakova

Abstract:

Background: Increasing educational attainment (EA) could decrease the occurrence of depression. We investigated the relationship between EA and depressive symptoms in older individuals across four European regions. Methods: We studied 108 315 Europeans (54 % women, median age 63 years old) from the Survey on Health, Ageing and Retirement in Europe assessing EA (7 educational levels based on ISCED classification); and depressive symptoms (≥ 4 points on EURO-D scale). Logistic regression estimated the association between EA and depressive symptoms, adjusting for sociodemographic and health-related factors; testing for sex/age/region and education interactions. Results: Higher EA was associated with lower odds of depressive symptoms, independent of sociodemographic and health-related factors. A threshold of the lowest odds of depressive symptoms was detected at the first stage of tertiary education (OR 0.60; 95% CI 0.55-0.65; p<0.001; relative to no education). Central and Eastern Europe showed the strongest association (OR for high vs. low education 0.37; 95% CI 0.33-0.40; p<0.001) and Scandinavia the weakest (OR for high vs. low education 0.69; 95% CI 0.60-0.80; p<0.001). The association was strongest amongst younger individuals. There was a sex and education interaction only within Central and Eastern Europe. Conclusion: The level of EA is reflected in later-life depressive symptoms, suggesting that supporting individuals in achieving EA, and considering those with lower EA at increased risk for depression, could lead to the decreased burden of depression across the life course. Further educational support in Central and Eastern Europe may decrease the higher burden of depressive symptoms in women.

Keywords: depression, education, epidemiology, Europe

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Authors: Faith Fang Xi Ooi, Kam-Fong Lee

Abstract:

Headlines are generally the summary of the content of news articles. With the added influence of hectic lifestyles, readers may rely solely on the headlines for information. In the media, what is reported concerning health issues are government responses and community involvement. There is a need for a call to action to curb health issues and not just reporting on what the government is doing about these health-related issues. In other words, linguistic elements of persuasive communicative function should be realized when reporting on health issues. Hence, this paper aims at identifying and analyzing the transitivity, Mood and Modality systems in two hundred news headlines from two Malaysian online news portals, namely The Star Online and New Straits Times. This study employs the purposive sampling method to obtain the news headlines on healthy eating using the search keyword ‘healthy eating’ and is based on Halliday’s Systemic Functional Linguistics (SFL) framework. The results show that the Material process dominates the process types along with its participants of Scope and Goal. The mood type that constitutes most of the headlines in the two newspapers is the declarative mood. Moreover, for Modality, the median Probability constitutes the highest in the headlines on healthy eating. This study contributes to the implications of being a source of reference for news writers and producers in constructing news headlines and for health campaign strategists to realize the persuasive appeals to influence behaviors and attitudes of the public towards healthy eating.

Keywords: healthy eating, modality, mood, news headlines, SFL

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Authors: Deok Hyun Han

Abstract:

Objective: To explore outcomes of UventaTM metallic ureteral stent between malignant and benign ureteral obstruction. Methods: We reviewed the medical records of 90 consecutive patients who underwent Uventa stent placement for benign or malignant ureteral obstruction from December 2009 to June 2013. We evaluated the clinical outcomes, complications, and reasons and results for unexpected stent removals. Results: The median follow-up was 10.7 (0.9 – 41) months. From a total of 125 ureter units, there were 24 units with benign obstructions and 101 units with malignant obstructions. Initial technical successes were achieved in all patients. The overall success rate was 70.8% with benign obstructions and 84.2% with malignant obstructions. The major reasons for treatment failure were stent migration (12.5%) in benign and tumor progression (11.9%) in malignant obstructions. The overall complication rate was similar between benign and malignant obstructions (58.3% and 42.6%), but severe complications, which are Clavien grade 3 or more, occurred in 41.7% of benign and 6.9% of malignant obstructions. The most common complications were stent migration (25.0%) in benign obstructions and persistent pain (14.9%) in malignant obstructions. The stent removal was done in 16 units; nine units that were removed by endoscopy and seven units were by open surgery. Conclusions: In malignant ureteral obstructions, the Uventa stent showed favorable outcomes with high success rate and acceptable complication rate. However, in benign ureteral obstructions, overall success rate and complication rate were less favorable. Malignant ureteral obstruction seems to be appropriate indication of Uventa stent placement. However, in chronic diffuse benign ureteral obstructions the decision of placement of Uventa stent has to be careful.

Keywords: cause, complication, ureteral obstruction, metal stent

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Authors: Muhammad Jawad Saleem, Faisal Hafeez, Muhammad Arshad, Afifa Naeem, Ayesha Iftekhar

Abstract:

Bacillus thuringiensis is a gram-positive spore-forming bacterium that belongs to the Bacillus cereus group of Bacilli and it produces ICP (insecticidal crystal protein) Cry toxins or Cysts toxins. Spores are produced as parasporal crystalline inclusions bodies (also known as endotoxins) at the onset of sporulation during the stationary growth phase. During vegetative growth that does not form crystals and is called vegetative insecticidal proteins (VIP) and secreted an insecticidal protein (SIP). Bacillus thuringiensis (Bt) is important for pest management either in the form of insecticides or through incorporated in the gene of the crop. Bioassays were conducted on the F2 generation of 1st instar larvae of H. armigera by the diet incorporation method to determine the susceptibility to Bt Cry toxins (Cry1Ac, Cry2Ab, Cry2A). The median lethal concentration (LC₅₀) of Cry1Ac, Cry2Ab, Cry2A ranged from 0.11 to 1.06 µg/ml and moult inhibitory concentration (MIC₅₀) of Cry1Ac, Cry2Ab, Cry2A ranged from 0.05 to 0.25 µg/ml. Cry1Ac was found most toxic to 1st instar larvae of H. armigera as compared to other Bt Cry toxins (Cry1Ac, Cry2Ab, Cry2A). The experimental results are important to policy-makers and technology providers to develop strategies for the exploitation of transgenic Bt cotton varieties as a component of integrated pest management.

Keywords: Bt toxin, Cry1Ac, Cry2Ab, Cry2A, susceptibility, Helicoverpa armigera

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Authors: Durata Haciu, Elif Sena Tekin, Gokce Ozturk, Patricia Ramey Balcı

Abstract:

Coastal zones are under increasing threat due to anthropogenic activities that introduce considerable pollutants such as heavy metals into marine ecosystems. As part of a larger experimental study examining species responses to contaminated marine sediments, surface sediments (top 5cm) were analysed for major trace elements at three locations in Istanbul Straight. Samples were randomly collected by divers (May 2018) using hand-corers from Istinye (n=4), Garipce (n=10) and Poyrazköy (n=6), at water depths of 4-8m. Twelve metals were examined: As, arsenic; Pb, lead; Cd, cadmium; Cr, chromium; Cu, Copper; Fe, Iron; Ni, Nickel; Zn, Zinc; V, vanadium; Mn, Manganese; Ba, Barium; and Ag, silver by wavelength-dispersive X-ray fluorescence spectrometry (WDXRF) and Inductively Coupled Plasma/Mass Spectroscopy (ICP/MS). Preliminary results indicate that the average concentrations of metals (mg kg⁻¹) varied considerably among locations. In general, concentrations were relatively lower at Garipce compared to either Istinye or Poyrazköy. For most metals mean concentrations were highest at Poyrazköy and Ag and Cd were below detection limits (exception= Ag in a few samples). While Cd and As were undetected in all stations, the concentrations of Fe and Ni fall in the criteria of moderately polluted range and the rest of the metals in the range of low polluted range as compared to Effects Range Low (ERL) and Effects Range median (ERM) values determined by US Environmental Protection Agency (EPA).

Keywords: effect-range classification, ICP/MS, marine sediments, XRF

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Authors: David P. Tantua, Abdulkader Helwan

Abstract:

Biometrics has been recently used for the human identification systems using the biological traits such as the fingerprints and iris scanning. Identification systems based biometrics show great efficiency and accuracy in such human identification applications. However, these types of systems are so far based on some image processing techniques only, which may decrease the efficiency of such applications. Thus, this paper aims to develop a human palmprint identification system using multi-layer perceptron neural network which has the capability to learn using a backpropagation learning algorithms. The developed system uses images obtained from a public database available on the internet (CASIA). The processing system is as follows: image filtering using median filter, image adjustment, image skeletonizing, edge detection using canny operator to extract features, clear unwanted components of the image. The second phase is to feed those processed images into a neural network classifier which will adaptively learn and create a class for each different image. 100 different images are used for training the system. Since this is an identification system, it should be tested with the same images. Therefore, the same 100 images are used for testing it, and any image out of the training set should be unrecognized. The experimental results shows that this developed system has a great accuracy 100% and it can be implemented in real life applications.

Keywords: biometrics, biological traits, multi-layer perceptron neural network, image skeletonizing, edge detection using canny operator

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