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Ammar, Kholoud, Amr Hussein, and Mahmoud Attia. "High space efficiency compact chipless RFID tag with equidistance resonances." International Journal of Engineering & Technology 7, no. 2 (April 23, 2018): 609. http://dx.doi.org/10.14419/ijet.v7i2.9254.
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Radio Frequency Identification (RFID) technology provides non line-of-sight communication between the reader and the tag. This technology is widely used for various applications such as item tracking, security, access control, health care, short and long-range applications. RFID can be used as low cost data identification technology using radio waves between the RFID transmitter and the RFID receiver. Many attempts are introduced to implement the chipless RFID tags but they suffer from non-equal spacing between resonances which makes it difficult to make the decision. In this paper, compact low cost spectral signature based chipless 8-bits RFID tag is introduced. Multi dual-band resonating circuits with different resonances are used. The operation bandwidth is limited by the second resonance of the resonator. To avoid the presence of harmonics in the operating frequency range, multiple resonators with different shapes are introduced. The proposed tag instead of encoding only one data bit it encodes two data bits providing higher bits/resonator. The proposed tag provides equidistance between resonance frequencies. The tag is implemented on FR4 substrate of dielectric constant =4.4, thickness h=1.6mm and loss tangent δ=0.0018. The scattering parameters of the fabricated tags are measured using the vector network analyzer (ROHDE&SCHWARZ ZVB 20). The designs of the tags are made using the software package CST MICROWAVE STUDIO.
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Hussein, Majed, and Ilian Hristov. "Effect of Removable Complete Dentures on the Fundamental Frequency of Speech." Folia Medica 62, no. 4 (December 31, 2020): 812–16. http://dx.doi.org/10.3897/folmed.62.e50718.
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Introduction: Removable complete dentures alter the spectrum of speech sounds by changing the elasto-plastic properties of certain areas of the oral cavity walls, and the geometric characteristics of the vocal resonator. These relationships predetermine largely the aims of conventional studies on the effect of prosthetic dentures on speech function. Aim: To investigate the effect removable dentures have on the fundamental frequency of speech during different stages of the adapta-tion period. Materials and methods: We analysed 96×2 digital sound recordings made by 64 patients (32 male and 32 female). Each patient was asked to say ‘three, two, one, zero, start’ three times: before denture placement, after denture placement, and after a two-week adaptation period. The pitch contours of F0 and the numeric values were obtained using the Speech Analyzer - SIL Language Technology software. Results: Immediately after denture placement, in male patients F0 increased by 12% on the average, and in female patients – by 10%. Two weeks after denture placement, F0 regained its normal value (p<0.05). The mean value of F0, whose raising can be interpreted as an acoustic correlate of temporary psychological stress, returned to normal after a brief adaptation period (in this case – 14 days). Conclusions: The results on the systematic changes of F0 in the course of the complete denture prosthetics are indicative for the systematic speech impediments before, and the absence of such impediments after (in case of successful prosthetics) the adaptation.
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Pedneault-Deslauriers, Julie. "Webern’s Angels." Journal of Musicology 32, no. 1 (January 1, 2015): 78–114. http://dx.doi.org/10.1525/jm.2015.32.1.78.
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Anton Webern’s Two Songs, Op. 8 on Poems by Rainer Maria Rilke (1910-1926) stand at the intersection between the composer’s spiritual ideals involving a fascination for angels, his personal circumstances at the time of the songs’ composition, and the literary influences of Weininger, Balzac, and especially Rilke. The Lieder absorb the Rilkean notions of transcendence and “intransitive love,” themes developed in the novel The Notebooks of Malte Laurids Brigge, the source of Webern’s texts. According to Rilke, lovers access the higher spiritual realm of angels by forsaking (rather than yearning for) proximity and possession. This concept resonates with the relationship Webern crafts between the chamber orchestra and the vocal line, one that eludes the goals it projects and expresses quasi-intangible motivic connections that dematerialize as soon as they form. The Op. 8 songs represent a turning point that reverberated throughout Webern’s personal and spiritual life: the promise of transcendence that Rilke’s poems held was couched in terms that echoed the hardships and rewards of his relationship with his future wife and, at the same time, resonated with the composer’s religious and artistic morals.
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Azola, Alba, Jeffrey Palmer, Rachel Mulheren, Riccardo Hofer, Florian Fischmeister, and W. Tecumseh Fitch. "The physiology of oral whistling: a combined radiographic and MRI analysis." Journal of Applied Physiology 124, no. 1 (January 1, 2018): 34–39. http://dx.doi.org/10.1152/japplphysiol.00902.2016.
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The fluid mechanics of whistling involve the instability of an air jet, resultant vortex rings, and the interaction of these rings with rigid boundaries (see http://www.canal-u.tv/video/cerimes/etude_radiocinematographique_d_un_siffleur_turc_de_kuskoy.13056 and Meyer J. Whistled Languages. Berlin, Germany: Springer, 2015, p. 74–774). Experimental models support the hypothesis that the sound in human whistling is generated by a Helmholtz resonator, suggesting that the oral cavity acts as a resonant chamber bounded by two orifices, posteriorly by raising the tongue to the hard palate, and anteriorly by pursed lips (Henrywood RH, Agarwal A. Phys Fluids 25: 107101, 2013). However, the detailed anatomical changes in the vocal tract and their relation to the frequencies generated have not been described in the literature. In this study, videofluoroscopic and simultaneous audio recordings were made of subjects whistling with the bilabial (i.e., “puckered lip”) technique. One whistling subject was also recorded, using magnetic resonance imaging. As predicted by theory, the frequency of sound generated decreased as the size of the resonant cavity increased; this relationship was preserved throughout various whistling tasks and was consistent across subjects. Changes in the size of the resonant cavity were primarily modulated by tongue position rather than jaw opening and closing. Additionally, when high-frequency notes were produced, lateral chambers formed in the buccal space. These results provide the first dynamic anatomical evidence concerning the acoustic production of human whistling. NEW & NOTEWORTHY We establish a new and much firmer quantitative and physiological footing to current theoretical models on human whistling. We also document a novel lateral airflow mechanism used by both of our participants to produce high-frequency notes.
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Bryndin, Evgeniy. "Fiber Optic Network Technology of Communication of Specialists via Mental Neurointerfaces." Network and Communication Technologies 6, no. 2 (December 30, 2021): 1. http://dx.doi.org/10.5539/nct.v6n2p1.
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Resonance communication of specialists can be carried out at a distance in real time in dialogue mode through a mental neurointerface with two-way communication. Mental neurointerface on the principles of magnetic resonance tomography captures a hologram of brain activity of the internal speech of the inductor specialist and transmits it to the mental neurointerface of the recipient's interlocutor through ultra-sensitive multi section nano resonators waveguides. The mental neurointerface of the recipient's interlocutor perceives the transmitted hologram of the brain activity of internal speech and resonates its internal speech to it. An interlocutor of the recipient with equivalent semantic memory in a resonant way makes sense of the internal speech of the inductor specialist. He forms the response with internal speech and transmits it to the interlocutor with his mental neurointerface through nano resonators in the form of holograms of the brain activity of internal speech. Interlocutors, as specialists in one subject area, have a similar semantic memory. Semantic memories are considered similar if they correspond to the principle of gold section according to a professional thesaurus. Specialists and interlocutors must learn a professional thesaurus before starting a dialogue through mental neurointerfaces. Thus, the problem of transmitting and reading thoughts at a distance using high technology is solved, taking into account the psychological aspects of the interlocutors. The development of mental neurointerfaces and ultra-sensitive multi section nano waveguide resonators for transmitting holograms of internal speech brain activity is just beginning. The use of resonant communication by mental neurointerfaces through nano waveguides resonators waveguides is currently very relevant in many areas of life activity.
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Goh, Shao Hung, and Stephen Eldridge. "New product introduction and supplier integration in sales and operations planning." International Journal of Physical Distribution & Logistics Management 45, no. 9/10 (October 5, 2015): 861–86. http://dx.doi.org/10.1108/ijpdlm-08-2014-0215.
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Purpose – The purpose of this paper is to investigate the implementation and performance benefits of sales and operations planning (S & OP) within organizations in Asia Pacific. Design/methodology/approach – A case study method was used, with two companies selected. The first company had recently commenced S & OP and applied it to facilitate new product introduction, while the second had integrated its supplier into an existing S & OP program. Supply chain performance data were collected and analyzed in the context of an S & OP maturity framework. Findings – Both cases show significant improvements in supply chain performance. In one case, the implementation of a common form of S & OP resulted in a 67 percent reduction in order lead time for newly introduced products. The second case demonstrated a 30 percent reduction in inventory levels and a 52 percent improvement in forecast accuracy through more advanced S & OP processes. Research limitations/implications – This paper studies just two companies and is not intended to be representative of outcomes at all companies implementing S & OP. Further studies are required for a more generalized picture of S & OP implementations in the Asia Pacific region to emerge. Practical implications – The findings illustrate the potential quantitative benefits of adopting S & OP and the circumstances under which these benefits may be achieved. The results are also supportive of the notion of a maturity model for S & OP implementations. Originality/value – This paper strengthens the link between practitioner and academic literature by providing empirical evidence of the benefits of S & OP. Furthermore, the findings are derived from the Asia Pacific region for which there have been few academic studies on S & OP to date.
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Li, TianYang. "Circuit Simulation of the Analog Computer and Proportional Controlled DC Motor Based on Op Amp." Advances in Engineering Technology Research 10, no. 1 (April 11, 2024): 464. http://dx.doi.org/10.56028/aetr.10.1.464.2024.
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Operational amplifier(op-amp) is a building block of many analog circuits, nowadays it has been the most widely used device in various electronics instruments. In modern electronics design, op-amp has a special weightage due to its robust characteristics. In this paper, two applications of op amp are discussed. One is using op-amp to construct an analog computer for solving second order differential equation. Another is to build a proportional controlled DC motor which transfer input voltage into angle. By varying the proportional gain at 1, 5 and 15, different result is obtained by octave simulation using step response graph and pole-zero diagram.
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Son, Shannon L., Ashley E. Benson, Emily Hart Hayes, Akila Subramaniam, Erin A. S. Clark, and Brett D. Einerson. "Outpatient Cervical Ripening: A Cost-Minimization and Threshold Analysis." American Journal of Perinatology 37, no. 03 (August 20, 2019): 245–51. http://dx.doi.org/10.1055/s-0039-1694791.
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Objective To evaluate cost of outpatient (OP) versus inpatient (IP) ripening with transcervical balloons, and determine circumstances in which each strategy would be cost saving. Study Design We created a decision model comparing OP and IP balloon ripening in term (≥37 weeks) singleton pregnancies with unfavorable cervix. We performed a cost-minimization analysis and threshold analyses comparing two OP ripening strategies (broad and limited use) to IP ripening from a health system perspective. Base case estimates of probability, utilization, and cost were derived from the literature. The primary outcome was incremental cost of OP versus IP ripening from a hospital perspective. One- and two-way sensitivity analyses explored uncertainty in the model. Results Both OP ripening strategies were cost saving compared with IP ripening: incremental cost −$228.40/patient with broad use and −$73.48/patient with limited use. OP ripening was no longer cost saving if hours saved on labor and delivery (L&D) were <3.5, insertion visit cost >$714, or facility cost/hour on L&D <$61. Two-way sensitivity analyses showed that OP ripening was cost saving under the most plausible clinical circumstances. Conclusion In patients with unfavorable cervix, OP transcervical balloon ripening was cost saving under a wide range of circumstances, particularly if OP ripening can shorten time spent on L&D by 3.5 hours.
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Kavya, K. Guru Sai, G. Nagasowmya, G. Ankitha, K. Bharathi, K. Reshma, and M. Sharmila. "Analysis of Two Stage CMOS Operational Amplifier in 90nm CMOS Technology." International Journal for Research in Applied Science and Engineering Technology 12, no. 2 (February 29, 2024): 444–49. http://dx.doi.org/10.22214/ijraset.2024.58338.
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Abstract: Operational amplifier circuits are used in computation, instrumentation and other applications. Precision op-amps previously used in instrumentation are now-a-days being used in industrial and automotive applications. Hence, there always exists a need for better precision op-amps. It should operate under a wide temperature range. Nowadays, due to the industry trend of applying standard process technologies to implement both analog circuits and digital circuits on the same chip, Complementary Metal-Oxide Semiconductor (CMOS) technology has become dominant over bipolar technology for analog circuit design in a mixed-signal system. Two-stage Op-Amp is one of the most commonly used Op-Amp architectures. In this work an operational amplifier based on CMOS is presented whose input depends on its bias currents which is 20µA and designed using 180nm and 90nm technologies. In sub-threshold region due to unique behavior of the MOS transistors not only allows a designer to work at low voltages and it also allows operating at low input bias currents. Most CMOS Op-Amps are designed for specific on-chip applications and are only required to drive capacitive loads of a few pf. In this proposed work, design of a two stage fully differential CMOS operational amplifier is presented and simulations are carried out in 180nm and 90nm technologies for various parameters. The simulation is to be carried out using Cadence Virtuoso Tool.
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Elwakil, A. S., and A. M. Soliman. "Two Modified for Chaos Negative Impedance Converter Op Amp Oscillators with Symmetrical and Antisymmetrical Nonlinearities." International Journal of Bifurcation and Chaos 08, no. 06 (June 1998): 1335–46. http://dx.doi.org/10.1142/s0218127498001030.
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Two sinusoidal oscillator circuits, that employ an operational amplifier (op amp) as a current negative impedance converter (CNIC), are modified for chaos using a nonlinear resistor of anti-symmetrical current-voltage characteristics formed by a junction field effect transistor (JFET) operating in the triode region. The internal op amp dominant pole is found to contribute significantly to the chaotic nature of one circuit while the other circuit develops different chaotic attractors when cubic and fifth power odd symmetrical nonlinearities are used. Mathematical models of the two generators are presented. Experimental laboratory results, circuit simulations and numerical simulations of the mathematical models well agree and are included.
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Engström, Gabriella, and Ingegerd Fagerberg. "Attitudes towards older people among Swedish health care students and health care professionals working in elder care." Nursing Reports 1, no. 1 (May 2, 2011): 2. http://dx.doi.org/10.4081/nursrep.2011.e2.
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The proportion of older people in the general population has increased and will continue to increase during the coming decade. Therefore, a positive attitude towards older people is important. The aim of the study was to gain knowledge about attitudes towards older people among health care students and health care staff in Swedish elder care settings. The study includes a convenience sample of 928 respondents comprised of health care students and three groups of professional caregivers [registered nurses (RNs) with university degrees, certified nursing assistants (CNAs), nurses] in a variety of health care settings in Sweden. The participants completed the Kogan’s Old People (KOPS) Scale with 17 positive (OP+) and 17 negative (OP–) statements. The statements score ranged from 17 to 85 respectively. A significant (P<0.05) difference in both positive and negative scores was observed among the three professional caregiver groups. RNs had the highest positive score (OP+:64) as well as the lowest negative score (OP–:36). Health care students in semester one had the most unfavourable attitude toward older people (OP–:41) while students in semester two had the most favourable attitude toward older people (OP+:62). RNs reported both a higher positive score as well as lower negative score compared to nurses without an academic degree and CNAs. In addition, we found that progression in one’s health care education contributes to reduce unfavourable attitudes toward older people. Health care professionals need to have the right skills to manage a more demanding role in the future in order to offer effective services for older people. A skilled workforce of health professionals is therefore very necessary.
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SOLIMAN, AHMED M. "GENERATION OF CFOA, CCII AND DVCC BASED OSCILLATORS FROM PASSIVE RLC FILTER." Journal of Circuits, Systems and Computers 20, no. 04 (June 2011): 621–39. http://dx.doi.org/10.1142/s0218126611007505.
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In a recent paper the link between the Op Amp-based two integrator loop oscillators and current feedback operational amplifier (CFOA)-based oscillators is detected and clearly explained. It was found that one of the grounded capacitor two CFOA two integrator loop oscillators, however, was not related directly to any of the Op Amp oscillators. In this paper the origin of the two CFOA grounded capacitor oscillator is found to be the passive second-order low-pass filter. It is also found that the differential voltage current conveyor (DVCC) grounded passive element oscillator is generated from the same passive second-order low-pass filter. A new family of grounded capacitor oscillators using current conveyors (CCII) and inverting current conveyors (ICCII) which includes sixteen members is introduced. A second new family of grounded passive elements oscillators using CCII and ICCII which includes eight members is also introduced. A discussion and a comparison with some of the previously reported CCII oscillator circuits is also given at the end of the paper.
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Khan, Muhammad Ahmed, Faiz Ul Hassan Nawaz, Muhammad Tahir, Hina Mazhar, Muhammad Dawood, and Ejaz Rahim. "COMPARISON OF MICRODEBRIDER - ASSISTED TURBINOPLASTY VERSUS ENDOSCOPIC PARTIAL TURBINECTOMY IN CASES OF INFERIOR TURBINATE HYPERTROPHY IN ALLERGIC RHINITIS PATIENTS." PAFMJ 71, Suppl-3 (December 31, 2021): S598–602. http://dx.doi.org/10.51253/pafmj.v71isuppl-3.4121.
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Objective: To compare microdebrider-assisted turbinoplasty versus endoscopic partial turbinectomy in cases of inferior turbinate hypertrophy in allergic rhinitis patients in terms of relief/improvement of nasal obstruction, post operative bleeding, crusting and synechie formation.
Study Design: Quasi experimental study.
Place and Duration of Study: Combined Military Hospital Mardan and Combined Military Hospital Malir, from Jan 2019 to Jan 2020.
Methodology: A total of 90 patients of allergic rhinitis with severe nasal obstruction due to bilateral inferior turbinate hypertrophy fulfilling the inclusion exclusion criteria were selected. Cases were randomly divided into two groups of 45 each. Group A cases underwent microdebrider assisted turbinoplasty and Group B cases underwent partial turbinectomy via endoscpic approach. They were comparedin terms of post op bleeding, relief of nasal obstruction, post op crusting & synechie/adhesions. All the data was entered on SPSS-17 and analyzed.
Results: Out of 90 cases, there were 43 (47.8%) females and 47 (52.2%) males with age range from 15-65, mean age 37.68 ± 11.56 Years. There was only 1 case of post op bleeding after microdebrider assisted turbinoplasty requiring nasal packing in contrast to 6 cases of post op bleeding after endoscopic partial turbinectomy. On one month post op visit, there was no case of nasal crusting in turbinoplasty group in contrast to 7 of mild and 1 of moderate crusting & 3 synechie/adhesions in endoscopic partial turbinectomy group.
Conclusion: Microdebrider-assisted turbinoplasty is associated with less post operative bleeding and synechie formation as compared to endoscopic turbinectomy.
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Keiffer, Gina, Kelly Hughes, Tingting Zhan, Lindsay Wilde, Neil Palmisiano, and Margaret Kasner. "Outpatient Vyxeos Induction without Planned Admission for Select Patients with Secondary Acute Myeloid Leukemia (sAML) Is Safe and Yields Healthcare Resource Savings." Blood 136, Supplement 1 (November 5, 2020): 2. http://dx.doi.org/10.1182/blood-2020-140055.
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INTRODUCTION: With the FDA approval of CPX-351 (Vyxeos; Jazz Pharmaceuticals, Inc.; Palo Alto, CA), the prospect of inducing select patients with acute myeloid leukemia (AML) with a regimen that does not require continuous intravenous in the outpatient (OP) setting became a reality. With the recognition that an OP-induction strategy has the potential benefits of reduced healthcare resource utilization (HRU),1,2 improved quality of life3 and decreased risk of nosocomial infections, some centers have opted to administer Vyxeos in the OP setting and to admit patients only if complications which necessitate inpatient (IP) management occur. The safety and decreased HRU of this approach during consolidation has been demonstrated4 in the study population treated on the pivotal phase III trial (NCT01696084).5 We present the first real-world experience of OP AML induction with Vyxeos without planned hospital admission. METHODS: We performed a retrospective analysis of all patients at our institution treated with OP-Vyxeos without planned admission (OP-Vyxeos) between August, 2017 and June, 2020. Patients were deemed safe for OP induction if they met the criteria outlined in Table 1 at diagnosis or could be stabilized in the hospital and discharged when these criteria were met. Primary and secondary objectives were to evaluate the safety and HRU, respectively, of this approach. The primary endpoint was 30-day mortality. Secondary endpoints included 60-day mortality, rate of adverse effects (AEs), number of hospitalizations, number of hospital days, number of intensive care (ICU) days, and number of days receiving intravenous (IV) antibiotics. When possible, primary and secondary endpoints were compared to patients who received Vyxeos induction in the inpatient setting (IP-Vyxeos) on the phase III trial.5,6 RESULTS: Twenty-five patients received OP-Vyxeos at our institution between August, 2017 and June, 2020 and all were evaluable for the primary endpoint. Baseline characteristics of the OP- and IP-Vyxeos populations are presented in Table 2. The mean age of OP-Vyxeos patients was less than IP-Vyxeos patients (65.4 years vs. 67.7 years) and a higher proportion of OP-Vyxeos patients were <60 years old (20% vs 0%). ECOG Performance Status (PS) was similar between the two groups. Baseline white blood cell count was similar between the two groups but a lower proportion of OP-Vyxeos patients had a platelet count </= 50 x109/L (32% vs. 62%). Clinical efficacy and safety outcomes are presented in Table 3. Complete response (CR) rate for Vyxeos was similar between the OP- and IP-Vyxeos groups (48% vs. 37%), as was time to neutrophil recovery (34 vs. 35 days). There were no early deaths (before 30 days) in the OP-Vyxeos group compared to 9 (5.9%) in the IP-Vyxeos group. Sixty-day mortality was similar between the two groups (4.5% vs. 13.7%). The cause of death in the one OP-Vyxeos patient who died was fungal pneumonia in the setting of presumed refractory leukemia. Febrile neutropenia (FN) with or without documented infection and bleeding (any grade) were the most common AEs in both groups, however, the rates varied significantly between OP- and IP-groups (FN: 88% vs. 68%; bleeding: 28% vs. 74.5%). FN was by far the most common AE in the OP-Vyxeos group and was the admission diagnosis for 91% (32/35) of admissions. HRU-metrics are presented in Table 4. The majority of OP-Vyxeos patients required hospitalization (88%); however, despite an increased mean number of hospitalizations (1.4 vs. 1.0), the median total number of hospital days in the OP group was decreased (22 vs. 28). Three patients (12%) never required hospitalization during OP-Vyxeos induction. The median days spent OP prior to first admission was 8 and 18% (4/22) of patients remained OP for >14 days. CONCLUSIONS: Outpatient Vyxeos induction without planned admission for select patients was safe and resulted in decreased healthcare resource utilization in our cohort of patients. There were no early deaths in the OP-Vyxeos group. Despite an increased mean number of hospitalizations, patients who received OP-Vyxeos had a decreased number of total hospital days. Limitations of this analysis include that this is a small, single-center, retrospective analysis. In the future, we hope to validate our criteria for OP-induction in a larger, multi-institution patient cohort. Disclosures Palmisiano: AbbVie: Research Funding; Genentech: Research Funding. Kasner:Jazz Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Research Funding; Otsuka Pharmaceutical: Research Funding.
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Otmani, Khawla, Dalila Naimi, Romuald Mentaverri, Thibaut Objois, Nadiabouderssa Nadiabouderssa, and Jean Pierre Marolleau. "Quantification of Nitric oxide in Multiple Myeloma Algerian Patients Using R&D and Arbor Assays Kits." Biomedical and Pharmacology Journal 11, no. 2 (June 28, 2018): 1051–59. http://dx.doi.org/10.13005/bpj/1466.
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Nitric oxide (NO) is an instable free radical considered as a marker of physiological and pathological processes. NO quantification is very sensitive and shows a great variability because of the NO short life time. Myeloma bone diseases (MBD) constitute one of the most visible aspects in MM cancer, which is a favorable microenvironment for the promotion of communication between malignant plasma cells and other cell types using cellular messengers including NO. On the other hand, many researchers have confirmed the association of osteoporosis with a high concentration of (NO), which has been proven to play a primary role in bone remodeling. The relationship between plasma NO concentration and MM pathology is poorly documented. This work aimed to study the variability of NO quantification using R&D and Arbor assays kits in plasma MM patients in comparison with osteoporosis (OP) patients as positive control. MM and OP blood samples were obtained from patients in three hospitals at the East of Algeria. The results showed a slight similarity (21.56%) between NOx concentrations assayed with two kits, that the average concentration of NOx in MM patients(54, 22μM / l ±20, 06μM/l) was higher than the average concentration of NOx in patients with OP (48,34μM/l ±16,71μM /l). Our results confirmed an important difference and variability in NO quantification Thus the high NOx level production in MM patients comparing with OPpatients was noticed.
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Sajid Khan, Akram Ullah, Bakht Jehan, Arif Hussain, Aafaq Ahmad Qarnain khalil, and Mumtaz Ali. "Improvement and Complications after Two-Level ACDF Surgery at a Tertiary Care Facility: A Retrospective Study." Pakistan Journal Of Neurological Surgery 27, no. 2 (June 9, 2023): 244–50. http://dx.doi.org/10.36552/pjns.v27i2.860.
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Objective: To assess immediate and long-term outcomes and complications of two-level ACDF in patients with degenerative cervical disc disease. Materials & Methods: A retrospective study was carried out in the Department of Neurosurgery at Prime teaching hospital, Peshawar. Patients with symptoms of cervical radiculopathy and radiculomyelopathy with two-level cervical disc disease were included. Patients with trauma, single-level disease, and those who had cervical corpectomy were excluded. Age, gender, Nurick Grading, level of involvement, and post-op outcomes were recorded. Results: 27 cases among which 18 were males and 9 females were studied. 21 patients had radiculopathy while 6 had radiculomyelopathy. The mean age was 46 years. Nurick grade was from 2 to 6. ACDF was chosen as the procedure of choice. Follow-up involved the immediate post-op period for dysphagia, hoarseness of voice, and any neurological deficit, at 6 months and one year for outcomes of pain relief, improvement in paresthesia, and spasticity. Conclusion: ACDF is a safe and recommended procedure for 2-level cervical disc disease in terms of pain relief, paresthesia, and spasticity with acceptable complications.
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Rodgers, Peter W. "Self-noise spectra for 34 common electromagnetic seismometer/preamplifier pairs." Bulletin of the Seismological Society of America 84, no. 1 (February 1, 1994): 222–28. http://dx.doi.org/10.1785/bssa0840010222.
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Abstract Because of a lack of such information, computed self-noise spectra are presented for a total of 34 frequently used electromagnetic-seismometer/preamplifier combinations. For convenience, most of these data are given in three sets of units. Peterson's Low Noise Model is included on each plot for comparison. The self noises of nine frequently employed electromagnetic seismometers properly matched to their operational amplifier (op-amp) preamplifiers are plotted. In terms of amplitude density spectra in (m/sec**2)/Hz**0.5, the values of the self-noise spectra at resonance range from a low of 3 × 10−10 for the GS-13 to a high of 1.3 × 10−8 for the HS-1. Between these two seismometers, in order of increasing noise at resonance, are the SV-1, SL-210V, S-13, SS-1, L-4C, S-6000CD, and the L-22D. To show which seismometers exhibit the lowest noise with which operational amplifier preamplifiers, the self noises of the HS-1, L-22D, L-4C, GS-13, SV-1, and SL-210V are plotted each paired with four commonly used op-amps: the LT1028, OP-227, OP-77, and the LT1012. For the GS-13, the LT1012 was the quietest. For the rest, the OP-227 was the best. For a given seismometer, the differences in self noise between op-amps were frequently a factor of 2 or 3, and as large as 10 in one case. The use of these op-amps in the analog front ends of five current digital seismic recorders is discussed.
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Agha, Mounzer E., Andrew M. Yeager, Carol Evans, Nikol Borkowski, Anne Marie Scekeres, Sarah Miller, Cheryl Tompkins, Rowena Schwartz, Albert D. Donnenberg, and Jeffrey Shogan. "Outpatient High-Dose Chemotherapy and Autologous Hematopoietic Cell Transplantation for Multiple Myeloma Is Associated with a Low Infection Safety Profile." Blood 104, no. 11 (November 16, 2004): 5070. http://dx.doi.org/10.1182/blood.v104.11.5070.5070.
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Abstract High-dose melphalan (MEL) and autologous hematopoietic cell transplantation (HCT) is now a standard therapy in patients (pts) with multiple myeloma (MM). This HCT procedure is sufficiently tolerable to be performed on either an outpatient (OP) or inpatient (IP) basis. We compared the infection profiles in 16 consecutive pts who underwent OP HCT and 31 consecutive pts who underwent IP HCT for MM over a 24-month period. The median age of each group was comparable (OP 58 yr, range 33–72 yr; IP 59 yr, range 32–74 yr). All pts received MEL 200 mg/m2 before HCT and anti-infective prophylaxis with oral acyclovir, fluconazole and levofloxacin. Empiric treatment of first neutropenic fever in the OP group was imipenem and vancomycin (VAN) and in the IP group was cefepime with addition of VAN for persistent fever and/or positive cultures with VAN-sensitive bacteria. Median time to neutrophils >0.5 x 109/L after HCT was 10 days in both groups (range 8–12 days for OP and 9–12 days for IP). Fever during neutropenia occurred in 7/16 (43.8%) of OP and 16/31 (51.6%) of IP HCT pts. Positive blood cultures (BCs) were identified in 3/7 (42.9%) of the febrile OP and 5/16 (31.3%) of the febrile IP HCT pts. Positive BCs in febrile OP HCT pts were coagulase-negative Staphylococcus (CNS) (2 pts) and Pseudomonas (1 pt). Positive BCs in febrile IP HSCT pts were CNS (2 pts), Streptococcus viridans (1 pt), Enterococcus (1 pt) and Bacillus (1 pt). One febrile OP HCT pt had cytomegalovirus pneumonia, and one afebrile IP HCT pt had a positive BC for CNS. Four febrile IP HCT pts with negative BCs had other infections, including cellulitis (2), facial abscess (1), and Clostridium difficile-associated colitis (CDAC) (1). Two other IP HCT pts (1 with fever and positive BC for CNS, 1 without fever) also had CDAC, for an overall incidence of CDAC of 3/31 (9.7%) after IP HCT. In contrast, no OP HCT pts had CDAC. Overall, the incidence of infections was 4/16 (25%) after OP HCT and 11/31 (35.5%) after IP HCT. We conclude that the infection profile of OP HCT compares favorably with that of IP HCT in pts with MM and is associated with a lower incidence of CDAC.
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Wetzstein, Gene A., Jeffrey E. Lancet, Jennifer E. Kallner, Jeffrey M. Sivik, Viet Q. Ho, Timothy J. George, Sheetal Desai, Shanel Fisher, Michael D. Newton, and Alan F. List. "Safety, Feasibility, and Cost-Effectiveness with Outpatient Administration of High-Dose Cytarabine Consolidation in Acute Myeloid Leukemia." Blood 112, no. 11 (November 16, 2008): 2405. http://dx.doi.org/10.1182/blood.v112.11.2405.2405.
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Abstract Introduction: High-dose cytarabine (HiDAC) consolidation chemotherapy is frequently used in acute myeloid leukemia (AML) patients less than 60 years of age. Traditionally, the potential risk for neurotoxicity, which has been reported to occur in 8–26% of patients, has limited its administration to the inpatient setting with a median length of stay of 5 days. Institutional retrospective data revealed the incidence to be much lower than previously reported with grade III/IV neurotoxicity in only 0.7% of cycles (N=267). As a result, we developed a comprehensive outpatient (OP) approach for the administration of HiDAC utilizing a pre-printed order and monitoring forms, pre-defined eligibility criteria/risk factors, administration/screening checklist, standard ancillary medications, designated scheduling, patient counseling, and written instructions for follow up. The benefits of OP administration may include improved patient satisfaction and decreased institutional costs and constraints on inpatient resources. However, there does not appear to be any published literature to date describing the OP administration of HiDAC. We report herein on the safety, feasibility, and outcomes of 43 patients receiving HiDAC consolidation therapy (n=88 cycles) between September 2006 and July 2008. Methods: Patients < 60 yo received 3 g/m2 over 1 hour every 12 hours on days 1, 3, and 5 and the dose was reduced to 1.5 g/m2 for pts ≥ 60 yo. All cycles of HiDAC were dosed based on age, renal, and hepatic function. There were no empiric dosage adjustments based on renal function alone. Post-treatment, patients received antibiotic prophylaxis and growth-factor support. Patients returned twice weekly for blood work until neutrophil and count recovery. Results: Forty-three patients received 88 cycles of HiDAC as an OP. The median patient age was 49 yrs (23–74) with 16% being over 60. Patient baseline characteristics of the OP group were similar to the inpatient group from our institutional review with respect to age, body surface area, gender, and race. Diagnosis, history of CNS radiation/disease, intrathecal chemotherapy, alcohol abuse, cumulative cytarabine dosage, and concurrent medications were also similar between the two groups. Only 1 patient was ineligible to receive OP therapy which was the result of both renal (estCL < 60mL/min) and hepatic (alk phos > 3X ULN) risk factors. Two patients with moderate renal insufficiency (est CL 30–60 mL/min) received full dose HiDAC without adverse event. All 43 patients successfully completed their full course of therapy. During the 88 cycles, there were no cases of clinically significant neurotoxicity (≥ grade III). There were 3 instances of grade I nystagmus. In all cases, therapy was completed without interruption. Rates of admission to the hospital post HiDAC OP consolidation for neutropenic fever (NF) was comparable to the inpatient group from our institutional review, occurring in 26% and 37% (p=0.07), respectively. All admissions post HiDAC OP was secondary to NF with the exception of one patient who was admitted for mucosal bleeding. Conclusions: In the present analysis, we confirm the safety and feasibility of OP-based HiDAC chemotherapy for the management of AML patients in remission. If patients are dosed and monitored properly, HiDAC can be successfully transitioned to the OP setting. With the implementation of this approach, we have improved patient convenience and satisfaction, decreased pressure on inpatient resources (nearly 450 days of hospital bed use), while maintaining similar rates of hospital re-admission. With proper patient selection, dosing, and education of both providers and patients, HiDAC can be safely administered in the OP setting and has become our standard of care.
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Loffredo, Elisabetta, and Nicola Senesi. "Fate of anthropogenic organic pollutants in soils with emphasis on adsorption/desorption processes of endocrine disruptor compounds." Pure and Applied Chemistry 78, no. 5 (January 1, 2006): 947–61. http://dx.doi.org/10.1351/pac200678050947.
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After providing a brief overview of the various phenomena that anthropogenic organic pollutants (AOPs) of various nature and origin are subjected to in soil, the paper focuses on an important class of these, the endocrine disruptor compounds (EDCs), which are hormone-like substances able to alter (i.e.) disrupt, the normal endocrine functions in animals and humans. EDCs may enter the soil through current agricultural practices andor disposal of urban and industrial effluents, sludges, and wastes. The estrogenic risk of EDCs is generally related to their distribution and speciation in the various soil phases, in which adsorption/desorption processes play a very important role. Adsorption kinetics and adsorption/desorption isotherms of the EDCs: bisphenol A (BPA), octylphenol (OP), 17-α-ethynilestradiol (EED), and 17-β-estradiol (17ED), onto four samples collected from the surface (depth 0-30 cm) and deep (depth 30-90 cm) horizons of two acidic sandy soils in Portugal (P) and Germany (G) (P30 and G30, and P90 and G90, respectively) were determined using a batch equilibrium method and the high-performance liquid chromatography (HPLC) technique. Adsorption of EDCs onto all soils examined occurs in two phases, a rapid one in less than 10 h of contact, and corresponding to more than 90 % of total adsorption, and a slow one that may need several hours until attainment of equilibrium. Experimental adsorption data fit best in a linear isotherm for BPA, in a nonlinear, L-shaped Freundlich isotherm for EED, in either a linear or a nonlinear Freundlich isotherm for OP, and in a Langmuir isotherm for 17ED. Thus, no limiting adsorption is observed for soils examined over the concentration range tested for BPA, OP, and EED, whereas a maximum adsorption (i.e., saturation) is reached only by 17ED. In general, the values of the Freundlich constant, K, and of the distribution coefficient, Kd, calculated from the experimental isotherms of the four EDCs onto soils examined follow the same trend, that is: G30 > P30 > P90 > G90. Further, the K and Kd values of any EDC are positively correlated with the soil organic carbon (OC) content, which is larger for surface horizon soils than deep horizon soils. Adsorption of BPA is generally reversible, and its desorption occurs quickly and completely, thus, it is expected to move down the soil profile, and possibly contaminate the groundwater. On the contrary, OP and EED are adsorbed almost irreversibly, and are slowly and only limitedly desorbed, thus are expected to accumulate, especially in the top soil layer, and cause soil contamination.
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Rankin, Danielle A., Zaid Haddadin, loren lipworth, Jon Fryzek, Mina Suh, Donald S. Shepard, Rendie McHenry, et al. "1406. Comparison of Clinical Presentations and Burden of Respiratory Syncytial Virus in Infants Across Three Distinct Healthcare Settings." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S711. http://dx.doi.org/10.1093/ofid/ofaa439.1588.
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Abstract Background Respiratory syncytial virus (RSV) accounts for the majority of lower respiratory tract illnesses in hospitalized infants. In the U.S., RSV hospitalizations are well characterized; yet, emergency department (ED) and outpatient (OP) visits are underrecognized. We evaluated the burden of RSV across three distinct healthcare settings during one respiratory season. Methods From 12/16/19-4/30/20, we conducted a prospective RSV surveillance study among Davidson County, TN infants under one year who presented to an inpatient (IP), ED, or one of four OP clinics with either fever or any upper respiratory (i.e., cough, earache, nasal congestion, rhinorrhea, sore throat) and/or lower respiratory [i.e., wheezing, crackles, rales, diminished breath sounds, shortness of breath (SOB)] symptoms. Demographic and illness history were collected during parental/guardian interviews, followed by medical chart abstraction. Nasal swabs were collected and tested for RSV using Luminex® NxTAG RPP. Due to the COVID-19 pandemic, on 3/16/20 enrollment at three of the four OP clinics ceased. Results A total of 627 infants were screened, of whom 473 (75%) were confirmed eligible, 364 (77%) enrolled, 361 (99%) were tested for RSV of which 101 (28%) were RSV+ (IP=37, ED=18, OP=46) (Figure 1). Compared to RSV-negative subjects, RSV+ subjects were younger (6.6 vs. 4.9 months, p< 0.001), 56% were male and 48% white. By setting, infants in the OP setting were older than those seen in the IP and ED [(p=0.002), Figure 2]. Compared to infants in the OP setting, hospitalized infants were more likely to present with SOB and rhonchi/rales, but less likely to have only upper respiratory symptoms (Figure 3) and be African American (p=0.046). Infants in the IP setting had a higher proportion of clinical RSV diagnostic testing (73%) compared to the ED (39%) and OP (28%) settings (p< 0.001). Figure 1. Davidson County Infants with RSV by MMWR Week and Healthcare Setting (n=101) Figure 2. Cumulative Enrollment of Davidson County Infants with RSV by Age in Months and Healthcare Setting (n=101) Figure 3. Proportion of Davidson County Infants with RSV Showing each Clinical Symptom, by Healthcare Setting Conclusion Two-thirds of RSV+ infants sought care from either an OP or ED setting, with nearly all hospitalized infants presenting with both upper and lower respiratory symptoms. The underutilization of diagnostic testing in the OP settings may underestimate the true burden of RSV. Future studies are essential to document the true prevalence of RSV in order to assess the need and impact of new interventions (e.g., immunizations, antivirals). Disclosures Danielle A. Rankin, MPH, CIC, Sanofi Pasteur (Grant/Research Support, Research Grant or Support) Zaid Haddadin, MD, CDC (Grant/Research Support, Research Grant or Support)Quidel Corporation (Grant/Research Support, Research Grant or Support)sanofi pasteur (Grant/Research Support, Research Grant or Support) Jon Fryzek, PhD, MPH, EpidStrategies (Employee) Mina Suh, MPH, International Health, EpidStrategies (Employee) Donald S. Shepard, PhD, Sanofi Pasteur (Grant/Research Support) Natasha B. Halasa, MD, MPH, Genentech (Other Financial or Material Support, I receive an honorarium for lectures - it’s a education grant, supported by genetech)Karius (Consultant)Moderna (Consultant)Quidel (Grant/Research Support, Research Grant or Support)Sanofi (Grant/Research Support, Research Grant or Support)
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Aggarwal, Ramesh K., Arun Prasad, and Kavita Aggarwal. "A comparative study between robotic sleeve gastrectomy and robotic mini gastric bypass: which one is better?" International Surgery Journal 10, no. 12 (November 28, 2023): 1919–24. http://dx.doi.org/10.18203/2349-2902.isj20233672.
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Background: Bariatric surgery now days is a commonly done procedure for morbid obese or super obese patients. With the development of less invasive procedures like laparoscopy & robotic surgery, the use of bariatric surgery is becoming more common. The present study was conducted with an idea to compare the post operative outcomes in 2 groups (robotic sleeve gastrectomy & robotic mini gastric bypass) in terms of various parameters such as operative time, post-op. pain, length of hospital stay. Methods: Present study has been conducted on 35 patients, divided into two groups, based on two commonly performed procedures, Group one-21 patients (Robotic one anastomosis gastric bypass/Mini gastric bypass) and group two-14 patients (Robotic Sleeve Gastrectomy). All the cases in both groups were selected according to the patient’s BMI, associated symptoms and patient’s own preference for the procedure; both groups were followed for a period of 6 months. Results: On analysis, group 2 patients had a shorter operating time (p<0.01) and shorter hospital stay (P value<0.05) with almost similar results in term of weight loss after 6 months. Only one patient in group 1 had significant post operative complication in term of pulmonary embolism that was successfully managed conservatively Conclusions: Group 2 had a significantly shorter operating time & shorter hospital stay, with almost similar weight reduction after 6 months period of follow up and had no post operative complication, group 1 had one post operatively complications in term of pulmonary embolism which was managed by conservative means.
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Khawcharoenporn, Thana, and Pimjira Kanoktipakorn. "99. Effectiveness of Antibiotic Prophylaxis Among Patients Undergoing Elective Transurethral Resection of the Prostate in the Era of Antibiotic Resistance." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S179—S180. http://dx.doi.org/10.1093/ofid/ofaa439.409.
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Abstract Background Data existing on effectiveness of antibiotic prophylaxis (AP) for transurethral resection of the prostate (TURP) are limited in the era of antibiotic resistance. Methods A 4-year prospective observational cohort study was conducted among patients undergoing TURP in an academic tertiary-care hospital during 2016–2019. Patients were excluded if pre-operative (pre-op) urine cultures were not sent or grew mixed (>2) organisms, or they had pre-op urinary tract infection (UTI) or lost follow-up after TURP. Appropriateness of AP was defined as 1) correct dosing and duration and narrowest spectrum according to the hospital AP guidelines and local epidemiology and 2) being active against uropathogens isolated from the pre-op culture. Primary outcome was the rate of UTI within 30 days post TURP compared between appropriate antibiotic prophylaxis (AAP) and inappropriate antibiotic prophylaxis (IAP) groups. Results 342 patients were screened and 61 were excluded. Of the 281 patients included, 139 (49%) received AAP and 142 (51%) received IAP. The reasons for IAP were prescribing too broad-spectrum antibiotics (57%), inactive antibiotics (41%) and incorrect dosing (2%). Pre-op urine cultures were no growth in 148 patients (53%). Among the 133 positive urine cultures with 144 isolates, Escherichia coli (52%) was the most commonly isolated. Thirty-one percent of these 144 isolates produced extended-spectrum beta-lactamase (ESBL) and 23 (16%) isolates were multidrug-resistant. The resistant rates of Enterobacteriaceae were 73% for ciprofloxacin, 65% for TMP-SMX and 46% for ceftriaxone. The two most commonly prescribed prophylactic antibiotics were ceftriaxone (51%) and ciprofloxacin (34%). The rate of UTI within 30 days post-TURP was significantly higher in IAP group compared to AAP group (47% vs 27%; P< 0.001). Prescribing inactive prophylactic antibiotics was the independent factor associated with 30-day post-TURP UTI (adjusted odds ratio 2.88; P=0.001). Conclusion Appropriate antibiotic prophylaxis significantly reduced UTI within 30 days of elective TURP. Obtaining pre-op urine culture and prescribing an active prophylactic agent are critical for preventing post-TURP UTI in the era of antibiotic resistance. Disclosures All Authors: No reported disclosures
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Curtis, Neil G. W. "Two Previously Unrecorded Jadeite Axeheads from North-east Scotland." Proceedings of the Prehistoric Society 63 (1997): 403–5. http://dx.doi.org/10.1017/s0079497x00002504.
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The collections of Marischal Museum, University of Aberdeen include three jadeite axeheads (Fig. 1) which probably come from prehistoric Scottish contexts. This short note aims to bring them to the attention of others interested in these spectacular objects, in the hope that further work will help their place in Scottish prehistory to be better understood.One of the axeheads (ABDUA:39404) has already been published (Murray, 1994, 104; Batey & King 1994, 25) and has been allocated number 107 by Murray (op. cit.) in the scheme set out by Jones et al. (1977). Under the Treasure Trove procedure it was allocated to Marischal Museum in 1994. The other two axeheads were only recognised after the acquisition of this specimen. One of these (ABDUA: 37080) was given to the museum by Sir Alexander Ogston in 1928. Previously it was in the collection of Dr Garden of Alford, having been found in the parish of Strathdon, Aberdeenshire. Since its discovery, this axehead has been hafted, probably by Ogston who presented nine other prehistoric implements with modern hafts to the museum.
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Klein, Erin E., Lowell Weil, Jeffrey R. Baker, Lowell Scott Weil, Wenjay Sung, and Jessica Knight. "Retrospective Analysis of Mini-Open Repair Versus Open Repair for Acute Achilles Tendon Ruptures." Foot & Ankle Specialist 6, no. 1 (October 11, 2012): 15–20. http://dx.doi.org/10.1177/1938640012463052.
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Purpose: Debate exists over optimal treatment for acute Achilles tendon ruptures. Recent literature suggests the mini-open technique may provide the reliability of the open repair with the decreased complication rate of non-operative treatment. This retrospective review compares acute tendon ruptures treated with one of two techniques: open repair (TO) or mini-open repair (MOA). Methods & Results: Records were reviewed and 34 patients were found to meet the inclusion criteria for open or mini-open repair of an acute Achilles tendon rupture with follow up of at least 12 months. TO (n=16) and MOA (n=18) had no statistically significant differences in age at time of injury [TO: 41 + 2.5 years (range 20 – 68); MOA: 46 + 2.5 years (range 33 – 73)] or time between injury and surgical repair [TO: 15 + 2 days (range 2 – 30); MOA: 15 + 2 days (range 2 – 30)]. Post-operative VISA-A scores were 82 + 10 (range 42 – 98) and 92 + 5 (range 66 – 100) for TO and MOA, respectively. Significant differences were found in the time between surgical intervention and beginning of rehabilitation [TO: Post op day 37 + 5 (range 21 – 46); MOA: Post op day 19 + 2 (range 7 – 32)] and the time between surgical intervention and full return to activity [TO: Post op month 7 + 1 (range 4 – 11); MOA: Post op month 5 + 0.6 (range 4 – 11)]. Conclusion: These results suggest that the mini-open repair provides acceptable surgical outcomes while optimizing patient function after Achilles tendon repair. Level of Evidence: Therapeutic, Level III: Retrospective Comparative
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Yadav, Priti, Vijay Bhaisare, Preeti Rawat, Shweta Walia, Neetu Kori, and Manushree Gautam. "A comparative study of the effect of topical 0.03% tacrolimus plus 1% topical prednisolone with 1% topical prednisolone alone in preventing rejection after penetrating keratoplasty." Indian Journal of Clinical and Experimental Ophthalmology 8, no. 1 (March 15, 2022): 36–43. http://dx.doi.org/10.18231/j.ijceo.2022.008.
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Immunologic corneal allograft rejection represents one of the main cause for graft failure. This study was conducted to observe and comparing the beneficial effect of topical 0.03% tacrolimus on corneal graft survival. To compare the effect of topical 0.03% tacrolimus plus 1% topical prednisolone with 1% topical prednisolone alone in preventing rejection after PK. 40 patients were randomly allocated into two groups:Group A: patients received 0.03% topical tacrolimus ointment twice daily for a month plus 1% prednisolone acetate eye drops 2 hourly and tapered monthly. Group B: patients received 1% prednisolone acetate eye drop only 2 hourly and tapered monthly.The clinical outcomes were assessed in terms of post-op complications, graft rejection, and visual acuity after 6 months of follow-up. SPSS software, 20.0 version, IBM, Chicago were used for statistical analysis. Out of 40 patients, 29 (72.5%) were male and 11(27.5%) were female. Type of surgery and continuous suture closure was found to be statistically significant (p-value < 0.05) with post-op visual acuity in both groups. Types of graft rejection were found to be statistically significant (p-value < 0.05) with enucleation transplantation time(hours) in both groups and with secondary glaucoma (p = <0.001) in group A. We conclude that 0.03% topical tacrolimus ointment along with 1% topical prednisolone shows promising results and can be considered as an effective modality for preventing complications like secondary glaucoma, graft rejection, and getting the better visual outcome, where p-value (<0.05) was statistically significant. All patients should be instructed with regards to the reasonable use of topical tacrolimus to avoid any side effects.
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Florez, Helena, José Hernández-Rodríguez, Africa Muxi, Josep Lluis Carrasco, Sergio Prieto-González, Maria C. Cid, Gerard Espinosa, et al. "Trabecular bone score improves fracture risk assessment in glucocorticoid-induced osteoporosis." Rheumatology 59, no. 7 (October 19, 2019): 1574–80. http://dx.doi.org/10.1093/rheumatology/kez464.
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Abstract Objective To analyse the clinical utility of trabecular bone score (TBS) evaluation for fracture risk assessment in glucocorticoid (GC)-treated patients compared with BMD assessment. Methods One hundred and twenty-seven patients on GC treatment were included [mean age 62 (18) years, 63% women] in this cross-sectional study. The medical history, anthropometric data, lumbar and femoral BMD (DXA) [considering osteoporosis (OP): T-score ⩽−2.5], TBS (considering degraded microarchitecture: <1.230) and dorsolumbar X-ray [to assess vertebral fractures (VF)] were evaluated. BMD and TBS sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were evaluated to determine the diagnostic accuracy of the two methods. Results All patients were receiving GC treatment for autoimmune diseases during 47.7 (68.9) months at a mean daily dose of 14.5 mg; 17% had VF, 28% any type of fragility fracture (VF + non-VF), 29% OP and 52% degraded microarchitecture. Degraded microarchitecture was significantly more frequent than densitometric OP in patients with VF (76% vs 38%) and with any fragility fracture (69% vs 36%). For VF, TBS and BMD sensitivity, specificity, PPV, and NPV were 0.76, 0.53, 0.25 and 0.92, and 0.38, 0.72, 0.22 and 0.85, respectively. Specificity increased to 0.89 for VF and 0.9 for any fragility fracture on combining BMD+TBS. TBS had better ability than BMD to discriminate between patients with fracture, especially VF (area under the curve = 0.73). Conclusion TBS seems to have greater discriminative power than BMD for fracture risk assessment in GC-treated patients, confirming the utility of this method as a complementary tool in the diagnosis of GC-induced OP.
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Sarma, Ch Amarnatha, Syed Inthiyaz, B. T. P. Madhav, and P. Sree Lakshmi. "An Inter digital- Poison Ivy Leaf Shaped Filtenna with Multiple Defects in Ground for S-Band bandwidth Applications." International Journal on Recent and Innovation Trends in Computing and Communication 10, no. 8 (August 31, 2022): 55–66. http://dx.doi.org/10.17762/ijritcc.v10i8.5668.
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The proposed work, a filtenna for s band application is implemented. It is designed by embedding an Interdigital band pass filter (IDBPF) and leaf shaped antenna which are operated in S band. The IDFBPF is having seven resonators with one end shorted through dual vias. It offers a bandwidth of 1.3GHz from 1.65GHz to 2.95GHz. A Dumbbell shaped DGS (Defected Ground Structure) provided in ground to improve the filter characteristics. Measured pass (BRL) band return loss (S11) & insertion loss (S12) are -18dB & -4.6dB correspondingly. Further, leaf shaped antenna is designed based on modified polar transformation equation; it has 2.7 GHz bandwidth from 1.3 GH to 3 GHz and has a gain of -5.45dBi, and return loss (S11) of -19.5 dB. The filtenna is obtained by integrating the IDBBPF in the fodder line of the leaf designed antenna. The final model has 1.2 GHz operating bandwidth from 02.30 GHz to 03.50 GHz with peak arrival damages at 2.4GHz and 3.1GHz with -20dB and-24dB respectively. The designed filtenna has a pass band gain of -5.3dBi. The shift in operating band is due to combining the filter with antenna. The proposed model is invented on FR4 substrate having a wideness of 01.60 mm and having a dimension of 0.25 0.58 ?02. In this final model two complementary slip ring resonators (CSRR) are used in addition with four dumbbell structures as defects in the ground plane to avoid ripples in return loss (S11) graph. A high degree of concordance exists between empirically measured and simulated outcomes. The radiation band is showing its application in S band wireless mobile communications, Wi-Fi and ISM 2.4GHz band.
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Oleh, Klendii. "The Semantics of Virtuosity in Genre-Stylistic System of C. Saint-Saëns’s Album for Piano op. 72." Problems of Interaction Between Arts, Pedagogy and the Theory and Practice of Education 52, no. 52 (October 3, 2019): 38–52. http://dx.doi.org/10.34064/khnum1-52.03.
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Background. In recent decades an intensive development of art semiotics, which contributes to the investigation of the concept of musical compositions and their functioning in performance practice, has been observed. Music semantics and performance texture are closely interrelated, since texture elements as semantic signs are able to convey the semantic expression of the language of music. Texture depends on a lot of factors. There is a strong semantic interrelation between an individual music genre and its typical texture, which has established itself in music practice and has become its distinctive feature. The typical examples are chant chords, which is a typical accompaniment of a waltz, and toccata martellato as an articulation technique. There is an interdependence of music styles and texture elements at historical, national and individual composer’s levels. For example, there is exquisite embellishment in French clavecinists’ works and Alberti bass in Viennese classics’ works. An unexpected outburst of virtuoso style in performance art has become a cultural heritage of Romantic era. In the 19th century the semantics of virtuosity, which is evident in the choice of the mediums of expression in piano works, was of significant importance more than ever before. Texture was in focus and tempo-rhythm, articulation, dynamics and agogics created tonal variations (clarity of Chopin’s jeu perlé, bravura octaval passage works by Liszt). Together with the main meaning-making mechanisms of genre and style in piano works of the 21st century, there is program music. In Baroque era it was closely connected with oratory and the theory of affects. Romanticists gained a better understanding of the potential of music art as a universal language. As a result, during the last two centuries, a “dictionary” of texture semantic signs connected with program music was in the process of its creation. Its demonstrative and wide-spread example is the onomatopoeia of bells (indexical sign by V. Kholopova), which provided for using chords, a broad range of registers and polyrhythm (F. Liszt, O. Borodin, S. Rachmaninoff, C. Debussy). C. Saint-Saëns is one of the most brilliant representatives of French piano school, who personifies the phenomenon of a “composer-virtuoso”. That is why, among all the kinds of conceptual-music and conceptual-word signs (by V. Kholopova), which make up the texture of C. Saint-Saëns’s piano music, virtuosity signs are of great importance and their scientific apprehension reveals the principles of his piano style better. Album for piano op. 72 was written in the years of C. Saint-Saëns’s intensive creative work as a performer and as a composer and it emphasizes the main trends in mature pianoforte mentality. Objectives. The paper covers the determination of the style basics of C. Saint-Saëns’s piano music in terms of the influence of a virtuoso performance practice, which was developed in Western European art. Methods. Research methodology is based on the unity of style, genre, intonation and system analysis types, which highlight the significance of the piano music heritage of the great artist for contemporary performers. Results. A genre and stylistic system of the miniature cycle of Album for piano op. 72 is complex and various. There is a principle of genre interrelation, which manifests itself in the use of folk genres of Italian music culture as a national tradition of this country and the combination of prelude genres of Baroque and Romantic eras (Baroque principles of composition in creating a romantic character). The composition of Album can be roughly divided into two “small cycles”, which are characterized, first of all, by the presence of motor (motor-dance) genres in the final parts and, secondly, by the contrast in the middle part, namely a sound representing one and a cantilena one. The first cycle contains Prélude, Carillon, and Toccata and the second one includes Valse, Chanson Napolitaine and Finale. As for the virtuosity, three main semantic complexes, through which it is manifested, can be distinguished. Their differentiation depends on the dominating expressive means. A high tempo, loud dynamics (ff, fff) and a high level of articulation clarity (non legato, marcatissimo, rinforzando) are the most significant ones in the first cycle. The second cycle is characterized by a multilayer texture with a complex metro-rhythm organization and the elements of a polyphonic notation, which compensates a medium tempo. The third complex represents the semantic values, which are opposite to the first one. They are reached due to a clear light texture, fine finger action combined with articulatory leggiero and dynamics (p, pp). C. Saint-Saëns’s Album for piano op. 72 requires the performer to have the whole set of technical skills. The works of this cycle contain not only a creative synthesis of the piano music of Baroque, Classicism and Romantic era, which is heritable for the artist, but also new ideas of a thematic organization followed by the appearance of music impressionism stylistics in future. Conclusions. C. Saint-Saëns’s piano music style combines the fundamentals of common European instrumental music and mental evidences of French national tradition. The main principles of the composer’s pianoforte mentality include polygenre, stylization, onomatopoeia in program music and virtuosity that were brilliantly embodied in the original authenticated forms of piano music. The virtuosity signs, which were determined in the process of the semantic analysis of Album, bring French instrumental miniature to the whole new level of artistic music creation. Being a virtuoso, C. Saint-Saëns further developed miniature poetics, and thus, contributed to the understanding of the virtuosity style of piano music performance.
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Zhang, Chaolong, Yigang He, Lei Zuo, Jinping Wang, and Wei He. "A Novel Approach To Diagnosis Of Analog Circuit Incipient Faults Based On KECA And OAO LSSVM." Metrology and Measurement Systems 22, no. 2 (June 1, 2015): 251–62. http://dx.doi.org/10.1515/mms-2015-0025.
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Abstract Correct incipient identification of an analog circuit fault is conducive to the health of the analog circuit, yet very difficult. In this paper, a novel approach to analog circuit incipient fault identification is presented. Time responses are acquired by sampling outputs of the circuits under test, and then the responses are decomposed by the wavelet transform in order to generate energy features. Afterwards, lower-dimensional features are produced through the kernel entropy component analysis as samples for training and testing a one-against-one least squares support vector machine. Simulations of the incipient fault diagnosis for a Sallen-Key band-pass filter and a two-stage four-op-amp bi-quad low-pass filter demonstrate the diagnosing procedure of the proposed approach, and also reveal that the proposed approach has higher diagnosis accuracy than the referenced methods.
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Batson, W., F. Zoueshtiagh, and R. Narayanan. "Two-frequency excitation of single-mode Faraday waves." Journal of Fluid Mechanics 764 (January 9, 2015): 538–71. http://dx.doi.org/10.1017/jfm.2014.724.
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AbstractThe purpose of this work is to investigate, for the first time, excitation of Faraday waves in small containers using two commensurate frequencies. This spatial restriction, which is encountered at low frequencies, leads to a wave composed primarily of one spatial eigenmode of the container. When two frequencies are used, the mode resonates primarily with one frequency, while the role of the second is to alter the instability threshold and the resulting nonlinear dynamics. As the parameter space expands greatly as a result of the introduction of three new degrees of freedom, viz. the frequency, amplitude and phase of the new component, the linear theory is first used as a guide to highlight basic two-frequency phenomena. These predictions and nonlinear phenomena are then studied experimentally with the system of Batson, Zoueshtiagh & Narayanan (J. Fluid Mech., vol. 729, 2013, pp. 496–523), who studied single-frequency excitation of different modes in a cylindrical cell. The two-frequency experiments of this work focus on excitation of the fundamental axisymmetric mode, and are quantitatively compared to the model via a posteriori Fourier decomposition of the parametric input. In doing so, experimental dependence of the instability on the new degrees of freedom is demonstrated, in accordance with the model predictions. This is done for a variety of frequency ratios, and overall agreement between the observed and predicted onset conditions is identical to that already reported for the single-frequency experiment. For each frequency ratio, the nonlinear behaviour is experimentally characterized by bifurcation and time series data, which is shown to differ significantly from comparable single-frequency excitations. Finally, we present and discuss a wave in which both temporal frequencies are used to simultaneously excite different spatial modes.
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Kłosiński, Michał, Ewa Kucharska, Brandon Henry, Anna Jarzębska, Bendik Skinningsrud, Zbigniew Dudkiewicz, Robert Chrzanowski, et al. "IMPACT OF MINIMALLY INVASIVE DECOMPRESSION SURGERY ON THE QUALITY OF LIFE OF PATIENTS WITH LUMBAR SPINAL STENOSIS – A 2 YEAR FOLLOW-UP STUDY." Acta Neuropsychologica 15, no. 3 (September 12, 2017): 0. http://dx.doi.org/10.5604/01.3001.0010.4302.
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Background: Lumbar spinal stenosis (LSS) may result in a progressive narrowing of the spinal canal leading to compression of the nerve roots. The advantages of minimally invasive surgical approaches to the lumbar spine have been rigorously evaluated, however, the long-term impact on the health-related quality-of-life (HRQoL) of patients with LSS that have undergone minimally invasive decompression surgery is uncertain. To this end, the aim of our study was to evaluate the impact of this procedure on the HRQoL of patients with LSS. Methods: Enrolled patients were recruited to this prospective study at two orthopedic centers in Krakow, Poland. Patients eligible for inclusion were above 18 years of age, had been qualified for spine surgery of the lumbar region due to either discopathy or non-traumatic spinal stenosis, had uni- or bilateral neurogenic claudication, and verified spinal stenosis. During the interview, each patient completed the Polish version of the SSSQ (P-SSSQ), SF-36, and a demographic data questionnaire. Apart from the preoperative assessment the patients were again approached to fill in the questionnaires 6, 12, 18, and 24 months postoperatively. Results: One hundred and seventy-one consecutive patients with a mean age of 59 years were included in the study. This study found that LSS decompression statistically significantly increases HRQoL in a 2-year observation. There was a significant difference between the preoperative and postoperative SF-36 and P-SSSQ scores. The largest increase in HRQoL is between the preoperative period and 6 months post-op (p<0.0001). Starting from around 18 months post-op, further changes in HRQoL are minimal. Late complications (persistent pain, the need for revision surgery) may decrease HRQoL at around 24 months post-op. Conclusions: Minimally invasive decompression surgery for elderly patients with LSS significantly improves their HRQoL
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Ishii, K., H. Matsuda, Y. Iwasa, and A. Sasaki. "Evolutionarily stable mutation rate in a periodically changing environment." Genetics 121, no. 1 (January 1, 1989): 163–74. http://dx.doi.org/10.1093/genetics/121.1.163.
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Abstract Evolution of mutation rate controlled by a neutral modifier is studied for a locus with two alleles under temporally fluctuating selection pressure. A general formula is derived to calculate the evolutionarily stable mutation rate mu(ess) in an infinitely large haploid population, and following results are obtained. (I) For any fluctuation, periodic or random: (1) if the recombination rate r per generation between the modifier and the main locus is 0, mu(ess) is the same as the optimal mutation rate mu(op) which maximizes the long-term geometric average of population fitness; and (2) for any r, if the strength s of selection per generation is very large, mu(ess) is equal to the reciprocal of the average number T of generations (duration time) during which one allele is persistently favored than the other. (II) For a periodic fluctuation in the limit of small s and r, mu(ess)T is a function of sT and rT with properties: (1) for a given sT, mu(ess)T decreases with increasing rT; (2) for sT </= 1, mu(ess)T is almost independent of sT, and depends on rT as mu(ess)T & 1.6 for rT < 1 and mu(ess)T & 6/rT for rT > 1; and (3) for sT >/= 1, and for a given rT, mu(ess)T decreases with increasing sT to a certain minimum less than 1, and then increases to 1 asymptotically in the limit of large sT. (III) For a fluctuation consisting of multiple Fourier components (i.e., sine wave components), the component with the longest period is the most effective in determining mu(ess) (low pass filter effect). (IV) When the cost c of preventing mutation is positive, the modifier is nonneutral, and mu(ess) becomes larger than in the case of neutral modifier under the same selection pressure acting at the main locus. The value of c which makes mu(ess) equal to mu(op) of the neutral modifier case is calculated. It is argued that this value gives a critical cost such that, so long as the actual cost exceeds this value, the evolution rate at the main locus must be smaller than its mutation rate mu(ess).
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Alkhreisat, Mohammad, M. Al-Maiyah, Jayasree Ramas Ramaskandhan, Andrea Pujol Nicolas, D. Rawlings, B. Purushothaman, A. Farrier, and Malik Siddique. "Change in Bone Mineral Density after Total Ankle Replacement: Two Year Follow Up." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0009. http://dx.doi.org/10.1177/2473011419s00090.
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Category: Ankle, Ankle Arthritis Introduction/Purpose: Bone strength about the components is an important factor in Arthroplasty survival. This importance has been studied in total hip & knee replacement. However, there is paucity of literature Where little has been published regarding the quality of the bone and bone mineral content postoperatively surrounding Ankle Arthroplasty and circumstances surrounding the development of stress fracture. This prospective study used a method to quantify Bone Mineral Density BMD in different regions of the surrounding bones adjacent to tibia and talar components of uncemented Mobility ankle prosthesis, and to study the effect of loading on local ankle bone in the presence of un-cemented three components ankle replacement, by analyzing the BMD of the areas around tibia and talus before and after Mobility total ankle replacement. Methods: Twenty three Ankles (7Females, 15 Males) who underwent a Mobility Total Ankle Arthroplasty (TAA) between March 2008 and April 2009 were included prospectively in this study. They underwent a Bone Density Scan using the DEXA HOLIGIC Scanner with the specific method designed for measuring BMD. Seven areas (R1-R7) around the prosthesis were studied (Please see attached figure). Scans were carried out pre-operatively and repeated at 1 and 2 years post-operatively. The results were also compared with clinical outcomes, using (AOFAS scores) both pre, 1 and 2 years post-op. Results: Mean age of patients was 63.3 years (SD 9, range 43 to 80). AOFAS scores showed significant improvement (from 28.8 pre-op to 78.7,76.9 at 12 and 24 months post-op respectively; p<0.05). BMD within the lateral malleolus decreased significantly from 0.5g/cm2 to 0.42g/cm2 (17%, P < 0.01), at one and two years postoperatively - R2. There was an insignificant increase in Mean BMD at medial side metaphysis of tibia increased by,7% (+0.07 g cm -2, R6), but this just failed to reach statistical significance, mean BMD within medial malleolus decreased slightly from 0.67g/cm2 to 0.64 g/cm2 at the same period which was statistically insignificant. There was little insignificant increase in BMD in tibia just proximal to implant (R7) and at talus (R5). Conclusion: Stemmed implant causes changes in Tibial BMD around prosthesis. There was stress shielding over the lateral malleolus resulting in decrease BMD in lateral malleolus and to a lesser extent of the medial malleolus. The increase in BMD at tibial metaphysis indicates an increase in mechanical stresses at that region, which may explain occasional postoperative stress fracture of medial malleolus or medial sided ankle pain. There is no further change in BMD from year 1 to year 2 following TAR.
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Abraham, Aby, Fouzia N., Sandeep Albert, Tulasi Geevar, Rutvi Gautam Dave, Suchita Chase, Vinay Rao, et al. "Prospective Evaluation of a Defined Replacement Protocol for Peri-Operative Hemostasis in Patients with Severe Hemophilia Α with and without Inhibitors on Emicizumab Prophylaxis Undergoing Elective Major Surgeries. (EmiSurg Study)." Blood 142, Supplement 1 (November 28, 2023): 5513. http://dx.doi.org/10.1182/blood-2023-184564.
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Introduction Emicizumab is expected to provide hemostasis equivalent of 10-20% FVIII activity. Major surgical procedures therefore require additional replacement therapy. A defined protocol of replacement therapy for peri-operative hemostasis in patients with hemophilia A on emicizumab prophylaxis undergoing elective major surgery was prospectively evaluated. Patients and methods In this ongoing investigator-initiated study of peri-operative hemostasis in patients with severe haemophilia A with or without inhibitors, aged 2 - 60 years on emicizumab prophylaxis for at least 4 weeks, those requiring elective major surgery were evaluated. Additional hemostasis was provided through standard half-life rFVIII (those without inhibitors) or rFVIIa (those with inhibitors) based on a defined protocol (Table 1). Replacement therapy was stopped after 5 or 7 days in those without or with inhibitors, respectively, unless otherwise indicated. No thromboprophylaxis was used. Outcome measures included efficacy of surgical (post-op assessment by surgeon) and post-operative hemostasis (assessed post wound healing by hematologist), as per ISTH SSC criteria. Other parameters monitored included blood counts, FVIII level, FVIII like activity, modified one stage FVIII assay with emicizumab calibrator, ROTEM, TGT and doppler screening of lower limbs for DVT at defined times. Results Thirty patients (12 with inhibitors), median age 30.5 years (range: 14 - 56) who underwent 32 surgical procedures were included in this analysis. There were 25 (78.1%) orthopedic, 4 (12.5%) abdomino-pelvic, 1 (3.1%) thoracic, 1 (3.1%) neck and 1 (3.1%) inner ear procedures. These included 3 long standing giant body cavity pseudotumors - 2 abdomino-pelvic and 1 thoracic - which were analysed separately as high-risk for surgical hemostasis. Hemostatic efficacy for the 29standard risk procedures was assessed as excellent in 27/29 (93%) and good in 2/29 (7%). It was assessed as fair in 2/3 (67%) and poor in 1/3 (33%) high risk cases. The overall hemostasis at wound healing was assessed as excellent in 28/29 (97%), good in 1/29 (3%) for standard risk procedures and good in 2/3 (67%) and moderate 1/3(33%) for high- risk procedures. Pre-op ROTEM and TGT parameters were normal / near normal after rFVIII or rFVIIa infusion. Breakthrough bleeds (BTB) occurred in a total of 7/29 (24.1%) standard risk procedures, neither requiring additional transfusion support nor affecting wound healing in 6 of them. All BTBs occurred only in total knee replacement (2 unilateral, 3 bilateral) and 2 large thigh pseudotumor excisions. In all except 1, these BTBs occurred after stopping rFVIII/rFVIIa 5- or 7-days post-op. BTBs occurred within day+14 (3 without & 1 with inhibitor) in 4 procedures & beyond day +14 after wound healing (3 without & 2 with inhibitors) in 5, during physiotherapy and mobilization, with some occurring in both phases in 3 procedures. (Table 2) In 2 patients with early BTB after bilateral TKR, the replacement was extended (rFVIIa Q4H from day +8 to day +12, Q6H from day +13 to day+14; & rFVIII Q12H from day +13 to day +15 and single doses on day+9 and day+29). Two patients with lower limb pseudotumor resections required additional support: 1 from day+11 to day +14 (rFVIII Q12H, 4 days for bleeding during physiotherapy) & the other from days +24 - +26 (rFVIIa Q4H, 3 days for re-exploration of a superficial hematoma). For the 3 high-risk patients who underwent abdomino-pelvic or thoracic giant pseudotumor resections (2 without inhibitor & 1 with inhibitor), the rFVIII / rFVIIa support was electively continued till day +21 in 2 and day+21 - 32 in 1. There were multiple BTB requiring additional transfusion of blood products (2 without inhibitors received only packed red cells) while the one with inhibitor had continued bleeding even with global hemostasis parameters in the normal range. This continued post-operatively with septic complications leading to death on day +23. There was no thromboembolism or thrombotic microangiopathy in any patient. Conclusions We have demonstrated a safe and effective protocol for standard risk major surgeries for hemophilia A patients with or without inhibitors on emicizumab prophylaxis with additional replacement therapy during the first 5-7 days post-op. Extended support needs to be individualized as per the surgical procedure and post-op care. Acknowledgements Supported by Roche. Novo Nordisk provided rFVIIa.
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Quintero, Genevieve Jorolan, and Connie Makgabo. "Animals as representations of female domestic roles in selected fables from the Philippines and South Africa." Scholarship of Teaching and Learning in the South 4, no. 1 (April 28, 2020): 37. http://dx.doi.org/10.36615/sotls.v4i1.121.
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South Africa and the Philippines are home to a number of indigenous groups whose cultures and traditions have not been tainted by centuries of colonization. This paper compares the pre-colonial literature of cultural communities in two countries, where one is part of a continent (South Africa) while the other is an archipelago (the Philippines). Despite the differences in their geographical features, the two countries share common experiences: 1) colonized by European powers; 2) have a significant number of indigenous communities; 3) a treasury of surviving folk literature. Published African and Philippine folktales reveal recurring images and elements. One of these is the use of animals as characters, performing domestic tasks in households, and representing gender roles. This paper compares how animal characters portray feminine characteristics and domestic roles in selected fables from South Africa and the Philippines, specifically on the commonalities in the roles of the female characters. The research highlights the relevance of recording and publishing of folk literature, and the subsequent integration and teaching thereof within basic and higher education curricula.Key words: Indigenous, Cultural communities, fables, folk literature, Philippine folk tales, South African folk talesHow to cite this article:Quintero, G.J. & Makgabo, C. 2020. Animals as Representations of Female Domestic Roles in selected fables from the Philippines and South Africa. Scholarship of Teaching and Learning in the South. v. 4, n. 1, p. 37-50. April 2020. Available at:https://sotl-south-journal.net/?journal=sotls&page=article&op=view&path%5B%5D=121This work is licensed under the Creative Commons Attribution 4.0 International License.To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
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Bie, Shuhang, and Shi Pu. "Array Design of 300 GHz Dual-Band Microstrip Antenna Based on Dual-Surfaced Multiple Split-Ring Resonators." Sensors 21, no. 14 (July 19, 2021): 4912. http://dx.doi.org/10.3390/s21144912.
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To meet the increasing need of high-data-rate and broadband wireless communication systems, the devices and its circuits R&D under Millimeter, Sub-Millimeter, or even Terahertz (THz) frequency bands are attracting more and more attention from not only academic, but also industrial areas. Most of the former research on the THz waveband (0.1–10 THz) antenna design is mainly focused on realizing high directional gain, such as horn antennas, even though the coverage area is very limited when comparing with the current Wi-Fi system. One solution for the horizontally omnidirectional communication antenna is using the structure of multiple split-ring resonators (MSRRs). Aiming at this point, a novel 300 GHz microstrip antenna array based on the dual-surfaced multiple split-ring resonators (DSMSRRs) is proposed in this paper. By employing the two parallel microstrip transmission lines, different MSRRs are fed and connected on two surfaces of the PCB with a centrally symmetric way about them. The feeding port of the whole antenna is in between the centers of the two microstrip lines. Thus, this kind of structure is a so-called DSMSRR. Based on the different size of the MSRRs, different or multiple working wavebands can be achieved on the whole antenna. Firstly, in this paper, the quasi-static model is used to analyze the factors affecting the resonance frequency of MSRRs. Simulation and measured results demonstrate that the resonant frequency of the proposed array antenna is 300 GHz, which meets the design requirements of the expected frequency point and exhibits good radiation characteristics. Then, a dual-band antenna is designed on the above methods, and it is proved by simulation that the working frequency bands of the proposed dual-band antenna with reflection coefficient below −10 dB are 274.1–295.6 GHz and 306.3–313.4 GHz.
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Tasnim, Rumana, Sheroz Khan, Atika Arshad, and Molla Rashied Hussein. "Non-Contact Capacitive Technique for Biomass Flow Sensing." Indonesian Journal of Electrical Engineering and Computer Science 11, no. 2 (August 1, 2018): 531. http://dx.doi.org/10.11591/ijeecs.v11.i2.pp531-541.
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To facilitate real-time flow measurement, this paper aims to realize biomass flow sensing through electronic non-contact capacitive means. Hardware implementation has been carried out using a modified OP-AMP-based bridge circuit, with one arm made of a standard capacitance while the other arm is made from two specifically designed capacitive electrodes fitted on a piping system sensing biomass flow. The experimental results are targeted to obtain data for given biomass types through a custom-developed biomass flow piping system. Several flow affecting parameters namely: electrodes’ shapes, the location of electrodes on the piping system, biomass material type, and particle size have been considered in obtaining experimental data. Also, the circuit has been simulated to analyze flow sensing behavior for the proposed technique by evaluating the measurement data and assessing conformity between experimentally obtained and simulated data.
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Chan, Arlene, Daphne Day, Rina Hui, Nicole McCarthy, Rosalind Wilson, Demiana Faltaos, Morena Shaw, and Caitlin Murphy. "Abstract P3-07-15: Preliminary data from a Phase 1b dose escalation study of OP-1250, an oral CERAN, in combination with palbociclib in patients with advanced and/or metastatic estrogen receptor (ER)-positive, HER2-negative breast cancer." Cancer Research 83, no. 5_Supplement (March 1, 2023): P3–07–15—P3–07–15. http://dx.doi.org/10.1158/1538-7445.sabcs22-p3-07-15.
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Abstract Background: OP-1250 is a small molecule oral complete estrogen receptor antagonist (CERAN) that binds the ligand binding domain of the ER and completely blocks ER-driven transcriptional activity. CDK4/6 inhibitors in combination with endocrine therapy have improved progression free survival and overall survival for patients (pts) with metastatic breast cancer (MBC) in the first- and second-line settings. However, most patients will progress and newer combinations such as with OP-1250 may provide improved clinical outcome. OP-1250 potently inactivates both wild-type ER and mutant forms of ER. The latter confers ligand independent activity and is a mechanism of resistance to standard of care endocrine therapies. In preclinical studies, OP-1250 in combination with palbociclib demonstrated synergistic activity in models of wild-type ER and those containing ESR1 activating mutations, and in models of brain metastasis. A Phase 1/2 monotherapy study of OP-1250 is ongoing in MBC subjects who have received 1 or more prior endocrine therapies (NCT04505826). Monotherapy is well tolerated and the recommended phase 2 dose is 120 mg QD. The aim of this combination trial is to define the maximum tolerated dose (MTD), safety, tolerability, and pharmacokinetics (PK) of OP-1250 in combination with palbociclib. Methods: Eligibility criteria include pts with MBC or locally advanced breast cancer who have received no more than 1 prior line of endocrine therapy (prior CDK4/6 inhibitors and one line of chemotherapy are permitted) and measurable or non-measurable disease. Using a 3+3 design, cohorts are sequentially enrolled, and pts receive escalating doses of OP-1250 orally QD continuously in combination with 125 mg of palbociclib orally for 21 of 28 days. Pts are evaluable for dose limiting toxicities (DLTs) if >75% of both treatments were administered within the first 28-day treatment cycle. Blood is collected for PK on cycle 1 days 1, 2 and cycle 2 days 15, 16 for OP-1250 and cycle 1 day 15 for palbociclib. PK profiles, exposure parameters, and drug-drug interactions (DDIs) are assessed. Pts are monitored for adverse events (AE) and tumor assessments (RECIST 1.1) are conducted every two cycles. Results: As of July 7, 2022, 9 pts were evaluable for DLTs after 28 days of treatment in dose levels 30 mg, 60 mg, and 90 mg of OP-1250 in combination with palbociclib. No DLTs occurred at any of the dose levels. As of May 13, 2022, of the 7 pt safety data set, the most common Grade 1/2 treatment emergent adverse events (TEAE), which occurred in 2 patients, were nausea, gastroesophageal reflux, vomiting, and fatigue. Grade 3 neutropenia occurred in 4 pts and all were attributed to palbociclib by the investigator. No Grade 4 events were observed. OP-1250 was highly bioavailable and showed dose proportional exposure in combination with palbociclib. The single and multiple dose exposure of OP-1250 was consistent with that observed in the monotherapy study, indicating an absence of effect of palbociclib on OP-1250 PK. 90 mg steady-state evaluation is ongoing. Palbociclib concentrations at steady state did not demonstrate a meaningful difference from published exposure parameters for the three dose levels evaluated, indicating an absence of DDI. Conclusions: In the first three cohorts of OP-1250 and palbociclib, the combination was well tolerated and no DLTs occurred. There were no clinically significant DDIs observed between OP-1250 and palbociclib at the doses evaluated and exposure of each drug was consistent with observed monotherapy exposure levels. Dose escalation of OP-1250 continues to 120 mg, to be followed by dose expansion. Updated data will be presented. (NCT05266105) Citation Format: Arlene Chan, Daphne Day, Rina Hui, Nicole McCarthy, Rosalind Wilson, Demiana Faltaos, Morena Shaw, Caitlin Murphy. Preliminary data from a Phase 1b dose escalation study of OP-1250, an oral CERAN, in combination with palbociclib in patients with advanced and/or metastatic estrogen receptor (ER)-positive, HER2-negative breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-07-15.
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Kota, Vamsi K., David Wei, Daisy Yang, Hela Romdhani, Dominick Latremouille-Viau, Annie Guérin, and Kejal Jadhav. "Incremental Healthcare Resource Utilization and Costs Associated with Non-Optimal Treatment in Patients with Chronic Myeloid Leukemia in Chronic Phase (CML-CP) Treated with Tyrosine Kinase Inhibitors (TKI) in Early Lines of Therapy in the United States (US)." Blood 142, Supplement 1 (November 28, 2023): 5098. http://dx.doi.org/10.1182/blood-2023-180772.
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Introduction: TKIs are the standard of care for CML-CP. Although effective TKI options are available in early lines of therapy of CML, patients may experience intolerance or resistance to TKI leading to non-optimal treatment (NOPT). This retrospective cohort study assessed the incremental healthcare resource utilization (HRU) and medical costs associated with NOPT in patients with CML treated in first-line (1L) or second-line (2L) TKI therapy in the US. Methods: Adult patients with CML who received 1L TKI therapy with imatinib, dasatinib, nilotinib, or bosutinib (1L cohort), and those who received 2L TKI therapy with imatinib, dasatinib, nilotinib, bosutinib, or ponatinib (2L cohort), in 2012 or later, were selected from the OptumInsight Clinformatics database (01/2007-06/2022). Patients were required to have ≥2 years of continuous health plan coverage post-1L/2L initiation (1L/2L index date). Patients were classified in NOPT subgroup if they met one of the following criteria: 1) treatment discontinuation/switch within the first 6 months post-index, or 2) temporary treatment interruption and/or dose reduction within the first 6 months post-index followed by treatment discontinuation within the first 12 months post-index, or 3) low treatment adherence (proportion of days covered [PDC] ≤50%). Patients were classified in the reference (REF) subgroup if they met one of the following criteria: 1) high treatment adherence (PDC >90%) and no treatment discontinuation, 2) high treatment adherence (PDC >90%) and treatment discontinuation occurring more than 12 months post-index. All-cause HRU (inpatient [IP] admissions, outpatient [OP] visits, and emergency department [ED] visits) and associated medical costs (2022 USD) were measured during the 2 years post-index and reported per-patient-per-year (PPPY). Incremental HRU and costs of NOPT (vs. REF) were estimated using multivariable Poisson regressions and two-part models (adjusted for age, gender, race, region, health plan type, time from CML diagnosis to index date, and Darkow Disease Complexity Index), respectively. Adjusted incidence rate ratios (IRR) and mean cost differences (Δ) were reported along with p-value, estimated using bootstrap technique. All analyses were conducted separately in the 1L and 2L cohorts. Results: Of 2,043 patients that initiated 1L TKI therapy in 2012 or later, 197 patients were included in NOPT subgroup (median age: 69 years; 52.3% female; 68.5% White) and 284 in REF subgroup (median age: 62 years; 40.1% female; 74.6% White). Patients in NOPT subgroup had 80% more IP admissions (adjusted IRR=1.8; p <0.001) with twice more IP days (adjusted IRR=2.0; p=0.024), 30% more OP visits (adjusted IRR=1.3; p=<0.001) in the first 2 years post-index, as compared to REF subgroup. Consistently, patients in NOPT subgroup had higher medical costs (adjusted Δ=$13,551 PPPY; p=0.012) mainly driven by higher IP costs (adjusted Δ =$5,989 PPPY; p=0.028) along with numerically higher OP costs (adjusted Δ=$5,483 PPPY; p=0.060) in the first 2 years post-index, as compared to REF subgroup ( Figure 1). Of 586 patients that initiated 2L TKI therapy in 2012 or later, 69 patients were included in NOPT subgroup (median age: 67 years; 60.9% female; 76.8% White) and 72 in REF subgroup (median age: 68 years; 51.4% female; 69.4% White). Patients in NOPT subgroup had 3 times more IP admissions (adjusted IRR=3.1; p <0.001) with almost 7 times more IP days (adjusted IRR=6.7; p<0.001), 80% more ED visits (adjusted IRR=1.8; p=0.036), and numerically more OP visits (adjusted IRR=1.2; p=0.056) in the first 2 years post-index, as compared to REF subgroup. Consistently, patients in NOPT subgroup had higher medical costs (adjusted Δ=$30,962 PPPY; p=0.008) mainly driven by higher OP costs (adjusted Δ=$8,380 PPPY; p=0.016) and higher ED costs (adjusted Δ=$4,332 PPPY; p=0.012) along with numerically higher IP costs (adjusted Δ=$14,063 PPPY; p=0.100) in the first 2 years post-index, as compared to REF subgroup ( Figure 1). Conclusions: In this study of patients with CML-CP non-optimal treatment resulting in early treatment discontinuation/switch or dose interruptions/reduction in the first 6 months from treatment initiation or low adherence with the currently approved TKIs in 1L and 2L therapy for CML was associated with significant incremental economic burden. This highlights the need for more tolerable therapeutic options early in the treatment course.
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ANUPAM BARIK. "Policy interventions, market, and trade considerations with special reference to rapeseed and mustard." Journal of Oilseeds Research 40, no. 1 and 2 (July 5, 2023): 13–21. http://dx.doi.org/10.56739/y6qhaa93.
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Rapeseed and mustard oil is one of the most consumed edible oils in India due to pungency and colour. India needs nearly 15-20 million tonnes of rapeseed and mustard seed to meet its growing demand as against current production of 9-10 million tonnes of seeds. As per WHO standards, mustard oil with low saturated fatty acid content and high mono unsaturated fatty acid content is a healthy oil and therefore needs special importance in domestic edible oil basket. Currently (2022-23), Government of India (GOI) is implementing National Food Security Mission (NFSM) - (Oilseeds & Oil palm) for increasing oilseeds production and area expansion under oil palm. The NFSM (OS&OP) will be dropped and two new Scheme National Mission on Edible oils (NMEO)-Oilseeds and NMEO-Oil Palm will be implemented with the aim to enhance the edible oilseeds production and oils availabilityin the countrybyharnessing oilseeds and palmoil productivityand to reduce import burden on edible oils. Besides, NMEO-OS the private participation in technology demonstration, input supply, procurement of produce, value addition, infrastructure development and honey production are very much essential to increase edible oils production.
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Samee, Muhammad Umair, Muhammad Furqan Sharif, Hafiz Muhammad Abdullah Tahir, Mirza Zeeshan Sikandar, Fahad Ahmad Khan, and Hassan Ashfaq. "Comparison between Sublay & Onlay Mesh hernioplasty in Ventral Wall Abdominal Hernia Repair." Pakistan Journal of Medical and Health Sciences 17, no. 5 (May 27, 2023): 189–91. http://dx.doi.org/10.53350/pjmhs2023175189.
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Background & Aim: Onlay and sublay repairs are the two surgical methods most commonly employed in ventral hernia patients. The repair of a ventral hernia is one of the most common surgical procedures performed globally. The results of simple ventral hernia onlay and sublay mesh repair methods were compared in this study to compare the results of onlay and sublay mesh ventral incisional hernia repair procedures. To investigate the frequency of seroma, wound infection, and wound disruption in patients with ventral abdominal hernias who had onlay and sublay mesh plasty. Incisional hernia (IH) is a very common surgical complication. Study design: Prospective Randomized Control Trial Place and duration of study: This study was done in department of General surgery at Central Park teaching Hospital, Lahore during a period of 4 months that span from October 2021 till January 2022. Methodology: This prospective research included 100 adults with primary or secondary uncomplicated ventral hernias. The onlay mesh repair procedure was used in both groups B (n = 50) and A (n = 50). We randomly assigned participants to one of two therapy groups using a computer-generated randomization process. The procedure's length, the length of the drain, the duration of any wound infections, the length of the post-op hospital stay, and any short-term recurrence were all noted. Results: When compared to the sublay group, the onlay group had a substantially shorter median operational time (52 vs. 91 min., respectively). However, in terms of wound complications and postoperative pain, the sublay group beat the control group significantly. Disease recurrence occurred in 8% and 3% of patients in groups A and B, respectively. Practical Implication: Sublay mesh repair, which is an alternative to onlay mesh repair, can be used to treat all types of ventral hernias. Conclusion: Sublay mesh repair, which is an alternative to onlay mesh repair, can be used to treat all types of ventral hernias. Mesh-related issues are associated with long drainage times, seroma development, wound infection, and recurrence. In terms of postoperative discomfort and wound complications, sublay mesh repair is preferred than onlay mesh repair for treating incisional hernias. The recurrence rates of the two procedures are comparable. Keywords: Ventral Hernia, Onlay Mesh Repair, Sublay Mesh Repair
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Cherednychenko, Olha. "S. Bortkiewicz’s piano style." Aspects of Historical Musicology 32, no. 32 (November 15, 2023): 7–21. http://dx.doi.org/10.34064/khnum2-32.01.
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Statement of the problem. The genre-style richness of S. Bortkiewicz’s legacy does not except the dominance of piano music in it, which is explained by the composer’s piano education, the experience of his public performances and teaching activities. The 21st century became a time of revival of the composer’s name in the modern culture, but the specifics of his piano style remain outside the scope of special studies. Recent research and publications shows the great interest in the artist’s figure. Scientists focus on the performance of S. Bortkiewicz himself (Levkulych, 2021), highlight his violin compositions (Yakubov, 2021), develop the theme of dance and dance quality in his music (Kościelak-Nadolska, 2016), examine the composer’s life and creative legacy (Ishioka, 2016), stylistic influences on his thinking (Johnson, 2016). Objectives, methods and novelty of the research. The purpose of the study is to reveal the features of S. Bortkiewicz’s piano style based on observations of leading solo genres (sonatas, preludes, etudes). The scientific novelty of the article is determined by the original thesis about participation in the realization of the artistic idea of a complex of certain pianistic techniques, which are perceived as carriers of emotional content. The presented study is based on the principle of historicism and a comprehensive scientific approach involving various methods of analysis. Research results. In S. Bortkiewicz’s legacy, the piano sonata is represented by two compositions: op. 9, B major, and op. 60, C sharp minor. The purely piano techniques, the totality of which indicates virtuosity as a means of realizing the art design, have the great importance in these works (large-scale technique, bright jumps, rapid octave passages on f, a wide dynamic palette from pp to fff). The combined technique, the use of rubato play become the typical features of his piano style. Preludes op. 13, op. 33, op. 40, and op. 66 are distinguished by the dominance of a single image, embodied by the laconic pianistic means. The image and genre spectrum of prelude cycles is diverse and reflects almost the entire experience of a romantic miniature. The composer finds his own ways to reveal individuality and to manifest the modern thinking, the essence of which is in the use of combinatorial methods in the field of both language means of expression and purely pianistic techniques. The etude genre can be classified as one of the most popular in S. Bortkiewicz’s creativity. Ten Etudes op. 15 and Twelve Etudes-novels op. 29 are a true anthology of the concert etude, which combines the effectiveness of style brilliant and al fresco with spiritual imagery, playing allusions, ironic approach to typical formulas, nostalgia for lost ideals. Conclusion. S. Bortkiewicz demonstrates his own attitude to the classical-romantic tradition, which reveals an individual author position. Relying on typical pianistic techniques, the composer combines a concert virtuoso style with inspired confessional expression, prefers lyrical and scherzo imagery realized often through widely uses polyrhythmic layering, closely connects each of the playing techniques with a certain artistic idea, due to which the author’s own “word” is always felt.
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Kiran, Sehrish, Hina Javed, Munazzah Bashir, Faiza Nawaz, Saleha Hassan, and Ayesha Ilyas. "Comparing Outcome of Peritoneal Closure with Nonclosure during Patients’ Caesarean Section." Pakistan Journal of Medical and Health Sciences 16, no. 1 (January 18, 2022): 278–79. http://dx.doi.org/10.53350/pjmhs22161278.
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Objective: To compare closure procedure with the nonclosure-peritoneum protocol during cesarean section. Study Design: Randomized control trial Place and Duration of Study: Department of Obstetrics &Gynecology, District Headquarter Hospital, Gujranwala from 12th May 2018 to 12th November 2018. Methodology: One hundred females were enrolled and divided into two different groups. In first Group designated as “Group I” visceral peritoneum was closed with chromic 2/0 suture while in group II, no closure was done. According to VAS the post-op pain was noted. Results: The mean age of the females from closure group was 31.06±7.57 years while the mean age of the females from non-closure group patients was 31.78±7.59 years. There were 19 (19%) female were nulliparous. The post-operative pain was noted in 30(30%) females (P<0.001). Conclusion: Closure group females showed significantly lower post-operative pain after 24 hours of cesarean section delivery than non-closure females. Keywords: Caesarean section, peritoneum, Closure, Postoperative pain, delivery
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Saxena, Anshul, Peter McGranaghan, Muni Rubens, Joseph Salami, Raees Tonse, Amanda Lindeman, Michelle Keller, Paul Lindeman, and Emir Veledar. "Natural language processing (NLP) and machine learning (ML) model for predicting CMS OP-35 categories among patients receiving chemotherapy." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e13591-e13591. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e13591.
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e13591 Background: The Hospital Outpatient Quality Reporting Program is a pay-for-quality data reporting program implemented by the Centers for Medicare & Medicaid Services (CMS). Hospitals collect data on various measures of the quality of care provided in outpatient settings for the CMS. One such measure is OP-35, where data about patients who received chemotherapy in outpatient settings are collected. Such quality measures help hospitals assess their performance and allow patients to compare the quality of care among different hospitals in that region. Currently, the process to label data for OP-35 categories is manual. This study aims to develop a model using NLP and ML to predict the ten OP-35 complication categories and automate the process. Methods: Data from 1000 adult cancer patients who received chemotherapy at a comprehensive cancer center in the South Florida region between Sept and Oct 2019 were extracted to train the ML models. Text from the Chief Complaint field was manually labeled into ten binary categories: anemia, nausea, dehydration, neutropenia, diarrhea, emesis, pneumonia, fever, sepsis, and pain. The data were divided into a training set (80%) and a test set (20%). After initial pre-processing of the text, term frequency–inverse document frequency (TF-IDF) feature extraction method with a vocabulary size of 10,000 was applied. Various models (stochastic gradient descent, support vector classification [SVC], and binary relevance, etc.) were trained to predict multiple labels. These models were evaluated using Jaccard score, accuracy, F1 score, and Hamming loss. Additionally, two deep learning approaches: a single dense output layer and multiple dense output layer models, were also used for comparison. Python version 3.8 was utilized for the analysis. Results: The best performing model was SVC, with a Jaccard score of 85.13 and 90% accuracy. In the first deep learning approach, a single dense output layer was used with multiple neurons where each neuron represented only one label. In the second approach, a separate dense layer for each label was created with one neuron. The model with a single output layer produced an accuracy score of 32%, and the model with multiple output layer had an accuracy score of 31%. Both deep learning models with single and multiple output layers did not perform well compared to SVC. Conclusions: Our study shows an early indication regarding the feasibility of modern ML techniques in predicting multiple label categories or outcomes. As a potential clinical decision support system, this model could replace manual data entry, minimize human error, and decrease resources for data collection. In the next stage, healthcare providers will validate this model by manually checking the predicted labels. In the final stage, model will be deployed in real-time to predict OP-35 categories automatically.
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Awan, Waseem Sadiq, Arslan Ahmed, Raza Farrukh, Yar Muhammad, Salman Athar, Hafiz Muhammad Sajid Jehangir, and Ghulam Mustafa Arain. "Role of Internal Sphincterotomy as an Adjunct to Open Haemorrhoidectomy for Management of Third- and Fourth Degree Haemorrhoids." BioMedica 36, no. 2 (June 30, 2020): 132–37. http://dx.doi.org/10.24911/biomedica/5-126.
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<p><strong>Background and Objective</strong>: Post-operative pain and complications are common after open haemorrhoidectomy. Addition of internal sphincterotomy has shown to improve the post-operative outcomes. This study is conducted to compare the outcomes of open haemorrhoidectomy with and without internal sphincterotomy.<br /><strong>Methods:</strong> A prospective randomized controlled trial was conducted in the Department of Surgery at Sargodha Medical College/District Headquarter Hospital, Sargodha from February 2016 to December 2017. One hundred and twenty-two patients presenting with third and fourth degree haemorrhoids were divided in two equal groups. In group “A”, haemorrhoidectomy with internal sphincterotomy and in group “B”, haemorrhoidectomy alone was performed. Outcome variables such as pain scores based on Verbal Rating Scales (VRS), hospital stay, complications and wound healing were compared in both groups.<br /><strong>Results:</strong> The mean pain scores were less in the internal sphincterotomy group A i.e., 3.3 ± 0.3 while it was 3.6 ± 0.4 in group B at 1st post-op day. The mean duration of hospital stay was less in group A (2.3 ± 0.7 days) and it was 3.4 ± 0.9 days in group B. On the 7th post-operative day, 13 (21.3%) patients in group A and 4 (6.6%) patients in group B had flatus incontinence. Urinary retention was present in 4 (6.6%) cases in group A and 13 (21.3%) in group B. Post-operative bleeding was present in 44 (72.1%) cases of group A and 41 (67.2%) of group B. Constipation was higher in the group B (44.3% vs. 37.7%). Wound healing was better in group A (63.3%). Anal stenosis occurred in 3 (4.9%) patients who were treated with <br />haemorrhoidectomy alone.<br /><strong>Conclusion:</strong> Addition of internal sphincterotomy improves the outcome of open haemorrhoidectomy in patients of third- and fourth-degree haemorrhoids. It is therefore recommended to carryout internal sphincterotomy when operating on such patients</p>
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Hoskins, Tyler, David Goyette, Jay Patel, Christopher Mazzei, Arianna L. Gianakos, Justin Koss, James Wittig, and David M. Epstein. "Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair." Foot & Ankle Orthopaedics 5, no. 4 (October 1, 2020): 2473011420S0025. http://dx.doi.org/10.1177/2473011420s00258.
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Category: Ankle; Sports; Trauma Introduction/Purpose: Achilles tendon rupture is a traumatic injury that can cause considerable morbidity and reduced function. The optimal treatment method for this injury remains controversial. Non-operative intervention puts patients at higher risk of re-rupture whereas surgical intervention has risks of infection and iatrogenic nerve injury. Recently, surgeons have established a less invasive surgical approach to repairing the achilles tendon. The ‘Percutaneous or Mini-Invasive’ technique was adopted in order to reduce infection rates and wound breakdown. However, due to the scarce amount of literature reported, the efficacy of this procedure still remains under scrutiny. The goal of this study was to examine the functional outcomes of patients treated at our facility for a ruptured achilles tendon using the percutaneous and minimally invasive surgical technique. Methods: From 2014 to 2020 eighty-one patients underwent a percutaneous or mini invasive surgery at our facility for the treatment of a ruptured achilles tendon. Functional outcome scores were assessed using the American Orthopaedic Foot & Ankle scoring system (AOFAS) and the Achilles Tendon Rupture Score (ATRS). Outcomes, complications, and any reoperations were recorded through retrospective chart review, direct patient examination, and phone calls to patients and their families. A statistical analysis was performed using Fischer’s Exact Test. Results were deemed statistically significant if the calculated p-value was less than 0.05. Results: The mean follow up for our patient cohort was 36.40 months (range, 6 to 71). The average age was 41.46 years (range, 17- 65). Mean pre-op AOFAS and ATRS were 45.60 and 47.18 respectively, compared to 90.29 and 87.97 after surgery (p-value <0.05). There were two significant complications reported post-operatively. One patient re-ruptured their Achilles tendon four months post-operatively. This patient was successfully treated with a mini invasive approach and reconstruction of the tendon. A second patient developed a superficial infection ten months post-operatively. This patient successfully underwent irrigation and debridement of the wound. Conclusion: The pre-op and post-op AOFAS and ATRS scores were deemed statistically significant. A percutaneous and mini invasive approach to repair a ruptured achilles tendon, although new, offers promising functional outcome results and remains a viable treatment option to decrease the incidence rate of post-operative infection and iatrogenic nerve injury. However, a prospective randomized controlled trial comparing the efficacy of this procedure to other surgical methods would be necessary to further evaluate and validate our findings.
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Burel, Oleksandr. "“Nuit Persane” by C. Saint-Saëns: Oriental Story from a Frenchman." Aspects of Historical Musicology 34, no. 34 (April 10, 2024): 55–91. http://dx.doi.org/10.34064/khnum2-34.03.
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Statement of the problem. Since the 18th century, oriental theme have been firmly established in French classical music . Camille Saint-Saëns (1835–1921) did not miss it in his vocal cycle “Persian Melodies” for voice and piano op. 26 (1870), which he transformed later into a picturesque symphonic canvas “Nuit Persane” op. 26-bis (1891). The very fact of such a transformation cannot fail to arouse research interest, especially since the score became not just a vocal-orchestral version of “Persian Melodies”, but acquired features of spectacular theatricality. If the early period of the composer’s work was marked by such significant achievements as Piano Quintet (1855), Christmas Oratorio (1858), Piano Trio No. 1 (1863), Introduction and Rondo-capriccioso (1863), Piano Concerto No. 2 (1868), numerous mélodies and sacred motets, then with the outbreak of the FrancoPrussian War (1870–71), the composer’s productivity decreased. It is indicatively that in 1870, when he wrote only a few compositions, “Mélodies Persanes” was among them. What significance, in the context of the composer’s creative evolution, was his appeal to the images of the East? How exactly does he reveal the oriental theme? Elucidation of this question, along with the study of the author’s style of C. Saint-Saëns, became the purpose of our research. Objectives, methods, novelty of the research. The following tasks were implemented: the main facts from the history of creation, first performances, sheet music publications of “Mélodies Persanes” and “Nuit Persane” were summarized; A. Renaud’s poems, which became the poetic basis of these works, were translated; the form, intonation structure and logic of harmonic development in each of the numbers of the Cantata were analyzed; the semantic constructions and the features of the musical dramaturgy of the work were characterized; and specific details of the orchestral writing were revealed. For analyzing the work, historical, genre and style, structural and functional, comparative, and systematic research methods were used. The vocal cycle “Mélodies Persanes” (the “prototype” of the Cantata) has attracted some research attention (Noske,1954; Ladjili, 1995; Johnson, 1997; Zeng Tao, 2016; Bertaux, 2021). There are significantly fewer studies of the cantata “Nuit Persane” op. 26-bis. One of the first reviews belonging É. Baumann (1905) emphasizes the difference between the Persian and the African Orient. Some research aspects are covered in the text materials dedicated to the 2007 CD edition of the Cantata. Y. Gérard (2008) provides valuable facts from the history of the work, while W. Yeoman (2008) focuses more on its musical construction. H. Macdonald draws the parallels with “The Damnation of Faust” by H. Berlioz and come to conclusion that a number of C. Saint-Saëns’ works “evoke the Muslim world, but none with more potency than Nui Persane”(Macdonald, n.d.). The mentioned materials leave considerable space for further, more in-depth research into the score by C. Saint-Saëns, including the reproducing the oriental flavor in it, which determines the novelty of our study. Research results. The first decades of C. Saint-Saëns’ composer work (1850s–1860s) marked by the creation of the outstanding chamber-vocal compositions, such as “Rising of the moon”, “Waiting”, “The Bell”, “The death of Ophelia”, “Moonlight”, “Sadness”, “The song of those who set sail upon the sea”. The song cycle “Mélodies Persanes” (1870) became a worthy continuation of previous successes. C. Saint-Saëns turned to the collection of poems “Les Nuits Persanes” (1870), created by his friend A. Renaud (1836–1895). Each of the six mélodies (“The Breeze”, “Empty Splendor”, “The Lonely Woman”, “Sword in Hand”, “In the Graveyard”, “Spinning”) is dedicated to a particular person – P. Viardot, M. Trélat, A. Holmès, H. Regnault, E. Jadin, L. Pagans. In the spring of 1891, C. Saint-Saëns decided to rework the song cycle. At the request of the composer, A. Renaud wrote a scenario for new version. The score was created in Algeria from November 21 to December 16, 1891. In addition to two soloists (contralto, tenor) and a symphony orchestra, a choir and a narrator were included into the score. The new work was called “Nuit Persane” ор. 26-bis and actually became a cantata, despite the absence of a genre designation on the title page of the score. From the very beginning, the features of the plot were laid in the “prototype” – the song cycle op. 26. In our opinion, it was the reason for the processing into a cantata, and not into a orchestral setting, like “Summer Nights” (1841) by H. Berlioz, or “Songs of a Wayfarer” (1884–85) by G. Mahler. Soon after the Cantata was written, some its fragments were performed at the concert on February 14, 1892 (Théâtre du Châtelet, Paris) conducted by Édouard Colonne. The performing was so good that the work was repeated the following week. The orchestral and piano scores were printed in 1893–1894; these editions were decorated with exquisite illustrations by G. Clairin, C. Saint-Saëns’s friend. The cantata was fully performed on January 3, 1897 by the Société des Concerts du Conservatoire. The critics and the audience took it very favorably. The cantata includes five of the six romances of “Mélodies Persanes” (without “Empty Splendor”, but with partial use of this musical material), and two new movements (“Flight” and “Swans”). Therefore, a total of seven movements were formed into four parts. Each part is preceded by the orchestral prelude with the narrator telling about the upcoming events. Conclusion. The cantata “Nuit Persane” combines emotional spirituality with the compositional skill, which made it possible to achieve significant expressiveness with a fairly economical use of musical means. The leading constants of C. Saint-Saëns’ style are clearly revealed in the sophistication of the writing, variety and detail of the design of this score. Regarding the specific melodic-harmonic, modal, rhythmic elements, the analysis of the work revealed a fairly dosed use of them, that testifies a moderate tribute to orientalism. As a result, there was a musical narrative about the events in the East, but still on behalf of the European C. Saint-Saëns.
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Subbiah, Ishwaria M., Caroline Schenkel, Margaret Kelsey Kirkwood, Jeffrey M. Peppercorn, Blase N. Polite, David Michael Waterhouse, Robin Zon, and Laura A. Levit. "Multilevel factors impacting clinical trial participation: An ASCO State of Cancer Care in America (SOCCA) analysis of oncology fellows’ perceptions of preparedness to conduct clinical research in practice and importance of clinical trial participation." JCO Oncology Practice 19, no. 11_suppl (November 2023): 110. http://dx.doi.org/10.1200/op.2023.19.11_suppl.110.
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110 Background: Despite cancer treatment advances from clinical trials, the proportion of those with cancer enrolling on oncology studies remains low, due to system-, patient-, and physician-level facilitators and barriers to participation. To better understand the upstream context impacting oncologists’ consideration of trials, we studied oncology fellows’ perceptions of trial participation and preparedness for clinical research. Methods: All year 1 (Y1), Y2, & Y3 fellows taking the 2023 ASCO Medical Oncology In-Training Exam (ITE) were invited to take a post-ITE optional survey. After consent, fellows answered whether they agree, disagree or are unsure of their preparedness by their fellowship program to address key elements of practice and research and their perceived importance of trial participation after training, ranging from Very Important, Important, Moderately, Slightly, or Not Important, the latter 3 ratings aggregated and labeled as ‘less important.’ Descriptive statistics and Chi-squared tests comparing responses by fellowship year are presented. Results: Overall, 97% of fellows (2184/2231) taking the 2023 ITE participated in this study and are included in this analysis; 32% were in Y1, 37% Y2, 30% Y3. When asked ‘my fellowship training program is adequately preparing me to address the following in my future,’ nearly one in four fellows felt unsure or disagreed that their program prepared them for (a) treating patients outside of an academic medical center (Y1 24%, Y2 24%, Y3 23%) or (b) conducting clinical research (Y1 26%, Y2 26%, Y3 28%). When asked ‘how important is it to you to have the opportunity to participate in clinical trials following completion of your training,’ nearly half of oncology fellows (Y1 49%, Y2 46%, Y3 40%, p.038) felt trial participation was ‘less important.’ When considering future practice setting, two out of 3 fellows (66%) planning a non-academic practice and one of 3 fellows (33%) planning an academic practice rated trial participation as ‘less important’ (p<.0001). When compared to fellows who reporting being unsure or unprepared by their programs to conduct clinical research, those who felt adequately prepared were more likely to rate trial participation as important/very important (57% vs 49%, p=.005). Conclusions: Our findings show that value of clinical trial participation is assigned early in oncologists’ careers during fellowship training. Addressing barriers to clinical trial participation calls for multilevel interventions that include efforts to identify and augment clinical research learning needs of oncology fellows and ensuring broad exposure during fellowship to successful and efficient conduct of cancer clinical trials.
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Mits, Oksana. "The genre of the piano miniature in the creative work of M. Moszkowski." Problems of Interaction Between Arts, Pedagogy and the Theory and Practice of Education 50, no. 50 (October 3, 2018): 136–48. http://dx.doi.org/10.34064/khnum1-50.10.
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Statement of the problem. Recently, there has been growing interest in the personality of the outstanding Polish composer, pianist, teacher and conductor M. Moszkowski (1854–1925), whose creativity occupies a significant place in the history of European musical art of the second half of the nineteenth – early twentieth centuries. The multifaceted composer’s legacy of M. Moszkowski gives a large variety of materials for researchers. His piano creativity, which encompasses composing, performing, teaching and editorial activities, is an outstanding phenomenon in the European musical culture. One of the key genres of piano music by composer is a miniature. The miniatures that were created by M. Moszkowski during his life, reflects the evolution of his individual style, clearly representing his creative method, aesthetics and piano performance features. However, the question of the genre of miniatures in the work of M. Moszkowski has not been considered by the researchers yet. Thus, there is a need for scientific analysis of M. Moszkowski’s piano miniatures in the context of the general stylistic norms of his creative work. The purpose of the article is characterization of stylistic features and attempt to classify of M. Moszkowski’s piano miniature in view of the role of this genre in the Polish composer’s creativity. Methods. The methodological basis of the study is the unity of scientific approaches, among which the most important is a functional one, associated with the analysis of the genre as a typical structure. The desire to realize the fundamental principles of scientific knowledge, comprehensiveness and concrete historical approach to the study of the target problem requires the combination of musical analysis with historical-cultural, stylistic generalizations, considering piano works by M. Moszkowski in the unity of historical, ideological, stylistic and performing problems involving the conceptual apparatus of theoretical musicology and the theory of pianism. Results. The vast majority of piano pieces by M. Moszkowski are miniatures. According to their place in the performing practice, miniatures are differentiated into concert-virtuoso, pedagogical, household directions. According to the internal genre typological features, they are divided into etudes, dance pieces (waltzes, mazurkas and polonaise serve as confirmation of the musical-historical experience of romantic composers) and others. In the palette of the latter are scherzo, capriccio, fantasia-impromptu, musical moments, arabesques, barcarole, lyrical pieces – that is, almost the whole arsenal of the most common types of miniatures of the Romantic era. The analysis of piano miniatures reveals the composer’s individual attitude to tradition, free choice of figurative and stylistic priorities by him. Under consideration are the piano cycles “Spanish dances” op. 12, “Arabesque” op. 61, the piece-fantasia “Hommage à Schumann” op. 5, Suite for 4 hands “From all over the World op. 23” and other miniatures that were creating throughout the life of the composer. These samples of the salon style of the late XIX century became a kind of generalization of creative searches of the previous constellation of composers – salon performers. Throughout his life, M. Moszkowski repeatedly turns to ancient forms and finds for creation of his miniatures an entirely new impulse: the small forms of the Baroque age. By rethinking, “romanticizing” them, the composer creates his own modifications of the genre models of ancient music in such works as “Canon” (op.15, op. 81, op. 83), “Rococo” op. 36, “Burre” op. 38, “Siciliana” op. 42, “Gavotte” (op. 43, op. 86), “Fugue” op. 47, “Sarabande” op. 56, “Prelude and Fugue” op. 85, as well as numerous “Minuets”. The latter carry out the traits of the aesthetics of the gallant style. Since 1900, Moszkowski prefers etudes. The arsenal of techniques he uses in these works is rich and diverse and emphasizes the artistic qualities of these compositions. Sometimes Moszkowski interprets the genre of the etude very freely: as a substitute for another genre (“Two miniatures” op. 67), as part of the cycle-diology (“Etude-Caprice” and “Improvisation”, op. 70), etc. Modern pianists seldom perform the piano music by Moszkowski. At the same time, the pieces represent a very interesting material that clearly reflects the originality of the musical language of the late romantic pianists, to which Moszkowski belonged. Perhaps, performers confused by the overload of musical material with various technical difficulties. The composer used a wide range of romantic pianistic means. The typical stylistic feature of his music is improvisation, based on the tradition of a brilliant piano style of performance with a romantically impulsive change in emotional states. The performance seems to be more unattainable, because the composer’s bold innovation in virtuoso texture is combined with a refined romantic manner of writing. This circumstance explains the fact that the works by Moszkowski were forgotten for many years. And only now, at the beginning of the twenty-first century, when many values and priorities are revised, art salon style and Moszkowski’s compositions are becoming of great interest. Conclusions. The piano “workshop of miniatures” is the most important component of the composer’s legacy of M. Moszkowski, reflecting the peculiarity of the author’s aesthetic position – cultivating a positive mood, elegance, refinement, virtuosity as signs of ownership of the instrument. It is these aesthetic principles – the feeling of Beauty as preciosity, delicacy, non-conflict state of reality – formed his attitude to the genre of miniatures. M. Moszkowski’s piano miniatures marked by the features of virtuoso style creating associations with the music of F. Chopin and R. Schumann. Chopin’s influences can be traced in the choice of genres of miniatures – among them there are waltzes, polonaises, impromptu, etudes, scherzo and barcaroles. However, for M. Moszkowski, as a composer of Polish origin, was simply necessary to be “native” to the musical heritage of F. Chopin. At the same time, the “similarity” of certain techniques to Chopin’s in the piano works by Moszkowski, always appears in the updated version without duplicating the original sources. The influence of R. Schumann is manifested in the dominance of melodious lyric and playful scherzo’s spheres, the tendency toward the characteristic images and the cycling of pieces, often combined with a certain artistic idea, specified by the programmatic subtitles or by the suite principle. Moszkowski’s piano works are perfect in a form, in possessing of specifics of the piano texture and the richness of figurative thinking. Moszkowski’s miniatures represent a very high level of piano skills, technically, they often require the ability to have a good command of the instrument, but technical difficulties submit to a vivid, meaningful image. Piano miniatures by M. Moszkowski became a significant contribution to the development of Western European art of the second half of the nineteenth and early twentieth centuries. The numerous piano pieces by the composer, distinguished by high artistic qualities, today should rightfully take a worthy place in the concert practice of modern pianists.