Search

AbstractMethiocarb is a carbamate pesticide and is widely used due to its short lifetime but is a health concern due to its toxicity. To address this challenge, a novel nano-sorbent (zinc aluminate hybrid doped onto a magnetic activated carbon cloth (magnetic ACC@ZnAl2O4)) was synthesized. The characterization of the composite was done using FTIR spectroscopy, SEM, XRD, and EDX. The synthesized composite was then employed for the efficient extraction of methiocarb from food samples. Under the optimum conditions of (pH: 7.0, vortex time: 0.5 min, adsorbent dose: 5 mg, initial volume of sample: 50 mL, volume of eluent: 1.0 mL), quantitative recovery values of methiocarb in food samples were obtained (80–114%). This method impresses with its exceptional sensitivity, achieving incredibly low detection (LOD: 20 µg L−1) and quantification (LOQ: 67 µg L−1) limits for methiocarb. Its efficiency is equally impressive, with high values of preconcentration factor (PF: 50) and enhancement factor (EF: 49.4), ensuring accurate and reliable analysis with a low value of relative standard deviation (RSD: 4.8%). The method’s impressive selectivity, evident in its minimal interference from other pesticides, paves the way for reliable methiocarb analysis in food samples. [ABSTRACT FROM AUTHOR]

Here is reported the synthesis of a magnetic phosphorus-containing adsorbent decorated with poly(N-isopropylacrylamide) (PNIPAM) brushes via surface-initiated atom transfer radical polymerization (SI-ATRP) and its application for vortex assisted solid phase extraction of lead in water, cigarettes and soil. The adsorbent was characterized using Fourier-transform infrared spectroscopy (FT-IR) and energy dispersive x-ray (EDX) spectroscopy. A high-resolution continuum source flame atomic absorption spectrometer (HR-CS FAAS) was used for the quantification of lead. All factors affecting the extraction efficiency including the solution pH, adsorbent dose, sample volume, vortex time, and elution protocols were optimized. The limits of detection (LOD) and quantification (LOQ) were determined to be 0.05 µg L−1 and 0.18 µg L−1, respectively. The preconcentration and enhancement factors were 20 and 18. Validation was performed using TMDA 64.3 fortified water and INCT-OBTL-5 tobacco leaves certified reference materials with satisfactory recoveries. The method was shown to be sensitive, efficient and reproducible. [ABSTRACT FROM AUTHOR]

AbstractVarious analytical techniques have been used for determination of trace aluminum (Al). However, due this element’s low concentration levels, these techniques are unsuitable for precise and accurate analysis of Al in various food and environmental samples without prior preconcentration. Therefore, many preconcentration procedures have been adopted to enrich Al for its precise and accurate quantification. This review summarizes solid phase and liquid phase preconcentration methods for the enrichment of Al. [ABSTRACT FROM AUTHOR]

Background and Objective: A thorough insight into the management of hand injuries can shape the approach of a surgeon in order to achieve optimal outcomes for the patients. The aim of this study was to share our experience in reconstruction of the hand and establishing an algorithm for classification and treatment of hand injuries. Methods: This is a descriptive cross sectional study and was conducted from January 2020 to August 2022 at Burns and Plastic Surgery center, Peshawar. Data was collected from medical records about the patient demographics, mechanism of injury and type of procedures done. Defect size was classified into small (<5cm), medium (5cm to 10 cm) and large (>10cm). The defect site and size was cross tabulated against the method of soft tissue reconstruction in order to make the algorithm for reconstruction of hand injuries. Data was analyzed using SPSS. Results: The study population included 41 (75.9%) male and 13 (24.1%) female patients, mean age 31.56±14.1. Machine injuries (33.3%) and electric burns (24.1%) were the most common cause of hand soft tissue defects. The most commonly performed flap was Posterior introsseous artery (PIA) flap, followed by First dorsal metacarpal artery (FDMA) flap. Flap necrosis was observed in three cases (5.6%). Conclusion: This treatment algorithm for coverage of soft tissue defects in hand injuries will help with the decision making process of hand reconstruction and has didactic value for novice surgeons. It will also form the foundation for further work on this aspect of hand injuries. [ABSTRACT FROM AUTHOR]

This work investigates substrate leakage in Capacitive Micromachined Ultrasonic Transducers, (CMUTs) having thin backings. CMUTs produced with solid or rigid substrates have a high Q resonance with flat baseline. However, if the operating wavelength of CMUT becomes larger than the thickness of substrate the real part of cell impedance shows elevated baselines with more leakage at DC than at higher frequencies. When a clamped CMUT membrane is excited harmonically the vibrations produced are counterbalanced by the backing medium. Hence some of the energy is coupled to substrate as loss resulting in a lower mechanical Q of resonance. We first derive this energy coupled to the backing medium using FEA analysis considering the velocity field and associated tensile stresses in a thin backing. Substrate impedance is found numerically from isotropic damping of dispersive elastic waves in the backing. This backing impedance is introduced as a shunt mechanical loss across the transduction force in equivalent circuit model. We characterize the measured impedance of CMUT cells with both FEMs and linear circuit models. Simulations results closely agree with the measured impedance levels, frequency and bandwidth of resonance. [ABSTRACT FROM AUTHOR]

Aim: The aim of this article is to share our experience of thumb reconstruction based on the defect and irrespective of the aetiology, and to work towards standardising the treatment for thumb defects. Material and method: This study was conducted at the Burns and Plastic Surgery Centre at Hayatabad Medical Complex from 2018 to 2021. Thumb defects were divided into small (<3 cm), medium (4–8 cm) and large defects (>9 cm). Patients were evaluated for complications post-operatively. The data for defect size and defect site was cross-tabulated for reconstructive options with the help of SPSS. Different flaps were performed depending on the site and size of the defect, which were arranged in a schema to develop an algorithm. Results: After scrutinising the data, 35 patients qualified for the study, comprising 71.4% (25) males and 28.6% (10) females. The mean age (and SD) was 31.17 +15.8 years. The right thumb was affected in the majority of the study sample (57.1%), and the majority were affected by machine injury or post-traumatic contractures, affecting 25.7% (n = 9) and 22.9% (n = 8), respectively. Injuries to the first web space and distal to the IPJ of the thumb were the most common, accounting for 28.6% (n = 10) each. A first dorsal metacarpal artery flap was the most common flap, followed by retrograde posterior interosseous artery flap, observed in 11 (31.4%) and 6 (17.1%) cases. The most common complication observed in the study population was flap congestion (n = 2, 5.7%) with a complete flap loss in 1 patient (2.9%). Based on the cross-tabulation of flaps against the size and location of defects, an algorithm was developed to help standardise reconstruction of thumb defects. Conclusion: Thumb reconstruction is critical in restoring the patient’s hand function. This classification-based, structured approach for thumb reconstruction will help hand surgeons in taking decisions and selecting effective coverage options with minimal complications. Most of these defects can be covered with local, simple flaps without the need for a microvascular reconstruction. [ABSTRACT FROM AUTHOR]

This study is focused on the design of a spectrophotometric technique for the liquid–liquid microextraction (Ss-LLME) of aluminum from water and hair samples to use a supramolecular solvent. Al (III)-curcumin complex was quantitatively isolated and preconcentrated using supramolecular solvent liquid–liquid microextraction at pH 6.0. The measured molar absorptivity for the compound was 9.28 × 104 L mol−1 cm−1 at 430 nm. Beers law was applicable in the concentration range of 0.1–12.0 µg mL−1. Extraction efficiency influencing factors like solution pH (6.0), mass of chelating agent (0.1 mg), sample volume (20 mL), type and volume of supramolecular solvent (decanol, 0.1 mL), the volume of THF (0.2 mL) and matrix effect was optimized. Parameters of merit like a limit of detection (0.056 mg L−1) and limit of quantification (0.189 mg L−1), preconcentration factors (50), enrichment factor (50), and determined relative standard deviations. The new method's precision was determined by analyzing verified reference materials TMDA-64.3 fortified water and NCS ZC81002B human hair. The procedure was applied to determination of aluminum contents of hair and water samples. [ABSTRACT FROM AUTHOR]

Objective: To share our experience with nasal reconstruction and to give a standardized algorithm for nasal reconstruction. Study Design: Descriptive cross sectional. Setting: Burns and Plastic Surgery Center, Peshawar. Period: January 2019 to December 2022. Material & Methods: Data was obtained from patient records after approval from IREB. Patients with multiple co-morbidities and small defects (<1.5cm) were excluded from this study. Defects were classified based on anatomic areas of radix, dorsum, sidewall, alar and lower third nasal defects. Cases were cross tabulated regarding site for the reconstructive options to generate the treatment algorithm. Results: A total of 51 cases were included in the study including 30 (58.8%) male patients. Mean age of patients was 48.12+21.89SD. Skin malignancies were the most common (n=35, 68.6%). Nasal ala was the most common site reconstructed in our study (25.5%) followed by nasal dorsum and sidewalls. Medium size (41.2%) was the most common. In 64.8% (n=33) cases, forehead based flaps were used to reconstruct the nasal defects (Table-I). In 5.9% cases we observed flap congestion. In 19 (37.25%) cases, patients presented with additional soft tissue defects which needed reconstruction (Table-II). Reconstructive options are presented as an algorithm based on the defect site (Figure-1). Conclusion: In this study we shared our experience with the readers regarding reconstruction of the nasal detects. We have formulated an algorithm for reconstruction of these defects that will simplify reconstruction in such cases. [ABSTRACT FROM AUTHOR]

Objective: To share our experience with reconstruction of the head and neck defects and to standardize the reconstruction options for such defects. Study Design: Descriptive Cross Sectional study. Setting: Burns and Plastic Surgery Center, Peshawar. Period: November 2018 to December 2022. Material & Methods: Data was collected from medical records about the patient demographics, mechanism of injury and type of procedures done. Defect size was classified into small (< 3 cm), medium (4 cm to 8 cm) and large (> 8 cm). Data was analyzed using SPSS. Results: Over the study period, 112 (70%) male and 48 (30%) female patients, with mean age of 44.36 + 21.35, were operated. The main cause of head and neck defects, were malignant lesions; 60% (n=96) cases. The most common site of was nose, either alone or in combination with surrounding areas. In 54 (33.4%) cases, the reconstructed defects were of medium size, followed by large defects (n=52, 32.5%). In 79 (49.4%) cases, the defects were reconstructed with local flaps, followed by pedicled flaps; 70 (43.8%) cases. Free flap reconstruction was performed in 11 (6.9%) cases. The most common free flap was fibula based (n=4). Complications were observed in 4.4% cases. Conclusion: The most common defects in head and neck region are on nose. In most cases the etiology is lesion excision. Other common defects encountered are scalp, eyelids and ear. Most of the defects can be covered with local flaps with very low complication rate. [ABSTRACT FROM AUTHOR]

Mercury (Hg) is a toxic heavy metal discharged into the environment by many human and natural sources. Therefore, the precise and accurate determination of trace mercury in samples is of immense importance. In this regard, a spectrophotometric method has been developed for the quantification of Hg (II) in water, hair, and fish using deep eutectic (choline chloride, ChCl + decanol) solvent-based liquid-liquid microextraction (DES-LLME). All of the relevant parameters, including pH (9), volume of 1-(2-pyridylazo)-2-naphthol (PAN) (300 µL), ratio of choline chloride and decanol (1:1), volume of DES (400 µL), volume of tetrahydrofuran (THF) (400 µL), and sample volume (40 mL) were optimized. The low limits of detection (LOD) (0.09 µg L−1) and quantification (LOQ) (0.325 µg L−1) demonstrate that the developed approach is highly sensitive. High preconcentration (PF) and enhancement factors (EF) of 50 show that the developed protocol is highly efficient. The relative standard deviation (RSD) is 6.32%, indicating that the method is reproducible. The method was validated by the analysis of TMDA-53.3 water and NCSZC81002B hair certified reference materials with high recoveries of 97% and 93%, respectively. The method was also employed for the analysis of tap water, dam water, river water, hair, and tuna fish with satisfactory recoveries from 95% to 102%. The developed approach was compared with literature methods on the basis of the limit of detection. [ABSTRACT FROM AUTHOR]

Objectives: To describe the demographics, reconstructive options for different area and defect sizes and the functional outcome of upper extremity reconstruction. Study design: Descriptive study Setting: Burns and Plastic Surgery Center, Hayatabad Medical Complex, Peshawar Duration: 6-years Material and Methods: This study was performed from 2018 to 2021 in the department of Burns and Plastic Surgery. All the patients with upper extremity defects, for which reconstruction was performed, were included in the study after informed consent. The data was collected from hospital record and functional outcome was assessed based on the Toronto Extremity Salvage Score (TESS) questionnaire after 6-months of reconstruction. All the data was organized and evaluated with the help of statistical soft ware. Results: A total of 67 patients were included in the study including 51(76.1%) male and 16(23.9%) female patients with age ranging from 5 weeks to 65 weeks (mean 30.27+14.9 SD). Right upper extremity was affected in 61.2 % (n=41). The main cause of injury was electric burns and machine injuries, accounting for 26.9% each. Hand was the mainly affected region. The most commonly performed flap in our series was retrograde posterior interosseous artery flap (n=14, 20.9). Insignificant partial flap necrosis was observed in 3 (4.5%). Post-operative TESS score ranged from 40% to 99% with a mean of 85.4+14.9SD. Conclusion: There are multitude of options available for upper limb reconstruction. Functional outcome should be assessed using standardized tools like Toronto Extremity Salvage Score (TESS). This will lead to standardization of treatment modalities in such patients. [ABSTRACT FROM AUTHOR]

Collaboration with local emergency services: Establishing relationships with local first responders and ensure that they are familiar with the layout of the event venue and that they are adequately staffed to respond to emergencies during sporting events. With large groups of spectators watching potentially dangerous sporting events, it is essential to consider the safety of all involved in these mass attendance events and to have a plan for all types of disasters, despite them luckily being rare events. Keywords: crowd; disaster; emergency; planning; sporting event EN crowd disaster emergency planning sporting event S1 S3 3 06/30/23 20230503 NES 230503 Sports disasters refer to a variety of events including accidents, injuries, or acts of violence that occur during sporting events. [Extracted from the article]

With large groups of spectators watching potentially dangerous sporting events, it is essential to consider the safety of all involved in these mass attendance events and to have a plan for all types of disasters, despite them luckily being rare events. Keywords: crowd; disaster; emergency; planning; sporting event EN crowd disaster emergency planning sporting event S1 S3 3 05/18/23 20230502 NES 230502 Sports disasters refer to a variety of events including accidents, injuries, or acts of violence that occur during sporting events. Collaboration with local emergency services: Establishing relationships with local first responders and ensure that they are familiar with the layout of the event venue and that they are adequately staffed to respond to emergencies during sporting events. [Extracted from the article]

Objective: We aim to look at the epidemiology of lower limb trauma and study the post-operative functional outcome. Study Design: Descriptive study Sett ing: Burns and Plastic Surgery Center, Hayatabad Medical Complex, Peshawar Duration: six years Material and Methods: After approval from the ethical board, data was collected from hospital records. Data regarding patient demographics, site, anatomic location of injury, and type of reconstructive procedure done was collected. Complications including partial (significant or insignificant) or complete necrosis was documented. Toronto extremity Salvage (TESS) score was calculated. Results: A total of 73 patients underwent lower limb reconstruction with mean age of 28.7+12.5 SD. Road traffic accidents (RTA) were the main cause of lower limb trauma (45.2%). There were 54.8% defects with associated fractures, most commonly tibia. The mean duration of presentation for reconstruction was 5.3 week +10.23SD. Total of 81 flaps were performed (68 pedicled and 13 free micro-vascular flaps). 35-patients required bony stabilization. Infection (8.2%) was the most common complication. Partial Flap necrosis was observed in 4(5.5%) cases, out of which 3(4.1%) were significant partial necrosis. Mean Toronto Extremity Salvage Score (TESS) was 84.8+13.6 SD. Discussion: Mostly younger male population are involved with lower limb trauma. Most patients had delayed presentation due to under developed infra-structure in the tribal areas and issues with timely referral from peripheral health care facilities. Most of the small and medium defects can be closed with local flaps. However large defects with bone involvement required free microvascular flaps. Post-operative outcome was good using TESS score. Conclusion: Robust referral system and single stage orthoplastic procedures should be adopted. Multi-center studies need to be conducted and liaison with orthopedic department is paramount to improve outcomes. [ABSTRACT FROM AUTHOR]

In this study, hydrogel beads were fabricated using alginate (Algt) polymer containing dispersed nickel phthalocyanine (NTC) nanomaterial. The viscous solution of Algt and NTC was poured dropwise into a divalent Ca2+ ions, resulting in the formation of hydrogel beads known as NTC@Algt-BDs. The surface of the NTC@Algt-BDs was further modified by coating them with different types of metal ions, yielding metal-coated M+/NTC@Algt-BDs. The adsorbed metal ions i.e., Cu+2, Ag+, Ni+2, Co+2, and Fe+3 were subsequently reduced to zero-valent metal nanoparticles (M0) by NaBH 4. The prepared beads were characterized using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS). Initially, M0/NTC@Algt-BDs were examined for the catalytic reduction of 4-nitrophenol (4-NP) to 4-aminophenol (4-AP). Among them, Cu0/NTC@Algt-BDs catalyst exhibited the highest reduction rate and therefore, investigated for reduction of different nitrophenols (NPs) and dyes, including 2-nitrophenol (2-NP), 2,6-dinitrophenol (2,6-DNP), methyl orange (MO), potassium ferrocyanide (PFC), congo red (CR), and acridine orange (ArO). The highest reduction rates of 2.019 and 1.394 min−1 were observed for MO and 2-NP, respectively. Furthermore, the fabricated catalysts were employed for the efficient production of H 2 gas by NaBH 4 methanolysis. Among which the Ag0/NTC@Algt-BDs catalyst showed excellent catalytic production of H 2 gas, exhibiting the lowest activation energy (Ea) of 25.169 kJ/mol at ambient temperature. Furthermore, the impact of NaBH 4 amount, and catalyst dosage on the reduction of 2-NP and H 2 gas production was conducted whereas the effect of temperature on methanolysis of NaBH 4 for evolution of H 2 gas was studied. The amount of H 2 gas was confirmed by GC-TCD system. Additionally, the recyclability of the catalyst was investigated, as it garnered significant research interest. [Display omitted] [ABSTRACT FROM AUTHOR]

The incidence of invasive fungal diseases (IFDs) has risen in hematologic malignancy patients due to neutropenia. While posaconazole is recommended as the first-line antifungal prophylaxis in acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) patients and voriconazole is an alternative, there is currently no direct comparison data available to assess their relative effectiveness.We retrospectively reviewed eligible patient charts from January 2017 to February 2019 to identify breakthrough IFD rates, drug adverse event frequency, and drug acquisition cost in AML/MDS patients.Forty-eight patients received 130 chemo cycles, with 50 (38%) cycles prescribed posaconazole and 80 (62%) prescribed voriconazole as primary IFD prophylaxis. The incidence rates of IFD in the posaconazole group were 8% (4 out of 50), of which two were probable and two were possible infections, while 6.26% (5 out of 80) of patients in the voriconazole group developed IFD, with four possible infections and one probable infection (p = 0.73). A higher percentage of patients in the voriconazole group discontinued prophylaxis due to adverse events, with six patients compared to two patients in the posaconazole group (p = 0.15). The drug acquisition cost of posaconazole is 5.62 times more expensive than voriconazole.The use of voriconazole instead of posaconazole for 130 chemo cycles would save $166,584.6. Posaconazole and voriconazole have comparable efficacy and safety in preventing IFD in AML and MDS patients receiving chemotherapy. However, posaconazole is more costly than voriconazole. [ABSTRACT FROM AUTHOR]

Background and Objective: Total Knee Arthroplasty is a commonly performed procedure for arthritic knees. Preventing complications is of utmost importance for good functional outcomes and preventing morbidity. Wound closure after the procedure is as important as the replacement aspect of surgery.The objective of this study was to provide subjective and objective evidence of better closure technique and material; we conducted the study so that the outcome of TKA can be further improved Methods: We conducted a randomized trial at The Indus Hospital, Karachi, from December 2018 to June 2020. All patients from age 40 to 70 years who underwent total knee arthroplasty were included in the study. The wound of one knee was closed with Polypropylene (Prolene) sutures, and the other with staples. The wound was assessed independently by two assessors using Hollander’s score; lower score means a worse outcome. All data was entered and analyzed using STATA version 16. Results: Thirty patients who underwent bilateral total knee replacement were included in the analysis, among which 71.8% were female. The average age of participants was 57.3 (± 7.5) years. The mean incision length on the right knee was 17.6 ± 1.1 cm, while on the left the incision length was 18.3 ± 1.2 cm. Overall, the mean Hollander score was significantly different among participants in the sutures and staples group in both the right (p-value=0.001) and left knees (p-value=0.001). The score was significantly higher in knees closed with sutures as compared to staples. Also, the mean Hollander score is significantly higher in females than males in both the right knee (B=0.56, p-value=0.049) and the left knee (B=0.38, p-value=0.044). Conclusion: The study has shown that Hollander’s score was significantly higher in knees closed with sutures as compared to the patients in whom staples were used for wound closure. [ABSTRACT FROM AUTHOR]

Two-dimensional computed tomography scans no longer offer the level of detail that many surgeons desire for more accurate and precise surgical intervention. Computed tomography image reconstruction into three dimensional (3D) virtual models with interactive capability is providing an enhanced understanding of the patient's anatomy and pathology allowing the surgeon to create tailored intraoperative plans, minimizing complications and maximizing the intended therapeutic outcome. In this case report we demonstrate the use of 3D image reconstruction software in the management of a 36-year-old female with metastatic breast cancer affecting the chest wall. [ABSTRACT FROM AUTHOR]

Wind power forecasting plays a key role in the design and maintenance of wind power generation which can directly help to enhance environment resilience. Offshore wind power forecasting has become more challenging due to their operation in a harsh and multi-faceted environment. In this paper, the data generated from offshore wind turbines are used for power forecasting purposes. First, fragmented data is filtered and Deep Auto-Encoding is used to select high dimensional features. Second, a mixture of the CNN and LSTM models is used to train prominent wind features and further improve forecasting accuracy. Finally, the CNN-LSTM deep learning hybrid model is fine-tuned with various parameters for reliable forecasting of wind energy on three different offshore Windfarms. A state-of-the-art comparison against existing models is presented based on root mean square error (RMSE) and mean absolute error (MAE) respectively. The forecasting analyses indicate that the proposed CNN-LSTM strategy is quite successful for offshore wind turbines by retaining the lowest RMSE and MAE along with high forecasting accuracy. The experimental findings will be helpful to design environment resilient energy transition pathways. [ABSTRACT FROM AUTHOR]

A composite of Ti 3 AlC 2 max phase and ZIF-67 metal-organic framework (Ti 3 AlC 2 @ ZIF- 67) was synthesized by mixing Ti 3 AlC 2 and ZIF-67 in dimethyl formamide and used for solid phase extraction of Pb(II). Fourier transformation infrared spectroscopy, scanning electron microscopy, x-ray diffraction, and energy dispersive x-ray were used to find functional group, surface morphology, surface area elemental composition, and crystalline structure of Ti 3 AlC 2 @ ZIF-67. Factors like solution pH (7.0), adsorbent dose (10.0 mg), sample volume, eluent concentration and volume (0.5 M, 1.0 mL), and vortex time (1.0 min) were optimized. The effect of interfering ions has been checked to determine the method's selectivity. Analytical parameters such as limit of detection (LOD) 0.26 µg L−1, limit of quantification (LOQ) 0.86 µg L−1, preconcentration factor (PF) 21, enhancement factor (EF) 20 and relative standard deviation (RSD) 4.6% were calculated under optimized experimental condition. Certified reference materials TMDA-64.3 water samples and INCT-OBTL-5 tobacco leaves were used to validate the accuracy of the proposed method for trace metals detection. The technique was also used for lead determination in food and water samples with satisfactory recovery results. • Novel Ti 3 AlC 2 @ ZIP 67 nanocomposite was synthesized. • Solid phase extraction of Pb(II), using Ti 3 AlC 2 @ ZIP 67 as an adsorbent. • Method validation using certified reference material. • Application of the method to food and water samples. [ABSTRACT FROM AUTHOR]

Background: Total knee arthroplasty (TKA) is a procedure performed for end stage knee osteoarthritis to reinstate leg function, pain control and improve quality of life. The surgery, however, is associated with a substantial risk of concealed blood loss for which tourniquets have been used to control bleeding. There has been a lot of debate over the relevance and benefits of using tourniquets during TKA. It has no effect on postoperative blood loss and has been claimed to be associated with post-operative pain, nerve damage, superficial wounds infections and deep vein thrombosis. Objective: The objective of the study was to compare the degree of blood loss and its clinical relevance in patients undergoing total knee arthroplasty with and without tourniquet. Study type settings and duration: A Randomized Controlled Trial conducted at The Indus Hospital, Karachi, Pakistan from January 2015 to September 2015. Methodology: In this randomized clinical trial, patients were recruited after local IRB approval. Sample size was calculated using OpenEpi and included all patients of age 40 to 80 years of either gender with chronic osteoarthritis, according to the Kellgren-Lawrence classification grade 4 of Osteoarthritis. The study included two groups, both consisting of 25 patients each. In group A (non-intervention, tourniquet), the tourniquet was inflated to 350 mmHg after the leg had been elevated and exsanguinated, and was deflated after closing the wound and application of compressive dressing. In group B (intervention, non-torniquet), the application of tourniquet took place but it was not inflated. Instead, electrical diathermy, and application of pressure with surgical swabs was performed intra-operatively to control bleeding. Blood loss was measured using the Mercuriali's formula. Results: There was an average blood loss of 807 ml during TKA. Group A had a mean blood loss of 604.6 (203.9) ml while a relatively higher statistically significant mean blood loss of 1010.7 (272.7) ml was noticed in the intervention group on whom tourniquets were not used (p <0.005). Conclusion: According to our study, calculated blood loss was relatively less in Group A, hereby showing that the use of tourniquet is superior to other forms of bleeding control during the surgery. We propose that the issue on the significance of the use of tourniquet during TKA verses no tourniquet use has to be decided on the basis of volume of blood loss. [ABSTRACT FROM AUTHOR]

Introduction: Stabbings are an increasing international problem and the UK is not exempt. Although the incidence and costs of negative laparotomy are well known, and laparoscopy has been available for over 100 years, it is only in the last three decades that has seen its effective utilization in trauma both as a diagnostic and therapeutic modality. Methods: A retrospective two-year study of all patients undergoing laparoscopy for suspicion of diaphragmatic injury or breach of the peritoneum who were haemodynamically stable from non-ballistic penetrating torso trauma at St Mary's Hospital (Imperial Healthcare Trust). Results: Three groups of patients were identified: diagnostic laparoscopy without injury (n = 31), laparoscopy with injury ± laparoscopic treatment (n = 41) and diagnostic laparoscopy converted to laparotomy (n = 10). The patients who had laparoscopic intervention had a shorter hospital stay (2 vs. 5 days, p = 0.004), decreased intensive treatment unit admission (p = 0.007) and decreased intensive treatment unit stay (p = 0.007) compared to those who had conversion to laparotomy. Conclusion: Trauma laparoscopy is a useful modality in managing selected trauma patient with suspected intra-abdominal injuries and can avoid unnecessary laparotomy. It is associated with a shorter hospital stay. [ABSTRACT FROM AUTHOR]

The article offers information related to REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta), a technique using a balloon catheter to temporarily occlude large vessels in support of hemorrhage control. It mentions that the military should explore the use of REBOA during the en route phase of care for patients with evidence of non-compressible haemorrhage that are at risk of exsanguinating before definitive haemorrhage control.

The potential uses of strain-sensitive and conductive hydrogels in a variety of sectors, including soft robotics, interfaces between humans and machines, along with tracking health, have been generating a great deal of scientific interest. Utilization is still restricted by poor tensile characteristics, poor electrical signal transmission, high hysteresis energy, low conductivity, low stretching, and slow shape recovery with large response times. In the present work, a simple and effective approach is employed to create stretchable and conductive hydrogels using acrylamide (AAm) and butyl acrylate (BA). By physically crosslinking hydrophobic BA into hydrophobically coupled with AAm monomer. Amphiphilic sodium dodecyl sulfate was utilized as a cross-linker and micelle-forming agent, while NaCl creates the hydrogel as an ionic conductive material, and interactions among hydrophobic regions within the hydrogel framework considerably enhance the hydrogels mechanical characteristics. With a 553 kPa of fracture stress, 696% tensile strain was observed. It is a good option to sense strain due to remarkable sensitivity (Gauge factor = 9.95 at 500% strain) allowing for precise and reliable detection of a wide range of human movements such as (wrist and neck movement, elbow rotation, speaking and finger bending,) and handwriting due to its low hysteresis energy of 13.5 kJm−3 and considerable conductivity (6.809 mS/cm). Due to the excellent shape-recovery properties, the hydrogels can withstand hydrostatic pressure and return to their initial form after undergoing compression. The hydrogel strain sensor also demonstrated a quick response-recovery time of 130 and 150 ms respectively, a wide variety of strains (25–400%), and outstanding cyclic durability exceeding 400 cycles. This hydrogel can be applied as a metallic touch pen for various electronic devices. [Display omitted] • Based on hydrophobic association, a novel hydrogel is designed. • The hydrogels have considerable mechanical properties. • The hydrogels have low hysteresis energy, shape-recoverability, high sensitivity, and conductivity. • The hydrogels retort quickly to human activity and worked as an electronic pen. [ABSTRACT FROM AUTHOR]

Introduction: Early cervical spine immobilisation has long been considered the standard of care in the management of trauma patients with suspected spinal cord injury. There has been conflicting evidence regarding its benefits and risks. This article reviews the current literature and whether the continued use of routine cervical spine immobilisation is still appropriate in modern trauma care. Method: A literature search was conducted using the Medline PubMed, Google Scholar and Cochrane Library online databases. The searches were limited to full text, English language studies conducted on adults in the last 20 years (July 1997 to July 2017). Results: The entrenchment of cervical spine immobilisation in trauma management is multifactorial. In the pre-hospital setting, immobilisation is recommended whilst awaiting full assessment. Fear of missed diagnoses of spinal injuries encourages defensive medicine and over-immobilisation. Effective cervical spine immobilisation is appropriate in certain cases and reduces the risk of further spinal cord injury. However, research has shown that we are over-immobilising, and in penetrating trauma, cervical spine immobilisation increases the risk of mortality. Conclusions: The practice of routine cervical spine immobilisation for trauma patients is outdated, ineffective and results in iatrogenic injury. Routine cervical spine immobilisation is not backed up by robust evidence. It has been clearly shown that in cases of penetrating spinal injuries, cervical spine immobilisation is not only ineffective but is also linked to an increased risk of mortality. Special considerations must also be taken in patients who have pre-existing spinal conditions, impending airway compromise, or at risk of aspiration and those with head injuries or suspected traumatic brain injuries. A selective approach to cervical spine immobilisation is recommended and should be reserved for cases deemed high risk rather than a standard rule for all trauma patients. [ABSTRACT FROM AUTHOR]

Objectives: To determine the reliability and versatility of forehead flap in terms of frequency of complications and uses. Study design: Cross-sectional observational study Settings: This study was performed from January, 2014 to December, 2018 in the departments of Plastic and Burns Hayatabad Medical Complex, Peshawar and Khyber Teaching Hospital, Peshawar. Material and Methods: After approval from the ethical committee, the data was collected of all patients in whom forehead flap was performed, was collected from hospital's record. The data were analyzed and organized to assess the demographics, etiologies of defects covered, type of flap used and frequency of complications. The results were projected in the form of tables and figures. Results: A total of 26 patients, including 17 (65.4%) male and 9 (34.6%) female patients with age ranging from 10 years to 70 years (mean 47+1.89) met the inclusion criteria. Nose was the most common site of defects with the main etiology of surgical excision of malignancies. The paramedian variant of forehead flap was performed in 69.2% which was used as island in 15.4% cases. We observed insignificant partial necrosis of the forehead flap in 3.8% case. In 76.9% case the donor forehead defect was closed primarily. Conclusion: The forehead flap is a very reliable flap for nasal and upper facial defects with good aesthetic results and low complication rates. [ABSTRACT FROM AUTHOR]

BACKGROUND: Tumor lysis syndrome (TLS) is one of the lethal complications of hematologic malignancies and some solid tumors. Hyperuricemia associated with TLS can be prevented and treated by using the drug rasburicase. As of now, the optimal rasburicase dose for adult patients has not been determined. OBJECTIVE: To evaluate the effectiveness of a single 6-mg fixed dose of rasburicase in the normalization of serum uric acid levels for 96 hours in adults with cancer. METHODS: This retrospective single-center study used the electronic medical records (EMR) of eligible patients who received rasburicase at the Princess Noorah Oncology Center between January 2008 and December 2012. Patients aged >14 years who received a single 6-mg fixed dose of rasburicase and had serum uric acid levels measured before and after treatment available in the EMR system were included in this analysis. The primary outcome measure was reductions in serum uric acid levels. The secondary outcome measures were reduction in serum uric acid levels to <7 mg/dL at 24 hours and 48 hours after the rasburicase dose and normalization of serum creatinine to <1.5 mg/dL at 96 hours, and to determine the number of rasburicase doses needed to reach these reduction levels. We also calculated the cost-savings when using a single fixed dose versus multiple doses of rasburicase. RESULTS: A total of 94 adult patients met the inclusion criteria during the 5-year study period. The patients' mean age was 44 years, with 69% (67) men and 31% (27) women. Overall, 79% (75) of the patients had a hematologic cancer diagnosis, and 21% (20) patients had a diagnosis of a malignant solid tumor. After receiving the single rasburicase dose, 79% (75) of the patients had normalization of serum uric acid (ie, <7 mg/dL; median, 1.00 mg/dL) at 24 hours, and approximately 81% (77) patients had normalized levels (median, 1.96 mg/dL) at 48 hours. Moreover, the normal uric acid levels (median, 2.97 mg/dL) were maintained for 96 hours. Normalization of serum creatinine levels (<1.5 mg/dL; median, 0.62 mg/dL) was achieved in 70% (66) of the patients at 96 hours. Overall, 78% (73) of the patients required a single 6-mg fixed dose of rasburicase, and 22% (21) required more than 1 dose of rasburicase. CONCLUSION: Our findings demonstrate that a single 6-mg fixed dose of rasburicase was effective in lowering uric acid and is as effective as weight-based rasburicase doses for multiple days. Based on these data, we recommend using the single 6-mg fixed-dose strategy for prevention or management of hyperuricemia in patients at high risk for TLS in our institution and in other cancer institutions. [ABSTRACT FROM AUTHOR]

Highlights • Surface analysis of nano-textured structure in the vertical LED is characterized using non-destructive techniques (NDT). • NDT provide non-contact, local, robust, sophisticated and non-destructive material characterization methodology adequate for measuring surface roughness and stress-states. • Surface topography of nano-textured surface of the LED has roughness of ∼300 nm and in a compression stress-state of 0.667 GPa with emission peak wavelength of 442 nm. • Texture engineering does not affect the active region of the LED. • Prospective optimizations are suggested in surface engineering for light enhancement in LEDs. Abstract In this work, the nano-textured surface of a GaN-based vertical light emitting diode (VLED) is characterized using a unified framework of non-destructive techniques (NDT) incorporating scanning electron microscopy (SEM), atomic force microscopy (AFM), Raman spectroscopy, Photoluminescence (PL), and X-ray diffraction (XRD) to optimize the light output efficiency. The surface roughness of ∼300 nm is revealed by AFM. Compressive stress-state of 0.667 GPa in the GaN surface is indicated by the E 2 (high) and A 1 (LO) phonon peak values at 569 cm−1 and 736 cm−1, respectively, in Raman spectrum and the wavelength at 442 nm rather 450 nm in PL spectrum. Without damaging the LED, surface analysis by NDT helps to advance the understanding of the optimized angular light redistribution subject to the high-roughness surface and the negative impacts of the stress induced at the top GaN layer, which leads to the optical efficiency degradation of the VLED. Furthermore, the impact of texturing on underneath n-GaN and MQWs layers is investigated via SEM-based transmission Kikuchi diffraction (TKD) and aberration-corrected scanning transmission electron microscopy (AC-STEM) and revealed a smooth surface morphology and good crystalline quality, indicating that the etch-induced damage by texture engineering does not impair the active region of the VLED. Accordingly, prospective optimizations are suggested in the context of surface engineering for light enhancement in VLEDs. [ABSTRACT FROM AUTHOR]

Objectives: To determine the reliability and versatility of forehead flap in terms of frequency of complications and uses. Study design: Cross-sectional observational study Sett ings: This study was performed from January, 2014 to December, 2018 in the departments of Plastic and Burns Hayatabad Medical Complex, Peshawar and Khyber Teaching Hospital, Peshawar. Material and Methods: After approval from the ethical committ ee, the data was collected of all patients in whom forehead flap was performed, was collected from hospital's record. The data were analyzed and organized to assess the demographics, etiologies of defects covered, type of flap used and frequency of complications. The results were projected in the form of tables and figures. Results: A total of 26 patients, including 17 (65.4%) male and 9 (34.6%) female patients with age ranging from 10 years to 70 years (mean 47+ 1.89) met the inclusion criteria. Nose was the most common site of defects with the main etiology of surgical excision of malignancies. The paramedian variant of forehead flap was performed in 69.2% which was used as island in 15.4% cases. We observed insignificant partial necrosis of the forehead flap in 3.8% case. In 76.9% case the donor forehead defect was closed primarily. Conclusion: The forehead flap is a very reliable flap for nasal and upper facial defects with good aesthetic results and low complication rates. [ABSTRACT FROM AUTHOR]

We propose an airborne collapse capacitive micromachined ultrasonic transducer (CMUT) as a practical viable ultrasound transducer capable of providing a stable performance at the off-resonance frequencies. Traditional practice is to bias the CMUT plate close to collapse voltage to achieve high coupling coefficient and sense the incoming ultrasound as an open-circuit receive voltage signal of the transducer or short-circuit receive current (SCRC). Maintaining CMUT plate in the vicinity of collapse threshold is rather difficult. In this paper, an analytic approach to design an airborne collapsed-mode CMUT for maximum off-resonance sensitivity is presented. We use small-signal circuit model to evaluate the performance of a collapsed CMUT for varying operating conditions. CMUT operational parameters that yield the highest off-resonance SCRC are directly obtained from performance design curves. Collapsed CMUT plate is then biased in a critical biasing region that produces a stable and maximum off-resonance sensitivity. We experimentally verify and measure a stable sensitivity of a fabricated collapsed CMUT cell of −60 dB V/Pa at 100 kHz when biased between 50 to 65 V. We characterize our linear circuit model performance against the measured performance of collapsed CMUT in air within 4-dB tolerance. [2018-0058] [ABSTRACT FROM AUTHOR]

[Display omitted] We present the first experimentally measured data set on the exsolution/dissolution kinetics of methane and bitumen system at the test temperature range of 80–160 °C, and a pressure difference of 0.69 MPa, between 1.81 MPa and 2.5 MPa. An analytical model is used to estimate the exsolution and dissolution diffusion coefficients for the methane/bitumen system from the acquired data set. The results revealed faster exsolution kinetics compared to dissolution for the methane-bitumen system. The exsolution and dissolution diffusion coefficients were found to be in the range of (1.13–14.2) × 10−8 m2/s and (1.95–56.9) × 10−9 m2/s, respectively. Furthermore, the experimentally measured diffusivity measurements were modeled using the Arrhenius-type relationship, and the analysis indicated higher activation energy for the dissolution of methane in bitumen compared to the exsolution. The reported exsolution and dissolution diffusivity measurements have applications in the design and simulation of the solvent-assisted thermal recovery of bitumen and heavy oil. [ABSTRACT FROM AUTHOR]

In wearable sensors, flexible and stretchable hydrogels attract much attention from researchers however, weak mechanical properties, low toughness, poor self-recovery, and large response time limit the practical applicability of hydrogels. Here, ultra-stretchable, tough, high antifatigue, and fast responsive hydrogels are prepared using 6-amino caproic acid (ACA) as a dynamic bridge between the cationic surfactant and hydrophobically associated acrylamide (Amm) hydrogels. The hydrophobic monomer lauryl methacrylate (LMA) stabilized in the micelles of surfactant which work as hydrophobic associations and keep the integrity of the hydrogel network. While the addition of ACA significantly regulates the mechanical properties of hydrogels, where ACA work as a bridge between the micelles and polymer chains through ionic interactions with cationic surfactant and hydrogen bonding with Amm. These non-covalent interactions endow excellent mechanical properties, high toughness, and good self-recovery in the hydrogel network. Moreover, the excellent mechanical performance and good conductivity of the hydrogels provide durability and antifatigue properties into hydrogels which make the hydrogels suitable for strain sensors and human motion monitoring. Our fabricated hydrogels have the capability of performing more than 350 cyclic loading and unloading cycles without any damage during strain sensing and also senses different large and small strains with a highest gauge factor (GF) of 12.8 (at 400% strain). Besides, the hydrogels have also the ability to monitor different large and subtle human motions that include wrist, neck, finger, swallowing, speaking, and writing with a very fast response and recovery time of 100 ms and 80 ms respectively. Our prepared hydrogels would discover a wide spread application in the field of soft robotics, electronic skin, human health care monitoring, strain, and pressure sensors. [Display omitted] [ABSTRACT FROM AUTHOR]

A supramolecular solvent microextraction procedure was established for the separation/preconcentration of uranium(VI) (U(VI)) prior to its determination by UV-Vis spectrophotometry. 1-(2-Pyridylazo)-2-naphthol (PAN) was used to form a red chelate (U-PAN) with U(VI) at pH 10. U-PAN was extracted by undecanol in tetrahydrofuran. All the parameters that affect extraction efficiency like solution pH, amount of ligand, type and volume of supramolecular solvent, sample volume, and diverse ion effect were optimized. The preconcentration factor was 17. The detection limit was 0.31 μg L-1 . The method was validated using GBW07424 (GSS-10 certified reference material). Microextraction was also applied to water and soil samples. [ABSTRACT FROM AUTHOR]

[Display omitted] • Novel material Ti 3 AlC 2 max phase graphene oxide GO nanocomposite has been synthesized. • Solid phase extrication method based Ti 3 AlC 2 max phase GO nanocomposite has been develop for palladium. • All the extrication efficiency effecting parameters of the adsorbent has been optimized. • The method was applied to medical appliances samples. Palladium is an important metal as it has a wide range of applications in different fields but can cause cancer in human beings. Therefore, precise quantification of palladium is important. For this purpose, new material Ti 3 AlC 2 max phase having unique properties like high stability, thermal conductivity and environmental friendly has been synthesized. To increase its surface area of Ti 3 AlC 2 max phase, graphene oxide (GO) has been incorporated to form Ti 3 AlC 2 max phase GO nanocomposite. Ti 3 AlC 2 max phase GO nanocomposite was used as solid phase extracting material for microextraction and preconcentration of Pd(II) in environmental samples and medical appliances. Characterization of the adsorbent was achieved by using fourier transform infrared spectroscopy (FT-IR), scanning electron microscope (SEM), X-ray diffraction (XRD), energy dispersive X-ray (EDX) and surface area analyzer (SAA). All the parameters that influence the extraction efficiency of the adsorbent like solution pH, amount of adsorbent, volume of sample, vortex time, desorption condition and interferences effect were determined and optimized. The limit of detection (0.327 µg/L) and limit of quantification (1.09 µg/L) show that the method is highly sensitive. The relative standard deviation was calculated as 5.48 % for five repeated measurements, which shows that the developed method is reproducible. The method is highly efficient with large values of preconcentration factor (20) and enhancement factors (20). The method was validated by applying the method to real water samples, soil samples and medical appliances with satisfied recovery results (94–106 %). [ABSTRACT FROM AUTHOR]

Over the years, hydrogels have been extensively studied and got a lot of attraction as wearable sensors, due to their stretchability and flexibility, however, their application of repetitive sensing is greatly constrained owing to their lengthy response time and poor mechanical properties. In the current study, a stretchable and conductive hydrogels were fabricated by interlinking lauryl methacrylate with acrylamide and sodium alginate via a physical crosslinked network, resulting in enhanced mechanical properties due to micelle dynamic crosslinking points and hydrogen bonding. The observed tensile strain was 1400 % with a fracture stress of 390 kPa and low hysteresis energy. In addition, the hydrogel strain sensor exhibited a wide range of strain (25–300 %), excellent cyclic stability of more than 350 cycles and showed quick response time of 200 ms. Moreover, the hydrogel is also designed to be a built-in sensor to monitor slight and subtle changes in the human body such as wrist, finger flexion, and swallowing. The strain sensors are also capable of recognizing letters written over it sensitively and distinctively. Hence, we believe that these hydrogel-based strain sensors could be applied in future wearable electronic devices and for human movement monitoring. [Display omitted] • Hydrophobically associated bio-based ionic hydrogels have been developed. • The hydrogels were highly stretchable with enhanced mechanical performance having dynamic interlinking points. • The hydrogels showed 1400 % tensile strain with a fracture stress of 390 kPa and excellent cyclic stability with quick response time of 200 ms. • The hydrogels can act as strain sensor and monitor slight and subtle changes in the human body. [ABSTRACT FROM AUTHOR]

[Display omitted] Data integrity (DI) reaffirms the pharmaceutical industry's commitment to manufacture drugs that are safe, effective and fulfil quality standards. At the same time, DI is a crucial tool for regulatory authorities to use in protecting public health. Recent FDA Form-483 observations and warning letters indicate that DI is the main issue the pharmaceutical industry is currently dealing with. Failure to comply with DI requirements may result in a high number of un-validated results, which may cause post-marketing issues and frequent product recalls. To address the underlying causes of DI problems, a comprehensive approach is necessary. The majority of DI issues are caused by poor quality culture, organizational or individual behaviour, leadership, processes, or technology. DI should be effectively integrated into the quality management system, and it should apply to both paper and electronic records. Employees should be trained on 21 CFR Part 11. Consistent review and audit are required to ensure that procedures are followed and audit trails are generated. Electronic systems, in addition to being an efficient solution (system integration, data verification at both input and output, security), offer advantages over traditional paper-based systems in terms of improved compliance with DI regulatory requirements. For example, many electronic system platforms provide enhanced security features and audit trail capabilities. Finally, management support for data governance is essential for successful implementation of DI. This article reviews commonly observed deviations by FDA pertaining to DI and discusses measures to be undertaken to avoid them. [ABSTRACT FROM AUTHOR]

In the present study, silica coated magnetic multiwalled carbon nanotubes impregnated with 1-(2-pyridylazo)-2-naphthol was synthesized and characterized by using instrumental techniques such as, Fourier transform infrared spectroscopy (FT-IR), BET surface area analysis, scanning electron microscopy (SEM) and X-ray diffraction (XRD). The novel adsorbent has been used for magnetic solid phase extraction of Pb(II) and Co(II) at trace levels. The parameters including pH of solution, adsorbent dose, sample volume, temperature and matrix effect were optimized. Quantitative recoveries for analytes were obtained at pH 6.5 with 100 mg of adsorbent. Limit of detection values for lead and cobalt were 1.76 μg L − 1 and 0.55 μg L − 1 . Preconcentration factor and standard deviation of both metals were 15 and lower than 3.3%. Kinetic data shows that the adsorption process follows pseudo second order kinetic. Positive values of ΔH° and ΔS° show that adsorption of Pb(II) and Co(II) is feasible and endothermic in nature. The validation of the method was carried out to waste water certified water reference materials. The presented separation-preconcentration method was applied to determination of lead and cobalt contents of water samples from Kayseri-Turkey. [ABSTRACT FROM AUTHOR]

Objectives: To determine the reliability and versatility of Superficial Sural Artery Flap (SSAF) for lower limb reconstruction in terms of flap survival and frequency of complications. Material and Method: This cross-sectional study was conducted in the department of Plastic and Burns Surgery, Khyber Teaching Hospital Peshawar from June 2014 to October 2016. All patients with leg defects, reconstructed with SSAF were included in the study. The data was acquired from the Hospital's record and analyzed with statistical package for social sciences (SPSS) to determine the frequency of different type and design of SSAF used and its complications of venous congestions and flap necrosis. Results: During the study duration, 16 male patients were included with age ranging from 12 years to 60 years with a mean of 36.18 years +SD. Road traffic accident was the most common etiology of the soft tissue defects (68.8%). Six (37.5%) patients had distal leg defects as the most common site of soft tissue loss. Reverse Superficial Sural Artery Flap (RSSAF) was performed in 10 (62.5%) followed by Proximally Based Superficial Sural Artery Flap (PSSAF) in 6 (37.5%). Flap congestion was observed in 5 (31.2%) patients. We did not observe any complete flap loss. In one case (6.2%) case, partial significant flap necrosis was noted. Conclusions: Superficial Sural Artery Flap is reliable source of reconstruction which can be used for the soft tissue defects of distal thigh, knee, leg, heel and proximal foot due to its versatile blood supply. [ABSTRACT FROM AUTHOR]

The current method of extricating a driver after a collision in motorsport remains controversial. The current setup and deployment of both vehicles and personnel are outdated and in certain circumstances potentially dangerous to drivers. This analysis, based on current literature and the specialist expertise of the authors, endeavours to address the issues and make evidence-based recommendations. [ABSTRACT FROM AUTHOR]

An editorial is presented on the military applications of physiological sensors. It expresses the view that soldiers can be considered as physically high-performing individuals to a large extent and, therefore, any battlefield advantage should be explored whether in terms of conditioning or medical care.

• Fe 3 O 4 -Ti 3 AlC 2 Max Phase has been synthesized used magnetic solid phase extraction of trace metals. • All the parameters that effect extraction efficiency were determined and optimized. • Certified reference materials were used for method validation. • The method was applied to water and food samples. In this work, we report the preparation of Fe 3 O 4 -Ti 3 AlC 2 max phase impregnated with 2-(5-Bromo-2-pyridylazo-5-(diethylamino) phenol) and its implementation for the extraction of cadmium, lead and cobalt from water and food samples. Blended Fe 3 O 4 -Ti 3 AlC 2 max phase impregnated with 2-(5-Bromo-2-pyridylazo-5-(diethylamino) phenol) was characterized using different instrumental techniques like scanning electron microscopy (SEM), surface area analyser (SAA), energy dispersive X-rays (EDX), Fourier transform infrared spectroscopy (FT-IR) and X-rays diffraction (XRD) for surface morphology, surface region, elemental composition, functional group and crystallinity, respectively. Factors that impact the % recoveries of analyte i.e pH, sample volume, vortex time, desorption condition and matrix impact were optimized. Analytical parameters like limit of detection (LOD) (Cd: 0.093 µg/L, Pb: 0.297 µg/L, Co: 0.223 µg/L), limit of quantifications (LOQ) (Cd: 0.310 µg/L, Pb: 0.992 µg/L, Co: 0.744 µg/L) preconcentration factors (PF) (Cd = Pb = Co: 40), enrichment factors (EF) (Cd: 39.8, Pb: 39, Co: 40) and relative standard deviation (RSD) (Cd: 3.8, Pb: 5.98, Co: 4.0) were determined under optimized trial conditions. The proposed strategy was tested using certified reference materials like TMDA-64.3 natural water and tobacco leaves (INCT-OBTL-5) for trace metal analysis. The developed strategy was also applied effectively to natural water samples and food samples using the standard addition method with good recovery results. [ABSTRACT FROM AUTHOR]

Phosphorus-containing polymer grafted 4-aminoantipyrine has been synthesized and used for solid phase extraction of U(VI) prior to its UV-Visible spectrophotometric determination by using arsenazo(III). The adsorbent was characterized by using FT-IR and SEM analysis. The influence of parameters including pH, adsorbent dose, amount of complexing reagent, sample volume and matrix effect have been optimized. The detection limit was determined as 1.4 µg L with preconcentration factor of 30 and RSD of 1.4 %. The accuracy was checked by the analysis of GBW07424 soil and TMDA-64.2 environmental water certified reference materials. The method was applied to natural water and soil samples. [ABSTRACT FROM AUTHOR]

Background Financial, clinical, and psychological considerations have made same-day surgery an attractive option for a variety of procedures. This article aimed to analyse the postoperative results of same-day primary unilateral cleft nasolabial repair. Methods This study was performed from 2011 to 2014. Unilateral cleft lip patients fulfilling the inclusion criteria were preoperatively classified as mild, moderate, and severe. All patients underwent same-day surgery and were discharged after satisfying the appropriate clinical criteria, receiving thorough counselling, and the establishment of a means of communication by phone. Postoperative outcomes were assessed and stratified according to preoperative severity and the type of repair. Results A total of 423 primary unilateral cleft lip patients were included. Fisher's anatomical subunit approximation technique was the most common procedure, followed by Noordhoff's technique. The postoperative outcome was good in 89.8% of cases, fair in 9.9% of cases, and poor in 0.2% of cases. The complication rate was 1.18% (n=5), and no instances of mortality were observed. The average hospital stay was 7.5 hours, leading to a cost reduction of 19% in comparison with patients who stayed overnight for observation. Conclusions Mild unilateral cleft lip was the most common deformity for which Fisher's anatomical subunit approximation technique was performed in most of the cases, with satisfactory postoperative outcomes. Refinements in the cleft rhinoplasty techniques over the course of the study improved the results regarding cleft nasal symmetry. Single-day primary unilateral cleft cheiloplasty was found to be a cost-effective procedure that did not pose an additional risk of complications. [ABSTRACT FROM AUTHOR]

Magnetic allylamine modified graphene oxide-poly(vinyl acetate-co-divinylbenzene) (MGO-DVB-VA) was synthesized and used for magnetic solid phase extraction of Pb(II), Cd(II), Cu(II), Ni(II) and Co(II) prior to their determination by flame atomic absorption spectroscopy. The adsorbent surface functional group was characterized by using FT-IR and Raman spectroscopy. XRD pattern was used to determine the layers of GO. Surface morphology and elemental composition of the adsorbent were evaluated by using SEM and EDX analysis. Various parameters, effecting adsorption efficiency like initial solution pH, adsorbent dose, type and volume of eluent, volume of sample and diverse ions effects were optimized. The preconcentration factor (PF) is 40 for all the metals and the limits of detection for Pb, Cd, Cu, Ni and Co are in the range of 0.37–2.39 µg L −1 and relative standard deviation below 3.1%. The method was validated by using the method for certified reference materials (Tobacco Leaves (INCT-OBTL-5), Tomato Leaves (1573a), Certified Water (SPS-ww2) and Certified Water (TMDA 64-2)). The method was successfully applied for natural water and food samples. [ABSTRACT FROM AUTHOR]

Water contamination is increasing globally by heavy metals, dyes, and cyanides day by day. Heavy metals are very toxic even if present in a small amount in water. Here, we have synthesized a novel type of self-healable, ultra-thin with high mechanical strength, and pH-responsive poly-(acrylic acid)@Fe/Ni (PAA@Fe/Ni) hybrid hydrogel membrane using filter paper as a substrate. Acrylic acid was polymerized on the surface and in pores of the filter paper by free radical addition polymerization reaction using NMBA as a cross-linker, iron ions as an accelerant, and persulfate radicals as initiator. The iron ions were subsequently converted to metal particles by coating with nickel particles to enhance their stability and act as an antifouling agent. The membrane was characterized by FTIR, SEM, EDX, and AFM techniques. The abundant carboxylic acid (–COOH) groups and iron ions present inside the polymer network provide self-healing ability to the membrane. The pore size of the filter paper was reduced from 2.5 to 1.04 μm and thus improving the rejection capability of the membrane. The results demonstrated that the membrane is efficient enough for the complete rejection of Cr(VI) from model water and industrial wastewater under different environmental stimuli (pH and concentration) up to 100 ppm. The self-healing behavior, ultra-thin with high mechanical stability, and responsive nature of the PAA@Fe/Ni hybrid hydrogel membrane are the significantly advanced features of the synthesized membrane. [ABSTRACT FROM AUTHOR]

Background: Radiology trainees were uncomfortable going to the CT scanner to review trauma panscans and interacting with trauma surgeons. Objective: This study aims to determine if radiology residents can be trained to accurately identify injuries requiring immediate surgical attention at the CT scanner. Methods: A high-fidelity simulation model was created to provide an immersive training experience. Between February 2015 and April 2017, 62 class 1 trauma panscans were read at the CT scanner by 11 PGY-3 radiology residents. Findings made at the scanner were compared to resident preliminary and attending radiology reports and correlated with clinical outcomes. Timestamps were recorded and analyzed. Surveys were administered to assess the impact of training on radiology residents' self-confidence and to assess trauma surgeons' preference for radiology at the scanner. Significance level was set at p < 0.05. Results: The mean time to provide results at the CT scanner was 11.1 min. Mean time for the preliminary report for CT head and cervical spine was 24.4 ± 9.8 min, and for the CT chest, abdomen, and pelvis was 16.3 ± 6.9 min. 53 traumatic findings on 62 panscans were identified at the scanner and confirmed at preliminary and final reports, for a concordance rate of 85%, compared to 72% for the control group. Radiology residents agreed or strongly agreed the training prepared them for trauma panscan reporting. Trauma surgeons shifted in favor of radiology presence at the scanner. Conclusion: Radiology residents can be trained to accurately and rapidly identify injuries requiring immediate surgical attention at the CT scanner. Clinical impact: These findings support the value-added of an in-person radiologist at the CT scanner for whole-body trauma panscans to facilitate timely detection of life-threatening injuries and improve professional relations between radiologists and trauma surgeons. [ABSTRACT FROM AUTHOR]

Objective: Oncocytic adrenal neoplasms (OANs) are rare, but are an important subtype of adrenal tumors that is being diagnosed with increasing frequency. Unfortunately, the imaging characteristics of this tumor have not been well described. Our purpose was to identify CT features to differentiate OANs from adrenocortical carcinomas (ACC). Materials and methods: From 1991 to 2012, 18 patients with OANs were identified from our institution's pathology database. Twelve had CT examinations available for review. CT characteristics of five benign and seven malignant OANs were reviewed by two abdominal radiologists, and compared to ACC ( n = 10). Morphologic characteristics and density measurements were recorded for each imaging phase. Absolute contrast washout was calculated and compared. Results: Benign OANs were smaller [mean size 3.7 cm (range 2.6-5.3)] and more homogeneous than malignant OANs and demonstrated greater washout [mean washout percentage 72.3% (range 61-88)]. Malignant OANs demonstrated features similar to ACCs, including size [mean 9.4 cm (range 5.2-9.8)] and internal necrosis ( n = 6). Mean enhancement washout percentage for malignant OANs was 12% (range −8 to 32). Conclusion: Benign OANs (oncocytomas) may be distinguished from lipid-rich adenomas on non-contrast CT but may be indistinguishable from lipid-poor adenomas. Malignant oncocytic neoplasms can demonstrate features similar to ACCs, including larger size, internal necrosis, and lower percentage enhancement washout. [ABSTRACT FROM AUTHOR]

Objectives. To determine the demographics and analyze the management and factors influencing the postoperative complications of hypospadias repair. Settings. Hayatabad Medical Complex Peshawar, Pakistan, from January 2007 to December 2011. Material and Methods. All male patients presenting with hypospadias irrespective of their ages were included in the study. The data were acquired from the hospital's database and analyzed with Statistical Package for Social Sciences (SPSS). Results. A total of 428patients with mean age of 8.12 ± 5.04 SD presented for hypospadias repair. Midpenile hypospadias were themost common. Chordee, meatal abnormalities, cryptorchidism, and inguinal hernias were observed in 74.3%, 9.6%, 2.8%, and 2.1% cases, respectively. Two-stage (Bracka) and TIP (tubularized incised urethral plate) repairs were performed in 76.2% and 20.8% of cases, respectively. The most common complications were edema and urethrocutaneous fistula (UCF).The complications were significantly lower in the hands of specialists than residents (P -value = 0.0086).The two-stage hypospadias repair resulted in higher complications frequency than single-stage repair (P value = 0.0001). Conclusion. Hypospadias surgery has a long learning curve because it requires a great deal of temperament, surgical skill and acquaintance with magnifications. Single-stage repair should be encouraged wherever applicable due to its lower postoperative complications. [ABSTRACT FROM AUTHOR]

Abstract: The focus of present research was to understand and control the variability of solid dispersion (SD) formulation of non-ribosomal peptide antibiotic, vancomycin (VCM). Hunter screening design was constructed using seven independent variables namely melting temperature (X 1), congealing temperature (X 2), mixing time (X 3), type of capsule shell (X 4), filling method (X 5), molecular weight of polyethylene glycol (PEG, X 6) and surfactant type (X 7), and responses measured were cumulative percentage of VCM released in 45min (Y 1) and potency (Y 2). The SD formulations were prepared by melt-fusion method, and tested for dissolution, potency, and characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), differential scanning calorimetry (DSC), powder X-ray diffraction (PXRD) and near infrared chemical imaging (NIR-CI). Statistically significant (p <0.05) effect of congealing temperature (X 2), type of capsule shell (X 4), filling method (X 5), molecular weight of PEG (X 6) was revealed on Y 1, and R 2 of 0.992 was obtained between experimental and predicted value. None of the factors have statistically significant (p >0.05) influence on Y 2. SEM, DSC and PXRD indicated crystalline nature of SD formulations. Homogeneity of SD formulations was shown by NIR-CI images. In summary, the quality of VCM SD formulations could be assured by controlling the critical factors during manufacturing. [Copyright &y& Elsevier]