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To expand the applications of hybrid fiber composites in structural engineering applications, it is essential to study their fatigue behavior. The tensile and fatigue performance of unidirectional hybrid basalt/glass epoxy composites made with vacuum‐assisted resin infusion molding are investigated in this research. The sequencing influence on tensile properties was assessed using the two configurations of basalt/glass fiber epoxy hybrid fiber composites, namely GBBBG and BGBGB, having nearly equal volume fractions. According to the test results, hybrid fiber composites showed a positive hybrid effect on their tensile strength. Both hybrid layups showed higher tensile strengths (3.5% to 10.5%) than GFRPs and BFRPs. The GBBBG laminate has slightly higher fatigue resistance than BGBGB laminate under tension–tension (T–T) fatigue. Scanning electron microscopy (SEM) images verify the fatigue failure modes, which include fiber, matrix cracking, delamination, and debonding. The DMA analysis showed the lower adhesion efficiency of hybrid fiber composites, signifying lower damping properties. Highlights: The basalt/glass fiber hybrid fiber composites were fabricated using VARIM.The static and fatigue properties of basalt/glass fiber hybrid fiber composites were studied.The stiffness degradation and hysteresis were calculated for the composites tested.The DMA was performed, and Tg, storage modulus, and adhesion efficiency factor were calculated. [ABSTRACT FROM AUTHOR]

This work compares the tensile and fatigue behavior of unidirectional glass fiber/epoxy (GFRPs) and basalt fiber/epoxy (BFRPs) composites manufactured using vacuum-assisted resin infusion molding (VARIM). The tensile and fatigue tests are performed, and results show that both GFRPs and BFRPs have very similar tensile behavior, whereas BFRPs perform better than the GFRPs in terms of fatigue life and degradation of properties, showing about 75 MPa more fatigue limit. The S-N curve shows that BFRPs resist fatigue failure and stiffness degradation due to their better interfacial adhesion. Fractographic observations reveal fatigue failure mechanisms of both BFRPs and GFRPs. From the regression analysis performed, an S-N curve was fitted with a model available in the literature, and regression parameters were calculated. Dynamic mechanical analysis of both BFRPs and GFRPs was performed to evaluate parameters like glass transition temperature, storage modulus, and loss modulus. From the findings of this research, BFRPs may be recommended as a suitable alternative to GFRPs. Highlights • This article compares the tension-tension fatigue properties of unidirectional GFRPs and BFRPs. • From the research work, the authors found that BFRPs perform better than GFRPs under fatigue loading. • The stiffness degradation behavior of GFRPs and BFRPs are studied and compared. • Scanning electron micrographs of fractured samples are used to observe fatigue failure mechanisms. • Dynamic mechanical analysis (DMA) was performed to determine the storage modulus, loss modulus, glass transition temperature, and damping coefficient (tand) for both composites. [ABSTRACT FROM AUTHOR]

Visual question answering (VQA) is a challenging task in computer vision. Recently, there has been a growing interest in text‐based VQA tasks, emphasizing the important role of textual information for better understanding of images. Effectively utilizing text information within the image is crucial for achieving success in this task. However, existing approaches often overlook the contextual information and neglect to utilize the relationships between scene‐text tokens and image objects. They simply incorporate the scene‐text tokens mined from the image into the VQA model without considering these important factors. In this paper, the proposed model initially analyzes the image to extract text and identify scene objects. It then comprehends the question and mines relationships among the question, OCRed text, and scene objects, ultimately generating an answer through relational reasoning by conducting semantic and positional attention. Our decoder with attention map loss enables prediction of complex answers and handles dynamic vocabularies, reducing decoding space. It outperforms softmax‐based cross entropy loss in accuracy and efficiency by accommodating varying vocabulary sizes. We evaluated our model's performance on the TextVQA dataset and achieved an accuracy of 53.91% on the validation set and 53.98% on the test set. Moreover, on the ST‐VQA dataset, our model obtained ANLS scores of 0.699 on the validation set and 0.692 on the test set. [ABSTRACT FROM AUTHOR]

In Visual question answering (VQA), a natural language answer is generated for a given image and a question related to that image. There is a significant growth in the VQA task by applying an efficient attention mechanism. However, current VQA models use region features or object features that are not adequate to improve the accuracy of generated answers. To deal with this issue, we have used a Two‐way Co‐Attention Mechanism (TCAM), which is capable enough to fuse different visual features (region, object, and concept) from diverse perspectives. These diverse features lead to different sets of answers, and also, there is an inherent relationship between these visual features. We have developed a powerful attention mechanism that uses these two critical aspects by using both bottom‐up and top‐down TCAM to extract discriminative feature information. We have proposed a Collective Feature Integration Module (CFIM) to combine multimodal attention features and thus capture the valuable information from these visual features by employing a TCAM. Further, we have formulated a Vertical CFIM for fusing the features belonging to the same class and a Horizontal CFIM for combining the features belonging to different types, thus balancing the influence of top‐down and bottom‐up co‐attention. The experiments are conducted on two significant datasets, VQA 1.0 and VQA 2.0. On VQA 1.0, the overall accuracy of our proposed method is 71.23 on the test‐dev set and 71.94 on the test‐std set. On VQA 2.0, the overall accuracy of our proposed method is 75.89 on the test‐dev set and 76.32 on the test‐std set. The above overall accuracy clearly reflecting the superiority of our proposed TCAM based approach over the existing methods. [ABSTRACT FROM AUTHOR]

The UiO-6x family of metal-organic frameworks has been extensively studied for applications in chemical warfare agent (CWA) capture and destruction. An understanding of intrinsic transport phenomena, such as diffusion, is key to understanding experimental results and designing effective materials for CWA capture. However, the relatively large size of CWAs and their simulants makes diffusion in the small-pored pristine UiO-66 very slow and hence impractical to study directly with direct molecular simulations because of the time scales required. We used isopropanol (IPA) as a surrogate for CWAs to investigate the fundamental diffusion mechanisms of a polar molecule within pristine UiO-66. IPA can form hydrogen bonds with the μ 3 -OH groups bound to the metal oxide clusters in UiO-66, similar to some CWAs, and can be studied by direct molecular dynamics simulations. We report self, corrected, and transport diffusivities of IPA in pristine UiO-66 as a function of loading. Our calculations highlight the importance of the accurate modeling of the hydrogen bonding interactions on diffusivities, with about an order of magnitude decrease in diffusion coefficients when the hydrogen bonding between IPA and the μ 3 -OH groups is included. We found that a fraction of the IPA molecules have very low mobility during the course of a simulation, while a small fraction are highly mobile, exhibiting mean square displacements far greater than the ensemble average. [ABSTRACT FROM AUTHOR]

Sports competitions and recreational activities are practiced by infants, kids, and teenagers for their physical and mental health. Unfortunately, engaging in sports increases the chance of suffering trauma to the mouth's delicate and hard tissues, including lacerations to the lips, various injuries to the gingiva, tongue, or mucosa, chipped, luxated, or avulsed teeth, maxillary or mandibular fractures. The importance of the dentistry profession in connection to the prevention of dental and other orofacial sporting injuries has increased due to the popularity of contact sports and the encouraging of participation at a young age. Inculcating the prevention, management, and treatment of oral and face injuries, sports dentistry is the newest and most promising area of dentistry. Dentists should make it a point to tell parents about the orofacial damage caused by sports and about the different preventive measures that are available. They should also have solid clinical understanding of sports-related dentofacial injuries. In this article, we go over the different facets of sports-related injuries as well as the risk factors that go along with them. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to assess the results of tunica vaginalis flap (TVF), dorsal preputial dartos flap (DPF), and spongioplasty alone as additional cover after neourethra formation in a Snodgrass repair for various types of hypospadias as per the selection criteria decided. Material and methods: This was a non-randomized experimental study of 97 patients with primary hypospadias treated via Snodgrass repair using various second layers (tunica vaginalis flap, dorsal preputial dartos flap, and spongiosum alone) as per the selection criteria in a single center by a single surgeon. The outcome of the procedure was assessed in terms of cosmesis, chordee correction, urinary stream, and uroflowmetry. Results: Of the 97 patients, we used dorsal preputial dartos flap in 42 (43.3%), tunica vaginalis in 38 (39.2%), and spongioplasty only in 17 (17.5%) for primary hypospadias. Urethrocutaneous fistula developed in four patients (three in DPF and one in the TVF groups). One patient each had skin necrosis, hematoma, and wound dehiscence in the DPF group. In the spongioplasty only group, one patient had meatal stenosis which was treated by meatoplasty after failing repeated periodic calibration. Conclusion: DPF should be preferably used for distal penile and TVF for mid and proximal penile hypospadias to ensure excellent result with minimum complications. Spongioplasty only as a second layer is sufficient to avoid the complications wherever it is thick and robust. [ABSTRACT FROM AUTHOR]

Traumatic dislocation of testis (TDT) is an uncommon event. During trauma, the cremasteric reflex can forcefully retract the testis out of the scrotal sac saving the testis from the injury. However, associated injuries in the form of skin degloving, penile avulsion, and amputation can be present. Early surgical intervention to locate and deposit the displaced testis to the scrotal sac is essential. We present a case of a 33-year-old man with bilateral congenital cryptorchidism who suffered blunt trauma to his genitalia following a road traffic injury. On presentation, based on a well-developed scrotum, it looked like a case of TDT. However, good history along with detailed physical and radiological evaluation helped us reach the correct diagnosis. TDT must be suspected in a case of blunt trauma to the genitalia when the scrotal sac (well-developed) is empty. This case report highlights the importance of detailed clinical and radiological evaluation in such cases. [ABSTRACT FROM AUTHOR]

Framework flexibility is one of the most important characteristics of metal–organic frameworks (MOFs), making them highly suitable for adsorption applications. There have been a limited number of computational efforts to study flexible MOFs in the literature, and they are mostly focused on MIL-53. We studied a flexible MOF known as LMOF-201, which was found to exhibit guest-induced flexible properties; however, the mechanism of the appearance of flexibility is still unclear. First, we validated our simulation results by reproducing the experimental isotherm and powder X-ray diffraction measurements of experimental structures using grand canonical Monte Carlo (GCMC) and reactive force field (ReaxFF) molecular dynamics (MD) simulations. Then, we demonstrated the importance of the presence of a carbonyl oxygen atom in LMOF-201 to induce flexibility. The mechanism determined in this study will enable LMOF-201 to be considered for adsorption applications in the future. [ABSTRACT FROM AUTHOR]

Micron-scale robots require systems that can morph into arbitrary target configurations controlled by external agents such as heat, light, electricity, and chemical environment. Achieving this behavior using conventional approaches is challenging because the available materials at these scales are not programmable like their macroscopic counterparts. To overcome this challenge, we propose a design strategy to make a robotic machine that is both programmable and compatible with colloidal-scale physics. Our strategy uses motors in the form of active colloidal particles that constantly propel forward. We sequence these motors end-to-end in a closed chain forming a two-dimensional loop that folds under its mechanical constraints. We encode the target loop shape and its motion by regulating six design parameters, each scale-invariant and achievable at the colloidal scale. We demonstrate the plausibility of our design strategy using centimeter-scale robots called kilobots. We use Brownian dynamics simulation to explore the large design space beyond that possible with kilobots, and present an analytical theory to aid the design process. Multiple loops can also be fused together to achieve several complex shapes and robotic behaviors, demonstrated by folding a letter shape "M," a dynamic gripper, and a dynamic pacman. The material-agnostic, scale-free, and programmable nature of our design enables building a variety of reconfigurable and autonomous robots at both colloidal scales and macroscales. [ABSTRACT FROM AUTHOR]

Do large datasets provide value to psychologists? Without a systematic methodology for working with such datasets, there is a valid concern that analyses will produce noise artifacts rather than true effects. In this paper, we offer a way to enable researchers to systematically build models and identify novel phenomena in large datasets. One traditional approach is to analyze the residuals of models--the biggest errors they make in predicting the data--to discover what might be missing from those models. However, once a dataset is sufficiently large, machine learning algorithms approximate the true underlying function better than the data, suggesting, instead, that the predictions of these data-driven models should be used to guide model building. We call this approach "Scientific Regret Minimization" (SRM), as it focuses on minimizing errors for cases that we know should have been predictable. We apply this exploratory method on a subset of the Moral Machine dataset, a public collection of roughly 40 million moral decisions. Using SRM, we find that incorporating a set of deontological principles that capture dimensions along which groups of agents can vary (e.g., sex and age) improves a computational model of human moral judgment. Furthermore, we are able to identify and independently validate three interesting moral phenomena: criminal dehumanization, age of responsibility, and asymmetric notions of responsibility. [ABSTRACT FROM AUTHOR]

Molecular modeling of mixture adsorption in nanoporous materials can provide insight into the molecular-level details that underlie adsorptive separations. Modeling of adsorption often employs a rigid framework approximation for computational convenience. All real materials, however, have intrinsic flexibility due to thermal vibrations of their atoms. In this article, we examine quantitative predictions of the adsorption selectivity for a dilute concentration of a chemical warfare agent, sarin, from bulk mixtures with aqueous and non-aqueous (methanol, isopropyl alcohol) solvents using metal–organic frameworks (MOFs). These predictions were made in MOFs approximated as rigid and also in MOFs allowed to have intrinsic flexibility. Including framework flexibility appears to have important consequences for quantitative predictions of adsorption selectivity, particularly for sarin/water mixtures. Our observations suggest the intrinsic flexibility of MOFs can have a nontrivial impact on adsorption modeling of molecular mixtures, especially for mixtures containing polar species and molecules of different sizes. [ABSTRACT FROM AUTHOR]

Finding examples where experimental measurements have been repeated is a powerful strategy for assessing reproducibility of scientific data. Here, we collect quantitative data to assess how often synthesis of a newly reported material is repeated in the scientific literature. We present a simple power-law model for the frequency of repeat syntheses and assess the validity of this model using a specific class of materials, metal-organic frameworks (MOFs). Our data suggest that a power law describes the frequency of repeat synthesis of many MOFs but that a small number of "supermaterials" exist that have been replicated many times more than a power law would predict. Our results also hint that there are many repeat syntheses that have been performed but not reported in the literature, which suggests simple steps that could be taken to greatly increase the number of reports of replicate experiments in materials chemistry. [ABSTRACT FROM AUTHOR]

Nowadays, automation plays a very important role in the market both in domestic and industrial purposes. In this paper, devices are gathered in such a way that it can sense the fire and do necessary actions after that. This automatic fire control system works without human effort. Due to the change in the recent technologies day by day, the robotics have gained a specific position. Nowadays in every work, automation plays a very crucial role. One of the necessities is designed in this work. In this paper, the authors have proposed a prototype to fight against fire, i.e. "firefighting robot". [ABSTRACT FROM AUTHOR]

In this paper, we present a surface potential based compact modeling of terminal charge, terminal capacitance, and drain current for III–V channel double gate field-effect transistor (DGFET) including the effect of conduction band nonparabolicity. The proposed model is developed accounting for the two-dimensional density of states and includes the effect of quantum capacitance associated with the low density of states channel material. In addition, model incorporates contribution of the first two sub-bands and efficiently captures the step like behavior appearing in the gate capacitance and transconductance with population of the higher sub-bands. The behavior of bias-dependent terminal capacitances and drain current is verified with the numerical simulation data of InGaAs channel DGFET and shows a close agreement with the simulation data. [ABSTRACT FROM PUBLISHER]

Objective: To test the null hypothesis that the deproteinizing, agent does not increase the sheaf bond strength of light cute bonding material bonded with conventional, self etching and moisture insensitive primers. Material And Method: one hundred thirty five human premolars extracted for orthodontic purpose were used and divided into nine subgroups: A1) Teeth with conventional etching, conventional primer and bonding, A2) Teeth with self etch primer and banding, A3) Teeth with conventional etching. moisture insensitive primer and bonding, B1) Teeth with deproteinizing agent, conventional etching, conventional primer and bonding B2) Teeth with deproteinizing agent, self etch primer and bonding, B3) Teeth with deproteinizing agent, conventional etching, moisture insensitive primer and bonding C1) Teeth with deproteinizing agent, conventional primer and bonding C2) Teeth with deproteinizing agent and bonding C3) Teeth with deproteinizing agent, moisture insensitive primer and bonding. After bonding, the mechanical tests were performed in a Universal mechanical test machine. The values obtained were submitted to an analysis of variance and afterward to the unpaired t test (P < .051. Results: The shear bond strength results demonstrated that the mean shear bond strength values of subgroup A1 (9.84MPa), subgroup A3(9.35MPa) subgroup B1 (10.58MPa) and subgroup 83 (10.34MPa) were in the range of 9-10 MPa which has been higher than the clinically acceptable limit 8MPa but the difference among them is statistically insignificant Conclusions: SBS value obtained with the use of deproteinizing agent was comparatively higher as compared to conventional bonding method but statistically not very significant. Still, the use of 37% phosphoric acid for 15 seconds for conditioning of enamel remains the best method for pretreatment of enamel. [ABSTRACT FROM AUTHOR]

Mangrove, the intertidal halophytic vegetation, are one of the most significant and diverse ecosystem in the world. They protect the coast from sea erosion and other natural disasters like tsunami and cyclone. In view of their increased destruction and degradation in the current scenario, mapping of this vegetation is at priority. Globally researchers mapped mangrove vegetation using visual interpretation method or digital classification approaches or a combination of both (hybrid) approaches using varied spatial and spectral data sets. In the recent past techniques have been developed to extract these coastal vegetation automatically using varied algorithms. In the current study we tried to delineate mangrove vegetation using LISS III and Landsat 8 data sets for selected locations of Andaman and Nicobar islands. Towards this we made an attempt to use segmentation method, that characterize the mangrove vegetation based on their tone and the texture and the pixel based classification method, where the mangroves are identified based on their pixel values. The results obtained from the both approaches are validated using maps available for the region selected and obtained better accuracy with respect to their delineation. The main focus of this paper is simplicity of the methods and the availability of the data on which these methods are applied as these data (Landsat) are readily available for many regions. Our methods are very flexible and can be applied on any region. [ABSTRACT FROM AUTHOR]

In contrast to the different approaches currently adopted for generating basic and side-split subcolumn distillation sequence for separating zeotropic multicomponent feed mixture, we present a unified graphical method applicable towards both basic and side-split subcolumn distillation sequence. For a given number of components in the feed mixture, we enforce constraints on a base graph to eliminate violations of conservation principles and to preclude distillation sequences that demand higher heat duty in all appraised practical scenarios. A compact set of algebraic constraints is transfixed using the graph counterpart for generating basic-only distillation configurations. These algebraic constraints utilize binary variables to quantify existence of submixture streams and this considerably reduces the number of variables in generating distillation sequences. We also suggest extension of the formulation to enable the exploration of thermally coupled configurations. [ABSTRACT FROM PUBLISHER]

Despite the fact that numerous researches have been carried out to prevent head and neck cancer (HNC) and treat those patients, there is no reduction in morbidity rate because the underlying molecular pathogenesis is still poorly understood. Endocrine microenvironment is another vital factor besides other traditional risk factors like tobacco smoking, infections, and alcohol. It has been proven that sex hormone receptors are also expressed in larynx and lungs, in addition to sex organs. Sex hormones play a vital role in gene expression involved in the plethora of biological and neoplastic processes. The role of sex hormones in HNC is still divisive and very few researches have been conducted to describe their role. So, this article is an effort to attract the attention of researchers, endocrinologists, pathologists, and clinicians toward the impending role of sex hormones, with special emphasis on progesterone, estrogen, and prolactin in HNC onset and progression, along with their therapeutic role. [ABSTRACT FROM AUTHOR]

A technoeconomic evaluation has been conducted by the US Department of Energy, for four conceptual photoelectrochemical (PEC) H2production systems namely, single-bed particle system, dual-bed particle system, PEC planar array system and PEC tracking solar concentrator system. The present work extends the analysis to capture solar energy in the vicinity of Indian oil refineries and generate H2at estimated costs of 42, 84, 281 and 85 in ₹/kg H2for the four systems, respectively. This includes the capital and operating costs involved if the PEC H2production plant is set up around these refineries. Employing PEC H2production systems obviate the CO2generated by conventional processes like steam reforming, and thereby earning carbon credits. Inclusion of such credits is found to increase the annual earnings of the four conceptual systems by 0.7–8% depending on the selling price of H2. The sensitivity analysis of various economic factors like payback time, H2price, carbon credit, efficiency of the system, etc., is performed which is useful in judging economics of the venture depending on the market variations in prices or rise in efficiency of the system or variable economic constraints of the investor. [ABSTRACT FROM PUBLISHER]

Mucocele is a benign lesion characterized by an extravasation or retention of mucous in submucosal tissue from minor salivary glands. Mucoceles are known to occur most commonly on the lower lip, followed by the floor of mouth and buccal mucosa being the next most frequent sites. Trauma and lip biting habits are the main cause for these types of lesions. Mucocele is a common oral mucosal lesion but it is rarely observed in the infant. This paper highlights the successful management of a rare case of mucocele in an 11-month-old child. Diagnosis and management of mucocele are challenging. For this reason we felt it would be interesting to review the clinical characteristics, histological features, differential diagnosis, and their treatment and evolution in order to aid decision-making in daily clinical practice. [ABSTRACT FROM AUTHOR]

Purpose Pain is a comorbid and aggravating symptom that in many conditions can be perceived differently and should therefore be managed accordingly. Numerous factors, both social and cultural, are thought to influence the analgesic prescription. However, elucidation of such areas is limited. We therefore conducted a systematic literature review to test the hypothesis that variations in provider characteristics predict the prescription of pain medication. Methods A MEDLINE and Psyc INFO database search from 1960 to 2009 was conducted using the search terms of 'pain' or 'pain treatment' along with culture, ethnicity, race, minority, gender/sex, knowledge, attitudes, physician-patient relationship, stereotype, and physician practices. Twelve original research articles based on predefined inclusion criteria were identified and analyzed to test the hypothesis of provider characteristics influencing analgesics prescription. Results Of the 12 studies, 11 were cross-sectional in design, and 10 used a survey instrument or clinical vignettes to measure different pain management responses. A randomized sampling methodology was used in 5 of the studies. The majority of providers were male (64.9% in 8 studies), white (73.5% in 5 studies), internal medicine physicians (37.4% in 11 studies), and located in the United States (75% across all 12 studies). Ten studies identified at least one provider characteristic that influenced prescription practices; age, level of experience, as well as sex were listed most frequently as contributing factors. The interplay of the sex of the provider and patient characteristics were found to be important variables in pain management. Conclusions Our systematic review of existing literature highlights that provider's age, sex, experience, specialty, and the interplay between provider and patient characteristics are important variables in pain management. However, generalizations relating to these findings are limited by the heterogeneity of the studies and the paucity of literature in this field. [ABSTRACT FROM AUTHOR]

Purpose: Video-assisted thoracoscopic surgery (VATS) has become an alternative tool for a variety of spinal conditions as this approach minimises much morbidity related to conventional thoracotomy. The purpose of this study was to determine the efficacy of VATS and its long-term results in patients with dorsal spinal tuberculosis.Materials and Methods: This retrospective long-term follow-up study of VATS-assisted surgical treatment of dorsal spine tuberculosis included 30 patients with a mean age of 33.5 years (range 15-60). Patients with dorsal spine tuberculosis who were suitable surgical candidates for VATS underwent a three-portal thoracoscopy for decompression with/without fusion of the spine along with routine chemotherapy for tuberculosis (TB). Patients were assessed for blood loss, duration of surgery, postoperative incision pain, duration of hospital stay, neurological recovery, and progression of deformity. Patients were observed for a minimum of five years.Results: The mean duration of surgery was 158.8 min (range 90-220 min) with mean blood loss of 296.7 ml (range 200-450 ml). Complications were seen in ten patients. The mean follow-up was 80 months (range 60-90 months) with neurological improvement and return of ambulatory power in all patients at final follow-up. There was an average increase in kyphus angle by 7.5° at final follow-up and 95% of patients achieved an excellent or good subjective outcome.Conclusion: VATS-assisted surgical decompression can be a safe and effective technique for anterior debridement and fusion in tuberculosis of the dorsal spine to achieve neurological recovery with reduced morbidity, blood loss, and hospital stay compared to thoracotomy. [ABSTRACT FROM AUTHOR]

Purpose: Video-assisted thoracoscopic surgery (VATS) has become an alternative tool for a variety of spinal conditions as this approach minimises much morbidity related to conventional thoracotomy. The purpose of this study was to determine the efficacy of VATS and its long-term results in patients with dorsal spinal tuberculosis. Materials and methods: This retrospective long-term follow-up study of VATS-assisted surgical treatment of dorsal spine tuberculosis included 30 patients with a mean age of 33.5 years (range 15-60). Patients with dorsal spine tuberculosis who were suitable surgical candidates for VATS underwent a three-portal thoracoscopy for decompression with/without fusion of the spine along with routine chemotherapy for tuberculosis (TB). Patients were assessed for blood loss, duration of surgery, postoperative incision pain, duration of hospital stay, neurological recovery, and progression of deformity. Patients were observed for a minimum of five years. Results: The mean duration of surgery was 158.8 min (range 90-220 min) with mean blood loss of 296.7 ml (range 200-450 ml). Complications were seen in ten patients. The mean follow-up was 80 months (range 60-90 months) with neurological improvement and return of ambulatory power in all patients at final follow-up. There was an average increase in kyphus angle by 7.5° at final follow-up and 95% of patients achieved an excellent or good subjective outcome. Conclusion: VATS-assisted surgical decompression can be a safe and effective technique for anterior debridement and fusion in tuberculosis of the dorsal spine to achieve neurological recovery with reduced morbidity, blood loss, and hospital stay compared to thoracotomy. [ABSTRACT FROM AUTHOR]

Purpose: The World Health Organisation has declared tuberculosis (TB) a global emergency and spinal tuberculosis is one of the most common forms. There is still controversy regarding optimum duration of treatment in osteoarticular tuberculosis due to the lack of well-defined criteria for the end point of treatment. Emergence of multi drug resistant tuberculosis, primarily due to use of poor drug regimens, further illustrates the need of newer and more effective diagnostic methods, particularly in developing countries.Methods: This prospective clinical study to evaluate the role of technetium ((99m)Tc)-ciprofloxacin scan as a tool to assess disease activity involved in 15 cases of TB spine with a mean age of 32.2 years (range 21-72). Following a clinico-radiological diagnosis, all patients were treated with standard anti tubercular treatment and a scan was done at zero, three and six months of treatment with tracer activity being recorded and compared in sequential scans along with a parallel evaluation of clinical and radiological profile at regular intervals.Results: Out of 15 cases, nine had an initially positive bone scan. Two patients (22%) converted to negative scans at three months, whereas the remaining seven (78%) turned negative at six months. The end of six months treatment was also accompanied by clinico-radiological resolution in all cases.Conclusion: In conclusion, technetium ((99m)Tc)-ciprofloxacin scan could be a promising tool for monitoring disease activity in selected cases of tuberculosis spine as an alternative for therapeutic drug monitoring; however, due to the small sample size, studies with a large number of patients might be of help in defining these cases in a better way. [ABSTRACT FROM AUTHOR]

Purpose: The World Health Organisation has declared tuberculosis (TB) a global emergency and spinal tuberculosis is one of the most common forms. There is still controversy regarding optimum duration of treatment in osteoarticular tuberculosis due to the lack of well-defined criteria for the end point of treatment. Emergence of multi drug resistant tuberculosis, primarily due to use of poor drug regimens, further illustrates the need of newer and more effective diagnostic methods, particularly in developing countries. Methods: This prospective clinical study to evaluate the role of technetium (Tc)-ciprofloxacin scan as a tool to assess disease activity involved in 15 cases of TB spine with a mean age of 32.2 years (range 21-72). Following a clinico-radiological diagnosis, all patients were treated with standard anti tubercular treatment and a scan was done at zero, three and six months of treatment with tracer activity being recorded and compared in sequential scans along with a parallel evaluation of clinical and radiological profile at regular intervals. Results: Out of 15 cases, nine had an initially positive bone scan. Two patients (22%) converted to negative scans at three months, whereas the remaining seven (78%) turned negative at six months. The end of six months treatment was also accompanied by clinico-radiological resolution in all cases. Conclusion: In conclusion, technetium (Tc)-ciprofloxacin scan could be a promising tool for monitoring disease activity in selected cases of tuberculosis spine as an alternative for therapeutic drug monitoring; however, due to the small sample size, studies with a large number of patients might be of help in defining these cases in a better way. [ABSTRACT FROM AUTHOR]

In the evidence-based medicine era, objective treatment guidelines have been laid down for pulmonary tuberculosis, but the same is not true for osteoarticular tuberculosis. This has led to demands for standardising the treatment protocol and to a lack of consensus between doctors regarding the composition and duration of treatment. Twenty-five patients with extraspinal osteoarticular tuberculosis were evaluated prospectively. Following the diagnosis, patients were given standard directly observed treatment short course (DOTS) regimen and were monitored for disease activity at zero, three and six months with the help of technetium-99m-labelled ciprofloxacin ((99m)Tc) scan. Tracer activity at the site was recorded and compared on sequential scans. Clinical and radiological profile of all the patients were also recorded at regular intervals and compared. All 25 cases had a positive (99m)Tc bone scan initially. Four patients (16%) converted to negative scans at three months, whereas the remaining 21 patients (84%) showed negative scans at six months. The end of six months therapy also coincided with resolution of clinical and radiological parameters in all cases. In conclusion, (99m)Tc scan is a promising tool for monitoring drug response in osteoarticular tuberculosis; however, due to the small sample size, studies with a large number of patients might be of help. [ABSTRACT FROM AUTHOR]

In the evidence-based medicine era, objective treatment guidelines have been laid down for pulmonary tuberculosis, but the same is not true for osteoarticular tuberculosis. This has led to demands for standardising the treatment protocol and to a lack of consensus between doctors regarding the composition and duration of treatment. Twenty-five patients with extraspinal osteoarticular tuberculosis were evaluated prospectively. Following the diagnosis, patients were given standard directly observed treatment short course (DOTS) regimen and were monitored for disease activity at zero, three and six months with the help of technetium-99m-labelled ciprofloxacin ( Tc) scan. Tracer activity at the site was recorded and compared on sequential scans. Clinical and radiological profile of all the patients were also recorded at regular intervals and compared. All 25 cases had a positive Tc bone scan initially. Four patients (16%) converted to negative scans at three months, whereas the remaining 21 patients (84%) showed negative scans at six months. The end of six months therapy also coincided with resolution of clinical and radiological parameters in all cases. In conclusion, Tc scan is a promising tool for monitoring drug response in osteoarticular tuberculosis; however, due to the small sample size, studies with a large number of patients might be of help. [ABSTRACT FROM AUTHOR]

Intertrochanteric fracture is a common injury of increasing geriatric population. Dynamic hip screw (DHS) is one of the commonly used implants used for the internal fixation of intertrochanteric fractures. Use of standard plate by a minimally invasive technique is both possible and advantageous to patient outcome in these fractures by allowing a smaller incision, a shorter surgical time, decreased operative blood loss and less postoperative pain. All these factors in turn will reduce the duration of hospital stay and improve the healing and rehabilitation potential of the elderly patients. In this article, we describe a modification of standard technique for DHS fixation with a clinical follow-up of 40 consecutive cases, all having satisfactory outcome. [ABSTRACT FROM AUTHOR]

Video sharing services that allow ordinary Web users to upload video clips of their choice and watch video clips uploaded by others have recently become very popular. This article identifies invariants in video sharing workloads, through comparison of the workload characteristics of four popular video sharing services. Our traces contain metadata on approximately 1.8 million videos which together have been viewed approximately 6 billion times. Using these traces, we study the similarities and differences in use of several Web 2.0 features such as ratings, comments, favorites, and propensity of uploading content. In general, we find that active contribution, such as video uploading and rating of videos, is much less prevalent than passive use. While uploaders in general are skewed with respect to the number of videos they upload, the fraction of multi-time uploaders is found to differ by a factor of two between two of the sites. The distributions of life-time measures of video popularity are found to have heavy-tailed forms that are similar across the four sites. Finally, we consider implications for system design of the identified invariants. To gain further insight into caching in video sharing systems, and the relevance to caching of lifetime popularity measures, we gathered an additional dataset tracking views to a set of approximately 1.3 million videos from one of the services, over a twelve-week period. We find that lifetime popularity measures have some relevance for large cache (hot set) sizes (i.e., a hot set defined according to one of these measures is indeed relatively "hot"), but that this relevance substantially decreases as cache size decreases, owing to churn in video popularity. [ABSTRACT FROM AUTHOR]

Low-density lipoprotein cholesterol (LDL-C) has been clearly associated with the risk of developing coronary heart disease. The best and most convenient method for determining LDL-C has come under increased scrutiny in recent years. We present comparisons of the Friedewald calculated LDL-C (C-LDL-C) and direct LDL-C (D-LDL-C) using 3 different homogenous assays. This highlights differences between the 2 methods of LDL-C measurement and how this affects the classification of samples into different LDL-C treatment goals as determined by the National Cholesterol Education Program Adult Treatment Panel III guidelines thus potentially affecting treatment strategies.Lipid profiles of a total of 2208 clinic patients were retrieved from the Central Arkansas VA Healthcare System clinical laboratory database. Samples studied were of 1-week period during the 3 periods studied: 2000 (period 1), 2002 (period 2), and 2005 (period 3). Different homogenous assays for D-LDL-C measurement were used for each of the 3 periods.There is a fundamental disagreement between D-LDL-C and C-LDL-C, although Pearson correlation coefficients are 0.93, 0.97, and 0.98 for periods 1, 2, and 3, respectively. Using the model for period 1, when C-LDL-C is 70 mg/dL, the predicted D-LDL-C is 95 mg/dL (36% higher). The differences between C-LDL-C and predicted D-LDL-C progressively decrease at higher LDL-C cut points. In the assay used in period 3, there are 290 samples with D-LDL-C values between 100 and 130 mg/dL. Of these, only 182 samples show agreement with C-LDL-C values, whereas 90 samples with a D-LDL-C in the 100- to 130-mg/dL range are in the 70- to 100-mg/dL range using the C-LDL-C assay. Although the κ statistics suggests the LDL-C measures have relatively high levels of agreement, the significant generalized McNemar tests (P < 0.01) provide additional evidence of disagreement between C-LDL-C and D-LDL-C during all the 3 periods.Our results highlight D-LDL-C measurements using 3 different assays during 3 different periods. In all assays, there is a substantial lack of agreement between D-LDL-C and C-LDL-C, which, in most cases, resulted in higher D-LDL-C values than C-LDL-C. This leads to clinically significant misclassification of patient's LDL-C to a different LDL-C treatment goal, which would potentially result in more drug usage, thus exposing patients to more potential adverse effects and at a much greater cost with little evidence of benefit. [ABSTRACT FROM AUTHOR]

Syphilis outbreaks in the United States have been reported since 2000 with highest rates in the South and many cases among HIV-infected individuals. We evaluated incident syphilis cases and concurrent gonorrhea and chlamydia screening at a southern HIV clinic. A retrospective cohort study included HIV-infected patients with at least one reactive plasma reagin (test for serum reagin antibodies to cardiolipin-cholesterol-lecithin antigen) and primary care visit from July 2004 to June 2007. Primary, secondary, and early latent syphilis cases were identified as incident syphilis and evaluation for gonorrhea and chlamydia within 1 month were described. Logistic regression was performed to determine factors associated with incident syphilis. Among 1544 patients, 40 incident syphilis cases were identified (5 primary, 29 secondary, and 6 early latent). The majority of patients were not virologically suppressed and only 25% had gonorrhea and chlamydia testing. In adjusted analyses, younger age (0.57 per 10 years, 95% confidence interval [CI] 0.41–0.80) and minority race (2.26, 95% CI 1.12–4.59) were associated with incident syphilis. Among 40 incident syphilis cases, only 1 in 4 were further tested for gonorrhea and chlamydia. These low rates are concerning as concurrent sexually transmitted infections (STIs) increase risk for HIV transmission. HIV care provider education with emphasis on STI testing in the setting of incident syphilis is key in prevention. [ABSTRACT FROM AUTHOR]

Introduction and Objective: Placement of a percutaneous nephrostomy tube for drainage has been an integral part of the standard percutaneous nephrolithotomy (PCNL) procedure. However, in recent years, the procedure has been modified to what has been called 'tubeless' PCNL, in which nephrostomy tube is replaced with internal drainage provided by a double-J stent or a ureteral catheter. The objective of this article is to review the evidence-based literature on 'nephrostomy-free' or 'tubeless' PCNL to compare the safety, effectiveness, feasibility, and advantages of tubeless PCNL over standard PCNL. Materials and Methods: We performed a MEDLINE database search to retrieve all published articles relating to 'tubeless' PCNL. Cross-references from retrieved articles as well as articles from urology journals not indexed in MEDLINE, were also retrieved. Results: The majority of the studies have shown 'tubeless' PCNL to be a safe and economical procedure, with reduced postoperative pain and morbidity and shorter hospital stay. Tubeless PCNL has been found to be safe and effective even in patients with multiple stones, complex staghorn stones, concurrent ureteropelvic junction obstruction, and various degrees of hydronephrosis. The technique has been successful in obese patients, children, and in patients with recurrent stones after open surgery. Conclusion: Tubeless PCNL can be used with a favorable outcome in selected patients (stone burden <3 cm, single tract access, no significant residual stones, no significant perforation, minimal bleeding, and no requirement for a secondary procedure), with the potential advantages of decreased postoperative pain, analgesia requirement, and hospital stay. However, for extended indications, like supine PCNL, multiple, complex and staghorn stones, and concurrent PUJ obstruction, the evidence is insufficient and should come from prospective randomized trials. [ABSTRACT FROM AUTHOR]

Immobilization of lower limb following neurorrhaphy for sciatic nerve injuries poses a difficult clinical situation both for the surgeon and for the patient. In this article, we describe a new technique for maintenance of lower limb in desired position of extension at hip and flexion of knee without application of spica cast using an external fixator. In this method, a spanning external fixator across the knee and hip joint is applied in the desired position following neurorrhaphy, and both joints are sequentially brought back to normal position. Clinical follow-up of 2 cases is also presented with preservation of range of motion at hip and knee joint as well as good functional outcome of nerve repair. [ABSTRACT FROM AUTHOR]