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In this study, the focus is on an implant used in the treatment of early-onset scoliosis called magnetically controlled growing rods (MCGR). The primary goal of the study is to address and propose solutions for the mechanical problems reported in the literature concerning MCGR. The problems of the MCGR are mainly due to excessive stress and mechanical bearing problems. Therefore, an MCGR removed from a patient is teardown and geometrically modeled. Then, eleven design parameters are determined on the MCGR for the mechanical problems experienced and these are evaluated by mechanical analysis over 14 control points. In this study, analysis processes are carried out with L12 orthogonal array for eleven design parameters and 2 levels using Taguchi’s experimental design method (DoE). With the obtained data by analyzing the experiments in L12, the fitness functions depending on the design parameters are created for 14 control points. Since the problem is multi-objective, a non-dominated sorting genetic algorithm (NSGA II) and multi-objective particle swarm optimization (MOPSO) are used to minimize stress and displacement in existing mechanical problems using fitness functions. The obtained design models from NSGA II and MOPSO are analyzed and evaluated in comparison with the existing mechanical model obtained through pre-optimization teardown study of MCGR.

Background/Objectives: A pronator quadratus pedicled bone graft (PQPBG) is a distal radius volar vascularized bone graft used not only for avascular necrosis of the lunate but also for scaphoid nonunion. Despite its potency and its possession of a muscular shield, this vascularized graft has a disadvantage in that the potential shortness of the muscular leash may limit the distal transfer of the bone graft. Releasing of the pronator quadratus (PQ) ulnar origin was used to enhance the distal mobility of the graft. We aimed to investigate the effect of a PQ release on the surgical outcomes of scaphoid nonunions that were operated on with the PQPBG technique. Methods: Patients with scaphoid nonunion that were treated with PQPBG from 2009 to 2020 were reviewed. Patient demographic characteristics, surgical notes, physical examinations, and radiological evaluation data were collected. Wrist range of motion, grip strength, modified Mayo wrist score, and Quick-DASH score were used to evaluate the outcomes. The included patients were divided into two groups based on the origin release status of their PQ, i.e., with and without release. Results: This study included 37 patients, 17 of whom underwent a PQ release and 20 of whom did not. The failure rates for the two groups were one and four patients, respectively, and there was no significant difference between them (p = 0.11). The postoperative mean wrist extension in the patients with a PQ release was significantly greater than that in the patients without a release (43.5 ± 6.8 vs. 36.5 ± 7.7, p = 0.0038). Although wrist flexion, ulnar deviation, radial deviation, mean outcome assessment scores, and grip strength were greater in the patients with a PQ release than in those without, no statistically significant intergroup differences were observed (p > 0.05). Conclusions: The PQPBG technique is a viable option for achieving bony union in patients with scaphoid nonunion, but it results in the postoperative restriction of wrist extension. PQ release during a graft transfer may have a favorable effect on both bone union and clinical outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Hamidiye Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Clustering texts together is an essential task in data mining and information retrieval, whose aim is to group unlabeled texts into meaningful clusters that facilitate extracting and understanding useful information from large volumes of textual data. However, clustering short texts (STC) is complex because they typically contain sparse, ambiguous, noisy, and lacking information. One of the challenges for STC is finding a proper representation for short text documents to generate cohesive clusters. However, typically, STC considers only a single-view representation to do clustering. The single-view representation is inefficient for representing text due to its inability to represent different aspects of the target text. In this paper, we propose the most suitable multi-view representation (MVR) (by finding the best combination of different single-view representations) to enhance STC. Our work will explore different types of MVR based on different sets of single-view representation combinations. The combination of the single-view representations is done by a fixed length concatenation via Principal Component analysis (PCA) technique. Three standard datasets (Twitter, Google News, and StackOverflow) are used to evaluate the performances of various sets of MVRs on STC. Based on experimental results, the best combination of single-view representation as an effective for STC was the 5-views MVR (a combination of BERT, GPT, TF-IDF, FastText, and GloVe). Based on that, we can conclude that MVR improves the performance of STC; however, the design for MVR requires selective single-view representations. [ABSTRACT FROM AUTHOR]

Background/Objectives: We sought to improve accuracy while minimizing radiation hazards, improving surgical outcomes, and preventing potential complications. Despite the increasing popularity of these systems, a limited number of papers have been published addressing the historical evolution, detailing the areas of use, and discussing the advantages and disadvantages, of this increasingly popular system in lumbar spine surgery. Our objective was to offer readers a concise overview of navigation system history in lumbar spine surgeries, the techniques involved, the advantages and disadvantages, and suggestions for future enhancements to the system. Methods: A comprehensive review of the literature was conducted, focusing on the development and implementation of navigation systems in lumbar spine surgeries. Our sources include PubMed-indexed peer-reviewed journals, clinical trial data, and case studies involving technologies such as computer-assisted surgery (CAS), image-guided surgery (IGS), and robotic-assisted systems. Results: To develop more practical, effective, and accurate navigation techniques for spine surgery, consistent advancements have been made over the past four decades. This technological progress began in the late 20th century and has since encompassed image-guided surgery, intraoperative imaging, advanced navigation combined with robotic assistance, and artificial intelligence. These technological advancements have significantly improved the accuracy of implant placement, reducing the risk of misplacement and related complications. Navigation has also been found to be particularly useful in tumor resection and minimally invasive surgery (MIS), where conventional anatomic landmarks are lacking or, in the case of MIS, not visible. Additionally, these innovations have led to shorter operative times, decreased radiation exposure for patients and surgical teams, and lower rates of reoperation. As navigation technology continues to evolve, future innovations are anticipated to further enhance the capabilities and accessibility of these systems, ultimately leading to improved patient outcomes in lumbar spine surgery. Conclusions: The initial limited utilization of navigation system in spine surgery has further expanded to encompass almost all fields of lumbar spine surgeries. As the cost-effectiveness and number of trained surgeons improve, a wider use of the system will be ensured so that the navigation system will be an indispensable tool in lumbar spine surgery. However, continued research and development, along with training programs for surgeons, are essential to fully realize the potential of these technologies in clinical practice. [ABSTRACT FROM AUTHOR]

Objective:This study was designed to characterize the distribution of otorhinolaryngological emergencies seen in the geriatric population in one year. In this article we present our results and discuss the differences between our results and those reported in the current literature.Methods:The study was carried out in a tertiary care university hospital. All patients aged 65 years or over that were referred by the general emergency department (ED) to the otorhinolaryngology emergency room in a one-year period were retrospectively reviewed. Demographic characteristics (age, gender), findings of physical examination, accompanying systemic diseases, diagnosis, and treatment methods were documented. Hospitalization and referral needs were also analyzed.Results:In the one-year period from April 2017 to April 2018, a total of 12,780 patients aged 65 or older presented to the ED and the otorhinolaryngology physician was consulted for 195 (1.5%) of these patients. The age range of the patients was 65–96 years, with a mean age of 75 years. The most common cause for presenting to the ED was maxillofacial trauma (31.7%), followed by epistaxis (18.7%). Dyspnea (9.7%) and peripheral facial paralysis (9.7%) were the third most frequent causes. The outcome analysis revealed that 9.7% of the patients were hospitalized.Conclusion:Identifying the characteristics of the geriatric patients presenting to EDs is important for developing proper management algorithms. Maxillofacial traumas were the most frequently seen ORL emergencies in our cohort of geriatric patients, followed by epistaxis. The distribution and the prevalence of the cases could differ according to the institutional protocols.

Background: The hypertensive pregnancies complicated by preeclampsia show an increase in maternal and perinatal morbidity and mortality.Color Doppler ultrasound has been employed for fetal surveillance. Objective: To evaluate the role of Doppler study in the prediction of adverse pregnancy outcomes in hypertensive pregnant women at the third trimester of pregnancy. Patients and Methods: A clinical prospective follow up study conducted in Outpatient Ultrasound Clinic at Al-Imamein Kadhimein Medical City, Baghdad, Iraq from 1st July, 2018 till 31st of July 2019 included 50 pregnant women with hypertensive disorder of pregnancy at the third trimester. The fetal and neonatal outcome was reported poor when intrauterine fetal death occurs during follow-up of pregnant women or more than two of the reported neonatal complications were poor. Results: Means of the middle cerebral artery and umbilical artery-resistance and pulasatility indices ratio were significantly decreased among pregnant women with poor neonatal outcomes. Similarly, the umbilical artery end-diastolic flow and Ductus Venousu waveforms were Conclusion: The middle cerebral artery and umbilical artery indices of pregnant women with hypertensive disorders are good predictors for neonatal outcomes.

Vitamin K2 (Menaquinone) stands out from other members of the vitamin K family due to its unique molecular structure. It is primarily found in meat and dairy products or converted from K1 in the gut. The conversion process of K1 to K2 in animal tissues, along with the role of intestinal bacteria in K2 production, is crucial for maintaining adequate levels. Extensive research has highlighted the importance of vitamin K2 in promoting bone health, preventing arterial calcification, and enhancing cardiovascular health. Additionally, vitamin K2 supports fertility and growth, and is associated with reducing the risk of cardiovascular diseases and certain cancers. [ABSTRACT FROM AUTHOR]

The feasibility of implementing digital predistortion for next-generation wireless communication is faced with a dilemma due to the ever-increasing demand for faster data rates. This causes the utilized bandwidth to increase significantly, as seen in the 5G NR standard in which bandwidths as high as 400 MHz are utilized. Hence, the development of new predistortion techniques in which the forward and feedback paths operate at lower sampling rates is of utmost importance to realize efficient and practical predistortion solutions. In this work, a novel predistortion technique is presented by which the predistortion is divided between the digital and analog domains. The predistorter is composed of a memoryless AM/AM gain function that is implementable in the analog domain, and a nonlinear model with memory effects in the digital domain to relax the sampling rate requirements on both the forward and feedback paths. Experimental validation was carried out with a 20 MHz and a 40 MHz 5G signal, and the results indicate minimal linearization degradation with a sampling rate reduction of 50% and 30%, respectively. This sampling rate reduction is concurrently applied in the digital-to-analog converter of the forward path and the analog-to-digital converter of the feedback path. [ABSTRACT FROM AUTHOR]

BACKGROUND: Treatment of reverse oblique fractures has the highest complication rate among proximal femur fractures. Although intramedullary nailing is the preferred treatment option, a high failure rate has been reported. Previous studies have identified several contributing factors to these failures, yet the significance of posterolateral wall integrity in ensuring postoperative stability has not been emphasized. This study aims to investigate the impact of posterolateral wall integrity on the failure rates of reverse oblique intertrochanteric fractures treated with intramedullary nails (IMN) and assess the vulnerability of certain IMN designs to these failures. METHODS: Between 2010 and 2016, 53 patients with reverse oblique fractures were analyzed to identify factors associated with IMN failure. Variables such as posterolateral wall integrity, quality of reduction, posteromedial support, and IMN design were considered as potential risk factors. Logistic regression analysis was conducted to evaluate these risk factors, with statistical significance defined as p<0.05. RESULTS: Eleven cases of implant failure were identified. Univariate statistical analysis indicated that loss of posterolateral support (p=0.002), IMN with single-screw proximal fixation (p=0.048), poor reduction quality (p=0.004), and loss of posteromedial support (p=0.040) were associated with implant failure. Multivariate analysis confirmed loss of posterolateral support (p=0.009), poor reduction quality (p=0.039), and loss of posteromedial support (p=0.020) as independent risk factors for failure. However, IMN with single proximal fixation (p=0.859) did not significantly impact fixation failure. CONCLUSION: Reverse oblique intertrochanteric fractures with compromised posterolateral support exhibit a high rate of mechanical failure when treated with IMN. Additionally, poor reduction quality and loss of posteromedial support increase the risk for failure of these fractures. An IMN design featuring dual separate proximal screw fixations could provide better stability compared to a design with a single proximal screw, thereby reducing the risk of mechanical failure. [ABSTRACT FROM AUTHOR]

Background: The aging of the population in developing and developed countries has led to a significant increase in the health burden of spinal diseases. These elderly patients often have a number of medical comorbidities due to aging. The need for minimally invasive techniques to address spinal disorders in this elderly population group cannot be stressed enough. Minimally invasive spine surgery (MISS) has several proven benefits, such as minimal muscle trauma, minimal bony resection, lesser postoperative pain, decreased infection rate, and shorter hospital stay. Methods: A comprehensive search of the literature was performed using PubMed. Results: Over the past 40 years, constant efforts have been made to develop newer techniques of spine surgery. Endoscopic spine surgery is one such subset of MISS, which has all the benefits of modern MISS. Endoscopic spine surgery was initially limited only to the treatment of lumbar disc herniation. With improvements in optics, endoscopes, endoscopic drills and shavers, and irrigation pumps, there has been a paradigm shift. Endoscopic spine surgery can now be performed with high magnification, thus allowing its application not only to lumbar spinal stenosis but also to spinal fusion surgeries and cervical and thoracic pathology as well. There has been increasing evidence in support of these newer techniques of spine surgery. Conclusions: For this report, we studied the currently available literature and outlined the historical evolution of endoscopic spine surgery, the various endoscopic systems and techniques available, and the current applications of endoscopic techniques as an alternative to traditional spinal surgery. [ABSTRACT FROM AUTHOR]

Study Design Prospective analysis of collected data. Purpose We determine the need for the use of mid-length pedicle screws (screws with 2.5-mm long increments) during posterior spinal instrumentation. Overview of Literature Many biomechanical studies have been performed showing that increasing the pedicle screw insertion depth provides an improved resistance to pullout, cyclic loading, and derotational forces, but no intermediate length screws were used. Methods We prospectively evaluated 120 patients who received posterior segmental instrumentation for structural scoliosis. Preoperatively, 91.44-cm long cassette anteroposterior (AP), lateral, and AP bending radiographs and multiplanar computed tomography were performed in all patients routinely. We measured chord length to determine the maximum probable screw length of all vertebrae. All pedicle screws were attempted to be placed as long as possible. The main intention was at least to engage the subcortical bone of the anterior vertebral cortex. Especially in the apical region, the screws were attempted to be inserted bicortically. The length, level, region, and side of each screw were recorded. Screws with 5-mm increments were called standard length screws (SLS), and middle-sized screws with 2.5-mm increments were called mid-length screws (MLS). Results Of 2,846 pedicle screws inserted, 1,575 (55.4%) were SLS and 1,271 (44.6%) were MLS, demonstrating a need for MLS in scoliosis surgery (p

Study DesignMechanical study.PurposeTo compare the pullout strength of different screw designs and augmentation techniques in an osteoporotic bone model.Overview of LiteratureAdequate bone screw pullout strength is a common problem among osteoporotic patients. Various screw designs and augmentation techniques have been developed to improve the biomechanical characteristics of the bone–screw interface.MethodsPolyurethane blocks were used to mimic human osteoporotic cancellous bone, and six different screw designs were tested. Five standard and expandable screws without augmentation, eight expandable screws with polymethylmethacrylate (PMMA) or calcium phosphate augmentation, and distal cannulated screws with PMMA and calcium phosphate augmentation were tested. Mechanical tests were performed on 10 unused new screws of each group. Screws with or without augmentation were inserted in a block that was held in a fixture frame, and a longitudinal extraction force was applied to the screw head at a loading rate of 5 mm/min. Maximum load was recorded in a load displacement curve.ResultsThe peak pullout force of all tested screws with or without augmentation was significantly greater than that of the standard pedicle screw. The greatest pullout force was observed with 40-mm expandable pedicle screws with four fins and PMMA augmentation. Augmented distal cannulated screws did not have a greater peak pullout force than nonaugmented expandable screws. PMMA augmentation provided a greater peak pullout force than calcium phosphate augmentation.ConclusionsExpandable pedicle screws had greater peak pullout forces than standard pedicle screws and had the advantage of augmentation with either PMMA or calcium phosphate cement. Although calcium phosphate cement is biodegradable, osteoconductive, and nonexothermic, PMMA provided a significantly greater peak pullout force. PMMA-augmented expandable 40-mm four-fin pedicle screws had the greatest peak pullout force.

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

An Implemented pot experiment has been conducted in Al-Qadisiyah city - sadder AL- Yusufiya - District 9 in Spring planting season 2016 to study the effect of the overlap between the mineral , organic and bio fertilization in some growth indicators to maize crop (Zea mays) in Silt Loam texture soils with factorial experiement according to completely randomize design (Complete random design) and with three replicates. The expenneit has been done by adding mineral fertilizers (240 kg N. ha-1 and 80 kg P. ha-1 and 120 kg K. ha-1) three levels (0, 50% and 100%) respectively; and two levels of organic fertilizer (0 and 10 Mg. ha-1) respectively; and two levels of bio-fertilizer (0 and 2 ml. L-1) respectively to the irrigation water. The addition of mineral , organic and bio fertilizers has a significant effecct on the dry matter amount and the treatment (M2O1B1) is given the highest average of the dry matter,which reaches to 57.27 g.pot-1 as compared with the control treatment (M0O0B0), reacches to 20.46 g.pot-1 and the increasing percentage reach to 179.91%. There are no significant differences between (M1O1B1) and (M2O1B1). The triple overlap among the metal and organic fertilizers and bio has a significant effect on increasing the percentages of N, P and K in maize plants%, the treatment (M2O1B1) has achieved the highest average of 3.67% N and 0.49% P and 2.19% K respectively, compared with the treatment control (M0O0B0) 2.21% N and 0.23% P and 1.33% K sequentially with increasing which presentage reached to 66.06 N% and 113.04 P% and 64.66 K%. There are no significant differences between the treatments (M1O1B1) and (M2O1B1). (M2O1B1).

Light fidelity considers a promising technology for wireless communications, it is assumed more secure and couldn't interface with another source. The technique depends on the line of sight between bi-directional sending and receiving sides, challenges are signal attenuation due to propagation non-line-of-sight, which can influence the power signal received from the receiver. The study focused on the effect of signal attenuation due to weather conditions of the communication line connecting to the end-user of visible light system, also this paper examined the effect of reflectors on the weakly obtained signals from LED due to non-line of sight under different weather conditions such as rain and dust to obtain an satisfactory signal power at the end user. The system was simulated by Optisystem tool version 18 to support 1 Gbps, where it consists of one free space optic channel, 40 Km length of fiber optic, and a visible light system with one Light Emitting Diode, the reflector on the VLC system has been made with the help of Matlab simulation. The system was estimated based on the bit error rate, signal-to-noise ratio, and quality factor, BER of VLC achieved an adequate implementation in dusty weather to a distance of around 700 m, while, in rainy weather, the performance of the Q-factor was fair to a distance of 1800 m, comparison of BER and SNR under variation irradiance angle with using reflectors and without them have made, BER and SNR were staying stable around 1E-50 and 60 with using reflectors. A reflector was utilized to improve the system's implementation due to the diffusion of signal; thus, this reflector explained its capability to fix reflection. [ABSTRACT FROM AUTHOR]

An Implemented pot experiment has been conducted in Al-Qadisiyah city - sadder AL- Yusufiya - District 9 in Spring planting season 2016 to study the effect of the overlap between the mineral , organic and bio fertilization in some growth indicators to maize crop (Zea mays) in Silt Loam texture soils with factorial experiement according to completely randomize design (Complete random design) and with three replicates. The expenneit has been done by adding mineral fertilizers (240 kg N. ha-1 and 80 kg P. ha-1 and 120 kg K. ha-1) three levels (0, 50% and 100%) respectively; and two levels of organic fertilizer (0 and 10 Mg. ha-1) respectively; and two levels of bio-fertilizer (0 and 2 ml. L-1) respectively to the irrigation water. The addition of mineral , organic and bio fertilizers has a significant effecct on the dry matter amount and the treatment (M2O1B1) is given the highest average of the dry matter,which reaches to 57.27 g.pot-1 as compared with the control treatment (M0O0B0), reacches to 20.46 g.pot-1 and the increasing percentage reach to 179.91%. There are no significant differences between (M1O1B1) and (M2O1B1). The triple overlap among the metal and organic fertilizers and bio has a significant effect on increasing the percentages of N, P and K in maize plants%, the treatment (M2O1B1) has achieved the highest average of 3.67% N and 0.49% P and 2.19% K respectively, compared with the treatment control (M0O0B0) 2.21% N and 0.23% P and 1.33% K sequentially with increasing which presentage reached to 66.06 N% and 113.04 P% and 64.66 K%. There are no significant differences between the treatments (M1O1B1) and (M2O1B1).

Construction delay in projects is a common manifestation in the construction industry. Delay in construction will lead to a bad relationship between the parties involved and will also lead to an increase in the allocated completion time. Delay in the ongoing project might result in the loss of the money, time and other facilities by the client and cause a lot of financial damage to the contractor due to its investment in the purchase of equipment, construction materials and the hire of skilled workers. Delay in construction is a common problem that occurs mostly due to the unforeseen problems during the design & construction stages which often lead to delays in the completion of the project. Oman's construction industry is one of the most important industries for the country's economic development and growth. In this study, analysis of some available literature was conducted, and a questionnaire survey was floated among contractors, consultants, clients, project managers, and engineers involved in construction projects. All the collected responses were evaluated by using SPSS. The results of the study identified a total of 60 causes of delay out of which three factors have a «High» significance level for construction delays. These factors of «High» significance were associated with «Client related issues only» in which the initial design was altered by the client, delaying in deciding by the client and, scope change by the client. Majority of the delay (84 %) was observed to be lying in the range of 1-2 years. This study also recognized the effect and minimization of regular delay and delay resulted due to Covid-19. Minimizing construction delay criteria can be managed by having a proper control system in the project time and funds. [ABSTRACT FROM AUTHOR]

When the amount of data and information is said to double in every 20 months or so, feature selection has become highly important and beneficial. Further improvements in feature selection will positively affect a wide array of applications in fields such as pattern recognition, machine learning, or signal processing. Bio-inspired method called Bat Algorithm hybridized with a Naive Bayes classifier has been presented in this work. The performance of the proposed feature selection algorithm was investigated using twelve benchmark datasets from different domains and was compared to three other well-known feature selection algorithms. Discussion focused on four perspectives: number of features, classification accuracy, stability, and feature generalization. The results showed that BANB significantly outperformed other algorithms in selecting lower number of features, hence removing irrelevant, redundant, or noisy features while maintaining the classification accuracy. BANB is also proven to be more stable than other methods and is capable of producing more general feature subsets.

Background Osteoarthritis (OA) is a complex degenerative articular disease that has an ambiguous pathogeny because variant risk factors participate in the process of cartilage deterioration. Genetic factors may have a role in the onset and progression of OA. Objective To investigate potential association between severity of knee OA (KOA) and Double von Willebrand factor A domains DVWA rs11718863 gene polymorphism. Methods One hundred and twenty Iraqi patients diagnosed with KOA, aged (45 years and above) and sixty healthy people (control) at the same age range, with no family history of OA were evaluated at Al-Imamein Al-Kadhimein Medical City (Rheumatology Department). The degree of severity of KOA was assessed by clinical and radiographic assessment. DVWA rs11718863 genotyping was performed using DNA sequencing (Sanger's method). Results Two different genotypes wild homozygote (TT) genotype and heterozygote (AT) appeared by genotyping of DVWArs:11718863. Highly significant difference (p<0.001) was found in distribution of the two genotypes in the three study groupsl the genotype (TT) was more frequent in control group (95.0%). Also, high significant difference (p<0.001) was noted in the two alleles (A, T) frequencies between control group and KOA patients group giving odd ratio 6.437 with 95% confidence intervals of (1.93-21.42). Conclusion Iraqi subjects carrying AT genotype of DVWA rs11718863 gene are mostly susceptible for developing of KOA and the allele A of Tyr169Asn polymorphism are more frequent in those patients indicating that allele A may be a risk factor of onset of this disease. Age and body mass index are considered risk factors of onset and progression of KOA. [ABSTRACT FROM AUTHOR]

Background: The hypertensive pregnancies complicated by preeclampsia show an increase in maternal and perinatal morbidity and mortality.Color Doppler ultrasound has been employed for fetal surveillance. Objective: To evaluate the role of Doppler study in the prediction of adverse pregnancy outcomes in hypertensive pregnant women at the third trimester of pregnancy. Patients and Methods: A clinical prospective follow up study conducted in Outpatient Ultrasound Clinic at Al-Imamein Kadhimein Medical City, Baghdad, Iraq from 1st July, 2018 till 31st of July 2019 included 50 pregnant women with hypertensive disorder of pregnancy at the third trimester. The fetal and neonatal outcome was reported poor when intrauterine fetal death occurs during follow-up of pregnant women or more than two of the reported neonatal complications were poor. Results: Means of the middle cerebral artery and umbilical artery-resistance and pulasatility indices ratio were significantly decreased among pregnant women with poor neonatal outcomes. Similarly, the umbilical artery end-diastolic flow and Ductus Venousu waveforms were Conclusion: The middle cerebral artery and umbilical artery indices of pregnant women with hypertensive disorders are good predictors for neonatal outcomes. [ABSTRACT FROM AUTHOR]

Background: Elastosonography is a promising non-invasive technique that developed in recent years for evaluating thyroid nodules. It assesses nodule stiffness or displacement depending on the applied force to differentiate malignant from benign thyroid nodules. Objectives: The aim of this study was to evaluate the diagnostic utility of real time US elastography in the differentiation the benign from malignant thyroid nodule. Patients and methods: A cross-sectional was carried out on 40 patients attending ultrasound unit/radiology in Al-Imamein Al-Kadhimein Medical city in Baghdad/Iraq from September 2018 to August 2019. All patients were examined by B-mode ultrasound, color Doppler, and real-time elastography by Voluson-E6 Ultrasound machine. Final diagnoses obtained from histological and/or cytological evaluation. Results: The mean age of 40 patients was 43.7±11.7 years with the range of 25-70 years. 28 (70%) of them were female and 12 (30%) were male. Of the 40 lesions 34 (85%) were benign and 6 (15%) were malignant lesions. Malignant thyroid nodules were significantly hypoechoic, with irregular margin, taller than wider, showed microcalcification and exhibited a significant increase in vascularity with varying rate of sensitivity and specificity. Orientation (taller than wider) was the most ultrasound predictive pattern of malignancy with sensitivity, specificity, and accuracy of 66.7%, 100%, and 92.5% respectively. The mean strain ratio of all nodules was 2.7±2.1 ranged 0.4-13.5 with significant result. The optimal strain ratio cutoff value was >2.5 and showed to have a sensitivity of 100%, specificity 88.2%, positive predictive value 67%, negative predictive value 100%, and accuracy rate 90%. Conclusion: Elastosonography can assist in the differential diagnosis of malignant and benign thyroid nodules, as strain elastosonography improve the diagnostic performance in differentiating the benign and malignant thyroid nodule. strain ratio is higher in malignant than benign nodules. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to characterize the distribution of otorhinolaryngological emergencies seen in the geriatric population in one year. In this article we present our results and discuss the differences between our results and those reported in the current literature. Methods: The study was carried out in a tertiary care university hospital. All patients aged 65 years or over that were referred by the general emergency department (ED) to the otorhinolaryngology emergency room in a one-year period were retrospectively reviewed. Demographic characteristics (age, gender), findings of physical examination, accompanying systemic diseases, diagnosis, and treatment methods were documented. Hospitalization and referral needs were also analyzed. Results: In the one-year period from April 2017 to April 2018, a total of 12,780 patients aged 65 or older presented to the ED and the otorhinolaryngology physician was consulted for 195 (1.5%) of these patients. The age range of the patients was 65-96 years, with a mean age of 75 years. The most common cause for presenting to the ED was maxillofacial trauma (31.7%), followed by epistaxis (18.7%). Dyspnea (9.7%) and peripheral facial paralysis (9.7%) were the third most frequent causes. The outcome analysis revealed that 9.7% of the patients were hospitalized. Conclusion: Identifying the characteristics of the geriatric patients presenting to EDs is important for developing proper management algorithms. Maxillofacial traumas were the most frequently seen ORL emergencies in our cohort of geriatric patients, followed by epistaxis. The distribution and the prevalence of the cases could differ according to the institutional protocols. [ABSTRACT FROM AUTHOR]

Study Design: Prospective analysis of collected data. Purpose: We determine the need for the use of mid-length pedicle screws (screws with 2.5-mm long increments) during posterior spinal instrumentation. Overview of Literature: Many biomechanical studies have been performed showing that increasing the pedicle screw insertion depth provides an improved resistance to pullout, cyclic loading, and derotational forces, but no intermediate length screws were used. Methods: We prospectively evaluated 120 patients who received posterior segmental instrumentation for structural scoliosis. Preoperatively, 91.44-cm long cassette anteroposterior (AP), lateral, and AP bending radiographs and multiplanar computed tomography were performed in all patients routinely. We measured chord length to determine the maximum probable screw length of all vertebrae. All pedicle screws were attempted to be placed as long as possible. The main intention was at least to engage the subcortical bone of the anterior vertebral cortex. Especially in the apical region, the screws were attempted to be inserted bicortically. The length, level, region, and side of each screw were recorded. Screws with 5-mm increments were called standard length screws (SLS), and middle-sized screws with 2.5-mm increments were called mid-length screws (MLS). Results: Of 2,846 pedicle screws inserted, 1,575 (55.4%) were SLS and 1,271 (44.6%) were MLS, demonstrating a need for MLS in scoliosis surgery (p <0.05). The need for MLS increased significantly in the thoracic region, apical vertebrae, and convex side (p <0.05). Conclusions: If anterior cortex engagement or longer placement of pedicle screws is intended during scoliosis surgery, for safer placement, screws with 2.5-mm increments should be available in posterior instrumentation systems. [ABSTRACT FROM AUTHOR]

Background Atopic dermatitis (AD) is a common inflammatory skin disease with a chronic relapsed-remitting course with manifestations started at early childhood. AD is two types; extrinsic and intrinsic. Zinc has a crucial role in the immune system functions and antioxidant mechanisms, it also serves in the metabolism and cell growth through signaling several enzymes. Objective To assess serum zinc level in patients with childhood AD. Methods A case-controlled study was conducted in Dermatology outpatient’s clinic in Al-Imamein Al-Kadhimein Medical City, from the period of September 2016-June 2017. Twenty patients with AD were enrolled in this study. AD severity was graded using the Scoring Atopic Dermatitis Index (SCORAD). The control group consisted of age-matched and sex-matched twenty healthy children were taken with weight above 80%. Fasting blood samples were taken from patients and controls between 8 AM and 10 AM. Results Of the twenty patients of AD, 13 (65%) were males and 7 (35%) were females. Their mean age was 4.58±3.13. Regarding the control group 9 (45%) were males and 11 (55%) were females, their mean age was 4.29±2.46. No statistical difference in serum zinc level between AD patients and control groups. Concerning zinc level in males and females, no statistical differences was found in AD patients, but highly significant difference was found in control group. Serum zinc level was highly significantly low in patients with moderate AD than in those with mild AD. There was negative correlation between serum zinc level and severity of AD. Conclusion There is a negative correlation between serum zinc level and severity of AD, also there is a gender variation in serum zinc level in normal children. [ABSTRACT FROM AUTHOR]

Background:At least in 25% of infertile men, no identifiable cause can be attributed to the problem,so it is termed idiopathic infertility. Those men are candidates for empiric medical therapy which include antioxidant therapy. Men upplement Plus (MFS Plus) uses a powerful all-natural formula of many antioxidants in addition to Relora to improve semen quality. Objectives:To evaluate the effect of MFS Plus on sperms concentration, motility and morphology in men with oligo and/or asthenozoopermia in sample of Iraqi infertile males. Methods:Acomparative clinical trial study was conducted at High Institute of Infertility Diagnosis and Assisted Reproductive Technologies during the period from July 2015 till February 2017. Male partner of infertile couples who had one or more of the following criteria oligo, astheno, and/or teratozospermia according to criteria of WHO 2010 were involved in this study. Eighty-one males were divided randomly into two groups, the first group (group A) were given MFS Plus capsule AMS® (America Medic & Science) two capsules twice daily for three months and the second group (group B) were given vitamin E capsule (one capsule three times daily) for the same period.A second semen analysis were done after three months for each subject in both groups to show the effect of both types of treatment on semen quality. Results:There was a highly significant increase in sperms progressive motility % (14.0±11.41 vs 29.35±15.61, p value < 0.001) and a highly significant decrease in immotile sperms % (60.15±19.3 vs 41.52±18.18, p value < 0.001) in the group of patients who received MFS Plus treatment. Moreover, there was significant increase in sperm concentration and percentage of normal sperm morphology (p value = 0.027, 0.019 respectively). However, no significant change was observed regarding semen volume and percentage of non-progressive motility.Whereas there were no significant changes in any of semen analysis parameters in the group of patients (group B) who received placebo. Conclusion:MFS Plus usage for three months is very beneficial for sperm motility in addition to its valuable effect on sperm concentration and morphology and it is more efficient than vitamin E alone. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate mechanisms by which adiponectin influences vascular Ca2+ signaling, K+ channel activity and thus contractile tone of small arteries. Vasodilation to adiponectin was studied in mesenteric resistance arteries constricted with intraluminal pressure. Ca2+ signals were characterized using high speed confocal microscopy of intact arteries. Patch clamp investigated the effect of adiponectin on individual VSMC potassium (K+) channel currents. Adiponectin dilated arteries constricted with pressureinduced tone by approximately 5% and the induced vasodilation was only transient. The dilation to adiponectin was reduced by pharmacological interruption of the Ca2+ spark/large conductance activated K+ (BK) channel pathway but from a physiological perspective, interpretation of the data was limited by the small effect. Neither Adiponectin nor the presence of intact perivascular adipose tissue (PVAT) influenced Ca2+ spark or Ca2+ wave frequency or characteristics. Studied using a perforated patch approach, Adiponectin marginally increased current through the VSMC BK channel but this effect was lost using the whole cell technique with dialysis of the cytoplasm. Adiponectin did not change the frequency or amplitude of Ca2+ spark-induced transient outward currents (STOC). Overall, our study shows that Adiponectin induces only a small and transient dilation of pressure constricted mesenteric arteries. This vasodilatory effect is likely to be independent of Ca2+ sparks or direct BK channel activation. [ABSTRACT FROM AUTHOR]

Study Design: Prospective unicentral nonrandomized study.Objective: To evaluate the safety and effectivity profile of magnetic controlled growing rods (MCGR) in patients with early onset scoliosis (EOS).Summary Of Background Data: Conventional growing rods are the most commonly used growth sparring devices in the treatment of EOS, as this technique requires repeated surgical operations for lengthening; it is associated with high rate of complications and increased costs. MCGR in treatment of EOS is effective in correcting deformity whereas allowing continuous spinal growth as reported by a few studies.Methods: A total of 18 patients with progressive EOS were treated by MCGR, two of them had undergone final fusion operation. Patients were followed-up for a minimium time of 9 months from the time of initial surgery. Radiological data were analyzed in terms of Cobb angle, kyphosis angle, T1-T12, and T1-S1 distances in preoperative, postoperative, and last follow up.Results: The mean preoperative Cobb and kyphosis angle were 68° (44-116°) and 43° (98-24°), it was corrected to 35° (67-12°) and 29° (47-21°) immediately after initial operation and maintained at 34.5° (52-10°) and 33° (52-20°) at last follow up, respectively.The mean preoperative T1-T12 and T1-S1 distance were 171 mm (202-130 mm) and 289 mm (229-370 mm), it was increased to 197 mm (158-245 mm) and 330 mm (258-406mm) immediately after initial operation and further increased to 215 mm (170-260 mm) and 357 mm (277-430 mm) at last follow up, respectively.Two patients had undergone final fusion, they had overall mean Cobb angle correction of 66° (62-70°), and kyphosis angle change of 53° (26-80°). Total height gain in T1-T12 and T1-S1 of 80.5 mm (67-94 mm) and 119 mm (105-133 ), respectively.Conclusion: MCGR is safe and effective technique in correction of EOS deformity and in maintaining the correction during nonsurgical distraction procedures. A further correction of the deformity and more spinal height gain can be achieved in the final fusion operation.Level Of Evidence: 3. [ABSTRACT FROM AUTHOR]

This paper presents a new hybrid of Bat Algorithm (BA) based on Mutual Information (MI) and Naive Bayes called BAMI. In BAMI, MI was used to identify promising features which could potentially accelerate the process of finding the best known solution. The promising features were then used to replace several of the randomly selected features during the search initialization. BAMI was tested over twelve datasets and compared against the standard Bat Algorithm guided by Naive Bayes (BANV). The results showed that BAMI outperformed BANV in all datasets in terms of computational time. The statistical test indicated that BAMI has significantly lower computational time than BANV in six out of twelve datasets, while maintaining the effectiveness. The results also showed that BAMI performance was not affected by the number of features or samples in the dataset. Finally, BAMI was able to find the best known solutions with limited number of iterations. [ABSTRACT FROM AUTHOR]

Background Male infertility constitutes about 50% of overall causes of infertility and apoptosis is known to have an essential role in the control of germ cell number in testis. Cigarette smoking is common in males at reproductive age. Studying the influence of smoking on apoptosis in male genital tract and its influence on fertility helps in the management of infertility in smokers. Objectives To assess the influence of cigarette smoking on seminal plasma (SP) soluble Fas (sFas) and the correlation between SP sFas and serum sex steroidal hormones and conventional semen parameters in males of infertile couples. Methods Seventy male partners of infertile couples (30 smokers and 40 non-smokers) were enrolled in this study. A subject was considered smoker if he had history of smoking of more 10 cigarettes per day for at least one year. Semen analysis was done according to World Health Organization (WHO) 2010. Specific kits were used for the measurement of SP sFas and serum testosterone and estradiol (E2). Results In smokers' group, SP sFas was significantly (p <0.05) negatively correlated with age and sperm motility and positively correlated with immotile sperm and round cell number. Conclusion Germ cell apoptosis in smoker males of infertile couples is interrelated with sperm motility. [ABSTRACT FROM AUTHOR]

Most of carpal tunnel syndrome cases are idiopathic, and secondary causes are so rare that can be easily missed. We present a patient with neglected undiagnosed lunate dislocation compressing on median nerve causing its signs and symptoms. [ABSTRACT FROM AUTHOR]