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We report a case of 15-year-old boy with postlingual bilateral total hearing loss following ototoxic medication during his pediatric intensive care unit stay. The patient received the SynCardia total artificial heart implant (50 mL; SynCardia Systems, Inc., Tucson, AZ, USA) for end-stage biventricular heart failure as a bridge to heart transplant. During his time on the urgent heart transplant wait list, he underwent successful cochlear implantation following optimized coagulation and hemostasis status and appropriate anesthetic preparation. Our case represents the world's first successful cochlear implant in a pediatric patient who received an artificial heart. Despite complexities in this patient population, elective surgical procedures can be performed safely with acceptable morbidity using a collaborative approach with the heart transplant team, including input from cardiovascular surgery, pediatric cardiology, anes thesiology, consultation-liaison psychiatry, physical therapy and rehabilitation, infectious diseases and clinical microbiology, and intensive care unit staff.

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.

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

Objectives:Ear, nose and throat (ENT) diseases are among the most common pathologies in the community, some of which may have high morbidity and mortality if early diagnosis and appropriate treatment approaches are not applied. Pediatric patients form an important part of emergency department admissions. The emergency diseases observed in children are different from the adult patient group and the diagnosis and treatment approaches differ accordingly. The aim of this study is to investigate the epidemiological features and approach methods among the pediatric patients presenting to the emergency department.Materials and Methods:Between 2016 and 2017, the data of 1732 patients younger than 18 years who were referred by the pediatric emergency to ENT department were retrospectively reviewed. Age, gender, admission Complaints, diagnosis, additional diseases, radiological and laboratory tests and treatment approaches were evaluated.Results:Among the patients included in the study, 751 were male (52.4%), 681 were female (47.5%); The average age was 7.2 years. Altı yüz seksen yedi (48.8%) patients were referred for rhinologic reasons, 515 (36.9%) patients had otologic complaints, while 73 (5.09%) patients had oral cavity and 44 (3.5%) patients had head and neck region related complains. The number of hospitalized patients was 41 (2.86%) patients. Yirmi dokuz (2.02%) patients were treated with surgical intervention.Conclusion:The majority of patients presenting with ENT related complains to pediatric emergency services may be examined and treated in the emergency unit without referring to ENT department. Most of the referred patients complain from simple trauma, minor epistaxis or simple infections. However, patients presenting with severe trauma or a foreign body that can cause aspiration should be evaluated as soon as possible and treated accordingly.

Light fidelity is a future technology due to significant advancements in Light-Emitting Diodes (LEDs) and visible-light communication. Existing LEDs for illumination in homes, factories, offices, and streets have large bandwidths, are secure, and exhibit high data rates; hence, LED has recently attracted considerable attention. This study investigates the effects of a bidirectional reflector technology on the vulnerability of received signals from five LEDs due to the nonline of sight that occurs because of walls of a standard room with a dimension of 5 × 5 × 3 m; the proposed indoor system supports a 1-Gbps data rate. The system was evaluated in phrases of the bit error rate, quality factor, signal power, and electrical signal-to-noise ratio. The effect of the irradiance angle variation on the quality factor and bit error rate of the signal was demonstrated in reflectivities of approximately 99% and 0.8%. Bidirectional reflector technology was used to enhance the system’s performance due to the dispersion of the received signal. Therefore, this technology demonstrated its ability to correct reflected signals.

Clearing of forests and burning of oil-origin fuels have enhanced the Earth’s natural greenhouse effect on our planet. The motivation behind this work is to control such an effect that is widely deemed to be crucial in maintaining life on earth. This effect causes global warming besides increasing environmental pollution due to the harmful carbon dioxide (CO2) emission. Remarkable applications of geospatial technologies have thus been clearly noticed in the relevant field of remote sensing. Such application has been justifiably witnessed in the rapid spatiotemporal monitoring of forest resources. This in turn has participated in the formulation of substantial strategy outlines to set the sustainable management of these forests. Many countries of the world are now heavily working to protect trees and conserve forests. Satellite imaging can hereby be a very efficient way for this purpose. The objective of this paper is to propose a model that uses satellite imaging with Google Earth application to protect forests from being cleared. The pertinent methodology of this model is conceptually based on the method of edge detection. The paper discusses the issues of satellite image acquisition and processing besides the international REDD+ forest conservation program for such protection. The governmental role in providing resources to protect this natural resource has further been highlighted. Using satellite imagery for the conservation of forest and protecting trees from being cut, the anticipated outcome of the proposed model is envisaged to achieve better results that are much “faster” and more “accurate” than the other available approaches. In addition to forests’ conservation, the application field of this work encompasses diverse issues like overcoming environmental and climate changes, diminishing deforestation, and defeating desertification.

Objective Distraction-based systems are the most common systems used in the treatment of early-onset scoliosis. In addition to its corrective and deformity progression preventive properties, its vertebral growth stimulation effect has been proved. Recently popularized magnetically controlled growing rods (MCGRs) showed superior results in terms of outcomes and decreased complication rate. Its vertebral growth stimulation effect has not been studied. The aim of the study is to evaluate the vertebral growth stimulation effect in patients treated with MCGR. Methods Patients with progressive scoliosis treated by dual MCGR, who had no obvious lumbar vertebral deformity and had a regular 3-month interval spinal lengthening for at least 30 months, were subdivided into 2 groups according to the inclusion of L3 vertebra within instrumentation segments. The L3 vertebral vertical and horizontal lengths were measured postoperatively and at the last follow-up, and their differences were analyzed statistically in both groups. Results Twenty-four patients were included; 18 of them had an L3 vertebra outside instrumentation segments, while the other 6 had spanned by MCGR. Uninstrumented L3 were followed up for an average of 36 months. The height difference between initial postoperative examination and the last follow-up was 3.55 mm ± 0.63 mm, and the width difference was 3.85 mm ± 0.75 mm. Conversely, patients with instrumented L3 were followed up for a mean of 38.9 months. Their initial postoperative examination and last follow-up differences in height and width were 6.91 mm ± 1.11 mm and 3.66 mm ± 0.92 mm, respectively. Conclusions Frequent distractions stimulate longitudinal vertebral growth in vertebrae spanned by MCGR.

STUDY DESIGN A prospective, a single-institution, nonrandomized study. OBJECTIVE The aim of this study was to evaluate the safety and effectivity of short-segment instrumentation in early-onset scoliosis (EOS) patients treated by magnetic-controlled growing rods (MCGRs). SUMMARY OF BACKGROUND DATA Despite the common use of conventional growing rods and the recent popularity of MCGR in the treatment of progressive EOS, distal instrumented vertebra and number of the spanned levels are not standardized. METHODS Patients with progressive EOS, characterized by the major thoracic curve and nonstructural compensatory curve, were a candidate to be treated by dual MCGR short segment spinal instrumentation spanning the major thoracic curve; such patients are followed up for a minimum period of 30 months. Radiological data were collected and analyzed in terms of Cobb angle of both primary and secondary curve, kyphosis angle, T1-T12, and T1-S1 distances, and T1-T12/T1-S1 ratio in preoperative, postoperative, and last follow-up. RESULTS Sixteen patients with different diagnoses of EOS, mean age at the operation was 7 years and 10 months (5 years and 6 months-9 years and 10 months), and mean period of follow-up was 37 (30-54) months. The Cobb angle of both major and compensatory curve are corrected by the mean value of 62° (44-85), 35° (22-45) preoperatively to 29° (12-49), 14° (9-24) postoperatively, and maintained at 28° (10-47), 10° (2-20) in the last follow-up, respectively. The T1-T12/T1-S1 ratio was 0.58 preoperatively, 0.6 postoperatively, and 0.62 at the last follow-up. The average yearly T1-T12 and T1-S1 length increase were calculated as 7 and 9 mm/year, respectively. CONCLUSION Selective fusion principals are applicable to EOS, in that short segment instrumentation with MGCR in thoracic curve EOS patients is an effective technique in correction of both structural and compensatory curve, and in maintaining the correction during subsequent nonsurgical spinal distraction. LEVEL OF EVIDENCE 4.

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.

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.

one of the popular things among succeeded companies is an automated system. The reasons behind using the automated system are to reduce human errors, work and to gain efficiency. The design focused on building an automated system for access control and attendance monitoring by the use of RFID technology. all the companies that still doing mural attendance will get a great help when it used the proposed system. this paper used RFID (tags, reader), microcontroller to collect data, ZigBee technology for transmitting and receiving data wirelessly, computer as a control station. the program at control station was written by using Visual C# and connect with database (DB) MSSQL server to store employees’ numbers (RFID tags) and used for attendance calculations. The initial results of the proposed system appear a high profit in time-saving and cost when compared with traditional systems. cost divided into two parts, firstly: a price of ZigBee device, secondly: security men

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.

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.