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Objectives: to evaluate the advantage of preserving the subvalvular structures of the mitral valve from both leaflets compared with the preservation of the subvalvular structures only from the posterior valve during mitral valve replacement surgery (MVR). Methods: A retrospective analysis of case histories of 41 patients with isolated rheumatic lesions of the mitral valve who underwent MVR, which were divided into 2 groups: with complete preservation of subvalvular structures (n = 24) and preservation of only the posterior leaflet (n = 17), was performed. Results: In the group with complete preservation of the chordal-papillary apparatus, there was a significant decrease in the end-systolic volume (p

Background. Acute intestinal infections (AII) caused by Shiga-like toxin-producing Escherichia coli and accompanied by hemolytic uremic syndrome (HUS) development are characterized by rapid progression and poor prognosis. Bloody diarrhea (hemorrhagic colitis) requires timely medical treatment both at young age and at adolescence. The severe course of HUS affected by AII caused by enterohaemorrhagic Escherichia coli requires additional medical attention and timely renal replacement therapy (hemodialysis). Clinical Case Description. The description and analysis of the severe course of HUS affected by AII in 14 years old adolescent girl is presented. There were some difficulties during diagnostics and thus the pathogenetic therapy onset was delayed. Differential diagnosis between typical and atypical HUS was performed. The disease was characterized by rapid progression of acute kidney injury, cerebrovascular disease and ischemia, multiple organ dysfunction syndrome and disseminated intravascular coagulation resulting in fatal case. Conclusion. Atypical HUS is the most frequent cause of multiple organ dysfunction syndrome alongside with acute kidney injury. The challenges of early diagnostics of atypical GUS in childhood are not fully solved nowadays and require additional attention of pediatricians. The clinical case of atypical GUS complicated by intestinal infection caused by enterohaemorrhagic Escherichia coli is described in this article. The severity of the disease course was due to the early manifestation of extrarenal symptoms and multiple organ failure.

Background: Diabetic foot syndrome (DFS) causes damage to the peripheral arteries in 50% of patients with diabetes mellitus (DM). The purpose of this study was to evaluate the efficacy of endovascular interventions, stenting, and balloon angioplasty for the treatment of patients with purulent and necrotic lesions in DFS. Methods: This was a retrospective study. During 2019-2020, stenting and balloon angioplasty were performed in 51 patients (study group) with purulent and necrotic complications of diabetic foot with limb ischemia. There were 32 women (62.7%) and 19 men (37.3%). The age of the patients varied from 45 to 81 years. Endovascular interventions were performed in combination with conservative therapy and topical treatment on 2 to 3 days after the debridement of the purulent lesions. To assess the outcomes of endovascular interventions, we studied the nature of changes in arterial circulation in the lower extremities. The mean blood flow velocity was calculated using the Doppler ultrasonography. The study was performed on the popliteal artery (PA), the posterior tibial artery (PTA), and on the dorsalis pedis artery. In this study, patients were divided into 2 groups: the study group— those who received endovascular intervention— and the control group— those who received only conservative therapy, which included local treatment without surgery. Results: The weightbearing function of the foot at discharge from the hospital was preserved in 94.2% (48 patients) of the study group and in 73.4% (22 patients) of the control group. During the next 6 months, repeated small foot surgeries were required in 7.3% (3 patients) of patients from the study group and in 20% (4 patients) of patients from the control group. Six months after discharge, the weightbearing function of the foot was preserved in all the patients from the study group available for follow-up and in 85% of the patients from the control group. Conclusion: The results of the study demonstrate the positive corrective effects of endovascular interventions, stenting, and balloon angioplasty on the clinical course of ischemic and neuroischemic forms of DFS.

Early writings in Islamic economics depicted a grand and, some would say, utopian image of the type of societal development that would result from implementing Islamic social and economic theory. However, despite the emergence of Islamic economics in a modern sense in the 1960s, we now find that the only manifestation that represents an Islamic alternative to mainstream neo-classical development is the Islamic banking and finance industry. However, the developments in the Islamic financial services industry indicate that it has converged toward conventional finance, which, arguably, contributes to the financialization of economy, as a result. Consequently, it has failed to fulfil the institutional and policy aspirations of Islamic economic system. This statement is investigated with an empirical study. We find evidence that initially Islamic banks played a positive role in reduction of income inequality, however, as Islamic finance has become a real force in the market place, financialization of the industry might have contributed to income inequality, thereby Islamic finance fails to meaningfully contribute to the realization of SDG 10, namely reducing inequalities.

ASME Turbo Expo 2018: Turbomachinery Technical Conference and Exposition, GT (2018: Oslo, Norway), Windage losses arise due to the viscous dissipation of air - oil mist flow driven by the rotating faces, sides of the gears in a gearbox. The windage losses can consume up to 3% of the transmitted power. In the open literature, theoretical investigations mostly focused on the single phase (air) flow. In the present study we attempt to elucidate the complex flow physics between the gears by considering the effects of oil particles in the air flow. The goals of this work is to develop a physical understanding of the aerodynamics of gear windage loss. A spur gear geometry was considered, for which experimental and theoretical data are available. A commercial Computational Fluid Dynamics algorithm (CFD++) was utilized for the numerical simulations. The first group of simulations were performed for a single phase (air) flow in order to validate the numerical approach. The results showed good agreement with the experiment. Various shrouding configurations and free spinning cases are studied at different rotation speeds of the gear. The effects of the oil droplets on the windage losses were quantified., Rotary Wing Technology Center, TAI (Turkish Aerospace Industries) [DKTM/2015/14]

We present a novel technique for resolving the problem of radical size mismatch at the time of orthotopic transplantation. A 48-year-old man presented with chronic rheumatic heart disease and a giant left atrium. Twenty-three years before, he had undergone mitral valve replacement with a mechanical prosthesis. At the time of the repeated intervention, the volume of his left atrium was 350 mL. Surgical features of the transplantation included approximation of the pulmonary vein ostia by gathering sutures intentionally, in order to decrease the area of the left atrial posterior wall and thereby enable appropriate coaptation with the donor left atrium. After the operation, left atrial volume had been reduced to 60 mL.

The design, synthesis, and characterization of new high-performance n-channel molecular/polymeric semiconductors that are solution-processable and air-stable is of great interest for the development of p-n junctions, bipolar transistors, and organic complementary circuitry (CMOS). While over the past two decades there have been many reports on n-channel materials, solution-processability and air-stability still remain as major challenges. We report here the synthesis and detailed characterization of a highly electron-deficient class of indeno[1,2-b]fluorene-6,12-dione, 2,2'-(indeno[1,2-b]fluorene-6,12-diylidene) dimalononitrile, bisindenofluorene-12,15-dione, and 2,2'-(bisindenofluorene-12,15-diylidene) dimalononitrile-based ladder-type building blocks (1-12) and their corresponding homo- and copolymers (P1-P14), and examine in detail the effects of core size, thiophene vs core regiochemistry, carbonyl vs dicyanovinylene functionality, and alkyl chain orientation on the physicochemical properties, thin film microstructures, and OFET device performance. New compounds are characterized by DSC, TGA, melting point, single-crystal X-ray diffraction (XRD), solution/thin film optical, PL, and cyclic voltammetry measurements to evaluate frontier molecular orbital energetics and intermolecular cohesive forces. Thin films are grown by vacuum deposition and spin-coating, and investigated by X-ray diffraction (XRD) and AFM. By tuning the HOMO/LUMO energetics of the present materials over a 1.1 eV range, p-type, n-type, or ambipolar charge transport characteristics can be observed, thus identifying the MO energetic windows governing majority carrier polarity and air stability. One of these systems, thiophene-terminated indenofluorenedicyanovinylene 10 exhibits an electron mobility of 0.16 cm(2)/V x s and an I(on)/I(off) ratio of 10(7)-10(8), one of the highest to date for a solution-cast air-stable n-channel semiconductor. Here we also report solution-processed ambipolar films of thiophene-based molecule 12 and copolymers P13 and P14 which exhibit electron and hole mobilities of 1 x 10(-3)-2 x 10(-4) and I(on)/I(off) ratios of approximately 10(4), representing the first examples of molecular and polymeric ambipolar semiconductors to function in air. Analysis of the operational air-stabilities of a series of thin films having different crystallinities, orientations, and morphologies suggests that operational air-stability for thermodynamically predicted (i.e., no kinetic barrier contribution) air-stable semiconductors is principally governed by LUMO energetics with minimal contribution from thin-film microstructure. The onset LUMO energy for carrier electron stabilization is estimated as -4.0 to -4.1 eV, indicating an overpotential of 0.9-1.0 eV. Density functional theory calculations provide detailed insight into molecule/polymer physicochemical and charge transport characteristics.

From 1949 to 1989, about 450 nuclear explosions were conducted at the Semipalatinsk Nuclear Test Site, Kazakhstan, which resulted in substantial levels of radiation exposure of neighboring settlements and their residents. The incidence of oncological diseases in the East Kazakhstan region, including Semipalatinsk, are very high in comparison to other regions of Kazakhstan. For example, the incidence of breast cancer in East Kazakhstan is 1.5-fold higher in comparison to the average rate of breast cancer in Kazakhstan and is 2.5-fold higher than that in South Kazakhstan. We documented the prevalence of breast cancer morbidity among patients from zones of extreme radiation risk and maximal radiation risk. Our results show an apparently strong association between fallout exposure and the prevalence of thyroid diseases. After the Tokyo International Conference in 1999, in which the health problems of populations living close to the Semipalatinsk Nuclear Test Site and methods of its rehabilitation were discussed, the Japanese government, JICA, scientists and NGO from Japan provided a really valuable support for the Semipalatinsk region of Kazakhstan. Modern medical equipment was granted by the Japanese government. Installed Telemedicine was very valuable for consultation of 1822 patients. Screening program covered more than 34,000 inhabitants from exposed and non-exposed villages. Collaborative research projects with scientists from Japan, including Nagasaki University, allowed us to successfully conduct epidemiological research projects in the Semipalatinsk region of Kazakhstan and considerably improve diagnosis and treatment of many diseases related to consequences of nuclear weapons testing.

Observed differences in medical utilization between the privately insured and uninsured reflect the combined effects of self-selection and insurance incentives (moral hazard). This article provides a Bayesian framework for decomposing the disparity into incentive and selection components. The effect of self-selection in private insurance on the number of doctor visits is estimated using a multiyear sample of the U.S. adult non-Medicare population obtained from the Medical Expenditure Panel Survey. We use a flexible econometric framework based on the “Roy model” and develop a Markov chain Monte Carlo algorithm. We estimate the distribution of treatment effects and find strong evidence indicating selection, which accounts, on average, for 50% or more of the observed disparity in doctor visits.

This paper studies the effect of managed care on medical expenditure using a model in which the insurance status is assumed to be endogenous. Insurance plan choice is modeled through the multinomial probit model. The medical expenditure variable, the outcome of interest, has a significant proportion of zeros that are handled using the two-part model, extended to handle endogenous insurance. The estimation approach is Bayesian, based on the Gibbs Sampler. The model is applied to a sample of 20 460 individuals obtained from the Medical Expenditure Panel Survey. The results provide substantial evidence of selectivity. Copyright © 2006 John Wiley & Sons, Ltd.

The Semipalatinsk region of Kazakhstan is known as a place of weeping and sorrow. Here, from 1949 to 1989, the earth trembled and the atmosphere convulsed from the force of 458 nuclear explosions. Epidemiological and clinical studies in the period from 1962 to 1997 were carried out among exposed groups of the population of five districts of the Semipalatinsk area. The range of the effective dose of radiation exposure was 0.35–0.99 and more than 1 Sv. The range of the effective dose of radiation for a group in comparison was 0.03–0.05 Sv. Clinical research has been conducted among 43 000 inhabitants, exposed groups of 28 000 people and a comparison group of 15 000 people. The prevalence of malignant diseases among exposed groups between the ages of 0 and 15 years at the moment of irradiation has been much higher than for those in the comparison group (p

When pulse amplitude and time stamp are recorded in list-mode time-stamping data acquisition, it is possible to correct for the system amplitude walk, typically observed as the time pickoff dependence on pulse amplitude. In this study, a method of correcting for amplitude walk during post-acquisition analysis of such list mode data is developed and demonstrated. The method is demonstrated using a simple two-channel system and a photon source capable of producing coincidence events (22Na). Two leading-edge discriminators, vulnerable to the amplitude walk, were used to produce the time pickoffs. The resulting corrected data show an amplitude walk less than the detector timing resolution. The method developed can be used in list-mode data acquisition systems such as medical imaging scanners or Compton scatter cameras.

Effects of plate separation and inclination on free convection between asymmetrically heated vertical and inclined parallel plates have been simulated. The upper isothermally heated plate is facing downwards, the lower plate is passively heated by the upper one. The plate inclinations are chosen to be 0 degrees, 30 degrees, 45 degrees with respect to vertical position. Three-dimensional laminar numerical simulations are obtained by solving the full elliptic governing equations using a commercial finite volume based computational fluid dynamics (CFD) code. Comparisons of computational results with experiments and data from the literature are made in terms of relevant dimensionless numbers. It was observed that plate spacing and inclination influence the overall heat transfer rate.

The potential contributions of a centralized data warehouse or repository in clinical research include the expedited accrual of subjects for phase II trials. Understanding the contribution of data warehouses that integrate clinical, biospecimen, and molecular data for the conduct of clinical trials is essential to inform private and public decisions on resource allocation and investment. We conducted a value of information analysis using data from recent trials at the Moffitt Cancer Center and simulated the potential reductions in trial size due to possible alternative scenarios of expedited accrual. In this study, we compared alternative data sets using a single model to assess value of information. Our findings suggest that the reductions in trial size range from 0% to 43%, depending on the amount of censoring in overall survival. The ability to expedite the accrual of patients for clinical trial studies using large data repositories that store data on inclusion/exclusion criteria and response to standard of care therapies demonstrated significant improvement in reducing the number of subjects needed to achieve similar end-results, as evaluated using value of information analysis with a limited number of parameters and a parsimonious model of overall survival.

Change in software is always an essential part of software development and maintenance. Estimating a proposed change’s effect on the later phases of the development helps project managers and developers with decision-making and predicting future progress. During development, on some occasions, speedy solutions are necessary to meet project schedules. Such quick changes may lead to major quality flaws in the long term, even though they solve local problems in the short term. Controlled management of change is achieved by being able to estimate the impact of changes. In this paper, we propose a new change impact factor estimation and present the design of an experiment to measure these effects, describe its application, and show the measured results of the change impact.

A novel approach for analyzing the relationship between code metrics and change count histories is presented. Specifically, neural networks are employed to determine a mapping between metrics and change count. While these neural networks can be trained to a high degree of accuracy, their internal workings remain opaque to the user. As such, a fuzzy modeling approach is additionally employed to generate the rules governing the neural computation. These rules are linguistic in nature and are thus more easily interpreted by software project managers. Application of this method to Mozilla change data reveals the importance of fan-out, total lines of code and maximum cyclomatic complexity metrics in predicting amount of change per file.

A prospective comparison of computerized tomography(CT), 18 fluoro-deoxyglucose positron emission tomography(FDG-PET) and endoscopic ultrasonography(EUS) in the preoperative evaluation of potentially operable esophageal cancer patients

WOS: 000509740400015, PubMed: 31985285, OBJECTIVE To evaluate the usefulness of intestinal biomarkers in determining the presence of intestinal epithelial damage in neonatal calves with diarrhea caused by 4 etiologic agents. ANIMALS 40 neonatal calves that were healthy (n = 10) or had diarrhea (30). PROCEDURES The study was a cross-sectional study. Results of hematologic analyses and serum concentrations of intestinal fatty acid-binding protein (I-FABP), liver fatty acid-binding protein (L-FABP), trefoil factor 3 (TFF-3), Claudin-3 (CLDN-3), gamma-enteric smooth muscle actin (ACTG2), intestinal alkaline phosphatase (IAP), interleukin-8 (IL-8), platelet-activating factor (PAF), and leptin (LP) were compared among calves grouped according to whether they were healthy (control group; G-1) or had diarrhea caused by K99 Escherichia coli (G-2; n = 10), bovine rota-or coronavirus (G-3; 5 each), or Cryptosporidium spp (G-4; 10). RESULTS Across the 3 time points at which blood samples were obtained and evaluated, the groups of calves with diarrhea generally had markedly higher mean serum concentrations of L-FABP, TFF-3, IAP, IL-8, and LP, compared with the control group. In addition, G-2 also consistently had markedly higher mean serum concentrations of I-FAB and ACTG2 and lower mean serum concentrations of CLDN-3, compared with the control group. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that degree of intestinal epithelial damage differed among calves grouped by the etiologic agent of diarrhea and that such damage might have been more severe in calves with diarrhea caused by K99 E coli. Additionally, our results indicated that serum concentrations of I-FABP, L-FABP, TFF-3, IAP, IL-8, ACTG2, LP, and CLDN-3 were useful biomarkers of intestinal epithelial damage in calves of the present study., Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [1160456], Funded by The Scientific and Technological Research Council of Turkey (TUBITAK; project No. 1160456).

Objectives: Dual antiplatelet therapy (DAPT), consisting of clopidogrel and aspirin, is the main-stay treatment of acute coronary syndromes (ACS). However, major adverse cardiovascular events may occur even in patients undergoing DAPT, and this has been related to the variable pharmacodynamic efficacy of these drugs, especially clopidogrel. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are novel inflammatory markers for cardiovascular risk stratification, which may reflect an inflammatory state and thus high on-treatment platelet reactivity (HPR). Methods: We investigated the usefulness of PLR and NLR in predicting HPR in clopidogrel-treated patients with ACS. A total of 244 patients were enrolled in this study, and 43 of them were nonresponsive to clopidogrel. Results: Logistic regression analysis indicated that PLR was significantly associated with HPR (P < 0.001). Using a cutoff level of 331, PLR predicted HPR with a sensitivity of 73% and a specificity of 69% (odds ratio: 376.15, 95% confidence interval = 37.813–3741.728 P < 0.001, receiver operating characteristic curve: 0.885). Conclusions: We suggest that more attention should be paid to the PLR values of these patients on admission to identify individuals who may not benefit from clopidogrel during the course of ACS.