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Exciting recent advances in genome sequencing, coupled with greatly reduced storage and computation costs, make genomic testing increasingly accessible to individuals. Already today, one’s digitized DNA can be easily obtained from a sequencing lab and later used to conduct numerous tests by engaging with a testing facility. Due to the inherent sensitivity of genetic material and the often-proprietary nature of genomic tests, privacy is a natural and crucial issue. While genomic privacy received a great deal of attention within and outside the research community, genomic security has not been sufficiently studied. This is surprising since the usage of fake or altered genomes can have grave consequences, such as erroneous drug prescriptions and genetic test outcomes. Unfortunately, in the genomic domain, privacy and security (as often happens) are at odds with each other. In this article, we attempt to reconcile security with privacy in genomic testing by designing a novel technique for a secure and private genomic range query protocol between a genomic testing facility and an individual user. The proposed technique ensures authenticity and completeness of user-supplied genomic material while maintaining its privacy by releasing only the minimum thereof. To confirm its broad usability, we show how to apply the proposed technique to a previously proposed genomic private substring matching protocol. Experiments show that the proposed technique offers good performance and is quite practical. Furthermore, we generalize the genomic range query problem to sparse integer sets and discuss potential use cases.

Objective To investigate the effect of electromyography (EMG)-driven robotic therapy on the recovery of the hand in a stroke case lasting 9 years. Case An 18-year-old patient with hemiparesis due to the ischemic lesion was admitted to our clinic with hand impairment. Fifteen sessions (5 weeks x 3 times) of robotic rehabilitation were applied with the Hand of Hope. Average EMG (mV) of flexor digitorum superficialis (FDS) muscle, average force (N) and the rate of force development (RFD)(N/s) were also assessed before and after the treatment following the 5th and 10th sessions and at the end of treatment. Also, Fugl-Meyer Assessment of Upper Extremity Scale (FMU-UE), Motor Activity Log (MAL), Canadian Occupational Performance Score (COPM) and Visual Analog Scale (VAS) were used for assessment before and after the treatment. Results The average EMG measured from FDS increased from 0.093-0.133 mV. The average force and average RFD increased from 45.6-97.7 and from 135.6-172.6 respectively. While affected and/or unaffected side force ratio increased dramatically from 54%-82%, the FMA-UE score increased from 56-59. The MAL quality of use score increased from 3.93-4.13. Performance and satisfaction scores of COPM changed from 5.25-7.25 and 4.5-8.25 respectively. VAS score for fatigue changed from 6 to 4. Discussion The improvement achieved 9 years later with 15 sessions of rehabilitation suggests that improvement may be possible for chronic stroke patients.

Purpose: Acute cerebrovascular diseases is an important reason of mortality and morbidity. Aortic stiffness is a important predictor of cerebrovascular, cardiovascular (CV) and all cause death, deadly and non-deadly coronary and neurologic situations, and severe strokes. In our study, we researched the association between aortic stiffness index (ASI) and stroke seriousness in acute ischemic stroke patients. Materials and Methods: A total of 97 patients (females, 55; males, 42; 65 ± 16 years) with acute ischemic stroke were enrolled in this study. 17 patients were excluded. 80 patients were evaluated. Subjects were categorized into two groups according to the calculated NIHSS score (Group 1, NIHSS score < 16; Group 2, NIHSS score ≥ 16). Clinical characteristics, echocardiographic and laboratory parameters for all patients were evaluated. Cardiac parameters and aortic stiffness index were evaluated by two-dimensional echocardiography within 48 hours of hospitalization to the neurology clinic. Results: There were no significant differences among the groups for age, gender, hypertension, diabetes mellitus, smoking, SBP, DBP, heart rate, dyslipidemia, infarct volume, troponin, HbA1c, glucose, creatinine, LDL cholesterol were significantly higher in Group 2 patients than in Group 1 patients. LV wall thickness, aortic stiffness index, E/e’ were significantly higher in Group 2 patients than in Group 1 patients. LVEF was significantly lower in Group 2 patients than in Group 1 patients. Conclusion: ASI was significantly higher in patients with severe acute ischemic stroke. Higher ASI is associated with higher NIHSS score in patients with acute ischemic stroke

Objective The purpose of this study was to investigate the frequency of monocyte chemoattractant protein (MCP)-1 CCR2 gene polymorphisms in Turkish patients with oral lichen planus (OLP). Study Design A cohort of 50 patients with OLP and 142 control participants without OLP were recruited to investigate the frequency of MCP-1 and CCR2 gene polymorphisms. Chi-square and Fisher's exact tests were used. Student t test and analysis of variance were used to compare demographic data between groups. Results The MCP AA genotype was less common in the patient group (52%) than in the control group (66.2%; odds ratio [OR] = 0.553; 95% confidence interval [CI], 0.287-1.065; P = .075). The MCP G allele was higher in the patient group (48%) than in the control group (33.8%; OR = 1.808; 95% CI, 0.939-3.479; P = .075). The frequency of the MCP GG genotype was observed to be higher in the patient group (4%) than in the controls (0.7%; OR: 5.875, 95% CI:0.521-66,24; p = 0.106). The CCR2 64I64I genotype was more common in the patient group (6%) than in the control group (2.8%). All results were not statistically significant. Conclusion We suggest that the G allele of MCP-1 and 64I64I genotype of CCR2 polymorphisms do not pose an increased risk for Turkish patients with OLP to develop oral squamous cell carcinoma.

This paper proposes a novel approach to the modelling of HTS transformer-rectifier flux pumps that can charge HTS magnet-ic loads without the need for bulky current leads or expensive cryogenic requirements. The model was built in MATLAB/Simulink for a flux pump with 2 HTS switches, an HTS transformer with a primary inductance of 15 mH, second-ary inductance of 50 H and an HTS magnetic load with an in-ductance of 2 mH. With a 5 A pk-pk triangular current wave-form at 2 Hz the system can load the HTS load to 34.63 A in 5 s. This incremental addition of flux to the load demonstrates the advantage of flux pumps as they can charge high-field magnets without the need for large power sources. The speed of flux pumping is improved by increasing the system frequency, the magnitude of the dynamic voltage developed in the HTS switches and by increasing the primary inductance of the trans-former. This has widespread industrial applicability in fields such as the charging of high-field magnets for MRI systems.

Renewable energy sources have great importance to deal with environmental detriments. To clean and sustainable future, various design renewable energy-assisted plants are of great importance. The current study examines the design and investigation of a double-flash binary geothermal energy-powered integrated system for useful products. For the purpose of producing hydrogen, power, heating, and drying, the proposed work basically consists of two steam turbines, a transcritical carbon dioxide Rankine cycle (tCO2-RC ) , a PEM electrolyzer, a domestic water heater (DHW), and a dryer. The chief target of this research study is to develop a more efficient plant as well as multigeneration productions. Additionally, detailed parametric modeling is carried out using energetically and exergetically approaches to examine this designed plant in the context of thermodynamic analysis. The variation of some parameters that influence the plant's performance, such as geothermal water temperature, flash pressure, and ambient temperature, are parametrically investigated. Subsequently, the thermodynamic simulation results show that the advised integrated plant produces 4431 kW electrical power. Also, the amount of the hydrogen generation capacity is 0.006809 kgs−1. The tCO2-RC sub-plant's energetic and exergetic performance is determined as 6.18% and 27.14%, respectively. Furthermore, the suggested integrated plant's energetic and exergetic performances are 26.20% and 37.49%. From the results, it can be finalized that the integration of various systems with the geothermal power plant is successfully possible and, in this way, there will be an increase in system performances.

Purpose: To obtain information on characteristics, management, current objective nutritional status and perception of nutritional status of children with cerebral palsy (CP) from healthcare professionals (HCPs) and caregivers. Materials and methods: A detailed survey of several items on eight main topics (general characteristics, motor function, comorbidities, therapies, anthropometry, feeding mode and problems and perceived nutritional status) was developed and tested for the study. Correlation between nutritional status and Gross Motor Function Classification System (GMFCS) levels was assessed using continuous variables (Z-scores for weight-for-age, height-for-age, weight-for-height, and body mass index-for-age), and categorical variables (being malnourished, stunted, or wasted). HCP and caregiver perceptions of the child's nutritional status as well as agreement between perceived and objective nutritional status and agreement between perceived nutritional status and concerns about the nutritional status were analyzed. Results: Data were available for 497 participants from eight European countries. Poorer nutritional status was associated with higher (more severe) GMFCS levels. There was minimal agreement between perceived and objective nutritional status, both for HCPs and caregivers. Agreement between HCP and caregiver perceptions of the child's nutritional status was weak (weighted kappa 0.56). However, the concerns about the nutritional status of the child were in line with the perceived nutritional status. Conclusions: The risk of poor nutritional status is associated with more severe disability in children and adolescents with CP. There is a mismatch between HCP and caregiver perceptions of participants' nutritional status as well as between subjective and objective nutritional status. Our data warrant the use of a simple and objective screening tool in daily practice to determine nutritional status in children and adolescents with CP., Danone Nutricia Research, Utrecht, the Netherlands; Nutricia Advanced Medical Nutrition in Czech Republic; Nutricia Advanced Medical Nutrition in Greece; Nutricia Advanced Medical Nutrition in Hungary; Nutricia Advanced Medical Nutrition in Italy; Nutricia Advanced Medical Nutrition in Poland; Nutricia Advanced Medical Nutrition in Slovakia; Nutricia Advanced Medical Nutrition in The Netherlands; Nutricia Advanced Medical Nutrition in Turkey; Danone Nutricia Research, This study was sponsored by Danone Nutricia Research, Utrecht, the Netherlands. Local financial support was provided by the local business units of Nutricia Advanced Medical Nutrition in Czech Republic, Greece, Hungary, Italy, Poland, Slovakia, The Netherlands, and Turkey. Medical writing support was provided by Tim Kelly, Medi-Kelsey Limited, funded by Danone Nutricia Research.

OBJECTIVES The hepatic vasculature is a unique system due to a dual supply that includes the hepatic artery and portal vein, which interact when the liver vascular supply is decreased. Hepatic artery buffer response, an intrinsic regulatory mechanism that compensates for blood supply, maintains increased hepatic artery flow and caliber in response to portal vein failure. Previous studies revealed that portal vein flow showed no alterations to establish adequate blood supply in response to hepatic artery occlusion. Here, we analyzed portal vein flow changes in patients with hepatic artery thrombosis after liver transplant. MATERIALS AND METHODS From December 1988 to October 2017, our center performed 580 liver transplant procedures. Those diagnosed with hepatic artery thrombosis (19 females, 24 males) by Doppler ultrasonography during postoperative week 1 were analyzed. Patients received either surgery or endovascular treatment for hepatic artery thrombosis, with patency confirmed by Doppler ultrasonography. We compared portal vein flow velocity and caliber before and after treatment using Wilcoxon signed rank and Mann Whitney U tests. RESULTS Mean patient age was 18.9 ± 21.4 years. Portal vein flow velocity pretreatment (median of 70 cm/ s) was significantly higher than posttreatment (median of 52 cm/ s) in all patients (P < .001). Median flow velocity decreased significantly after treatment when subgroups were compared, including age (adult vs child), transplant type (orthotopic transplant vs living donor), and treatment (surgery vs endovascular). However, portal vein flow velocity showed a significantly higher decrease in the surgery subgroup than in the endovascular treatment subgroup (P = .018). There was no significant relationship between portal vein calibers before and after treatment (P = .36). CONCLUSIONS The significant decrease in portal vein flow velocity after successful treatment of hepatic artery thrombosis may represent a compensatory flow change of the portal vein in response to diminished hepatic artery flow.

Osteomas are slow-growing benign osseous tumors that particularly located in the paranasal sinuses (PS). Here, we aimed to define the clinical symptoms and features, diagnostic conditions caused by osteomas located in four different PSs, to evaluate the surgical indications and methods, to compare the factors that can affect the surgical decision, radiological findings, and prognosis.The data of patients with paranasal sinus lesions and diagnosed as osteoma according to the radiological imaging, who applied to our clinic between 2010 and 2020, were retrospectively collected and re-evaluated in the light of clinical, radiological, and pathological data. Patients who underwent surgical treatments and were definitively diagnosed as osteoma by pathology were enrolled in this study.We presented the data of 117 patients retrospectively. Most of these cases (n = 77, 65.8%) had an osteoma located in the frontal sinus, while 32 cases (27.4%) had osteoma in the ethmoid, two cases (1.7%) had in sphenoid and six cases (5.1%) had in maxillary sinus. We found that the presence of symptoms, diameter of osteoma, surgical indications including state of sinus drainage, and chronic/recurrent sinusitis influence the choices of physicians in management of frontal sinus osteomas. Moreover, we found a significant correlation between the grading systems defined to classify the frontal sinus osteoma to be operated (r = 0.878, 95% CI: 0.724-0.949, P0.0001).There are several grading systems useful for the choice of surgical approaches, however, the clinical symptoms and surgical indications should not be neglected in the follow-up of patients with frontal sinus osteoma. If there are concerns about the grade of osteoma and the endoscopic approach is considered not to be sufficient for resection, the surgical procedure may be initiated endoscopically, and, if necessary, it can be combined with an external approach.

Stroke is a multifactorial disease. Arylesterase (ARE) activities have been considered as an anti-atherosclerosis factor. Increased pulse pressure (PP) may lead to a high risk of coronary artery disease and neurovascular morbidity and mortality. Nevertheless, there are limitations for PP as an evaluation index. In order to overcome the defects of PP, there is a novel parameter, “pulse pressure/systolic pressure” named “pulse pressure index (PPI)” for evaluation of cardiovascular effect. We researched the relationship between ARE activities and pulse pressure index (PPI) in acute ischemic stroke patients. We evaluated and compared the ARE activity and PPI in 87 ischemic stroke patients and 48 control patients. ARE activity was measured with the ultraviolet (UV) spectrophotometric method by using “Rel Assay Diagnostic” kits. Pulse pressure was measured by subtraction of diastolic blood pressure from systolic blood pressure. PPI was calculated as “pulse pressure / systolic pressure”. Hypertension, age, diabetes mellitus, dyslipidemia importantly higher in ischemic stroke patients than the control group (p

Introduction Contralateral prophylactic mastectomy has the potential to decrease the occurrence of cancer and reduce psychological burden. However, it is known that complications after bilateral mastectomy are higher compared with unilateral mastectomy. Our goal was to evaluate outcomes of immediate breast reconstruction in patients undergoing bilateral mastectomy and to compare complication rates between therapeutic and prophylactic sides. Patients and Methods Electronic medical records of patients with unilateral breast cancer who underwent bilateral mastectomy and immediate reconstruction with expanders were reviewed. Postoperative complications were compared between therapeutic and prophylactic mastectomy sides. Results Sixty-two patients were analyzed. The overall complication rate after both stages was 23.9% on the therapeutic side and 16.5% on the prophylactic side. Infection was the most common complication on both sides. All infections on the prophylactic mastectomy side were successfully treated with intravenous (IV) antibiotics (salvage rate of 100%), whereas 35.7% of infected tissue expander/implants on the therapeutic mastectomy side were explanted despite treatment. Conclusion Careful counselling of patients undergoing elective contralateral prophylactic mastectomy is essential as complications can develop in either breast after reconstruction.

Objective Although dual-energy x-ray absorptiometry (DXA) remains the gold standard for the measurement of bone mineral density (BMD), degenerative spine and spinal instrumentation yields inaccurate results, warranting the need for optional methods. Methods Surgical options depend on the BMD of the patients, and to accommodate this need, we compared Hounsfield unit (HU) measurements obtained from computed tomography (CT) scans with the T-scores obtained from DXA scans to inquire whether HU measurements can screen for BMD. In this study, we also evaluated the relationship between body mass index and spontaneous fractures. Results Based on the findings described in this study, we provide evidence that HU measurements obtained from CT scans can predict BMD. Conclusions This, therefore, allows HU measurements to be used as an effective diagnostic method in lieu of DXA scans when deciding on appropriate management of therapy for patients with spinal instrumentation or degenerative spines.

OBJECTIVE: This study aimed to determine the characteristics of instant messaging application (IMA) usage for clinical consultation among orthopedic residents in Turkey and to explore their experiences and opinions concerning potential legal problems. METHODS: A questionnaire titled “Instant messaging for consultation among orthopedic surgeons” consisting of 21 questions was applied to orthopedic surgery residents, and the results were analyzed. The questions were designed to obtain information on 4 categories: 1) demographics and professional experience, 2) attitudes on the use of cellular phones, 3) IMA usage for clinical consultation purposes, and 4) problems and comments on smartphone application usage for clinical consultation purposes. The participants who had no experience with a smartphone or IMA usage were excluded at the final analysis. RESULTS: A total of 860 orthopedic residents (849 males [98.7%]; mean age=28.6 years; age range=22–44 years) participated in the survey (participation rate: 97.3%). The distribution of residency years was as follows: 1(st) year, 27%; 2(nd) year, 21.4%; 3(rd) year, 18.4%; 4(th) year, 17.4%; and 5(th) year, 49.9%. The most frequently used IMAs were WhatsApp (99.3%), Facebook Messenger (14.8%), Viber (8%), and Tango (1.3%). The rate of IMA usage for consultation was 95.3%. The most common reasons to prefer IMAs for consultation were being “fast” and “easy,” but only 26.3% of the residents reported that they prefer the use of IMAs because they find them “reliable.” Moreover, 41.7% of the respondents reported that they had an experience of misdiagnosis owing to the use of IMAs; 81.2% of the participants used the personal information of the patients during the consultation; 57.6% of the respondents considered that legal problems may arise because of the use of IMAs during the consultation; and 51.4% believed that an electronic platform, solely for consultation purposes, is required. CONCLUSION: This survey has shown that it is necessary to make some legal regulations regarding the use of IMAs for consultation purposes and to develop applications only for medical consultation purposes. Most of the trainees make decisions using IMAs without a proper examination, putting the patients at the risk of misdiagnosis. Moreover, the confidentiality of the patient’s personal information appears to be in danger when IMAs are used. LEVEL OF EVIDENCE: Level IV, Diagnostic Study

BACKGROUND: We aimed to investigate the long-term effects of tenofovir disoproxil fumarate and entecavir treatment on bone mineral density and evaluated the fracture risk assessment tool score in patients with chronic hepatitis B. METHODS: A total of 58 chronic hepatitis B patients treated with tenofovir disoproxil fumarate (n = 40) and entecavir (n = 18) were included in this prospective study from 2012 to 2016. To evaluate bone mineral density, dual-X-ray absorptiometry, fracture risk assessment tool, and laboratory examinations were performed in all patients first at baseline and second at the end of the study. RESULTS: Age, sex, body mass index, fibrosis score, and viral load were similar in both groups. The mean follow-up was 33 months in the tenofovir disoproxil fumarate group and 31 months in the entecavir group. In patients treated with entecavir, there was no statistically significant difference between baseline and second bone mineral density including lumbar spine (L) and total hip T score. In patients treated with tenofovir disoproxil fumarate, there was a significant difference in the second bone mineral density compared with baseline bone mineral density for L3 (P = .033) and the major fracture risk assessment tool score (P = .03). When patients were divided into 3 groups (normal bone mineral density, osteopenic, and osteoporotic), there was a significant increase in the number of osteopenic patients in the total hip T score after tenofovir disoproxil fumarate treatment (P = .034). CONCLUSION: Our results suggest a decrease in the bone mineral density for lumbar spine (L3), an increase in the number of patients with hip osteopenia, and major fracture risk assessment tool score after long-term tenofovir disoproxil fumarate treatment in patients with rechronic hepatitis B.

Renewable energy-based hydrogen production plants can offer potential solutions to both ensuring sustainability in energy generation systems and designing environmentally friendly systems. In this combined work, a novel solar energy supported plant is proposed that can generate hydrogen, electricity, heating, cooling and hot water. With the suggested integrated plant, the potential of solar energy usage is increased for energy generation systems. The modeled integrated system generally consists of the solar power cycle, solid oxide fuel cell plant, gas turbine process, supercritical power plant, organic Rankine cycle, cooling cycle, hydrogen production and liquefaction plant, and hot water production sub-system. To conduct a comprehensive thermodynamic performance analysis of the suggested plant, the combined plant is modeled according to thermodynamic equilibrium equations. A performance assessment is also conducted to evaluate the impact of several plant indicators on performance characteristics of integrated system and its sub-parts. Hydrogen production rate in the suggested plant according to the performance analysis performed is realized as 0.0642 kg/s. While maximum exergy destruction rate is seen in the solar power plant with 8279 kW, the cooling plant has the lowest exergy destruction rate as 1098 kW. Also, the highest power generation is obtained from gas turbine cycle with 7053 kW. In addition, energetic and exergetic efficiencies of solar power based combined cycle are found as 56.48% and 54.06%, respectively.

Drawing on a comprehensive panel data of 137 low income and developing countries, this study queries the macro-economic drivers of Public Private Partnership (PPP) in these countries. PPP is mainly used as a method to address infrastructure needs of nation states which cannot allocate their financial resources towards infrastructure investments and/or cannot secure finance through other instruments. Previous studies in the field remain partial as they included a limited number of macro-economic factors and a smaller number of countries. Our findings suggest that general government balance, population size, money supply and the share of investments in GDP are significant determinants of PPP activity.

In this paper, a proposal for a novel integrated Brayton cycle, supercritical plant, trans critical plant and organic Rankine cycle-based power systems for multi-generation applications are presented and analyzed thermodynamically. The plant can generate power, heating-cooling for residential applications, and hydrogen simultaneously from a single energy source. Both energetic and exergetic analyses are conducted on this multi-generation plant and its subsystems in order to evaluate and compare them thermodynamically, in terms of their useful product capabilities. The energetic and exergetic effectiveness of the multi-generation system are computed as 44.69% and 42.03%, respectively. After that, a parametric study on each of the subsystems of the proposed combined system is given in order to provide a deeper understanding of the working of these subsystems under different states. Lastly, environmental impact assessments are provided to raise environmental concerns for several operating conditions. For the base working condition, the results illustrate that the proposed plant has 0.5961, 0.0442, 0.6265 and 1.678 of exergo-environmental impact factor, exergy sustainability index, exergy stability factor and sustainability index, respectively.

Background: Pancreatic ductal adenocarcinoma differs from other solid tumors with its unique immunosuppressive microenvironment and non-immunogenic feature. There are not many studies in the literature investigating the effect of these features on prognosis. Aims: To investigate the prognostic value of tissue-resident memory T cells, tumor microenvironment features, and tumor-associated immune cells in resected pancreatic ductal adenocarcinomas. Study Design: Retrospective cross-sectional study. Methods: Of 138 patients diagnosed with pancreatic ductal adenocarcinoma between 2011 and 2018, 81 were included in the study. Specimens from operated patients were reassessed separately as peritumoral and intratumoral areas for tissue resident memory cells and tumor microenvironmental elements (tumor infiltrating lymphocytes, tumor stroma, CD204+ macrophages, PDL1+ immune cells). Disease-free survival and overall survival were defined from the date of operation to the date of recurrence and the date of first diagnosis to the date of death, respectively. If the patient was alive, the last visit date was taken into account. Results: The median age at diagnosis was 63 (range: 40-78). The median follow-up period was 18.9 months (range: 1.4-80.4 months). Median overall survival was 23.7 months (1.4-80.4 months) and median disease-free survival was 10.8 months (1.4-74.4 months). Patients with higher intra-tumoral tissue-resident memory cell counts had a longer survival trend than those having lower values (25.6 months vs. 18 months, respectively, P = .84). According to microenvironmental evaluations, lower stromal score (defined as stroma having less desmoplasia and rich in cells) and presence of peritumoral Crohn’s-like inflammatory response were associated with higher survival (29.2 months vs. 19.7 months for low vs. high stromal scores, respectively, P = .16 and 30.2 months vs. 18.1 months for the presence of Crohn’s-like inflammatory response P = .13). Decreased survival was observed in tumors with increased CD204+ tumor-associated macrophages which were immunosuppressive elements of the microenvironment (12 months vs. 26.3 months for intra-tumoral assessment, P = .29). Conclusion: Tissue-resident memory T cells and other microenvironmental features may be prognostic in resectable pancreatic ductal adenocarcinomas. Further studies with larger cohorts are needed for validation.

Monitoring and identifying gait has recently emerged as a promising solution candidate for unobtrusive human recognition. In order to enable ubiquitous and reliable application, a gait recognition system must be robust to environment changes and easy to use without requiring too much user cooperation and recalibration, while maintaining high accuracy, which is often not satisfied in conventional approaches. In this paper, we present , a high-accuracy gait recognition system with minimal training requirement using a single commodity millimeter wave (mmWave) radio. To reduce the training overhead, we propose gait data cube, a novel 3D joint-feature representation of micro-Doppler and micro-Range signatures over time that can comprehensively embody the physical relevant features of one’s gait. With a pipeline of signal processing, can automatically detect and segment human walking and effectively extract the gait data cubes. We implement and evaluate through experiments conducted at 6 different locations in a typical indoor space with 10 subjects over a month, resulting in >50,000 gait instances. The results show that achieves an accuracy of 96.1% with a single gait cycle using one receive antenna, and the accuracy increases to 98.3% when combining all the receive antennas. Further, it achieves an average recognition accuracy of 79.1% for testing over different times and unseen locations by using only 2 minutes of training data collected in a single location, enabling a practical and ubiquitous gait-based identification.

Background: Acute bronchiolitis is one of the most common diseases of early childhood. There are many recent changes in the treatment of acute bronchiolitis. The aim of this study is to evaluate treatment approaches to acute bronchiolitis among clinicians and to observe compliance with clinical guidelines. Materials and Methods: Our study was designed as a multicenter cross-sectional descriptive study. A cohort of pediatric residents, fellows, and attendants were surveyed with a questionnaire including general and occupational characteristics of pediatricians and treatment choices in acute bronchiolitis. Results: A total of 713 questionnaires were collected. Most commonly applied treatment among pediatricians was inhaled salbutamol, followed by intravenous hydration, hypertonic saline, and inhaled steroid. Most commonly preferred treatment in the management of mild bronchiolitis was oral hydration and inhaled salbutamol in severe bronchiolitis. Conclusion: Although recent guidelines for the treatment of acute bronchiolitis does not support the use of many different therapies, pediatricians still tend to use them, especially bronchodilators, corticosteroids, and antibiotics.

Objectives: Replantation of a single finger amputated at the flexor zone 2 level keeps contradicting because the replanted finger may get in the way of other digits due to stiffness. On the other hand, some studies concluded that as the replantation results do not differ from stump closure, one should not immediately head towards stump closure. Therefore, we aimed to present our functional results of this level of replantation. Methods: Twenty-one patients with replantation for single finger flexor zone 2 total amputation were enrolled in the study. Kirschner wires were used to fix the bone. Only flexor digitorum profundus (FDP) tendon was repaired. Two veins per digital artery were anastomosed. Early motion was allowed from the third postoperative week. The functional results were assessed by Quick-DASH and modified Mayo scores, total active range of motion (TAM), and presence of cold intolerance. Results: The mean follow-up period was 33.9 (range 24-79) months. The mean Quick-DASH score was 18.1±8.6 (range 2.3-38.6). According to the modified Mayo score, three patients had excellent, nine had good, seven had fair, and two had poor results. TAM was found to be excellent in three, good in eleven, fair in five, and poor in two patients. Conclusion: We recommend bone fixation preserving the joints, only FDP tendon repair, vein anastomoses as many as possible, and early motion to achieve successful results in single finger amputations replanted at the flexor zone 2 level. [Hand Microsurg 2021; 10(3.000): 211-218]

Objective To evaluate whether or not embryo transfer day has an effect on the rates of clinical pregnancy (CPR) and live birth (LBR) in in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) treatment. Material and Methods A total of 757 patients who had undergone IVF-ICSI treatment between 2012 and 2017 were included in this study. The participants were stratified according to embryo transfer day as Group 1 (day 2 transfer; n= 43), Group 2 (day 3 transfer; n=633), and Group 3 (day 5 (blastocyst) transfer; n=81). Basal parameters and IVF-ICSI outcomes were compared between the groups. Results Groups 1 and 2 patients were older, had a higher BMI, worse responder rate, lower antral follicle count, lower peak E2 levels, and less endometrial thickness, and required an increased total gonadotropin dose than the other transfer day groups. In addition, the number of oocytes and MII oocytes, fertilization rate, and 2 PN were statistically different between the groups and the CPR (19.5% vs 36.9% vs 39.0%, respectively) and LBR (14.6% vs 30.4% vs 35.1%, respectively) were lower in group 1 than groups 2 and 3 (p

We propose a multi-layer unit cell consisting of Minkowski fractal shaped reflector with aperture coupled phasing stubs to obtain a broad phase range for the reflectarray antenna with smaller unit cell size and inter-element spacing compared to some other studies in the literature. In the study, simulations are conducted using HFSS(TM) program with Floquet Port incidence. A unit cell with two cycles of phase range and very low reflection loss is designed. 21.9% shrinkage is achieved in patch surface area using Minkowski fractals. Subsequently, proposed unit cell is used to design and fabricate a full scale 221 element reflectarray antenna. At 10 GHz, simulation results are compared with measured data and good agreement is observed., 14 pages, 8 figures, journal

Prisons are poorly ventilated confined spaces with limited physical distancing opportunities, making an environment conducive to the spread of infectious diseases. Based on empirical research with correctional officer recruits in Canada, we analyze the reasons and sources of fear, and the measures that recruits adopt to counter their fear of contagion. Our study marks an advance in the correctional work literature, which, to date, has tended to view perceived contagion risks as a workplace challenge that can be overcome with occupational skill and experience. In contrast with the existing literature, we present fear and perceived contagion risk as an “operational stress injury” that affects all correctional officers; a structural occupational health and safety problem that needs redressing from the labor policy perspective.

In recent years, the use of advanced high strength steels (AHSS) in the automotive industry has increased due to their potential in reducing weight, leading to lower fuel consumption and carbon dioxide emissions. The AHSS structures would be the optimum choice for many applications; however, there are many defects to overcome in their stamping. In this present study, different types of defects and remedies of AHSS stampings are presented. Keywords: Advanced high strength steel, AHSS, Failure analysis, Damage behavior of multiphase steels, Failure prediction. 1. INTRODUCTION Lightweight materials, such as composites, aluminum, and magnesium alloys are commonly used in the automotive and aerospace industries. However, when lower density materials (such as Al and Mg alloys) are used, thicker parts are required to compensate for their lower strength. In addition, there are some difficulties in the cold forming of such low-density alloys. After the oil crisis in the 1970s, the steel industry has started to develop the dual-phase (DP) steels (ferritic-martensitic) in order to decrease fuel consumption and exhaust tail pipe emissions. DP steels are part of broader type of steels which are known as advanced high strength steels. These AHSS offer up to five times the strength relative to the mild steels. Therefore, they can be an attractive alternative to lightweight materials in achieving lightweight structuring. Obviously, AHSS are not considered to be lightweight materials, however; due to their high yield strength, the sheet thicknesses can be significantly reduced and consequently weight reduction can be achieved. Advanced high strength steel tubes are currently used as side impact door beams, seat structures, and instrument panel beams in automobiles [1]. AHSS have been being increasingly used in automobile structural components due to their corrosion resistance, toughness, and high resistance to impact. In specific, Martensitic Steels (MS) are typically used to provide collision protection by minimizing the deformation from sideward impacts [2]. A more extensive use of AHSS in the automotive industry would cause a significant reduction in weight without

BackgroundAntipsychotics are increasingly used among women of childbearing age and during pregnancy.ObjectiveTo determine whether children exposed to antipsychotics in utero are at increased risk of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD), accounting for maternal diagnoses of bipolar, psychotic and other psychiatric disorders.DesignPopulation-based cohort study, including a sibling analysis.SettingNationwide data on all pregnant women and their live-born singletons in Denmark (1997-2017), Finland (1996-2016), Iceland (2004-2017), Norway (2004-2017), and Sweden (2006-2016).Participants4 324 086 children were eligible for inclusion to the study cohort.InterventionAntipsychotic exposure in utero, assessed by pregnancy trimester, type of antipsychotic, and varying patterns of use.Main outcome measuresNon-mutually exclusive diagnoses of ADHD and ASD. We used Cox proportional hazard models to calculate hazard ratios (HRs) controlling for maternal psychiatric disorders and other potential confounding factors.FindingsAmong 4 324 086 singleton births, 15 466 (0.4%) were exposed to antipsychotics in utero. During a median follow-up of 10 years, we identified 72 257 children with ADHD and 38 674 children with ASD. Unadjusted HRs were raised for both outcomes but shifted substantially towards the null after adjustment; 1.10 (95%CI 1.00 to 1.27) for ADHD and 1.12 (0.97 to 1.29) for ASD. Adjusted HRs remained consistent by trimester of exposure and type of antipsychotic. Comparing in utero exposure with pre-pregnancy use yielded HRs of 0.74 (0.62 to 0.87) for ADHD and 0.88 (0.70 to 1.10) for ASD. Sibling analyses yielded HRs of 1.14 (0.79 to 1.64) for ADHD and 1.34 (0.75 to 2.39) for ASD.DiscussionOur findings suggest little or no increased risk of child ADHD or ASD after in utero exposure to antipsychotics.Clinical implicationsResults regarding child neurodevelopment are reassuring for women who need antipsychotics during pregnancy.

Objectives In this study, we aimed to describe a new hook plate technique (HPT) and to compare our results with the conventional extension block technique (EBT) with a Kirschner wire (K-wire) for bony mallet finger treatment. Patients and methods Between April 2015 and January 2018, a total of 19 patients including 10 who were treated with EBT (7 males, 3 females; mean age: 30.1±7.3 years; range, 17 to 48 years) and nine who were treated with HPT (6 males, 3 females; mean age: 31.7±11.3 years; range, 19 to 42 years) for bony mallet finger with distal interphalangeal (DIP) joint subluxation and/or fracture fragment larger than one-third of distal phalanx (Wehbe-Schneider type 1/b, 2/a, 2/b, 3/a) joint were retrospectively analyzed. The DIP range of motion (ROM), Warren and Crawford scores, time to return to work/daily activity, operation time, the number of fluoroscopy shots, cost and complications were compared. Results No significant difference was found in the DIP ROM (p=0.708) and the Warren/Norris and Crawford scores (p=0.217 and p=0.175, respectively) between the two groups. Operation time and material cost were higher with HPT (p=0.006, p=0.001). There was no significant difference in the number of fluoroscopy shots (p=0.344). Although DIP joint motion was started at two weeks in the HPT group and at eight weeks in the EBT group, no significant difference was observed in the time of return to work and normal daily life in both groups (p=0.859). Complications were observed in two patients in the EBT group and in three patients in the HPT group. No significant difference in total complications was observed between the two groups (p=0.666). Conclusion Bony mallet finger treatment with a custom-made hook plate prepared from 1.3-mm AO plates appeared to be clinically and radiologically similar to EBT. Additionally, HPT had the advantages of allowing early ROM to DIP joint and eliminating the need for a secondary surgery such as K-wire removal. On the other hand, hardware cost with HPT was higher than EBT.

BACKGROUND Neurofibromatosis type 1 (NF1) is a neurocutaneous disorder that results in a predisposition to the growth of multiple tumors in the central nervous system, the peripheral nervous system, and the skin. The clinical manifestations of neurofibromatosis are associated with loss of neurofibromin expression which causes the upregulation of the RAS pathway. Although neurofibromatosis type 1 can be diagnosed based on the National Institutes of Health criteria, sometimes the diagnosis is difficult, in cases where the characteristic features do not develop. Moreover, other RAS-related disorders may present with significantly overlapping clinical features. AIMS To determine the clinical and molecular genetic characteristics of Turkish patients with neurofibromatosis type 1. STUDY DESIGN Cross-sectional study. METHODS For the genetic analysis of 27 Turkish families clinically diagnosed with NF1 between 1990 and 2019, we used a multi-step process consisting of next-generation sequencing, multiplex ligation-dependent probe amplification, and array-comparative genomic hybridization. RESULTS In this study, we identified 11 novel and 11 previously reported single-nucleotide variants in 22 families. Whole gene deletions were detected by multiplex ligation-dependent probe amplification analysis in 3 families. Of those, array comparative genomic hybridization analysis defined a 17q11.2 deletion in 4 patients from 2 families and 1.2-Mb involving 1 unrelated patient. All patients with a deletion had facial dysmorphism, suggesting a peculiar phenotype in this group. We could not find any pathogenic variant in the 2 families that met the National Institutes of Health criteria. CONCLUSION The novel pathogenic variants identified in this study broaden the spectrum of pathogenic variants in NF1 and provide better clinical characterization of NF1. RNA-seq experiments are recommended in patients who meet the National Institutes of Health diagnostic criteria for NF but have not identified any variants in nextgeneration sequencing, multiplex ligation-dependent probe amplification, or array-comparative genomic hybridization analysis.

The HTS flux pump is a promising device which can charge the HTS magnet for various high field applications. In an HTS flux pump, the superconducting tapes are the circuit connections between the charging loop and the load circuit, and using soldering joints between the superconducting layers is a general method. For a large scale HTS flux pump, the joints should endure the electrical current over kA level, and with durable mechanical structures. In our kA level HTS flux pump, the HTS-copper joint was used to connect the charging loop, the HTS bridge and the potential HTS load. Three methods of HTS-copper soldering were tested and compared for a simple HTS-copper circuit: pure indium wire pre-tinning, IN52/SN48 ribbon direct soldering, and IN52/SN48 ribbon pre-tinning. Experiments show the soldering of IN52/SN48 ribbon pre-tinning archived the lowest joint resistance among these three methods, and the individual resistances were determined. This method was used to solder the joint for the kA level HTS flux pump, and acceptably low resistance was achieved.

OBJECTIVES To analyse the entity of retinal vasculitis, including frosted branch angiitis (FBA), or retina vascular occlusion in patients with familial Mediterranean fever (FMF). METHODS Retrospective collaborative case series using invitation by email to uveitis specialists around the Mediterranean basin. This series was combined with a literature review. Exclusion criteria included infectious diseases, Behcet's disease or other autoimmune diseases. RESULTS A total of 16 patients (21 eyes) had FMF and retinal vasculitis (FBA 11 patients, mild retinal vasculitis 5 patients). The mean age at onset of vasculitis was 29.5 ± 13.4 (range 9-62) with a female to male ratio of 9 to 7. In 19 eyes treated with various forms of corticosteroid and/or immunosuppression, the mean initial spectacle-corrected visual acuity improved from 6/194 to 6/10.5 at the last mean follow-up of 29.0 ± 34.9 months (p

One of the strategic objectives of China is to increase renewable energy consumption by reducing non-renewable energy consumption. This motivates us to carefully investigate the asymmetric effects of financial deepening on renewable and non-renewable energy consumption for China, using annual data from 1990 to 2019. The results show that in China, a positive shock in bank deposits and broad money has a significant increasing effect on renewable energy consumption, while a negative shock in bank deposits and broad money has also a significant increasing effect on renewable energy consumption in the long-run. Moreover, positive change in bank deposits and broad money has an inverse impact on non-renewable energy consumption, while negative change has stimulating non-renewable energy consumption in long run. Thus, government and policymaker’s policies aimed at promoting financial deepening in China must be persistent and sustainable to foster renewable energy consumption.

OBJECTIVES: It was aimed to demonstrate the applicability of the prone position with high-flow oxygen to COVID-19 patients with severe respiratory failure in the service in September when the number of cases and the need for intensive care were increased. MATERIAL AND METHODS: The prone position was applied for a minimum of 30-minute periods for at least four hours a day. The patients' oxygen saturation levels and respiration rates were monitored before and 30 minutes after prone positioning. RESULTS: Ten patients, nine males (9/1, M/F), were included in the study. Mean oxygen saturation at baseline was 75.8±12.14 (min: 50 %; max: 90 %) and all patients had high oxygen demand. The oxygen saturation of the patients differed significantly before and after (83.4±6.38 %; 90±5.31 %, p

Aims The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) European Endocarditis (EURO-ENDO) registry aims to study the care and outcomes of patients diagnosed with infective endocarditis (IE) and compare findings with recommendations from the 2015 ESC Clinical Practice Guidelines for the management of IE and data from the 2001 Euro Heart Survey. Methods and results Patients (n = 3116) aged over 18 years with a diagnosis of IE based on the ESC 2015 IE diagnostic criteria were prospectively identified between 1 January 2016 and 31 March 2018. Individual patient data were collected across 156 centres and 40 countries. The primary endpoint is all-cause mortality in hospital and at 1 year. Secondary endpoints are 1-year morbidity (all-cause hospitalization, any cardiac surgery, and IE relapse), the clinical, epidemiological, microbiological, and therapeutic characteristics of patients, the number and timing of non-invasive imaging techniques, and adherence to recommendations as stated in the 2015 ESC Clinical Practice Guidelines for the management of IE. Conclusion EURO-ENDO is an international registry of care and outcomes of patients hospitalized with IE which will provide insights into the contemporary profile and management of patients with this challenging disease.

Purpose To compare muller muscle conjunctival resection (MMCR) and external levator advancement (ELA) in terms of objective and subjective symmetry in unilateral ptosis. Methods The patients who underwent unilateral MMCR (group1, n = 25) and ELA (group2, n = 25) were reviewed retrospectively. With the written algorithm, margin reflex distance-1 (MRD1), localization of the contour peak, and the percentage of overlapping curvatures (POC) of both upper eyelid curves were calculated. Semi-automated measurements were compared with the manual measurements. The correlation between objective and subjective symmetry was evaluated. Results Preoperative levator functions were similar in both groups (13.93 ± 3.25 mm and 13.3 ± 2.86 mm, respectively). We found strong correlations between manual and semi-automated measurements (ICC: 0.942, 95% CI = 0.924–0.956, p Conclusions Besides subjective symmetry, MMCR and ELA are equally effective in ensuring symmetry objectively, as measured with MRD1 and contour peak symmetry and POC in unilateral ptosis. POC may be used as a criterion of symmetry in the evaluation of ptosis.

Since the outbreak of coronavirus disease (COVID-19) and with the absence of conventional social interactions, artificial intelligence and simulation become essential part of sustaining productivity around the world. MyDispense, an online pharmacy simulation, allows students to experience real-life situations in a virtual professional setting to behave as a pharmacist and undertake professional tasks. Aim: The study aim was to see how MyDispense influenced pharmacy students' clinical pharmacy education outcomes. Methods: A questionnaire was used to assess satisfaction, confidence and motivation, clinical experience, and decision-making among 81 students ofboth genders pre and post the practice. Results:Pre and post-test differences in all four dimensions of the questionnaire were statistically significant (p

Elastography has emerged as a preferred non-invasive imaging technique for the clinical assessment of liver fibrosis. Elastography methods provide liver stiffness measurement (LSM) as a surrogate quantitative biomarker for fibrosis burden in chronic liver disease (CLD). Elastography can be performed either with ultrasound or MRI. Currently available ultrasound-based methods include strain elastography, two-dimensional shear wave elastography (2D-SWE), point shear wave elastography (pSWE), and vibration-controlled transient elastography (VCTE). MR Elastography (MRE) is widely available as two-dimensional gradient echo MRE (2D-GRE-MRE) technique. US-based methods provide estimated Young's modulus (eYM) and MRE provides magnitude of the complex shear modulus. MRE and ultrasound methods have proven to be accurate methods for detection of advanced liver fibrosis and cirrhosis. Other clinical applications of elastography include liver decompensation prediction, and differentiation of non-alcoholic steatohepatitis (NASH) from simple steatosis (SS). In this review, we briefly describe the different elastography methods, discuss current clinical applications, and provide an overview of advances in the field of liver elastography.

OBJECTIVES Diced cartilage grafts are used for correcting nasal dorsal deformities and irregularities. However, cartilage resorption is among most common problems after rhinoplasty. The purpose of this experimental study was to investigate the effects of esterified hyaluronic acid, adipose tissue, and blood glue on the viability of diced cartilage grafts. METHODS A total of 24 Wistar albino rats were used for the study. Cartilage grafts were obtained from 1 side ear and diced. The rats were divided into 4 groups (6 in each group): bare diced cartilage (group 1), diced cartilage wrapped with adipose tissue (group 2), diced cartilage blended with blood glue (group 3), and diced cartilage wrapped with esterified hyaluronic acid (group 4). The grafts were inserted into the subcutaneous pockets of the back of same rat. After 2 months follow-up specimens were harvested for histopathological and dimensional examination. The sections were stained with Hematoxylin and Eosin, Masson-Trichrome, and Elastic Van-Gieson. Chronic inflammation, loss of chondrocyte nucleus, vascularization, foreign body reaction, collagen content of matrix, and extent of elastic fiber were assessed under light microscopy. RESULTS Foreign body reaction in adipose tissue and blood group was significantly higher than bare cartilage and esterified hyaluronic acid group (P = 0.001). With respect to loss of chondrocyte nucleus esterified hyaluronic acid group had significant higher rate of nucleus loss than other groups (P = 0.002). CONCLUSIONS This study suggests that blood glue, esterified hyaluronic acid and autologous adipose tissue have not beneficial effects in improving viability of diced cartilage grafts.

Chorda tympani schwannomas are rare benign tumors of the middle ear cleft. This is a case of incidental chorda tympani schwannoma identified intraoperatively. The patient was a 50-year-old male with chronic active otitis media complicated by left-sided facial paralysis. During closed mastoidectomy and tympanoplasty approach, a well-demarcated swelling on the left chorda tympani nerve was identified and sectioned for pathologic evaluation. The histopathologic evaluation established the diagnosis of schwannoma. Although the tumor was unlikely the cause of the disease process in this patient, his facial paralysis and middle ear disease were resolved after surgery.

The experimental realization of the two-frequency 14N nuclear quadrupole resonance (NQR) technique with use of the gradiometer radiofrequency (RF) probe for applications in the remote detection of explosives and other substances has been proposed. The planar two-frequency gradiometer has been designed, modeled and manufactured. The regions, where the RF magnetic fields are nearly orthogonal to each other, have been determined by finite-element modeling studies. The two-frequency experiments have been carried out for the detection of hexahydro-1,3,5-trinitro-s-triazine C3H6N6O6 (RDX). The possibility of the combined use of the two-frequency 14N NQR technique and the gradiometer RF probe in practice for detection of explosives hidden under clothes or underground has been also discussed.

Background and purpose The European Federation of Neurological Associations (EFNA), in partnership with the NeuroCOVID‐19 taskforce of the European Academy of Neurology (EAN), has investigated the impact of the first wave of the COVID‐19 pandemic on individuals with neurological diseases, as well as the hopes and fears of these patients about the post‐pandemic phase. Methods An EFNA‐EAN survey was available online to any person living with a neurological disorder in Europe. It consisted of 18 items concerning the impact of the first wave of the COVID‐19 pandemic on the medical care of people with neurological disorders, and the hopes and fears of these individuals regarding the post‐pandemic phase. Results For 44.4% of the 443 survey participants, the overall care of their neurological disease during the pandemic was inappropriate. This perception was mainly due to significant delays in accessing medical care (25.7%), insufficiently reliable information received about the potential impact of COVID‐19 on their neurological disease (49.6%), and a substantial lack of involvement in their disease management decisions (54.3%). Participants indicated that their major concerns for the post‐pandemic phase were experiencing longer waiting times to see a specialist (24.1%), suffering from social isolation and deteriorating mental well‐being (23.1%), and facing delays in clinical trials with disinvestment in neuroscience research (13.1%). Conclusions Despite the great efforts of health services to cope with the first wave of the COVID‐19 pandemic, individuals with neurological conditions feel they have been left behind. These findings provide invaluable insights for improving the care of patients with neurological disorders in the further course of the COVID‐19 pandemic., For 44.4% of individuals with neurological disorders participating in the survey, the overall care of their neurological disease during the pandemic was inappropriate due to significant delays in accessing medical care, insufficient information about the potential impact of COVID‐19 on their neurological disease, and a lack of involvement in their disease management decisions. Survey participants indicated that their major concerns for the post‐pandemic phase were experiencing longer waiting times to see a specialist, suffering from social isolation and deteriorating mental well‐being, and facing delays in clinical trials. Overall, despite the great efforts of health services to cope with the first wave of the COVID‐19 pandemic, people with neurological disorders feel they have been left behind.

Objectives Internal carotid artery (ICA), the main artery of the brain, passes through the cavernous sinus (CS) which forms one of these venous pools. During this transition, while there is arterial blood in the lumen of ICA, its outer surface is in contact with venous blood from the brain. Herein, we aimed to detect the receptor differences of ICA in this highly specialized anatomical region of the skull base. Methods We performed the study on 10 human cadavers and searched CGRPR, TRP12, ASIC3 and ACTHR receptors via immunostaining using laser scanning confocal microscopy. Results We determined TRP12 receptor positive in the tunica media and tunica adventitia layers of the cavernous segment of ICA. We did not detect similar positivity in the cervical part of the ICA. In the receptor scan we made in terms of CGRPR, while we detected positivity in the tunica media layer of the cavernous segment, we found positivity in the tunica intima layer of the cervicalis segment of the ICA. We did not detect any positivity for ASIC3 and ACTHR receptors in both parts of the ICA. Conclusions As a result, we observed various differences in receptors between ICA segments. While the outer surface of the ICA in the cervical region did not show any receptor positivity, we detected TRP12 receptor positivity along the tissue contour of vessel in the CS. We assume that it may provide a new perspective on pathologies of the CS/ICA and preservation of brain hemodynamics for clinicians.

WOS:000704610500004 ESCI PubMed ID34651109 Objective: The purpose of this study was to look into the relationship between breast size and mammographic breast density in women and breast radiation dose on full-field digital mammography (FFDM), as well as the factors that influence radiation dose. Materials and Methods: The study included a total of 2,060 FFDM images from 515 consecutive participants. The participants were divided into two groups: those exposed to high doses (>3 mGy) and those exposed to low doses (

Background We report the results of INICC surveillance study from 2013 to 2018, in 664 intensive care units (ICUs) in 133 cities, of 45 countries, from Latin-America, Europe, Africa, Eastern-Mediterranean, Southeast-Asia, and Western-Pacific. Methods Prospective data from patients hospitalized in ICUs were collected through INICC Surveillance Online System. CDC-NHSN definitions for device-associated healthcare-associated infection (DA-HAI) were applied. Results We collected data from 428,847 patients, for an aggregate of 2,815,402 bed-days, 1,468,216 central line (CL)-days, 1,053,330 mechanical ventilator (MV)-days, 1,740,776 urinary catheter (UC)-days. We found 7,785 CL-associated bloodstream infections (CLAB), 12,085 ventilator-associated events (VAE), and 5,509 UC-associated urinary tract infections (CAUTI). Pooled DA-HAI rates were 5.91% and 9.01 DA-HAIs/1,000 bed-days. Pooled CLAB rate was 5.30/1,000 CL-days; VAE rate was 11.47/1,000 MV-days, and CAUTI rate was 3.16/1,000 UC-days. P aeruginosa was non-susceptible (NS) to imipenem in 52.72% of cases; to colistin in 10.38%; to ceftazidime in 50%; to ciprofloxacin in 40.28%; and to amikacin in 34.05%. Klebsiella spp was NS to imipenem in 49.16%; to ceftazidime in 78.01%; to ciprofloxacin in 66.26%; and to amikacin in 42.45%. coagulase-negative Staphylococci and S aureus were NS to oxacillin in 91.44% and 56.03%, respectively. Enterococcus spp was NS to vancomycin in 42.31% of the cases. Conclusions DA-HAI rates and bacterial resistance are high and continuous efforts are needed to reduce them.