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Abstract Background In critical care medicine, the use of transthoracic echo (TTE) is expanding. TTE can be used to measure dynamic parameters such as cardiac output (CO). An important asset of TTE is that it is a non-invasive technique. The Probefix is an external ultrasound holder strapped to the patient which makes it possible to measure CO using TTE in a fixed position possibly making the CO measurements more accurate compared to separate TTE CO measurements. The feasibility of the use of the Probefix to measure CO before and after a passive leg raising test (PLR) was studied. Intensive care patients were included after detection of hypovolemia using Flotrac. Endpoints were the possibility to use Probefix. Also CO measurements with and without the use of Probefix, before and after a PLR were compared to the CO measurements using Flotrac. Side effects in terms of skin alterations after the use of Probefix and patient’s comments on (dis)comfort were evaluated. Results Ten patients were included; in eight patients, sufficient recordings with the use of Probefix could be obtained. Using Bland–Altman plots, no difference was found in accuracy of measurements of CO with or without the use of Probefix before and after a PLR compared to Flotrac generated CO. There were only mild and temporary skin effects of the use of Probefix. Conclusions In this small feasibility study, the Probefix could be used in eight out of ten intensive care patients. The use of Probefix did not result in more or less accurate CO measurements compared to manually recorded TTE CO measurements. We suggest that larger studies on the use of Probefix in intensive care patients are needed.

Posterior cranial fossa tumours frequently develop hydrocephalus as first presentation in up to 80% of paediatric patients and 21.4% of adults, although it resolves after tumour removal in 70–90% and 96%, respectively. New onset hydrocephalus is reported in about 2.1% of adult and 10–40% of paediatric patients after posterior fossa surgery. There is no consensus concerning prophylactic external ventricular drainage (EVD) placement that is frequently used before posterior fossa lesion removal, as well in those cases without clear evidence of hydrocephalus. The aim of the study was to define the most correct management for patients who undergo posterior fossa tumour surgery, thus identifying cohorts of patients who are at risk of persistent hydrocephalus prior to surgery. A systematic review of literature has been performed, following PRISMA guidelines. Most of the studies reported CSF shunt only in the presence of hydrocephalus, whereas only a few authors suggested its prophylactic use in the absence of signs of ventricular dilatation. Predictive factors for postoperative hydrocephalus has been identified, including young age (< 3 years), severe symptomatic hydrocephalus at presentation, EVD placement before surgery, FOHR index > 0.46 and Evans index > 0.4, pseudomeningocele, CSF leak and infection. The use of pre-resection CSF shunt in case of signs and symptoms of hydrocephalus is mandatory, although it resolves in the majority of cases. As reported by several studies included in the present review, we suggest CSF shunt also in case of asymptomatic hydrocephalus, whereas it is not indicated without evidence of ventricular dilatation. [ABSTRACT FROM AUTHOR]

Background: Many adjunctive techniques exist for dacryocystorhinostomy (DCR), with varying levels of supportive evidence. Methods: Literature from PubMed, EMBASE, and Cochrane Databases was reviewed between January 1990 and January 2020 to examine evidence regarding the utility of adjunctive techniques to DCR, including mucosal flap preservation, concurrent septoplasty, stenting, topical mitomycin C (MMC), and 5‐fluorouracil (5‐FU), as well as perioperative antibiotics and steroids. Recommendations were made based on the evidence found. Results: Seven adjunctive techniques used in DCR were examined. The literature supported concurrent septoplasty when septal deviation is present. Silicone stents are recommended for external DCR approaches. MMC use is optional in external DCR and revision cases. The literature does not support the routine use of silicone stents or MMC in primary endoscopic DCR. Mucosal flap preservation is optional, with evidence showing comparable results with or without utilization. The level of evidence is limited for topical 5‐FU, as well as perioperative antibiotic and steroid use. Conclusion: Recommendations for adjunctive techniques to external and endoscopic DCR surgeries can be made based on the current literature. Higher‐level studies are needed to better optimize perioperative approaches to DCR. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the rotational profile of the lower extremity using computed tomography (CT) in accordance with the degree of varus deformity in medial condyle-affected knee joint osteoarthritis (OA). Methods: This retrospective study included 1036 patients (872 lower extremities) with end-stage knee OA. The coronal alignment of the lower extremity was measured using standing anteroposterior radiography. The CT parameters of femoral anteversion and tibial torsion were assessed in relation to the knee joint. The axes were the femoral neck axis; the distal femoral axis, which was composed of the anterior trochlear axis, the clinical transepicondylar axis, and the posterior condylar axis; the axis of the proximal tibial condyles; and the bimalleolar axis. Results: There was a tendency for increased external rotation of the knee joint parameters in relation to the hip and ankle joints as varus deformity of the lower extremity increased. The relative external rotational deformity of the knee joint in relation to the hip joint had a positive value with a good correlation. The relative external rotational deformity of the knee joint in relation to the ankle joint also demonstrated a positive value with a good correlation. Conclusion: The distal femur and proximal tibia (knee joint) tended to rotate externally in relation to the hip and ankle joint, respectively, as the degree of varus deformity increased. This study identified the relationship between lower extremity varus deformity and rotational deformity of knee joints with OA. Level of evidence: III. [ABSTRACT FROM AUTHOR]

External ear malformations are commonly associated with middle ear malformations due to their closely related embryogenesis. Inner ear anomalies are less consistently seen due to their independent development. Cross-sectional imaging has come to play a critical role in the workup of congenital deafness in the pediatric age group. To optimize speech and language development, early diagnosis and treatment are very crucial. Identification of these anomalies is additionally important when operative intervention is being planned because they may complicate or perhaps preclude the surgery. [ABSTRACT FROM AUTHOR]

Objectives/hypothesisDetermine the effective electromechanical reshaping (EMR) parameters for shape change and cell viability in the ex vivo rabbit costal cartilage model.Study designEx vivo animal study combined with computer modeling to guide electrode placement and polarity selection.MethodsRabbit costal cartilages were secured in a jig that approximated the shape of the rabbit auricle framework. Finite element modeling was used to select the initial electrode geometry, polarity, spacing, and estimate dosimetry parameters. Porcine costal cartilage was utilized to refine the selection of dosing parameters. Parametric analysis was performed to determine the effect of voltage and application time on tissue shape change. Next, rabbit rib cartilage was reshaped, varying voltage and application time to identify the lowest parameters to produce acceptable shape change mimicking native auricular cartilage. Acceptable qualitative shape change was determined on a five-point Likert scale analyzed using one-way general linear analysis of variance. Confocal microscopy with live/dead cell viability analysis determined the degree of injury and the distribution of live and dead cells.ResultsThe minimum acceptable deformation of rabbit costal cartilage was found at 4 V-3 minutes. Viability analysis of cartilage reshaped at 4 V-3 minutes demonstrates cell injury extending 2 mm away from each electrode with viable cells found between the electrodes.ConclusionsThe EMR parameters of 4 V-3 minutes demonstrates appropriate shape change producing grafts that resemble the native auricle and contains the viable cells adequate for clinical evaluation. The rabbit auricular reconstruction model using EMR is a feasible one.

Nurses working within the perioperative environment need to understand normal and abnormal physiology and its impact on the patient during an acute intervention. Understanding how our immune system responds and abnormal responses can allow us to change and adapt our care of the patient and be an active member during an emergency. [ABSTRACT FROM AUTHOR]

ObjectiveTo report the first successful study to date of in vivo electromechanical reshaping of ear cartilage in a rabbit model.MethodsEars of New Zealand white rabbits were reshaped using percutaneous needle electrode electromechanical reshaping (5 V for 4 minutes) and were then bolstered for 4 weeks. Ten ears were treated, with 2 undergoing sham procedures and serving as controls. The treatment was performed using a platinum array of electrodes consisting of 4 parallel rows of needles inserted across the region of flexures in the ear. After 4 weeks, the animals were killed, and the ears were photographed and sectioned for conventional light microscopy and confocal microscopy (live-dead fluorescent assays).ResultsSignificant shape change was noted in all the treated ears (mean, 102.4°; range, 87°-122°). Control ears showed minimal shape retention (mean, 14.5°; range, 4°-25°). Epidermis and adnexal structures were preserved in reshaped ears, and neochondrogenesis was noted in all the specimens. Confocal microscopy demonstrated a localized zone of nonviable chondrocytes (

The location of touch can be represented in a somatotopic reference frame and, combined with proprioceptive information, in an external reference frame. There is evidence that body position influences where individuals feel touch on the skin surface, indicating that proprioceptive information affects tactile localization in a somatotopic reference frame. In conditions with visual and proprioceptive mismatch of body position, where do individuals feel touch on the body? We used the mirror box illusion to address this question. Participants placed 1 hand on each side of a mirror aligned with the body midline, such that the hand reflection in the mirror looked like the hand hidden behind the mirror. The illusion creates a spatial mismatch between the actual hidden hand position and where the participant perceives their hand to be (the mirror image location). Across three experiments, localization judgments on the hidden hand were consistently and systematically biased toward the actual hand position relative to the viewed hand position. These findings provide evidence that proprioceptive estimates of limb position influence tactile localization and are discussed in relation to two models of tactile localization. Public Significance Statement: Where do people feel a touch when the viewed hand is displaced from its actual position? In the classic rubber hand illusion, people feel touch on the seen rubber hand when it is brushed in synchrony with their unseen actual hand. But does the actual hand still influence tactile perception? Using the mirror box illusion, we found that when there was spatial mismatch between visual and proprioceptive information of hand position, the perceived location of tactile stimuli on the skin surface was systematically biased toward the proprioceptively-defined hand position compared to baseline. These results provide evidence that the actual hand position exerts influence on tactile localization, adding to past findings that information from external space affects tactile localization in somatotopic space. [ABSTRACT FROM AUTHOR]

This article assesses the impact of untraditional security threats on the origin and institutional configuration of existing and prospective developmental states in Africa. It adopts a case study research methodological approach which interrogates the effect of internal and global security threats on the formation of 21st-century African developmental states through the presence of four developmental state features: Development-Oriented Political Leadership; Presence of a Pilot Agency; Private Sector and/or Broad-Based Developmental Coalitions; and Popular Mobilisation through a Developmentalist Ideology. The case studies under review include four existing (Botswana, Mauritius, Ethiopia, and Rwanda) and one prospective (South Africa) African developmental states. This article finds that intense ethnic rivalries and domestic development imperatives were sufficient factors triggering the construction of developmental states in Botswana, Mauritius, Ethiopia, and Rwanda. Furthermore, the outbreak of COVID-19 has served as a global threat which precipitated developmental state project in South Africa. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the debt-economic growth nexus among states domiciled in South-South region of Nigeria. Using data from 2014-2019, the study employed the dynamic panel ordinary least squares (DOLS) to correct for simultaneity bias among the regressors and small sample bias, which are all associated with OLS estimator. It also adopted the Pedroni (1999, 2004) and Larsson, Lyhagen and Lothgreen (2001) techniques to establish the presence of a long-run relationship. The results affirmed that the South-South States are bedevilled by huge debt burden through the years, restraining and inhibiting their economic performance, since both domestic and external debts have impacted negatively on economic growth. The findings of this study showed that South-South states, and by extension other sub-national governments are faced with numerous macroand micro-level challenges orchestrated by external and domestic debts and requires responses from relevant stakeholders to stabilize the narrative. The novelty of this study is twofold. This systematic analysis of the impact of domestic and external debt is the first of its kind focusing solely on South-South geopolitical zone of Nigeria. Unlike previous studies, the study carried out a state-by-state as well as panel cointegration test to establish longrun relationship. [ABSTRACT FROM AUTHOR]

The extent of barriers in technology integration that teachers have faced in the teachinglearning process has long been the focus of researchers. The main purpose of the current study is to map the perceived internal and external barriers of teachers on TAM while integrating technology into their classroom. The proposed comprehensive model was extended with the internal and external barriers and analyzed by the structural regression technique. The findings, from a sample of 399 teachers across Turkey, show that internal technology barriers have a direct effect on perceived usefulness, perceived ease of use, attitudes, and behavioural intention. External technology barriers do not have a direct effect but have an indirect effect on perceived usefulness, perceived ease of use, attitudes and behavioural intention. Finally, the findings show that external technology barriers have a direct impact on internal technology barriers. [ABSTRACT FROM AUTHOR]

In Spain a significant number of individuals die from atherosclerotic disease of the coronary and carotid arteries without having classic risk factors and prodomal symptoms. The diagonal ear lobe crease (DELC) has been characterized in the medical literature as a surrogate marker which can identify high risk patients having occult atherosclerosis. This topic however has not been examined in either the medical or dental literature emanating from Spain. The majority of clinical, angiography and postmortem reports support the premise that DELC is a valuable extravascular physical sign able to distinguish some patients at risk of succumbing to atherosclerosis of the coronary arteries. A minority of studies have however failed to support this hypothesis. More recently reports using B mode ultrasound have also linked DELC to atherosclerosis of the carotid artery and another report has related DELC to the presence of calcified carotid artery atheromas on panoramic radiographs. DELC is readily visible during head and neck cancer screening examinations. In conjunction with the patient's medical history, vital signs, and panoramic radiograph, the DELC may assist in atherosclerotic risk.

INTRODUCTION: Major external structural birth defects are typical and have been attributed to childhood morbidity, mortality and lifelong resource-intensive disabilities. These defects continue to occur; however, they are yet to be recognized as public health problems in Kenya. The objective of this study was to estimate the prevalence of major external structural birth defects in Kiambu County in Kenya, 2014-2018. METHODS: a cross-sectional study design was adopted; a retrospective review of medical records was conducted between 2014 and 2018 abstracting 873 birth defects. Following a predetermined inclusion criterion, a five-year prevalence numerator of 362 cases was determined, whereas, a five-year prevalence denominator of 299,854 cases of registered live-births was obtained from the birth registrar. Annual prevalence estimates of 29 sub-groups and 6 groups of these defects were calculated as the number of cases (numerator) divided by the number of live-births (denominator). Associated 95% binomial exact 95% confidence intervals were also computed and expressed per 100,000 live-births. RESULTS: defects of the musculoskeletal system, the central nervous system, orofacial, genital organs, eye and anus were observed. Defects of the musculoskeletal system were the most prevalent, ranging from 22.98 (95% CI: 11.87-40.13) to 116.9 (95% CI: 92.98-145.08) per 100,000 live-births. Defects of the central nervous system followed ranging between 13.40 (95% CI: 5.39-27.61) and 32.79 (95% CI: 20.79-49.19) per 100,000 live-births. CONCLUSIONS: despite musculoskeletal system defects being the most common group, hypospadias; a defect of the male genital organ was the most prevalent among the sub-group of these defects.

Eagle syndrome refers to a clinical syndrome caused by the abnormal elongation of the styloid process with calcification/ossification of the stylohyoid ligament. We present the first reported case of Eagle syndrome resulting in an external carotid artery (ECA) pseudoaneurysm. A patient presented to emergency room with an expanding, painful right-neck mass. CT angiography with three-dimensional volume rendering showed a bilobed 4.0-cm right ECA pseudoaneurysm and bilateral ossification of the stylohyoid ligaments with a sharpened edge of the right styloid process at the level of the carotid artery. Aneurysmectomy was performed, and a common carotid to internal carotid bypass with reversed saphenous vein restored arterial continuity. Local resection of the styloid process with a rotational sternocleidomastoid flap was performed. The pathology report was consistent with a diagnosis of a pseudoaneurysm. A six-month clinical follow-up confirmed the complete resolution of symptoms with no neurological deficits.

An external electric field (EEF) has a strong controlling effect on the structure, electron distribution, and optoelectronic properties of a system. In this study, the geometric structure, electronic distribution and electronic transition properties of [6,6]carbon nanobelt ([6,6]CNB) were investigated under different EEFs based on density functional theory and wave function analysis. These theoretical studies determined that EEF can significantly change the geometry of [6,6]CNB by elongating its structure. The system deformation was mainly caused by forces pulling in the direction of the EEF. After removal of the EEF, the system reverted to its original structure. Electronic polarization played a major role in structural stability during the deformation process. The changes in geometric structure and electronic distribution affected the photoelectric properties of [6,6]CNB. Under the action of EEFs, the absorption peak of [6,6]CNB was red-shifted and gradually appeared in the visible light region. This study facilitates an understanding of the performance of [6,6]CNB as a new type of nanomaterial and provides the necessary theoretical basis for the application of [6,6]CNB in the field of optoelectronics.

In the article, temperament is considered as a psychological and psychophysiological determinant of eating disorders. The results of the relationship between the temperament type and eating behavior in the adult population (150 people) are presented according to gender and age characteristics. Only 12 % of respondents have a rational type of eating behavior. The sample was 33.3 % of respondents with melonchal temperament, 28.7 % – phlegmatic, 20 % sanguine and 18 % choleric, respectively. It is established that women-melancholiacs are more likely to develop an emotiogenic type of eating disorders, and men-melancholiacs are of a restrictive type. Emotiogenic type of eating behavior occurs in representatives of all types of temperament, but in different periods of ontogenesis: sanguine and choleric patients under 29 years old; melancholics at the age of 30 and older; phlegmaticians since 50 years of age, respectively. The external type of eating behavior is most characteristic for choleric persons under the age of 29. The results showed that temperament is indeed a factor in eating disorders and depends on age and gender characteristics.

PURPOSE: The purpose of this study is to compare the success rates of endoscopic endonasal dacryocystorhinostomy (EN-DCR) and external DCR (EX-DCR) for the treatment of primary acquired nasolacrimal duct obstruction (PANLDO). DESIGN: This was a retrospective, comparative, nonrandomized clinical study. METHODS: Reviewed medical records of PANLDO underwent DCR at Far-Eastern Memorial Hospital from May 2011 to June 2017. Data regarding the lacrimal passage system, comorbidities, surgical outcomes, and postoperative complications were analyzed. Anatomical success was defined as patency confirmed by intranasal endoscopic inspection of the ostium and successful lacrimal irrigation; functional success was defined as complete resolution of epiphora and positive fluorescein dye disappearance test, which were assessed at postoperative 6th months. RESULTS: One hundred and seventy patients (37 males, 133 females, mean age 57 years) underwent 178 DCR surgeries for PANLDO. The overall anatomical success rate was 94.4% (93.5% in EN-DCR vs. 95.8% in EX-DCR, P = 0.511) and functional success rate was 90.4% (90.7% in EN-DCR and 90.1% in EX-DCR, P = 0.909). Surgical outcomes were comparable between two groups. Complication rate was low in both groups, including 11 cases of early canalicular stent dislodge (7 in EN-DCR, 4 in EX-DCR), one case of postoperative nasal bleeding in EN-DCR, and two skin wound dehiscence and three cutaneous keloid formation in EX-DCR. None of these cases were concluded into surgical failure at the final visit. The time to symptoms relief was statistical significantly shorter in EN-DCR group (1.7 vs. 3.7 weeks in EX-DCR, P < 0.001). CONCLUSIONS: Success rate of DCR for PANLDO in our study was high, and complication rate was low for both endoscopic and external approaches. There was no statistically significant difference between them. EN-DCR provided higher satisfaction due to quicker recovery and lack of external incision. Endoscopic DCR should be considered as the primary treatment of choice for PANLDO.

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

Introduction: major external structural birth defects are typical and have been associated with childhood morbidity, mortality and lifelong resource-intensive disabilities. These defects continue to occur; however, they are yet to be recognized as public health problems in Kenya. The objective of this study was to estimate the prevalence of major external structural birth defects in Kiambu County in Kenya, 2014-2018. Methods: a cross-sectional study design was adopted; a retrospective review of medical records was conducted between 2014 and 2018 abstracting 873 birth defects. Following a predetermined inclusion criterion, a five-year prevalence numerator of 362 cases was determined, whereas, a five-year prevalence denominator of 299,854 cases of registered livebirths was obtained from the birth registrar. Annual prevalence estimates of 29 sub-groups and 6 groups of these defects were calculated as the number of cases (numerator) divided by the number of live-births (denominator). Associated 95% binomial exact confidence intervals were also computed and expressed per 100,000 live-births. Results: defects of the musculoskeletal system, the central nervous system, orofacial, genital organs, eye and anus were observed. Defects of the musculoskeletal system were the most prevalent, ranging from 22.98 (95% CI: 11.87-40.13) to 116.9 (95% CI: 92.98-145.08) per 100,000 live-births. Defects of the central nervous system followed ranging between 13.40 (95% CI: 5.39-27.61) and 32.79 (95% CI: 20.79-49.19) per 100,000 livebirths. Conclusion: despite musculoskeletal system defects being the most common group, hypospadias; a defect of the male genital organ was the most prevalent among the sub-group of these defects. [ABSTRACT FROM AUTHOR]

Objectives: Osteomas are osseous tumors that primarily occur at the skull, in particular the paranasal sinus system. Surgical tumor resection is the "gold standard" treatment in symptomatic osteomas. The aim of this study was to investigate the use of surgical approaches (endoscopic, open, combined) and to provide a step-by-step approach for patients' management.Methods: Fifty-eight patients (31 m, 27 f, 42.1 ± 15.3 years) that were treated between 2001 and 2015 at our department were included in this retrospective, single center study.Results: In almost half of cases (n = 28, 48.3%) endoscopic, endonasal approaches were used for tumor resection while open (n = 11, 19%) or combined (n = 19, 32.8%) approaches were used in the rest of the cohort. Open or combined approaches were applied in patients suffering from osteomas localized in the maxillary or frontal sinuses only.Conclusion: Beside interviews, clinical examination, nasal endoscopy, and computed tomography are crucial for diagnosis of paranasal sinus osteomas. Magnet resonance imaging can be useful in extensive pathologies. The preoperative selection of the optimal approach for osteoma resection might be most challenging in patients' management. Although useful recommendations regarding the use of surgical approaches have been published, technical requirements and surgical experience of surgeons have to be considered in the limitations of endoscopic approaches. If there are doubts about the resectability of an osteoma by an endoscopic approach, the surgical procedure may be started endoscopically, and, if necessary, it can be combined with an external approach.Level Of Evidence: IV Laryngoscope, 130:2105-2113, 2020. [ABSTRACT FROM AUTHOR]

Radiation-induced risks for all solid cancer incidence and mortality were studied in the cohort of Russian Chernobyl emergency workers. The cohort included 69,440 persons with documented individual radiation dose accrued over the time of working in the Chernobyl zone. The mean age at entry into the zone of recovery operations was 33.9 years and accumulated radiation dose was 132.9 mGy. A total of 6981 solid cancer incident cases and 4272 deaths occurred in this cohort from 1992 to 2017. Three follow-up periods were studied: 1992–2009, 1992–2013, and 1992–2017. For each follow-up period, the lowest dose range with statistically significant (p < 0.05) radiation-induced risk of all solid cancer incidence and mortality were obtained. For the incidence of all solid cancer during the follow-up period 1992–2009, this lowest dose range was estimated to be 0–250 mGy with an excess relative risk per dose of ERR Gy−1 = 0.51 and 95% confidence interval (CI) (0.02; 1.05) Gy−1. For the period 1992–2013, the lowest dose range was 0–175 mGy with ERR Gy−1 = 0.85 (95% CI 0.03; 1.78), while for the whole follow-up period 1992–2017, it was 0–175 mGy with ERR Gy−1 = 0.81 (95% CI 0.08; 1.62). For mortality from all solid cancers during the follow-up period 1992–2009, the lowest dose range with statistically significant radiation-induced risk was estimated to be 0–225 mGy with ERR Gy−1 = 1.07 (95% CI 0.31; 0.97). For the period 1992–2013, the lowest dose range was 0–225 mGy with ERR Gy−1 = 0.86 (95% CI 0.23; 1.58), while for the whole follow-up period 1992–2017, the lowest dose range was 0–200 mGy with ERR Gy−1 = 0.82 (95% CI 0.10; 1.65). Thus, it was found that the minimal level of significant exposure (Dmin), for which a statistically significant radiation-induced risk of all solid cancers was obtained for Russian emergency workers (with individual doses of 0 – Dmin), decreases with increasing duration of cohort observation, both for cancer incidence and mortality. [ABSTRACT FROM AUTHOR]

Copyright of Optimum: Journal of Economics & Management Sciences / Ekonomi ve Yönetim Bilimleri Dergisi is the property of Optimum: Journal of Economics & Management Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There are a number of installations and technological processes, the movement of which is carried out by an external source of energy, and the electric machine, not being the main source of movement, constantly or periodically is in the mode of electric generating braking to provide the desired characteristics of the workflow. The problem solved in this research is to expand the functionality of the generator and the motor in the electric braking mode. The problem is solved by an automatic control of the coordinates of the electric machine in the generator mode. A feature of the proposed control method is that one or more coordinates of generator or motor in electric braking mode are forcibly set by an external energy source, and the goal of coordinated control of other variables of an electric machine is to provide a given law for converting mechanical energy into electrical or an algorithm for the movement of an executive object of a working machine. The article presents example of the synthesis of regulated electric drive control algorithm based on the principle of coordinated control of variables. The example concerns the inverted mode of operation of a pumping unit of a hydro storage power station. According to the criterion of constant output power under conditions of changing the liquid level, an algorithm for frequency control of an asynchronous machine is synthesized, which is realized by adjusting the calculated idling speed of the engine, the rotor of which rotates an external motion source with a speed, that can generally change according to an random law. The task of the control algorithm is to maintain a constant power generation energy, regardless of the actual speed of rotation of the rotor. The proposed approach to the synthesis of generator mode of electric machines, through the use of the principle of coordinated control of variables, acquires qualitatively new properties, as compared with traditional methods of electric braking, increases the technical and economic indicators of the electromechanical system as a whole. Bibl. 9, fig. 6. [ABSTRACT FROM AUTHOR]

Background: Symptomatic or active hydrocephalus in children is linked to an elevation in intracranial pressure (ICP), which is likely to be multifactorial in origin. The CSF outflow resistance, venous sinus resistance and total cerebral blood flow are likely factors in the ICP elevation. The purpose of this paper is to define the incidence, site and significance of venous sinus stenosis and/or cerebral hyperemia in a cohort of children diagnosed with hydrocephalus at a tertiary referral hospital. Methods: The imaging database was reviewed over a 10 year period and the index MRI of all children between the ages of 4 months and 15 years, who were diagnosed with treatment naive hydrocephalus of any type (excluding secondary to tumor) and had magnetic resonance venography (MRV) and flow quantification were selected. Patients were compared with children undergoing an MRI with MRV and flow quantification who were subsequently shown to have no abnormality. The cross-sectional area and circumference of the sinuses were measured at 4 levels. The hydraulic and effective diameters were calculated. An area stenosis of 65% or greater was deemed significant. A total cerebral blood flow greater than two standard deviations above the mean for controls was taken to be abnormal. Results: There were a total of 55 children with hydrocephalus compared to 118 age matched control MRV's and 35 control flow quantification studies. A high grade stenosis occurred in 56% of patients but in none of the controls (p < 0.0001). The commonest site of narrowing was in the distal sigmoid sinus. Cerebral hyperemia occurred in 13% of patients but did not occur in the controls. Conclusions: The elevation in ICP in symptomatic hydrocephalus is multifactorial. Both high grade venous stenosis and cerebral hyperemia are common in childhood hydrocephalus. High grade stenosis was noted to be a risk factor for conservative management failure. Hyperemia was a good prognostic indicator. [ABSTRACT FROM AUTHOR]

Background: Complex periarticular fractures of the metacarpophalangeal joint (MCPJ) are often challenging to treat. Conservative and operative treatments are often burdened with stiffness, loss of function, and poor clinical outcome. These phenomena could be a direct consequence of long period of immobilization. To promote a short time of immobilization and a quick return to daily activities, it is mandatory to stabilize the fracture maintaining the active range of motion (AROM) of the ray. A simple solution is to reduce the fragments by means of dynamic ligamentotaxis. The authors propose a new dynamic distraction device (DDD) for the MCPJ. Methods: The DDD for the MCPJ was made of Kirschner wires bent and connected to counteract dislocation forces and to allow mobilization of the joint. The DDD was tested on a cadaver model under a simulated load in physiological conditions, and also in metacarpal and proximal phalanx (P1) fracture patterns. The effectiveness of the device was evaluated under fluoroscopy. Results: The data showed that DDD is able to achieve fracture reduction through ligamentotaxis and primary fragments stability and to avoid secondary dislocation during AROM of complex periarticular fractures of the MCPJ. Conclusions: The frame could be an alternative option to treat periarticular fractures of the MCPJ. The DDD implant has several advantages: It is time efficient because assembly and application take only few minutes. Furthermore, it is very versatile; indeed, it can be used in all metacarpal and phalanx bones, even in the central rays. [ABSTRACT FROM AUTHOR]

Objectives: This study was an examination of the long-term results of transcanalicular laser (TCL) and external (EX) dacryocystorhinostomy (DCR). Methods: Patients who had undergone TCL-DCR or EX-DCR between 2009 and 2013 were invited for long-term follow-up in 2019. All of the patients who responded had an ophthalmic examination and were assessed using lacrimal irrigation. An intranasal evaluation was performed when the irrigation test had non-patent results. TCL procedures were performed with a diode laser (980 nm). Ostium cleansing with a suction unit and a nasal endoscope was performed in the first week. In EX-DCR procedures, an anterior flap was created and tented to the orbicularis oculi muscle. A silicon tube was implanted in both methods and removed at 4-6 months. Results: A total of 74 EX-DCR patients were assessed. The lacrimal irrigation test was negative in 5 cases. The functional success rate was 93.2% with a follow-up of 8 years. A total of 63 patients who had undergone TCL-DCR were evaluated and the irrigation test was negative in 9 patients. The functional success rate was 85.7% with a follow-up of 7 years. The difference in the success rate was statistically insignificant with a p value of 0.09. Conclusion: The long-term success rates of both EX-DCR and TCL-DCR were high. [ABSTRACT FROM AUTHOR]

The aim of this qualitative case study was to ascertain factors impacting the examination preparation process and causing concerns for London upper secondary students, to learn steps taken to reduce and/or resolve the concerns, and to discuss the implications for teachers and teaching. A subsidiary yet important aim was to give the students a "voice" in the research literature. Using convenient or opportunity sampling, I conducted face-to-face interviews with 14 grade 12 and 13 students, ages 16-18, in a south-west London secondary school. The analysis of the data revealed external factors and a personal need factor, that is the need to pass the exam, impacted the examination preparation process and caused concerns for students. Schools and students have use various solutions to reduce and/or resolve concerns. For example, school-based solutions included offering make-up or additional sessions or extra classes. Students--when faced with large amounts of material and information--employed solutions such as "things-to-do lists" and breaking down tasks into manageable sections. Implications for teachers and teaching include the need for teachers' lesson contents to address factors impacting exam preparation and students' concerns. Teachers also need to equip students to use a variety of revision strategies, encourage students to use social support and ensure that promised extra lessons materialize. [ABSTRACT FROM AUTHOR]

Copyright of Bulletin of the 'Carol I' National Defence University / Buletinul Universitatii Nationale de Aparare 'Carol I' is the property of Carol I National Defence University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Introduction The tone-evoked auditory brainstem responses (tone-ABR) enable the differential diagnosis in the evaluation of children until 12 months of age, including those with external and/or middle ear malformations. The use of auditory stimuli with frequency specificity by air and bone conduction allows characterization of hearing profile. Objective The objective of our study was to compare the results obtained in tone-ABR by air and bone conduction in children until 12 months, with agenesis of the external auditory canal. Method The study was cross-sectional, observational, individual, and contemporary. We conducted the research with tone-ABR by air and bone conduction in the frequencies of 500 Hz and 2000 Hz in 32 children, 23 boys, from one to 12 months old, with agenesis of the external auditory canal. Results The tone-ABR thresholds were significantly elevated for air conduction in the frequencies of 500 Hz and 2000 Hz, while the thresholds of bone conduction had normal values in both ears. We found no statistically significant difference between genders and ears for most of the comparisons. Conclusion The thresholds obtained by bone conduction did not alter the thresholds in children with conductive hearing loss. However, the conductive hearing loss alter all thresholds by air conduction. The tone-ABR by bone conduction is an important tool for assessing cochlear integrity in children with agenesis of the external auditory canal under 12 months.

This study aims to determine the competitive advantage of SMEs, which are associated with the management process strategy of internal and external sides of SMEs.Conducted on Jambi batik area SMEs which were selected in a sample by purposive sampling. Data collection was done by using observation, interviews and FGD on 6 SMEs selected by purposive sampling.Research analysis is carried out qualitatively, by implementing the results of SWOT analysis. Which aims to develop strategies that must be done by SMEs in making decisions to excel in competition.Identified 24 strategies that need to be done by SMEs in running the business optimally, so that they can face competition with other business sub-sectors and Jambi batik SMEs can continue to have competitive advantages. Keyword: strategy management, internal, external, SWOT

Pin tract infections are virtually universal complications with the use of external fixation. While most are superficial and respond to oral antibiotics and local care, septic loosening may occur at the bone-pin interface, which may lead to instability of the fixator, catastrophic failure, fracture, and long-term osteomyelitis. Classification systems and prevention protocols have been developed to address this ubiquitous complication. Treatment of severe pin tract infections often requires debridement, parenteral antibiotics, and removal of the offending pin or the entire external fixator. In cases of osteomyelitic pin tracks, a sizable cavity is often present. We describe a simple technique for treatment of deep bone pin tract infection through the use of debridement, irrigation, and an antibiotic "sparkler," which is a specially prepared percutaneous implant of antibiotic laden bone cement.Levels of Evidence: Level 5., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This paper discusses the causal relationship between the internal and external environment of business with managerial competence in the effort of deciding on choosing a craft small business funding. The researcher proposes a new concept and wants to explain the role of managerial competence as an intermediate variable. Using structural equations in 384 respondents drawn proportionally from a population of 36,343 handicraft entrepreneurs in East Java. Criteria for respondents are entrepreneurs who have actively conducted business activities for at least 1 year, while the sampling method uses proportional random sampling. The findings indicate that the proposed concept is accepted, and shows that the internal environment has no bearing on the decision to choose a craft small business funding. External environment, dominantly influences the decision to choose funding. Research also proves that managerial competence is an intermediate variable, and contributes positively to the decision to choose business funding. The novelty in this research is, the use of indicators: understanding the organization, leading and managing people, managing resources, and communicating effectively as indicators of managerial competence. [ABSTRACT FROM AUTHOR]

Interest in the use of mindfulness-based activities with youth is growing. Students with externalized disorders often have problems with mindfulness and attention activities. The relationship between mindfulness and externalizing problems in children and adolescents has important therapeutic implications. This study was designed to investigate the predictive role of mindfulness in externalizing disorders among adolescents. In this study, 250 high school students were selected. In order to measure the mindfulness characteristics, mindfulness attention awareness scale brown & ryan and to measure externalizing disorders, youth self-report of Achenbach's self-report form were used was. There was a significant inverse relationship between score of mindfulness and total score of externalizing problems. In addition, there was a significant inverse relationship between mindfulness and components related to externalizing problems (lawlessness, aggression, problems with attention deficit/ hyperactivity, oppositional defiant disorder issues and problems associated with conduct disorder). Regression analysis showed that mindfulness with 19% of variance explained can predict symptoms of externalizing disorders. The results showed Mindfulness has significant negative correlation with externalizing disorders symptoms and also mindfulness is able to predict symptoms of externalizing disorders. [ABSTRACT FROM AUTHOR]

This paper provides analysis on Cadbury, Inc and confectionery industry. The paper analyzes the external and internal forces affecting the company, the industry it operates and its business level strategy. Further, it gives detailed information about the SWOT analysis of the company. Considering the situational features such as opportunities and threats when designing the environmental analysis and making realistic marketing plan is very crucial because a company will benefit from its own strengths, eliminate its weaknesses, benefit from environmental opportunities and protect itself from environmental threats. On the simple basis of product quality and taste, Cadbury proves to be superior to other commercially available chocolate even with the seeming similarities in texture. This paper deals with two main research flows: environmental analysis and situational factors which allows organizations to compose a realistic and effective marketing plan. This study provides a framework that implement a common consensus on these research flows by specifiying some important issues for future research and by making effective strategy analysis in the confectionery industry. [ABSTRACT FROM AUTHOR]

The increasing amount of available biological information on the markers can be used to inform the models applied for genomic selection to improve predictions. The objective of this study was to propose a general model for genomic selection using a link function approach within the hierarchical generalized linear model framework (hglm) that can include external information on the markers. These models can be fitted using the well-established hglm package in R. We also present an R package (CodataGS) to fit these models, which is significantly faster than the hglm package. Simulated data were used to validate the proposed model. We tested categorical, continuous and combination models where the external information on the markers was related to 1) the location of the QTL on the genome with varying degree of uncertainty, 2) the relationship of the markers with the QTL calculated as the LD between them, and 3) a combination of both. The proposed models showed improved accuracies from 3.8% up to 23.2% compared to the SNP-BLUP method in a simulated population derived from a base population with 100 individuals. Moreover, the proposed categorical model was tested on a dairy cattle dataset for two traits (Milk Yield and Fat Percentage). These results also showed improved accuracy compared to SNP-BLUP, especially for the Fat% trait. The performance of the proposed models depended on the genetic architecture of the trait, as traits that deviate from the infinitesimal model benefited more from the external information. Also, the gain in accuracy depended on the degree of uncertainty of the external information provided to the model. The usefulness of these type of models is expected to increase with time as more accurate information on the markers becomes available. [ABSTRACT FROM AUTHOR]

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

Copyright of Journal of Animal & Poultry Production is the property of Egyptian National Agricultural Library (ENAL) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Exposed fractures of the tibial pylon are infrequent lesions that are associated with the appearance of multiple complications derived from the intensity of the traumain addition to the real sepsis possibility of soft tissues or bone and bone consolidation disorders related to the affected zone. Adequate management of these conditions by the medical staff avoids the appearance of important complications, for this reason it was decided to share the experience in the management of these conditions by presenting a case. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic ventral mesh rectopexy (LVMR) has proved effective in the treatment of internal and external rectal prolapse. The present meta-analysis aimed to determine the predictive factors of recurrence of full-thickness external rectal prolapse after LVMR.Methods: An organized, systematic search of electronic databases including PubMed/Medline, Embase, Scopus, and Cochran library was conducted in adherence to PRISMA guidelines. Studies that reported the outcome of LVMR in patients with full-thickness external rectal prolapse were included according to predefined criteria. A meta-regression analysis and sub-group meta-analyses were performed to recognize the patient and technical factors that were associated with higher recurrence rates.Results: Seventeen studies comprising 1242 patients of a median age of 60 years were included. The median operation time was 122.3 min. Conversion to open surgery was required in 22 (1.8%) patients. The weighted mean complication rate across the studies was 12.4% (95% CI 8.4-16.4) and the weighted mean rate of recurrence of full-thickness external rectal prolapse was 2.8% (95% CI 1.4-4.3). The median follow-up duration was 23 months. Male gender (SE = 0.018, p = 0.008) and length of the mesh (SE = - 0.007, p = 0.025) were significantly associated with full-thickness recurrence of rectal prolapse. The weighted mean rates of improvement in fecal incontinence and constipation after LVMR were 79.3% and 71%, respectively.Conclusion: LVMR is an effective and safe option in treatment of full-thickness external rectal prolapse with low recurrence and complication rates. Male patients and length of the mesh may potentially have a significant impact on recurrence of rectal prolapse after LVMR. [ABSTRACT FROM AUTHOR]