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Background: Infertility is a condition where couple failure to conceive after 1 year of regu­lar unprotected coitus. At least 50 million couples worldwide experience infertility. Several adverse consequences of infertility like tension, hostility, anxiety, depression, self-blame and suicidal ideation are now being increasingly recognized. This study was designed to assess the awareness regarding infertility among women attending Chitwan Fertility Center. Methods: A cross sectional analytical study design was used and population for study includes those married women who had failure to conceive and visited to Chitwan infertility centre. The data was collected through semi-structured interview schedule. Collected data was coded and entered and analyzed in Microsoft office Excels and SPSS 20 version by using descriptive and in­ferential statistics. Results: In present study, among 96 respondents, majority of the respondents 45.8% were from age group of 25-30 years. Most of the respondents 56.3% had completed bachelor level and above level education. Majority of women 87.5% had good awareness on infertility. There was no signifi­cant association between level of awareness and socio-demographic variables. Conclusions: It can be concluded that the awareness about infertility among the participants at­tending Chitwan fertility center is relatively good. Most of the participants were educated, dura­tion of marriage was also 5-10years and most of them came to the infertility center for the treat­ment and management of infertility that might be the reason they have good awareness regarding infertility. But there is still misconception in some of the participants.

Background. Ophthalmic viscoelastic devices (OVDs) used during small-incision cataract surgery have numerous advantages. However, OVDs have longer retention time in an eye after surgery resulting in intraocular pressure (IOP) spikes. The purpose of this study is to analyze and quantify the effect of various OVDs on both IOP and best corrected visual acuity (BCVA) by systematically reviewing the literature and performing meta-analysis. Methods. Numerous databases from January 1, 1985, to present were systematically searched. Thirty-six (3893 subjects) of 3313 studies identified were included for analysis. Standardized mean difference (SMD) was computed, and meta-analysis was performed. Results. A total of 3313 records were retrieved including 1114 from database search and 2199 from grey literature search. Significant increase in postoperative IOP in 1-day follow-up with Healon (SMD = 0.37, CI: [0.07, 0.67]), Viscoat (SMD = 0.29, CI: [0.13, 0.45]), Provisc (SMD = 0.46, CI: [0.17, 0.76]), and Soft Shell (SMD = 0.58, CI: [0.30, 0.86]) was computed. On the other hand, results implied a nonsignificant increase in postoperative IOP with Healon GV (SMD = 0.07, CI: [−0.28, 0.41]), Healon5 (SMD = 0.15, CI: [−0.33, 0.64]), 2% HPMC (SMD = 0.32, CI: [−0.0, 0.64]), and OcuCoat (SMD = 0.26, CI: [−0.37, 0.9]). Additionally, a nonsignificant reduction in postoperative IOP was inferred with Viscoat + Provisc (SMD = −0.28, CI: [−2.23, 1.68]). Conclusion. Improvement in IOP was shown with Viscoat + Provisc. Additionally, IOP nonsignificant upsurge was observed with Healon GV, Healon5, 2% HPMC, and OcuCoat compared to significant upsurge with Healon, Viscoat, and Soft Shell.

The selective arterial calcium stimulation test (SACST) is one of the most useful localization tests for insulinoma but can cause false-positive and/or unexpected multi arterial positive results that hamper clinical decisions. There are also several adverse effects, such as nausea and hypoglycemia, at the conventional dose (0.025 mEq/kg) of calcium injection. We herein report five consecutive insulinoma cases in which low-dose (0.005-0.007 mEq/kg) calcium injection for SACST led to successful insulinoma localization. No adverse effects of SACST were observed. In conclusion, a low-dose SACST can be a favorable option as an insulinoma localization test in terms of accuracy and safety.

Objective The psychological status is a key factor in smoking continuance. However, details on short-term changes in mild depressive states after smoking cessation (SC) are still unknown. The purpose of the present study was to investigate these short-term changes. Methods A total of 989 patients who visited our SC Clinic were assessed using the Zung Self-Rating-Depression-Scale (SDS), an official instrument to measure depressive tendencies. The participants were classified into normal and neurotic groups based on their SDS scores during their initial visit; they were assessed again 2, 4, 8, and 12 weeks thereafter. Results The majority of patients in the neurotic group were women. These patients were also younger, with a higher nicotine dependence, and presented with a lower successful SC rate than the patients in the normal group. A decrease in SDS scores after starting the SC treatment was observed only in the neurotic group, especially during the first two weeks. In patients who continued to smoke, no improvement in depressive tendencies was noted in this period. Conclusion Depressive tendencies of patients with neurosis improve in the initial stages of the SC treatment (i.e., within two weeks after starting the treatment). This finding fills the mentioned knowledge gap regarding the effects of SC on mild depressive states in the short term.

In this paper, Maximum power point is tracked in both solar and wind energy conversion system using MPPT controller and also analyzed the performance of the renewable energy system with MPPT and without MPPT controller. Among all the renewable resources, Solar and Wind are the most popular resources due to its ease of availability. Alone PV system or Wind system cannot completely meet load demands.Hence photovoltaic and wind system are hybridized and optimized to satisfy the load demand. This paper proposed a standalone hybrid renewable energy system which employs incremental conductance algorithm for photovoltaic system and perturb and observe algorithm for wind energy conversion system is implemented. Usage of this system combines the advantages of each generation system and provides electrical power to meet various load conditions. Maximization and stabilization of power from the system with and without MPPT controller is designed and analyzed in MATLAB/Simulink environment.

In existing method separate DC-DC and DC-AC converter topologies are required to supply DC and AC loads in which efficiency is poor. In the proposed work single converter topology of interleaved hybrid converter is used to provide simultaneous AC and DC output. Battery is used to supply load in absence of solar power. Artificial Neural Network control strategy is used to provide gating signals for the converter which improves the overall performance and stability of the system.AC and DC output from the interleaved hybrid converter are obtained using MATLAB/Simulink

Electroencephalography (EEG) is almost contaminated with many artifacts while recording the brain signal activity. Clinical diagnostic and brain computer interface applications frequently require the automated removal of artifacts. In digital signal processing and visual assessment, EEG artifact removal is considered to be the key analysis technique. Nowadays, a standard method of dimensionality reduction technique like independent component analysis (ICA) and wavelet transform combination can be explored for removing the EEG signal artifacts. Manual artifact removal is time-consuming; in order to avoid this, a novel method of wavelet ICA (WICA) using fuzzy kernel support vector machine (FKSVM) is proposed for removing and classifying the EEG artifacts automatically. Proposed method presents an efficient and robust system to adopt the robotic classification and artifact computation from EEG signal without explicitly providing the cutoff value. Furthermore, the target artifacts are removed successfully in combination with WICA and FKSVM. Additionally, proposes the various descriptive statistical features such as mean, standard deviation, variance, kurtosis and range provides the model creation technique in which the training and testing the data of FKSVM is used to classify the EEG signal artifacts. The future work to implement various machine learning algorithm to improve performance of the system.

特集「欧州難民・移民危機の再検討」

本研究では圧力センサ内蔵BLEビーコンを用いた在席・離席管理手法を提案する。圧力センサ内蔵BLEビーコンを用いることで、執務者の負担を減らし、プライバシー面も考慮した。圧力センサ内蔵BLEビーコンのバッテリー消費を考慮し、適切な電波強度、送信間隔を設定するために、検証を行った。また、執務者の在席・離席をセンシングし、正しく在離席を検知できることを確認した。さらに在離席状況を分析する際に必要なログデータを蓄積するシステムを構築した。提案システムをオフィスを模擬した実験室において一週間稼働させ、在離席のログデータを取得した。ログデータを分析することでオフィスにおいて好まれる座席と好まれない座席の傾向を分析することができた。, In this research, we propose a seat presence / absence management method using BLE beacon with built-in pressure sensor. By using the BLE beacon with integrated pressure sensor, we reduced the burden on the officer and also considered the privacy side. I sensed the presence / absence of an office worker and confirmed that I could detect my seat properly. In addition, we built a system that accumulates log data necessary for analyzing the situation of resident seats. The proposed system was operated for one week in a laboratory simulating office, Log data from system was acquired. Analyzing the log data allowed us to analyze the trends in the office preferred seats and undesirable seats.

The mobile devices usage has been widespread, which directly impacts the increase of mobile communication, the increased usage of Mobile Ad-hoc networks(MANETs) has brought a rapid growth in the technology development. MANETs can be deployed in any environment conveniently as it comes under the category of ad-hoc networks which is infrastructureless. Due to flexibility of deployment features, it is compatible with other networks like PAN, LAN, etc.,. MANET is applicable in many applications like rescue of emergency disasters, military operations and other special environments where wired system may not support and of urgency. Since, MANETs are having the property of infrastructureless, nature of topology of network being dynamic, and lack of authority certification leads to certain problems with regard to security from attackers. In MANETs high attention should also be given to security parameter along with other parameters for efficient routing. With the aim of facing the possibility of malicious node attacks, the proposed paper presents the technique of detecting the malicious nodes attacks caused form two major attacks like blackhole and wormhole attacks are detected and prevented by Cooperative Bait Detection Scheme (CBDS). Once those attacks are prevented, the routing efficiency in MANETs for Chicken Swam Optimization based A* algorithm is improved, which is a computer algorithm that is broadly deployed in path finding and graph traversal. The comparative examination of Optimized A*, Ad-hoc On-Demand Distance Vector (AODV) with the proposed model against attacks, enhances the performance.

Longitudinal bone growth is achieved by a tightly controlled process termed endochondral bone formation. C-type natriuretic peptide (CNP) stimulates endochondral bone formation through binding to its specific receptor, guanylyl cyclase (GC)-B. However, CNP/GC-B signaling dynamics in different stages of endochondral bone formation have not been fully clarified, especially in terms of the interaction between the cyclic guanine monophosphate (cGMP) and cyclic adenosine monophosphate (cAMP) pathways. Here, we demonstrated that CNP activates the cAMP/protein kinase A (PKA) pathway and that this activation contributed to the elongation of the hypertrophic zone in the growth plate. Cells of the chondrogenic line ATDC5 were transfected with Förster resonance energy transfer (FRET)–based cGMP and PKA biosensors. Dual-FRET imaging revealed that CNP increased intracellular cGMP levels and PKA activities in chondrocytes. Further, CNP-induced PKA activation was enhanced following differentiation of ATDC5 cells. Live imaging of the fetal growth plate of transgenic mice, expressing a FRET biosensor for PKA, PKAchu mice, showed that CNP predominantly activates the PKA in the hypertrophic chondrocytes. Additionally, histological analysis of the growth plate of PKAchu mice demonstrated that CNP increased the length of the growth plate, but coadministration of a PKA inhibitor, H89, inhibited the growth-promoting effect of CNP only in the hypertrophic zone. In summary, we revealed that CNP-induced cGMP elevation activated the cAMP/PKA pathway, and clarified that this PKA activation contributed to the bone growth–promoting effect of CNP in hypertrophic chondrocytes. These results provide insights regarding the cross-talk between cGMP and cAMP signaling in endochondral bone formation and in the physiological role of the CNP/GC-B system.

In 2018, there were more than 12,000 self-harm presentations to emergency departments (EDs) in Ireland with 50% occurring between 7p.m. and 3a.m. There is evidence that the assessment quality and follow-up is variable across clinicians. To address this, The National Clinical Programme for the Management of Self-Harm in the ED (NCPSH 2016) was developed to set clear standards.Our aim was to compare diagnosis and management of patients presenting to Beaumont Hospital (BH) ED, across a 3-year period, by the on-site Liaison Psychiatry Service, during normal working hours, to the off-site on call service outside of normal working hours (OOH).This is a retrospective audit of BH ED patients referred for psychiatric assessment between 2018 and 2020, using patient electronic records for data collection, and Pearson's chi square testing for group differences. Post hoc analysis was performed using adjusted residuals and Bonferroni correction.Of 3659 psychiatric referrals to Beaumont ED from 2018 to 2020, alcohol-related disorders were the most common diagnosis and were diagnosed more frequently during normal working hours (n = 592, 16.2%; 22.9% normal hours vs 8.5% OOH, p 0.001), while personality disorder was diagnosed more frequently out of hours. (n = 432, 11.8%; 9.6% normal hours vs 14.4% out of hours, p 0.001). There was a statistically significant difference in referral to voluntary services out of hours (7.2% normal hours vs 0.3% OOH).In contrast to previous findings, our study found higher rates of alcohol-related disorders diagnosed during normal hours vs OOH. Furthermore, voluntary and addiction services were under-utilised OOH and this presents an important teaching opportunity.

The increasing integration of distributed energy resources (DERs) into power grid makes it significant to forecast solar irradiance for power system planning. With the advent of deep learning techniques, it is possible to forecast solar irradiance accurately for a longer time. In this paper, day-ahead solar irradiance is forecasted using encoder-decoder sequence-to-sequence models with attention mechanism. This study formulates the problem as structured multivariate forecasting and comprehensive experiments are made with the data collected from National Solar Radiation Database (NSRDB). Two error metrics are adopted to measure the errors of encoder-decoder sequence-to-sequence model and compared with smart persistence (SP), back propagation neural network (BPNN), recurrent neural network (RNN), long short term memory (LSTM) and encoder-decoder sequence-to-sequence LSTM with attention mechanism (Enc-Dec-LSTM). Compared with SP, BPNN and RNN, Enc-Dec-LSTM is more accurate and has reduced forecast error of 31.1%, 19.3% and 8.5% respectively for day-ahead solar irradiance forecast with 31.07% as forecast skill.

[spa] El tumor de células gigantes (TCG) es una neoplasia ósea considerada benigna generalmente, aunque localmente agresiva y puede presentar recidivas. Se origina en la epífisis/metáfisis de los huesos largos, su presentación en un arco costal es rara y de ocurrir generalmente se sitúa en la porción posterior, existiendo pocos casos reportados en la porción anterior. Se presenta el caso de una paciente femenina de 40 años de edad con gran masa en el hemi-tórax derecho. Clínicamente aparentaba un tumor profundo de la mama con invasión local de la pared torácica. La detallada evaluación radiográfica reveló una lesión costal con invasión de tejidos blandos. El examen histológico mostró células gigantes. El tumor se extirpó junto con la costilla, el defecto fue reconstruido y la paciente se recuperó sin incidentes. Se concluye que el TCG de las costillas es un caso raro, pero el diagnóstico diferencial de una masa de la pared torácica anterior debe incluirlo., [eng] Giant cell tumor (GCT) is a bone tumor usually considered benign, although locally aggressive and may recur. It originates in the epiphysis / metaphysis of the long bones. Its presentation in a costal arch is rare and if it occurs it is usually located in the posterior portion. There are very few cases reported in the anterior portion of the costal arches. The case of a 40-year-old female patient is presented with large mass in the right hemi-thorax. Clinically it appeared a deep tumor of the breast with local invasion of the thoracic wall. The detailed radiographic evaluation revealed that the mass was a costal lesion with soft tissue invasion. Histological examination of the biopsy sample showed giant cells. The tumor was removed along with the rib. The defect was reconstructed and the patient recovered without incident. It is concluded that it is a case of GCT originating in the anterior arch of a rib with dimensions between the two largest reported in the specialized literature. It is a rare case, but the differential diagnosis of a mass of the anterior chest wall should include GCT of the ribs.

[eng] Endometrial cancer is one of the most common cancers among women especially in urban areas. The appearance of symptoms such as abnormal uterine bleeding or infertility on clinical examination increases the risk of endometrial lesion. Vaginal ultrasound and diagnostic hysteroscopy are common gynecological examinations for endometrial lesions. Endometrial cancer is often diagnosed in the early stages, in which case surgical removal of the uterus often cures endometrial cancer. However, screening and treatment programs are important in the timely diagnosis and treatment of this disease. Due to the importance of the topic, the present study was conducted to investigate the prevalence of this disease, the relationship between artificial intelligence as well as various imaging methods and the diagnosis of endometrial cancer., [spa] El cáncer de endometrio es uno de los cánceres más comunes entre las mujeres, especialmente en las zonas urbanas. La aparición de síntomas como sangrado uterino anormal o infertilidad en el examen clínico aumenta el riesgo de lesión endometrial. La ecografía vaginal y la histeroscopia diagnóstica son exámenes ginecológicos comunes para detectar lesiones endometriales. El cáncer de endometrio a menudo se diagnostica en las primeras etapas, en cuyo caso la extirpación quirúrgica del útero a menudo cura el cáncer de endometrio. Sin embargo, los programas de detección y tratamiento son importantes en el diagnóstico y tratamiento oportuno de esta enfermedad. Debido a la importancia del tema, el presente estudio se realizó para investigar la prevalencia de esta enfermedad, la relación entre la inteligencia artificial, así como diversos métodos de imagen y el diagnóstico de cáncer de endometrio.

[spa] La COVID-19 es una nueva enfermedad con una alta morbilidad y mortalidad en el mundo y gran variabilidad clínica en su comportamiento. Con el objetivo de caracterizar variables clínicas y epidemiológicas en los pacientes positivos a la COVID-19 de la provincia de Villa Clara, se realizó un estudio descriptivo de casos clínicos positivos a la prueba de Reacción en Cadena a la Polimerasa de Transcriptasa Reversa en tiempo real de la provincia de Villa Clara (317 pacientes), desde marzo a noviembre de 2020. Se utilizó el registro de pruebas de PCR del Laboratorio Provincial de Microbiología y se revisaron las encuestas epidemiológicas. Predominaron los pacientes del sexo femenino, el grupo de edad de 40 a 59 años y los residentes en el municipio de Santa Clara. La mayoría de los enfermos se encontraban asintomáticos al diagnóstico. Los síntomas de mayor frecuencia resultaron la tos y la fiebre. La Hipertensión arterial y la Diabetes Mellitus fueron las comorbilidades que más acompañaron a la enfermedad., [eng] COVID-19 is a new disease with high morbidity and mortality in the world and great clinical variability in its behavior. With the aim of characterizing clinical and epidemiological variables in patients positive for COVID-19 in the province of Villa Clara, a descriptive study of positive clinical cases to the real-time Reverse Transcriptase Polymerase Chain Reaction test was carried out. from the province of Villa Clara (317 patients), from March to November 2020. The registry of PCR tests of the Provincial Laboratory of Microbiology was used and the epidemiological surveys were reviewed. Female patients, the age group from 40 to 59 years and residents in the municipality of Santa Clara prevailed. Most of the patients were asymptomatic at diagnosis. The most frequent symptoms were cough and fever. Arterial hypertension and Diabetes Mellitus were the comorbidities that most accompanied the disease.

In peripheral tissues, triiodothyronine (T3) production and consequent thyroid hormone actions are mainly regulated by iodothyronine deiodinases (DIOs) classified into 3 types: D1, D2, and D3. We aimed to investigate the effects of peripheral DIOs on thyroid hormone economy independent of the hypothalamus-pituitary-thyroid axis. We cloned coding sequences of human DIOs with FLAG-tag and HiBiT-tag sequences into a pcDNA3.1 vector. To obtain full-length proteins, we modified these vectors by cloning the selenocysteine insertion sequence of each DIO (SECIS vectors). Western blot analyses and HiBiT lytic assay using HEK293T cells revealed that SECIS vectors expressed full-length proteins with substantial activity. Subsequently, in vivo transfections of pLIVE-based SECIS vectors into male C57BL/6J mice were performed by hydrodynamic gene delivery to generate mice overexpressing DIOs predominantly in the liver (D1, D2, and D3 mice). After 7 days from transfections, mice were analyzed to clarify phenotypes. To summarize, serum thyroid hormone levels did not change in D1 mice but D2 mice had higher serum free T3 levels. D3 mice developed hypothyroidism with higher serum reverse T3 (rT3) levels. Transfections with levothyroxine administration suggested that thyroid hormone action was upregulated in D2 mice. Our DIO-overexpressing mice provided insights on the physiological properties of upregulated DIOs: D2 augments local thyroid hormone action and recruits T3 into the circulation: D3 decreases circulating T3 and T4 levels with elevated rT3, leading to consumptive hypothyroidism. As D3 mice are expected to be a novel hypothyroidism model, they can contribute to progress in the field of thyroid hormone economy and action.

In 2017, the Primary Aldosteronism Surgical Outcome (PASO) investigators proposed consensus criteria for clinical and biochemical outcomes. However, 6 to 12 months need to pass in order to assess for the outcome in patients who have undergone surgery for the management of primary hyperaldosteronism. This study aims to evaluate the post-operative biochemical and clinical outcomes of primary aldosteronism (PA) on the basis of the laboratory findings obtained within 10 days after surgery. We retrospectively studied 59 consecutive patients with unilateral PA who underwent adrenalectomy and were assessed for plasma aldosterone concentration (PAC) and plasma renin activity both at the initial assessment (1-10 days after surgery) and the final assessment (6-12 months after surgery). When comparing the complete biochemical success group (n = 51) and the partial or absent biochemical success group (n = 8), the median post-operative PAC at the initial assessment was significantly greater in the partial or absent biochemical success group (12.7 ng/dL; interquartile range [IQR], 10.6-14.5) than that in the complete biochemical success group (6.3 ng/dL; IQR, 5.0-7.9) (p < 0.001), while no significant differences were observed in other factors. The receiver operating characteristic curves of post-operative PAC at the initial assessment, which was used to predict biochemical outcomes, indicated that 8.1 ng/dL is the optimal PAC cut-off for biochemical success (sensitivity, 76.5%; specificity, 100%). Low post-operative PAC at the initial assessment may predict the biochemical cure of PA.