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Review of the published articles does not show any study done to see if children with torus fracture are with Vitamin D deficiency. The aim of this study was to determine association of inadequacy of Vitamin D level with torus fracture and its predictors in children in Karachi Pakistan.Patient underage of 13 years came with torus fracture were included in study, and managed non-operatively with below elbow cast. Proforma was made which includes demographic data (age, gender, nutritional status) and exposure to sunlight, dietary habits, kind to apparel and type of accommodation they were living at. All participants underwent measurement of serum vitamin D level.Out of 558 children presented with limb fractures in emergency department, 190 (34.05%) had torus fracture, with mean age of 6.0 ± 4.2 years. 93 (48.94%) in pre-school group, 59 (31.05%) in school and 38 (20%) were breast-fed. On nutritional status, malnourished were 72 (37.89%), out of which 32 (44.44%) had first-degree malnutrition. On vitamin D level status only 52 (27.36%) participants had Vitamin D within normal range while 86 (45.26%) were found Vitamin D deficient. We found that vitamin D level is directly related to nutritional status, duration of sun exposure maternal vitamin d levels and not significantly related to age, gender, type of accommodation and different fabric types.In this study torus fracture in children is significantly associated with Vitamin D deficiency, with common predictors including nutritional status, maternal Vitamin D level for lactating mothers and duration of exposure of sunlight. Vitamin D supplementation in children can prevent a significant number of fractures via national programs for food fortification and increase the awareness of general population on the importance of sunlight exposure and intake of food rich in Vitamin D.

BACKGROUND This study aims to evaluate the awareness of osteoporosis and related risk factors in elderly Asian patients who present with distal radius fractures. The distal radius fracture is one of the most frequent fractures in the elderly cohort, owing to osteoporosis, and maybe a harbinger for further fractures, however, data is scarce regarding awareness of this condition among these patients. METHOD This cross-sectional study was conducted on patients aged 45 and above that presented in the emergency department with low-energy distal radial fractures in Karachi from January-December 2018. Data were collected via a self-designed questionnaire, assessing the demographic information, knowledge about osteoporosis and its risk factors. The data was analysed using SPSS 20 for statistical significance. RESULTS From a total of 550 patients with a mean age of 70.5 ± 32.82 years, there were 442 (80.36%) females and 108 (19.63%) males. On educational consideration, 243 (44.18%) patients could not read or write and only 110 (20%) of the patients received secondary school education. Only 123 (22.36%) were well informed about osteoporosis, the predominant source of information being their physician. There were 427 (77.63%) patients who were unaware of osteoporosis, 16% of which were smokers, 26% indicated they exercised at least 30 minutes daily, and 2% reported drinking alcohol occasionally. On dietary supplements, 24.27% of patients reported calcium and 17.81% reported vitamin D supplement consumption on regular basis. CONCLUSION We found a positive correlation between a patient's education status and osteoporosis awareness We believe that the role of the physician could be crucial in preventing further fractures in such patients via physician lead educational campaigns to target modifiable risk factors.

High-speed data communication is becoming essential for many applications, including satellite communication. The security algorithms associated with the communication of information are also required to have high-speed for coping up with the communication speed. Moreover, the Authenticated Encryption (AE) algorithms provide high-speed communication and security services include data encryption, authentication, and integrity. The AE algorithms are available with serial and parallel architectures; among them, the Galois Counter Mode (GCM) algorithm has a parallel architecture. The Synthetic Initialization Vector (SIV) mode in the AES-GCM-SIV algorithm provides the nonce misuse protection using the GCM algorithm. Besides, reduced data throughput is provided using the AES-GCM-SIV algorithm as compared to the AES-GCM algorithm. This work introduced a parallel algorithm with re-keying and randomization of the initialization vector for high data throughput, nonce misuse protection, and side-channel attack protection. The implementation of the proposed algorithm is performed on Field Programmable Gate Array (FPGA) and it’s compared with the FPGA implementations of AES-GCM, AES-GCM-SIV, and recently introduced algorithms. The optimization of the proposed algorithm and security analysis is presented for space application using different optimizations and a combination of optimizations.

The digital design methodologies are evolving with the increase of digital systems utilization in daily life. The Model Based Design (MBD) methodology provides a unique methodology for design and implementation of digital systems on Field Programmable Gate Array (FPGA). Recently, a lot of research effort has been put to exploit new methodologies for designing and prototyping of digital systems on FPGA. The FPGA hardware provides prototyping which provides means of verifying your design at an early stage of development cycle. This helps to evaluate design trade-offs by testing the design in real-time on hardware. Making prototypes is a common practice in research-oriented projects. However, it requires excess development time which increases time to market of the product. This paper illustrates the use of reconfigurable MBD for rapid prototyping of digital systems on Microsemi ACTEL FPGAs for improving the design-cycle and time-to-market of a product. The model is simulated to verify the functionality of the design at system-level and a high-level code is generated from the MBD toolset embedded in MATLAB for hardware implementation. Then, a High-Level Synthesis (HLS) is performed on the generated code which converts this high-level code into Verilog-HDL suitable for hardware implementation on FPGA. Hence, this work presents a methodology and its analysis for design of digital system using high-level synthesis on Microsemi ACTEL FPGA.

Over the past 60 years, satellite technology has demonstrated its usefulness successfully. However, this usefulness is at stake from a future point of view, due to the well-admitted orbital/space debris threat. This article thoroughly reviews all aspects of space debris issue including causes, amount and sizes of orbital debris, potential threats, counter-strategies with their latest status and related legal issues to highlight the criticality and urgency of the problem. This review elaborates the fact that despite all the worries and threats, the efforts to confront this challenge are considerably insufficient until today. This bitter reality demands for at-least curtailing the number of future launches to ensure the long-term sustainability of space, until the improvement in debris situation. However, contradictory to this necessity, large satellite constellations have been proposed that can drastically increase the existing orbital population in coming years. This approach will certainly not help in improving the space environment in the future; instead, it can worsen the space environment situation as recent studies shows. Also, space resources (i.e. orbital slots and frequencies) are limited to accommodate many more satellite projects from commercial and government organization in the future. So, there is a serious question of how the space industry can move forward to maintain a balance in controlling the future number of the satellite while accommodating many commercial or government space entities. This article also identifies two optimized approaches as a way forward for future satellite projects that can also enhance the effectiveness of space technology in the future.

Advances in high-speed means of transportation have provided a convenient and fast way of traveling. Besides, the high-speed transportation has impact on the number of accidents reported every year. The monitoring of accidents is significant for improving the rules and regulations for transportation to avoid future accidents. The accident monitoring is performed using different networks on the ground, in the air, in the water, and in the space. Furthermore, the Space Air Ground Integrated Network (SAGIN) provides enlargement of coverage for applications like accident monitoring. In this paper, a framework is proposed for monitoring of accidents using SAGIN along with communication protocol. In this work, a simulation for verification of the framework and visualization of the deployment is performed. The improvement of services offered by proposed framework is discussed for comprehending the benefits.

Recently, the security of public key security algorithms have been research extensively; besides, the utilization of public key cryptography requires key exchange protocol. The security of key exchange protocol is significant as it transmits the key and therefore, the security of public key algorithms depend on the security of key exchange protocol. In addition, the concept of Perfect Forward Secrecy (PFS) is evolving with the number of security threats. Traditionally, the key exchange protocols use asymmetric and symmetric to exchange session keys, which consumes more hardware resources and time for implementation. Moreover, these encryption based key exchange protocols requires several messages to exchange before sending the key, which cause delay in key exchange and consume bendwidth ineffciently. This work provides a new key exchange protocol with randomized initialization vector and advanced features for PFS. The proposed algorithm is simple and faster as compared to previous algorithms, the security of proposed algorithm is comparable to One Time Pad (OTP) algorithm.

Background:Vitamin D deficiency is associated with an increased risk of falls and hip fractures in older adults. Risk factors are suboptimal sunlight exposure and the lower cutaneous synthesis of vitamin D, reduced dietary intake of D2 (ergocalciferol) and D3 (cholecalciferol), impaired intestinal absorption, and impaired hydroxylation in the liver and kidneys. The present study's objective was to determine the frequency of vitamin D levels in females with hip fractures presenting to a tertiary care facility in Karachi, Pakistan. Methodology:A cross-sectional study was conducted at the Orthopaedic Surgery Department of Jinnah Postgraduate Medical Center, Karachi, from 17thMay to 16thNovember 2016. A total of 123 females with Hip fracture of ≤ 4 weeks were included in this study. Patient's age, occupation, education level, and comorbidities like diabetes mellitus (DM), hypertension (HTN), and Vitamin D levels were observed. The patient was labeled with vitamin D sufficiency, insufficiency, and deficiency on the basis of Vitamin D levels. Stratification was done, and the post-stratification Chi-square test was applied. Results:The mean age of study participant was 60.32 ± 9.14 years and the mean duration of fracture was 12.27 ± 5.84 days, Body Mass Index (BMI) was 24.57 ± 2.77 kg/m2, vitamin D level was 18.28 ± 8.10 ng/ml. Only 8.9% were found with sufficient vitamin D levels. Insufficiency was found in 28.5% of patients. Vitamin D deficiency was found in 62.6% of patients. Conclusion:Vitamin D deficiency is common in elderly female patients with hip fractures and is associated with age and DM. This initial work warrants further larger-scale studies of vitamin D variations. Link:http://aeirc-edu.com/ojs14/index.php/IJEHSR/article/view/462/620

The rapid development in the industrial sector has caused severe damage to the environment, which resulted in the occurrence of catastrophic disasters of high magnitude on earth. Moreover, the efforts for providing better early warnings and rescue operations during and after the disasters largely depend on communication protocol utilized for disaster management. Therefore, researchers are working to devise an efficient communication protocol for detection and communication of disasters. The communication protocol must comprise a methodology to transmit images of the disaster site effectively and facilitates communication between disaster site and disaster management centers. Presently, the disaster management is performed using terrestrial networks (using the Internet and mobile networks), space-ground networks (using satellites in different orbits), and air-ground networks (using Un-manned Aerial Vehicle and airships). Besides, the utilization of all devices in space, air, and ground can help to enhance the services for disaster management. In this work, Space-Air-Ground Integrated Network (SAGIN) is proposed to be used for disaster management. Moreover, a framework is proposed for the realization of the enhanced services using Internet Protocol (IP) for the detection and communication of disasters. Also, a comparison with the presently deployed networks is provided for comparison of services provided for disaster management.

The increase in the flow of information and high-speed communication has compelled researchers to use satellite networks for different applications. The satellite networks comprise different satellites in different orbits that require the data security algorithms for the providing security and privacy of consumers' information. The data security primarily consists of data confidentiality service, which is provided by data encryption algorithms. The data encryption algorithm for example AES algorithm is utilized in many applications, including the satellites. The challenges for AES algorithm utilization in satellite applications are high-speed computation, lightweight implementation, and catering the radiations in the space environment. In this work, optimizations are proposed for coping with the challenges in a data encryption algorithm for the space environment. Also, the high-throughput optimization for the AES algorithm is realized on FPGA, and it equated with previous work. Moreover, the recent security attacks, for instance the nonce misuse attack is challenging for the security of encryption algorithms. The high-throughput optimized encryption algorithm protects against the recent attacks by the modifications in the AES algorithm. Moreover, the security analysis is provided against the latest attacks for the validation of high-throughput optimizations.

Power semiconductor switches such as MOSFET are widely used in electric vehicles, electric trains, and power conversion systems. The prognostics and health monitoring (PHM) and reliability of the MOSFETS are critical in power electronic systems. The ON-state resistance of the MOSFETS is the primary and significant precursor of failure. In this paper, we present a data-driven approach to predict the change in ON-state resistance using Long-Short Term Memory (LSTM) Recurrent Neural Network (RNN). The experimental data are obtained by power cycling the MOSFET in thermal stress. The LSTM network's hyperparameters are optimized using Bayesian Optimization, which improves results and reduces time to develop the model. Our proposed Bayesian Optimized LSTM RNN (BO-LSTM RNN) gives good prediction accuracy using less number of layers. The model's performance is also analyzed using a small percentage of data used to train the LSTM RNN. The proposed model is also tested on different MOSFETS degradation data to prove the universality of the model using the same hyperparameters.

The satellite networks are used for technological enhancement in many fields including mobile communication (i.e. 5G technology). Similarly, the aviation industry is in process of adopting the satellite network for effective and efficient air traffic control for enhancing the safety of passengers and aircrafts. Recently, the space-based Automatic Dependent Surveillance-Broadcast (ADS-B) system is introduced for aviation industry as an advancement of existing radar-based surveillance. Moreover, this system has its limitations such as inefficient satellite network utilization, global adaptability, and many more; which advocates its ineffectiveness as an efficient surveillance system. The challenges faced by the aviation industry can be resolved by using heterogeneous networks such as the Space-Air-Ground Integrated Network (SAGIN). Therefore, in this work, challenges faced by aviation industry and lagging in current and under-development systems are discussed, besides, a framework based on SAGIN is proposed for air traffic control. Moreover, the Satellite Communication Protocol Specifications (SCPS) is proposed for air traffic control communication and the proposed framework is simulated.

The need to explore outer and deep space and make it more beneficial for mankind is emphasized in the space industry. But such exploration missions demand intensive attitude control even under a harsh and challenging environment. Due to these external interruptions, the actuators installed at the spacecraft may suffer degradation in its performance with time and may cause partial or complete mission failure. This paper presents a fixed-time robust, yet simple, passive fault-tolerant control for a class of rigid spacecraft with partial loss of actuator effectiveness, external disturbance, and inertial uncertainties. A quaternion presents the spacecraft's attitude dynamics. The error trajectories of angular velocity and attitude are made to converge rapidly to a smaller region around the equilibrium in a fixed time. The trajectories then asymptotically converge to equilibrium. Simulation results endorse the effectiveness of the presented robust fixed-time passive fault-tolerant controller.

This paper compares the performance of a robust model predictive control (MPC) with a nominal MPC. The robust scheme is applied to a nonlinear system with input constraints, bounded unknown additive disturbances, and uncertainties on the system states. The design of the robust controller relies on the linearized version of the nonlinear model along its trajectory. It comprises two components, one of which is obtained by a continuous-time MPC approach with tightened constraints for stabilizing the nominal system. The other one is chosen as standard LQR gain, ensuring that the error system trajectories lie in a particular invariant set. The controller is implemented in a digital environment and utilizes a continuous-time model and equations, vastly reducing the computational burden. Furthermore, with some plausible assumptions, the closed-loop system is demonstrated to have regional exponential stability around the origin. Simulation results verify the improvement in disturbance rejection property of the employed controller over nominal MPC.

Introduction Many young females present with an advanced stage of breast cancer, which has a negative effect on the prognosis. Digital breast tomosynthesis is a new emerging imaging technique that aids in improving the specificity of mammography with subsequent early detection of breast cancer, especially in women with radiographically dense breasts. Tomosynthesis is subjectively preferred to conventional mammography and may offer superior diagnostic accuracy for the evaluation of breast lesions. Method Two breast radiologists retrospectively reviewed asymmetric densities using protocols that were institutional review board-approved in 185 patients aged 18 - 70 years (mean: 48 years) who underwent diagnostic mammography and tomosynthesis. Each asymmetric density was interpreted once with tomosynthesis and once with supplemental mammographic views; both modes included the mediolateral oblique and craniocaudal views in a fully crossed and balanced design by using a five-category Breast Imaging Reporting and Data System (BI-RADS) assessment and a probability-of-malignancy score. If the abnormality persisted and appeared benign or completely disappeared on both modalities, the agreement between additional views and tomosynthesis was determined by calculating Kappa value. If there was a discrepancy between additional views and tomosynthesis, the abnormality was subjected to ultrasound. In our study, 89 asymmetric densities were subjected to ultrasound. Results In a total of 182 cases, 84 (46.15%) were categorized as BIRADS-0; 97 (53.30 %) as BIRADS-I, and one (0.55 %) as BIRADS-II on an additional view. Among the asymmetric densities categorized as BIRADS-0 on additional mammography views, digital breast tomosynthesis categorized 72, six, five, and one patient as BIRADS-0, BIRADS-I, BIRADS-II, and BIRADS-IV, respectively. For densities categorized as BIRADS-I (97) on additional view, digital breast tomosynthesis categorized 10 and 87 densities as BIRADS-0 and BIRADS-I, respectively. No change in the BIRADS category was observed among BIRADS-II and BIRADS-IV. A significant difference was observed with the chi-square test among BIRADS categories assigned by an additional view and digital breast tomosynthesis with a p-value of < 0.001. There was, however, a substantial agreement among additional views and tomosynthesis with a kappa value of 0.767. Conclusion Our study results suggest that tomosynthesis may be equivalent to, if not more equivalent to, additional imaging in the assessment of mammographically-detected asymmetric densities, thus improving BI-RADS classification and patient management.

BACKGROUND In the light working under the constant threat of getting infected while treating orthopedic related patients, and trying to minimize their exposure as much as possible to avoid the contagion, has stressed out even the more seasoned orthopedicians. So we decided to initiate an anonymous online survey, and our target was to solely involve the orthopedic surgeons of our country to figure out how much this ongoing pandemic has affected their mental well-being, how prepared they feel they are to face this threat and what, according to them in the end-game solution to this pandemic. OBJECTIVE The objective of our study is to assess the impact of COVID-19 pandemic on clinical practice as well as psychological impact on orthopedic surgeons of Pakistan. METHODS An online survey involving orthopedic surgeons working in different regions of Pakistan through social media platforms like whatsapp and facebook and also through email, to assess the impact of COVID-19 pandemic. The questionnaire comprises of multiple options all carefully chosen with a definitive aim to understand the impact of COVID-19 on their day to day practice and how well equipped they feel they are , in terms of knowledge as well as personal protective equipment . Our survey also aims to evaluate their state of mind and physical as well as emotional wellbeing in the wake of COVID-19 pandemic. RESULTS Among 77 respondents, mean age of participants was 47 ± 12 years, mostly 31 (40.3%) were consultant and mostly 28(36.4%) having experience in field of orthopedics was between 5-10 years.This data revealed 48(62.3%) respondent did not received any specific training or recommendations about COVID pandemic from their institute and principle source of knowledge among them was social media 46 (59.7%) and only 37(48.1%) reported they are well informed on latest COVID guidelines. During pandemic 73(94.8%) did not operate any covid patient and among them 31(40.3%) not declared willingness to do elective orthopedic surgery on covid positive patient. Interestingly, this data revealed the willingness of orthopedic surgeons 30(39%) to take care of COVID-19 positive patients and support their colleagues in intensive care units, if needed. Concerning their orthopedic practice, mostly 35(45.5%) stopped planned surgeries and 20(26%) reported decrease in emergency surgeries during pandemic, this might be due to decrease in road traffic accident notified by study participant 24(31.2%). For consultation 56(72.7%) respondent used telemedicine and video conference during pandemic. During pandemic respondent revealed that in suspicious of covid infection mostly 34(44.2%) agreed on go through covid test and isolation while 28(36.4%) agreed to stay at home and observe and 65(84.4%) agreed on complete isolation on positive testing. 67(87%) feel anxious, stressed, furious, angry or depressed due to pandemic and most common fear among them was to infect their family members followed by getting infected and loss of their life and health. As the age decreased, the percentage of orthopaedic surgeons feeling stressed out increased and only 4(5.8%) estimate their protection as well protected. 40(51.9%) did not think their institute is well equipped to deal COVID pandemic and 31(40.3%) did not agreed to strategy of their institute to face COVID pandemic. Mostly agreed on specific vaccine 25(32.5%) quarantine 26(33.8%) would be best solution to preventive method to handle pandemic. CONCLUSIONS COVID-19 pandemic has pitted our orthopedic community against challenges rarely encountered in the field of health care professionals. They nevertheless have to play an important role in the face of an increasing psycological and emotional stress which comes from working in a post COVID era . The dread of getting infected while treating and operating on patients and the sinking feeling of spreading the contagion to their loved ones has put a massive toll on the emotional well being of our orthopedic community and needs to be addressed through open and fair discussion . So during these trying times, we need to rise to the occasion and work as a close knitted team to overcome every obstacle encountered in the face of COVID-19 pandemic.

Background: In traumatic patients there is increase loss of blood and requires excessive blood transfusion as compared to other diseases. Clinical efficacy and clinical safety of tranexamic acid in decreasing blood loss assess during this study in post traumatic patients. Method: Prospectively conducted randomized doubleblind placebo controlled study carried out. Patients were blindly randomized into two groups to receive either intravenous 1gm tranexamic acid 20 min or similar volume of 0.9% saline as placebo (P). Inclusion criteria was based on pulse rate >110 per min or systolic pressure level