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Background: Surgical management of Tuberculosis (Tb) spine has evolved from debridement and laminectomy to navigation assisted procedures; from high morbidity and mortality to excellent clinical outcomes. Objective: The objective of this narrative review was to trace the evolution of surgical procedures for the treatment of active spinal tuberculosis in adults. Methods: PubMed, MEDLINE, EMBASE, Springer, Elsevier Science Direct, Cochrane Library, and Google scholar were searched for relevant studies published up to May 2023. The keywords of ‘spinal tuberculosis’, ‘surgery and spinal tuberculosis’, ‘surgery and Pott's paraplegia’ ‘decompression and spinal tuberculosis’ ‘instrumentation and spinal tuberculosis’, ‘bone graft and spinal tuberculosis’, ‘surgical approach and spinal tuberculosis’ were used. Results: Initial search resulted in 5673 articles. 298 were listed for full text review. Six studies were meta-analyses, two systematic reviews and one a randomized control trial. One hundred five studies described anterior approach and debridement with or without instrumentation; 153 described posterior approach and instrumentation with or without debridement; 74 described combined anterior and posterior approach while 6 studies described a direct lateral approach to the lesion. One hundred seventy five studies advocated use of autologous bone graft while 27 studies used interbody cages. Fourteen studies described minimally invasive techniques. Conclusion: Spine surgery for Tb has evolved through the pre-chemotherapy, biological, mechanical and technological eras over the last 7 decades. Current strategy includes posterior instrumentation with anterior column debridement and reconstruction preferably by less invasive technologies.

Marek's disease, an economically important disease of chickens caused by virulent serotype 1 strains of the Mardivirus Marek's disease virus (MDV-1), is effectively controlled in the field by live attenuated vaccine viruses including herpesvirus of turkeys (HVT)—both conventional HVT (strain FC126) and, in recent years, recombinant HVT viruses carrying foreign genes from other avian viruses to protect against both Marek's disease and other avian viral diseases. Testing to monitor and confirm successful vaccination is important, but any such test must differentiate HVT from MDV-1 and MDV-2, as vaccination does not prevent infection with these serotypes. End-point and real-time PCR tests are widely used to detect and differentiate HVT, MDV-1 and MDV-2 but require expensive specialist laboratory equipment and trained operators. Here, we developed and validated two tube-based loop-mediated isothermal amplification tests coupled with detection by lateral flow device readout (LAMP-LFD): an HVT-specific test to detect both conventional and recombinant HVT strains, and a second test using novel LAMP primers to specifically detect the Vaxxitek® recombinant HVT. Specificity was confirmed using DNA extracted from virus-infected cultured cells, and limit of detection was determined using plasmid DNA carrying either the HVT or Vaxxitek® genome. The LAMP-LFD tests accurately detected all HVT vaccines, or Vaxxitek® only, in crude DNA as well as purified DNA extracted from field samples of organs, feathers, or poultry house dust that were confirmed positive for HVT by real-time PCR. These LAMP-LFD tests have potential for specific, rapid, simple, and inexpensive detection of HVT vaccines in the field.

Abstract Cloud repository is one of the most important services afforded by Cloud Computing where information is preserved, maintained, archived in distant servers and made available to the users over the Internet. Provided with the cloud repository facilities, customers can organize themselves as a cluster and distribute information with one another. In order to allow public integrity auditing on the information stored in semi-trusted cloud server, customers compute the signatures for every chunk of the shared information. When a malicious client is repudiated from the group, the chunks that were outsourced to the cloud server by this renounced customer need to be verified and re-signed by the customer present in the cluster (i.e., the straightforward approach) which results in huge transmission and reckoning cost for the customer. In order to minimize the burden of customers present in the cluster, in the existing scheme Panda, the semi-trusted Cloud Service Provider (CSP) is allowed to compute the R e−s i g n key. Further, the CSP audits and re-signs the revoked customer chunks by utilizing the R e−s i g n key. So, it is easy for the CSP by colluding with the revoked customer to find the secret keys of the existing customer. We introduce a novel Collusion Resistant User Revocable Public Auditing of Shared Data in Cloud (CRUPA) by making use of the concept of regression technique. In order to secure the secret keys of the existing customers from the CSP, we have allowed the information proprietor to compute the R e−s i g n key using the regression technique. Whenever the information proprietor revokes the customer from the cluster, the information proprietor computes the R e−s i g n key using the regression technique and sends to the CSP. Further, the CSP audits and re-signs the revoked customer chunks using the R e−s i g n key. The R e−s i g n key computed by the information proprietor using regression method is highly secure and the malicious CSP cannot find the private information of the customers in the cluster. Besides, our mechanism achieves significant improvement in the computation cost of the R e−s i g n key by information proprietor. Further, the proposed scheme is collusion resistant, supports effective and secure customer repudiation, multi-information proprietor batch auditing and is scalable.

To describe the biomechanically relevant anatomy of the Axis vertebra and the load transfer patterns within the bone, and on that basis, to postulate its mechanism of injury, a literature review was conducted of the anatomy and biomechanics of Axis fractures. Two hypotheses have been presented: the internal gear hypothesis and the leaf spring hypothesis. Both are based on the trabecular anatomy of the vertebra and its load transmission patterns. The relationship of the Axis with Hangman’s injury is also discussed. According to the leaf spring hypothesis, the C2 pedicle corresponds to the shackle in the assembly and constitutes the weak link. The trabecular architecture of the Axis is such that the primary compression of the trabeculae is directed from the superior facet to the C2–3 endplate, with few trabeculae directed to the inferior facet. Along with the trabecular void in this area, this renders the isthmus vulnerable to trauma. The isthmus of the Axis is biomechanically susceptible to injury due to its unique anatomy in relation to the whole cervical spine and the internal load transmission patterns of the bone. The author suggests that in the flexion type of Hangman’s injury, the C1–2 posterior ligaments are disrupted and need to be addressed.

Objectives: This study aimed to evaluate the effects of early versus late tracheostomies among patients with cervical spinal cord injuries (CSCIs). Methods: This retrospective study included 69 adult CSCI patients who underwent bedside percutaneous tracheostomies at the Intensive Care Unit of Khoula Hospital, Muscat, Oman, between January 2011 and October 2015. The tracheostomy was considered early if the procedure took place within one week of the CSCI. The impact of an early tracheostomy on patient outcomes was analysed in terms of duration of mechanical ventilation and intensive care unit (ICU) stay among patients with high (C1–C2 vertebrae) and low (C3–C7 vertebrae) CSCIs. Ventilator dependence, bradycardia episodes and surgical intervention outcomes were also examined. Results: Patients with a high CSCI who underwent an early tracheostomy spent significantly fewer days on mechanical ventilation compared to those who underwent a late tracheostomy (9.3 ± 7.2 days versus 13.7 ± 3.2 days; P = 0.041). Low CSCI patients who received an early tracheostomy also experienced significantly fewer days on mechanical ventilation compared to those undergoing a late tracheostomy (12.1 ± 10.4 days versus 25.2 ± 17.7 days; P = 0.035). Moreover, ICU mortality was significantly lower for high CSCI patients who underwent an early tracheostomy (P = 0.015). However, there was no association between length of ICU stay and either type of CSCI or timing of the tracheostomy procedure. Conclusion: An early tracheostomy is beneficial in reducing the duration of mechanical ventilation among patients with CSCIs, irrespective of the level of injury.

This study reports a rare case of both column acetabulum fracture with femoral artery injury that presented late and was managed with arterial reconstruction and fracture fixation.A thirty-one year old man sustained both column acetabular fracture on the left in a motor vehicle accident. On admission there was no obvious neuro-vascular deficit. During surgery for the fracture after 7 days of the injury the femoral artery was found to be severely crushed with no blood flow. The anterior column of the acetabulum was stabilised followed by resection and reconstruction of the femoral artery. The post-operative period was uneventful and he was discharged normally. At 6 months from injury the fractures had united well with excellent limb circulation and good lower limb function.Femoral artery injury with acetabular fracture is rare and late presentations are unreported hitherto. The results of fracture stabilisation and vessel reconstruction seem to be excellent. Literature of similar injuries is reviewed. Keywords: Acetabular fractures, Both column fractures, Anterior column fractures, Vascular injury, Femoral artery injury

Learning analytics (LA) is considered a promising field of study as it's helping to improve learning and the context in which it occurs. A learner's performance can be defined as how well students are learning in terms of knowledge and skills development and can be analyzed based on students' outcomes and engagement in the course. We have consolidated the work carried out from 2011 to 2022 to improve learners' performance using LA, describe criteria that define learners' performance, discuss parameters that impact learners' performance, and how predictive models can be created to forecast learners' performance using these parameters. Results showed that the data collected from log files of the Learning Management System (LMS) had been used to get insights into the learner's performance in online platforms and LA could bring incredible benefits in the field of the education sector, such as improvement of learners' involvement with learning activities as well as learning outcomes, identification of students at risk, providing real-time feedback, and personalization of learning. Hence, we can say usage of LA significantly helps learners' performance improvement in learning portals. But we can get better results if we augment data from log files of LMS with the learner's personal data from his birth to the current moment, which is a bit challenging with respect to data collection i.e., huge and from multiple sources.

BackgroundThe impact of the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for diagnosis and management of hypertension on the prevalence of hypertension in India is unknown.MethodsWe analyzed data from the Cardiac Prevent 2015 survey to estimate the change in the prevalence of hypertension. The JNC8 guidelines defined hypertension as a systolic blood pressure of ≥140 ​mmHg or diastolic blood pressure of ≥90 ​mmHg. The 2017 ACC/AHA guidelines define hypertension as a systolic blood pressure of ≥130 ​mmHg or diastolic blood pressure of ≥80 ​mmHg. We standardized the prevalence as per the 2011 census population of India. We also calculated the prevalence as per the World Health Organization (WHO) World Standard Population (2000-2025).ResultsAmong 180,335 participants (33.2% women), the mean age was 40.6 ​± ​14.9 years (41.1 ​± ​15.0 and 39.7 ​± ​14.7 years in men and women, respectively). Among them, 8,898 (4.9%), 99,791 (55.3%), 35,694 (11.9%), 23,084 (12.8%), 9,989 (5.5%) and 2,878 (1.6%) participants belonged to age group 18-19, 20-44, 45-54, 55-64, 65-74 and ​≥ ​75 years respectively. The prevalence of hypertension according to the JNC8 and 2017 ACC/AHA guidelines was 29.7% and 63.8%, respectively- an increase of 115%. With the 2011 census population of India, this suggests that currently, 486 million Indian adults have hypertension according to the 2017 ACC/AHA guidelines, an addition of 260 million as compared to the JNC8 guidelines.ConclusionAccording to the 2017 ACC/AHA guidelines, 3 in every 5 Indian adults have hypertension.