A Comparative Analysis Of Conventional Software Development Approaches Vs. Formal Methods In Call Distribution Systems

When we think about formal method; the first thing which comes in our mind is mathematical approach. The process of formalization is an approach based on mathematics and used to elaborate the properties of systems (hardware and software). The mathematical modeling or formal methods provide us a framework for large and complex systems. Thus these systems can be specified, analyzed, designed, and verified in a systematic way rather than the approaches which are used conventionally. Formal verification and the methods are applied using theoretical computer science fundamentals to solve the complex and difficult problems in large and complex software and hardware systems to ensure the systems will not fail with run-time errors. Conventional approaches of software verification in call distribution systems rely on quality assurance to verify the system behavior and robustness. The process of software testing cannot show the absence of errors it can only show the presence of errors in software systems. [1] In contrast, the mathematically-based techniques of verification are based on formal methods to prove certain software attributes, for example proving that software does or does not contain the occurrence of errors at run-time such as overflows, divide-by-zero, and access violation, invalid memory access and stack/heap corruption. [1] In this paper later we will have comparative analysis of formal methods vs. conventional software development approaches in call distribution systems. Using this comparison we‘ll try to identify the methodologies and approaches which would be better in SDLC for call distribution systems.

Factors affecting wool quality and quantity in sheep

There are varieties of factors which can affect wool (macro and micro elements of wool) in sheep directly or indirectly. Genetic and environmental factors are major factors influencing wool quality and quantity. There are some bacterial, viral, fungal and espically parasitic diseases which also affect the wool. Other factors are exogenous chemicals, hormones, weather and photo period. In the present study, existing knowledge on the factors affecting wool were reviewed but there are gaps to conduct research on fundamental aspects of wool growth, which could have relevance to other areas of biology.Keywords: Wool quality, staple length, ultra high-sulphur proteins, fleec

Association Of Electroencephalogram Patterns With Ammonia Levels In Hepatic Encephalopathy Patients

Objective: To find out the association between electroencephalogram (EEG) and hepatic encephalopathy. Methodology: This cross-sectional study included 100 patients (with the age of52.5±6.09years for males and 51.7 ± 6.10 years for females) of reported hepatic encephalopathy, visiting the medical department (indoor and OPD) at Federal Government Polyclinic Hospital, Islamabad. The study was conducted from January 2020 to May 2021. Patients who had known epileptic and structural brain lesions or strokes were excluded from the study. Statistical analysis was done using GraphPad Prism software. The significance of data (p-value or R2 value) was calculated through a two-tailed test or correlation coefficient. Results: All the patients in hepatic encephalopathy grade IV reported abnormal EEG representing triphasic waves and flattening of EEG pattern. There was no correlation observed between age, gender and hepatic encephalopathy grades. However, a significant correlation (R2= 0.9032) was observed between serum ammonia levels and hepatic encephalopathy grades. Elevated serum ammonia levels depicted the severity of hepatic encephalopathy. Overall, the percentage of patients with abnormal EEG increased with increasing grade of hepatic encephalopathy. It was quite intriguing to note that EEG, being the common method to diagnose hepatic encephalopathy grades, is not dependent on patients’ socio-economic status. Conclusion: Data concluded that serum ammonia levels are well associated with the progression of hepatic encephalopathy. Moreover, the EEG patter provides the appropriate information about the neurological abnormalities associated with the severity of hepatic encephalopathy. Hence, serum ammonia levels and EEG both should accurately be used as indicators for diagnosis and monitoring the response to the treatment of various grades of hepatic encephalopathy. Data warrant further investigations to get a better insight into hepatic encephalopathy's relationship with EEG patterns through the inclusion of molecular parameters

Enhancing the catalytic activity of eggshell-derived CaO catalyst and its application in biodiesel production from waste chicken fat.

The comparatively greater cost of producing biodiesel in comparison to petroleum diesel is one of the key drawbacks. Eggshells and leftover chicken fat are examples of poultry wastes that can be used to produce biodiesel at a low cost as catalysts and oil, respectively. In this study, eggshell-derived CaO and its doping with sodium methoxide catalyst for enhancing catalytic activity was synthesized for the transesterification of waste chicken fat and characterized by FT-IR and XRD analyses. XRD studies confirmed the crystalline structure of the developed catalyst and doping of sodium with eggshell-derived CaO. The transesterification reaction was performed at different reaction parameters such as the catalyst loading, the methanol to oil ratio, the reaction temperature, and the reaction time. The biodiesel produced at the maximum yield was evaluated by gas chromatography mass spectrometry analysis. A maximum yield of 96% biodiesel was obtained with catalyst loading of 2 wt% of oil, as well as a methanol to oil ratio of 13:1 at 60 °C in 1 h. The output demonstrates that eggshell waste is a potentially accessible source of biomass-derived nano catalyst for the synthesis of biodiesel using chicken fat as a feedstock

Incidental Detection of Thyroid Nodule on Carotid Color Doppler Ultrasound in Patients Presenting with Cerebrovascular Diseases

Background: Thyroid nodules are often detected in clinical practice, during physical examination, or accidentally during different imaging techniques. Most of these nodules are characterized as benign, and thyroid cancer is identified in only a small subclass. Ultrasonography is considered an important tool in thyroid nodule evaluation. Therefore, the study aimed to determine the frequency of incidental detection of a nodule of thyroid on carotid color Doppler ultrasound in patients presenting with cerebrovascular diseases. Methods: A cross-sectional descriptive study was carried out in the PNS Shifa hospital, Radiology department, from August 2017 to May 2018. Patients (n=110) underwent Color Doppler Ultrasound examinations with a scanner (Xario), furnished with a linear transducer operational at 10 MHz by the researcher. Incidental detection of thyroid nodule was labeled. Demographic detail including name, age, gender, and BMI was noted. Echogenicity and size of the thyroid gland was compared to that of encompassing glandular parenchyma. The data collected were analyzed and interpreted using SPSS version 20. Results: The patient’s mean age was 59.92 ± 11.03 years with the ratio being 1.2:1 between males and females respectively. Diabetes and hypertension were existent in 43(39.1%) and 54(49.1%) patients respectively. Family history of thyroid nodules was present in 31(28.2%) patients. Thyroid nodule was detected in 34(30.91%) patients. The Benign pattern of thyroid nodules on grayscale. However, the histologic pattern of a mildly differentiated follicular thyroid carcinoma was detected. Conclusion: The frequency of incidental detection of thyroid nodule on carotid color Doppler ultrasound was 30.91% in patients presenting with cerebrovascular diseases. Keywords: Carotid Color Doppler Ultrasound; Incidental Detection; Cerebrovascular; Thyroid Nodule

Diagnostic Accuracy of Mammography Versus Ultrasound in Prediction of Malignancy with Palpable Breast Lesion

Background: Breast malignancy is globally the most prevalent type of cancer. Early and appropriate screening is important for proper treatment. Ultrasonography (USG) is extensively useful as an adjunct to mammography in clinical practice. This study aimed to compare the diagnostic accurateness of mammography versus ultrasound imaging in predicting breast malignancies in women with palpable lesions using histopathology as the gold standard. Methods: The bilateral mammography was performed on 100 patients of age 35-80 years in the Radiology department, PNS Shifa hospital, Karachi. Bilateral whole-breast USG was also performed and findings were recorded. Then histopathology was done by taking samples (localized solid swelling fixed to breast tissue and skin feeling different from normal breast parenchyma, present more than 1 month) through TruCut 18 G needle and compared with mammography and ultrasound. The data was analyzed by SPSS and a screening test was applied to check the sensitivity and specificity. Results: The mean age of the patients (n=100) was 58.91±13.46 years. The USG diagnosed malignant breast lesions in 46% and benign breast lesions in 54% of patients. Whereas, by mammography, malignancy was diagnosed in 47% and benign in 53% of patients. The USG tool showed 69.64% sensitivity, 84.09% specificity, 84.78% negative predictive value (NPV), 68.52% positive predictive value (PPV) and 76% diagnostic accuracy, respectively. However, mammography had 60.71% sensitivity, 70.45% specificity, 72.34% NPV, 58.49% PPV and 65% accuracy, while considering histopathology as the gold standard. Conclusion: The ultrasonography (USG) was found more sensitive than mammography in the prediction of breast malignancy presenting with palpable breast lesions. Keywords: Mammography; Ultrasonography; Accuracy; Histopathology; Breast Cancer

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

The Use of PCSWMM for Assessing the Impacts of Land Use Changes on Hydrological Responses and Performance of WSUD in Managing the Impacts at Myponga Catchment, South Australia

Personal Computer Stormwater Management Model (PCSWMM) was applied to investigate: (1) hydrological responses in the Myponga catchment as a result of land use changes; and (2) the possibility of adopting Water Sensitive Urban Design (WSUD) technologies (bio-retention cells) to manage resulting floods. Calibrated and validated models predicted the measured data with satisfactory accuracy and reliability. Different urbanization scenarios were tested. When the level of urbanization increased from 10% to 70%, mean discharge increased from 45% to 322%. Frequency of flood at 2-year Average Recurrence Interval (ARI) increased from 1 to 44 and frequency of floods at 100-year ARI increased from none to 8. At 70% urbanisation, trialled bio-retention facilities used as WSUD measures almost completely ameliorated 2-year ARI floods by reducing the frequency of such events from 44 to 2. Floods at smaller ARIs (2, 5, 10 and 20 years) were effectively managed by WSUD measures while floods at 50- and 100-year ARIs remained unchanged. The overall results improve understanding of the severity of the impacts of land use changes on the hydrology of a catchment and the ability of bio-retention cells to alleviate the risk of small to medium floods in the Myponga catchment