Pre-Operative Workup of Cochlear Implant

Hearing loss, an increasing problem across the globe, results in an important solution in the form of cochlear implants, highlighting the critical need for effective interventions. This review involves analyzing 46 relevant publications via databases such as PubMed and Google Scholar, providing current insights into pre-operative issues. Studies through databases such as PubMed and Google Scholar, ensuring contemporary insights into the pre-operative considerations. The pre-operative evaluation encompasses medical history, covering prenatal events and immediate post-natal health, along with physical examinations and complete audiometric assessments. High-Resolution Computed Tomography (HRCT) and Magnetic Resonance Imaging (MRI) emerge as crucial imaging techniques, guiding surgical planning and electrode placement. Brainstem Evoked Response Audiometry (BERA) supplements inconclusive MRI data, while vestibular screening aids in candidate selection. Cochlear duct length determination, often assessed through imaging techniques, contributes to optimal electrode array selection. Models in cochlear implant research, spanning computational, animal, tissue engineering, and physical models, further enhance our understanding and refinement of cochlear implant designs. In conclusion, this comprehensive pre-operative workup plays a significant role in assessing patient health, identifying causes of deafness, and contributing to the overall success of cochlear implantation, a transformative solution for profound hearing impairment

Probabilistic Analysis of Strength of Structural Concrete for Post-Code Buildings in Developing Countries

Code compliance and quality construction remain a point of interest for developing countries. For structural vulnerability studies on reinforced concrete buildings, researchers usually adopt random strength parameters to represent the compressive strength of concrete for various structural members. This matter becomes a challenge if researchers are dealing to quantify the structural response of code-compliant buildings. Since the research on the response of code-compliant buildings is limited hence this paper aims at data collection and presenting the probabilistic trends in compressive strength variation of structural concrete being used or has been used in multiple projects of the federal capital city of Pakistan for code-compliant buildings. The data has been collected from well-reputed academic and commercial testing labs in the area for past 10 years (the timeline after implementation of BCP 2007). Compressive strength testing records of concrete cylinders for 28 days strength have been sorted for different structural members i.e., beams, columns, shear walls, slabs and footings separately. From the selected data, histograms have been plotted for each member category and mean values with standard deviations have been highlighted. Obtained results are further compared with anticipated design compressive strengths which were obtained from different tagged reports, design offices and resident engineers of the sites. The produced results would lead to true representation of structural strength of concrete for code-compliant buildings, to be further studied for structural vulnerability and risk assessments of the desired areas in developing countries

Comprehensive comparison of hetero-homogeneous catalysts for fatty acid methyl ester production from non-edible jatropha curcas oil

The synthesis of biodiesel from Jatropha curcas by transesterification is kinetically controlled. It depends on the molar ratio, reaction time, and temperature, as well as the catalyst nature and quantity. The aim of this study was to explore the transesterification of low-cost, inedible J. curcas seed oil utilizing both homogenous (potassium hydroxide; KOH) and heterogenous (calcium oxide; CaO) catalysis. In this effort, two steps were used. First, free fatty acids in J. curcas oil were reduced from 12.4 to less than 1 wt.% with sulfuric acid-catalyzed pretreatment. Transesterification subsequently converted the oil to biodiesel. The yield of fatty acid methyl esters was optimized by varying the reaction time, catalyst load, and methanol-to-oil molar ratio. A maximum yield of 96% was obtained from CaO nanoparticles at a reaction time of 5.5 h with 4 wt.% of the catalyst and an 18:1 methanol-to-oil molar ratio. The optimum conditions for KOH were a molar ratio of methanol to oil of 9:1, 5 wt.% of the catalyst, and a reaction time of 3.5 h, and this returned a yield of 92%. The fuel properties of the optimized biodiesel were within the limits specified in ASTM D6751, the American biodiesel standard. In addition, the 5% blends in petroleum diesel were within the ranges prescribed in ASTM D975, the American diesel fuel standard

Optical coherence tomography-guided vs. intravascular ultrasound-guided percutaneous coronary intervention: a systematic review and meta-analysis of randomized controlled trials

BackgroundOptical coherence tomography (OCT) and intravascular ultrasound (IVUS) are superior to coronary angiography for guiding percutaneous coronary intervention (PCI). However, whether one technique is superior to the other is inconclusive.MethodsWe searched PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov from inception to November 2023 for randomized controlled trials (RCTs) comparing OCT and IVUS in patients undergoing PCI. RevMan 5.4 was used to pool outcomes with risk ratio (RR) as the effect measure.ResultsSix RCTs (4,402 patients) were included in this meta-analysis. There was no significant difference between the OCT- and IVUS-guided PCI groups in the risk of major adverse cardiovascular events (RR 0.87, 95% CI: 0.65, 1.16; I2 = 0%) and cardiac mortality (RR 0.73, 95% CI: 0.24, 2.21; I2 = 0%). The results were consistent across the subgroups of the presence or absence of left main disease (Pinteraction >0.1). There were no significant differences between OCT and IVUS in the risk of target lesion revascularization (RR 0.78, 95% CI: 0.47, 1.30; I2 = 0%), target vessel revascularization (RR 1.06, 95% CI: 0.69, 1.62; I2 = 0%), target-vessel myocardial infarction (RR 0.79, 95% CI: 0.40, 1.53; I2 = 0%), stent thrombosis (RR 0.59, 95% CI: 0.12, 2.97; I2 = 0%), and all-cause mortality (RR 1.01, 95% CI: 0.53, 1.90; I2 = 0%).ConclusionsOur meta-analysis demonstrated similar clinical outcomes in OCT- and IVUS-guided PCI. New large-scale multicenter RCTs with long-term follow-up are required to confirm or refute our findings and provide more reliable results.Systematic Review RegistrationPROSPERO, identifier, CRD4202348693

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

An Extremely Rare Presentation of Four Coronary Anomaly Patterns Originating from the Right Coronary Sinus

Background. “Coronary anomaly” is defined as the coronary feature or pattern seen in <1% of the population. The most common CAAs are anomalies of origin, specifically having a separate LCX and LAD origin with an incidence of 0.41%. The second most common anomaly is the LCX arising from the RCA (0.37%). Treatment options include CABG, coronary unroofing, reimplantation, or medical therapy. Case Presentation. We present the case of an 85-year-old male who presents with an acute coronary syndrome who was found to have an extremely rare combination of different coronary anomaly patterns including left main coronary artery (LMCA) atresia, small LAD arising posteriorly from the right coronary cusp, anomalous left circumflex artery arising from the RCA, and an anomalous LAD arising from the left circumflex artery which is originating from the RCA. Conclusions. To the best of our knowledge, this is the first case report to describe four coronary anomalies in a single patient. When CAAs are diagnosed, it is of utmost importance for cardiologists to do further imaging and workup that might include a stress test to be able to offer patients the best management options

Un Modèle de Propagation Quasi 3D Déterministe et Rapide pour les Réseaux de Capteurs à Faible Portée

International audienceCe papier propose un modèle de propagation déterministe quasi 3D et rapide pour une configuration micro-cellule, appliqué aux réseaux de capteurs sans fil pour les villes intelligentes dont les noeuds se trouvent en-dessous du niveau moyen des toits. Ce modèle rapide re-pose, d'un côté, sur une structure accélératrice calculée dans un plan 2D horizontal et intègre, d'un autre côté, d'autres optimisations reposant notamment sur l'exploi-tation de la portée des noeuds et d'un ensemble d'arbres de visibilité pré-calculés. Dans un premier temps, ce mo-dèle est validé par confrontation à la mesure, puis les stra-tégies d'accélération y sont intégrées. L'ensemble de ces approches permet de réduire considérablement les temps de calcul sans perte significative de la précision

Comparative proteomic analysis of different stages of breast cancer tissues using ultra high performance liquid chromatography tandem mass spectrometer.

BACKGROUND:Breast cancer is the fifth most prevalent cause of death among women worldwide. It is also one of the most common types of cancer among Malaysian women. This study aimed to characterize and differentiate the proteomics profiles of different stages of breast cancer and its matched adjacent normal tissues in Malaysian breast cancer patients. Also, this study aimed to construct a pertinent protein pathway involved in each stage of cancer. METHODS:In total, 80 samples of tumor and matched adjacent normal tissues were collected from breast cancer patients at Seberang Jaya Hospital (SJH) and Kepala Batas Hospital (KBH), both in Penang, Malaysia. The protein expression profiles of breast cancer and normal tissues were mapped by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). The Gel-Eluted Liquid Fractionation Entrapment Electrophoresis (GELFREE) Technology System was used for the separation and fractionation of extracted proteins, which also were analyzed to maximize protein detection. The protein fractions were then analyzed by tandem mass spectrometry (LC-MS/MS) analysis using LC/MS LTQ-Orbitrap Fusion and Elite. This study identified the proteins contained within the tissue samples using de novo sequencing and database matching via PEAKS software. We performed two different pathway analyses, DAVID and STRING, in the sets of proteins from stage 2 and stage 3 breast cancer samples. The lists of molecules were generated by the REACTOME-FI plugin, part of the CYTOSCAPE tool, and linker nodes were added in order to generate a connected network. Then, pathway enrichment was obtained, and a graphical model was created to depict the participation of the input proteins as well as the linker nodes. RESULTS:This study identified 12 proteins that were detected in stage 2 tumor tissues, and 17 proteins that were detected in stage 3 tumor tissues, related to their normal counterparts. It also identified some proteins that were present in stage 2 but not stage 3 and vice versa. Based on these results, this study clarified unique proteins pathways involved in carcinogenesis within stage 2 and stage 3 breast cancers. CONCLUSIONS:This study provided some useful insights about the proteins associated with breast cancer carcinogenesis and could establish an important foundation for future cancer-related discoveries using differential proteomics profiling. Beyond protein identification, this study considered the interaction, function, network, signaling pathway, and protein pathway involved in each profile. These results suggest that knowledge of protein expression, especially in stage 2 and stage 3 breast cancer, can provide important clues that may enable the discovery of novel biomarkers in carcinogenesis

Role of Serum Amyloid A as a Biomarker for Predicting the Severity and Prognosis of COVID-19

Objective. To detect biomarkers that can be used to predict COVID-19 severity to identify patients with high probability of disease progression and poor prognosis. Methods. Of the 102 patients with confirmed COVID-19 who were admitted to King Fahd General Hospital, Jeddah City, Saudi Arabia, from July 1, 2021 to August 5, 2021, 50 were included in this cross-sectional study to investigate the influence of serum amyloid A (SAA) on disease severity and survival outcomes of COVID-19 patients. Dynamic shifts in SAA, C-reactive protein (CRP), white blood cell (WBC), lymphocytes, neutrophils, biochemical markers, and disease progression were examined. At admission, and at three, five, and seven days after treatment, at least four data samples were collected from all patients, and they underwent clinical status assessments. Results. Critically ill patients showed higher SAA and CRP levels and WBC and neutrophil counts and significantly lower lymphocyte and eosinophil counts compared to the moderately/severely ill patients, especially with regard to disease progression. Similarly, nonsurvivors had higher SAA levels than survivors. The moderately/severely ill patients and the survivors had significantly higher dynamic changes in SAA compared to the critically ill patients and nonsurvivors, respectively, with differences clearly noticed on the fifth and seventh day of treatment. ROC curve analysis revealed that the combination of SAA and CRP was valuable in evaluating the disease progression and prognosis of COVID-19 patients at different time points; however, a combination of SAA and lymphocyte counts was more sensitive for disease severity prediction on admission. The most sensitive parameters for predicting survival on admission were the combination of SAA/WBC and SAA/neutrophil count. Conclusions. The study findings indicate that SAA can be used as a sensitive indicator to assess the degree of disease severity and survival outcomes of COVID-19 patients