Revision of total hip replacement with proximal femur bone defect

Background: The revision surgery has been evolving constantly. From polyethylene wear, osteolysis and loosening, to complexities such as pelvic discontinuity, there is a wide range of surgical options for successful reconstruction.Objective: The aim of the present study was to provide optimal treatment to the increasing number of patients requiring revision surgery with femur bone defect.Patients and methods: This study included 10 patients with failed primary total hip replacement and have femoral bone defects selected as purposive simple random sample requiring revision of total hip replacement at Zagazig University Hospitals.Results: All of the patients had femoral defects which were difficult to evaluate accurately preoperatively by radiograph but were properly evaluated during surgery after removal of the loose implant by simple manual traction. Femoral bone defects were classified according to Paprosky classification, they were six patients type 1, three patients type 2 and one patient type 3A. No weight bearing was allowed on the affected limb for 4 weeks. All the patients reached full weight bearing between 7 – 9 weeks after surgery regarding preoperative mean Harris hip score, it was 89. There were no cases of dislocation or deep infection in this series up to the final follow up visit.Conclusion: The revision surgery has been evolving constantly. However, we do not have complex solution. The optimal surgical approach for revision total hip arthroplasty (THA) varies considerably among different settings

A New Flavonoid C-Glycoside from Celtis australis L. and Celtis occidentalis L. Leaves and Potential Antioxidant and Cytotoxic Activities

A major development over the past two decades has been the realization that free radical induced lipid peroxidation and DNA damage are associated with major health problems, e.g. cancer and ageing. Plant-derived antioxidants are increasingly found beneficial in protecting against these diseases. Celtis australis L. and Celtis occidentalis L. are two plants that have a variety of uses in folk medicine but have not been evaluated before for their antioxidant and cytotoxic properties. Therefore, the extracts of both plants’ leaves were investigated for these activities, as well as isolation of the bioactive compounds responsible for the activities. Molecular structures of the compounds were elucidated by UV, HRESIMS, 1D (1H and 13C) and 2D (1H-13C HSQC and 1H-13C HMBC) NMR analyses. The ethanolic and aqueous extracts, n-butanol fractions and the isolated major compound were tested for their antioxidant activity using DPPH radical scavenging assay, xanthine oxidase-induced generation of superoxide radical and lipid peroxidation assay by thiobarbituric acid-reactive substances (TBARS) method using rat tissue homogenates. Cytotoxic activities were studied using standard MTT assay. A novel flavonoid C-triglycoside, 4‴-α-rhamnopyranosyl-2″-O-β-d-galactopyranosylvitexin, was isolated from both plants’ leaves, together with seven known flavonoids. The n-butanol fractions and the major compound 2″-O-β-galactopyranosylvitexin showed significant antioxidant activities, more pronounced than the tested standards BHT and dl-α-tocopherol in most tests. All extracts showed variable cytotoxic activities. This study provides strong evidence for the antioxidant and cytotoxic activities of the extracts of Celtis australis L. and Celtis occidentalis L. leaves, which were attributed to the polar n-butanol fractions and the major isolated flavonoid 2″-galactosylvitexin

Chapter 21 Artificial intelligence and data analytics for geosciences and remote sensing theory and application

To address the limitation of conventional statistics in dealing with hyperspectral data of satellite and airborne images, two contextual analyses are introduced in this chapter. The first case study presents the development of an artificial intelligence (AI) and data analytics algorithm capable of classifying hyperspectral data to support remote sensing and geographic information systems researchers in understanding and predicting changes in natural earth processes. The classification algorithm is based on a fuzzy approach combining a decision tree classifier with a fuzzy multiple-criteria decision analysis classifier. The second case study presents the development of an AI tool that extracts features from the hyperspectral data to transform a two-dimensional (2D) satellite and airborne picture to a pseudo-3D picture to improve complexity and produce multidirectional sun-shaded pictures and their edges. Such 3D images are useful in supporting the discovery of prospective ground for mineral exploration, extraction from the earth of precious minerals or other geological materials, usually from deposits of ore, veins, lodes, seams, reefs, or placer deposits, and overall to improve the efficiency and effectiveness of mineral exploration

Combining machine learning and metaheuristics algorithms for classification method PROAFTN

© Crown 2019. The supervised learning classification algorithms are one of the most well known successful techniques for ambient assisted living environments. However the usual supervised learning classification approaches face issues that limit their application especially in dealing with the knowledge interpretation and with very large unbalanced labeled data set. To address these issues fuzzy classification method PROAFTN was proposed. PROAFTN is part of learning algorithms and enables to determine the fuzzy resemblance measures by generalizing the concordance and discordance indexes used in outranking methods. The main goal of this chapter is to show how the combined meta-heuristics with inductive learning techniques can improve performances of the PROAFTN classifier. The improved PROAFTN classifier is described and compared to well known classifiers, in terms of their learning methodology and classification accuracy. Through this chapter we have shown the ability of the metaheuristics when embedded to PROAFTN method to solve efficiency the classification problems

Hybrid multicriteria fuzzy classification of network traffic patterns, anomalies, and protocols

© 2017, Springer-Verlag London Ltd., part of Springer Nature. Traffic classification in computer networks has very significant roles in network operation, management, and security. Examples include controlling the flow of information, allocating resources effectively, provisioning quality of service, detecting intrusions, and blocking malicious and unauthorized access. This problem has attracted a growing attention over years and a number of techniques have been proposed ranging from traditional port-based and payload inspection of TCP/IP packets to supervised, unsupervised, and semi-supervised machine learning paradigms. With the increasing complexity of network environments and support for emerging mobility services and applications, more robust and accurate techniques need to be investigated. In this paper, we propose a new supervised hybrid machine-learning approach for ubiquitous traffic classification based on multicriteria fuzzy decision trees with attribute selection. Moreover, our approach can handle well the imbalanced datasets and zero-day applications (i.e., those without previously known traffic patterns). Evaluating the proposed methodology on several benchmark real-world traffic datasets of different nature demonstrated its capability to effectively discriminate a variety of traffic patterns, anomalies, and protocols for unencrypted and encrypted traffic flows. Comparing with other methods, the performance of the proposed methodology showed remarkably better classification accuracy

Physicians Report Barriers to Deliver Best Practice Care for Asplenic Patients: A Cross-Sectional Survey

Background: Current management of asplenic patients is not in compliance with best practice standards, such as defined by the British Committee for Standards in Haematology. To improve quality of care, factors inhibiting best practice care delivery need to be identified first. With this study, we aimed to identify and quantify physicians' barriers to adhere to best practice management of asplenic patients in the Netherlands. Methods and Principal Findings: A cross-sectional survey, preceded by multiple focus group discussions, was performed among Dutch physicians responsible for prevention of infections in asplenic patients, including specialists ( of Internal medicine and Surgery) and general practitioners (GPs). Forty seven GPs and seventy three hospital specialists returned the questionnaire, yielding response rates of 47% and 36,5% respectively. Physicians reported several barriers to deliver best practice. For both GPs and specialists, the most frequently listed barriers were: poor patient knowledge (> 80% of hospital specialists and GPs) and lack of clarity about which physician is responsible for the management of asplenic patients (50% of Internists, 46% of Surgeons, 55% of GPs). Both GPs and hospital specialists expressed to experience a lack of mutual trust: specialists were uncertain whether the GP would follow their advice given on patient discharge (33-59%), whereas half of GPs was not convinced that specialists' discharge letters contained the correct recommendations. Almost all physicians (> 90%) indicated that availability of a national guideline would improve adherence to best practice, especially if accessible online. Conclusion: This study showed that, in accordance with reports on international performance, care delivery for asplenic patients in the Netherlands is suboptimal. We identified and quantified perceived barriers by physicians that prevent adherence to post-splenectomy guidelines for the first time. Better transmural collaboration and better informed patients are likely to improve the quality of care of the asplenic patient population. A national, online-available guideline is urgently require

Skin-to-skin contact after birth : Developing a research and practice guideline

Funding Information: Funding for the two in‐person meetings (one of the Steering Group and one of the Expert Panel) was provided through a grant from Healthy Children Project, Inc., a not‐for‐profit (501c3) non‐governmental organisation (NGO) located in the United States. Publisher Copyright: © 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica. © 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.Aim: Skin-to-skin contact immediately after birth is recognised as an evidence-based best practice and an acknowledged contributor to improved short- and long-term health outcomes including decreased infant mortality. However, the implementation and definition of skin-to-skin contact is inconsistent in both practice and research studies. This project utilised the World Health Organization guideline process to clarify best practice and improve the consistency of application. Methods: The rigorous guideline development process combines a systematic review with acumen and judgement of experts with a wide range of credentials and experience. Results: The developed guideline received a strong recommendation from the Expert Panel. The result concluded that there was a high level of confidence in the evidence and that the practice is not resource intensive. Research gaps were identified and areas for continued work were delineated. Conclusion: The World Health Organization guideline development process reached the conclusion immediate, continuous, uninterrupted skin-to-skin contact should be the standard of care for all mothers and all babies (from 1000 g with experienced staff if assistance is needed), after all modes of birth. Delaying non-essential routine care in favour of uninterrupted skin-to-skin contact after birth has been shown to be safe and allows for the progression of newborns through their instinctive behaviours.Peer reviewe

An examination of the gender gap in smartphone adoption and use in Arab countries:a cross-national study

This is the first research to study gender differences among consumers in a cross-national context in the Middle East: the United Arab Emirates (UAE) and Jordan. A conceptual framework was developed by extending the extended unified theory of acceptance and use of technology (UTAUT2) further. It was tested among individuals aged 18–29 years using multi-stage cluster sampling. A total sample of around 900 usable responses from both countries were included in the analysis. The factors national IT development, enjoyment, perceived relative advantage, price value and effort expectancy were found to be significant in the model among Arab women in the UAE and Jordan. The study has theoretical, social and policy relating contributions. The study shows how an extended UTAUT2 fits among both genders in a cross-national context. The study is helpful for policymakers who intend to reduce the gender gap in smartphone adoption and use. The advancement of national IT development and the presence of effective policies focusing on women were found important in both countries

Genome-wide analysis identifies 12 loci influencing human reproductive behavior.

The genetic architecture of human reproductive behavior-age at first birth (AFB) and number of children ever born (NEB)-has a strong relationship with fitness, human development, infertility and risk of neuropsychiatric disorders. However, very few genetic loci have been identified, and the underlying mechanisms of AFB and NEB are poorly understood. We report a large genome-wide association study of both sexes including 251,151 individuals for AFB and 343,072 individuals for NEB. We identified 12 independent loci that are significantly associated with AFB and/or NEB in a SNP-based genome-wide association study and 4 additional loci associated in a gene-based effort. These loci harbor genes that are likely to have a role, either directly or by affecting non-local gene expression, in human reproduction and infertility, thereby increasing understanding of these complex traits