Comparison of Efficiencies of Neurological Physical Examination, Neurothesiometer and PainDETECT Questionnaire in Diagnosing Diabetic Neuropathy

Objective: To compare the efficacies of neurological physical examination, neurothesiometer and PainDETECT questionnaire in diagnosing diabetic neuropathy. Study Design: Prospective cross-sectional Place and Duration of Study: Department of General Medicine, Nishtar Hospital Multan, Pakistan from 1st December 2018 to 10th March 2019. Materials and Methods: One hundred and four patients of both type 1 and type 2 diabetes visiting the outdoor department were included in this study. They were assessed by lab results of glycosylated hemoglobin, fasting and random blood sugar levels and neurological physical examination. Results: The physical examination with Michigan Neuropathy Screening instrument showed that around 29 of the patients were having established neuropathy. The PainDETECT questionnaire on the other hand showed about 42 patients having a definitive neuropathy while the neurothesiometer showed that 79 of the total patients had varying degrees of neuropathy. Conclusion: The neurothesiometer is a better diagnostic tool for diagnosing diabetic neuropathy in patients

GA101 (obinutuzumab) monocLonal Antibody as Consolidation Therapy In CLL (GALACTIC) trial: study protocol for a phase II/III randomised controlled trial

Background: Chronic lymphocytic leukaemia (CLL) is the most common adult leukaemia. Achieving minimal residual disease (MRD) negativity in CLL is an independent predictor of survival even with a variety of different treatment approaches and regardless of the line of therapy. Methods/design: GA101 (obinutuzumab) monocLonal Antibody as Consolidation Therapy In CLL (GALACTIC) is a seamless phase II/III, multi-centre, randomised, controlled, open, parallel-group trial for patients with CLL who have recently responded to chemotherapy. Participants will be randomised to receive either obinutuzumab (GA-101) consolidation or no treatment (as is standard). The phase II trial will assess safety and short-term efficacy in order to advise on continuation to a phase III trial. The primary objective for phase III is to assess the effect of consolidation therapy on progression-free survival (PFS). One hundred eighty-eight participants are planned to be recruited from forty research centres in the United Kingdom. Discussion: There is evidence that achieving MRD eradication with alemtuzumab consolidation is associated with improvements in survival and time to progression. This trial will assess whether obinutuzumab is safe in a consolidation setting and effective at eradicating MRD and improving PFS. Trial registration: ISRCTN, 64035629. Registered on 12 January 2015. EudraCT, 2014-000880-42. Registered on 12 November 2014

A New Look At Management Accounting

This paper presents a comparison of the traditional management accounting with the new approach of management accounting with the use of latest information technology and manufacturing technologies.  The information and data of the research were gathered from various sources of secondary data. Many online articles and journals were available through these search engines such as Google, Infoseek, Lycos, Excites and Altavista. These articles were downloaded from Internet Websites including IFAC library, CPA online newsletters, Institute of Management Accountants, CIMA (Chartered Institute of Management Accountants), Technical Bulletin and Institute of Commercial and Financial Accountants.  The modern techniques used in Management Accounting are discussed. TQM (Total Quality Management), ABC (Activity Based Costing) and BSC (Balanced score card) are some of the tools that are introduced in management accounting to keep up with the latest technology.  This research highlights the emergence of new, more proactive management accounting that increasingly becomes part of the management team with the business process. The future roles and expectations of these accountants in the competitive global economy are discussed

Characterisation and classification of soils in the dry sub-humid area of Maiduguri, Borno state, Nigeria

This study examines the characteristics and classification of soils in a dry, sub-humid area of Borno, North-Eastern Nigeria. The objective was to provide detailed soil information for improving land use, research,and agricultural productivity. It involved soil sampling from eight pedons representing upland, midland,and lowland areas. We examined soil samples for their morphological, physical, and chemicalcharacteristics. The soils were classified using the taxonomic and the world reference base systems. Pedon 8has a very high organic carbon content, exceeding 2.0%, in both its surface and subsurface horizons. Pedon1 shows high organic carbon only in the surface Ap horizon, while all other pedons are rated low on bothsurfaces and suboptimal for sustainable productivity. Nitrogen values for crop production were adequate inthe surface and subsurface of pedons 7 and 8, ranging from 0.2 to 0.5%. The Ap horizons of Pedons 1, 4, 6,and 8 have medium levels of available phosphorus, which can support crops with some inputs. In contrast,other pedons exhibit low phosphorus levels (5 to 10 mg/kg), indicating a likely deficiency. The pH values(6.20 to 6.81) are neutral to slightly acidic in all soils studied. Cation exchange capacity (15.15 to 34.22cmol/kg) and base saturation of over 97% in the Ap surface horizons are often high, indicative of nutrientspresent. The nutrient availability decreases with depth in organic carbon, total nitrogen, and availablephosphorus diminish in the subsurface horizons. Pedons 1 - 8 are Typic Haplustept (USDA soil taxonomy)while correlating with the Eutric Cambisols of the WRB system for soil resources. Thus, it needs specialisedmoisture and nutrient management. These findings will inform future land management and farmingpractices for optimised soil use in the region

Assessment of ibrutinib plus rituximab in front-line CLL (FLAIR trial): study protocol for a phase III randomised controlled trial

Background Treatment of chronic lymphocytic leukaemia (CLL) has seen a substantial improvement over the last few years. Combination immunochemotherapy, such as fludarabine, cyclophosphamide and rituximab (FCR), is now standard first-line therapy. However, the majority of patients relapse and require further therapy, and so new, effective, targeted therapies that improve remission rates, reduce relapses, and have fewer side effects, are required. The FLAIR trial will assess whether ibrutinib plus rituximab (IR) is superior to FCR in terms of progression-free survival (PFS). Methods/design FLAIR is a phase III, multicentre, randomised, controlled, open, parallel-group trial in patients with previously untreated CLL. A total of 754 participants will be randomised on a 1:1 basis to receive standard therapy with FCR or IR. Participants randomised to FCR will receive a maximum of six 28-day treatment cycles. Participants randomised to IR will receive six 28-day cycles of rituximab, and ibrutinib taken daily for 6 years until minimal residual disease (MRD) negativity has been recorded for the same amount of time as it took to become MRD negative, or until disease progression. The primary endpoint is PFS according to the International Workshop on CLL (IWCLL) criteria. Secondary endpoints include: overall survival; proportion of participants with undetectable MRD; response to therapy by IWCLL criteria; safety and toxicity; health-related quality of life (QoL); and cost-effectiveness. Discussion The trial aims to provide evidence for the future first-line treatment of CLL patients by assessing whether IR is superior to FCR in terms of PFS, and whether toxicity rates are favourable. Trial registration ISRCTN01844152. Registered on 8 August 2014, EudraCT number 2013-001944-76. Registered on 26 April 2013

A semantic rule based digital fraud detection

Digital fraud has immensely affected ordinary consumers and the finance industry. Our dependence on internet banking has made digital fraud a substantial problem. Financial institutions across the globe are trying to improve their digital fraud detection and deterrence capabilities. Fraud detection is a reactive process, and it usually incurs a cost to save the system from an ongoing malicious activity. Fraud deterrence is the capability of a system to withstand any fraudulent attempts. Fraud deterrence is a challenging task and researchers across the globe are proposing new solutions to improve deterrence capabilities. In this work, we focus on the very important problem of fraud deterrence. Our proposed work uses an Intimation Rule Based (IRB) alert generation algorithm. These IRB alerts are classified based on severity levels. Our proposed solution uses a richer domain knowledge base and rule-based reasoning. In this work, we propose an ontology-based financial fraud detection and deterrence model

Zero-phase phasor fields for non-line-of-sight imaging

Non-line-of-sight imaging employs ultra-fast illumination and sensing devices to reconstruct scenes outside their line of sight by analyzing the temporal profile of indirect scattered illumination on a secondary relay surface. Commonly, the NLOS methods transform the temporal domain into the frequency domain and operate on it, and then identify surface locations by locating the maxima in amplitude along the reconstruction volume. Phase information, which is virtual as it results from a Fourier transform, is very often discarded or ignored. We incorporate phase information into our novel Zero-Phase Phasor Fields imaging technique, which we derive for a confocal capture configuration. We show how, at positions that belong to the hidden geometry, we can ensure the phase is zero, so we can locate the hidden geometry with great precision by locating the zero crossings in the phase. This allows us to reconstruct at widely spaced locations and still achieve up to 125 micrometer depth precision, as our experimental validation shows with both synthetic and captured data, the latter publicly available. Moreover, the phase is robust to noise, as we demonstrate with decreasing signal-to-noise ratio using publicly available dataset captures of the same scene

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication