Comparing Treatment with a Control Using Recovery of Inter-Block Information in Augmented Balance Incomplete Block Design

Many times, the experimenter wishes to compare treatments with a control, in incomplete block designs. To obtain greater precision for such comparisons, the control occurs more often in each block. The analysis of such designs using recovery of inter-block information is provided in this paper. Estimates of the weights for combining intra and inter-block estimates are also provided. Key words: Control, incomplete block designs, recovery of inter-block information, estimation of weights

Context-directed segmentation algorithm for handwritten numeral strings

A context-directed algorithm is proposed for segmenting connected numeral strings into their components. The algorithm is hierarchical (tree-like structure) in the sense that it tests various hypotheses ranging from the case where the numerals are completely isolated to that where the numerals may be connected, touching and/or existing in overlapping fields. Test results indicate that the algorithm is very effective in providing an accurate segmentation in a form suitable for further processing by a recognition algorithm.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26810/1/0000366.pd

SERUM CHROMIUM, MAGNESIUM AND ZINC LEVELS IN SUDANESE TYPE 2 DIABETIC PATIENTS

Objectives: The purpose of this study was to evaluate the difference in serum chromium, magnesium and zinc levels between diabetic and control groups, and to determine the correlations between these elements and serum glucose in patients with type 2 diabetes mellitus. Methods: Forty patients suffering from type 2 diabetes and 30 controls were selected randomly. The level of serum chromium, magnesium and zinc were measured and compared between the two groups. Correlations of serum Cr, Mg and Zn with serum glucose were conducted. Results: There was a very significant difference in some serum trace elements level between diabetic and control groups. Serum magnesium and zinc were significantly lower in diabetic group compared with the control group (P= 0.014, P < 0.0001 respectively). Negative but not significant correlations were shown between Cr, Mg and Zn and serum glucose. ConclusioN: There is trace elements metabolism disorder in patients with type 2 diabetes mellitus. Magnesium and zinc could be considered suitable for inclusion in a nutritional supplement for diabetes with significant value for the treatment of diabetics and prevention of complications

PHYSICIAN AS A MANAGER: PERSONAL AND MANAGERIAL CHARCTERISTICS, SAUDI ARABIA

BACKGROUND: The emergence of physicians' roles in key adminstrative positions within many King Saudi Arabia health care organizations has represented a major change in the medical profession over the last two decades. This have created a need for physicians who are willing to assume a high level of responsibility for managing evovling health care organizations. The study explores the perception of physician managers regarding their work, personal and managerial characteristics. METHODS: The data for this study were obtained from a sample of 200 physicians working in management positions in different health care organizations in Riyadh. Physicians were selected at random with probability proportional to size from a list containing managers in all health care organization to participate in the study RESULTS: Our results indicated that physician managers lack admistration skills. No formal training in medical adminstration and management because management principles are not integrated in the medical context and the majority were experienced in management for less than four years.  Very few possess the technical comptencies such as strategic planning, financial and economics knowledge. Boredom with medical practice, improvement of personal position and encouragement from others are related to being older, having more years in medicine and interest in medicine is reduced. The finding also supported the notion that physician manager can maintain stable levels of loyality to professional interest and organization. This dual commitment is related to work-relate characteristics involving sharing his time favorably to management job and to patient care. Recommendation: To improve their management skills physicians can benefit from mamagement education programs such as those offered by King Saud University

Efficacy of Semi-Rigid Ureteroscopy and Holmium:YAG Laser Lithotripsy in the Treatment of Ureteric Calculi, a Retrospective Study

Background: Urolithiasis is a common worldwide health problem. Many endosurgical treatments became available for urinary calculi.Objectives: To find out the success clearance and complication rates of ureteric stone treatment using semi-rigid ureteroscopy and Holmium:YAG laser lithotripsy as a day case procedure.Methods: In the period from April 2011 to October 2013, a total of 64 patients who were treated by laser lithotripsy were reviewed retrospectively using Fedail Hospital data. Diagnosis was radiologically confirmed. Semi-rigid ureteroscopy and Holmium:YAG laser lithotripsy was conducted as a day case surgery. Operative details, clearance of stone fragments, failure and complications were analysed. Cases were followed clinically and radiologically after one week and one month.Results: The studied cases were 47 males and 17 females with average age of 47.3 years and ASA I in 52(81.3%). Those who had left ureteric stones were 28(43.8%) patients, only one patient had bilateral stones and 60(93.8%) patients had single stones. The largest stone diameter was 1.9cm. 68.8% had distal ureteric stones, 14.1% had mid third stones, and 17.2% had upper third stones. Most cases 96.9% were operated under spinal anaesthesia with mean operation time 61.2 minutes. Seven patients needed VUJ balloon dilatation to get access to the ureter.20 watt Holmium:YAG laser fibres were used for stone disintegration. 92.2% of cases had uncomplicated clearance, 3.1% minor complications and 4.7% failure of the procedure.100% clearance was confirmed during follow up. Conclusion: Semi-rigid ureteroscopy and Holmium:YAG laser lithotripsy is a safe treatment for ureteric calculi and can be conducted as a day case with high success rate and very low morbidity.Key words: ureteric stone, Semi-rigid ureteroscopy, Holmium:YAG laser lithotripsy

Comparative pharmacokinetics of ampicillin trihydrate, gentamicin sulphate and oxytetracycline hydrochloride in Nubian goats and desert sheep

In this investigation the pharmacokinetics of three commonly used antibiotics, ampicillin trihydrate (10 mg/kg), gentamicin sulphate (3 mg/kg) and oxytetracycline hydrochloride (5 mg/kg), given intravenously, were each studied in five Nubian goats and five desert sheep. The pharmacokinetic parameters were described by a two-compartment open model. The results indicated that there were significant differences between the two species in some kinetic parameters of ampicillin and oxytetracycline but not gentamicin. Ampicillin elimination half life (t1/2β) in goats (1.20 h) was shorter than that in sheep (2.48 h), and its clearance (Cl) significantly higher in goats (2921mL/h·kg) compared to sheep (262 mL/h·kg) (P < 0.01). Ampicillin volume of distribution (Vdarea) was found to be significantly larger in goats (5673 mL/kg) than in sheep (992 mL/kg) (P < 0.01). For oxytetracycline, the t1/2β in goats (3.89 h) was significantly shorter than that in sheep (6.30 h) and the Cl value in goats (437 mL/h·kg) was significantly higher than in sheep (281 mL/h·kg). The results suggest that when treating sheep and goats, the pharmacokinetic differences between the two species must be considered in order to optimize the therapeutic doses of ampicillin and oxytetracycline

Major Cardiovascular Advances: Highlights from the 2019 American College of Cardiology Annual Scientific Session

The 69th American College of Cardiology Annual Scientific Session and Expo was held in New Orleans, Louisiana on March 16–18, 2019. For many years this meeting has gathered together an enormous number of participants, abstracts, oral presentations, poster presentations, educational sessions, late-breaking clinical trial results, and clinical practice guidelines under one roof. The authors have selected and summarized the key points from a number of key landmark trials, featured clinical research results and clinical practice guidelines that were presented during this year’s meeting

A comparative study of four intensive care outcome prediction models in cardiac surgery patients

<p>Abstract</p> <p>Background</p> <p>Outcome prediction scoring systems are increasingly used in intensive care medicine, but most were not developed for use in cardiac surgery patients. We compared the performance of four intensive care outcome prediction scoring systems (Acute Physiology and Chronic Health Evaluation II [APACHE II], Simplified Acute Physiology Score II [SAPS II], Sequential Organ Failure Assessment [SOFA], and Cardiac Surgery Score [CASUS]) in patients after open heart surgery.</p> <p>Methods</p> <p>We prospectively included all consecutive adult patients who underwent open heart surgery and were admitted to the intensive care unit (ICU) between January 1^st2007 and December 31^st2008. Scores were calculated daily from ICU admission until discharge. The outcome measure was ICU mortality. The performance of the four scores was assessed by calibration and discrimination statistics. Derived variables (Mean- and Max- scores) were also evaluated.</p> <p>Results</p> <p>During the study period, 2801 patients (29.6% female) were included. Mean age was 66.9 ± 10.7 years and the ICU mortality rate was 5.2%. Calibration tests for SOFA and CASUS were reliable throughout (p-value not < 0.05), but there were significant differences between predicted and observed outcome for SAPS II (days 1, 2, 3 and 5) and APACHE II (days 2 and 3). CASUS, and its mean- and maximum-derivatives, discriminated better between survivors and non-survivors than the other scores throughout the study (area under curve ≥ 0.90). In order of best discrimination, CASUS was followed by SOFA, then SAPS II, and finally APACHE II. SAPS II and APACHE II derivatives had discrimination results that were superior to those of the SOFA derivatives.</p> <p>Conclusions</p> <p>CASUS and SOFA are reliable ICU mortality risk stratification models for cardiac surgery patients. SAPS II and APACHE II did not perform well in terms of calibration and discrimination statistics.</p