Role of Ventriculoperitoneal Shunt for Haemorrhagic or Ischemic Strokes Causing Hydrocephalus

Posterior fossa hemorrhagic involve or infract associated hydrocephalus are serious neurosurgical emergencies which requires immediate and prompt action.Purpose: To highlight the role of VP shunt in the management plan of Hydrocephalus caused by spontaneous hemorrhagic or ischemic infarcts.Material and Methods: This is retrospective study of 16 cases over a period of 4 years from March 2007 to March 2011 conducted simultaneously at Neurosurgical departments of CMH Lahore, CMH Multan and Farooq Hospital Lahore.Results: A total of 16 cases were included in this study and all those patients underwent some sort of CSF diversion procedure for obstructive hydrocephalus. Ten Patients (62.5%) were male and six (37.5%) patients were female. The age ranged from 32 – 70 years with mean age of 53.4 years. Clinically all patients presented with headache, vomiting and neck pain followed by loss of consciousness. Glasgow coma scale ranged from 5/15 to 12/15. The radiological findings were those of hemorrhagic or ischemic infarcts causing obstructive hydro-cephalus. Patients were broadly divided into two main groups with eight patients in each group. Group A inclu-ded 6 males and 2 females, all these patients were managed conservatively for the hemorrhagic or ischemic strokes while they underwent VP Shunt for the obstructive hydrocephalus. Two of these patients (a male and a female) had thalamic bleed (hemorrhagic stroke) with third ventricular blockade. These two patients were also managed by VP Shunt only. Outcome of patients in group A was excellent in 7 patients whereas one patients developed complications with prolonged hospital stay but ultimately recovered and discharged. Group B inclu-ded 8 patients (4 male and 4 female) who underwent hematoma evacuation of cerebellar bleed along with place-ment of external ventricular drain (EVD). EVD was converted to VP Shunt in six patients when they deteriorated after blocking EVD on 5th post operative day. 2 patients out of these eight did not deteriorate on EVD blockade and VP Shunt was not passed in these patients and they had excellent recovery. One patient died in group B. One patient required redo surgery due to Shunt Blockade and had poor recovery whereas two more patients had poor recovery due to other reasons including poor neurological status pre operatively. Two patients had fairly good recovery after converting EVD into VP Shunt.Conclusion: Obstructive hydrocephalus caused by hemorrhagic stroke or infarcts is a relatively rare entity requiring some sort of CSF diversion. Patients who are having smaller hematomas with hydrocephalus and GCS more than 8/15 can be managed with VP Shunt alone

An Effective Approach for Human Activity Classification Using Feature Fusion and Machine Learning Methods

Recent advances in image processing and machine learning methods have greatly enhanced the ability of object classification from images and videos in different applications. Classification of human activities is one of the emerging research areas in the field of computer vision. It can be used in several applications including medical informatics, surveillance, human computer interaction, and task monitoring. In the medical and healthcare field, the classification of patients’ activities is important for providing the required information to doctors and physicians for medication reactions and diagnosis. Nowadays, some research approaches to recognize human activity from videos and images have been proposed using machine learning (ML) and soft computational algorithms. However, advanced computer vision methods are still considered promising development directions for developing human activity classification approach from a sequence of video frames. This paper proposes an effective automated approach using feature fusion and ML methods. It consists of five steps, which are the preprocessing, feature extraction, feature selection, feature fusion, and classification steps. Two available public benchmark datasets are utilized to train, validate, and test ML classifiers of the developed approach. The experimental results of this research work show that the accuracies achieved are 99.5% and 99.9% on the first and second datasets, respectively. Compared with many existing related approaches, the proposed approach attained high performance results in terms of sensitivity, accuracy, precision, and specificity evaluation metric.publishedVersio

PRINCE2 METHODOLOGY: AN INNOVATIVE WAY FOR IMPROVING PERFORMANCE OF MALAYSIAN AUTOMOTIVE INDUSTRY

The role of project management is identically essential for organizations and it’s converted into an important issue for implementing modern projects. Operations & Management division is the spine of any corporate organization, and it is the key factor for progress the performance of the industry. International competition in automotive industry compulsory required, well-organized project management in each area, for satisfaction of clients and quality. The novel approach of Project Management is Project Management PRINCE2 (PMP2), which is the generic framework, which design to suit every type of project in industry. Therefore, the aim of this research is to investigate the impact of project management prince2 methodology in Malaysian automotive industry. PRINCE2 is a structured method for effective project management. PRINCE2 has strongly established in UK and spread all over the world fluently; as a generic, process based approach of project management. In view of the fact that its emphasis on, the dividing the project into manageable and controllable stages. This research will encourage the implementation of Prince2 methodology in automotive industry of Malaysia. Additionally, it will encourage the prospect applications of PRINCE2, which ultimately improve the human performance in automotive industry

PRINCE2 METHODOLOGY: AN INNOVATIVE WAY FOR IMPROVING PERFORMANCE OF MALAYSIAN AUTOMOTIVE INDUSTRY

The role of project management is identically essential for organizations and it’s converted into an important issue for implementing modern projects. Operations & Management division is the spine of any corporate organization, and it is the key factor for progress the performance of the industry. International competition in automotive industry compulsory required, well-organized project management in each area, for satisfaction of clients and quality. The novel approach of Project Management is Project Management PRINCE2 (PMP2), which is the generic framework, which design to suit every type of project in industry. Therefore, the aim of this research is to investigate the impact of project management prince2 methodology in Malaysian automotive industry. PRINCE2 is a structured method for effective project management. PRINCE2 has strongly established in UK and spread all over the world fluently; as a generic, process based approach of project management. In view of the fact that its emphasis on, the dividing the project into manageable and controllable stages. This research will encourage the implementation of Prince2 methodology in automotive industry of Malaysia. Additionally, it will encourage the prospect applications of PRINCE2, which ultimately improve the human performance in automotive industry

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : an analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2.5 originating from ambient and household air pollution.Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2.5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2.5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2.5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals.Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2.5 exposure, with an estimated 3.78 (95% uncertainty interval 2.68-4.83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13.4% (9.49-17.5) of deaths and 13.6% (9.73-17.9) of DALYs due to type 2 diabetes were contributed by ambient PM2.5, and 6.50% (4.22-9.53) of deaths and 5.92% (3.81-8.64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2.5.Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2.5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Peer reviewe

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : An analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure–response curve from the extracted relative risk estimates using the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68–4·83) deaths per 100 000 population and 167 (117–223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49–17·5) of deaths and 13·6% (9·73–17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22–9·53) of deaths and 5·92% (3·81–8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes

Fungal systematics and evolution : FUSE 6

Fungal Systematics and Evolution (FUSE) is one of the journal series to address the “fusion” between morphological data and molecular phylogenetic data and to describe new fungal taxa and interesting observations. This paper is the 6th contribution in the FUSE series—presenting one new genus, twelve new species, twelve new country records, and three new combinations. The new genus is: Pseudozeugandromyces (Laboulbeniomycetes, Laboulbeniales). The new species are: Albatrellopsis flettioides from Pakistan, Aureoboletus garciae from Mexico, Entomophila canadense from Canada, E. frigidum from Sweden, E. porphyroleucum from Vietnam, Erythrophylloporus flammans from Vietnam, Marasmiellus boreoorientalis from Kamchatka Peninsula in the Russian Far East, Marasmiellus longistipes from Pakistan, Pseudozeugandromyces tachypori on Tachyporus pusillus (Coleoptera, Staphylinidae) from Belgium, Robillarda sohagensis from Egypt, Trechispora hondurensis from Honduras, and Tricholoma kenanii from Turkey. The new records are: Arthrorhynchus eucampsipodae on Eucampsipoda africanum (Diptera, Nycteribiidae) from Rwanda and South Africa, and on Nycteribia vexata (Diptera, Nycteribiidae) from Bulgaria; A. nycteribiae on Eucampsipoda africanum from South Africa, on Penicillidia conspicua (Diptera, Nycteribiidae) from Bulgaria (the first undoubtful country record), and on Penicillidia pachymela from Tanzania; Calvatia lilacina from Pakistan; Entoloma shangdongense from Pakistan; Erysiphe quercicola on Ziziphus jujuba (Rosales, Rhamnaceae) and E. urticae on Urtica dioica (Rosales, Urticaceae) from Pakistan; Fanniomyces ceratophorus on Fannia canicularis (Diptera, Faniidae) from the Netherlands; Marasmiellus biformis and M. subnuda from Pakistan; Morchella anatolica from Turkey; Ophiocordyceps ditmarii on Vespula vulgaris (Hymenoptera, Vespidae) from Austria; and Parvacoccum pini on Pinus cembra (Pinales, Pinaceae) from Austria. The new combinations are: Appendiculina gregaria, A. scaptomyzae, and Marasmiellus rodhallii. Analysis of an LSU dataset of Arthrorhynchus including isolates of A. eucampsipodae from Eucampsipoda africanum and Nycteribia spp. hosts, revealed that this taxon is a complex of multiple species segregated by host genus. Analysis of an SSU–LSU dataset of Laboulbeniomycetes sequences revealed support for the recognition of four monophyletic genera within Stigmatomyces sensu lato: Appendiculina, Fanniomyces, Gloeandromyces, and Stigmatomyces sensu stricto. Finally, phylogenetic analyses of Rhytismataceae based on ITS–LSU ribosomal DNA resulted in a close relationship of Parvacoccum pini with Coccomyces strobi.http://www.sydowia.at/index.htmpm2021Medical Virolog