Long-term Results after Restoring Flexor Tendon Injury in Children Younger than Age 10 Years

Background: In regard to the rarity of pediatric tendon lacerations compared with the adult population, sparse knowledge exists. Published reports indicate that the incidence of “good” flexor tendon repair outcomes is low. This study aimed to determine the injury pattern and demographics of pediatric flexor tendon injuries over the past decade.Methods: A retrospective chart review of all flexor tendon injuries between 2005 and 2015 was performed. Parameters reviewed included demographics, injury mechanism, repair technique, outcomes, and complications.Results: A total of 20 patients with a median age of 4 years and 4 months experienced 45 tendon injuries. The most common cause of injury was glass (n = 10), with the most common digit injured being the index finger (n = 8). Zone II had the highest number of injuries (n = 14). The modified Kessler core and peripheral running sutures technique were used in all primary repairs (n = 18). Using author designed evaluation system, 80% of patients experienced excellent recovery. Four patients had good results. Only one patient complicated with rupture necessitating further surgery that its final evaluation was excellent.Conclusions: The outcome of restoring flexor tendon injury of children is satisfactory, and we recommend that

Misnomers in Hand Surgery

Hand surgery literature is full of disease names and terms. Some of them are misnomers, which are misleading to physicians outside the specialty. Therefore, we decided to collect all misnomers and provide them via this paper. Considering development of sciences in future, perhaps avoidance from new misnomers is impossible, but awareness of this fact, lead us to be more ingenious in interpretation. On the other hand, we believe his collection would be interesting for most specialists in hand surgery and as well informative for others

Evaluation of Indoleamine 2, 3-Dioxygenase Gene Expression and Activation in Chronic Spontaneous Urticaria

Chronic spontaneous urticaria (CSU) is a common skin disorder characterized by the emergence of hives for at least six weeks without any known etiologic agent. Indoleamine 2,3-dioxygenase (IDO) which catalyzes tryptophan (Trp) to kynorenin (KYN) is an immunomedulatory enzyme and complicated in immunological diseases. In this study, Trp, KYN and IDO gene expression in CSU patients were analyzed. We studied 20 CSU patients (mean age: 28 +/- 6 years, mean duration: 27 +/- 4 months) and 20 healthy individuals (mean age: 28 +/- 9 years). Peripheral blood mononuclear cells (PBMCs) were isolated from both patients and healthy control and stimulated by phytohemmaglutinin (PHA). Real-time PCR was applied to quantify IDO gene expression and its activity was estimated by KYN/Trp ratio in supernatant of PBMCs by HPLC. Our study results showed that the gene expression of IDO was higher in CSU patients (0.33 +/- 0.27) compare to healthy individuals (0.31 +/- 0.6, p=0.02). Amazing, the activity of IDO (KYN/Trp) was decreased in CSU patients (322.5 +/- 432.3) contrast of healthy ones (685.9 +/- 531.7, p=0.02). Previous studies documented the impaired of IDO gene expression in CSU patients, however in the present study we observed a decrease activity of IDO in CSU patients which might suggest the function of this factor is impaired in CSU patients

Knowledge management national policies for moving towards knowledge-based development: A comparison between micro and macro level

Knowledge management is a business model that embraces knowledge as an organizational asset to drive sustainable business advantage. Nowadays the leaders know that they are moving towards knowledge era very fast and they should align all activities in a way that knowledge management facilitates the competition in a better way.Developed countries also try to apply knowledge policies all over their governance to deploy knowledge management in a national level. Existing studies have derived their findings from single perspective, organizational level, or country level, or in a better way, micro or macro level and have not considered a mutual perspective to cover all requirements in a systematic way and compare the micro and macro level for knowledge management establishment.This paper is aimed to bridge this gap through a framework resulted from the analysis of the research data

Food-dependent exercise-induced anaphylaxis due to wheat in a young woman

Food Dependent Exercise-Induced Allergy is a rare condition. However, the occurrence of anaphylaxis is increasing especially in young people. The diagnosis of anaphylaxis is based on clinical criteria and can be supported by laboratory tests such as serum tryptase and positive skin test results for specific IgE to potential triggering allergens. Anaphylaxis prevention needs strict avoidance of confirmed relevant allergen. Food-exercise challenge test may be an acceptable method for diagnosis of Food Dependent Exercise-Induced Allergy and dietary elimination of food is recommended to manage it. In this study, a 32 year-old woman visited the allergy clinic with a history of several episodes of hives since 11 years ago and 3 life-threatening attacks of anaphylaxis during the previous 6 months. The onsets of majority of these attacks were due to physical activity after breakfast. On Blood RAST test, the panel of common food Allergens was used and she had positive test only to wheat flour. On skin prick tests for common food allergens she showed a 6 millimeter wheal with 14 mm flare to Wheat Extract. The rest of allergens were negative. The patient was diagnosed as wheat-dependent exercise-induced, and all foods containing wheat were omitted from her diet. In this report we emphasized on the importance of careful history taking in anaphylaxis diagnosis

A theoretical analysis of pitch stability during gliding in flying snakes

Abstract Flying snakes use their entire body as a continuously morphing 'wing' to produce lift and shallow their glide trajectory. Their dominant behavior during gliding is aerial undulation, in which lateral waves are sent posteriorly down the body. This highly dynamic behavior, which is unique among animal gliders, should have substantial effects on the flight dynamics and stability of the snakes, resulting from the continuous redistribution of mass and aerodynamic forces. In this study, we develop two-dimensional theoretical models to assess the stability characteristics of snakes in the pitch direction. Previously measured force coefficients are used to simulate aerodynamic forces acting on the models, and undulation is simulated by varying mass. Model 1 is a simple three-airfoil representation of the snake's body that possesses a passively stable equilibrium solution, whose basin of stability contains initial conditions observed in experimental gliding trajectories. Model 2 is more sophisticated, with more degrees of freedom allowing for postural changes to better represent the snake's real kinematics; in addition, a restoring moment is added to simulate potential active control. The application of static and dynamic stability criteria show that Model 2 is passively unstable, but can be stabilized with a restoring moment. Overall, these models suggest that undulation does not contribute to stability in pitch, and that flying snakes require a closed-loop control system formed around a passively stable dynamical framework

PRIMARY QUALITIES IN PHYTOTHERAPY AND TRADITIONAL MEDICINES

Objectives: The significance of principles of traditional medicines in research protocols are emphasized by World Health Organization. Primary qualities, traditionally referred to as “hotâ€, “coldâ€, “dry†and “wetâ€, are fundamental concepts of many medical traditions of antiquity such as Persian, Chinese, Greek, and Indian. In Humoral-based traditional medicines, these qualities are regulating factors and act in dynamic balance to maintain health. Therefore, understanding of the primary qualities of body humors and drugs is decisive for treatment, self-care and prevention of diseases in many traditional medicines. The main goals of this study are to consider the relationships among primary qualities and botanical or phytochemical profiles of the traditional Iranian Medicinal herbs.Method: A number of 489 medicinal plants were accommodated with proposed scientific names and the corresponding primary qualities were extracted from Old Persian pharmacopeias. Based on literatures, two data sets screened for statistical study. To ensure consistency and similarity of screened samples, they were examined by Chi-square (χ2) test. Influences of botanical families on primary qualities were studied by screening of 339 plants in 29 botanical families tested with χ2 test. In the second stage, major phytochemicals of 192 herbs were categorized based on existence of 23 groups of phytochemicals and a model based on traditional medicine concepts was made using logistic regression.Results: Statistical outcomes revealed that although a few botanical families tend to correlate in specific primary qualities, most others displayed no significant relationship. The proposed phytochemical model was able to estimate the relationship between primary qualities and phytochemical classes in more than 77% of the cases. The findings were in accordance with literatures.Conclusion: The botanical family classification is not an empirically acceptable indicator of primary qualities in medicinal plants. On the other hand, phytochemical profile of a plant is an authentic indicator of primary qualities

New Challenges in Neutrosophic Theory and Applications

Neutrosophic theory has representatives on all continents and, therefore, it can be said to be a universal theory. On the other hand, according to the three volumes of “The Encyclopedia of Neutrosophic Researchers” (2016, 2018, 2019), plus numerous others not yet included in Encyclopedia book series, about 1200 researchers from 73 countries have applied both the neutrosophic theory and method. Neutrosophic theory was founded by Professor Florentin Smarandache in 1998; it constitutes further generalization of fuzzy and intuitionistic fuzzy theories. The key distinction between the neutrosophic set/logic and other types of sets/logics lies in the introduction of the degree of indeterminacy/neutrality (I) as an independent component in the neutrosophic set. Thus, neutrosophic theory involves the degree of membership-truth (T), the degree of indeterminacy (I), and the degree of non-membership-falsehood (F). In recent years, the field of neutrosophic set, logic, measure, probability and statistics, precalculus and calculus, etc., and their applications in multiple fields have been extended and applied in various fields, such as communication, management, and information technology. We believe that this book serves as useful guidance for learning about the current progress in neutrosophic theories. In total, 22 studies have been presented and reflect the call of the thematic vision. The contents of each study included in the volume are briefly described as follows. The first contribution, authored by Wadei Al-Omeri and Saeid Jafari, addresses the concept of generalized neutrosophic pre-closed sets and generalized neutrosophic pre-open sets in neutrosophic topological spaces. In the article “Design of Fuzzy Sampling Plan Using the Birnbaum-Saunders Distribution”, the authors Muhammad Zahir Khan, Muhammad Farid Khan, Muhammad Aslam, and Abdur Razzaque Mughal discuss the use of probability distribution function of Birnbaum–Saunders distribution as a proportion of defective items and the acceptance probability in a fuzzy environment. Further, the authors Derya Bakbak, Vakkas Uluc¸ay, and Memet S¸ahin present the “Neutrosophic Soft Expert Multiset and Their Application to Multiple Criteria Decision Making” together with several operations defined for them and their important algebraic properties. In “Neutrosophic Multigroups and Applications”, Vakkas Uluc¸ay and Memet S¸ahin propose an algebraic structure on neutrosophic multisets called neutrosophic multigroups, deriving their basic properties and giving some applications to group theory. Changxing Fan, Jun Ye, Sheng Feng, En Fan, and Keli Hu introduce the “Multi-Criteria Decision-Making Method Using Heronian Mean Operators under a Bipolar Neutrosophic Environment” and test the effectiveness of their new methods. Another decision-making study upon an everyday life issue which empowered us to organize the key objective of the industry developing is given in “Neutrosophic Cubic Einstein Hybrid Geometric Aggregation Operators with Application in Prioritization Using Multiple Attribute Decision-Making Method” written by Khaleed Alhazaymeh, Muhammad Gulistan, Majid Khan, and Seifedine Kadry

Association of serum immunoglobulin G level with peritonitis in patients undergoing peritoneal dialysis: An analytical study

Introduction: Peritonitis is one of the most common complications of peritoneal dialysis. On the other hand, reduced levels of immunoglobulins (Igs), mainly IgG, can increase the risk of infection in various pathologic conditions. Here, we aimed to determine the association of severity and frequency of peritonitis with serum IgG levels in peritoneal dialysis patients. Methods: 100 patients with chronic renal failure referred to Imam Reza Hospital, Tabriz, Iran, for peritoneal dialysis were included in the study. Serum IgG levels were measured in all of these patients at the beginning of the study and after six months of follow-up. In case of peritonitis, serum IgG levels were also measured, and samples were sent to Imam Reza Hospital laboratory for analysis. Results: 40 cases (40%) were women, and 60 cases (60%) were men with a mean age of 47 years. 24 cases (24.0%) had at least one episode of peritonitis during the study. Among those with peritonitis, 14 cases (60.9%) had at least one more peritonitis episode in the 6-month follow up. The mean serum IgG levels were 1079 mg/dl and 429 mg/dl at the beginning and after six months of follow up, respectively. The difference was shown to be statistically significant (P = 0.006). There was no correlation between serum IgG level reduction and peritonitis in these patients (P > 0.999). Conclusion: This study found reduced levels of serum IgG in patients undergoing peritoneal dialysis. However, it was not associated with increased risk of peritonitis in these patients