589 research outputs found

    Ventriculo-Peritoneal Shunt Infections in Infants and Children

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    Objective: To determine the rate and the type of ventriculoperitoneal (VP) shunt infections in infants and children admitted to King Fahad Hofuf hospital of Al-Ahsaa area at the Eastern Province of Saudi Arabia.Methods: From mid 2003 to end of 2006; VP shunt infection episodes were reviewed. Once infection was suspected, a cerebrospinal fluid (CSF) sample was taken and empirical antibiotics were recommended. Once infection was confirmed, VP shunt was removed and external ventricular drainage (EVD) was inserted until CSF became sterile after which a new shunt was inserted.Results: 25.9% of patients with VP shunts had infections which represents 29.3% of the procedures. 40% of infected patients had recurrent episodes. 59.1% of infections occurred throughout the first two months following insertion. Single pathogen was isolated in each episode. Pseudomonas auerginosa represented 50% of isolated pathogens compared with 18.2% with Staphylococcus epidermidis.Conclusions: There is a high incidence of VP shunt infections in King Fahad Hofuf hospital when compared with other international centres. Gram negative organisms are the most common cause of the infection

    Conditional analysis of turbulent premixed and stratified flames on local equivalence ratio and progress of reaction

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    Previous studies on the Cambridge/Sandia stratified burner have produced a comprehensive database of line Rayleigh/Raman/CO LIF measurements of scalars, as well as LDA and PIV measurements of velocity, for flames under non-uniform mixture fraction, under moderate turbulent conditions where the ratio of the turbulent velocity fluctuations to the laminar flame speed is of order 10. In prior work, we applied multiple conditioning methods to demonstrate how local stratification increases the levels of CO and H2, relative to the corresponding turbulent premixed flame, and enhances surface density function (SDF) and scalar dissipation rate of progress of reaction (SDR), based on extent of temperature rise, at a particular location in the flame where the mixing layer and flame brush cross. In the present study, we examine the global features of selected flames at all locations, by obtaining probability density functions (PDFs) for species concentrations, SDRs, and SDFs, conditioned on local equivalence ratio and location in the flame brush throughout the domain. We find that for most cases, species profiles as a function of temperature are well represented by laminar flame relationships at the local equivalence ratio, with some deviations attributable to either differential diffusion near the flame base and local stratification effects further downstream where the flame brush crosses the mixing layer. In particular, CO2 is significantly affected by differential diffusion, and CO and H2 by stratification. However, the stratification effects on the species are relatively minor when conditioned on local equivalence ratio, a simplifying result in the context of modeling. Measurements of the gradient of progress of reaction and scalar dissipation rates, conditioned on local equivalence ratio, show that the thermal zone of the flame is thickened by turbulence: the mean SDF and SDR values are in general lower than those of unstrained laminar flames. The effect is greater under rich conditions, with conditional mean SDR decreasing to less than half of the corresponding laminar value. The extent of flame thickening is the same in the premixed as the stratified case, once the stratified measurements are conditioned on the same equivalence ratio.M. Mustafa Kamal acknowledges funding from University of Engineering and Technology Peshawar (Pakistan). The measurements at Sandia National Labs were sponsored by the United States Department of Energy, Office of Basic Energy Sciences, Division of Chemical Sciences, Geosciences and Biosciences. Sandia National Laboratories is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the United States Department of Energy under contract DE-AC04-94-AL85000. The authors also thank Dr. Akihiro Hayakawa for his contributions to the laminar flame calculations and Dr. Saravanan Balusamy for his valuable suggestions regarding data processing

    Traumatic brain injury in pediatric age group; predictors of outcome in Pediatric Intensive Care Unit

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    Objective: To determine predictors for outcomes of traumatic brain injury (TBI) in infants and children younger than twelve years admitted to our pediatric intensive care units (PICU).Methods: This is a retrospective cohort study from 2004-5, done at the PICU of King Fahad Hofuf Hospital, Eastern Province, Saudi Arabia. One hundred and six patients with TBI; 65 boys and 41 girls ages 12 or under, with a mean age of 5.7 years, were included. Of them, 11.3% died (Deaths group), 11% survived with neurological deficits (ND-group), and 77% survived with no neurological deficits (NND-group). The potential predictors for death or neurological deficits were examined.Results: 83% of deaths had initial Glascow coma scale (GCS) of ≀ 4/15, 50% of ND had initial GCS ≀ 8 and 27% of NND had GCS < 12. The initial brain CT was abnormal in 92% of deaths and ND groups, but in only 37% of NND. Combined brain pathologies were found in 92% of deaths, 63% of ND and only in 5% of NND. Hypotension was seen in 67% of deaths, 17% ND and only in 1% of NND. Mechanical ventilation was required in all deaths and more than half of ND. Liver enzymes were high in 50% of deaths and 66% of ND but in only 20% of NND. Serum albumin was low in 33% of deaths, 42% of ND and only 1% NND.Conclusion: Glasgow coma score, brain CT findings, combined brain pathologies, hypotension, high liver enzymes and low serum albumin predict outcome after TBI in pediatric age group

    Pengaruhpenerapan Standar Akuntansi Pemerintahan, Pengelolaan Keuangan Daerah, Sistem Pengendalian Intern, Dan Kompetensi Staf Akuntansi Terhadap Kualitas Laporan Keuangan Pemerintah Daerah (Studi Empiris pada SKPD Kabupaten Grobogan)

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    The purpose of this study is to analyze the influence of the Application of Government Accounting Standards, Management of Regional Finance, Internal Control System, Accounting Staff Competence on the quality of local government financial statements. Population in this research is Civil Servant sampling technique using purposive sampling where there are 50 employees at 18 duty at Work Unit of Local Area in Grobogan Regency which used as research sample consisting of head of sub finance department, treasurer, and accounting staff. This research method using multiple linear regression analysis. The results of research data on the management of regional financial and accounting staff competence affect the quality of financial statements while the implementation of government accounting standards and internal control system does not affect the quality of local government financial statement

    Favre- and Reynolds-averaged velocity measurements: Interpreting PIV and LDA measurements in combustion

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    Previous studies using particle image velocimetry (PIV) and laser Doppler anemometry (LDA) have raised the question of how these measurements should be compared. This study reports on the difference between Favre-averaged and Reynolds-averaged velocity statistics for a turbulent burner using PIV and LDA for unconditional and conditional velocity measurements. The experimental characterization of flow fields of premixed and stratified methane/air flames is carried out under globally turbulent lean conditions (global equivalence ratio at 0.75), over a range of stratifications and swirl numbers. Unconditioned velocity data was acquired using aluminium oxide to seed the flow field. Conditioned measurements were performed using vegetable oil aerosol as seed, which burns through the flame front, thus allowing only the non-reacting flow velocities to be obtained. A critical comparison of unconditioned velocity profiles measured using both PIV and LDA, including axial, radial, and tangential components is made against conditioned and reconstructed mean velocities at different cross-sections of the flame. The comparison reveals how the differences between the Favre-averaged (unconditioned) and the Reynolds-averaged (conditioned) velocity measurements in the flame brush region can be accounted for using the mean progress of reaction, and highlights the limits of the accuracy and agreement between PIV and LDA measurements.The authors would like to thank the University of Engineering and Technology Peshawar (Pakistan) and the University of Cambridge for their financial contributions to this workThis is the author accepted manuscript. The advanced access article on the publisher's website can be found at: http://www.sciencedirect.com/science/article/pii/S1540748914002193# © 2014 The Combustion Institute. Published by Elsevier Inc. All rights reserved

    Contrasting genetic influence of PON 1 coding gene polymorphisms L55M and Q192R on individuals’ response to environmental agents

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    Background: Paraoxonase (PON1) is an A-esterase capable of hydrolyzing the active metabolites (oxons) of many organophosphorus (OP) insecticides. Human PON1 displays two polymorphisms in the coding region (Q192R and L55M) and several polymorphisms in the promoter and the 30-UTR regions. Animal studies have shown that PON1 is an important determinant of OP toxicity though a direct satisfactory verification in humans is still lacking.Aim: To investigate the impact of polymorphisms in the PON1 coding region (Q192R and L55M) on individual sensitivity to OP poisoning.Subjects and methods: This study enrolled 42 subjects (21 females and 21 males, age range 1.5– 53 years) diagnosed of acute OP poisoning. They were classified into 4 grades according to manifestations. All subjects were genotyped for the PON1 gene polymorphisms; Q192R and L55M using RFLP-PCR, then genotype frequencies were compared between different OP grades.Results: Genotype frequency distribution of PON1 L55M polymorphism among different OP poisoning grades revealed no significant difference (p&gt;0.05) between the four grades. In contrast, frequency distribution of PON1 Q192R polymorphism showed a highly significant (p&lt; 0.001) difference between different grades of OP poisoning, with QQ genotype predominating in grade 4 with a frequency of 66.7%, followed by QR genotype (33.3%), while the RR and QR genotypes were similarly distributed in grade 1 with a frequency of 50% for each.Conclusion: The current results suggest a possible association between QQ genotype and poor OP poisoning prognosis.KEYWORDS Paraoxonase; L55M; Q192R; Organophosphate; Poisoning grad

    Oxidative Stress -a Phenotypic Hallmark of Fanconi Anemia and Down Syndrome: The Effect of Antioxidants

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    Background: Oxidative stress plays a major role in the pathogenesis of leukemia.prone diseases such as Fanconi anemia (FA) and Down syndrome (DS). Aim: To explore the oxidative stress state in children with DS and FA by estimating the levels of antioxidants (e.g., malondialdehyde [MDA], total antioxidant capacity, and superoxide dismutase [SOD] activity) and DNA damage, and to evaluate of the effect of antioxidant treatment on these patients.Subjects and Methods: The study included 32 children clinically diagnosed with (15 patients) and FA (17 patients) in addition to 17 controls matched for age and sex. MDA, total antioxidant capacity, SOD activity, and DNA damage were measured. Antioxidants including Vitamin A, E, and C were given to the patients according to the recommended daily allowance for 6 months. Clinical follow.up and re.evaluation were conducted for all patients. Laboratory tests including complete blood count, karyotyping, DNA  damage, and oxidative stress were re.evaluated. Statistical analysis was performed using statistical computer program Statistical Package for the Social Sciences version 14.0. Results: Children with FA and DS had elevated levels of oxidative stress and more DNA damage than controls. Oxidative stress parameters and DNA damage improved in FA and DS patients after antioxidant administration. Conclusion: Early administration of antioxidants to FA and DS patients is recommended for slowing of the disease course with symptoms   amelioration and improvement of general health.Keywords: Down syndrome, Oxidative DNA damage, Oxidative stres

    An improved particle swarm algorithm for multi-objectives based optimization in MPLS/GMPLS networks

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    Particle swarm optimization (PSO) is a swarm-based optimization technique capable of solving different categories of optimization problems. Nevertheless, PSO has a serious exploration issue that makes it a difficult choice for multi-objectives constrained optimization problems (MCOP). At the same time, Multi-Protocol Label Switched (MPLS) and its extended version Generalized MPLS, has become an emerging network technology for modern and diverse applications. Therefore, as per MPLS and Generalized MPLS MCOP needs, it is important to find the Pareto based optimal solutions that guarantee the optimal resource utilization without compromising the quality of services (QoS) within the networks. The paper proposes a novel version of PSO, which includes a modified version of the Elitist Learning Strategy (ELS) in PSO that not only solves the existing exploration problem in PSO, but also produces optimal solutions with efficient convergence rates for different MPLS/ GMPLS network scales. The proposed approach has also been applied with two objective functions; the resource provisioning and the traffic load balancing costs. Our simulations and comparative study showed improved results of the proposed algorithm over the well-known optimization algorithms such as the “standard” PSO, Adaptive PSO, BAT, and Dolphin algorithm
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