Efficacy of high-resolution, 3-D diffusion-weighted imaging in the detection of breast cancer compared to dynamic contrastenhanced magnetic resonance imaging

Purpose: To evaluate the utility of high-resolution, 3-D diffusion-weighted imaging (DWI) in the detection of breast cancer and to compare the sensitivity, specificity, and area under the curves of DWI and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Material and method: Prospective IEC approved study included 131 breast lesions detected on mammography and breast ultrasound. Cases underwent MRI on a 3 Tesla scanner using a dedicated breast coil. T2WI, STIR, T1WI, and dynamic post contrast MR. DWI MRI with b value of 50, 800, and 1500 s/mm2. Post-processing data with apparent diffusion coefficient (ADC) calculations and kinetic curves were obtained. Characteristics for lesions were analysed as per ACR BI-RADS descriptors. Final histopathological diagnosis was considered as the standard of reference. c2 test, t-test, receiver operating characteristic (ROC) curve analysis, pairwise comparison of ROC curves, sensitivity, specificity, diagnostic accuracy, and area under the curve (AUC) were calculated. Results: Sixty-six (50.38%) malignant and 65 (59.62%) benign lesions were included in the study. The mean ADC of malignant lesions was 0.870 × 10-3 mm2/s and 1.637 × 10-3 mm2/s (p < 0.0001) for benign lesions. Sensitivity and specificity for DWI were 95.45% and 90.76%, respectively, and for DCE-MRI they were 96.97% and 87.69%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) were obtained at 91.30% and 95.16%, respectively, in DWI while in DCE-MRI they were 88.88% and 96.61%, respectively. The AUC for ADC was 0.979. In ROC comparison of AUC for DWI 0.931 and for DCE-MRI 0.923, the difference between the areas was 0.00781 (p = 0.782). Conclusions: High-resolution DWI is a non-contrast MRI technique, which improves the lesion detection with diagnostic performance comparable to DCE-MRI and has potential as an adjunct with screening mammography

Primary bipolar replacement arthroplasty versus internal fixation in the management of unstable intertrochanteric fractures in the elderly

Background: Management of unstable intertrochanteric femur fracture in the elderly has been always a matter of debate. There has been always a dilemma between osteosynthesis and prosthesis.Methods: We retrospectively evaluated, 108 osteoporotic elderly patients with unstable intertrochanteric for internal fixation versus primary bipolar replacement arthroplasty in a span of 4 years.Results: Bipolar replacement arthroplasty gives better outcome as compared to internal fixation with sliding hip screw.Conclusions: It was found that cemented bipolar arthroplasty is the choice in freely mobile elderly osteoporotic comminuted displaced intertrochanteric fracture, though is a surgically demanding technique, it spares the postoperative complication of non-weight bearing after internal fixation of these fracture. The internal fixation is also compounded by osteoporosis, medical illness, difficulty to achieve and maintain reduction of comminuted and widely displaced unstable fractures, which restricts the mobilization and weight bearing and further increase the risk of morbidity and mortality in elderly in comparison to cemented bipolar replacement arthroplasty which allows early mobilization and weight bearing

Decision making for improving maritime traffic safety using constraint programming

A*STAR-Fujitsu-SMU Urban Computing and Engineering Centre of Excellence; Singapore National Research Foundatio

Envisioning marriage and sexuality in New-India

Marriage has been a timeless and honored institution for social affirmation of a heterosexual relationship. It also has several legal dimensions with the intent to safeguard civil and legal rights, values and cultural nuances. Sexuality although eclipsed under societal expectations is an equally complex yet important cornerstone of any relationship irrespective of age, region and religion. [1]However the day-to-day realities of any partnership has its own dimensions. The very patriarchal nature of partnership since ages is being re challenged by the evolving social and legal revolutions such as questioning gender stereotypes and roles, rights of partners and free expression of individuality. Covid-19 pandemic played a major role in breakdown of many so-calledsocial equilibrium. As a consequence, many women faced genderbased violence in their households. The whole purpose of social protection under the umbrella of marriage may not be always true [2] as evident in many cases. Hence it becomes important to debate, re-understand and remodel the institution of marriage and sexuality in context of the current social trends. This issue of the journal focuses on many important dimensions of relationship both traditional and contemporary starting from discussing sexuality, the new age relationships, embracing inclusivity for sexual minorities, dissolving strict gender roles and the safeguarding against violence

External fixation versus plating in intra-articular distal end radius fractures

Background: Distal end radius fractures are one of the most common encountered fractures in Orthopaedics. Prompt intervention in terms of volar locking plate or external fixation can be performed. The purpose of this study was to derive a better outcome as to which type of fixation is a better choice for the treatment of intra-articular distal end radius fracture.Methods: A prospective randomized controlled study was conducted with 30 patients and comparison was made between the plating and external fixator group using the modified clinical-scoring system of Green and O'Brien and demerit point system at each follow-up.Results: In the plating group 14 patient’s fracture united in 6th week and 1 patient’s fracture united at 8th week this result was similar to the external fixator group were 14 patient’s fracture united in 6th week and 1 patient’s fracture united at 8th week. 1 patient each developed wrist joint stiffness and delayed union in the plating group as compared to the external fixator group were 1 patient each developed wrist joint stiffness, delayed union and broken implant in situ and pin tract infection.Conclusions: During the initial follow ups the functional outcome of the plating group were better than the external fixator group but as the time passed at the final follow up plating was only marginally better than the external fixator group. It was seen that radiologically plating lead to a better correction of all the parameters as compared to external fixator group

Comparison of Filtering Techniques for Transfer Alignment of Air Launched Tactical Guided Weapons

The transfer alignment technique is very useful for the accurate initialization and calibration of gyroscopes and accelerometers of INS for air-launched tactical guided weapon systems. In the present war scenario, the initialization of INS should be accurate and rapid to launch the tactical weapon against air or land targets within the shortest available time. A lot of development has been carried out by researchers for INS transfer alignment in the field of state estimation. The study and method presented in the research are relevant to aerial launch vehicles. However, to meet present guidance requirements within less time for initializing weapons, more appropriate transfer alignment algorithms are needed. This paper discusses the relative performance of Kalman Filter (KF), Extended KF, and Unscented KF for aligning the weapon INS using the data from Master INS. New developments, limitations, applicability, and design methods for the Kalman filters, became a key component in the transfer alignment of air-launched tactical missiles. These methodologies are extensively utilized in Navigation and Control systems; therefore, this research work will be an informative and perfect guide to existing and potential readers

Rapid and Accurate INS Transfer Alignment for Air Launched Tactical Missile Using Kalman Filter

An Inertial Navigation System (INS) independently measures the Position, Velocity, and Attitude (PVA) of thevehicle to navigate it towards the target. Since INS is a dead-reckoning system, it requires accurate initialization toprovide the navigation (PVA) solution. In the case of an air-launched tactical missile, the aircraft navigation system(Master INS) information is used to initialize accurately the missile INS (Slave INS). Rapid transfer alignment isneeded in today’s combat operation to converge slave INS initialization in the shortest possible time using aircraftnavigation information. The transfer alignment consists of first initializing the missile INS and establishing anavigation solution (PVA) using the missile IMU rates and accelerations, then a Kalman filter is used to, estimatethe errors between the Slave INS and Master INS. The proposed method’s simulation results show that a tacticalmissile INS can be aligned to an acceptable accuracy in a very short time based on the aircraft’s attitude information and with natural maneuvers experienced during aircraft take-off

A prospective study to assess the efficacy of tranexamic acid in reducing blood loss during total hip arthroplasty

Background: Tranexamic acid has been reported to reduce bleeding, risk of thromboembolic events and the need for allogenic blood transfusion in total hip replacement patients. The present study was conducted to assess the efficacy of tranexamic acid in reducing blood loss during total hip replacement surgery.Methods: Total hip arthroplasty patients (n=60) were divided into control and test groups with 30 patients each. Test group was administered with tranexamic acid (15 mg/kg) for 15 min before and after the surgery. Patients were administered cefuroxime (1.5 g), 30 min prior to the surgery and deep vein thrombosis prophylaxis; enoxaparin (40 mg), 48 hours after surgery. Demographic details along with levels of hemoglobin and blood loss before, during and after the surgery were recorded.Results: Tranexamic acid reduced the early post-surgical blood loss (292±132.38 vs. 155.8±86.56 ml; p&lt;0.0001), total blood loss (989.6±340.98 vs. 580.4±131.88 ml; p&lt;0.0001), and the blood loss during surgery (723.5±277.73 vs. 434.3±131.83 ml; p&lt;0.05). Test group required fewer transfusions (6.7%) than control group (26%) and had no increased incidence of deep-vein thrombosis. Postsurgical hemoglobin in the control group had significantly reduced as compared to test group.Conclusions: Administration of intravenous tranexamic acid before and after the surgery was effective in reducing the blood loss and transfusion requirements and its related complications

Genetic factors regulating lung vasculature and immune cell functions associate with resistance to pneumococcal infection

Streptococcus pneumoniae is an important human pathogen responsible for high mortality and morbidity worldwide. The susceptibility to pneumococcal infections is controlled by as yet unknown genetic factors. To elucidate these factors could help to develop new medical treatments and tools to identify those most at risk. In recent years genome wide association studies (GWAS) in mice and humans have proved successful in identification of causal genes involved in many complex diseases for example diabetes, systemic lupus or cholesterol metabolism. In this study a GWAS approach was used to map genetic loci associated with susceptibility to pneumococcal infection in 26 inbred mouse strains. As a result four candidate QTLs were identified on chromosomes 7, 13, 18 and 19. Interestingly, the QTL on chromosome 7 was located within S. pneumoniae resistance QTL (Spir1) identified previously in a linkage study of BALB/cOlaHsd and CBA/CaOlaHsd F2 intercrosses. We showed that only a limited number of genes encoded within the QTLs carried phenotype-associated polymorphisms (22 genes out of several hundred located within the QTLs). These candidate genes are known to regulate TGFb signalling, smooth muscle and immune cells functions. Interestingly, our pulmonary histopathology and gene expression data demonstrated, lung vasculature plays an important role in resistance to pneumococcal infection. Therefore we concluded that the cumulative effect of these candidate genes on vasculature and immune cells functions as contributory factors in the observed differences in susceptibility to pneumococcal infection. We also propose that TGFbmediated regulation of fibroblast differentiation plays an important role in development of invasive pneumococcal disease.This work was supported by the European Union-funded Pneumopath Project HEALTH-F3-2009-222983. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer-reviewedPublisher Versio

Emerging evidence on the role of secondary metabolites as nutraceutical

Nutraceuticals have time-honored considerable interest because of their reputed safety, nutritional and therapeutic potential effects. Pharmaceutical and nutritional industries are conscious of the monetary success taking advantage of the more health-seeking consumers. Natural products such as cereals are likely to form the basis of nutraceutical as its revolution represents an enormous opportunity for growth and expansion. Wheat, rice, millets, barley, oat, buckwheat, corn, sorghum, flaxseed psyllium, brown rice, and products are notify the most common cereal based functional foods and nutraceuticals. The nutrients in the cereals have identified prospective for reducing the risk of coronary heart disease, diabetes, tumor incidence, cancer risk, blood pressure, reduces the rate of cholesterol and fat absorption, delaying gastrointestinal emptying and providing gastrointestinal health. Thus, the regular insertion of cereals and their processed products can make a payment to health endorsement and disease avoidance