Minimal Invasive Chirurgie der Zehengelenke mit Hilfe der C-Bogen Technik

Deckblatt-Impressum persönlicher Dank Contents Abbreviations Introduction Review of literature Materials and methods Results Discussion Conclusions Summary Zusammenfassung References Acknowledgment SelbständigkeitserklärungThis study was carried out on 140 horses of different sexes, ages and breeds which were admitted to the Equine Clinic at the Free University, Berlin between January 2000 and May 2004. A total of 158 phalangeal joints underwent successful fluoroscopic guided minimal invasive surgery using the mobile C-arm fluoroscope (Philips BV212 Rlease 4). The indications in all horses were: 1-Surgical removal of isolated shadows (radiopaque bodies) from the region of the common digital extensor tendon insertion at the extensor process of the pedal bone (28 horses). 2- Surgical removal of isolated shadows (radiopaque bodies) from the dorsal aspect of the pastern (3 horses). 3-Surgical removal of isolated shadows (radiopaque bodies) from the dorsal or the palmar/plantar aspect of the fetlock joint (76 horses). 4-Surgical repair of intra-articular fractures associated with the phalangeal joints (25 horses). 5-Surgical managements of subchondral bone cysts (8 horses). All personnel in the operating room wore standard radioprotective aprons and every one had a portable dosimeter. Each surgeon wore an additional ring dosimeter. At monthly intervals, the radiation doses were measured for every one in mSv and were very low and did not exceed the legal limits permitted in Germany. From the technical point of view all the operations were easily performed and no intraoperative complications encountered. In equine orthopedic surgery, minimal invasive techniques should be more applied to improve wound healing by a minimal access and consequently to shorten the convalescence period. Phalangeal joints are from the joints that can be successfully operated with the aid of fluoroscopic guided C-arm technique as a minimal invasive technique. The possibility now exists to operate these joints only under fluoroscopic control which constitutes a further step in the replacement of arthroscopy and arthrotomy techniques by fluoroscopy (especially in case of the small joints or in case of isolated shadows which located in the joint vicinity and are embedded or buried within the joint capsule, tendons or ligaments). The use of a combination of fluoroscopy and arthroscopy techniques is also possible. Fluoroscopic guide C-arm technique is practical from the technical and cosmetic point of view. The technique is not sophisticated, quick, and easy to perform. Following fluoroscopic guided surgery the cosmetic appearance was improved and the convalescent time decreased.Diese Studie wurde an 140 Pferden mit unterschiedlichem Geschlecht, Alter und Rasse, die im Zeitraum Januar 2000 bis Mai 2004 in der Klinik für Pferde der Freien Universität vorgestellt wurden, durchgeführt. Insgesamt wurden 158 Zehnengelenke mittels minimalinvasiver Chirurgie und unter Durchleuchtungkontrolle mit einer C- förmigen Bogen (Philips BV212 Release 4) operiert. Die Indikationen bei allen Pferden waren: 1-Chirurgische Entfernung der isolierten Verschattung aus dem Bereich des Prozessus extensorius (28 Pferde). 2- Chirurgische Entfernung der isolierten Verschattung aus der dorsalen Gelenkaussackung des Kronglenkes (3 Pferde). 3- Chirurgische Entfernung der isolierten Verschattung aus dem dorsalen oder palmaren/ plantaren Bereich des Fesselgelenks (76 Pferde). 4- Interne Fragmentfixation (Osteosynthese) von intraartikulären Frakturen der Zehengelenke (25 Pferde). 5- Chirurgische Behandlung zystoider Knochendefekte (8 Pferde). Alle beteiligten Personen im Operationssaal waren mit Röntgenschürzen und Dosimeter ausgestattet. Die Chirurgen trugen zusätzlich Fingerring Dosimeter. Die Dosimeter wurden in monatlichen Intervallen ausgewertet und die gemessene Werte (mSv) übersteigen in keinen Fall die zugelassenen Normalwerte. Aus technischer Sicht waren alle Operationen einfach durchzuführen und es kam zu keinen intraoperativen Komplikationen. In der Pferdeorthopädie sollte die minimalinvasive Technik mehr eingesetzt werden, um die Wundheilung zu verbessern und die Rekonvaleszenzzeit zu verkürzen. Die Zehenengelenke können mit dem Einsatz des C-Bogens erfolgreich minimalinvasiv operiert werden. Diese Operationtechnik mit C-Bogen Kontrolle kann als Ersatz einer Arthroskopie oder Arthrotomie-Technik eingesetzt werden (besonders in Fällen bei kleinen Gelenken oder im Fall von isoliertem Verschattungen, die außerhalb des Gelenkes, in der Gelenkkapselwand, in Sehnen oder in Bänden eingebaut sein können). Der Einsatz von Kombinationen mit C-Bogen und Arthroskopie-Technik ist ebenfalles vorteilhaft. Die Durchleuchtungskontrolle mit dem C-Bogen ist aus technischen und kosmetischen Gesichtpunkt praktisch. Die Technik ist hoch entwickelt, schnell, und einfach durchzuführen

Multi-dialect Arabic broadcast speech recognition

Dialectal Arabic speech research suffers from the lack of labelled resources and standardised orthography. There are three main challenges in dialectal Arabic speech recognition: (i) finding labelled dialectal Arabic speech data, (ii) training robust dialectal speech recognition models from limited labelled data and (iii) evaluating speech recognition for dialects with no orthographic rules. This thesis is concerned with the following three contributions: Arabic Dialect Identification: We are mainly dealing with Arabic speech without prior knowledge of the spoken dialect. Arabic dialects could be sufficiently diverse to the extent that one can argue that they are different languages rather than dialects of the same language. We have two contributions: First, we use crowdsourcing to annotate a multi-dialectal speech corpus collected from Al Jazeera TV channel. We obtained utterance level dialect labels for 57 hours of high-quality consisting of four major varieties of dialectal Arabic (DA), comprised of Egyptian, Levantine, Gulf or Arabic peninsula, North African or Moroccan from almost 1,000 hours. Second, we build an Arabic dialect identification (ADI) system. We explored two main groups of features, namely acoustic features and linguistic features. For the linguistic features, we look at a wide range of features, addressing words, characters and phonemes. With respect to acoustic features, we look at raw features such as mel-frequency cepstral coefficients combined with shifted delta cepstra (MFCC-SDC), bottleneck features and the i-vector as a latent variable. We studied both generative and discriminative classifiers, in addition to deep learning approaches, namely deep neural network (DNN) and convolutional neural network (CNN). In our work, we propose Arabic as a five class dialect challenge comprising of the previously mentioned four dialects as well as modern standard Arabic. Arabic Speech Recognition: We introduce our effort in building Arabic automatic speech recognition (ASR) and we create an open research community to advance it. This section has two main goals: First, creating a framework for Arabic ASR that is publicly available for research. We address our effort in building two multi-genre broadcast (MGB) challenges. MGB-2 focuses on broadcast news using more than 1,200 hours of speech and 130M words of text collected from the broadcast domain. MGB-3, however, focuses on dialectal multi-genre data with limited non-orthographic speech collected from YouTube, with special attention paid to transfer learning. Second, building a robust Arabic ASR system and reporting a competitive word error rate (WER) to use it as a potential benchmark to advance the state of the art in Arabic ASR. Our overall system is a combination of five acoustic models (AM): unidirectional long short term memory (LSTM), bidirectional LSTM (BLSTM), time delay neural network (TDNN), TDNN layers along with LSTM layers (TDNN-LSTM) and finally TDNN layers followed by BLSTM layers (TDNN-BLSTM). The AM is trained using purely sequence trained neural networks lattice-free maximum mutual information (LFMMI). The generated lattices are rescored using a four-gram language model (LM) and a recurrent neural network with maximum entropy (RNNME) LM. Our official WER is 13%, which has the lowest WER reported on this task. Evaluation: The third part of the thesis addresses our effort in evaluating dialectal speech with no orthographic rules. Our methods learn from multiple transcribers and align the speech hypothesis to overcome the non-orthographic aspects. Our multi-reference WER (MR-WER) approach is similar to the BLEU score used in machine translation (MT). We have also automated this process by learning different spelling variants from Twitter data. We mine automatically from a huge collection of tweets in an unsupervised fashion to build more than 11M n-to-m lexical pairs, and we propose a new evaluation metric: dialectal WER (WERd). Finally, we tried to estimate the word error rate (e-WER) with no reference transcription using decoding and language features. We show that our word error rate estimation is robust for many scenarios with and without the decoding features

APPRAISEMENT OF THE GEOLOGIC FEATURES AS A GEO-HERITAGE IN ABU-ROASH AREA, CAIRO- EGYPT

Egypt contains Geologic Heritage that create much opportunity to develop educational and recreational programs as well as tourism projects. Enhancement of Geologic Heritage and awareness of the importance of Geologic Heritage is a great challenge. This paper focuses on a neglected area inside Cairo that is facing a great destruction from the people living there. The Abu-Roash archaeological site is located at 31ᵒ 02′ 42″ E longitude and 30ᵒ 02′ 42″ N latitude. It is one of the most important areas for education and scientific study inside Cairo. Although the area is not suited as a geo-heritage or even a protected area, it contains Cretaceous to upper Eocene sedimentary beds and fossils, and a great variety of structural features. Not only an important geologic aspect found in the area but also an archeological site is present which provide the area of a great scientific, cultural/historical, aesthetic and/or social/economic value. These different criteria qualifies the study are to have a regional/provincial rank for its Geo-heritage. Abu Roash area are possess good geo-diversity, geo abundance and geo richness which lead us to start point for establishing potential geo-heritage that should be conserved the area also need to be recognized as a geological conservation sites, the area should be Stated as a protected area of a heritage legislation to protect geo-heritage

Screening of social phobia symptoms in a sample of Egyptian university students

Background: Public speaking is a main requisite for academic achievement amongst university students. Epidemiological data on social phobia among University students in the Arab World are scarce. Objectives: To screen for social phobia symptoms in a representative sample of Egyptian university students, and to highlight some putative risk factors associated with them. Methods: Two thousand nine hundred and nineteen Egyptian university students participated in the study. They were screened for social phobia using Brief Social Phobia Scale (BSPS). Students total and subdomain scores on the BSPS were correlated with their demographic and scholastic variables. Results: Social phobia symptoms were estimated to be prevalent among (44%) of the study sample. A significant (p < 0.05) negative correlation was found between students’ age and avoidance scores on BSPS and between students’ educational year and their scores on fear, avoidance and physiologic subdomains on the BSPS. Regression analysis pointed out to a number of predictive factors for the higher total BSPS scores such as female gender and being a medical student. Discussion: Our study demonstrated a high rate of social phobia symptoms in university students. It also demonstrated a number of significant predictive factors associated with the domains of social phobia such as gender, BMI, scholastic year and faculty type

Salp Swarm Optimization with Self-Adaptive Mechanism for Optimal Droop Control Design

The collaboration of the various distributed generation (DG) units is required to meet the increasing electricity demand. To run parallel-connected inverters for microgrid load sharing, several control strategies have been developed. Among these methods, the droop control method was widely accepted in the research community due to the lack of important communication links between parallel-connected inverters to control the DG units within a microgrid. To help to solve the power-sharing process, keep to frequency and voltage constrained limits in islanded mode microgrid system. The parameter values must therefore be chosen accurately by using the optimization technique. Optimization techniques are a hot topic of researchers; hence This paper discusses the microgrid droop controller during islanding using the salp swarm inspired algorithm (SSIA). To obtain a better fine microgrid output reaction during islanding, SSIA-based droop control is used to optimally determine the PI gain and the coefficients of the prolapse control. The results of the simulation show that the SSIA-based droop control can control the power quality of the microgrid by ensuring that the keep to frequency and voltage constrained limits and deviation and proper power-sharing occurs during the microgrid island mode during a load change

Impact of Knowledge and Attitude on Saudis’ Physical Activity Practice and Inactivity Barriers: A Questionnaire-based Study

BACKGROUND: Community participation in physical activity is considered a major public health preference of WHO. Saudi Arabia in the last decades faced many tremendous economic changes leading to adoption of western dietary habits associated with sedentary lifestyle. AIM: We aimed to study the relationship between both physical activity knowledge and attitude of community to the practice of individuals. METHODS: We used a questionnaire consists of a mixture of closed-ended questions. Participants were recruited through direct meetings in local markets, schools, and workplaces. Seven hundred and sixty six individuals agreed to participate. RESULTS: Overall correct answers to questions about importance of physical activity were 76.58%. The predominance of participants’ attitude was to establish public places for physical activity in each neighborhood (92.1%). Participants acknowledged that they exercise to improve their health (47.5%). Participants mainly perform light exercises (47.2%) on basis of 1–3 times weekly (48.9%). About 90.8% of participants admitted that they like to increase duration of their physical activity. CONCLUSIONS: Overall physical activity practice of participants’ needs encourage overcoming obstacles that prevent individuals from practicing especially lack of time

Prognostic model development and molecular subtypes identification in bladder urothelial cancer by oxidative stress signatures

Background: Mounting studies indicate that oxidative stress (OS) significantly contributes to tumor progression. Our study focused on bladder urothelial cancer (BLCA), an escalating malignancy worldwide that is growing rapidly. Our objective was to verify the predictive precision of genes associated with overall survival (OS) by constructing a model that forecasts outcomes for bladder cancer and evaluates the prognostic importance of these genetic markers. Methods: Transcriptomic data were obtained from TCGA-BLCA and GSE31684, which are components of the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO), respectively. To delineate distinct molecular subtypes, we employed the non-negative matrix factorization (NMF)method. The significance of OS-associated genes in predicting outcomes was assessed using lasso regression, multivariate Cox analysis, and univariate Cox regression analysis. For external validation, we employed the GSE31684 dataset. CIBERSORT was utilized to examine the tumor immune microenvironment (TIME). A nomogram was created and verified using calibration and receiver operating characteristic (ROC) curves, which are based on risk signatures. We examined variations in clinical characteristics and tumor mutational burden (TMB) among groups classified as high-risk and low-risk. To evaluate the potential of immunotherapy, the immune phenomenon score (IPS) was computed based on the risk score. In the end, the pRRophetic algorithm was employed to forecast the IC50 values of chemotherapy medications. Results: In our research, we examined the expression of 275 genes associated with OS in 19 healthy and 414 cancerous tissues of the bladder obtained from the TCGA database. As a result, a new risk signature was created that includes 4 genes associated with OS (RBPMS, CRYAB, P4HB, and PDGFRA). We found two separate groups, C1 and C2, that showed notable variations in immune cells and stromal score. According to the Kaplan-Meier analysis, patients classified as high-risk experienced a considerably reduced overall survival in comparison to those categorized as low-risk (P<0.001). The predictive capability of the model was indicated by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve surpassing 0.6. Our model showed consistent distribution of samples from both the GEO database and TCGA data. Both the univariate and multivariate Cox regression analyses validated the importance of the risk score in relation to overall survival (P < 0.001). According to our research, patients with a lower risk profile may experience greater advantages from using a CTLA4 inhibitor, whereas patients with a higher risk profile demonstrated a higher level of responsiveness to Paclitaxel and Cisplatin. In addition, methotrexate exhibited a more positive outcome in patients with low risk compared to those with high risk. Conclusions: Our research introduces a novel model associated with OS gene signature in bladder cancer, which uncovers unique survival results. This model can assist in tailoring personalized treatment approaches and enhancing patient therapeutic effect in the management of bladder cancer

The Impact of Antiepileptic Drugs on Thyroid Function in Children with Epilepsy: New Versus Old

 Abstract ObjectivesTo investigate the effects of traditional antiepileptic drugs (AEDs) versus newer AEDs on the thyroid hormone profile of children with epilepsy.Materials &amp; MethodsA total of 80 children with epilepsy were included in this study and were divided into two groups. Group 1 included 40 children with epilepsy on traditional AEDs, and group 2 included 40 children with epilepsy on newer AEDs. Forty healthy children were also included as the control group (group 3). We analyzed the serum levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH).Results: Epileptic children treated with traditional drugs showed a statistically significant decrease in the serum fT4 and increase in TSH concentrations compared to the control group (P &lt; 0.001). Whereas epileptic children treated with newer drugs showed no statistically significant changes in the serum fT3, fT4 and TSH concentrations compared to the control group Conclusions: Traditional AEDs have a significant impact in the thyroid hormone profile compared to the newer AEDs