The Long-term Outcome of Sleeve Gastrectomy in Managing Obstructive Sleep Apnea in Prader–Willi Syndrome Patients: A Case Series

Background: Prader–Willi syndrome (PWS) is a genetic disorder with multisystem involvement. Bariatric laparoscopic Sleeve Gastrectomy (SG) surgery has been proposed as a means of weight control in PWS patients. There is some controversy around sleeve gastrectomy as a management strategy in PWS to control Obstructive Sleep Apnea (OSA). Case-Series: In this case series we are questioning the effectiveness of bariatric gastric sleeve surgery as a long-term solution for weight control. Therefore, we followed up four patients with PWS in our center who had SG and evaluated their growth parameters along with symptoms of sleep disordered breathing. The median age of patients in this group was 7.5 years. There were three males and one female. The average Body Mass Index (BMI) prior to SG was 40.5. The average BMI after SG, at 5–7 years, was 40.8. This shows an insignificant effect of SG on BMI and control of OSA on follow-up over more than 5 years. Conclusion: We believe that SG has limited and transient success for obesity management in PWS patients, especially in the absence of a multidisciplinary team that can provide behavioral therapy, nutritional plan, and psychosocial support. Further studies are necessary to compare the long-term outcome sleeve gastrectomy with behavioral and strict nutritional therapy

Performance Characteristics of the 5-Ring GE Discovery Mi PET/CT Scanner Using AAPM Tg-126 Report

AIM: To report on the performance characteristics of the 5-ring GE Discovery MI PET/CT systems using the AAPM TG-126 report and compare these results to NEMA NU 2-2012 where applicable. MATERIALS AND METHODS: TG-126 testing was performed on two GE 5-Rings Discovery MI scanners. Tests performed included spatial resolution, PET/CT image-registration accuracy, sensitivity, count rate performance, accuracy of corrections, image contrast, scatter/attenuation correction, and image uniformity. All acquired data were analyzed using scanner console or free software tools as described by TG-126 and the results were then compared to published NEMA NU 2-2012 values. RESULTS: Both scanners gave similar resolution results for TG-126 and NEMA NU 2-2012 and were within manufacturer specifications. Image-registration accuracy between PET and CT using our clinical protocol showed excellent results with values ≤1 mm. Sensitivity using TG-126 was 19.43 cps/kBq while for NEMA the value was 20.73 cps/kBq. The peak noise-equivalent counting rate was 2174 kcps at 63.1 kBq/mL and is not comparable to NEMA NU 2-2012 due to differences in phantoms and methods used to measure and calculate this parameter. The accuracy of corrections for count losses for TG-126 were expressed in SUV values and found to be within 10% of the expected SUV measurement of 1. Image contrast and scatter/attenuation correction using the TG-126 method gave acceptable results. Image uniformity assessment resulted in values within the recommended ± 5% limits. CONCLUSION: These results show that the 5-ring GE Discovery MI PET/CT scanner testing using TG-126 is reproducible and has similar results to NEMA NU 2-2012 tests where applicable. We hope these results start to form the basis to compare PET/CT systems using TG-126

The Reading Perception Of Medical Staff About The Use Of Prehospital Ultrasound

This study was a focus on the use of pre-hospital ultrasound in Saudi Arabia. Generally, ultrasound is used in a high frequency by health care providers in different countries within hospitals or pre-hospital. The main point of using the ultrasound was to reduce the time of diagnosis at the hospital and decrease the rate of mortality and morbidity. The study was a cross-sectional study and was used to assess the perception of medical staff about the use of pre-hospital ultrasound. This survey study had 130 participants, and 80 of them were agreed to involve in this study. It was conducted in King Abdulaziz Hospital of National Guards, Al Ahsa and College of Applied Medical Sciences, King Saud Bin Abdul Aziz University for Health Sciences, Al Ahsa Campus, Saudi Arabia. ATLAST ti 8 was used for systematic literature review and SPSS v23 obviously for data analysis. This was a new and novel study as the Pre-hospital ultrasound was not used before in the pre-hospital. On the other hand, the findings showed that the participants displayed a high level of interest in improving their knowledge and skills of using ultrasound during its application in the pre-hospital setting. It was also recommended to have more research in future on the subject

Evaluation of the effectiveness of contrast-enhanced ultrasound in the diagnosis of early hepatocellular carcinoma: a systematic review

ObjectivesTo investigate the evaluation of the effectiveness of contrast-enhanced ultrasound (CEUS) in the diagnosis of small hepatocellular carcinoma (HCC).MethodsA thorough search was conducted for pertinent literature using PubMed, SCOPUS, Web of Science, Science Direct, and Wiley Library. Rayyan QRCI was used throughout this extensive procedure.ResultsOur results included thirteen studies with a total of 2016 patients, and 1672 (82.9%) were males. The follow-up duration ranged from 3 months to 24 months. CEUS was useful in anticipating the early recurrence of HCC, predicting the early recurrence of solitary lesion HCC patients, and differentiating between HCC and intrahepatic cholangiocarcinoma <3 Cm, distinguishing HCC from dysplastic nodules from tiny liver nodules, CEUS in cirrhotic patients. When paired with CEUS, conventional ultrasonography can detect minor HCC and assist in patient monitoring for those who receive an early diagnosis of HCC. CEUS showed high concordance with CECT for diagnosing lesions 2.1–3.0 cm in size. Notable limitations included heterogeneity in protocols and predominance of Asian populations (12/13 studies).ConclusionCEUS offers significant clinical value as a noninvasive diagnostic tool, particularly for 1–3 cm lesions in cirrhotic patients and cases where CT is contraindicated, though protocol standardization and Western population validation remain needed

Formulation of Nursing Process Assessment Tool from students\u27 perception as outcome of exploratory mixed methods

This ongoing research project is an exploratory sequential mixed methods design which aims to formulate a Nursing Process Assessment Tool based from the students perceptions. This three-phase multi-staged design is currently administered with 3rd and 4th year students

A generalized laser simulator algorithm for mobile robot path planning with obstacle avoidance

This paper aims to develop a new mobile robot path planning algorithm, called generalized laser simulator (GLS), for navigating autonomously mobile robots in the presence of static and dynamic obstacles. This algorithm enables a mobile robot to identify a feasible path while finding the target and avoiding obstacles while moving in complex regions. An optimal path between the start and target point is found by forming a wave of points in all directions towards the target position considering target minimum and border maximum distance principles. The algorithm will select the minimum path from the candidate points to target while avoiding obstacles. The obstacle borders are regarded as the environment’s borders for static obstacle avoidance. However, once dynamic obstacles appear in front of the GLS waves, the system detects them as new dynamic obstacle borders. Several experiments were carried out to validate the effectiveness and practicality of the GLS algorithm, including path-planning experiments in the presence of obstacles in a complex dynamic environment. The findings indicate that the robot could successfully find the correct path while avoiding obstacles. The proposed method is compared to other popular methods in terms of speed and path length in both real and simulated environments. According to the results, the GLS algorithm outperformed the original laser simulator (LS) method in path and success rate. With application of the all-direction border scan, it outperforms the A-star (A*) and PRM algorithms and provides safer and shorter paths. Furthermore, the path planning approach was validated for local planning in simulation and real-world tests, in which the proposed method produced the best path compared to the original LS algorithm

Data analysis in electric power system embedded with solar PVs

Conventional source of energy are overly dependent on fossil fuel which tend to face several challenges such as the depleting of fossil fuel, environmental threat and human health. To deal with such challenges, solar PV system has been proposed to be embedded in the distribution system. Weather conditions plays a major role on affecting the power output of renewable energy sources, thus several power quality issues such as voltage variations are expected. Since the problem is of a stochastic nature, a probabilistic approach using Monte Carlo simulation techniques is adopted in this work. This project investigates the effect of PVs on residential house voltage and transformer power and Loss of Life through integrating rooftop solar PVs into the grid in such a way that the variations in the supply voltage caused by the solar irradiance and temperature remain within the acceptable limits set by IEEE Standards. In this respect, the analysis presented in this work also considers different scenarios including different penetrations of rooftop solar PVs (e.g., 0, 2, 4, 6, 8 and 10 kW), and the Monte Carlo algorithm is used to compute the impact of irradiance and temperature on the node voltages and transformer’s power. The results of these scenarios reveal that with different PV penetrations, the node voltages of the houses supplied from 25 kVA transformers may experience more impacts compared to those houses supplied from 50 kVA transformers.University of Ontario Institute of Technolog

The Effect of Peer Assessment on the Evaluation Process of Students

This study aims at finding out the effect of peer assessment on the evaluation process of students. The hypothesis underlying this study is that assessment is an integral part of the learning process, which should play an important role in the educational model. The current study will emphasize the importance of using peer assessment as a tool to engage students in the evaluation process, clarify the role of peer assessment in promoting student learning, diversify the scope of the evaluation through the frameworks of theory and methodology to get to understand the uses and limitations of peer assessment as a tool for assessment, and discuss the goals and benefits that can be achieved by the students from practicing peer assessment in accordance with scientific standards and bases, which emphasize active participation of the students in their learning and responsibility. Additionally, this study will check the credibility of peer assessments as a suitable tool in the assessment process. Findings show that there is a statistically significant relationship between the assessment of peers to each other, as well as between peer assessment and teacher assessment.</jats:p