Evaluation of results of minimally invasive per cutaneous surgeries in management of calcaneal fractures

 Background: To analyze the outcome percutaneous surgeries in fractures of the calcaneum.Methods: 20 patients admitted in a tertiary care center in Ahmedabad were followed up from admission to until 2 years post operatively and functional outcomes in them following operative intervention were analyzed using AOFAS and Maryland scoring system.Results: Majority of patients have excellent or good outcome following percutaneous surgery in fractures of the calcaneum. The results were evaluated for 22 people with intraarticular calcaneum fractures using the Maryland foot score and AOFAS score. The mean AOFAS score was 86. There were 6 excellent, 12 good and 4 fair results.Conclusions: Percutaneous fixation in fractures of the calcaneum is a middle path in treatment of calcaneum fracture having the benefit of better reduction of ORIF plating and lesser soft tissue injury or chances of infection of conservative management

Sustainable development goal reporting: Contrasting effects of institutional and organisational factors

Businesses are increasingly expected to disclose their progress towards sustainable development via engagement with the United Nations Sustainable Development Goals. Although there is increasing trend towards disclosure, corporate reporting on Sustainable Development Goals varies in content and quality, posing a challenge to assess and improve the quality of disclosure. To understand variation in Sustainable Development Goal disclosure, it is essential to examine significant factors influencing corporate reporting. Accordingly, this research aims to investigate key drivers of reporting. The study undertakes content analysis of sustainability reports from leading Australian companies and conducts multinomial logistic regression analysis to provide evidence on drivers of disclosure. Using institutional theory and agency theory, a set of hypothesised relationships between Sustainable Development Goal disclosures and determinants of disclosure are developed. The study finds that Sustainable Development Goal reporting practices are a developing trend driven by external institutional factors and organisational characteristics. The study concludes there is need for a more robust Sustainable Development Goal measurement and reporting framework that can support companies to align their business strategies with the goals. This research makes several contributions to the literature by providing empirical evidence on the determinants of specific attributes of Sustainable Development Goal disclosure; empirical insights into potential motives for Sustainable Development Goal reporting; and a unique disclosure quality index that will be useful to academics and practitioners interested in assessing and ranking Sustainable Development Goal disclosures

Rethinking the Ecological Problem- A paradigm shift in the architect’s response to climate crisis

18 pagesClimate change exacerbates existing social inequalities and our response to the environmental crisis does not address these structural inequalities. Climate change and its cascading disasters expose a rift in our current socioeconomic structures. It shows how the system is broken and it provides a unique opportunity to reconfigure a fair system in its place. These inequalities are perpetuated by larger forces of market and governance. If sustainability is taken as a one pronged environmentalist strategy then the solutions could neglect larger social issues. To that end, how do we redefine these ecological issues so that they don’t just mean a better environment but a better environment for everyone? What role can architects play in this system? Instead of being agents of the state or capital, architects can move beyond just providing services. Can we propose an alternate response to the climate crisis which is embedded in causes of social equity? Architecture is one of the few remaining generalist professions. We have the ability and the burden to ground ourselves in the present while speculating about the future. So can we leverage this unique position to become catalysts of change

Tricuspid valve replacement outcomes in a diverse variety of valve replacement cases: Mortality, mechanical versus biological – A single-center study

Background: The initial trial in tricuspid surgery is repair; however, replacement is done whenever the valve is badly diseased. Tricuspid valve replacement (TVR) as an isolated procedure and combined with other valve replacements presents a challenge as these patients are in the high-risk subset. Materials and Methods: The present retrospective study was performed using the medical records of 42 cases who underwent TVR since 2017 at our institute. The mean age of the participants was 36.3 ± 13.2 years and male–female was 66.7% and 33.3%, respectively. Isolated TVR was done in 35.7% of cases, associated with mitral valve replacement (MVR) in 38.1%, with aortic valve replacement (AVR) in 4.8%, triple-valve replacement (MV, TV, and AV) in 19.0%, and TVR associated with pulmonary valve replacement in 2.4% of cases. This diverse variety of valve replacement cases is the highlight of our study. About 30.9% of participants were undergoing the procedure as a redo surgery. Trial of repair was given in 33.3% of cases. Moreover, bioprosthesis and mechanical valve prosthesis were used in 73.8% and 26.2%, respectively. Results: Early mortality occurred in 8 (19.0%) cases. Cause of death common in all deaths was right ventricular failure in all cases 8/8 (100%) seconded by multi-organ failure in 7/8 cases (87.5%), previous cardiac surgery was a factor in 4/8 (50%) cases, mediastinitis occurred in 2/8 (25%) cases, and both arrhythmias and cerebrovascular accident happened in 1/8 (12.5%) case each. Mortality rate was 3/15 (20.0%) in cases of isolated TV surgery. Mortality rate for concomitant MVR was 3/15 (20.0%), and for concomitant AVR with MVR (triple-valve replacement) was 2/8 (25.0%). No early mortality happened in the concomitant AVR and concomitant pulmonary valve replacement group. Late mortality happened in 11/42 (26.2%) cases during follow-up. Total mortality as per the valve types has been 5/11 (45.5%) in the mechanical valve replacement group and 14/31 (45.2%) for the biological valve group. Conclusions: The patients who require TVR are usually high-risk surgical candidates with high early and late mortality. The most common cause of death was right ventricular failure in this study. TVR associated with other heart valve replacement increases the risk strata of the patient which is the highlight of our study. In the end, we conclude that we had 19.0% early (0–30 days) and 26.2% late mortality (0–1 year) making a composite of 45.2% mortality at the end of 1 year. No difference in the effect of mortality as per the valve type has been observed

Exploring the short-term momentum effect in the cryptocurrency market

This study explores the short-term momentum effect in the cryptocurrency market. Utilising a comprehensive cryptocurrency dataset and the portfolio construction methods of Fama and French (J Financ Econ 33:3-56, 1993) and Carhart (J Finance 52:57-82, 1997), we construct cryptocurrency portfolios and examine their performance. The main findings are: (1) the cryptocurrency market portfolio significantly outperforms major stock markets globally in terms of risk-adjusted return; (2) from an asset pricing perspective, short-term momentum effects are significantly priced in the cryptocurrency market, while size effects are controlled, suggesting that the short-term momentum effect explains variations in the returns of cryptocurrency portfolios; and (3) the portfolios constructed according to the short-term momentum effect do not outperform the cryptocurrency market portfolio

Cardiovascular complications in coronavirus disease-2019 patients

Background and Aims: Cardiovascular (CV) complications of coronavirus disease 2019 (COVID-19) are neither well-defined nor comprehensively characterized. Hence, long-term studies are required to monitor silent but progressive CV complications postrecovery in COVID-19 patients. Our aim of the study was to assess and determine the presence of CV morbidity and mortality in COVID-19 patients. Materials and Methods: A retrospective study was conducted at our institute. All COVID-19-positive patients who were admitted in the intensive care unit during April 3, 2020–May 23, 2021, were recruited for the study. A total of 1460 patients were enrolled and monitored until discharge/death. Patients were evaluated based on demographics, clinical data, and laboratory values and 42 patients among them underwent coronary angiography for an adequate understanding of CV complications. Results: The total reported deaths among the study sample were 453 (31%). Common preexisting clinical conditions among them were hypertension 520 (35.6%), diabetes 211 (14.45%), CV disease 88 (6.02%), and hypothyroidism 61 (4.17%). A total of 149 patients displayed elevated creatine phosphokinase-MB (CPK-MB) levels, while 141 patients displayed elevated hs-TnI levels. The absolute rise of cardiac troponin (hs-TnI) and CPK-MB displayed a technically positive correlation, but a weaker relationship (r: 0.2113, P < 0.01 for correlation). Twenty-two out of 42 patients showed the presence of single/multivessel disease and 31 patients displayed mild-to-severe left ventricular dysfunction. Conclusions: The results of the current study provide evidence for the risk and burden of CV complications among COVID-19 patients. Hence, attention to long-term CV health and disease among COVID-19 survivors is necessary

An Ensembling Architecture Incorporating Machine Learning Models and Genetic Algorithm Optimization for Forex Trading

Algorithmic trading has become the standard in the financial market. Traditionally, most algorithms have relied on rule-based expert systems which are a set of complex if/then rules that need to be updated manually to changing market conditions. Machine learning (ML) is the natural next step in algorithmic trading because it can directly learn market patterns and behaviors from historical trading data and factor this into trading decisions. In this paper, a complete end-to-end system is proposed for automated low-frequency quantitative trading in the foreign exchange (Forex) markets. The system utilizes several State of the Art (SOTA) machine learning strategies that are combined under an ensemble model to derive the market signal for trading. Genetic Algorithm (GA) is used to optimize the strategies for maximizing profits. The system also includes a money management strategy to mitigate risk and a back-testing framework to evaluate system performance. The models were trained on EUR&ndash;USD pair Forex data from Jan 2006 to Dec 2019, and subsequently evaluated on unseen samples from Jan 2020 to Dec 2020. The system performance is promising under ideal conditions. The ensemble model achieved about 10% nett P&amp;L with &minus;0.7% drawdown level based on 2020 trading data. Further work is required to calibrate trading costs &amp; execution slippage in real market conditions. It is concluded that with the increased market volatility due to the global pandemic, the momentum behind machine learning algorithms that can adapt to a changing market environment will become even stronger