Pediatric Elbow Fractures in a Major Trauma Center in Iran

Background: Elbow fractures are one of the most common traumatic fractures in the pediatric population. Since severe complications may occur, appropriate diagnosis and treatment are imperative when dealing with this type of fracture. Objectives: The aim of this study was to evaluate the epidemiology of elbow fracture in children admitted in Alzahra hospital, Isfahan, IR Iran over a one year period. Patients and Methods: During a one year period, a prospective study was conducted on 300 patients under the age of 16 who had sustained elbow fractures. Data included age, gender, mechanism of trauma, type of elbow fractures, complications, and outcomes. Results: The mean age of the patients was 8.1 ± 2.31 years old. Boys were injured 2.6 times more often than the girls. Falling was the major cause of pediatric elbow fractures (86%). Supra condylar were the most common type of fracture. There was a significant association between gender and type of injury (P < 0.01). Conclusions: Supracondylar fracture is the most common fracture type resulting from 4 - 8 year old boys’ falls. Our findings indicate the critical nature of appropriate treatment in order to prevent severe complications

Evaluation of the Safe Ischemic Time of Clamping During Intermittent Pringles Maneuver in Rabbits

Background: The liver is the most commonly injured organ in blunt abdominal trauma. Although major hepatic bleeding may be partially controlled with portal triade clamping (the Pringle’s maneuver), continuous prolonged clamping results in liver ischemia. Objectives: The purpose of this study was to determine the safe time of Pringle maneuver based on pathologic changes of liver in rabbit models. Materials and Methods: In an experimental study, 20 New-Zealand white rabbits were selected. In laparotomy, a blunt dissector was passed through the foramen of Winslow and the hepato-duodenal ligament encircled with an umbilical tape. En masse Pringle maneuver was performed using atraumatic flexible clamps. Rabbits were divided into four groups based on Pringle maneuver time (30 minutes, 45 minutes, 60 minutes, and 75 minutes). A hepatic biopsy was performed at the beginning of operation. The degree of tissue injury was evaluated using blood markers. Results: There were five rabbits in each group. At the end of 60 minutes ischemia, only minor alterations were observed in pathological specimens. At the end of 75 minutes, hepatocyte damage and necrosis were observed. The serum levels of alanine aminotransferase (Group A: P = 0.02; Group B: P = 0.01; Group C: P = 0.0002; Group D: P = 0.01) and Aspartate aminotransferase (Group A: P = 0.03; Group B: P = 0.002; Group C: P = 0.0004; Group D: P = 0.0003) were significantly increased post-operatively. The maximum level was in the first day after operation. Conclusions: Continuous portal triade clamping (the Pringle maneuver) during liver ischemia (30 and 45 minutes) in rabbits resulted in no ischemic change. Increasing time of clamping to 30 minutes was safe in intermittent Pringle maneuver

Detection of On-Chip Generated Weak Microwave Radiation Using Superconducting Normal-Metal SET

The present work addresses quantum interaction phenomena of microwave radiation with a single-electron tunneling system. For this study, an integrated circuit is implemented, combining on the same chip a Josephson junction (Al/AlO /Al) oscillator and a single-electron transistor (SET) with the superconducting island (Al) and normal-conducting leads (AuPd). The transistor is demonstrated to operate as a very sensitive photon detector, sensing down to a few tens of photons per second in the microwave frequency range around 100 GHz. On the other hand, the Josephson oscillator, realized as a two-junction SQUID and coupled to the detector via a coplanar transmission line (Al), is shown to provide a tunable source of microwave radiation: controllable variations in power or in frequency were accompanied by significant changes in the detector output, when applying magnetic flux or adjusting the voltage across the SQUID, respectively. It was also shown that the effect of substrate-mediated phonons, generated by our microwave source, on the detector output was negligibly small

Paratuberculosis: The Trojan in genetic resources of dairy cattle

Mycobacterium avium subspecies paratuberculosis, the main cause of paratuberculosis or Johne’s disease is an intestinal granulomatous infection among ruminants. This review will focus on the Johne’s disease in dairy cattle. This disease by global spread is introduced as a 21st-century disease and can be considered a nightmare for dairy breeders. Due to the long incubation period and its high transmissibility from infected animals to others, the disease is detected when most of the animals are infected. The same issue leads to significant financial and economic losses for the breeders. These losses are not only limited to breeders and will affect the economic network of each country but will also result in a great loss for the export programs of the producing countries. The lack of an accurate diagnostic method has made the management and prevention of Johne's disease difficult. In recent years, special attention has been paid to managing and reducing side effects caused by this disease and efforts to find accurate, fast, and available diagnostic methods for this infection have increased. This study tries to review various aspects of the economic losses, the threat of this infection for genetic resources and breeding programs, and introduce novel physical diagnostic methods to prevent losses caused by this disease

Spatial and Spectral Reconstruction of Breast Lumpectomy Hyperspectral Images

(1) Background: Hyperspectral imaging has emerged as a promising margin assessment technique for breast-conserving surgery. However, to be implicated intraoperatively, it should be both fast and capable of yielding high-quality images to provide accurate guidance and decision-making throughout the surgery. As there exists a trade-off between image quality and data acquisition time, higher resolution images come at the cost of longer acquisition times and vice versa. (2) Methods: Therefore, in this study, we introduce a deep learning spatial–spectral reconstruction framework to obtain a high-resolution hyperspectral image from a low-resolution hyperspectral image combined with a high-resolution RGB image as input. (3) Results: Using the framework, we demonstrate the ability to perform a fast data acquisition during surgery while maintaining a high image quality, even in complex scenarios where challenges arise, such as blur due to motion artifacts, dead pixels on the camera sensor, noise from the sensor’s reduced sensitivity at spectral extremities, and specular reflections caused by smooth surface areas of the tissue. (4) Conclusion: This gives the opportunity to facilitate an accurate margin assessment through intraoperative hyperspectral imaging.</p

Tumor Segmentation in Colorectal Ultrasound Images Using an Ensemble Transfer Learning Model:Towards Intra-Operative Margin Assessment

Tumor boundary identification during colorectal cancer surgery can be challenging, and incomplete tumor removal occurs in approximately 10% of the patients operated for advanced rectal cancer. In this paper, a deep learning framework for automatic tumor segmentation in colorectal ultrasound images was developed, to provide real-time guidance on resection margins using intra-operative ultrasound. A colorectal ultrasound dataset was acquired consisting of 179 images from 74 patients, with ground truth tumor annotations based on histopathology results. To address data scarcity, transfer learning techniques were used to optimize models pre-trained on breast ultrasound data for colorectal ultrasound data. A new custom gradient-based loss function (GWDice) was developed, which emphasizes the clinically relevant top margin of the tumor while training the networks. Lastly, ensemble learning methods were applied to combine tumor segmentation predictions of multiple individual models and further improve the overall tumor segmentation performance. Transfer learning outperformed training from scratch, with an average Dice coefficient over all individual networks of 0.78 compared to 0.68. The new GWDice loss function clearly decreased the average tumor margin prediction error from 1.08 mm to 0.92 mm, without compromising the segmentation of the overall tumor contour. Ensemble learning further improved the Dice coefficient to 0.84 and the tumor margin prediction error to 0.67 mm. Using transfer and ensemble learning strategies, good tumor segmentation performance was achieved despite the relatively small dataset. The developed US segmentation model may contribute to more accurate colorectal tumor resections by providing real-time intra-operative feedback on tumor margins.</p

Separating Surface Reflectance from Volume Reflectance in Medical Hyperspectral Imaging

Hyperspectral imaging has shown great promise for diagnostic applications, particularly in cancer surgery. However, non-bulk tissue-related spectral variations complicate the data analysis. Common techniques, such as standard normal variate normalization, often lead to a loss of amplitude and scattering information. This study investigates a novel approach to address these spectral variations in hyperspectral images of optical phantoms and excised human breast tissue. Our method separates surface and volume reflectance, hypothesizing that spectral variability arises from significant variations in surface reflectance across pixels. An illumination setup was developed to measure samples with a hyperspectral camera from different axial positions but with identical zenith angles. This configuration, combined with a novel data analysis approach, allows for the estimation and separation of surface reflectance for each direction and volume reflectance across all directions. Validated with optical phantoms, our method achieved an 83% reduction in spectral variability. Its functionality was further demonstrated in excised human breast tissue. Our method effectively addresses variations caused by surface reflectance or glare while conserving surface reflectance information, which may enhance sample analysis and evaluation. It benefits samples with unknown refractive index spectra and can be easily adapted and applied across a wide range of fields where hyperspectral imaging is used.</p

Tissue classification of breast cancer by hyperspectral unmixing

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Minimally Disruptive Cooperative Lane-change Maneuvers

A lane-change maneuver on a congested highway could be severely disruptive or even infeasible without the cooperation of neighboring cars. However, cooperation with other vehicles does not guarantee that the performed maneuver will not have a negative impact on traffic flow unless it is explicitly considered in the cooperative controller design. In this letter, we present a socially compliant framework for cooperative lane-change maneuvers for an arbitrary number of CAVs on highways that aims to interrupt traffic flow as minimally as possible. Moreover, we explicitly impose feasibility constraints in the optimization formulation by using reachability set theory, leading to a unified design that removes the need for an iterative procedure used in prior work. We quantitatively evaluate the effectiveness of our framework and compare it against previously offered approaches in terms of maneuver time and incurred throughput disruption.Comment: 6 pages, 2 figure

Analgesic effects of intravenous ketamine during spinal anesthesia in pregnant women undergone Caesarean section; a randomized clinical trial

Suitable analgesia after cesarean section helps mothers to be more comfortable and increases their mobility and ability to take better care of their infants. Objectives: Pain relief properties of ketamine prescription were assessed in women with elective cesarean section who underwent spinal anesthesia with low dose intravenous ketamine and midazolam and intravenous midazolam alone. Patients and Methods: Sixty pregnant women scheduled for spinal anesthesia for cesarean section were randomized into two study groups. Ketamine (30 mg) + midazolam (1 mg = 2CC) or 1mg midazolam (2CC) alone, was given immediately after spinal anesthesia. Pain scores at first, second and third hours after CS operation, analgesic requirement and drug adverse effects were recorded in all patients. Results: Ketamine group had significant pain relief properties in compare with control group in first hours after cesarean section (0.78 ± 1.09 vs. 1.72 ± 1.22, VAS score, P = 0.00). Total dose of meperidine consumption in women of ketamine group was significantly lower than women of control group (54.17 ± 12.86 vs. 74.44 ± 33.82 mg, P = 0.02). There were no significant drug side effects in participated patients. Conclusions: Intravenous low-dose ketamine combined with midazolam for sedation during spinal anesthesia for elective Caesarean section provides more effective and long lasting pain relief than control group. © 2013 Iranian Society of Regional Anesthesia and Pain Medicine