Comparision of Hook Phlebectomy and Endovenous Laser Therapy for Below Knee Varicose Veins

Background: Varicose vein is a common surgical problem having multiple modalities available for their treatment. We studied the treatment modalities available for the below knee varicose veins comparing Endovenous Laser Therapy (EVLT) and Hook Phlebectomy at Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha.Methods: All patients with varicose veins presenting to our hospital were included in the study. All the patients in our study were assessed by clinico-etiological anatomical and pathological (CEAP) classification. Diagnosis was further confirmed by Duplex ultrasonography.Results and Conclusions: of the 76 patients studied in this study, 15 patients underwent EVLT whereas 55 patients underwent Hook Phlebectomy for below knee varicose veins. 6 patients underwent EVLT for above knee varicose veins in combination with Hook Phlebectomy for below knee varicose veins.Conclusions: We find Hook Phlebectomy to be much better option than EVLT for below knee varicose veins

Thymoma: A pathological study of 50 cases

BACKGROUND: A combination of epithelial cells and lymphocytes results in a varied histomorphology of thymomas and consequent varied classification systems. AIM: To correlate the Marino and Muller-Hermelink (MMH) classification with the invasive behaviour of thymomas. SETTING AND DESIGN: Retrospective analysis. MATERIALS AND METHOD: Thymomas encountered in the past 21 years were re-classified with the MMH classification and correlated with Masaoka's staging and clinical presentation. RESULTS: The thymomas formed 91% of the primary thymic epithelial tumours. Predominantly cortical thymomas (n=21) and cortical thymomas (n=22) were the common subtypes and 60% and 77% of these, respectively, were in stages II or III. Cystic change, necrosis or haemorrhage played no role in predicting invasive behaviour. Cortical epithelium correlated well with the presence of para-thymic syndromes, especially myasthenia gravis. CONCLUSION: MMH classification is easy to apply. Cortical thymomas in stage I should be followed up for possible recurrence

Invasive pulmonary aspergillosis: A study of 39 cases at autopsy

Background: Aspergillus is a common cause of invasive mycosis, especially in immunocompromised or immunosuppressed individuals. Aims: To study the incidence of invasive pulmonary aspergillosis and evaluate the predisposing factors and clinico-pathological manifestations. Settings and Design: Retrospective analysis of autopsy material from a tertiary care hospital. Material and Methods: All autopsies performed over a 12-year period were reviewed and cases with invasive aspergillosis were analysed with respect to their clinical presentation, predisposing factors, gross and histological features, complications and causes of death. Results: Among a total of 20475 autopsies performed in 12 years, 39 patients (0.19 %) had invasive pulmonary aspergillosis. There were 28 males and 11 females. Their ages ranged from five months to 67 years. Dyspnoea, fever, cough with mucopurulent expectoration, chest pain and haemoptysis were commonly encountered symptoms. Forty-one per cent of the patients had no respiratory symptoms. Fungal aetiology was not entertained clinically in any of the patients. The major underlying conditions were prolonged antibiotic therapy, steroid therapy, and renal transplantation, often associated with underlying lung diseases. Pneumonia, abscesses, vascular thrombosis and infarction were common findings at autopsy. Antecedent tuberculosis, mucormycosis, Pneumocystis carinii pneumonia and Cytomegalovirus infection were also present. In most cases, death was related to extensive pulmonary involvement or fungal dissemination. Conclusion: A diagnosis of invasive pulmonary aspergillosis should always be borne in mind whenever one is dealing with recalcitrant lung infections even with subtle immunosuppression. Radiological investigations and serologic markers can be utilised for confirmation and prompt therapy

Engineering Art Galleries

The Art Gallery Problem is one of the most well-known problems in Computational Geometry, with a rich history in the study of algorithms, complexity, and variants. Recently there has been a surge in experimental work on the problem. In this survey, we describe this work, show the chronology of developments, and compare current algorithms, including two unpublished versions, in an exhaustive experiment. Furthermore, we show what core algorithmic ingredients have led to recent successes

Long-lived charged Higgs at LHC as a probe of scalar Dark Matter

We study inert charged Higgs boson $H^\pm$ production and decays at LHC experiments in the context of constrained scalar dark matter model (CSDMM). In the CSDMM the inert doublet and singlet scalar's mass spectrum is predicted from the GUT scale initial conditions via RGE evolution. We compute the cross sections of processes $pp\to H^+H^-,\, H^\pm S_i^0$ at the LHC and show that for light $H^\pm$ the first one is dominated by top quark mediated 1-loop diagram with Higgs boson in s-channel. In a significant fraction of the parameter space $H^\pm$ are long-lived because their decays to predominantly singlet scalar dark matter (DM) and next-to-lightest (NL) scalar, $H^\pm\to S_{\text{DM, NL}} ff',$ are suppressed by the small singlet-doublet mixing angle and by the moderate mass difference $\Delta M=M_{H^+}-M_{\text{DM}} .$ The experimentally measurable displaced vertex in $H^\pm$ decays to leptons and/or jets and missing energy allows one to discover the $H^+H^-$ signal over the huge $W^+W^-$ background. We propose benchmark points for studies of this scenario at the LHC. If, however, $H^\pm$ are short-lived, the subsequent decays $S_{\text{NL}}\to S_{\text{DM}} f\bar f$ necessarily produce additional displaced vertices that allow to reconstruct the full $H^\pm$ decay chain.Comment: 15 pages, 5 figure

Mechanical properties of Ti-6Al-4V selectively laser melted parts with body-centred-cubic lattices of varying cell size

Significant weight savings in parts can be made through the use of additive manufacture (AM), a process which enables the construction of more complex geometries, such as functionally graded lattices, than can be achieved conventionally. The existing framework describing the mechanical properties of lattices places strong emphasis on one property, the relative density of the repeating cells, but there are other properties to consider if lattices are to be used effectively. In this work, we explore the effects of cell size and number of cells, attempting to construct more complete models for the mechanical performance of lattices. This was achieved by examining the modulus and ultimate tensile strength of latticed tensile specimens with a range of unit cell sizes and fixed relative density. Understanding how these mechanical properties depend upon the lattice design variables is crucial for the development of design tools, such as finite element methods, that deliver the best performance from AM latticed parts. We observed significant reductions in modulus and strength with increasing cell size, and these reductions cannot be explained by increasing strut porosity as has previously been suggested. We obtained power law relationships for the mechanical properties of the latticed specimens as a function of cell size, which are similar in form to the existing laws for the relative density dependence. These can be used to predict the properties of latticed column structures comprised of body-centred-cubic (BCC) cells, and may also be adapted for other part geometries. In addition, we propose a novel way to analyse the tensile modulus data, which considers a relative lattice cell size rather than an absolute size. This may lead to more general models for the mechanical properties of lattice structures, applicable to parts of varying size

How managers can build trust in strategic alliances: a meta-analysis on the central trust-building mechanisms

Trust is an important driver of superior alliance performance. Alliance managers are influential in this regard because trust requires active involvement, commitment and the dedicated support of the key actors involved in the strategic alliance. Despite the importance of trust for explaining alliance performance, little effort has been made to systematically investigate the mechanisms that managers can use to purposefully create trust in strategic alliances. We use Parkhe’s (1998b) theoretical framework to derive nine hypotheses that distinguish between process-based, characteristic-based and institutional-based trust-building mechanisms. Our meta-analysis of 64 empirical studies shows that trust is strongly related to alliance performance. Process-based mechanisms are more important for building trust than characteristic- and institutional-based mechanisms. The effects of prior ties and asset specificity are not as strong as expected and the impact of safeguards on trust is not well understood. Overall, theoretical trust research has outpaced empirical research by far and promising opportunities for future empirical research exist

Oxygen saturation and outcomes in preterm infants

BACKGROUN

Production of phi mesons at mid-rapidity in sqrt(s_NN) = 200 GeV Au+Au collisions at RHIC

We present the first results of meson production in the K^+K^- decay channel from Au+Au collisions at sqrt(s_NN) = 200 GeV as measured at mid-rapidity by the PHENIX detector at RHIC. Precision resonance centroid and width values are extracted as a function of collision centrality. No significant variation from the PDG accepted values is observed. The transverse mass spectra are fitted with a linear exponential function for which the derived inverse slope parameter is seen to be constant as a function of centrality. These data are also fitted by a hydrodynamic model with the result that the freeze-out temperature and the expansion velocity values are consistent with the values previously derived from fitting single hadron inclusive data. As a function of transverse momentum the collisions scaled peripheral.to.central yield ratio RCP for the is comparable to that of pions rather than that of protons. This result lends support to theoretical models which distinguish between baryons and mesons instead of particle mass for explaining the anomalous proton yield.Comment: 326 authors, 24 pages text, 23 figures, 6 tables, RevTeX 4. To be submitted to Physical Review C as a regular article. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Perspectives of Patients with Insulin-Treated Type 1 and Type 2 Diabetes on Hypoglycemia: Results of the HAT Observational Study in Central and Eastern European Countries

INTRODUCTION: The aim of this study was to determine the level of awareness of hypoglycemia, the level of fear for hypoglycemia, and the response to hypoglycemic events among insulin-treated diabetes patients from Central and Eastern Europe (CEE). The impact of hypoglycemia on the use of healthcare resources and patient productivity was also assessed. METHODS: This was a multicenter, non-interventional, two-part, patient self-reported questionnaire study that comprised both a retrospective cross-sectional evaluation and a prospective observational evaluation. Study participants were insulin-treated adult patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) from CEE. RESULTS: Most patients (85.4% T1DM and 83.6% T2DM) reported normal hypoglycemia awareness. The median hypoglycemia fear score was 5 out of 10 for T1DM and 4 out of 10 for T2DM patients. Patients increased glucose monitoring, consulted a doctor/nurse, and/or reduced the insulin dose in response to hypoglycemia. As a consequence of hypoglycemia, patients took leave from work/studies or arrived late and/or left early. Hospitalization was required for 31 (1.2%) patients with T1DM and 66 (2.1%) patients with T2DM. CONCLUSION: Hypoglycemia impacts patients' personal and social functioning, reduces productivity, and results in additional costs, both direct (related to increased use of healthcare resources) and indirect (related to absenteeism. FUNDING: Novo Nordisk