Gastric GIST

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. The stomach is considered the most common site of GIST, and the most common histopathological type of GISTs is spindle cell. Mutational analysis may help in defining the management of GIST. Multiple stratification modules are available for the estimation of GISTs’ prognosis. Surgery is considered the only curative option for GISTs. The discovery of KIT protein has allowed better identification of GISTs and has allowed creation of selective tyrosine kinase inhibitors which dramatically affected GIST management. Results of trials on neoadjuvant imatinib therapy are promising. Adjuvant imatinib therapy is recommended for 3 years and has proven to improve outcome in high-risk GISTs. New therapeutic agents are now available in case of imatinib resistance. Follow-up of patients with GISTs depends on the type of GIST

Two Stages repair of proximal hypospadias: Review of 33 cases

Background/Purpose: Proximal hypospadias with chordee is the most challenging variant of hypospadias to reconstruct. During the last 10 years, the approach to sever hypospadias has been controversial. Materials & Methods: During the period from June 2002 to December 2009, I performed 33 cases with proximal hypospadias, at Demerdash hospital; Ain Shams University; department of paediatric surgery. Data were collected retrospectively and included patient's age at operation, degree of the hypospadias, degree of associated chordee, the procedure performed complications and any repeated operation. All patients underwent 2 staged procedures with 9 to 12 month interval in-between. Results: Thirty three patients with proximal hypospadias were operated upon in a period of 7 years. Byars's 2 staged operation was used in all 33 cases. All patients had 2 staged repairs. Neither complete disruption nor urethral diverticula occurred in the 33 patients. Twenty four patients had no complication. Single fistula was present in 6 patients . Two patients had 2 fistulas; one at the original site of the hypospadias and the other was sub-coronal. The last patient had moderate meatal stenosis, which was successfully treated by repeated dilatations. Conclusion: Two Stages procedure using the principles of Byars's technique; is a versatile operation that can be used for the proximal hypospadias. It decreases the rate of fistula formation; disruption; stenosis and gives a satisfactory cosmetic appearance.Index Word: proximal hypospadias, two stages repair

Filling the Vacant Space: A Close Reading of Kant’s Dialectic of Pure Practical Reason

The main aim of this thesis is to explore Kant’s central notion of rational belief. Kant’s account of rational belief could be viewed as the ground on which rational moral agents assent to propositions that enable them to avoid any practical incoherence as they engage in their moral duty. The paper will offer a close reading of the dialectic of pure practical reason, particularly the doctrine of the postulates of practical reason. In this doctrine, Kant argues that although there is no theoretical proof for or against freedom, God, and the immortality of the soul, rational moral agents ought to believe in their reality, as there are practical grounds to believe in them. The need to introduce these practical postulates is the necessity of a hypothesis that can and must be formed by the subject only from a practical point of view. This paper will show that not only could the postulates be viewed as a point of connection between what Kant conceives of as the phenomenal world of spatio-temporal appearances and the noumenal realm of things in themselves, but also as architectonic elements which – in their connection to the concept of freedom – are part of what “constitutes the keystone of the whole structure of a system of pure reason” (KpV, 5:3 f.) and thus also crucial for the conceivability of the unity of the theoretical and practical use of reason in accomplishing the “highest vocation of reason” (5:108), i.e., the actualization of the highest good

Improved Slow Feature Analysis for Process Monitoring

Unsupervised multivariate statistical analysis models are valuable tools for process monitoring and fault diagnosis. Among them, slow feature analysis (SFA) is widely studied and used due to its explicit statistical properties, which aims to extract invariant features of temporally varying signals. This inclusion of dynamics in the model is important when working with process data where new samples are highly correlated to previous ones. However, the existing variations of SFA models cannot exploit increasingly tremendous data volume in modern industries, since they require the data to be fed in as a whole in the training stage. Further, sparsity is also desirable to provide interpretable models and prevent model overfitting. To address the aforementioned issues, a novel algorithm for inducing sparsity in SFA is first introduced, which is referred to as manifold sparse SFA (MSSFA). The non-smooth sparse SFA objective function is optimized using proximal gradient descent and the SFA constraint is fulfilled using manifold optimization. An associated fault detection and diagnosis framework is developed that retains the unsupervised nature of SFA. When compared to SFA, sparse SFA (SSFA), and sparse principal component analysis (SPCA), MSSFA shows superior performance in computational complexity, interpretability, fault detection, and fault diagnosis on the Tennessee Eastman process (TEP) and three-phase flow facility (TPFF) data sets. Furthermore, its sparsity is much improved over SFA and SSFA. Further, to exploit the increasing number of collected samples efficiently, a covariance free incremental SFA (IncSFA) is adapted in this work, which handles massive data efficiently and has a linear feature updating complexity with respect to data dimensionality. The IncSFA based process monitoring scheme is also proposed for anomaly detection. Further, a new incremental MSSFA (IncMSSFA) algorithm is also introduced that is able to use the same monitoring scheme. These two algorithms are compared against recursive SFA (RSFA) which can also process data incrementally. The efficiency of IncSFA-based monitoring is demonstrated with the TEP and TPFF data sets. The inclusion of sparsity in the IncMSSFA method provides superior monitoring performance at the cost of a quadratic complexity in terms of data dimensionality. This complexity is still an improvement over the cubic complexity of RSFA

Shear Strengthening of Reinforced Concrete Beams Using GFRP Wraps

The objective of the experimental work described in this paper was to investigate the efficiency of GFRP composites in strengthening simply supported reinforced concrete beams designed with insufficient shear capacity. Using the hand lay-up technique, successive layers of a woven fiberglass fabric were bonded along the shear span to increase the shear capacity and to avoid catastrophic premature failure modes. The strengthened beams were fabricated with no web reinforcement to explore the efficiency of the proposed strengthening technique using the results of control beams with closed stirrups as a  web reinforcement. The test results of 18 beams are reported, addressing the influence of different shear strengthening schemes and variable longitudinal reinforcement ratios on the structural behavior. The results indicated that significant increases in the shear strength and improvements in the overall structural behavior of beams with insufficient shear capacity could be achieved by proper application of GFRP wraps

Sorting Out the Myths from the Facts: Commentary on Yasemen Adali et al. (2018) article " The Relationship Between Histopathologic Findings and Body Mass Index in Sleeve Gastrectomy Materials "

[No abstract available]Scopu

Compared to What? Is BMI Associated with Histopathological Changes in Laparoscopic Sleeve Gastrectomy Specimens?

Background: Obesity is a risk for many different cancers. Laparoscopic sleeve gastrectomy (LSG) is common, and benign or pre-malignant histopathology types are reported in the removed gastric specimens. We assessed whether higher BMI was associated with certain benign or pre-malignant histopathological changes. Method: Retrospective chart review of all primary LSG patients (N = 1555). Demographic, clinical, and LSG histopathology data were retrieved. BMI of patients with specific benign or pre-malignant conditions in their gastric specimens was compared with the BMI of the rest of the patients with abnormal histopathology specimens and also compared with the BMI of patients with normal control specimens. Results: Females comprised 70% of the patients. Mean BMI were 46.3 (females) and 48 (males). Normal LSG specimens comprised 52%. Most common abnormal histopathologies were chronic inactive gastritis (33%), chronic active gastritis (6.8%), follicular gastritis (2.7%), lymphoid aggregates (2.2%), intestinal metaplasia (1.4%) and GIST (0.7%). After controlling for confounders (age, gender, H. pylori, diabetes mellitus type 2, hypertension), no significant association was observed between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies. Conclusion: When confounders were taken into account, there appeared no significant associations between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies of their gastric specimens. There was a very weak correlation between BMI and other covariates. - 2019, The Author(s).Acknowledgements Open Access funding provided by the Qatar National Library. The authors wish to thank Dr. Prem Chandra for assistance with the statistical analysis and the Medical Research Center at HMC for their support for the current study.Scopu

Reconfiguration technique for Optimization of the Photovoltaic array output power under partial shading conditions

A partial shading condition is a case under which the PV array is exposed to many problems such as losses of the output power of the PV array, and the PV array has more than one maximum power point (MPP), which makes it so difficult to track the MPP. This paper presents the effect of different partial shading patterns on PV array characteristics and the effect on the output power of the PV array, and provides a comparative literature review on methods to mitigate these effects and the drawbacks of these methods. It also proposed a new reconfiguration strategy that increases the output power of the PV array by 13.8 % from the total power under shadow condition, and a new technique for enhancing the output power of the PV array by 20 % of the total power under fully illumining conditions by controlling the switch matrix between the photovoltaic array and adaptive batteries bank. This paper gives a solution for the problem of the difficulty of tracking the MPP, because the proposed strategy makes only one MPP. The simulation was carried out by using MATLAB Simulink under different shading patterns.Citation: Mohamed, A. M., Saafan, S. M., Attalla, A. M., and Elgohary, H. (2018). Reconfiguration technique for Optimization of the Photovoltaic array output power under partial shading conditions. Trends in Renewable Energy, 4, 111-124. DOI: 10.17737/tre.2018.4.2.006

Some Physical and Computational Features of Unloaded Power Transmission Lines' Switching-off Process

The paper presents results of research some physical and computational features of unloaded power transmission lines switching-offs. It was stated that there are not monotonous dependence between magnitudes of transitional voltages at switching-off high voltage aerial lines and their lengths. There was studied influence of the circuit-breaker type (SF6 or vacuum ones) on transitional voltages. Features of use the ordinary differential equations' solvers at computer simulation from the point of view stability of solutions and simulation time consuming were investigated in the presented research

Combined Cisplatin Treatment and Photobiomodulation at High Fluence Induces Cytochrome c Release and Cytomorphologic Alterations in HEp-2 Cells

BACKGROUND: Photochemotherapy is thought to be a novel therapeutic modality for cancer. The photobiomodulation (PBM), applied through high fluence low-level laser irradiation (HF-LLLI), can be combined with the chemotherapeutic drug cisplatin to gain the benefit of potentiating its cytotoxic effect at possibly lower doses. AIM: The study aimed at investigation of the apoptotic effect of PBM, through LLLI (at HF), alone and in combination with cisplatin on cultured laryngeal cancer (HEp-2) cells. MATERIALS AND METHODS: In the current experimental in vitro research, cultured laryngeal cancer cell line (HEp-2) was treated with the half maximal inhibitory concentration of cisplatin, with and without LLLI. The study design consisted of four groups: Control (untreated), cisplatin-alone-treated, PBM-alone-treated, and combination cisplatin + PBM treated groups. Cells were irradiated once with diode laser (wavelength 808 nm, energy output 350 mW, 3 min, fluence 190.91 J/cm2, and continuous wave mode). Cytotoxicity was assessed by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay and the potential apoptotic effect was evaluated by cytochrome c (CYC) release through enzyme-linked immunosorbent assay (ELISA), in conjunction with visualization of cytomorphologic alterations by light microscopic examination, followed by digital morphometric analysis of nuclear changes through estimation of nuclear area factor (NAF). Analysis of variance and post hoc multiple-comparison tests were used for statistical analysis of the data of cytotoxicity assay, ELISA, and nuclear morphometric analysis. RESULTS: PBM alone had a neutral effect on viability of HEp-2 cells, but it induced CYC release and lowered NAF mean value, significantly. When PBM was combined with cisplatin, more conspicuous deterioration in bioavailability of HEp-2 cells was observed, a higher amount of CYC was liberated and NAF value dropped in HEp-2 cells, compared to those which received separate treatments with cisplatin alone or PBM alone. CONCLUSION: Based on the current findings, low-level laser photochemotherapy might be a promising adjunctive anticancer treatment for laryngeal cancer, as PBM at HF was able to augment the apoptotic effect of cisplatin on HEp-2 cancer cells