Plantar Vein Thrombosis due to Busy Night Duty on Intensive Care Unit

A 32-year-old woman with severe foot pain came to our emergency department after a busy night duty in hospital followed by an extended sleep period. Physical examination revealed a discrete swelling of the medial aspect of the right foot and a painful plantar arch during digital examination. Magnetic resonance imaging (MRI) with intravenous gadolinium showed filling efects in the lateral plantar vein. Doppler sonography displayed noncompressible structures in the plantar veins without flow signals, suggesting a plantar vein thrombosis. Therapy was initiated with low-molecular-weight heparin in combination with customized elastic bandages for the lower leg. Follow-up sonography 6 weeks later showed complete patency of the plantar veins. To our knowledge, we present the first case of isolated plantar vein thrombosis independent of trauma, surgery, or malignant disease, most probably caused by a busy night duty on the intensive care unit (ICU) followed by a prolonged sleeping period

Three-Dimension Numerical Simulation of Scour Temporal Changes due to Flow in the Downstream of Combined Weirs and Gate Model

Most of weirs create a region with relatively static water in upstream, which can be the place of sediments and wastes deposition in water. Sediments accumulation in upstream changes flow conditions.  In this case, combined weir and gate can be propounded as a useful solution. In the present paper, Flow3D was used to numerically simulate temporal changes of scour in combined free flow over weirs and below gates. Numerical modeling was run after fully preparing and the obtained data was analyzed under three-dimensional conditions. Comparing experimental and numerical results with data fitness revealed that determination coefficient (R2) of the numerical model results to the experimental model results is 0.94. Also, it was found that the relative error of the numerical model results relative to the experimental results equals 7.36%. Further, it was found that at the start of computations in the numerical model, compared to the end of running the model, the turbulent energy dissipation was decreased to 38% and decreasing the turbulent energy dissipation led to the creation of scour hole balance in the numerical model

Das Thoracic-Outlet-Syndrom

Der Begriff Thoracic-Outlet-Syndrom (T.O.S.) faßt alle Kompressionssyndrome des neurovaskulären Bündels im Bereich der oberen Thoraxapertur zusammen. Den unterschiedlichen Kompressionsmechanismen entsprechend ist das klinische Bild des T.O.S. vielfältig bunt, schwer erkennbar und kaum objektivierbar. Wichtig sind die Früherkennung von vaskulären Kompressionen und therapieresistenten, neurogenen Beschwerden, die eine absolute Indikation für eine operative Therapie darstellen. Ziel dieser Untersuchung war die differenzierte Erfassung der spezifischen Symptome, die ausführliche Darstellung der Indikation zur operativen Therapie sowie der daraus resultierenden Ergebnisse vor allem unter Berücksichtigung der vaskulären Komplikationen. Anhand eines standardisierten Untersuchungsbogens wurden neben demographischen Daten die OP-Techniken, die anatomischen, klinischen und radiologischen Befunde, sowie Komplikationen und der postoperative Verlauf erfaßt. Eingang in den Fragebogen fand dabei jeweils auch die subjektive Einschätzung der Patienten zu ihren Beschwerden sowie zum Behandlungsergebnis. In die vorliegende Arbeit gingen 56 Patienten (36 Frauen und 20 Männer) mit 64 Operationen ein, die im Zeitraum zwischen 1983 und 1999 in der Gefäßchirurgie der Chirurgischen Klinik und Poliklinik, Klinikum Innenstadt LMU-München wegen eines T.O.S. behandelt wurden. Eine vaskuläre Komplikation aufgrund eines T.O.S. wurde in 22 Fällen diagnostiziert, dabei hatten 9 Patienten arterielle Embolisationen und 13 Patienten eine Thrombose der V. axillaris und subclavia erlitten. Bei 24 Patienten wurden Halsrippen nachgewiesen, davon bei 7 Patienten beidseits und bei 14 rechtsseitig. In 43 Fällen wurde nur die 1. Rippe und in 13 Fällen die 1. Rippe und eine Halsrippe entfernt. In drei Fällen war lediglich die Entfernung einer Halsrippe und in fünf anderen Fällen nur eine Scalenotomie durchgeführt worden. Insgesamt wurden 56 mal der transaxilläre und fünf mal der supraklaviculäre Zugang gewählt. Bei zwei Patienten erfolgte die transaxilläre Resektion der 1. Rippe und die supraklaviculäre Resektion der Halsrippe kombiniert und in einem weiteren Fall wurde supra- und infraklavikulär vorgegangen. Bei 3 Patienten wurden die Aneurysmen der A. subclavia durch Gefäßprothesen und bei einem weiteren durch eine Stent-Implantation erfolgreich ausgeschaltet. Bei 94 % der untersuchten Patienten wurde ein kompletter Rückgang oder eine deutliche Besserung der Symptomatik durch die Operation erreicht. 6 % der Patienten haben unveränderte neurologische Beschwerden. Die standardisiert erhobene subjektive Einschätzung der Patienten über die Veränderung von Beschwerden durch die Behandlung steht in guter Übereinstimmung mit den klinischen und apparativen Untersuchungsbefunden. 88 Die transaxilläre Resektion der 1. Rippe (gegebenenfalls mit der Halsrippe) bei Patienten mit T.O.S. ist die Behandlung der Wahl. In besonderen Fällen ist der supraklaviculäre Zugang als alternative Technik zu erwägen. Vor allem, wenn die vaskuläre Symptomatik im Vordergrund steht, ist durch die Anwendung einer multimodalen Therapie bestehend aus Embolektomie, Lyse und anschließender Dekompressionsoperation und gegebenenfalls eine Gefäßrekonstruktion eine komplette Heilung zu erreichen

PERSIANN-CNN: Precipitation Estimation from Remotely Sensed Information Using Artificial Neural Networks-Convolutional Neural Networks

Abstract Accurate and timely precipitation estimates are critical for monitoring and forecasting natural disasters such as floods. Despite having high-resolution satellite information, precipitation estimation from remotely sensed data still suffers from methodological limitations. State-of-the-art deep learning algorithms, renowned for their skill in learning accurate patterns within large and complex datasets, appear well suited to the task of precipitation estimation, given the ample amount of high-resolution satellite data. In this study, the effectiveness of applying convolutional neural networks (CNNs) together with the infrared (IR) and water vapor (WV) channels from geostationary satellites for estimating precipitation rate is explored. The proposed model performances are evaluated during summer 2012 and 2013 over central CONUS at the spatial resolution of 0.08° and at an hourly time scale. Precipitation Estimation from Remotely Sensed Information Using Artificial Neural Networks (PERSIANN)–Cloud Classification System (CCS), which is an operational satellite-based product, and PERSIANN–Stacked Denoising Autoencoder (PERSIANN-SDAE) are employed as baseline models. Results demonstrate that the proposed model (PERSIANN-CNN) provides more accurate rainfall estimates compared to the baseline models at various temporal and spatial scales. Specifically, PERSIANN-CNN outperforms PERSIANN-CCS (and PERSIANN-SDAE) by 54% (and 23%) in the critical success index (CSI), demonstrating the detection skills of the model. Furthermore, the root-mean-square error (RMSE) of the rainfall estimates with respect to the National Centers for Environmental Prediction (NCEP) Stage IV gauge–radar data, for PERSIANN-CNN was lower than that of PERSIANN-CCS (PERSIANN-SDAE) by 37% (14%), showing the estimation accuracy of the proposed model

Friction Stir Welding of Dissimilar Joints Between Commercially Pure Titanium Alloy and 7075 Aluminium Alloy

In this study, a joint between commercially pure titanium alloy and 7075 aluminium alloy was butt welded by using friction stir welding at a rotational speed of 1120 rpm and a traverse speed of 50 mm*min-1. The evaluation of hardness and microstructure was performed by using scanning electron microscopy. The phases in the weld area were identified by apply-ing the X-ray diffraction technique and the Energy Dispersive X-ray Spectroscopy (EDS) analysis was used for the evaluation of intermetallic compounds of the weld area. The weld zone is cone-shaped and consists of aluminium and titanium particles that play an important role in increasing hardness and tensile strength. The weld area has three zones, namely the titanium base metal zone, the aluminium base metal zone, and the titanium-aluminium inter-metallic compound mixed zone. It was also observed that the joint area on the aluminium side includes the stirred area, the thermo-mechanically affected zone, and the heat-affected zone, while the titanium joint area contains the stirred zone and the heat-affected zone. The hard-ness value of the weld area was around 360 HV, which means that in this area, compared to the base metal of titanium and aluminium, hardness has increased by 6% and 20%, respectively. This can be attributed to severe plastic deformation and formation of intermetallic compounds of titanium and aluminium in this area

Investigating Effect of Development of Agricutural, Industrial, Service and Oil Revenue to ICOR ofAgricultural Sector

In this study, considering the importance of incremental capital output ratio (ICOR) in agriculture Investment capital and self-sufficiency in this sector in order to grow and being influenced by the past and previous relationships strong agricultural sector productivity growth in other sectors of the economy, especially the effect of oil revenues, was trying to, long-term relationships as well as their adjustment process described by the Autoregressive-Distributed Lag model (ARDL) to investigate.The results also confirm the long-run relationship between the variables of the model show that oil revenues in appropriate path to growth agricultural productivity have beentoo much attention to the industry and imports of agricultural products decreased investment in agricultural productivity. However, the service sector growth by improving marketing activities and financing farmers to improve venture capital productivity in the agricultural sector operates. In the long run, adjusting the intersection, the model indicates improved productivity in the agricultural sector is of capital. Shown the necessary support to the agricultural sector in the short term

Characterization of Tribological and Mechanical Properties of the Si3N4 Coating Fabricated by Duplex Surface Treatment of Pack Siliconizing and Plasma Nitriding on AISI D2 Tool Steel

Abstract Silicon nitride (Si3N4) coating was deposited on AISI D2 tool steel through employing duplex surface treatments—pack siliconizing followed by plasma nitriding. Pack cementation was performed at 650 °C, 800 °C, and 950 °C for 2 and 3 hours by using various mixtures to realize the silicon coating. X-ray diffraction analyses and scanning electron microscopy observations were employed for demonstrating the optimal process conditions leading to high coating adhesion, uniform thickness, and composition. The optimized conditions belonging to siliconizing were employed to produce samples to be further processed via plasma nitriding. This treatment was performed with a gas mixture of 75 pct H2-25 pct N2, at the temperature of 550 °C for 7 hours. The results showed that different nitride phases such as Si3N4-β, Si3N4-γ, Fe4N, and Fe3N can be recognized as coatings reinforcements. It was demonstrated that the described composite coating procedure allowed to obtain a remarkable increase in hardness (80 pct higher with respect to the substrate) and wear resistance (30 pct decrease of weight loss) of the tool steel

Visceral embolus protection by catheters with balloon-inflatable tips during hybrid repair of thoracoabdominal aortic aneurysm

Thoracoabdominal aortic aneurysms (TAAA) are associated with high rupture rates and poor outcome in patients who do not have surgical repair. Endovascular and hybrid techniques have gained increasing acceptance for the treatment of TAAA in patients with multiple comorbidities and an increased anesthetic risk. One of the complications of endovascular repair in TAAA is procedurally related embolism to visceral vessels. Visceral embolism causes bowel ischemia and is a potentially lethal complication. This report illustrates the intermittent use of catheters with balloon-inflatable tips as visceral embolus protection systems. These catheters are easy to apply and demonstrated perfect prevention of visceral embolization. To date, 10 patients have undergone operations at our clinic using this protection system, and no embolic complications were observed at the visceral vessels. Therefore, catheters with balloon-inflatable tips for visceral embolous protection should be considered in patients undergoing a two-stage hybrid TAAA repair to avoid embolus-associated morbidity and mortality

Effect of experimental hyperthyroidism on CatSper1 and CatSper2 genes expression in the seminiferous tubules of BALB/c mice: An experimental study

Background: CATSPER 1 (Cation Channel Sperm Associated 1) and CATSPER2 channels have an important role in sperm motility. In this study, the effects of hyperthyroidism on Catsper1 and 2 genes of seminiferous tubules in mice testes were investigated. Objective: The present study was conducted to investigate the effect of hyperthyroidism on the expression of CATSPER1 and CATSPER2 genes in the seminiferous tubules of mice. Materials and Methods: This study was conducted on 20 BALB/C male mice divided into two groups - experimental and control. The experimental group was administered with 500 mg/l levothyroxine (L-thyroxine) liquid solution for two months for inducing hyperthyroidism, which was confirmed by radioimmunoassay. On the other hand, the control group was kept in animal houses under a normal condition. The implementation of real-time polymerase chain reaction and immunohistochemical studies was accomplished after the removal of the testes of the mice under anesthesia induced by chloroform. Results: Results showed that there was no significant difference in CATSPER1 (p = 0.45) and CATSPER2 (p = 0.34) gene expression between groups. At the same time, the color intensity showed no significant enhancement in the hyperthyroidism group (CATSPER1 p = 0.17 and CATSPER2 p = 0.22) as compared to the control group. Conclusion: Considering the key role of CATSPER in the molecular structure of the sperm, our findings showed that the hyperactivity of the thyroid gland has no significant effects on the function of these components. Therefore, it might be concluded that hyperthyroidism has no considerable effects on the seminiferous tubules. Key words: CATSPER1, CATSPER2, Hyperthyroidism, Mice, Sperm