Study of functional outcome of muller type C distal femur fracture treated with locking compression plate

Background: To evaluate the functional outcome of Muller type C distal femur fracture treated with locking compression plate (LCP). Methods: This prospective study was carried out at Al-Ameen medical college and hospital, Vijayapura. Forty patients (24 males and 16 females) with Muller type C distal femur fractures were enrolled in our study. Patients were treated with open reduction and internal fixation with LCP. They were followed up for 9 months with clinical examination and serial x-rays. The functional outcome was evaluated using Neer’s scoring system. Results: Forty patients who completed follow up of 9 months were included. There were 18 muller type C1, 14 muller type C2 and 8 Muller type C3 fractures. The functional evaluation with Neer’s scoring system was excellent in 8 patients, good in 20 patients, fair in 8 patients and poor in 4 patients. Complications observed were difficulty in reduction, superficial infections, knee stiffness and limb length discrepancy. Conclusions: The LCP is a safe and effective tool to manage these difficult fractures as we had no incidence of implant failure, delayed union, non-union and revision surgery except that we had knee stiffness as commonest complication which can be tackled by early surgery, surgical expertise, meticulous soft tissue handling and vigorous early knee mobilisation.

CRNN model for text detection and classification from natural scenes

In the emerging field of computer vision, text recognition in natural settings remains a significant challenge due to variables like font, text size, and background complexity. This study introduces a method focusing on the automatic detection and classification of cursive text in multiple languages: English, Hindi, Tamil, and Kannada using a deep convolutional recurrent neural network (CRNN). The architecture combines convolutional neural networks (CNN) and long short-term memory (LSTM) networks for effective spatial and temporal learning. We employed pre-trained CNN models like VGG-16 and ResNet-18 for feature extraction and evaluated their performance. The method outperformed existing techniques, achieving an accuracy of 95.0%, 96.3%, and 96.2% on ICDAR 2015, ICDAR 2017, and a custom dataset (PDT2023), respectively. The findings not only push the boundaries of text detection technology but also offer promising prospects for practical applications

Dependence of the Confinement Time of an Electron Plasma on the Magnetic Field in a Quadrupole Penning Trap

A quadrupole Penning trap is used to confine electrons in weak magnetic fields. Perturbations due to space charge and imperfections in the trap geometry, as well as collisions with the background gas molecules, lead to loss of the electrons from the trap. We present in this work the results on measurements of the electron confinement time and its dependence on the magnetic field in a quadrupolar Penning trap. We describe a method to measure the confinement time of an electron cloud under weak magnetic fields (0.01 T - 0.1 T). This time is found to scale as τ∝B1.41 in variance with the theoretically expected confinement time that scales as τ∝B2 for trapped electrons that are lost through collisions with the neutrals present in the trap. A measurement of the expansion rate of the electron plasma in the trap through controlled variation of the trap voltage, yields expansion times that depend on the energy of escaping electrons. This is found to vary in our case in the scaling range B 0.32 to B 0.43. Distorting the geometry of the trap, results in a marked change in the confinement time's dependence on the magnetic field. The results indicate that the confinement time of the electron cloud in the trap is limited by both, effects of collisions and perturbations that result in the plasma loss through expansion in the trap

Superconductivity in single crystals of a quasi-one dimensional infinite chain cuprate Srx_xCa1−x_{1-x}CuO2_2 at 90 K

Although there is no complete theory of high temperature superconductivity, the importance of CuO$_2$ planes in cuprate superconductors is confirmed from both theory and experiments. Strong Coulomb repulsion between electrons on the CuO$_2$ plane makes the resultant electron system highly correlated and a difficult problem to solve since exact solutions of many-body Hamiltonian in two dimensions do not exist. If however, superconductivity can arise in structures having chains rather than planes and having a high critical temperature, then the high temperature superconductivity problem could become more tractable since exact solutions in one dimension do exist. In this paper, we report the observation of bulk superconductivity in single crystals of a cuprate Sr$_x$Ca$_{1-x}$CuO$_2$ at very high critical temperature, T$_c$, of $\sim$ 90 K whose structure reveals the presence of infinite double chains of Cu-O-Cu-O instead of CuO$_2$ planes, thus, ensuring quasi-one dimensional superconductivity. Bulk superconducting behaviour was observed in \textit{dc} magnetisation, \textit{ac} susceptibility as well as resistance measurements. The observation of bulk superconductivity in Sr$_x$Ca$_{1-x}$CuO$_2$ having chains of Cu-O-Cu-O rather than planes of CuO$_2$ at a high T$_c$ of 90 K is expected to profoundly impact our understanding of high temperature superconductivity.Comment: 15 pages, 4 figure

Use of multidimensional item response theory methods for dementia prevalence prediction : an example using the Health and Retirement Survey and the Aging, Demographics, and Memory Study

Background Data sparsity is a major limitation to estimating national and global dementia burden. Surveys with full diagnostic evaluations of dementia prevalence are prohibitively resource-intensive in many settings. However, validation samples from nationally representative surveys allow for the development of algorithms for the prediction of dementia prevalence nationally. Methods Using cognitive testing data and data on functional limitations from Wave A (2001-2003) of the ADAMS study (n = 744) and the 2000 wave of the HRS study (n = 6358) we estimated a two-dimensional item response theory model to calculate cognition and function scores for all individuals over 70. Based on diagnostic information from the formal clinical adjudication in ADAMS, we fit a logistic regression model for the classification of dementia status using cognition and function scores and applied this algorithm to the full HRS sample to calculate dementia prevalence by age and sex. Results Our algorithm had a cross-validated predictive accuracy of 88% (86-90), and an area under the curve of 0.97 (0.97-0.98) in ADAMS. Prevalence was higher in females than males and increased over age, with a prevalence of 4% (3-4) in individuals 70-79, 11% (9-12) in individuals 80-89 years old, and 28% (22-35) in those 90 and older. Conclusions Our model had similar or better accuracy as compared to previously reviewed algorithms for the prediction of dementia prevalence in HRS, while utilizing more flexible methods. These methods could be more easily generalized and utilized to estimate dementia prevalence in other national surveys

Global mortality from dementia : Application of a new method and results from the Global Burden of Disease Study 2019

Introduction Dementia is currently one of the leading causes of mortality globally, and mortality due to dementia will likely increase in the future along with corresponding increases in population growth and population aging. However, large inconsistencies in coding practices in vital registration systems over time and between countries complicate the estimation of global dementia mortality. Methods We meta-analyzed the excess risk of death in those with dementia and multiplied these estimates by the proportion of dementia deaths occurring in those with severe, end-stage disease to calculate the total number of deaths that could be attributed to dementia. Results We estimated that there were 1.62 million (95% uncertainty interval [UI]: 0.41–4.21) deaths globally due to dementia in 2019. More dementia deaths occurred in women (1.06 million [0.27–2.71]) than men (0.56 million [0.14–1.51]), largely but not entirely due to the higher life expectancy in women (age-standardized female-to-male ratio 1.19 [1.10–1.26]). Due to population aging, there was a large increase in all-age mortality rates from dementia between 1990 and 2019 (100.1% [89.1–117.5]). In 2019, deaths due to dementia ranked seventh globally in all ages and fourth among individuals 70 and older compared to deaths from other diseases estimated in the Global Burden of Disease (GBD) study. Discussion Mortality due to dementia represents a substantial global burden, and is expected to continue to grow into the future as an older, aging population expands globally

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods: GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk–outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk–outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk–outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings: The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51–12·1) deaths (19·2% [16·9–21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12–9·31) deaths (15·4% [14·6–16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253–350) DALYs (11·6% [10·3–13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0–9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10–24 years, alcohol use for those aged 25–49 years, and high systolic blood pressure for those aged 50–74 years and 75 years and older. Interpretation: Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public