Use of a Javid™ shunt in the management of axillary artery injury as a complication of fracture of the surgical neck of the humerus: a case report

<p>Abstract</p> <p>Introduction</p> <p>Axillary artery injury is a rare but severe complication of fractures of the surgical neck of the humerus.</p> <p>Case presentation</p> <p>We present a case of axillary artery pseudoaneurysm secondary to such a fracture, in a 82-year-old white woman, presenting 10 weeks after the initial injury, successfully treated with subclavian to brachial reversed vein bypass together with simultaneous open reduction and internal fixation of the fracture. We discuss the use of a Javid™ shunt during combined upper limb revascularisation and open reduction and internal fixation of the fractured humerus.</p> <p>Conclusion</p> <p>This case highlights the usefulness of a Javid™ shunt, over other forms of vascular shunts, in prompt restoration of blood flow to effect limb salvage. It can be considered as a temporary measure whilst awaiting definitive revascularisation which can be performed following fracture fixation.</p

Environmental impacts of utilization of ageing fixed offshore platform for ocean thermal energy conversion

Most Malaysian jacket platforms have outlived their design life. As these old platforms have outlived their design life, other alternatives must be considered. As several offshore oil and gas extraction installations approach the end of their operational life, many options such as decommissioning and the development of a new source of energy such as wind farms are introduced. The objective of this paper is to investigate the environmental impacts of utilising ageing fixed offshore platform as a source for Ocean Thermal Energy Conversion (OTEC). The environmental impact of utilising an ageing fixed offshore platform as an OTEC source is discussed. OTEC produces energy by taking advantage of temperature variations between the ocean surface water and the colder deep water through cold-water intake piping, which requires a seawater depth of 700 metres. The output of this study shows that OTEC is envisioned to preserve marine life, becoming a new and reliable source of energy, assist clean water production, and reduce the negative impact of climate change. OTEC platforms utilising ageing platforms may lead to 44 % of fish catch in the ocean, remove 13 GW of surface ocean heat for every GW of electricity production per year, generate 1.3105 tonnes of hydrogen per year for each GW of electricity generated. In addition, OTEC platforms can reduce approximately 5106 tonnes of carbon dioxide from the environment for 1 GW of electricity generated per year, and supply 2 million litres of water per day for a 1 MW platform. Since Malaysia's seawater profile allows for installing a fixed offshore platform as an OTEC power plant, Malaysia has many potentials to profit from the OTEC process

Psychiatric rating scales in Urdu: a systematic review

<p>Abstract</p> <p>Background</p> <p>Researchers setting out to conduct research employing questionnaires in non-English speaking populations need instruments that have been validated in the indigenous languages. In this study we have tried to review the literature on the status of cross-cultural and/or criterion validity of all the questionnaires measuring psychiatric symptoms available in Urdu language.</p> <p>Methods</p> <p>A search of Medline, Embase, PsycINFO and <url>http://www.pakmedinet.com</url> was conducted using the search terms; Urdu psychiatric rating scale, and Urdu and Psychiatry. References of retrieved articles were searched. Only studies describing either cross-cultural or criterion validation of a questionnaire in Urdu measuring psychiatric symptoms were included.</p> <p>Results</p> <p>Thirty two studies describing validation of 19 questionnaires were identified. Six of these questionnaires were developed indigenously in Urdu while thirteen had been translated from English. Of the six indigenous questionnaires five had had their criterion validity examined. Of the thirteen translated questionnaires only four had had both their cross-cultural and criterion validity assessed.</p> <p>Conclusion</p> <p>There is a paucity of validated questionnaires assessing psychiatric symptoms in Urdu. The BSI, SRQ and AKUADS are the questionnaires that have been most thoroughly evaluated in Urdu.</p

A SRY-HMG box frame shift mutation inherited from a mosaic father with a mild form of testicular dysgenesis syndrome in Turner syndrome patient

Background: Sex determining factor (SRY) located on the short arm of the Y chromosome, plays an important role in initiating male sex determination, resulting in development of testicular tissue. Presence of the SRY gene in females results in XY sex reversal and increased risk of gonadal germ cell tumours if the karyotype also includes the so-called GonadoBlastoma on the Y chromosome (GBY) region. The majority of mutations within the SRY gene are de novo affecting only a single individual in the family. The mutations within the high-mobility group (HMG) region have the potential to affect its DNA binding activity.Case Presentation: We performed G- and R-banding cytogenetic analysis of the patient and her family members including her father. We also performed molecular genetic analysis of SRY gene. Cytogenetic analysis in the patient (Turner Syndrome) revealed the mosaic karyotype as 45, X/46, XY (79%/21% respectively) while her father (milder features with testicular dysgenesis syndrome) has a normal male karyotype (46, XY). Using molecular approach, we screened the patient and her father for mutations in the SRY gene. Both patient and her father showed the same deletion of cytosine within HMG box resulting in frame shift mutation (L94fsX180), the father in a mosaic pattern. Histological examination of the gonads from the patient revealed the presence of gonadoblastoma formation, while the father presented with oligoasthenozoospermia and a testicular seminoma. The frameshift mutation at this codon is novel, and may result in a mutated SRY protein.Conclusion: Our results suggest that lack of a second sex chromosome in majority cells of the patient may have triggered the short stature and primary infertility, and the mutated SRY protein may be associated with the development of gonadoblastoma. It is of importance to note that mosaic patients without a SRY mutation also have a risk for malignant germ cell tumors

The E3 ubiquitin ligase EDD is an adverse prognostic factor for serous epithelial ovarian cancer and modulates cisplatin resistance in vitro

Despite a high initial response rate to first-line platinum/paclitaxel chemotherapy, most women with epithelial ovarian cancer relapse with recurrent disease that becomes refractory to further cytotoxic treatment. We have previously shown that the E3 ubiquitin ligase, EDD, a regulator of DNA damage responses, is amplified and overexpressed in serous ovarian carcinoma. Given that DNA damage pathways are linked to platinum resistance, the aim of this study was to determine if EDD expression was associated with disease recurrence and platinum sensitivity in serous ovarian cancer. High nuclear EDD expression, as determined by immunohistochemistry in a cohort of 151 women with serous ovarian carcinoma, was associated with an approximately two-fold increased risk of disease recurrence and death in patients who initially responded to first-line chemotherapy, independently of disease stage and suboptimal debulking. Although EDD expression was not directly correlated with relative cisplatin sensitivity of ovarian cancer cell lines, sensitivity to cisplatin was partially restored in platinum-resistant A2780-cp70 ovarian cancer cells following siRNA-mediated knockdown of EDD expression. These results identify EDD as a new independent prognostic marker for outcome in serous ovarian cancer, and suggest that pathways involving EDD, including DNA damage responses, may represent new therapeutic targets for chemoresistant ovarian cancer

Remaining idle time aware intelligent channel bonding schemes for cognitive radio sensor networks

Channel bonding (CB) is a technique used to provide larger bandwidth to users. It has been applied to various networks such as wireless local area networks, wireless sensor networks, cognitive radio networks, and cognitive radio sensor networks (CRSNs). The implementation of CB in CRSNs needs special attention as primary radio (PR) nodes traffic must be protected from any harmful interference by cognitive radio (CR) sensor nodes. On the other hand, CR sensor nodes need to communicate without interruption to meet their data rate requirements and conserve energy. If CR nodes perform frequent channel switching due to PR traffic then it will be difficult to meet their quality of service and data rate requirements. So, CR nodes need to select those channels which are stable. By stable, we mean those channels which having less PR activity or long remaining idle time and cause less harmful interference to PR nodes. In this paper, we propose two approaches remaining idle time aware intelligent channel bonding (RITCB) and remaining idle time aware intelligent channel bonding with interference prevention (RITCB-IP) for cognitive radio sensor networks which select stable channels for CB which have longest remaining idle time. We compare our approaches with four schemes such as primary radio user activity aware channel bonding scheme, sample width algorithm, cognitive radio network over white spaces and AGILE. Simulation results show that our proposed approaches RITCB and RITCB-IP decrease harmful interference and increases the life time of cognitive radio sensor nodes