Anaesthetic management of appendectomy in a patient with cerebral arteriovenous malformation

Background: The aim of anaesthetic management for appendectomy in a patient with cerebral arteriovenous malformation (AVM) is to maintain a stable cardiovascular system. As this condition is rare, there are no definitive guidelines regarding the anaesthetic management of such patients. Case report: We report a case of appendectomy in a patient with cerebral AVM. The patient was diagnosed with cerebral AVM four years prior to presentation with acute appendicitis and was advised surgical intervention, which he refused. Management of this patient presenting with acute appendicitis is discussed. Conclusion: General anaesthesia may be used successfully for appendectomy in a patient with cerebral AVM if haemodynamic fluctuations at times of stress are minimised.Keywords: appendectomy; arteriovenous malformation; general anaesthesi

Biofilm-based simultaneous nitrification, denitrification, and phosphorous uptake in wastewater by Neurospora discreta

Biological removal of nitrogen and phosphorous from wastewater conventionally involves multiple processing steps to satisfy the differing oxygen requirements of the microbial species involved. In this work, simultaneous nitrification, denitrification, and phosphorous removal from synthetic wastewater were achieved by the fungus Neurospora discreta in a single-step, biofilm-based, aerobic process. The concentrations of carbon, nitrogen, and phosphorous in the synthetic wastewater were systematically varied to investigate their effects on nutrient removal rates and biofilm properties. Biofilm growth was significantly (p < 0.05) affected by carbon and nitrogen, but not by phosphorous concentration. Scanning electron microscopy revealed the effects of nutrients on biofilm microstructure, which in turn correlated with nutrient removal efficiencies. The carbohydrate and protein content in the biofilm matrix decreased with increasing carbon and nitrogen concentrations but increased with increasing phosphorous concentration in the wastewater. High removal efficiencies of carbon (96%), ammonium (86%), nitrate (100%), and phosphorus (82%) were achieved under varying nutrient conditions. Interestingly, decreasing the phosphorus concentration increased the nitrification and denitrification rates, and decreasing the nitrogen concentration increased the phosphorus removal rates significantly (p < 0.05). Correlations between biofilm properties and nutrient removal rates were also evaluated in this study

Aircraft requirements for low/medium density markets

A study was conducted to determine the demand for and the economic factors involved in air transportation in a low and medium density market. The subjects investigated are as follows: (1) industry and market structure, (2) aircraft analysis, (3) economic analysis, (4) field surveys, and (5) computer network analysis. Graphs are included to show the economic requirements and the aircraft performance characteristics

Study of surface morphology, elemental composition and origin of atmospheric aerosols (PM2.5 and PM10) over Agra, India

In situ measurements of PM (PM2.5 and PM10) particles were carried out using a medium volume air sampler (offline) and particle number concentrations of PM were measured by a Grimm aerosol spectrophotometer (online) during the study period of 2010�2011. The morphology and elemental composition analyses of PM were performed by Scanning Electron Microscopy (SEM) and Energy Dispersive Spectrometry (EDS), respectively. The average mass concentrations of PM2.5 and PM10 were 97.2 and 242.6 µg/m3 at roadside (RD) and 121.2 and 230.5 µg/m3 at a semirural (SR) site, respectively. These concentrations were substantially higher than the NAAQS, WHO and USEPA standards. The highest mass and number concentrations of PM2.5 and PM10 were observed during winter, followed by those during the post-monsoon period and summer, with the lowest in the monsoon period. SEM and EDS analysis of PM indicated the presence of soot, mineral, tarballs, fly ash, aluminosilicates/silica, fluorine, carbon rich, and Cl-Na rich particles. Of these particles, soot, tarballs, and F-C rich particles dominate in PM2.5, whereas mineral, aluminosilicates, and Cl-Na rich particles dominate in PM10. The morphology and elemental composition of the particles varied over the seasons due to atmospheric processing. The highest carbon concentration (56) was observed in PM2.5 during summer at the RD, while in the monsoon, post-monsoon period and winter the carbon concentration was ~9 lower at the RD as compared to the SR. However, the concentration of carbon in PM10 was ~38 higher at the RD as compared to SR during both summer and winter. Air mass backward trajectory cluster analysis was performed, and the results indicate that the aerosol loadings over Agra are mainly transported from the Middle East and Arabian Sea during the summer and monsoon period, while during the pre-monsoon period and winter the aerosol loadings came from the northern region, and were due to the burning of biomass and coal, as well as other local activities

Raising awareness of the accessibility challenges in mathematics MOOCs

MOOCs provide learning environments that make it easier for learners to study from anywhere, at their own pace and with open access to content. This has revolutionised the field of eLearning, but accessibility continues to be a problem, even more so if we include the complexity of the STEM disciplines which have their own specific characteristics. This work presents an analysis of the accessibility of several MOOC platforms which provide courses in mathematics. We attempt to visualise the main web accessibility problems and challenges that disabled learners could face in taking these types of courses, both in general and specifically in the context of the subject of mathematics

Complications After Systematic, Random and Image-guided Prostate Biopsy

CONTEXT: Prostate biopsy (PB) represents the gold standard method to confirm the presence of cancer. In addition to traditional random or systematic approaches, a magnetic resonance imaging (MRI)-guided technique has been introduced recently. OBJECTIVE: To perform a systematic review of complications after transrectal ultrasound (TRUS)-guided, transperineal, and MRI-guided PB. EVIDENCE ACQUISITION: We performed a systematic literature search of Web of Science, Embase, and Scopus databases up to October 2015, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Complications and mortality following random, systematic, and image-guided PBs were reviewed. Eighty-five references were included. EVIDENCE SYNTHESIS: The most frequent complication after PB was minor and self-limiting bleeding (hematuria and hematospermia), regardless of the biopsy approach. Occurrence of rectal bleeding was comparable for traditional TRUS-guided and image-guided PBs. Almost 25% of patients experienced lower urinary tract symptoms, but only a few had urinary retention, with higher rates after a transperineal approach. Temporary erectile dysfunction was not negligible, with a return to baseline after 1-6 mo. The incidence of infective complications is increasing, with higher rates among men with medical comorbidities and older age. Transperineal and in-bore MRI-targeted biopsy may reduce the risk of severe infectious complications. Mortality after PB is uncommon, regardless of biopsy technique. CONCLUSIONS: Complications after PB are frequent but often self-limiting. The incidence of hospitalization due to severe infections is continuously increasing. The patient's general health status, risk factors, and likelihood of antimicrobial resistance should be carefully appraised before scheduling a PB. PATIENT SUMMARY: We reviewed the variety and incidence of complications after prostate biopsy. Even if frequent, complications seldom represent a problem for the patient. The most troublesome complications are infections. To minimize this risk, the patient's medical condition should be carefully evaluated before biopsy

Design and Development of Microcontroller-Based Clinical Chemistry Analyser for Measurement of Various Blood Biochemistry Parameters

Clinical chemistry analyser is a high-performance microcontroller-based photometric biochemical analyser to measure various blood biochemical parameters such as blood glucose, urea, protein, bilirubin, and so forth, and also to measure and observe enzyme growth occurred while performing the other biochemical tests such as ALT (alkaline amino transferase), amylase, AST (aspartate amino transferase), and so forth. These tests are of great significance in biochemistry and used for diagnostic purposes and classifying various disorders and diseases such as diabetes, liver malfunctioning, renal diseases, and so forth. An inexpensive clinical chemistry analyser developed by the authors is described in this paper. This is an open system in which any reagent kit available in the market can be used. The system is based on the principle of absorbance transmittance photometry. System design is based around 80C31 microcontroller with RAM, EPROM, and peripheral interface devices. The developed system incorporates light source, an optical module, interference filters of various wave lengths, peltier device for maintaining required temperature of the mixture in flow cell, peristaltic pump for sample aspiration, graphic LCD display for displaying blood parameters, patients test results and kinetic test graph, 40 columns mini thermal printer, and also 32-key keyboard for executing various functions. The lab tests conducted on the instrument include versatility of the analyzer, flexibility of the software, and treatment of sample. The prototype was tested and evaluated over 1000 blood samples successfully for seventeen blood parameters. Evaluation was carried out at Government Medical College and Hospital, the Department of Biochemistry. The test results were found to be comparable with other standard instruments

On the A-dependence of nuclear generalized parton distributions

We perform a microscopic evaluation of nuclear GPDs for spin-0 nuclei in the framework of the Walecka model. We demonstrate that the meson (non-nucleon) degrees of freedom dramatically influence nuclear GPDs, which is revealed in the non-trivial and unexpected A-dependence of DVCS observables. In particular, we find that the first moment of the nuclear D-term, d_A(0) ~ A^2.26, which confirms the earlier prediction of M.Polyakov. We find that in the HERMES kinematics, contrary to the free proton case, the nuclear meson degrees of freedom in large nuclei enhance the nuclear DVCS amplitude which becomes comparable to the Bethe-Heitler amplitude, and, thus, give the non-trivial A-dependence to the DVCS asymmetries: as a function of the atomic number the beam-charge asymmetry increases whereas the beam-spin asymmetry decreases slowly.Comment: Final version published in J. Phys. G. 17 pages, 9 figure