Management And Outcome Of Diabetic Charcot’s Foot: Jabir Abueliz Diabetic Center Experience 2019 (JADC)

Charcot foot is a rare but a serious diabetic related condition. Usually it is misdiagnosed although its prognosis related to timely and proper management. Objective: To study the management and outcome of diabetic Charcot’s foot in Jabir AbuEliz diabetic center in period between 2012 and 2019. Methods: A combined retro-prospective descriptive analytical study and hospital based. Study conducted to 134 diabetic patients with charcot joint attended to JADC during the study period. The study sample was calculated by total coverage. Study questionnaires captured mainly quantitative data. Data analyzed by using SPSS version 21. Results: 134 diabetic patients with charcot joint were involved in this study, most of the patients were males, in the age group 51-60 years and had NIDDM associated with other medical disorders.  At the time of presentation, 91% of the patients presented with swelling and 53.7% of the patients had pain. On examination of the foot; 84.3% of the patients had swelling and 59.7% of the patients had dry skin. Hammer toes deformity was the commonest feet deformity. Based on modified Sella and Barrette classification, 17.2% of the patients in grade 1. Casting was performed to all patients with good outcome to 91.1% of the patients. Conclusion: This study reveals that grade 0,1&2 Charcot neuroarthropathy feet had good outcome if properly recognized and early managed. The total contact cast (TCC) and CAM walker is effective in the management

ヒトおよびマウスにおける母と胎児のRR間隔の類似性と胎児発達との関係

Tohoku University齋藤昌利課

New Iterative Method Based on Laplace Decomposition Algorithm

We introduce a new form of Laplace decomposition algorithm (LDA). By this form a new iterative method was achieved in which there is no need to calculate Adomian polynomials, which require so much computational time for higher-order approximations. We have implemented this method for the solutions of different types of nonlinear pantograph equations to support the proposed analysis

Quantification of sterol-specific response in human macrophages using automated imaged-based analysis

BACKGROUND: The transformation of normal macrophage cells into lipid-laden foam cells is an important step in the progression of atherosclerosis. One major contributor to foam cell formation in vivo is the intracellular accumulation of cholesterol. METHODS: Here, we report the effects of various combinations of low-density lipoprotein, sterols, lipids and other factors on human macrophages, using an automated image analysis program to quantitatively compare single cell properties, such as cell size and lipid content, in different conditions. RESULTS: We observed that the addition of cholesterol caused an increase in average cell lipid content across a range of conditions. All of the sterol-lipid mixtures examined were capable of inducing increases in average cell lipid content, with variations in the distribution of the response, in cytotoxicity and in how the sterol-lipid combination interacted with other activating factors. For example, cholesterol and lipopolysaccharide acted synergistically to increase cell lipid content while also increasing cell survival compared with the addition of lipopolysaccharide alone. Additionally, ergosterol and cholesteryl hemisuccinate caused similar increases in lipid content but also exhibited considerably greater cytotoxicity than cholesterol. CONCLUSIONS: The use of automated image analysis enables us to assess not only changes in average cell size and content, but also to rapidly and automatically compare population distributions based on simple fluorescence images. Our observations add to increasing understanding of the complex and multifactorial nature of foam-cell formation and provide a novel approach to assessing the heterogeneity of macrophage response to a variety of factors

Deep learning identifies cardiac coupling between mother and fetus during gestation

In the last two decades, stillbirth has caused around 2 million fetal deaths worldwide. Although current ultrasound tools are reliably used for the assessment of fetal growth during pregnancy, it still raises safety issues on the fetus, requires skilled providers, and has economic concerns in less developed countries. Here, we propose deep coherence, a novel artificial intelligence (AI) approach that relies on 1 min non-invasive electrocardiography (ECG) to explain the association between maternal and fetal heartbeats during pregnancy. We validated the performance of this approach using a trained deep learning tool on a total of 941 one minute maternal-fetal R-peaks segments collected from 172 pregnant women (20–40 weeks). The high accuracy achieved by the tool (90%) in identifying coupling scenarios demonstrated the potential of using AI as a monitoring tool for frequent evaluation of fetal development. The interpretability of deep learning was significant in explaining synchronization mechanisms between the maternal and fetal heartbeats. This study could potentially pave the way toward the integration of automated deep learning tools in clinical practice to provide timely and continuous fetal monitoring while reducing triage, side-effects, and costs associated with current clinical devices

Diagnoses and clinical features associated with high risk for unplanned readmission in vascular surgery. A cohort study

Background: Readmission rate is an established health quality indicator. Preventable readmissions bear an unnecessary, high cost on the healthcare system. An analysis performed by the National Centre for Health Outcomes Development (NCHOD) has demonstrated an increasing trend in emergency readmissions in the UK. Vascular surgery has been reported to have high readmission rates second only to congestive heart failure. This study aims to identify diagnoses and other clinical risk factors for high unplanned readmission rates. This may be the first step to sparing both the health care system and patients of unnecessary readmissions. Results: The overall 30 day readmission rate for Leeds Vascular Institute was 8.8%. The two diagnoses with the highest readmission rates were lower limb ischaemia and diabetic foot sepsis. The readmission rate for medical reasons was overwhelmingly higher than for surgical reasons (6.5% and 2.3% respectively). The most common medical diagnoses were renal disease and COPD. The majority of the patients readmitted under the care of vascular surgery required further surgical treatment. Conclusion: Vascular units should focus on holistic and multidisciplinary treatment of lower limb ischaemia and diabetic foot sepsis, in order to prevent readmissions. Furthermore, the early involvement and input of physicians in the treatment of vascular patients with renal disease and COPD may be appropriate

Wind driven plate tectonics

The objective of this project was to investigate if plate tectonics could be partly influenced by the dominating winds i.e. to investigate how predominate winds over the continents are correlated to tectonic plate movements. This report presents the principle explanations and calculation methods to the hypothesis. The required data of the monthly mean wind velocity and the wind direction at 117 locations on the continents of the world were collected. By calculating the monthly mean wind force the resulting monthly force was calculated. The result indicates a relatively strong correlation between the plate movement and predominant wind in four out of five cases. These results are mainly of scientific interest but could also be of interest for the climate change, since changing wind pattern would eventually affect the tectonic plate movements.Validerat; 20101217 (root

Wind driven plate tectonics

The objective of this project was to investigate if plate tectonics could be partly influenced by the dominating winds i.e. to investigate how predominate winds over the continents are correlated to tectonic plate movements. This report presents the principle explanations and calculation methods to the hypothesis. The required data of the monthly mean wind velocity and the wind direction at 117 locations on the continents of the world were collected. By calculating the monthly mean wind force the resulting monthly force was calculated. The result indicates a relatively strong correlation between the plate movement and predominant wind in four out of five cases. These results are mainly of scientific interest but could also be of interest for the climate change, since changing wind pattern would eventually affect the tectonic plate movements.Validerat; 20101217 (root