Role of Latissimus Dorsi Island Flap in Coverage of Mutilating Upper Limb Injuries in Pediatric Age Group

Background/Purpose: Latissimus dorsi muscle (LDM) is one of the most versatile muscles that is commonly used in different reconstructive procedures. Severe mutilating injuries of the upper limb in children represent a great challenge to reconstructive surgeons especially when important structures become exposed. Materials & Methods: we utilized LDM as an island flap to cover extensive soft tissue defects in the upper limb of pediatric patients. This work included 17 children (13 males and 4 females). All of them had extensive soft tissue loss of the upper limb with exposure of important structures. The cause of injury was road traffic accident in all patients. We analyzed the operative time, need for multi-stage surgery and the recorded complications. Finally, we recorded the ultimate functional and aesthetic outcome after a period of two years of follow up. Results: From the harvested seventeen flaps, none of them was lost. Split thickness skin graft was done one week after flap harvesting and insetting to cover the muscle flap. There were four cases with partial loss of the skin graft secondary to infection. Those four cases needed re-grafting after eradication of infection that needed almost two weeks of local wound care and dressing. Re-grafting was successful in the four cases. Conclusion: For complex upper extremity wounds in the pediatric age group, we advice aggressive debridement and early reconstruction with LDM pedicle flap with a split-thickness skin graft cover over it. The technique is reliable, with minimal donor site morbidity and very accepted functional and cosmetic outcome.Index Word: Latissimus dorsi muscle flap, complex trauma, pediatric age group

Systematic review of brucellosis in the Middle East: disease frequency in ruminants and humans and risk factors for human infection

This paper considers the problem of finding global states incoming to a specified global state in a Boolean network, which may be useful for pre-processing of finding a sequence of control actions for a Boolean network and for identifying the basin of attraction for a given attractor, We show that this problem is NP-hard in general along with related theoretical results, On the other hand, we present algorithms that are much faster than the naive exhaustive search-based algorithm. ©2007 IEEE.link_to_subscribed_fulltex

Utjecaj fluniksina na uklanjanje i dinamiku rezidua oksitetraciklina u mlijeku mliječnih pasmina koza

This research assessed the impact of flunixin meglumine (FM) co-administration on the elimination and milk residual properties of oxytetracycline (OTC) in dairy goats. OTC was administered via single intravenous (i/v) and intramuscular (i/m) injections at a dose of 10 mg/kg body mass (b.m.). Serum, urine, milk and ruminal juice were analysed using high-performance liquid chromatography (HPLC). The OTC serum concentrations were higher than the MIC for 12 hours against most susceptible pathogens in both groups. The half-lives of the distribution (T1/2α) and elimination (T1/2β) of OTC were 0.24 and 5.79 hours, respectively. The total body clearance was significantly increased in the FM coadministered groups. Following i/m injection, the absorption half-life (T1/2ab) with the maximum absorption time (Tmax) revealed a rapid absorption rate. Furthermore, the systemic bioavailability (F%) after i/m was 107.2%, indicating complete absorption from the muscular tissues. The bounded fraction of OTC with serum proteins was 18.73%. FM significantly decreases OTC concentration in milk and ruminal juice. OTC is eliminated primarily through the kidneys and to a lesser extent via milk and ruminal juice in dairy goats. Milk obtained from OTC treated goats may not be safe for human consumption two days post administration. Concomitantly, the use of FM with OTC may necessitate the surveillance and optimization of OTC dosage.Istražen je utjecaj fluniksina-meglumina (FM) na uklanjanje i rezidualna svojstva oksitetraciklina (OTC) u mlijeku mliječnih pasmina koza. OTC je dan jednokratno intravenski i intramuskularno u dozi od 10 mg/kg tjelesne mase. Serum, urin, mlijeko i buražni sok analizirani su tekućinskom kromatografijom visoke učinkovitosti (HPLC). Koncentracije OTC u serumu bile su tijekom 12 sati više od najmanje inhibitorne koncentracije za najosjetljivije patogene u objema skupinama. Vrijeme polurazgradnje OTC-a (T1/2α) bilo je 0,24 sata, a vrijeme uklanjanja (T1/2β) 5,79 sati. Vrijeme potpunog uklanjanja OTC-a statistički znakovito je poraslo u skupinama kojima je istodobno dan i fluniksin-meglumin. Nakon intramuskularne injekcije poluvijek apsorpcije (T1/2ab) s maksimalnim vremenom apsorpcije (Tmax) pokazao je veću brzinu apsorpcije. Osim toga sistemska bioraspoloživost (F %) nakon intramuskularne primjene bila je 107,2 % što upućuje na potpunu apsorpciju iz mišićnih tkiva. Dio OTC-a vezan na serumske proteine iznosio je 18,73 %. Fluniksin-meglumin statistički znakovito je smanjio koncentracije OTC-a u mlijeku i buražnom soku. OTC je uklonjen ponajprije putem bubrega i, u manjoj mjeri, mlijekom i buražnim sokom u mliječnih pasmina koza. Mlijeko dobiveno od koza kojima je davan OTC nije prikladno za upotrebu u ljudi do dva dana nakon primjene. Istodobna primjena FM-a s OTC-om može zahtijevati praćenje i optimizaciju OTC doze

Theoretical analysis of the spatial variability in tillage forces for fatigue analysis of tillage machines

This paper presents a new theoretical model to describe the spatial variability in tillage forces for the purpose of fatigue analysis of tillage machines. The proposed model took into account both the variability in tillage system parameters (soil engineering properties, tool design parameters and operational conditions) and the cyclic effects of mechanical behavior of the soil during failure ahead of tillage tools on the spatial variability in tillage forces. The stress-based fatigue life approach was used to determine the life time of tillage machines, based on the fact that the applied stress on tillage machines is primarily within the elastic range of the material. Stress cycles with their mean values and amplitudes were determined by the rainflow algorithm. The damage friction caused by each cycle of stress was computed according to the Soderberg criterion and the total damage was calculated by the Miner's law. The proposed model was applied to determine the spatial variability in tillage forces on the shank of a chisel plough. The equivalent stress history resulted from these forces were calculated by means of a finite element model and the Von misses criterion. The histograms of mean stress and stress amplitude obtained by the rainflow algorithm showed significant dispersions. Although the equivalent stress is smaller than the yield stress of the material, the failure by fatigue will occur after a certain travel distance. The expected distance to failure was found to be df=0.825×106km. It is concluded that the spatial variability in tillage forces has significant effect on the life time of tillage machines and should be considered in the design analysis of tillage machines to predict the life time. Further investigations are required to correlate the results achieved by the proposed model with field tests and to validate the proposed assumptions to model the spatial variability in tillage force

Improvement in Accounting Students’ Perception and Judgment on Ethical Issues as They Progress Through the Accounting Curriculum

The present study used a series of questions to test students on their ethical awareness and judgment. The test was given to three groups of undergraduate accounting students at different levels of the accounting curriculum at a large state university in California. The test results from each group were tabulated based on correct or wrong answers for each question. Significant differences in the comparative percentage of correct answers among the three groups indicated that certain groups of students have better ethical perception and judgment compared to the other groups of students in the study

Optical properties of absorbing and non-absorbing aerosols retrieved by cavity ring down (CRD) spectroscopy

International audienceApplication of cavity ring down (CRD) spectrometry for measuring the optical properties of pure and mixed laboratory-generated aerosols is presented. The extinction coefficient (?ext), extinction cross section (?ext) and extinction efficiency (Qext) were measured for polystyrene spheres (PSS), ammonium sulphate ((NH4)2(SO4), sodium chloride (NaCl), glutaric acid (GA), and Rhodamine-590 aerosols. The refractive indices of the different aerosols were retrieved by comparing the measured extinction efficiency of each aerosol type to the extinction predicted by Mie theory. Aerosols composed of sodium chloride and glutaric acid in different mixing ratios were used as model for mixed aerosols of two non-absorbing materials, and their extinction and complex refractive index were derived. Aerosols composed of Rhodamine-590 and ammonium sulphate in different mixing ratios were used as model for mixing of absorbing and non-absorbing species, and their optical properties were derived. The refractive indices of the mixed aerosols were also calculated by various optical mixing rules. We found that for non-absorbing mixtures, the linear rule, Maxwell-Garnett rule, and extended effective medium approximation (EEMA), give comparable results, with the linear mixing rule giving a slightly better fit than the others. Overall, calculations for the mixed aerosols are not as good as for single component aerosols. For absorbing mixtures, the differences between the refractive indices calculated using the mixing rules and those retrieved by CRD are generally higher

Intuitive Decision-Making in the GCC Cryptocurrency Market

The aim of this study is to investigate the phenomenon of intuitive decision-making in the GCC cryptocurrency market using both secondary data and primary data. In this paper, we explore how investors in the GCC cryptocurrency market use intuition to make decisions. The study collected 310 daily observations of the five most well-known cryptocurrencies, the GCC stock market indices, the VIX, and gold between January 1, 2022, and January 1, 2023, using data from the coin market cap and data streams. The study also adopted Hensman and Sadler-Smiths typology of intuitive and contextual signaling and conducted extensive semi-structured interviews with 18 experienced investors from Bahrain, Saudi Arabia, and the United Arab Emirates and self-reported cognitive tests with 12 participants It finds that Bitcoin is the most popular and volatile cryptocurrency, while Ripple is the least popular and least volatile. Bahraini investors are more likely to rely on instinct than investors from Saudi Arabia and the UAE. Investors should consider the volatility and average value of cryptocurrencies when making investment decisions, and be aware of their preferred cognitive thinking style

Coreless vortex formation in a spinor Bose-Einstein condensate

Coreless vortices were phase-imprinted in a spinor Bose-Einstein condensate. The three-component order parameter of F=1 sodium condensates held in a Ioffe-Pritchard magnetic trap was manipulated by adiabatically reducing the magnetic bias field along the trap axis to zero. This distributed the condensate population across its three spin states and created a spin texture. Each spin state acquired a different phase winding which caused the spin components to separate radially.Comment: 5 pages, 2 figure