Advances in Surgical and Anesthetic Techniques for Cochlear Implantation

Cochlear implantation (CI) is usually performed under general anesthesia using the classic surgical approach, the mastoidectomy posterior tympanotomy approach (MPTA), which was originally described by William House in 1961. Many alternative surgical approaches have been described for CI. Robotic image-guided cochlear implantation has also been described as a new advance in CI. Also, in some situations, CI can be performed under conscious sedation with local anesthesia (CS-LA) instead of general anesthesia (GA). With the ongoing advance in CI devices and surgical techniques, CI surgery nowadays could preserve hearing in ears with preoperative residual hearing. This chapter describes different approaches and techniques in CI surgery, whether classic or alternative technique, with special attention to advantages and disadvantages of each approach or technique. Also this chapter describes, in surgical points of view, the anesthetic techniques in CI, whether GA or CS-LA, with focus on indications, advantages, and disadvantages of CS-LA in CI

Decentering the Bard: The Localization of King Lear in Egyptian TV Drama Dahsha

Dahsha [Bewilderment] is an Egyptian TV series written by scriptwriter Abdelrahim Kamal and adapted from Shakespeare’s King Lear. The TV drama locates Al Basel Hamad Al Basha, Lear’s counterpart, in Upper Egypt and follows a localized version of the king’s tragedy starting from the division of his lands between his two wicked daughters and the disinheritance of his sincere daughter till his downfall. This study examines the relationship between Dahsha and King Lear and investigates the position of the Bard when contextualized in other cultures, revisited in other locales, and retold in other languages. It raises many questions about Shakespeare’s proximity to the transcultural/transnational adaptations of his plays. Does Shakespeare’s discourse limit the interpretation of the adapted works or does it promote intercultural conversations between the varying worldviews? Where is the Bard positioned when contextualized in other cultures, revisited in other locales, and retold in other languages? Does he stand in the center or at the margin? The study attempts to answer these questions and to read the Egyptian localization of King Lear as an independent work that transposes Shakespeare from a central dominant element into a periphery that remains visible in the background of the Upper Egyptian drama

Design and analysis of routing protocol for cognitive radio ad hoc networks in Heterogeneous Environment

Multi-hop routing protocol in cognitive radio mobile ad hoc networks (CRMANETs) is a critical issue. Furthermore, the routing metric used in multi-hop CRMANETs should reflect the bands availability, the links quality, the PU activities and quality of service (QoS) requirements of SUs. For the best of our knowledge, many of researchers investigated the performance of the different routing protocols in a homogeneous environment only. In this paper, we propose a heterogeneous cognitive radio routing protocol (HCR) operates in heterogeneous environment (i.e. the route from source to destination utilize the licensed and unlicensed spectrum bands). The proposed routing protocol is carefully developed to make a tradeoff between the channel diversity of the routing path along with the CRMANETs throughput. Using simulations, we discuss the performance of the proposed HCR routing protocol and compare it with the AODV routing protocol using a discrete-event simulation which we developed using JAVA platform

Health Care System Based on Semantic Web and XML Technologies

The purpose and the goal of the paper is using a semantic web and XML (the Extensible Markup Language) technologies for managing medical information during a diagnostic process is studied. Following a steady international move towards optimization of health care delivery, the latest development in information technology has drawn the health care industry decision makers’ attention. The introduction of proper information technology innovations within the health care processes should provide the necessary optimization. In this manner can be proposed an approach to manage medical data during the whole diagnostic process using the semantic Web and XML technologies. The purpose of the Semantic Web is to bring structure to the content of Web pages allowing software agents to carry out intelligent tasks for the user. This opens a new set of opportunities that can be utilized to improve health care management on a personal and health care provider level. The aim of this paper in progress is to identify the needs and match them to the services possible with the Semantic Web. In this paper, presented an ontology-based framework that successfully combines both Semantic Web and XML technologies to enable the integrated access to biological data sources. The main goal is the seamless integration and application of these technologies in such a way that their deficiencies are over come and their utility maximized. Keywords: Health Care, Semantic Web, Ontology, XM

Diagnostic performance of multidetector computed tomography (MDCT) in diagnosis of sinus variations

Background: In this prospective study, we looked for correlations between anatomic variants of paranasal sinuses and chronic or recurrent sinusitis. Material/Methods: Two hundred and forty (240) patients with clinical features of chronic rhinosinusitis were examined; patients with first-onset or allergic sinusitis and pregnant females were excluded. Routine multi-slice CT of the paranasal sinuses was performed to look for mucosal disease of the paranasal sinuses, drainage pathways, and presence of anatomical variations and their relation to known sinus drainage pathways. Results: Anatomic variations were very frequent, and we classified them into four easily recognized groups: nasal septum variations, middle turbinate variations, uncinate process variations, and ethmoidal variations. Deviated nasal septum was the most frequent variation in patients with chronic or recurrent sinusitis, and it was detected in 48.8% of cases. Agger nasi cells and concha bullosa were equally frequent (30.6%), and Haller cells were detected in 11.2%. Uncinate process variations were detected in 18.1%, and the large ethmoid bulla was detected in 10%. Conclusions: The importance of anatomic variations is that they can compromise drainage pathway of the related sinus, which results in inflammatory sinus disease. Anatomical variations are not diseases on their own and may be present as incidental findings in patient with chronic sinusitis

On the Application of Data Clustering Algorithm used in Information Retrieval for Satellite Imagery Segmentation

This study proposes an automated technique for segmenting satellite imagery using unsupervised learning. Autoencoders, a type of neural network, are employed for dimensionality reduction and feature extraction. The study evaluates different segmentation architectures and encoders and identifies the best performing combination as the DeepLabv3+ architecture with a ResNet-152 encoder. This approach achieves high performance scores across multiple metrics and can be beneficial in various fields, including agriculture, land use monitoring, and disaster response

The Value of 18 Fluorine-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Breast Cancer Staging

BACKGROUND: Accurate staging is important for management decisions in patients with newly diagnosed breast cancer. AIM: This study was conducted to evaluate the value of 18 fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging in breast cancer staging.. METHODS: A prospective study of 80 patients (1 male and 79 female) mean age 51.13 years with histologically confirmed breast cancer. The staging procedures included history, physical examination, mammography, and CT of neck, chest, abdomen, and pelvis; then, PET/CT was performed in a time interval <30 days. The findings of PET/CT were compared with those of the other conventional methods. RESULTS: The agreement between conventional methods (mammography, breast ultrasound, contrast-enhanced CT of the neck, chest, abdomen, and pelvis) and 18F FDG-PET/CT was 0.6 for assessing the T stage, 0.39 for N stage, and 0.75 for M stage. There was moderate agreement between CT and 18F FDG-PET/CT in the detection of nodal lesions (K=0.6) and pulmonary lesions (K=0.51), while a perfect agreement was noted for detecting osseous (K=0.82) and liver lesions (K=0.81). In total, 50 patients (62.5%) were concordantly staged between the conventional imaging and 18F-FDG PET/CT, while 30 patients (37.5%) showed a different tumor, node, and metastasis stage. The changes were driven by the detection of additional findings (n=26) or exclusion of findings (n=4), mainly at the lymph nodes (LNs) and/or distant sites. Regarding N status, 18F FDG-PET/CT revealed previously unknown regional lymphatic spread in supraclavicular (n=4; 5%), infraclavicular (n=11; 13.7%), and internal mammary (n=12; 15%) lymph node groups. 18F-FDG PET/CT changed M status in a total of four patients (5%); three of them were upstaged by detecting distant metastases, while osseous deposits were excluded in one patient leading to downstaging. CONCLUSION: 18F-FDG-PET/CT is considered a valuable imaging tool in the initial staging of breast cancer, which significantly impacts the overall American Joint Committee on Cancer staging in 37.5% of our study population

Overview on Hepatitis B vaccination

Background: Hepatitis B virus (HBV) infection is increasing globally, posing a serious public health problem. Hepatitis B virus (HBV) infection and mortality are among the leading causes of death worldwide. Concerns for public health are amplified by the fact that about a third of the world's population is afflicted with HBV. HBV infection may result in cirrhosis, hepatocellular cancer, or both (HCC).Immunization is the most cost-effective strategy available worldwide for controlling and preventing hepatitis B in terms of benefit-cost ratio. Objective: This review article discusses the most critical components of the HBV vaccine and the most efficient strategies for increasing HBV vaccinatio

Multiple-Level Anterior Cervical Discectomy and Fusion Using PEEK Cages in Cervical Myelopathy. Is Anterior Platting Necessary?

Background Data: The use of anterior cervical discectomy and fusion (ACDF) is common in the surgical treatment of cervical myelopathy and radiculomyelopathy. Additional anterior plating is usually performed in multiple ACDF to overcome several possible complications. Purpose: To assess the safety and effectiveness of PEEK interbody fusion cages for the treatment of cervical disc disease and their application in multilevel surgery without anterior plating. Study Design: Prospective study. Patient Sample: Eight patients with cervical myelopathy and twelve with radiculomyelopathy; the study included fourteen females and six males and the mean age at surgery was 58.4±7.1 (range 50-69). Outcome Measures: Total blood loss and operative time were recorded. Clinical outcome was assessed by the JOA score and VAS. Fusion was assessed using plain radiographs. Methods: All patients had multiple levels ACDF using PEEK cages packed with autogenous bone graft obtained from the removed osteophytes. Results: Postoperatively, radiculopathy improved in all patients, whereas myelopathy improved in nineteen patients. After 12 months, fusion was achieved in 95% and cervical lordosis was restored. Neither cage extrusion nor symptomatic pseudarthrosis were observed. Conclusions: Stand-alone PEEK interbody cages are effective and reliable to increase segmental stability of the cervical spine and achieve excellent fusion rate even in multilevel disease without the need for anterior platting. (2012ESJ012