Splenic artery angiography: clinical classification of origin and branching variations of splenic artery by multi-detector computed tomography angiography method

Background: The splenic artery (SA) variations are rarely reported in the literature. Knowledge of the range of the SA and other arterial anomalies and their specific frequencies is very important ever for every visceral surgeon as well as for treatment of gastrointestinal bleeding, organ transplantation, transarterial chemoembolisation of neoplasm, infusion therapy, therapeutic arterial ligation, iatrogenic injuries. At the literature, there are more studies on the coeliac trunk, superior mesenteric artery and hepatic artery variations, but studies on the SA variations are uncommon. The studies on the SA variations are mostly in the form of case reports, but there are not many studies with large population on this issue. The purpose of this study was to evaluate the SA alone and to determine the variations determined separately from the other arteries. Accurate awareness of all the possible anatomic variations is crucial in the upper abdomen surgery. Materials and methods: Seven hundred fifty patients undergoing multi-detector computed tomography angiography between 2015 and 2017 were retrospectively evaluated for the SA variations. We created a new classification system to determine anatomic variations of the SA. Results: Twenty-three different types were identified related to anatomic variations in the origin and branching pattern of the SA. While 596 (79.47%) patients had standard SA anatomy, 154 (20.53%) patients had variant SA anatomy. Conclusions: The SA has quite different variation types and the practical context of the issue is of primary importance in surgery, gastroenterology, oncology and radiology. Liver and pancreas transplantation, splenectomy, embolisation of tumours of the abdominal organs, as well as other numerous diagnostic and therapeutic procedures, require detailed anatomical knowledg

Recurrence of atretic parietal cephalocele in adult: a case report and review of literature

Common presentation of atretic parietal cephalocele is mostly seen in infants and young children. It is a palpable midline parietal soft tissue mass which is thought to represent involuted true cephalocele (meningocele or encephalocele) connected to dura mater via a fibrous stalk. Atretic parietal cephalocele is associated with increased incidence of intracranial anomalies.. Parietal cephaloceles comprise about 1% of all cerebrospinal congenital malformations and 10% of cephaloceles. We report here the case of an atretic parietal cephalocele with no associated brain malformations in adult

Inflation and Disinflation in Turkey

Based on its outward-oriented development strategy, respectable growth, increased integration into world trade and financial markets, and imperfect though vibrant and wide-based democracy, Turkey is often cited as a development model for other countries in the region and elsewhere. Countering this positive picture of the Turkish economy over the last two decades, however, is the incompleteness of its reform process: the boom-bust nature of its growth, persistently high inflation, delays in privatising state-owned enterprises, and high and persistent government budget deficits. In January 2000 Turkey embarked on an ambitious IMF-backed stabilization program designed to correct the weaknesses in its economy, and, in particular, to reduce inflation to single digits by the end of 2002. Since then, though, Turkey has experienced two financial crises and redesigned its stabilization program to bring inflation down more gradually. This collection analyzes the nature of Turkey's inflation and the likely costs and benefits of disinflation

An integrated approach of multiple correspondences analysis (MCA) and fuzzy AHP method for occupational health and safety performance evaluation in the land cargo transportation

Land cargo transportation is one of the components of the logistics chain with high impact on economic and social development worldwide. However, problems such as top logistics costs, deficiencies in transportation infrastructure and the failure to adopt good operating practices in aspects such as quality, environment, and occupational safety and health affect the ability of companies to comply with the agreements, requirements, and regulations of the clients and other interested parties. One of the most relevant problems for the sector is associated with the high accident rates that make this medium less advantageous compared to other means of transport with impact on operational costs, on logistics indicators, on compliance with legal regulations and customer satisfaction. However, although there are legal standards and management standards in occupational safety and health, evaluating performance can become a difficult and subjective process, due to the complexity of the land cargo transportation and the different interest groups involved. Besides, there is little information in the literature that provides solutions for the industry. Therefore, this document presents an integrated approach between multi-criterion decision making models (MCDM) and the Multiple Correspondences Analysis (MCA) to facilitate the evaluation and improvement of occupational health and safety performance, with a logical process, objective, robust and using both qualitative and quantitative techniques, with real application in the land cargo transportation sector. First, the multivariate method of Multiple Correspondences Analysis (MCA) was used for the evaluation of a sample of companies in the industry, considering the factors and sub-factors identified in the first stage and performing correlational analyzes among the variables. Subsequently, a multicriteria decision-making model was designed to determine the factors and sub-factors that affect occupational health and safety performance through the technique of the Fuzzy Analytic Hierarchy Process (FAHP). Finally, improvement strategies are proposed based on the approaches suggested in this document

Using fahp-vikor for operation selection in the flexible job-shop scheduling problem: A case study in textile industry

Scheduling of Flexible Job Shop Systems is a combinatorial problem which has been addressed by several heuristics and meta-heuristics. Nevertheless, the operation selection rules of both methods are limited to an ordered variant wherein priority-dispatching rules are not simultaneously deemed in the reported literature. Therefore, this paper presents the application of dispatching algorithm with operation selection based on Fuzzy Analytic Hierarchy Process (FAHP) and VIKOR methods while considering setup times and transfer batches. Dispatching, FAHP, and VIKOR algorithms are first defined. Second, a multi-criteria decision-making model is designed for operation prioritization. Then, FAHP is applied to calculate the criteria weights and overcome the uncertainty of human judgments. Afterwards, VIKOR is used to select the operation with the highest priority. A case study in the textile industry is shown to validate this approach. The results evidenced, compared to the company solution, a reduction of 61.05% in average delay

Genome-wide association analyses of symptom severity among clozapine-treated patients with schizophrenia spectrum disorders

Clozapine is the most effective antipsychotic for patients with treatment-resistant schizophrenia. However, response is highly variable and possible genetic underpinnings of this variability remain unknown. Here, we performed polygenic risk score (PRS) analyses to estimate the amount of variance in symptom severity among clozapine-treated patients explained by PRSs (R2) and examined the association between symptom severity and genotype-predicted CYP1A2, CYP2D6, and CYP2C19 enzyme activity. Genome-wide association (GWA) analyses were performed to explore loci associated with symptom severity. A multicenter cohort of 804 patients (after quality control N = 684) with schizophrenia spectrum disorder treated with clozapine were cross-sectionally assessed using the Positive and Negative Syndrome Scale and/or the Clinical Global Impression-Severity (CGI-S) scale. GWA and PRS regression analyses were conducted. Genotype-predicted CYP1A2, CYP2D6, and CYP2C19 enzyme activities were calculated. Schizophrenia-PRS was most significantly and positively associated with low symptom severity (p = 1.03 × 10−3; R2 = 1.85). Cross-disorder-PRS was also positively associated with lower CGI-S score (p = 0.01; R2 = 0.81). Compared to the lowest tertile, patients in the highest schizophrenia-PRS tertile had 1.94 times (p = 6.84×10−4) increased probability of low symptom severity. Higher genotype-predicted CYP2C19 enzyme activity was independently associated with lower symptom severity (p = 8.44×10−3). While no locus surpassed the genome-wide significance threshold, rs1923778 within NFIB showed a suggestive association (p = 3.78×10−7) with symptom severity. We show that high schizophrenia-PRS and genotype-predicted CYP2C19 enzyme activity are independently associated with lower symptom severity among individuals treated with clozapine. Our findings open avenues for future pharmacogenomic projects investigating the potential of PRS and genotype-predicted CYP-activity in schizophrenia

Dynamic temporary blood facility location-allocation during and post-disaster periods

The key objective of this study is to develop a tool (hybridization or integration of different techniques) for locating the temporary blood banks during and post-disaster conditions that could serve the hospitals with minimum response time. We have used temporary blood centers, which must be located in such a way that it is able to serve the demand of hospitals in nearby region within a shorter duration. We are locating the temporary blood centres for which we are minimizing the maximum distance with hospitals. We have used Tabu search heuristic method to calculate the optimal number of temporary blood centres considering cost components. In addition, we employ Bayesian belief network to prioritize the factors for locating the temporary blood facilities. Workability of our model and methodology is illustrated using a case study including blood centres and hospitals surrounding Jamshedpur city. Our results shows that at-least 6 temporary blood facilities are required to satisfy the demand of blood during and post-disaster periods in Jamshedpur. The results also show that that past disaster conditions, response time and convenience for access are the most important factors for locating the temporary blood facilities during and post-disaster periods

Microsatellite diversity of the Nordic type of goats in relation to breed conservation: how relevant is pure ancestry?

In the last decades, several endangered breeds of livestock species have been re-established effectively. However, the successful revival of the Dutch and Danish Landrace goats involved crossing with exotic breeds and the ancestry of the current populations is therefore not clear. We have generated genotypes for 27 FAO-recommended microsatellites of these landraces and three phenotypically similar Nordic-type landraces and compared these breeds with central European, Mediterranean and south-west Asian goats. We found decreasing levels of genetic diversity with increasing distance from the south-west Asian domestication site with a south-east-to-north-west cline that is clearly steeper than the Mediterranean east-to-west cline. In terms of genetic diversity, the Dutch Landrace comes next to the isolated Icelandic breed, which has an extremely low diversity. The Norwegian coastal goat and the Finnish and Icelandic landraces are clearly related. It appears that by a combination of mixed origin and a population bottleneck, the Dutch and Danish Land-races are separated from the other breeds. However, the current Dutch and Danish populations with the multicoloured and long-horned appearance effectively substitute for the original breed, illustrating that for conservation of cultural heritage, the phenotype of a breed is more relevant than pure ancestry and the genetic diversity of the original breed. More in general, we propose that for conservation, the retention of genetic diversity of an original breed and of the visual phenotype by which the breed is recognized and defined needs to be considered separately

An integrated fuzzy approach for evaluating remanufacturing alternatives of a product design

Remanufacturing has emerged as a competitive strategy for manufacturers to tackle environmental and economic challenges. In this paper, an integrated fuzzy approach is developed for the evaluation of remanufacturing alternatives. Then, importance weights of main remanufacturing processes and evaluation criteria are obtained through fuzzy extent analysis. Fuzzy hierarchical TOPSIS is then applied to evaluate the alternatives. A case study is presented to demonstrate the applicability of the proposed approach. The analysis results show that it is a viable approach and can be used as an effective tool for design evaluation from the remanufacturing point of view. Finally, conclusions are discussed and future research directions are suggested