Correction of complex foot deformities using the V-osteotomy and the Ilizarov technique

Complex foot deformity is a multiplanar deformity with or without foot shortening. It also includes deformed feet with poor soft-tissue coverage, relapsed or neglected cases, and those with acompanying problems such as leg-length discrepancy, lower leg deformity, osteomyelitis and nonunions. Traditionally, correction of these deformities can be achieved by extensive soft tissue releases, osteotomies or arthrodesis with or without internal fixation. This usually involves excision of large appropriate bony wedges and has many disadvantages, including neurovascular injury, soft tissue problems and a shortened foot. We present our experience with a group of severe deformities of the foot that we managed using the V-osteotomy combined with the Ilizarov technique. We present our algorithm of management of complex foot and ankle deformities, together with our prerequisites for patient selection. A detailed description of the operative technique, postoperative care and possible complications is also presented. The combination of the Ilizarov technique and the V-osteotomy offers versatility in foot deformity correction, enabling correction of individual components of the deformity at rates that may be tailored to achieve accurate three-dimensional control

An improved moth flame optimization algorithm based on rough sets for tomato diseases detection

Plant diseases is one of the major bottlenecks in agricultural production that have bad effects on the economic of any country. Automatic detection of such disease could minimize these effects. Features selection is a usual pre-processing step used for automatic disease detection systems. It is an important process for detecting and eliminating noisy, irrelevant, and redundant data. Thus, it could lead to improve the detection performance. In this paper, an improved moth-flame approach to automatically detect tomato diseases was proposed. The moth-flame fitness function depends on the rough sets dependency degree and it takes into a consideration the number of selected features. The proposed algorithm used both of the power of exploration of the moth flame and the high performance of rough sets for the feature selection task to find the set of features maximizing the classification accuracy which was evaluated using the support vector machine (SVM). The performance of the MFORSFS algorithm was evaluated using many benchmark datasets taken from UCI machine learning data repository and then compared with feature selection approaches based on Particle Swarm Optimization (PSO) and Genetic Algorithms (GA) with rough sets. The proposed algorithm was then used in a real-life problem, detecting tomato diseases (Powdery mildew and early blight) where a real dataset of tomato disease were manually built and a tomato disease detection approach was proposed and evaluated using this dataset. The experimental results showed that the proposed algorithm was efficient in terms of Recall, Precision, Accuracy and F-Score, as long as feature size reduction and execution time

Effect of Experimental Phenylketonuria on the Bone of Pregnant Mothers and Their Young During Perinatal Life and After Delivered Newborn of Albino Rats

Phenylketonuria (PKU) is a genetic disorder that is characterized by an inability of the body to utilize the essential amino acid, phenylalanine. The disease results from a deficiency in phenylalanine hydroxylase, the enzyme catalyzing the conversion of phenylalanine to tyrosine. Although, this inborn error of metabolism was among the first in humans to be understood biochemically and genetically, little is known about the mechanisms involved in the pathology of PKU during neonatal development. Elevated concentrations of plasma phenylalanine were induced in pregnant rats by oral administration of 50mg/100g body weight alpha-methylphenylalanine plus phenylalanine supplementation at a dosage of 60mg/100g body weight two times daily after the 6th day of onset of gestation till 14 & 16 days of gestation as well as at parturition. Treatment with alpha-methylphenylalanine/ phenylalanine resulted in a significant decrease of accumulated body weight gain during pregnancy as well as exhibited marked growth retardation of prenatal fetuses and delivered newborn. The growth retarded fetuses was manifested by decreased body weight, malformed both fore- & hindlimb, oedematous skin & superficial hematomas widely spread in different parts of the body. Ossification of bones was greatly altered. Skeletal abnormalities restricted mainly in skull, sternebrae, lumbar, caudal vertebrae and distal phalanx of both fore- & hindlimb. Histological examination of femoral bone revealed varieties of histopathological abnormalities which illustrated and discussed. These results suggested that exposure of the fetus to high plasma concentrations of phenylalanine cause deformities of bone

Camel-related pancreatico-duodenal injuries: A report of three cases and review of literature

Background: Human pancreatico-duodenal injuries caused by camels are extremely rare.Objective: We report three patients who sustained camel-related pancreatico-duodenal injuries and review the literature on this topic.Results: A 32-year camel caregiver was kicked by a camel which then stepped on his abdomen trying to kill him. The patient’s abdomen was soft and lax. CT scan of the abdomen showed free retroperitoneal air. Laparotomy revealed a complete tear of the anterior wall of the second part of duodenum which was primarily repaired. A 40-year camel caregiver was directly kicked into his abdomen by a camel. He developed traumatic pancreatitis which was treated conservatively. A 31-year-old male fell down on his abdomen while riding a camel. Abdominal examination revealed tenderness and guarding. Abdominal CT Scan showed complete transection of the neck of the pancreas which was confirmed by laparotomy. The patient had distal pancreatectomy with preservation of the spleen. All patients were discharged home in good condition.Conclusion: These cases demonstrate the misleading presentation of the camel-realted pancreatico-duodenal injuries and their unique mechanism of injury.Key words: Duodenum, pancreas, pancreatitis, injury, trauma, came

An Intelligent and Low-cost Eye-tracking System for Motorized Wheelchair Control

In the 34 developed and 156 developing countries, there are about 132 million disabled people who need a wheelchair constituting 1.86% of the world population. Moreover, there are millions of people suffering from diseases related to motor disabilities, which cause inability to produce controlled movement in any of the limbs or even head.The paper proposes a system to aid people with motor disabilities by restoring their ability to move effectively and effortlessly without having to rely on others utilizing an eye-controlled electric wheelchair. The system input was images of the users eye that were processed to estimate the gaze direction and the wheelchair was moved accordingly. To accomplish such a feat, four user-specific methods were developed, implemented and tested; all of which were based on a benchmark database created by the authors.The first three techniques were automatic, employ correlation and were variants of template matching, while the last one uses convolutional neural networks (CNNs). Different metrics to quantitatively evaluate the performance of each algorithm in terms of accuracy and latency were computed and overall comparison is presented. CNN exhibited the best performance (i.e. 99.3% classification accuracy), and thus it was the model of choice for the gaze estimator, which commands the wheelchair motion. The system was evaluated carefully on 8 subjects achieving 99% accuracy in changing illumination conditions outdoor and indoor. This required modifying a motorized wheelchair to adapt it to the predictions output by the gaze estimation algorithm. The wheelchair control can bypass any decision made by the gaze estimator and immediately halt its motion with the help of an array of proximity sensors, if the measured distance goes below a well-defined safety margin.Comment: Accepted for publication in Sensor, 19 Figure, 3 Table

The fate of plasma-generated oxygen atoms in aqueous solutions: non-equilibrium atmospheric pressure plasmas as an efficient source of atomic O(aq)

Non-equilibrium radio-frequency driven atmospheric-pressure plasma in He/0.6%O2 gas mixture has been used to study the reaction mechanism of plasma-generated oxygen atoms in aqueous solutions. The effluent from the plasma source operated with standard and 18O-labeled O2 gas was used to treat water in the presence of phenol as a chemical probe. Comparing the mass spectrometry and gas chromatography-mass spectrometry data of the solutions treated with plasma under normal and labeled oxygen provides clear evidence that O(aq) originating from the gas phase enters the liquid and reacts directly with phenol, without any intermediate reactions. Additionally, the atmospheric-pressure plasma source demonstrates great potential to be an effective source of O(aq) atoms without the requirement for any precursors in the liquid phase

Seatbelt use and risk of major injuries sustained by vehicle occupants during motor-vehicle crashes: A systematic review and meta-analysis of cohort studies

BackgroundIn 2004, a World Health Report on road safety called for enforcement of measures such as seatbelt use, effective at minimizing morbidity and mortality caused by road traffic accidents. However, injuries caused by seatbelt use have also been described. Over a decade after publication of the World Health Report on road safety, this study sought to investigate the relationship between seatbelt use and major injuries in belted compared to unbelted passengers.MethodsCohort studies published in English language from 2005 to 2018 were retrieved from seven databases. Critical appraisal of studies was carried out using the Scottish Intercollegiate Guidelines Network (SIGN) checklist. Pooled risk of major injuries was assessed using the random effects meta-analytic model. Heterogeneity was quantified using I-squared and Tau-squared statistics. Funnel plots and Egger's test were used to investigate publication bias. This review is registered in PROSPERO (CRD42015020309).ResultsEleven studies, all carried out in developed countries were included. Overall, the risk of any major injury was significantly lower in belted passengers compared to unbelted passengers (RR 0.47; 95%CI, 0.29 to 0.80; I-2=99.7; P=0.000). When analysed by crash types, belt use significantly reduced the risk of any injury (RR 0.35; 95%CI, 0.24 to 0.52). Seatbelt use reduces the risk of facial injuries (RR=0.56, 95% CI=0.37 to 0.84), abdominal injuries (RR=0.87; 95% CI=0.78 to 0.98) and, spinal injuries (RR=0.56, 95% CI=0.37 to 0.84). However, we found no statistically significant difference in risk of head injuries (RR=0.49; 95% CI=0.22 to 1.08), neck injuries (RR=0.69: 95%CI 0.07 to 6.44), thoracic injuries (RR 0.96, 95%CI, 0.74 to 1.24), upper limb injuries (RR=1.05, 95%CI 0.83 to 1.34) and lower limb injuries (RR=0.77, 95%CI 0.58 to 1.04) between belted and non-belted passengers.ConclusionIn sum, the risk of most major road traffic injuries is lower in seatbelt users. Findings were inconclusive regarding seatbelt use and susceptibility to thoracic, head and neck injuries during road traffic accidents. Awareness should be raised about the dangers of inadequate seatbelt use. Future research should aim to assess the effects of seatbelt use on major injuries by crash type

Concurrent breast stroma sarcoma and breast carcinoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Breast cancer is one of the most important health problems in the world and affects a great number of women over the entire globe. This group of tumors rarely presents as bilateral disease and, when it does happen, normally occurs within the same histological type. We report a rare case of concurrent bilateral breast cancer with two different histology types, a breast carcinoma and a breast sarcoma, in a 42-year-old woman referred to our hospital.</p> <p>Case presentation</p> <p>A 42-year-old Caucasian woman admitted to our institute in August 1999, presented with a nodule in the left breast of 3.0 × 2.5 cm, and, in the right breast, one of 1.0 cm, suspected of malignancy and with a clinically negative armpit. Biopsies had revealed invasive mammary carcinoma (right breast) and sarcoma (left breast). She was submitted to bilateral modified radical mastectomy. A histological study showed an invasive mammary carcinoma degree II lobular pleomorphic type with invasion of seven of the 19 excised axillary nodes in the right breast and, in the left breast, a sarcoma of the mammary stroma, for which the immunohistochemistry study was negative for epithelial biomarkers and positive for vimentin. Later, she was submitted for chemotherapy (six cycles of 75 mg/m²5-fluorouracil, epirubicin and cyclophosphamide) followed by radiotherapy of the thoracic wall and axillary nodes on the left. Hormone receptors were positive in the tumor of the right breast, and tamoxifen, 20 mg, was prescribed on a daily basis (five years) followed by letrozole, 2.5 mg, also daily (five years). She presented no sign of negative evolution in the last consultation.</p> <p>Conclusion</p> <p>The risk of development of bilateral breast cancer is about 1% each year within a similar histological type, but it is higher in tumors with lobular histology. In this case, the patient presented, simultaneously, two histologically distinct tumors, thus evidencing a rare situation.</p

Reproducibility of `COST Reference Microplasma Jets'

Atmospheric pressure plasmas have been ground-breaking for plasma science and technologies, due to their significant application potential in many fields, including medicinal, biological, and environmental applications. This is predominantly due to their efficient production and delivery of chemically reactive species under ambient conditions. One of the challenges in progressing the field is comparing plasma sources and results across the community and the literature. To address this a reference plasma source was established during the `Biomedical Applications of Atmospheric Pressure Plasmas' EU COST Action MP1101. It is crucial that reference sources are reproducible. Here, we present the reproducibility and variance across multiple sources through examining various characteristics, including: absolute atomic oxygen densities, absolute ozone densities, electrical characteristics, optical emission spectroscopy, temperature measurements, and bactericidal activity. The measurements demonstrate that the tested COST jets are mainly reproducible within the intrinsic uncertainty of each measurement technique

Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO) : 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group

Background: Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods: The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion. Recommendations: Adhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO. Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention. Discussion: This guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.Peer reviewe