Reverse Sural Fascio-Cutaneous Flap for Management of Patients with Distal Third of Lower Limb Soft Tissue Defects Referring to the Emergency Department Following Traumatic Events; A Review of 13 Cases

Introduction: Soft tissue defects over the distal leg and/or heel are probable injuries that need a flap. Various coverage techniques have been described in this regard. It seems that applying Reverse Sural Fascio-Cutaneous Flap (RSFCF) for reconstructing soft tissue defects of lower limbs has superiorities over other techniques. Objective: We intend to present a case series with soft tissue defect over the distal third of lower limb, covered using RSFCF technique. Methods: This is a case series and longitudinal study in which patients with crush injuries who referred to the emergency department (Sina hospital, Tehran, Iran) from 2013 until 2020 and were treated with RSFCF technique were included. The data were collected using patients’ charts, by interviewing the patients, and from hospital records. The patients' wounds were prepared, examined, and the surgery was done. Tendon and bone defects were repaired, and wounds were closed using reverse sural Fascio-Cutaneous Flap. Results: A total of 13 patients were eligible during the 6-year study period. Men were more commonly affected with no conclusive gender trend. The posterolateral part of the foot of the right leg was the most frequently injured part (53.8%). Only 1 patient had mentioned complications after surgery including mild congestion and abnormal sensory and motor examination. Patients were followed by the surgeons until 3 months after the operation and all of them had been able to resume their daily life activities by then. Conclusion: According to our findings, almost all of the patients (except one) had received their flaps without any complications. All the patients had been able to resume their daily life activities three months after the surgery. This may show that RSFCF, which can be quickly performed and does not need microsurgical skills, could be a suitable option for the coverage of distal third of lower limb soft tissue defects caused mainly by trauma

Development of Concrete Water Absorption Testing for Quality Control

Concrete durability can be evaluated by a number of properties - such as water absorption and chloride diffusion. Each of these properties can be measured using Standardized methods. Water absorption can be linked to porosity and therefore to eventual deterioration. Tests based on absorption have the potential to be simple and rapid tests for placed concrete. However, it is impossible to provide the Standard conditions for in-situ measurements. Water absorption is strongly affected by environmental temperature and concrete moisture content. These different conditions may cause incorrect evaluation of concrete performance. In this thesis, several samples were taken from three different construction projects in the Montréal region. These samples were taken to the laboratory, conditioned in different relative humidity and temperature environments and later water absorption tests were performed on them to investigate the effect of these two factors. In addition, three samples of each concrete mixture were placed outdoors and were tested in different environmental situations. Lastly, in-situ water absorption tests were performed on real concrete elements for one of the projects in actual field conditions. It was found that the concrete water absorption rate increases linearly with increasing temperature and decreasing moisture content. In addition, surface relative humidity was found as an accurate and practical indicator of concrete moisture content. These relationships were verified by additional exposed and in-situ measurements. It is suggested to perform several water absorption tests along with temperature and concrete surface relative humidity measurements to arrive at a Standardized value for quality control purposes

Weak Wardowski contractive multivalued mappings and solvability of generalized phi-Caputo fractional snap boundary inclusions

In this paper, we introduce the notion of weak Wardowski contractive multivalued mappings and investigate the solvability of generalized '-Caputo snap boundary fractional differential inclusions. Our results utilize some existing results regarding snap boundary fractional differential inclusions. An example is given to illustrate the applicability of our main results

Guillain-Barre Syndrome Due to Tramadol

Tramadol is a powerful prescription medication used for pain relief of varying intensities. Tramadol was initially produced in Germany to alleviate postsurgical and chronic pains. We describe a case of a 22-year-old male with no past medical history who took tramadol for the second time and then had a tonic-clonic seizure episode that worsened the weakness of his inferior limbs and followed by loss of consciousness. According to physical examination, clinical and paraclinical tests, he was diagnosed with Guillain-Barre syndrome. After treatment with intravenous immunoglobulin, he was improved and discharged 9 days after treatment. He was recommended to continue physiotherapy. The relation between tramadol using and Guillain-Barre syndrome development is unknown but it can be due to reactive oxygen species generation. &nbsp

PROJETO GENERATIVO E OTIMIZAÇÃO DE DESEMPENHO IEQ DE EDIFÍCIOS ESCOLARES COM BASE EM UM ALGORITMO PARAMÉTRICO

This research aims to examine the potential of generative and optimization algorithms in the early stage of a school building design in Tabriz to achieve better IEQ. It also investigates the compatibility of the evolutionary optimization tools combined with a parametric model in stimulating building comfort performance in achieving an optimized design. This process includes four steps: defining the parametric building model, defining its material and construction properties, stimulation of thermal and visual comfort and carbon dioxide concentration, optimization, and choosing the best result. The adaptive PMV model is used for thermal comfort, imageless daylight glare probability is used for visual comfort, and a CO2 concentration is used for IAQ assessment. It was found that the performance of the options introduced by the algorithm is more appropriate than the design prototype. However, the results show that the samples are acceptable in carbon dioxide concentration. What needs further investigation is thermal and visual comfort. Among the studied variables on IEQ performance, the WWR ratio of the southern wall had the most significant impact. Based on the optimization results, thermal comfort changed in the range of 10%, visual comfort in the range of 30%, and CO2 concentration in the range of 0.19%.Esta pesquisa tem como objetivo examinar os potenciais de algoritmos generativos e de otimização na fase inicial de um projeto de edifício escolar em Tabriz para obter um melhor IEQ. Também investiga a compatibilidade das ferramentas de otimização evolutiva combinadas com um modelo paramétrico para estimular o desempenho de conforto de construção na obtenção de um design otimizado. Este processo inclui quatro etapas: definição do modelo paramétrico de construção, definição de suas propriedades materiais e construtivas, estimulação do conforto térmico e visual e da concentração de dióxido de carbono, otimização e escolha do melhor resultado. O modelo adaptativo PMV é usado para conforto térmico, a probabilidade de ofuscamento da luz do dia sem imagens é usada para conforto visual, uma concentração de CO2 é usada para avaliação de IAQ. A investigação revelou que o desempenho das opções introduzidas pelo algoritmo é mais adequado do que o protótipo de projecto. No entanto, os resultados mostram que as amostras são aceitáveis na concentração de dióxido de carbono. É necessário mais investigação para conforto térmico e visual. Dentre as variáveis estudadas sobre o desempenho do IEQ, a relação WWR da parede sul teve o impacto mais significativo. Com base nos resultados da otimização, o conforto térmico mudou na faixa de 10%, o conforto visual na faixa de 30% e a concentração de CO2 na faixa de 0,19%

Modeling the effect of levothyroxine therapy on bone mass density in postmenopausal women: a different approach leads to new inference

<p>Abstract</p> <p>Background</p> <p>The diagnosis, treatment and prevention of osteoporosis is a national health emergency. Osteoporosis quietly progresses without symptoms until late stage complications occur. Older patients are more commonly at risk of fractures due to osteoporosis. The fracture risk increases when suppressive doses of levothyroxine are administered especially in postmenopausal women. The question is; "When should bone mass density be tested in postmenopausal women after the initiation of suppressive levothyroxine therapy?". Standard guidelines for the prevention of osteoporosis suggest that follow-up be done in 1 to 2 years. We were interested in predicting the level of bone mass density in postmenopausal women after the initiation of suppressive levothyroxine therapy with a novel approach.</p> <p>Methods</p> <p>The study used data from the literature on the influence of exogenous thyroid hormones on bone mass density. Four cubic polynomial equations were obtained by curve fitting for Ward's triangle, trochanter, spine and femoral neck. The behaviors of the models were investigated by statistical and mathematical analyses.</p> <p>Results</p> <p>There are four points of inflexion on the graphs of the first derivatives of the equations with respect to time at about 6, 5, 7 and 5 months. In other words, there is a maximum speed of bone loss around the 6^thmonth after the start of suppressive L-thyroxine therapy in post-menopausal women.</p> <p>Conclusion</p> <p>It seems reasonable to check bone mass density at the 6^thmonth of therapy. More research is needed to explain the cause and to confirm the clinical application of this phenomenon for osteoporosis, but such an approach can be used as a guide to future experimentation. The investigation of change over time may lead to more sophisticated decision making in a wide variety of clinical problems.</p

Removal of acid bleu 113 by UV/H2O2/Fe3O4 process: Optimization of treatment conditions using experimental design

Background and aims: Colored wastewaters are highly toxic for animals, human and habitat areas and cause several diseases in humans such as allergy, cancer and mutation. This study was aimed to remove of acid blue 113 color with application of UV/H2O2 with nano-catalyst of Fe3O4. Optimization of the process was investigated using experiment design methodology. Methods: In this experimental study, in order to study the effective parameters such as initial concentration of acid blue 113 (AB 113), pH, contact time, amounts of hydrogen peroxide and nano-catalyst Fe3O4 in removal of acid blue 113 and finding optimal conditions was investigated using of response surface methodology. Data were analyzed using design experiment software. Results: Optimum conditions of removal including initial concentration of AB113 dye 62.3 mg/L, pH 3.83, contact time 29.5 minutes, the amount of hydrogen peroxide 31.53 mmol/L and concentration of Fe3O4 1.81 g/L were obtained for maximum removal efficiency of 95.51%. The removal efficiency by increasing H2O2, contact time and catalyst concentration increased and with increasing of initial dye concentration and pH was decreased. Conclusion: The results showed that the removal amount of AB113 dye from synthetic wastewater using UV/H2O2/Fe3O4 process obtained 95.51% in optimal condition. Therefore, this method has an effective potential in AB113 removal and can be applied for removal of this dye from industrial wastewater

Evaluating the Feasibility of Poly (3-hydroxybutyrate-co-3-hydroxyvalerate) Co-Biopolymer Production from Rice Wastewater by Azohydromonas lata

 Background and objective: Biopolymers are environmental friendly, non-toxic renewable alternatives for conventional synthetic polymers. Rice wastewater contains high biochemical and chemical oxygen demands and organic contents mainly in form of starch which can cause serious environmental problems, while, it can be used as a potentially low-cost substrate for biopolymer production. The objective of the current study was to investigate the ability of Azohydromonas lata to produce poly (3-hydroxybutyrate-co-3-hydroxyvalerate) (P3HB-co-P3HV) from rice wastewater in a batch system.Material and methods: Aspergillus niger was first used to hydrolyze the starch content of rice wastewater to fermentable soluble sugars. Then, the bacterium Azohydromonas lata was cultured in hydrolyzed wastewater at various C: N: P ratios to produce biopolymers. So, effects of different nitrogen and carbon sources on P (3HB) and P (3HV) contents at a C: N: P ratio of 100:4:1 were assessed.Results and conclusion: This study showed that Azohydromonas lata was able to produce poly (3-hydroxybutyrate-co-3-hydroxyvalerate) (P3HB-co-P3HV) from rice wastewater in the presence of simple carbon sources and under limited nutrient conditions, especially phosphorus. The highest content of P (3HB) was achieved when ammonium sulphate was used as nitrogen source at a C: N: P ratio of 100:4:1. The highest recorded cell dry mass and biopolymer concentration were 4.64 and 2.8 g l-1 respectively, at a P(3HB) content in biomass of 60%  w w-1. Results indicated that phosphorus and nitrogen limitations could significantly affect P (3HB) production. In general, rice wastewater is a potential alternative for carbon sources such as glucose and maltose in polyhydroxybutyrate production.Conflict of interest: The authors declare no conflict of interest

Adverse Selection and Search Frictions in Corporate Loan Contracts

We provide empirical evidence of both (1) price dispersion and (2) credit rationing in the corporate loan market. We argue that these properties are caused by two factors: an adverse selection resulting from the information asymmetry between lenders and borrowers, and search frictions in matching borrowers with lenders. We develop a model of loan markets in which lenders post an array of heterogeneous contracts, then borrowers tradeoff terms of loan contracts and matching probability between themselves. We show that a unique separating equilibrium exists where each type of borrower applies to a certain type of contract