Graph neural networks in EEG spike detection.

OBJECTIVE: This study develops new machine learning architectures that are more adept at detecting interictal epileptiform discharges (IEDs) in scalp EEG. A comparison of results using the average precision (AP) metric is made with the proposed models on two datasets obtained from Baptist Hospital of Miami and Temple University Hospital. METHODS: Applying graph neural networks (GNNs) on functional connectivity (FC) maps of different frequency sub-bands to yield a novel architecture we call FC-GNN. Attention mechanism is applied on a complete graph to let the neural network select its important edges, hence bypassing the extraction of features, a model we refer to as CA-GNN. RESULTS: On the Baptist Hospital dataset, the results were as follows: Vanilla Self-Attention →0.9029±0.0431, Hierarchical Attention →0.8546±0.0587, Vanilla Visual Geometry Group (VGG) →0.92±0.0618, Satelight →0.9219±0.046, FC-GNN →0.9731±0.0187, and CA-GNN →0.9788±0.0125. In the same order, the results on the Temple University Hospital dataset are 0.9692, 0.9113, 0.97, 0.9575, 0.963, and 0.9879. CONCLUSION: Based on the good results they yield, GNNs prove to have a strong potential in detecting epileptogenic activity. SIGNIFICANCE: This study opens the door for the discovery of the powerful role played by GNNs in capturing IEDs, which is an essential step for identifying the epileptogenic networks of the affected brain and hence improving the prospects for more accurate 3D source localization.

Higher symptom score, larger residual rectocele, and lower rectal compliance predict failure of improvement after surgical treatment of rectocele

Background: Rectocele is a frequent finding in women and is usually asymptomatic. However, it is sometimes associated with symptoms of obstructed defecation syndrome (ODS). While most patients with ODS due to rectocele respond well to conservative treatment, some may require surgical treatment. The aim of the study was to determine the predictors of failure of symptom improvement after rectocele repair. Methods: The study included adult women with rectocele who underwent surgical treatment by transperineal repair (TPR) or transvaginal repair (TVR). The preoperative and postoperative assessment was done using the Wexner constipation score, anorectal manometry, and defecography. Results: A total of 93 female patients with a mean age of 43.7 years were included. Among them, 65.6% of patients underwent TPR and 34.4% underwent TVR; 22 (23.7%) patients reported failure of significant improvement in ODS symptoms after surgery. The independent predictors of failure of improvement were higher preoperative Wexner score (odds ratio, OR: 1.4, 95% confidence interval, CI: 1.09-1.84, p = 0.009), larger residual rectocele after repair (OR: 2.95, 95% CI: 1.43-6.08, p = 0.003), and lower postoperative maximum tolerable volume (OR: 0.949, 95% CI: 0.907-0.992, p = 0.02). The predictive cutoff point for the preoperative Wexner score was 15. Conclusions: Patients with a preoperative Wexner score higher than 15 and larger residual rectocele after surgery may experience little improvement in symptoms after rectocele repair. Although TPR was associated with a poorer relief of symptoms than did TVR; it was not an independent predictor of failure. (AU)

Comprehensive literature review of the applications of surgical laser in benign anal conditions.

Surgery for benign anal conditions is a common practice and is usually followed by a good outcome. The present review aimed to summarize the emergence and evolution of different laser techniques used for the treatment of benign anal conditions and report their current outcome. PubMed and Scopus were searched for studies that assessed the use of laser in benign anal conditions. Anal conditions reviewed were hemorrhoids, anal fistula, anal warts, anal stenosis, and anal fissure. The full text of the studies retrieved was summarized in a narrative and tabular form. Laser techniques used for the treatment of hemorrhoidal disease were laser open hemorrhoidectomy, laser hemorrhoidoplasty, and Doppler-guided hemorrhoidal laser dearterialization. Resolution of hemorrhoidal symptoms was reported in 72-100% of patients after laser treatment. YAG laser, fistula laser closure, and photodynamic therapy have been used for the treatment of anal fistula with success rates ranging from 20 to 92.6%. Anal warts can be treated with photodynamic therapy with or without YAG or CO2 laser with a success rate up to 88%. A few studies reported the use of laser in the treatment of chronic anal fissure and anal stenosis. The use of laser in the treatment of benign anal conditions is associated with promising outcomes. Laser was most assessed in hemorrhoidal disease and anal fistula and showed more consistent success rates with hemorrhoidal disease than with anal fistula. Preliminary reports assessed the outcome of laser treatment in other conditions as anal fissure and warts with acceptable outcomes.

Azo-Linked Porous Organic Polymers for Selective Carbon Dioxide Capture and Metal Ion Removal.

The facile and environmentally friendly synthesis of porous organic polymers with designed polar functionalities decorating the interior frameworks as an excellent adsorbent for selective carbon dioxide capture and metal ion removal is a target worth pursuing for environmental applications. In this regard, two azo-linked porous organic polymers denoted man-Azo-P1 and man-Azo-P2 were synthesized in water by the azo-linking of 4,4'-diaminobiphenyl (benzidine) and 4,4'-methylenedianiline, respectively, with 1,3,5-trihydroxybenzene. The resulting polymers showed good BET surface areas of 290 and 78 m2 g-1 for man-Azo-P1 and man-Azo-P2, respectively. Due to the enriched core functionality of the azo (-N=N-) and hydroxyl groups along with the porous frameworks, man-Azo-P1 exhibited a good CO2 uptake capacity of 32 cm3 g-1 at 273 K and 1 bar, in addition to the remarkable removal of lead (Pd), chromium (Cr), arsenic (As), nickel (Ni), copper (Cu), and mercury (Hg) ions. This performance of the synthesized man-Azo-P1 and man-Azo-P2 in the dual application of CO2 capture and heavy metal ion removal highlights the unique properties of azo-linked POPs as excellent and stable sorbent materials for the current challenging environmental applications.

Comprehensive literature review of the outcome, modifications, and alternatives to double-stapled low pelvic colorectal anastomosis.

BACKGROUND: The double-stapled technique is widely used for creation of colorectal anastomosis after anterior resection of the rectum. Anastomotic leak has been recognized as one of the serious complications of low pelvic colorectal anastomosis. The present review aimed to illustrate the collective outcome of double-stapled technique, risk factors for anastomotic leak, and the modifications and alternatives of double-stapled technique. METHODS: A comprehensive review of PubMed/Medline, Scopus, and Web of Science was conducted to search articles that entailed patients who underwent low anterior resection with double-stapled low pelvic anastomosis. The main outcome measures were anastomotic leak and complication rates of double-stapled technique and its technical modifications. RESULTS: Overall, the median anastomotic leak rate across 25 studies was 7.3% (range: 0.7%-24.5%). The most commonly reported predictors of anastomotic leak after double-stapled technique were low tumor location, multiple stapler firings, male sex, longer operation time, and perioperative blood transfusion. Several modifications of the double-stapled technique were described and include hand-sewn colonic J-pouch, vertical division of the rectum, transanal reinforcement of anastomosis, transanal pull-through with single stapling technique, elimination of dog-ears using sutures, the natural orifice intracorporeal anastomosis with extraction of specimen procedure, and transanal transection and single-stapled. CONCLUSION: The median rate of anastomotic leak after double-stapled technique was less than 8%; however, it showed a wide range from less than 1% to approximately 25%. This wide variation might be related to additional risk factors of anastomotic leak, namely low tumor location and multiple stapler firings. Several techniques were described to modify the double-stapled technique to try to reduce the incidence of anastomotic leak.

An Open Prospective Study on Whether Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) Offers a Better Outcome Than Conventional Intracytoplasmic Sperm Injection (ICSI).

Objective To differentiate the in vitro fertilization (IVF) outcomes between the two procedures, intracytoplasmic morphologically selected sperm injection (IMSI) and intracytoplasmic sperm injection (ICSI) in terms of relation to chemical pregnancy percentage, clinical pregnancy, live birth, miscarriage, and fertilization rates, respectively. Patients and methods This Open Prospective clinical trial was conducted during the period between Jan 2016 and Dec 2017 at one IVF unit. A total of 446 ICSI cycles and 79 IMSI cycles were conducted. Females were divided into four subgroups according to age. Results The study involved 525 couples (446 first trial ICSI cycles) and (79 first trial IMSI cycles). ICSI was statistically better than the IMSI in relation to the chemical pregnancy, clinical pregnancy (CPR), live birth (LBR), and fertilization rates, respectively (p < 0.05). However, there were no statistically significant differences between the ICSI and IMSI in relation to the miscarriage rate. There were statistically significant differences favoring ICSI in all subgroups except 35-37, in relation to chemical pregnancy; and in the 38-40 and >40 subgroups in relation to CPR. There were no statistically significant differences in these subgroups regarding the live birth, miscarriage, or fertilization rates. Conclusions This study showed that IMSI is not superior to conventional ICSI at the first attempt. Based on the findings in this study, we would not advise couples to choose IMSI at their first treatment attempt.

Literature review of the outcome of and methods used to improve transperineal repair of rectocele.

BACKGROUND: Rectocele is commonly seen in parous women and sometimes associated with symptoms of obstructed defecation syndrome (ODS). AIM: To assess the current literature in regard to the outcome of the classical transperineal repair (TPR) of rectocele and its technical modifications. METHODS: An organized literature search for studies that assessed the outcome of TPR of rectocele was performed. PubMed/Medline and Google Scholar were queried in the period of January 1991 through December 2020. The main outcome measures were improvement in ODS symptoms, improvement in sexual functions and continence, changes in manometric parameters, and quality of life. RESULTS: After screening of 306 studies, 24 articles were found eligible for inclusion to the review. Nine studies (301 patients) assessed the classical TPR of rectocele. The median rate of postoperative improvement in ODS symptoms was 72.7% (range, 45.8%-83.3%) and reduction in rectocele size ranged from 41.4%-95.0%. Modifications of the classical repair entailed omission of levatorplasty, addition of implant, concomitant lateral internal sphincterotomy, changing the direction of plication of rectovaginal septum, and site-specific repair. CONCLUSION: The transperineal repair of rectocele is associated with satisfactory, yet variable, improvement in ODS symptoms with parallel increase in quality-of-life score. Several modifications of the classical TPR were described. These modifications include omission of levatorplasty, insertion of implants, performing lateral sphincterotomy, changing the direction of classical plication, and site-specific repair. The indications for these modifications are not yet fully clear and need further prospective studies to help tailor the technique to rectocele patients.

The leukotriene receptor antagonist montelukast in the treatment of non-alcoholic steatohepatitis: A proof-of-concept, randomized, double-blind, placebo-controlled trial.

Non-alcoholic fatty liver disease (NAFLD) is associated with fat accumulation in the liver which can progress into non-alcoholic steatohepatitis (NASH). There is no specific treatment strategy for NASH. In this context, this study aimed at evaluating the efficacy and safety of montelukast in the treatment of patients with NASH. In this randomized double-blind placebo-controlled study, 52 overweight/obese patients with NASH were randomized into group 1 (n = 26) which received montelukast 10 mg tablets once daily and group 2 (n = 26) which received placebo tablets once daily for 12 weeks. The fibro-scan was used to assess liver stiffness as a primary outcome at baseline and 12 weeks post-treatment. Furthermore, patients were assessed for biochemical analysis of liver aminotransferases, metabolic parameters, TNF-α, 8-hydroxy-2'-deoxyguanosine (8-OHdG), liver fibrosis biomarkers including hyaluronic acid (HA) and transforming growth factor beta-1 (TGF-ß1). Beck depression inventory questionnaire was used to report depressive symptoms. Data were statistically analyzed by paired and unpaired student's t-test, and Chi-square test. A total number of 44 patients completed the study. The two groups were statistically similar at baseline. After treatment and as compared to baseline data and placebo, montelukast showed a statistically significant improvement in liver stiffness, liver enzymes, metabolic parameters (except LDL-C), TNF-α, 8-OHdG, and liver fibrosis biomarkers (HA and TGF-ß1). Furthermore, montelukast was well tolerated and didn't provoke depression. In this proof-of-concept study, treatment with montelukast may represent a promising therapeutic strategy for patients with non-alcoholic steatohepatitis secondary to its efficacy and safety. Clinicaltrial.gov ID: NCT04080947.

Mass spectrometric identification and denovo sequencing of novel conotoxins from vermivorous cone snail (Conus inscriptus), and preliminary screening of its venom for biological activities in vitro and in vivo.

Venom of Conus inscriptus, a vermivorous cone snail found abundantly in the southern coastal waters was studied to yield conotoxins through proteomic analysis. A total of 37 conotoxins (4 with single disulfide bonds, 20 with two disulfide bonds and 11 three disulfide-bonded peptides) were identified using mass spectrometric analysis. Among them, amino acid sequences of 11 novel conopeptides with one, two and three disulfides belonging to different classes were derived through manual de novo sequencing. Based on the established primary sequence, they were pharmacologically classified into α conotoxins, µ conotoxins and contryphans. Except In1696 all other conopeptides have undergone C-terminal amidation. The natural venom exhibited 50% lethality at 304.82 µg/mL against zebrafish embryo and 130.31 µg/mL against brine shrimp nauplii. The anticonvulsant study of natural venom effectively reduced the locomotor activity against pentylenetetrazole (PTZ) treated zebrafish. This concludes that the venom peptides from Conus inscriptus exhibit potential anticonvulsant function, which leads to the discovery of lead molecules against seizures.

Mosquitocidal effect of monoterpene ester and its acetyl derivative from Blumea mollis (D. Don) Merr against Culex quinquefasciatus (Diptera: Culicidae) and their insilico studies.

The present study was conducted to assess the mosquitocidal efficiency of compound isolated from Blumea mollis (D. Don) Merr against Culex quinquefasciatus. Eggs and larvae of Cx. uinquefasciatus were exposed to different concentrations 0.5, 1.0, 1.5 and 2.0 ppm of compounds prepared using DMSO. Compound 1 was identified as (4R, 5S)-4-hydroxy-7-tigloyloxy carvotanacetone, from which new derivative was synthesized and confirmed as (4R, 5S)-4-acetoxy-7-tigloyloxy carvotanacetone. Both the compounds presented larvicidal and ovicidal activities. Compounds 1 and 2 at 2-ppm concentration showed 64% and 78% larval mortality in 24 h, respectively. The LC50and LC90values of compounds 1 and 2 on Cx. quinquefasciatus larvae were 1.73, 1.27 and 4.59, 3.33 ppm, respectively. The eluted compound 1 and synthesized compound 2 presented 68% and 77% of ovicidal activity, respectively, against eggs of Cx. quinquefasciatus at 120 h post-treatment. Histopathological studies of the compound-treated larvae revealed serious damage on the larval midgut cells. Furthermore, compounds 1 and 2 was tested for toxicity study and the results showed both the compounds were found to be harmless to non-target organism Poecilia reticulata. Computational analysis of compound 2 showed strong binding interaction with the AChE1 of Cx. quinquefasciatus. These results clearly suggest that compounds from Blumea mollis could act as good mosquitocidal agents against Cx.quinquefasciatus and compound 2 was first time reported.

Development and validation of risk prediction score for incisional surgical site infection after appendectomy.

Surgical site infection (SSI) is a challenging and resource-consuming healthcare problem. Predicting the onset of SSI beforehand can help prevent or minimize its incidence. The present study aimed to determine the independent predictors of incisional SSI after open appendectomy using a multivariate analysis and to establish a predictive risk score of SSI after appendectomy. Records of eligible patients who underwent open appendectomy were reviewed. The characteristics and treatment outcomes of patients were collected and analyzed. Significant association between different variables and SSI after appendectomy was examined by univariate analysis. Then, variables with a significant association with SSI were entered into a multivariate binary logistic regression analysis to determine the significant independent predictors of SSI. The study included 343 patients (51.3% female). Incisional SSI was recorded in 44 (12.8%) patients. Univariate analysis revealed five parameters with a significant association with SSI, including BMI > 30 kg/m2 (p < 0.0001), diabetes mellitus (DM) (p = 0.0001), total leukocyte count (p = 0.04), free intraperitoneal fluid (p < 0.0001), and perforated/gangrenous appendicitis (p < 0.0001). After identifying four significant independent predictors of incisional SSI by binary logistic regression analysis, a predictive risk score was developed. The independent predictors of SSI were DM (OR = 6.05, p = 0.005), free intraperitoneal fluid (OR = 6.94, p = 0.0001), obesity (OR = 8.94, p = 0.0001), and perforated/gangrenous appendicitis (OR = 24.64, p = 0.0001). Four independent predictors of incisional SSI after open appendectomy were found after multivariate analysis. A predictive risk score of SSI was developed and included obesity, DM, free intraperitoneal fluid, and perforated/gangrenous appendicitis as predictors of SSI.

Hepatoprotective activity of silymarin encapsulation against hepatic damage in albino rats.

Liver fibrosis occurs due to liver injuries and toxins. Silymarin (SMR) extracted by the milk thistle seeds, is widely used such as herbal drug for its hepatoprotective properties. The purpose of this study to assess the properties of an optimized dose of encapsulated crude SMR on antidiabetic activity and liver fibrosis induced by paracetamol in male albino rat. Hepatic fibrosis was assessed by measuring liver enzymes. Results revealed that the consumption of encapsulated SMR, can effectively affluence the target and avoid the degradation of bioactive compound. Body weight of animal also significantly increased in each group during all the period. According to our optimized study, the long-term induction of SMR (300 mg/kg) significantly amplified survival time of rats with paracetamol induced hepatic injuries. The changes of liver fibrosis and the significant increase of hepatic enzyme biomarkers were also observed. In conclusion, the results suggest that SMR acts as a hepatoprotective agent by inhibiting the fibrogenisis and apoptosis in liver, as well as insulin resistance.

Spectral characterization of hydroxyapatite extracted from Black Sumatra and Fighting cock bone samples: A comparative analysis.

At present, chicken business is occupying a major portion in the market and huge amount of bone wastes are dumped into the open places lead in environmental pollution. In this analysis, natural hydroxyapatite was extracted by thermal calcination process at different temperature ranges from 700 °C, 900 °C and 1100 °C and compared its spectral characteristics. The crystalline nature, functional groups and morphological characteristics of hydroxyapatite obtained from both bone samples were studied using XRD, FTIR and SEM analysis. The crystallite size, lattice parameters, specific surface area, volume and degree of crystallinity were measured using XRD data. The mean grain size of Black Sumatra and Fighting Cock bone hydroxyapatite was 62.67 nm and 31.34 nm respectively. The FTIR spectrum showed major peaks at 634.58 cm-1 and 470.63 cm-1, 1413.82 cm-1 and 1460 cm-1 indicates the presence of carbonate group and phosphate groups in both samples. The SEM micrograph confirmed the existence of maximum pores in matrix of fighting cock bone than Black Sumatra bone sample. Thus, the comparative analysis concluded that nano-sized hydroxyapetite obtained from bone wastes of fighting cock can be utilized as a low-cost biomaterial for the production of various implant coating materials and substitute for ceramics in bones and dentistry applications.

Interrelationship of milk acute-phase proteins and casein percentage in cows and buffaloes subclinical mastitis.

A total number of 62 clinically healthy dairy animals of three farms located in Kafr El Sheikh governorate, Egypt, were subjected to field screening surveys of subclinical mastitis (SCM) using California mastitis test (CMT). The obtained results revealed that 38.80% of quarter milk samples were positive to CMT. The most frequently major causative agents isolated from the positive CMT samples were Escherichia coli, Staphylococcus aureus, and environmental streptococcus spp. Acute-phase proteins (APPs), as immunological biomarkers for SCM, including milk serum amyloid A (mSAA) and haptoglobin (Hp) were measured using ELISA. A significant positive correlation was found between the severity of the mammary infection of cow's quarter milk samples represented in somatic cell count (SCC) and each of APPs and pH values. The correlation coefficient (R) between SCC and mSAA, Hp and pH were 0.54, 0.38 and 0.73, respectively. On the other hand, there was a significant negative correlation between casein percentage in milk of SCM cases, and each of APPs, pH and the presence of bacterial pathogens in the milk samples. The obtained results threw light on the inter-relationship between SCC, mSAA, pH value and casein percentage in milk of cows and buffalo suffered from SCM. The percentage of casein in milk is considered a significant accurate tool for diagnosis of SCM and this finding offers the farmers a cheap and fast selection for diagnosis of such disease. These results presented a specific structured view on the efficacy of different diagnostic tools of SCM in dairy herds.

Drug-naïve Egyptian females with migraine are more prone to sexual dysfunction than those with tension-type headache: a cross-sectional comparative study.

Headache is one of the chronic disorders that can trigger sexual dysfunction due to complex mechanisms. This study recruited 120 consecutive patients from our outpatient clinics with migraine (n = 60), TTH (n = 60) as well as healthy age-matched controls (n = 60) for a total of 180 patients. All the participants were evaluated by the Arabic version of the female sexual function index (ArFSFI: 19 items), the abridged 5-item version of the international index of erectile function (IIEF-5), hospital anxiety and depression scale (HADS: 14 items), visual analog scale (VAS) score, and the headache impact test questionnaire (HIT-6TM: 6 items). A significant correlation was noticed between scores of total ArFSFI in women with TTH and their partners' IIEF-5 scores (r = 0.773, p < 0.001). In contrast, significant negative correlations were also found between scores of total ArFSFI in women with migraine(r - 0.327, p 0.011), HADS-A scores (r - 0.504, p < 0.001), HADS-D scores (r - 0.579, p < 0.001), HITS scores (r - 0.413, p 0.001), VAS scores (r 0.737, p < 0.001), and their partners' IIEF-5 scores (r - 0.839, p < 0.001). Interestingly, our study had shown a bidirectional relation between SD, anxiety, and depression subscales of HADS in females with migraine only (28.49 ± 9.46, 13.54 ± 4.44, 15.17 ± 7.73 respectively, p 0.009), while females with migraine and SD reported statistical higher scores of anxiety and depression (25.21 ± 11.70, 12.71 ± 4.20, 17.95 ± 8.05, respectively, p 0.006). This study had demonstrated that drug-naïve Egyptian females with migraine are more prone to SD than those with TTH.

Horizontal versus vertical plication of the rectovaginal septum in transperineal repair of anterior rectocele: a pilot randomized clinical trial.

AIM: Anterior rectocele is usually an asymptomatic condition in many women, yet it can be associated with obstructed defaecation syndrome (ODS). Transperineal repair of rectocele (TPR) has been followed by variable rates of improvement in ODS. The present pilot randomized clinical trial aimed to evaluate the outcome of TPR with vertical plication (VP) of the rectovaginal septum compared to horizontal plication (HP). METHODS: Adult women with anterior rectocele were recruited to the study and were randomly allocated to one of two equal groups. The first group underwent TPR with VP of the rectovaginal septum and the second group underwent TPR with HP. The main outcome measures were improvement in ODS, recurrence of rectocele, complications and dyspareunia. RESULTS: The trial included 40 female patients with anterior rectocele. There was no significant difference between the two groups regarding the postoperative Wexner score. Complete cure and significant improvement in ODS symptoms were comparable after the two techniques. The reduction in rectocele size after HP was significantly greater than after VP (1.7 vs. 2.6, P < 0.0001). Significant improvement in dyspareunia was recorded after HP (P = 0.001) but not after VP (P = 0.1). There was no significant difference between the two groups with regard to operating time, complications and recurrence. CONCLUSION: VP and HP of the rectovaginal septum in TPR were associated with a comparable improvement in ODS symptoms and similar complication rates. HP was followed by a greater reduction in the rectocele size and greater improvement in dyspareunia than VP.

Traditional Usage of Wild Fauna among the Local Inhabitants of Ladakh, Trans-Himalayan Region.

Zootherapy is accepted all around the globe not only in ancient cultures but different animal derived medicines are also part of the practice in the modern health care systems. The present study assessed the traditional ethnozoological usage of wild animals by local inhabitants in Ladakh region, India, and the reference data for scientific approaches for protection of faunal diversity in trans-Himalayas. The ethnozoological documentation of the animals in Ladakh was carried out through semistructured and close-ended questionnaire surveys and interviews. Multivariate ecological community analysis was used to elucidate the relationship between ethnozoological usage and animal species. Our results showed three animal usage clusters with 32% similarity. Moreover, the similarity in animal usage between digging tools, trophy, handle of tools, decoration, and matting, showed less than 32% of similarity. The highest priority of local people was for food followed by decoration and medicinal usage. The most frequently used animal parts were meat followed by fur and horn. Medicinal uses of 48% of the reported species, i.e., Alectoris chukar (chukar), Cuon alpinus (Asiatic wild dog), Lepus oiostolus (hares), Marmota himalayana (marmots), Ovis aries vignei (Ladakh urial), Pantholops hodgsonii (Tibetan antelope), Procapra picticaudata (Tibetan gazelle), Pseudois nayaur (blue sheep), Tetraogallus himalayensis (Himalayan snow), Tetraogallus tibetanus (Tibetan snow cock), and Lutra lutra (common otter) were reported for the first time from this region. Our study provides innovative information regarding the ethnozoological knowledge in the Ladakh region and reference data for policymakers, researchers, land managers, common public, and the other stakeholders to develop logical and scientific approaches for sustainable use of faunal diversity in hotspot regions like trans-Himalayas and other similar biodiversity-rich sites.

A randomized controlled trial on irrigation of open appendectomy wound with gentamicin- saline solution versus saline solution for prevention of surgical site infection.

BACKGROUND: Surgical site infection (SSI) is one of the most common complications after abdominal surgery. The present trial examined the efficacy of saline irrigation of open appendectomy wound with or without topical antibiotics in prevention of SSI. METHODS: This was a double-blind randomized trial on patients with acute appendicitis who underwent open appendectomy. Patients were randomly allocated to one of three equal groups; group I had layer-by-layer wound irrigation with gentamicin-saline solution, group II had wound irrigation with saline solution, and group III received no irrigation (Control group). The main outcome measures were the incidence of incisional SSI, surgical site occurrence (SSO), other complications, operation time, postoperative pain, and patients' satisfaction. RESULTS: 205 patients (113 female) of a mean age of 27.9 years were included. The average hospital stay and pain scores were similar in the three groups. Groups I and II had significantly lower rates of incisional SSI (4.3% Vs 2.9%; Vs 17.4%, p = 0.005) and SSO (24.6% Vs 13.4% Vs 43.5%; p = 0.0003) as compared to group III. Groups I and II had comparable rates of SSI and SSO. The three groups had similar rates of wound seroma, hematoma, and dehiscence. Groups I and II had significantly higher satisfaction with the procedure than group III. CONCLUSIONS: Layer-by-layer irrigation of open appendectomy wound decreased the rates of incisional SSI and SSO significantly compared to the no-irrigation group. Adding gentamicin to saline solution was useless to improve the outcome and did not decrease rates of SSI or other complications.

Modulation format identification of optical signals: an approach based on singular value decomposition of Stokes space projections.

In this paper, two Stokes space (SS) analysis schemes for modulation format identification (MFI) are proposed. These schemes are based on singular value decomposition (SVD) and Radon transform (RT) for feature extraction. The singular values (SVs) are extracted from the SS projections for different modulation formats to discriminate between them. The SS projections are obtained at different optical signal-to-noise ratios (OSNRs) ranging from 11 to 30 dB for seven dual-polarized modulation formats. The first scheme depends on the SVDs of the SS projections on three planes, while the second scheme depends on the SVDs of the RTs of the SS projections. Different classifiers including support vector machine (SVM), decision tree (DT), and K-nearest neighbor (KNN) for MFI based on the obtained features are used. Both simulation and experimental setups are arranged and tested for proof of concept of the proposed schemes for the MFI task. Complexity reduction is studied for the SVD scheme by applying the decimation of the projections by two and four to achieve an acceptable classification rate, while reducing the computation time. Also, the effect of the variation of phase noise (PN) and state of polarization (SoP) on the accuracy of the MFI is considered at all OSNRs. The two proposed schemes are capable of identifying the polarization multiplexed modulation formats blindly with high accuracy levels up to 98%, even at low OSNR values of 12 dB, high PN levels up to 10 MHz, and SoP up to 45°.