Sensitivity analysis of natural convection in a porous cavity filled with nanofluid and equipped with horizontal fins using various optimization methods and MRT-LB.

In the present study, natural convection heat transfer is investigated in a porous cavity filled with Cu/water nanofluid and equipped with horizontal fins. Optimization and sensitivity analysis of the fin's geometry, porous medium and nanofluid properties to maximize heat transfer rate is the aim of this work. To achieve this purpose, a design space is created by input parameters which include length, number of fins, distance between fins, porosity, Darcy number and volumetric fraction of the nanoparticles. Several tools have been used to implement optimization methods including the Taguchi method (TM) for design points generation, sensitivity analysis of design variables by using signal-to-noise ratio (SNR) and analysis of variance (ANOVA), response surface method (RSM) for interpolation and regression by using nonparametric regression, and genetic algorithm (GA) for finding optimum design point. The double multi-relaxation time lattice Boltzmann method (MRT-LBM) is used to analyze and simulate the flow field and heat transfer in each design point. The results show that the optimal configuration leads to an average Nusselt number of 5.56. This optimal configuration is at the length of fins L/2, the number of fins 2, the distance between fins L/12, porosity 0.8, Darcy number 0.1, and the volumetric fraction of the nanoparticles 0.02. By using the SNR results, the Darcy number and the number of fins have the most and the least effect in maximizing the average Nusselt number, respectively. The ANOVA results and global sensitivity analysis (GSA) findings further validated this conclusion.

Risk factors for kyphosis recurrence after implant removal in percutaneous osteosynthesis for post-traumatic thoracolumbar fracture.

PURPOSE: Short-segment minimally invasive percutaneous spinal osteosynthesis has now become one of the treatments of choice to treat thoracolumbar fractures. The question of implant removal once the fracture has healed is still a matter of debate since this procedure can be associated with loss of sagittal correction. Therefore, we analyzed risk factors for kyphosis recurrence after spinal implants removal in patients treated with short-segment minimally invasive percutaneous spinal instrumentation for a thoracolumbar fracture. METHODS: A total of 32 patients who underwent implant removal in percutaneous osteosynthesis for post-traumatic thoracolumbar fracture were enrolled in our study. Patient's medical record, operative report and imaging examinations carried out at the trauma and during the follow-up were analyzed. RESULTS: Every patient experienced fracture union. Vertebral kyphotic angle (VKA) and Cobb angle (CA) improved significantly after stabilization surgery. VKA, CA, upper disk kyphotic angle (UDKA) and lower disk kyphotic angle (LDKA) significantly gradually decreased during follow-up. Traumatic disk injury (p: 0.001), younger age (p: 0.01), canal compromise (p: 0.04) and importance of surgical correction (p < 0.001) were significantly associated with kyphosis recurrence after implant removal. Anterior body augmentation did not affect loss of correction (CA and VKA) during the follow-up period (p: 0.57). CONCLUSION: Despite correction of the fracture after stabilization, we observed a progressive loss of correction over time appearing even before implant removal. Particular attention should be paid to post-traumatic disk damage or canal invasion, to young patients and to surgical overcorrection of the traumatic kyphosis.

Mono-segmental percutaneous screw fixation in the management of AoSpine thoracolumbar type B fracture in patients with ankylosing spondylitis: A new treatment.

PURPOSE: To assess the viability and effectiveness of mono-segmental percutaneous screw fixation in the treatment of unstable type B thoracolumbar fracture due to ankylosing spondylitis. METHODS: We report here all 40 patients treated by mono-segmental screw fixation in this indication, between January 2018 and January 2022, with follow-up at 3 and 9 months. Study variables comprised operating time, length of stay, fusion, stabilization quality, and peri-operative morbidity and mortality. RESULTS: One patient showed early displacement of rods caused by technical error. None of the others showed secondary displacement of rods or screws. Mean age was 73 years (range 18-93), mean hospital stay 4.8 days (range 2-15), mean operative time 52minutes (range 26-95minutes) and mean estimated blood loss 40ml. There were 2 deaths caused by intensive care unit complications. All patients except those in intensive care were verticalized within 24hours after surgery. Parker score was unchanged for each patient before and after surgery and during follow-up. CONCLUSION: Mono-segmental percutaneous screw fixation in the treatment of unstable type B thoracolumbar fracture due to ankylosing spondylitis was safe and effective. This study showed that this surgery reduced length of hospital stay, operative time, blood loss and complications compared to open or extended percutaneous surgery, and allowed fast rehabilitation in this vulnerable population.

Medical and Personal Characteristics Can Predict the Risk of Lung Metastasis.

AIMS: Understanding the correlations between underlying medical and personal characteristics of a patient with cancer and the risk of lung metastasis may improve clinical management and outcomes. We used machine learning methodologies to predict the risk of lung metastasis using readily available predictors. MATERIALS AND METHODS: We retrospectively analysed a cohort of 11 164 oncological patients, with clinical records gathered between 2000 and 2020. The input data consisted of 94 parameters, including age, body mass index (BMI), sex, social history, 81 primary cancer types, underlying lung disease and diabetes mellitus. The strongest underlying predictors were discovered with the analysis of the highest performing method among four distinct machine learning methods. RESULTS: Lung metastasis was present in 958 of 11 164 oncological patients. The median age and BMI of the study population were 63 (±19) and 25.12 (±5.66), respectively. The random forest method had the most robust performance among the machine learning methods. Feature importance analysis revealed high BMI as the strongest predictor. Advanced age, smoking, male gender, alcohol dependence, chronic obstructive pulmonary disease and diabetes were also strongly associated with lung metastasis. Among primary cancers, melanoma and renal cancer had the strongest correlation. CONCLUSIONS: Using a machine learning-based approach, we revealed new correlations between personal and medical characteristics of patients with cancer and lung metastasis. This study highlights the previously unknown impact of predictors such as obesity, advanced age and underlying lung disease on the occurrence of lung metastasis. This prediction model can assist physicians with preventive risk factor control and treatment strategies.

A rare case of ureteral tuberculosis mimicking a tumor.

Isolated ureteral involvement in urogenital tuberculosis is rare. The diagnosis can be difficult to evoke. The radiological aspect often evokes tumor involvement, hence the importance of mentioning this pathology in endemic countries. The purpose of this study is to show that it will be necessary to think of ureteral tuberculosis in the presence of ureteral thickening living in an endemic country. We reported a case of ureteric tuberculosis in a 46-years old man mimicking a tumor.

Surgery for spinal deformity in Parkinson's disease patients: What are we missing?

INTRODUCTION: Deformity associating coronal and sagittal malalignment can severely impair quality of life in Parkinson's disease (PD). Realignment using patient-specific rods (PSRs) is useful for achieving alignment goals. METHODS: This was a retrospective single-center analysis of a prospectively maintained database of all PD patients who underwent surgery between January 2013 and January 2017. Clinical evaluation, preoperatively and at 1 year's follow-up, used the Oswestry Disability Index (ODI). Radiological evaluation used systematic preoperative and 1-year postoperative full-spine radiographs. RESULTS: Twelve patients were included: 6 female, 6 male; mean age, 68.4 years. Mean follow-up was 40.8 months [range 12-70]. On average, 14 levels were fused [range 10-18]. Unplanned revision surgery was necessary for 8 patients at a mean 15.625 months after index surgery. Mean preoperative ODI score was 64% preoperatively [range 56-70] versus 52% [range 28-64] at 1 year's follow-up (P=0.004). Lumbar lordosis improved significantly, from -16.7° preoperatively to -41.4° at 1 year (P=0.006). Pelvic tilt was the least effectively corrected parameter, with a mean preoperative value of 31.6° vs. 27.8° at 1 year (P=0.19). Mean preoperative sagittal vertical axis was 149.7mm versus 73.6mm at 1 year (P=0.013). Mean preoperative coronal tilt was 68.2mm versus 22.9mm at 1 year (P=0.007). CONCLUSION: Parkinson's disease is a degenerative disease frequently associated with major spine malalignment. The severity of the postural disorders in these patients needs special precautions to avoid complications.

Assessment of personal care and medical robots from older adults' perspective.

Demographic reports indicate that population of older adults is growing significantly over the world and in particular in developed nations. Consequently, there are a noticeable number of demands for certain services such as health-care systems and assistive medical robots and devices. In today's world, different types of robots play substantial roles specifically in medical sector to facilitate human life, especially older adults. Assistive medical robots and devices are created in various designs to fulfill specific needs of older adults. Though medical robots are utilized widely by senior citizens, it is dramatic to find out into what extent assistive robots satisfy their needs and expectations. This paper reviews various assessments of assistive medical robots from older adults' perspectives with the purpose of identifying senior citizen's needs, expectations, and preferences. On the other hand, these kinds of assessments inform robot designers, developers, and programmers to come up with robots fulfilling elderly's needs while improving their life quality.

Detection Mutations of JAK2 exon 12 in Patients with JAK2 (V617F)-negative Myeloproliferative Disorders.

BACKGROUND: Mutations in exon 12 of JAK2 gene are detected as clonal markers in hematopoietic lineages in myeloproliferative disorders (MPNs). Our aim was, to study the relation between N542-E543del mutation of JAK2 gene and myeloproliferative neoplasms in V617Fnegative patients. PATIENTS AND METHODS: DNA specimen from 34 patients and 44 healthy controls were genotyped using ARMs- PCR method. We analyzed exon 12 JAK2 aberration in 34 myeloproliferative cases to be readily detected by both ARMS-PCR and DNA analysis regardless of whether peripheral blood or bone marrow cells was manipulated as the origin of RNA. RESULTS: In this case-control study, there was no significant difference in Pearson chi square analysis between the patients and control groups in genotype distribution of the frequency of single nucleotide polymorphism rs7869668 of JAK2 exon 12 (P > 0.05). Also, gene detection finding showed that the patients were negative of JAK2-V617F mutation. DISCUSSION AND CONCLUSION: Present finding on a small number of patients diagnosed of various categories of MPDs revealed and needs more investigation and data for the prevalence and the incidence of the JAK2-V617F mutation. However, the clinical and genotyping of finding a disorder and non-significant correlation between patients and control group in this study in such a small fraction of the patients is unknown.

Detection of Loa loa Microfilariae in Follicular Fluid During Assisted Reproductive Technology: Case Report and Review of the Literature.

We report on a case of loiasis revealed during an assisted reproductive technology (ART) cycle. Loa loa could limit implantation outcome. We propose to focus on an ART strategy with frozen embryos to treat the patient before any transfer.

Impact of surgical correction of a U-shaped sacral fracture on sagittal spino-pelvic alignment: Regarding one case.

U-shaped sacral fractures are uncommon and are mostly the consequence of a high-energy kinetic trauma. The sacrum is a crucial element for sagittal alignment in a standing position as it determines the value of the pelvic incidence, which is a fixed and unchanging parameter for a given individual. We report the case of a 21-year-old man who underwent corrective surgery for a type II U-shaped fracture of the sacrum (according to the Roy-Camille classification), associated with a S1-S2 dislocation and sacral kyphosis that modified the patient's pelvic incidence. At one-year follow-up, radiographic examinations revealed solid bony fusion and stable results after removal of the implants. The surgery was managed for neurological decompression, stabilization of the fracture and correction of sacral kyphosis. The restoration of the theoretical pelvic incidence depended on the estimated lumbar lordosis. The aim of this study was to highlight the particularities in the management of a sacral U-shaped fracture and their relationship with the sagittal alignment.

Human papillomavirus detection using in situ hybridization and correlations with histological and cytological findings.

BACKGROUND AND OBJECTIVE: The human papillomavirus (HPV) is the main causative agent of cancerous and precancerous lesions in cervical cancers. The infection detection is performed by cytological and histological examination. However, molecular testing for HPV infection remains necessary to distinguish nonspecific inflammatory lesions from HPV-related lesions. We aimed to compare cytological and histological diagnosis of HPV lesions and to confront histological findings with molecular detection of HPV by in situ hybridization (ISH). MATERIAL AND METHODS: A total of 2399 pap smears were collected between 1997 and 2002. Twenty-nine of them presented with lesions indicative of HPV infection. Colposcopy and biopsy were performed on 23 of these 29 pap smears, with a comparison of the cytological and histological findings. Molecular testing for HPV by ISH was performed on 11 pap smears. RESULTS: A 79% cytological and histological agreement was observed. ISH revealed the presence of the virus in seven case patients, amounting to a 63% histological and molecular agreement. Seven HPV genotypes were categorized (6-11-16-18-31-33-51). CONCLUSION: HPV detection by ISH adds little to the diagnosis of HPV-associated lesions based on cytological and histological features. It, however, helps improve the specificity of the diagnosis and determine the viral genotype which, in turn, helps better define the lesion prognosis.

[Management of spinal metastasis by minimal invasive surgery technique: Surgical principles, indications: A literature review]. / Prise en charge des métastases rachidiennes par technique chirurgicale mini-invasive : principes chirurgicaux, indications : revue de la littérature.

INTRODUCTION: Spinal metastasis are getting more frequent. This raises the question of pain and neurological complications, which worsen the functional and survival prognosis of this oncological population patients. The surgical treatment must be the most complete as possible: to decompress and stabilize without delaying the management of the oncological disease. Minimal invasive surgery techniques are by definition, less harmful on musculocutaneous plan than opened ones, with a comparable efficiency demonstrated in degenerative and traumatic surgery. So they seem to be applicable and appropriate to this patient population. MATERIAL AND METHODS: We detailed different minimal invasive techniques proposed in the management of spinal metastasis. For this, we used our experience developed in degenerative and traumatic pathologies, and we also referred to many authors, establishing a literature review thanks to Pubmed, Embase. RESULTS: Thirty eight articles were selected and allowed us to describe different techniques: percutaneous methods such as vertebro-/kyphoplasty and osteosynthesis, as well as mini-opened surgery, through a posterior or anterior way. DISCUSSION: We propose a surgical approach using these minimal invasive techniques, first according to the predominant symptom (pain or neurologic failure), then characteristics of the lesions (number, topography, type…) and the deformity degree. Whatever the technique, the main goal is to stabilize and decompress, in order to maintain a good quality of life for these fragile patients, without delaying the medical management of the oncological disease.

Urinary catheterization as a successful treatment option for post-cesarean section vesicouterine fistula.

Surgery, the usual treatment option for vesicouterine fistula (VUF), is often delayed to allow involution of the uterus. The authors report a case of successful treatment with urinary catheterization. A 39-year-old, gravida 7, para 6, woman presented at term with obstructed labor. She had one previous cesarean section followed by a vaginal birth before. She underwent emergency cesarean section. She was readmitted after one week because of pelvic collection. Aspiration revealed pus and urine. Retrograde cystogram and pelvic MRI confirmed the presence of VHF. Urinary bladder catheterization for six weeks resulted in the successful treatment of the fistula. Urinary catheterization in the early postpartum period can result in resolution of post-cesarean section VUF, without delaying surgical intervention if it becomes necessary.

[Use of pedicle percutaneous cemented screws in the management of patients with poor bone stock]. / Utilisation de vis cimentées percutanées dans la prise en charge rachidienne des patients à faible capacité osseuse.

INTRODUCTION: Management of patients with poor bone stock remains difficult due to the risks of mechanical complications such as screws pullouts. At the same time, development of minimal invasive spinal techniques using a percutaneous approach is greatly adapted to these fragile patients with a reduction in operative time and complications. The aim of this study was to report our experience with cemented percutaneous screws in the management of patients with a poor bone stock. METHODS: Thirty-five patients were included in this retrospective study. In each case, a percutaneous osteosynthesis using cemented screws was performed. Indications were osteoporotic fractures, metastasis or fractures on ankylosing spine. Depending on radiologic findings, short or long constructs (2 levels above and below) were performed and an anterior column support (kyphoplasty or anterior approach) was added. Evaluation of patients was based on pre and postoperative CT-scans associated with clinical follow-up with a minimum of 6 months. RESULTS: Eleven men and 24 women with a mean age of 73 years [60-87] were included in the study. Surgical indication was related to an osteoporotic fracture in 20 cases, a metastasis in 13 cases and a fracture on ankylosing spine in the last 2 cases. Most of the fractures were located between T10 and L2 and a long construct was performed in 22 cases. Percutaneous kyphoplasty was added in 24 cases and a complementary anterior approach in 3 cases. Average operative time was 86minutes [61-110] and blood loss was estimated as minor in all the cases. In the entire series, average volume of cement injected was 1.8 cc/screw. One patient underwent a major complication with a vascular leakage responsible for a cement pulmonary embolism. With a 9 months average follow-up [6-20], no cases of infection or mechanical complication was reported. CONCLUSION: Minimal invasive spinal techniques are greatly adapted to the management of fragile patients. The use of percutaneous cemented screws is, in our experience, a valuable alternative for spinal fixation in patients with poor bone stock. This technique allows a good bony fixation with a low rate of complications. However, rigorous preoperative planning is necessary in order to avoid complications.

Minimal Invasive Circumferential Management of Thoracolumbar Spine Fractures.

INTRODUCTION: While thoracolumbar fractures are common lesions, no strong consensus is available at the moment. OBJECTIVES: The aim of this study was to evaluate the results of a minimal invasive strategy using percutaneous instrumentation and anterior approach in the management of thoracolumbar unstable fractures. METHODS: 39 patients were included in this retrospective study. Radiologic evaluation was based on vertebral and regional kyphosis, vertebral body height restoration, and fusion rate. Clinical evaluation was based on Visual Analogic Score (VAS). All evaluations were done preoperatively and at 1-year follow-up. RESULTS: Both vertebral and regional kyphoses were significantly improved on postoperative evaluation (13° and 7° versus -1° and -9° P < 0.05, resp.) as well as vertebral body height (0.92 versus 1.16, P < 0.05). At 1-year follow-up, mean loss of correction was 1°. A solid fusion was visible in all the cases, and mean VAS was significantly reduced form 8/10 preoperatively to 1/10 at the last follow-up. CONCLUSION: Management of thoracolumbar fractures using percutaneous osteosynthesis and minimal invasive anterior approach (telescopic vertebral body prosthesis) is a valuable strategy. Results of this strategy offer satisfactory and stable results in time.

Rare chromosome structural aberration characterizing oncology malignancy.

UNLABELLED: Ring chromosome aberration are rare abnormality potentially involving any chromosome in patients diagnosing in Oncology. The present review and case study has focused on the ring chromosome associated with oncology malignancies. MATERIAL AND METHODS: An electronic peer review article search was performed systematically to obtain relevant literature with the CINAHL, Google scholar, and Pub Med databases. The keywords included marker, abnormalities, structural, Ring chromosome. The inclusion criteria for the review were that the documents were original quantitative research and published in English. This was also initiated using Medline, Mitelman database (http://cgap.nci.nih.gov/Chromosomes/Mitelman), Danish cytogenetic register and other pertinent web references on ring chromosomes in Oncology malignancies. Articles that were not directly relevant to the present objective were excluded. Also the un-stimulated bone marrow specimen of present case manipulated with Methotrexate cells culture synchronization and finally was treated by GTGbanding technique. RESULTS: Ring chromosome was observed in 10% of the total cells. Cytogenetic analysis demonstrated apparently ring (15) 46, XY, r(15) karyotype. The clinical findings revealed history of nausea, loss of appetite, diarrhea, night sweats, and a weight loss, anemia and diagnosed as accelerated CML. CONCLUSION: Our finding adds to the spectrum of both morphology and genetic rearrangements in oncology malignancies. Additional future analyses in similar subject will be necessary to draw firm conclusions.

Hepatitis B virus infection in patients with blood disorders: a concise review in pediatric study.

Childhood Hepatitis B virus (HBV) infection causes both medical and public health challenges. Infants who acquire HBV parentally have up to 90% risk of developing chronic HBV infection. It is now estimated that approximately 10% of worldwide cancers are attributable to viral infection, with the vast majority (>85 %) occurring in the developing world. In this distribution, elevated rate and prevalence of HBV marker have been found in patients with malignancies as compared to the general population. By reviewing the web-based search for all Persian and English types of scientific peer review published articles initiated using Iran Medex, MEDLINE/PubMed, CINAHL and other pertinent references on websites about HBV and HCV blood disorders. The high prevalence of HBV and HCV infective markers was detected in patients with different malignancies. Moreover, identification of high prevalence of HBV infective markers in leukemia patients proposed strong association between hepatitis viral infections and leukemia.

Standardised second-line treatment of multidrug-resistant tuberculosis during pregnancy.

We describe the efficacy and outcome of standardised second-line anti-tuberculosis (TB) medications during pregnancy. Treatment outcomes of five pregnant women with documented multidrug-resistant TB (MDR-TB) referred to the National Research Institute of Tuberculosis and Lung Diseases from 2003 to 2009 were analysed in two categories, maternal and neonatal. Patients became pregnant during treatment for MDR-TB without any changes in their anti-tuberculosis regimen. None of them had any adverse effects during pregnancy and delivery. No adverse effects were observed in mothers or neonates. The treatment of MDR-TB during pregnancy with a standardised second-line regimen in this study population was safe, with an acceptable rate of treatment success.

Analysis of mental health research in the Islamic Republic of Iran over 3 decades: a scientometric study.

This study described the characteristics of mental health research from the Islamic Republic of Iran published from 1973-2002. Research articles in psychiatry, psychology and neuroscience published in local or international journals were drawn from IranPsych, a national database of research in mental health and related disciplines. Of 3113 articles, 21.8% appeared in international journals, but there was international collaboration among the authors in only 2.3%. There was a marked increase in the number of publications over time, especially in the last 5 years. Analysis of research areas showed a proportionate rise in neuroscience research and a decline in mental health service research. Our study provides an empirical basis for policy-making and strategy planning in the nation's mental health research.

Gravimetric and analytical evaluation of welding fume in an automobile part manufacturing factory.

BACKGROUND: Welding is one of the most exercised industrial processes which welders are exposed to chemical and physical Hazardous agents. This study was conducted to evaluate occupational and environmental exposures to aerosols generated by welding processes in a factory. METHODS: A total of 28 samples of aerosols were collected at 4 different locations including indoor, outdoor, source of welding and the stacks using a high volume pump with a volumetric flow rate of 112 lit/min calibrated with a dry gas meter. The samples were collected on round 110 mm fiber glass filters, measured gravimetrically, extracted using nitric acid and analyzed with atomic absorption spectroscopy method for heavy metals including Fe, Mn, Ni, Cr3+, Cr+6, Co, and Zn. RESULTS: Gravimetric measuring has shown the mean values of indoor air: 1.33 mg/m3, breathing zone of the welders using coated electrodes and CO2: 7.25 mg/m3 and 6.45 mg/m3 respectively and in ventilation exhausts: 95.07 mg/m3. The mean values of Fe, Mn, and Ni were 0.8, 0.041, and 0.00 mg/m3 in indoor air, 2.7, 0.18, and 0.15 mg/m3 in breathing zone of welders used coated electrodes, and 1.75, 0.08, and 0.22 mg/m3 in breathing zone of welders used CO2 welding respectively. The concentrations of Cr3+, Cr+6, Co, and Zn were too low to be detected. CONCLUSION: The welders were exposed to high concentration of metallic fumes, which raise the risk of pulmonary dysfunction and other health disorders. Using suitable respiratory masks and Appling the effective local ventilation system may improve the working condition.