Case History Data Research Articles

Machine Learning Approach to Injury Monitoring in Children and Adolescents

Abstract Pediatric injuries are common and associated with individual suffering and costs for the healthcare systems and society. The incidence of injuries among children in Switzerland has so far been insufficiently monitored. Emergency department patient records can be a valuable database to assess medically relevant injuries and gain information for monitoring and evidence-based prevention. The talk will outline our stepwise development of a machine-learning program for a pediatric injury monitoring system and lessons learnt. In this feasibility study we draw on electronic case histories of children treated for injuries between 2018 and 2022 at the University Children’s Hospital Zürich emergency department (N= to 30’884). The ML- approach follows different steps: step 1. utility evaluation of electronic pediatric patient records regarding ML and injury monitoring and prevention requirements in a test-sample of 100 electronic pediatric case histories; step 2. choice/adaptation of coding tree; step 3. coder training and inter-coder reliability testing; step 4. manual annotation of a sub-sample (n 1000) of the electronic pediatric patient records, step 5. design and testing of the ML program in an iterative process, and step 6. performance testing in a random sample of pediatric patient records. First lessons learnt indicate that electronic case history data contain relevant data and fulfill requirements for monitoring and prevention purposes. The IDB coding system proved too complex and detailed for the pediatric data base, providing too few examples for the ML-learning process, and needed to be adapted. Initial data analyses indicate the majority of cases are classified as less severe (73%) and only few (<1%) as very severe but the later provide the most detailed data. ML is a promising approach and makes use of hospital data for a national monitoring of pediatric injuries in Switzerland.

The Use of Fuzzy Vault Technology to Find Out Fingerprint Differences

Fuzzy vault technology is different from biometric security and information recovery. In this article, we explore the utilization of fuzzy vaults in healthcare, because we can acquire crucial information like the vital signs of a person and the specific details of their fingerprint, even when there is limited information about the individual. We discuss both the conceptualized ideas that serve as the foundation for fuzzy vaults, as well as the practical application of these ideas to secure biological templates via biometric means. Our research involves both computer-simulated and actual case history data. Through this, we attempt to balance between preserving biometric privacy while still achieving a degree of identificable physiological variation. In our presentation, we demonstrate a hybrid of tabular data alongside visual illustrations that illustrate the association between different parameters regarding accuracy and the degree of difficulty associated with information recovery via fuzzy vaults. Let's consider the benefits and drawbacks of our options- elements like strength in security, precision, or the potential for application in limited spaces. To conclude this discussion without a definitive conclusion, but by pointing out what additional investigations should be conducted regarding the subject; likely medical advances caused by the adoption of new methods in medical settings should be noted.

Acute kidney injury and point-of-care ultrasound in liver cirrhosis: redefining hepatorenal syndrome.

Acute kidney injury (AKI) in patients with cirrhosis is a diagnostic challenge due to multiple and sometimes overlapping possible etiologies. Many times, diagnosis cannot be made based on case history, physical examination or laboratory data, especially when the nephrologist is faced with AKI with a hemodynamic basis, such as hepatorenal syndrome. In addition, the guidelines still include generalized recommendations regarding withdrawal of diuretics and plasma volume expansion with albumin for 48 h, which may be ineffective and counterproductive and may have iatrogenic effects, such as fluid overload and acute cardiogenic pulmonary edema. For this reason, the use of new tools, such as hemodynamic point-of-care ultrasound (PoCUS), allows us to phenotype volume status more accurately and ultimately guide medical treatment in a noninvasive, rapid and individualized manner.

Insights from the Compilation and Critical Assessment of Breach and Runout Characteristics from Historical Tailings Dam Failures: Implications for Numerical Modelling

Numerical models are used for detailed and site-specific tailings dam breach analyses (TDBAs) to estimate the downstream inundation and deposition resulting from a potential breach at a tailings dam. The results of TDBAs are key inputs into risk assessments, consequence classification, and emergency planning. This paper describes the research and development of a database of 12 tailings dam breach events with a specific focus on observations that are needed for numerical modelling, in conjunction with an assessment of existing dam breach conventions to improve consistency in reporting. The characteristics relevant to modelling include outflow volumes, breach processes, breach geometries, and runout observations local to the downstream area. This study and the new database shed light on the diversity of outflow materials, facility arrangements, breach processes, and downstream environments that affect the breach development and tailings runout. Familiarity with case studies is a crucial element of expert judgement for forward-analysis TDBAs, which this database supports. The database can also be used to define model inputs for back-analysis of additional tailings dam breach events, and simultaneously provides calibration or validation constraints with the runout observations. Continued review and critical assessments are needed to reduce uncertainties and to enhance case history data availability and quality in this database.

Test case generation and history data analysis during optimization in regression testing: An NLP study

Test case generation and history data analysis during optimization in regression testing: An NLP study

Select liquefaction case histories from the 2001 Nisqually, Washington, earthquake: A digital data set and assessment of model performance

While soil liquefaction is common in earthquakes, the case-history data required to train and test state-of-practice prediction models remains comparatively scarce, owing to the breadth and expense of data that comprise a single case history. The 2001 Nisqually, Washington, earthquake, for example, occurred in a metropolitan region and induced damaging liquefaction in the urban cores of Seattle and Olympia, yet case-history data have not previously been published. Accordingly, this article compiles 24 cone-penetration-test (CPT) case histories from free-field locations. The many methods used to obtain and process the data are detailed herein, as is the structure of the digital data set. The case histories are then analyzed by 18 existing liquefaction response models to determine whether any is better, and to compare model performance in Nisqually against global observations. While differences are measured, both between models and against prior global case histories, these differences are often statistically insignificant considering finite-sample uncertainty. This alludes to the general inappropriateness of championing models based on individual earthquakes or otherwise small data sets, and to the ongoing needs for additional case-history data and more rigorous adherence to best practices in model training and testing.

A New Zealand regional work-related sprains and strains surveillance, management and prevention programme: study protocol

BackgroundThe impact and costs associated with work-related sprains and strains in New Zealand and globally are substantial and a major occupational and public health burden. In New Zealand around one-third of all sprains and strains workers compensation (ACC) claims (2019) are for back injuries, but shoulder and arm injuries are increasing at a faster rate than other sprain and strain injuries (ACC, 2020). A need exists for a change to current approaches to sprains and strains prevention, to more effectively manage this significant and persistent problem in workplaces. Designing out hazards is one of the most effective means of preventing occupational injuries and illnesses. This paper outlines the study protocol of the surveillance, management and prevention programme and describes the utilisation of prevention through design principles in the prevention of work-related sprains and strains in agriculture/horticulture/food production in the Hawkes Bay region of New Zealand.MethodsThis is a prospective mixed methods study incorporating the collection of quantitative data to describe the epidemiology of work related sprains and strains injuries presenting to the regional health centre (Hastings Health Centre) over a period of 24 months and qualitative data from participants presenting at the health centre to identify high risk industry sectors/ occupations/ workplaces and tasks and design, develop and apply prevention through design principles/ solutions/interventions to critical features of the work and work environment and undertake an outcome evaluation during the last 6 months of the project.DiscussionThe purpose of this project is to establish an epidemiological surveillance programme to assess the incidence and prevalence of work-related sprains and strains according to age, sex, industry sector and occupation to target efforts to prevent work-related sprains and strains, by applying prevention through design (PtD) principles in selected workplaces in agriculture. The collection of more detailed case, occupational and work history data from a sample of patients presenting at the HHC clinic will identify high risk industry sectors/occupations/workplaces and tasks. Assessment techniques will include comprehensive design, design thinking and human factors/ergonomics methodologies through co-design and participatory ergonomics techniques. The PtD solutions/ interventions implemented will be evaluated using a quasi-experimental design consisting of a pre-test/ post-test with-in subjects design with control groups that do not receive the intervention.

The value of case history and early treatment data as predictors of enuresis alarm therapy response

Two central problems with the enuresis alarm are the family workload and the lack of predictors of therapy response. We wanted to look at predictors of alarm response in a setting reflecting clinical reality. An alarm linked to a smartphone app was provided to enuretic children managed at pediatric outpatient wards. Baseline data (sex, age, daytime incontinence, urgency, previous therapies, arousal thresholds and baseline enuresis frequency) were recorded. Further information, such as enuretic episodes and actual alarm use, was gathered via the app during therapy. Therapy was given for 8-12 weeks or until 14 consecutive dry nights had been achieved. For the 196 recruited children the outcome was as follows: full responders (FR) 18.4%, partial responders (PR) 20.4%, nonresponders (NR) 22.4% and dropouts 38.8%. We found no clear predictors of response or adherence among baseline data. But as treatment progressed responders reduced their enuresis frequency as compared to NR (week two P=0.003, week three and onwards P<0.001). This is further illustrated in the Figurebelow. Furthermore, the children unable to complete the full treatment had more non-registered nights already from the second week (week two P=0.005, week three P=0.002 and so on). Anamnestic data give little predictive information regarding enuresis alarm response or adherence. Contrary to common belief neither daytime incontinence nor previous alarm attempts influenced treatment success. But after 2-4 weeks of therapy the children with a good chance of treatment success could be discerned by decreasing enuresis frequency, and the families that would not be able to comply with the full treatment showed incomplete adherence already during the first weeks. Maybe the enuresis alarm strategy should be changed so that the treatment is reassessed after one month and only children with a high chance of success continue. This way, unnecessary frustration for the families of therapy-resistant children may be reduced.

Radiological Semiotics of Different Types of Nontuberculous Pulmonary Mycobacterioses

Objective: to determine, evaluate, and describe different radiological patterns of microbiologically identified nontuberculous pulmonary mycobacterioses (NTPM) based on multislice computed tomography data. Material and methods. The study included 102 patients with radiological signs of lung disease and different types of NTPM. Slowly growing types of NTPM were detected in 62 (60.8 %) patients, and rapidly growing NTPM – in 40 (39.2 %). The diagnosis was established considering a patient’s complaints, a specified case history, radiological and clinical laboratory data including microscopic studies of sputum from 63 (61.8 %) patients, bronchoalveolar lavage and different types of bronchial biopsies data from 19 (18.6 %) patients, samples of lung video-assisted thoracoscopic surgery from 17 (16.7%) patients, pleural fluid samples from 2 (1.9 %) patients, and oropharyngeal wash samples from 1 (1 %) patient. We used the Somatom Emotion 16 multislice computed tomograph (Siemens) and the high-resolution algorithm (HRCT) with 0.8 mm slice thickness and 1.5 mm slice increment. Results. The HRCT data were highly polymorphic and showed interstitial focal changes, different calibre bronchiectasis, conglomerates or cavities, involvements of vessels or pleural layers. In some patients, changes in the axial interstitium were accompanied by single small focal consolidations located either discretely or in small groups. Peribronchovascular spread of dissemination foci in NTPM was detected by HRCT as irregular infiltration of the axial interstitium (vasculitis type). Changes in the bronchial tree in NTPM were characterized by bronchiolitis symptoms (extensive thickening of bronchial walls, bronchioles) with development of the tree-in-bud sign predominantly in the subpleural lung regions. In some cases, bronchiectatic changes formed conglomerate consolidations of sublobular or lobular extent. Changes of the bronchial tree were detected by HRCT predominantly as signs of deforming bronchitis, cylindrical, varicose, or cystic bronchiectasis, either restricted or spread. Changes might be accompanied by single multi-dimensional cystic bronchiectatic cavities. Conclusion. Typical HRCT signs of NTPM are endobronchial and peribronchovascular spread of foci, development of multi-dimensional conglomerates, deforming bronchitis, bronchiectasis, and presence of single multi-dimensional cystic bronchiectatic cavities.

Analytical Method for Capped Pile–Soil Interaction considering the Load Action of Soil under the Pile Cap

To study the pile–soil interaction mechanism of capped pile, an analytical method considering the load action of soil under the pile cap is proposed. The shearing displacement method is used to derive the lateral friction of pile body under the pile top load, and the Boussinesq solutions is used to derive the lateral friction of pile body considering the load of soil under the cap. The theoretical expressions of axial force and load-settlement curves are also achieved by means of establishing and solving the equilibrium differential equation of the pile body. Comparison of calculation results with the ordinary pile indicates that soil load under the pile cap reduces the lateral friction value; the influenced depth is about four times of the load action radius. The axial force and the load-settlement curve data are verified by a case history data. The results show that the computed data agree well with the measured data. The proposed method can direct the design of capped pile composite foundations.

Hemodynamic, Surgical and Oncological Outcomes of 40 Distal Pancreatectomies with Celiac and Left Gastric Arteries Resection (DP CAR) without Arterial Reconstructions and Preoperative Embolization.

Simple SummaryDistal pancreatectomy with the celiac artery resection (DPCAR) is an oncologically justified procedure for locally advanced pancreatic ductal adenocarcinoma (PDAC). The results of its use in our selective group of 40 consecutive patients demonstrated a high rate of R0-resections, acceptable morbidity, and survival better than that for resectable PDAC. The unsolved problems of this procedure are the liver and stomach ischemic complications, which can be lethal or lead to prolonged hospital stay and deterioration in survival. The existing clinical data do not explain the mechanisms of these specific complications in sufficient detail and can’t be used for their prognosis and prevention. We have studied the correlation of clinical data and hemodynamic changes of the collateral arteries in a series of technically homogeneous procedures. The geometrical changes of the pancreatoduodenal arcade elements after DPCAR could explain the causes of ischemic complications after surgery and determine the directions for their prevention.DPCAR’s short- and long-term outcomes are highly diverse, while the causes and prevention of ischemic complications are unclear. To assess oncological, surgical, and hemodynamic outcomes of 40 consecutive DPCARs for pancreatic (n37) and gastric tumors (n3) (2009–2021), retrospective analyses of mortality, morbidity, survival, and hemodynamic consequences after DPCAR were undertaken using case history data, IOUS, and pre- and postoperative CT measurements. In postoperative complications (42.5%), the pancreatic fistula was the most frequent event (27%), 90-day mortality was 7.5. With 27 months median follow-up, median overall (OS) and progression-free survival (PFS) for PDAC were 29 and 18 months, respectively; with 1-, 3-, and 5-years, the OS were 90, 60, and 28%, with an R0-resection rate of 92.5%. Liver and gastric ischemia developed in 0 and 5 (12.5%) cases. Comparison of clinical and vascular geometry data revealed fast adaptation of collateral circulation, insignificant changes in proper hepatic artery diameter, and high risk of ischemic gastropathy if the preoperative diameter of pancreaticoduodenal artery was <2 mm. DP CAR can be performed with acceptable morbidity and survival. OS and RFS in this super-selective cohort were compared to those for resectable cancer. The changes in the postoperative arterial geometry could explain the causes of ischemic complications and determine directions for their prevention.

FACTORS AFFECTING MECHANISMS OF INCREASED BONE DENSITY FORMATION IN CHILDREN LIVING ON RADIOLOGICALLY CONTAMINATED TERRITORIES AFTER THE ChNPP ACCIDENT.

to determine the causes of increased bone mineral density (BMD) based on case history, clinical and laboratory data, including the assay of hormones involved in ossification processes in children, living on radiologically contaminated territories (RCT) after the accident at the ChNPP, compared to the normative BMD patterns. There were 289 children involved in the study. The 1st group included persons with a BMD above 100 IU, 2nd group - with normative BMD (100-85 IU). Family history of diseases was assessed featuring cancer and endocrine diseases, cholelithiasis, and urolithiasis. Weight of the child at birth, frequency of bone fractures, complaints about osalgia, jaw abnormalities, dental caries, presence or absence of obesity, peripheral blood count, blood biochemical parameters (total protein, creatinine, iron, alkaline phosphatase, calcium), serum pituitary thyroid-stimulating hormone and cortisol were accounted. Children's radiation doses were calculated according to the materials of the «General dosimetric certification of settlements of Ukraine that were exposed to radioactive contamination after the Chornobyl accident». Higher than normative BMD values were found in children after puberty, while normative ones - in puberty (р < 0.001), regardless of gender. A direct correlation between the bone fractures frequency was established in children with increased BMD (р < 0.01). Jaw anomalies and dental caries occurred at that significantly less often than in normative BMD (р > 0.05). A direct correlation was established between the obesity and BMD (р < 0.001).Increased alkaline phosphatase activity was inversely correlated with BMD (rs = -0.21; р < 0.05). In children with elevated BMD a direct correlation was established between the level of iron and endocrine disorders in the family history (р > 0.001). Serum level of cortisol was directly correlated with dental caries (р < 0.05). In children, regardless of BMD value, a direct correlation was established between the radiation dose, age and obesity (р < 0.001). Higher than normative BMD is accompanied by an increased frequency of bone fractures, jaw abnormalities, metabolic changes in bone tissue and bone tissue hormonal regulation in children, which requires application of pathogenetic therapy for the osteogenesis.

Evaluating the risk of psilocybin for the treatment of bipolar depression: A review of the research literature and published case studies

• Despite psilocybin's apparent effectiveness in depression, people with bipolar have been excluded from all modern trials. • Epidemiological data and religious ceremony data do not provide strong evidence for excluding people with bipolar disorder from carefully designed clinical trials. • In a systematic review of the case study literature of individuals using psychedelics we found 17 cases of an adverse event possibly involving mania, five involving psilocybin, and two cases involved individuals with a likely pre-existing diagnosis of bipolar disorder. • Thus there is some reason for caution in the use of psilocybin as a treatment, but the risks may be low relative to the treatment needs of this population. Growing evidence suggests that psilocybin, the active ingredient in hallucinogenic mushrooms, can rapidly and durably improve symptoms of depression, leading to recent breakthrough status designation by the FDA and legalization for mental health treatment in some jurisdictions. Depression in bipolar disorder is associated with significant morbidity and has few effective treatments. However, there is little available scientific data on the risk of psilocybin use in people with bipolar disorder. Individuals with bipolar disorder have been excluded from modern clinical trials, out of understandable concerns of activating mania or worsening the illness course. As psilocybin becomes more available, people with these disorders will likely seek psilocybin treatment for depression and have likely already been doing so in unregulated settings. Our goal here is to summarize the known risks of psilocybin use (and similar substances) in bipolar disorder and to systematically evaluate examples of published case history data, in order to critically evaluate the relative risk of psilocybin as a treatment for bipolar depression. We found 17 cases suggesting that there is potential risk for activating a manic episode, thereby warranting caution. Nonetheless, the relative lack of systematic data or common case examples indicating risk appears to show that a cautious trial, using modern trial methods focusing on appropriate ‘set’ and ‘setting’, targeted at those lowest at risk for mania in the bipolar spectrum (e.g., bipolar 2 disorder), is very much needed, especially given the degree to which depression impacts this population.

Effect of Densification on the Random Field Model Parameters of Liquefiable Soil and their Use in Estimating Spatially-Distributed Liquefaction-Induced Settlement

Densification-type ground improvement has gained wide acceptance as an effective technique to improve the static and cyclic strength and seismic performance of liquefiable soils. However, there has been little attempt to quantify the degree of change in certain measures of soil spatial variability following densification. This study uses the random field model (RFM) framework to quantify changes in the trend, inherent variability, and the autocorrelation of soil following various densification-based ground improvement methods using case history data. Ground improvement technologies investigated include driven displacement piles, vibro-replacement (i.e., stone columns), and deep dynamic compaction. Vertical RFM parameters are shown to change significantly following densification, with reductions in the coefficient of inherent variability, and increases in the scale of fluctuation, the latter of which appears related to the initial relative density. One case history is used to illustrate the utility of the RFM framework to link spatial variability of the post-shaking settlements to the results of a geostatistical model of the subsurface, including the three-dimensional distribution of CPT measurements and fines content. It is shown that the spatial distribution of differential surface settlements is correlated to those spatially-varying subsurface characteristics that are known to lead to larger liquefaction-induced settlement. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:Times New Roman,serif;}

What Can We Learn About Therapeutic Change From Case History Data? The Research Jury Method with the Couple Case of "Carl" and "Sandra"

The purpose of this study was to explore the usefulness of using case history data to assess change in psychotherapy. This was a follow up to previous investigations utilizing a "research jury method" to evaluate psychotherapy outcome. Three judges studied the critical first five sessions of a ten session video of emotionally focused therapy with a couple, Carl and Sandra. They took intensive notes and then functioned as a "jury"” to evaluate the evidence. They concluded that the evidence from within the case history is strong that the couple changed for the better. The evidence also supported the conclusion that therapy contributed to the change, although, by their judgment, at the "preponderance of evidence" level. Finally, the evidence was used to evaluate how therapy contributed to change. It was concluded that the most likely factors contributed by the therapist were her helping the couple see that each other’s underlying intentions were positive, and by fostering their hope. Evidence also supported the contributions the clients themselves made through their taking responsibility for themselves, through their exploring their past experiences, and through their creativity. Limitations are discussed and conclusions for the evaluation of psychotherapy are drawn.

Empirical Probability Distribution Models for Soil-Layer Thicknesses of Liquefiable Ground

Probability distribution models (PDMs) of variables are cornerstones in the performance-based earthquake engineering framework. For liquefiable ground in earthquake-prone regions, the liquefiable layer often is sandwiched between nonliquefiable layers. However, PDMs for thicknesses of these soil layers, particularly the nonliquefiable crust and the liquefiable layer, are not yet well established. To fill this gap, this study leveraged field case history data from different regions to develop empirical PDMs for the soil-layer thicknesses of liquefiable ground. Seventeen probability density functions (PDFs) were examined to identify the appropriate ones that well characterize the thickness uncertainties. It was found that the lognormal PDF is an appropriate choice for either thickness variable at either region of interest. Means and standard deviations of the established PDMs for different regions, such as China, Japan, New Zealand, and the US, were tabulated for the expedience of implementation.

CPT-based liquefaction case histories compiled from three earthquakes in Canterbury, New Zealand

Earthquakes occurring over the past decade in the Canterbury region of New Zealand have resulted in liquefaction case-history data of unprecedented quantity. This provides the profession with a unique opportunity to advance the prediction of liquefaction occurrence and consequences. Toward that end, this article presents a curated dataset containing ∼15,000 cone-penetration-test-based liquefaction case histories compiled from three earthquakes in Canterbury. The compiled, post-processed data are presented in a dense array structure, allowing researchers to easily access and analyze a wealth of information pertinent to free-field liquefaction response (i.e. triggering and surface manifestation). Research opportunities using these data include, but are not limited to, the training or testing of new and existing liquefaction-prediction models. The many methods used to obtain and process the case-history data are detailed herein, as is the structure of the compiled digital file. Finally, recommendations for analyzing the data are outlined, including nuances and limitations that users should carefully consider.

Hearing in individuals enrolled for drug-resistant tuberculosis treatment: a retrospective study from a South Indian city

Purpose Some of the anti-tuberculosis (TB) drugs used for drug-resistant tuberculosis (DR-TB) are ototoxic and can result in hearing loss with extended use. Hearing loss can be present in individuals with DR-TB even before the initiation of anti-TB treatment. Not all studies investigating the adverse drug reactions of DR-TB treatment performed standard audiometric tests on their participants. Thus, the pre-treatment hearing status of individuals with DR-TB is less documented. We aimed to retrospectively profile hearing status in individuals diagnosed with DR-TB before initiation of anti-TB medication. Method Retrospective analysis of pre-treatment audiological reports from 110 individuals (81 males) aged between 18 and 82 years diagnosed with DR-TB from August 2017 to August 2018 who reported to a tertiary care hospital in Mangaluru, Karnataka, a South Indian city was done. Case history and pure tone audiometry data were available for all individuals. Descriptive statistics for each parameter were considered and the Chi-square test of independence was performed between selected variables to check for any association between variables. Results Only 29.09% (n = 32) of the individuals reported ear and hearing-related complaints. Pre-treatment for DR-TB, 88 individuals (80%) had some degree of hearing loss in at least one ear. Mild degree (60.4%) and sensorineural type (55.68%) of hearing loss were most frequently observed. Greater hearing loss was noted at high frequencies than at low frequencies. A significant association between age and prevalence of hearing loss was found [χ 2(2, N = 110)=10.28, p < .05]. There was no significant association between age and degree of hearing loss [χ 2(8, N = 87)=4.46, p > .05] as well as age and the type of hearing loss [χ 2(4, N = 87)=4.29, p > .05]. Conclusion High prevalence of hearing loss in individuals with DR-TB before initiation of anti-TB treatment was observed. However, very few individuals reported reduced hearing during case history. We emphasise performing standard audiometric tests as recommended by the World Health Organisation (WHO) to monitor the effects of ototoxicity in individuals undergoing treatment for DR-TB rather than depending on self-reported measures of change in hearing or clinician determined need for hearing tests.

COVID-19 Associated Mucormycosis(CAM) in a Tertiary Care Hospital inBangalore: A Case-Series Report

Background While the country is still grappling with the COVID-19 pandemic it finds itself in yet another crisis of COVID-19 Associated Mucormycosis CAM. India being the second largest populated country with diabetes mellitus has the highest cases of mucormycosis in the world.Objective This study was undertaken to help find more specific causes for increased number of mucormycosis cases in the second wave when compared to the first wave. Methodology The present study was conducted among active mucormycosis patients admitted in Victoria hospital from 24th May to 4th June 2021. A detailed case history data collection tool was prepared. Information was collected about their demographic profile symptoms COVID-19 treatment details comorbidities risk factors investigations and treatment details in their understandable language. A total of 63 subjects were interviewed and the process involved collecting information from the subjects and their attenders assessing case files and interaction with treating doctors. Later the data was exported into MS office excel and analyzed with IBM SPSS V20.0.Results Mean age of the subjects was 49.4 years 23 years - 76 years. Diabetes mellitus 5688.8 was the dominant predisposing factor 49 77.7 had poor glycemic control and in 23 44 patients among them hyperglycemia was diagnosed during the evaluation of mucormycosis. The main causes that appear to be aiding mucormycosis to infect the patients with COVID-19 are hyperglycemia hypoxia antibiotic and steroid use not being vaccinated for COVID-19 neutropenia deranged ferritin levels along with social factors like poor hygiene overcrowding and lower socio-economic status.Conclusion It is important to do whole genomic sequencing of SARS-COV2 virus to explore any possible causative role of it in these patients. Judicious use of steroids only when necessary and when prescribed along with strict control of blood glucose in COVID-19 patients who are known diabetics and pre-diabetics is necessary.nbsp

Site classification using equivalent soil profiles for building-liquefaction interaction

The seismic behaviour of a building on a liquefiable deposit is a complex interaction which involves quantifying both shaking induced damage and permanent ground deformation-related damage. In this paper the key parameters that influence both surface shaking and foundation settlements have been identified as the depth, thickness and liquefaction resistance of an equivalent liquefiable layer. These parameters can be used to develop an ‘equivalent soil profile’ that is analogous to the equivalent single degree-of-freedom that reduces the complexity of the dynamic response of a building into comparable and easily understood quantities. The equivalent soil profile is quantified independent of the seismic hazard, making it compatible with performance based design and assessment frameworks such that the building and soil profile can be directly assessed at different levels of seismic hazard. Several numerical studies are presented that demonstrate the influence of these key parameters on the ground surface shaking and foundation settlement. A set of criteria are proposed for classifying soil profiles into 22 different soil classes for regional loss assessment. An algorithm was developed for automatically fitting the equivalent soil profile to a cone penetration test trace and issues with the fitting are discussed. Field reconnaissance was undertaken to collect additional data to support existing datasets on the performance of buildings in Adapazari, during the 1999 Kocaeli, Turkey, earthquake (Mw = 7.4). The field case history data was used to investigate the correlation between the depth, thickness and liquefaction resistance of an equivalent liquefiable layer, on the extent of foundation permanent deformation. The case history data showed that in general a shallow, thick and weak liquefiable layer near the surface results in significant settlement but a lack of data for buildings on non-liquefiable deposits and the additional complexities involved with real buildings and soil deposits, meant that the trends observed in the idealised numerical models could not identified in the field case history data set.