Midpoint Research Articles

Analysis of association between periodontal disease and thickness of maxillary sinus mucosa using cone beam computed tomography – A retrospective study

PurposeThe aim of this study was to measure the thickness of the mucous membrane lining the maxillary sinus and to correlate this thickening of the Schneiderian membrane with the presence or absence of periodontal bone loss of adjacent teeth, by using cone beam computed tomography (CBCT). Methods255 CBCT images were analyzed of which 140 images were selected for the study. Based upon the absence of radiographic periodontal bone loss and presence of 50% or more bone loss, these CBCT images were respectively divided into two groups viz. Group I (Healthy) and Group II (Periodontal Bone Loss Group), each group consisting of 70 images each. The thickening of the mucous membrane lining of the floor of maxillary sinus was measured at four points on the CBCT. These points were the anterior most point of the thickened mucosa, the posterior most point of the thickened mucosa, at the midpoint (MP) (point midway between the anterior most and the posterior most point) and the point of maximum thickness of the sinus mucosa. ResultsThe age adjusted mean thickness for Group II was significantly greater than that of Group I (p < 0.001) at all the four points. There was a positive association between presence of periodontal bone loss and thickening of Schneiderian membrane at the floor of the sinus. There was a weak positive association between age and mucosal thickness. Of all the four points measured, the maximum correlation between age and thickness was obtained at MP (r = 0.171), which was statistically significant (p = 0.044). ConclusionThe present study concluded that there is a positive association between presence of periodontal bone loss and thickening of mucosa of floor of maxillary sinus and also exhibited a weak positive relation between age and increased mucosal thickening of floor of maxillary sinus.

Discretization error in the random finite element method for spatially variable undrained shear strength

This study decomposes the discretization error in the random finite element method into finite element and random field discretization errors. Two numerical problems are considered: a soil column and a retaining wall with spatially variable undrained shear strength. It is observed that these two errors tend to accumulate if the spatial averaging (SA) method is adopted for discretization, whereas the two errors may not accumulate if the midpoint (MP) method is adopted. Therefore, MP may outperform SA. Suggestions for mesh sizes are provided, but these suggestions may be restricted to these two numerical problems.

Correlation between stigma and glucose control among adolescents with type 1 diabetes mellitus

Objective To explore the correlation between stigma and glucose control among adolescents with type 1 diabetes mellitus (T1DM) . Methods From June 2014 to June 2016, we selected 75 adolescent patients with T1DM as subjects in Endocrinology Department of Nanyang City Center Hospital of He'nan Province and collected their general information and laboratory indexes. The Link Stigma Series Scale was used to investigate the situation of patients' stigma. Pearson correlation was used to analyze the correlation between stigma and glucose control of adolescents with T1DM. Results The average score of terms of Stigma Series Scale of adolescents with T1DM was higher than the midpoint (2.50) of scale. Pearson correlation analysis showed that the sense of disparagement-discrimination, emotional experience of stigma had positive correlations with fasting plasma glucose (FPG) , 2-hour postprandial blood glucose (2hPG) and HbA1c (P<0.05) , besides stigma had negative correlations with FPG, 2hPG and HbA1c (P<0.05) . Conclusions The stigma of adolescents with T1DM is correlated with glucose control. We should provide psychological care for patients so as to reduce their stigma and improve glucose control. Key words: Diabetes mellitus, type 1; Adolescent; Stigma; Blood glucose

Rotation tendency of the posteriorly displaced proximal segment after vertical ramus osteotomy

Intraoral Vertical Ramus Osteotomy (IVRO) is one of the operative techniques used for orthognathic surgery. The aim of this study was to assess the posterior displacement of the proximal segment in patients undergoing IVRO at 1-year follow-up.In total, 52 hemimandibles from 26 patients who underwent IVRO in whom the proximal segment was posteriorly displaced without overlap with the distal segment at immediate post-operation (Imm) (30 cases, experimental group), and 26 patients in whom the proximal segment was not posteriorly displaced with overlap with the distal segment (Imm) (22 cases, control group) under three-dimensional computed tomography (3D CT) were included in the study. To analyze the movement of segments, the positions of the mid condyle point (MCP) and angle of condyle line (Con) were determined and the movement of the ramus angle (posterior edge of proximal segments) was measured at the proximal segment.Regression of the proximal segment in sagittal direction of the MCP was observed in both groups and all directions of the ramus angle in the experimental group, and only sagittal direction in the control group.In conclusion, posterior displacement of the proximal segment after IVRO showed tendency to regress its original position.

Analysis of Bridge Currents and UMP of an Induction Machine With Bridge Configured Winding Using Coupled Field and Circuit Modeling

Unbalanced magnetic pull (UMP) reduction is an important aspect of high-speed electrical machines and it can be reduced using a specialized winding scheme called bridge configured winding. A bridge configuration winding has two parallel paths in each phase. The mid points of these two parallel paths can be short-circuited to achieve passive control of the UMP or a power supply can be added in between these points to achieve active control of UMP. Moreover, it is important to understand the behavior of UMP in different eccentricity conditions for its active suppression. A finite-element modeling of a bridge configured induction machine has been developed to study the effects of different eccentricity conditions on UMP and bridge currents. A generalized circuit equation has been coupled with the field equation for the implementation of bridge configuration winding. All of the three kinds of eccentricity conditions have been simulated. In addition, two experimental setups have been developed to study the UMP-induced vibration and to study the effect of eccentricity on bridge currents.

The surgical outcomes of early transection at mid point of choledochal cyst during excision of choledochal cyst

The surgical outcomes of early transection at mid point of choledochal cyst during excision of choledochal cyst

Abstract 315: Time-resolved Expression of Membrane-targeted Proteins During Ipsc-cardiomyocyte Differentiation

Background: The ability to create human cardiomyocytes from induced pluripotent stem cells (iPSCs) has spurred advances in disease modeling and drug testing, but there remains an ongoing need to improve the purity and functional maturity of derived cardiomyocytes. Membrane proteins are an integral component of cell signaling and specification. To better understand iPSC-cardiomyocyte differentiation and identify potential surface markers of cell maturity, we set out to examine how membrane-targeted proteins gradually remodel in differentiating cardiomyocytes. Methods: Human iPSCs from three donors were differentiated into cardiomyocytes in 40 independent differentiation plates. We sampled protein expression at independent time points at up to daily intervals during day 0 to day 14 post-differentiation, then sparsely up to 100 days. The extracted proteins were analyzed using a Q-Exactive HF Orbitrap high-resolution mass spectrometer to quantify how the relative quantity of membrane-targeted proteins changes over time in differentiating cells. Results: We identified 1095 annotated cell membrane proteins and quantified their temporal changes in abundance across 40 samples. Protein expression in the first two principal components recapitulated gradual differentiation of iPSCs into mesoderm, cardiac progenitors, and more mature cardiomyocytes. Membrane protein expression partitioned the samples into three discernible clusters, representing early (day 0-5), mid (day 6-10), and late (day 11+) differentiation time points. In total, 115 cell membrane proteins showed differential expression in late vs. early differentiation, including two popeye-domain-containing proteins (POPDC2 and BVES) known to be involved in cardiac development. In particular, we identified two proteins, dysferlin (DYSF) and alpha-1 syntrophin (SNTA1), which continued to show strong upward changes in late differentiation time points, nominating these proteins for investigation as markers for mature cells. Conclusion: We report the time-resolved expression profiles of over 1000 membrane-targeted proteins during iPSC-cardiomyocyte differentiation. Future work into the membrane proteome may lead to maturity markers to guide maturation efforts.

Friday, September 28, 2018 1:00 PM–2:30 PM abstracts: achieving lumbar interbody fusion: 198. The changes of volume of psoas muscle after oblique lateral interbody fusion L4-5 for treatment of degenerative lumbar disease: the observation of the effect on atrophic changes and correlation with clinical outcomes

BACKGROUND CONTEXT Recently, minimally invasive lateral lumbar interbody fusion has gradually increased popularity as substituted method of conventional lumbar fusion.There are two methods of DLIF (direct lateral lumbar interbody fusion) and OLIF (oblique lateral interbody fusion) in lateral lumbar interbody fusion. PURPOSE In MIS-DLIF, blunt retroperitoneal and trans-psoas dissection poses a risk of injury to the psoas muscle and lumbar plexus, especially at lower lumbar level.As an alternative, MIS-OLIF uses a window between the prevertebral venous structures and psoas muscle, and gets an access to the target disc obliquely. Theoretically, MIS-OLIF preserves psoas muscle with reducing the complication of direct lateral approach. However, in most case, some psoas muscle violation cannot be avoided during the OLIF. So, the purpose of this study was to evaluate the changes of psoas muscle volume after OLIFand also to analysis whether there is a correlation between the change of psoas volume and clinical outcomes STUDY DESIGN/SETTING The study was approved by the Institutional Review Board (IRB) of our institution. Medical and radiological charts of 30 consecutive patients who underwent MIS-OLIF for various L4/L5 level pathologies and whose follow-up time exceeded 12 months (mean follow-up time 14.4 months, between July 2013 and May 2016) by a single surgeon were reviewed. PATIENT SAMPLE A total of 30 patients were included in this study. A total of 22 patients were female (73.3%). The mean age was 65.4 years, with a range from 52 to 83 years. The average follow up period among all patients was 14.4±7.2 months (range, 6.0–34.0 months). OUTCOME MEASURES Whole lumbar lordotic angles were significantly (P METHODS The clinical outcomes were assessed before surgery and postoperatively at 6 months, 1 year and 2 years by using visual analog pain scale (VAS), Oswestry disability index (ODI) score, and total time of daily walk. Radiologic outcomes were assessed with plain radiography, computed tomography (CT) and magnetic resonance imaging (MRI). We checked the radiologic datas before surgery and postoperatively at 6 months, 1 year and 2 years. Whole and segmental Lumbar lordosis, disk and foraminal height at index level were measured by using plain radiography.We used Modified Bridwell fusion criteria to define fusion rate.Both size of psoas muscles were measured with cross sectional area by axial slice of CT scan at mid point of L4/5 disc.We recorded cage subsidence postoperatively at 1 year and 2 years. RESULTS Mean age of the patients included in this study was 65.4±8.0 (52–83, Sex M: 8, F: 22) and preoperative diagnoses were Spinal stenosis/DDD in 14 patients (47%), Spondylolisthesis in 14 patients (47%) and HNP in two patients (6%). single level OLIF (L4–5) was performed in 23 patients (77%) and more than two levels OLIF (include L4–5) was performed in seven patients (23%). There was statistically significant improvement of clinical outcomes. (VAS (back, leg), ODI, walking time for 1 day, all of them p CONCLUSIONS MIS-OLIF is a relatively safe procedure without definite atrophic change or reduction of volume of psoas muscle at the first follow after surgery and overall the volume of the psoas muscle at L4-5 significantly increased postoperatively, especially in the group with good clinical outcomes.

Patellar Tendon Thickness and Failure After Anterior Cruciate Ligament Reconstructions with Bone-Patella Tendon-Bone Autograft

Objectives:The purpose of this study was to determine if patellar tendon (PT) thickness measured on pre-operative magnetic resonance imaging (MRI) is a risk factor for failure after anterior cruciate ligament reconstruction (ACLR) using bone-patella tendon-bone (BTB) autograft.Methods:18 patients [age (mean 96 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 5.4 pt 0in 5.4 pt; mso-para-margin:0in; mso-para-margin-bottom:.0001 pt; mso-pagination: widow-orphan; font-size:11.0 pt; mso-bidi-font-size:12.0 pt; font-family: Helvetica;} ± standard deviation) 21.5 ± 4.99years] that underwent an ACLR with BTB autograft and returned for revision ACLR between July 2005-January 2017 at our institution were included in the study. Failures were age-, sex-, height-, and weight-matched to 36 control (age 21.5 ± 4.99years) BTB-ACLR patients that have not required revision at a minimum of 2-years follow-up. Demographic data and mechanism of injury were recorded from patients’ medical records. PT thickness was measured at 3 points (5 mm lateral to the center, center, and 5 mm medial to the center) each at the level of the inferior pole of the patella (IPP), midpoint (MP), and insertion to tibial tubercle (ITT) on pre-operative axial-cut MRI.Results:All ACLR failures occurred after a non-contact pivot-shift type injury. Mean time between primary ACLR and revision was 2.4 ± 2.4 years and mean follow-up time was 3.1 ± 0.9 years in the control group. Patients with a failed ACLR had significantly thicker PTs at the IPP (lateral: 4.66 ± 1.47 vs 3.96 ± 0.66 mm; central: 5.39 ± 1.49 vs 4.51 ± 1.04 mm; medial: 5.51 ± 1.52 vs 4.59 ± 1.05 mm) and MP (lateral: 4.50 ± 0.83 vs 4.12 ± 0.54 mm; central: 4.83 ± 0.80 vs 4.43 ± 0.59 mm; medial: 4.57 ± 0.88 vs 4.13 ± 0.59 mm). There were no significant differences in PT thickness at the ITT. PT width tended to be larger in the failure cohort but this was not statistically significant (IPP: 32.2 ± 4.6 vs 29.8 ± 4.3 mm; MP: 31.3 ± 4.9 vs 29.5 ± 3.8 mm; ITT: 27.7 ± 3.7 vs 26.2 ± 2.9 mm).Conclusion:Contrary to conventional wisdom, we found that BTB autograft ACLR failures had significantly thicker patellar tendons at the inferior pole of the patella and midpoint. Further studies are need to investigate possible causes for this inverse correlation, such as poor histological tendon quality or mechanical impingement due to increased tendon size.

Hermite-Hadamard type inequalities pertaining conformable fractional integrals and their applications

In this paper, our main aim is to give results for conformable fractional integral version of Hermite-Hadamard inequality and their applications for mid-point formula and means. First, we prove an identity associated with the Hermite-Hadamard inequality for conformable fractional integrals. By using this identity and convexity of different classes of functions and some well-known inequalities, we obtain several results for the inequality. At the end, we also present applications for some error estimations of the mid-point formula and means. The results obtained in this paper generalize the earlier results. Furthermore, the identity can be used to obtain results for Hermite-Hadamard inequality for some other generalized classes of convex functions.

On the numerical solution of high order multi-dimensional elliptic PDEs

Using the idea of differential quadrature, two new methods are constructed to approximate the solution of elliptic partial differential equations in higher dimensions. To obtain the weighting coefficients of the first method, a mixture of grid points and mid points of the uniform partition is used. The order of convergence obtained by the first algorithm is non-optimal, so we mixed the idea with spline collocation to obtain higher order approximations. Using the weighting coefficients of the non-optimal algorithm, some new weighting coefficients are obtained which are used to obtain higher accuracy. For the first time, a sixth order approximation is obtained to the solution of well-known high order multi-dimensional elliptic PDEs such as biharmonic and triharmonic problems. We found a way to increase the order of convergence and the accuracy without increasing the CPU runtime. The block form of the coefficients matrix for the linear case is presented to have a better vision on the system arised from the method. Some examples of biharmonic and triharmonic problems are solved to show the good performance and applicability of the proposed algorithms.

Skurczowe przemieszczenie pierścienia mitralnego — nowa technika szybkiej oceny globalnej funkcji skurczowej lewej komory oparta na algorytmie śledzenia markerów akustycznych

Wstep. Tkankowe przemieszczenie pierścienia mitralnego (TMAD) jest nową techniką szybkiej oceny funkcji skurczowej mieśnia lewej komory opartą na śledzeniu markerow akustycznych. Pozwala ona na ocene przemieszczenia pierścienia mitralnego w stosunku do koniuszka w typowych projekcjach koniuszkowych (cztero- i dwujamowej). Celem pracy bylo porownanie parametrow otrzymanych przy uzyciu TMAD z analizą trojwymiarowego (3D) pomiaru frakcji wyrzutowej lewej komory (LVEF) jako metody referencyjnej. Material i metody. Badaniem objeto 49 pacjentow (w tym 33 mezczyzn, średni wiek 65 ± 10 lat) hospitalizowanych z powodu bolow stenokardialnych, ktorych poddano przezklatkowemu badaniu echokardiograficznemu z oceną LVEF 3D podczas analizy off-line na podstawie zbiorow uzyskanych z badania. Poza tym dokonano pomiarow przemieszczenia skurczowego pierścienia mitralnego przy uzyciu algorytmu TMAD u wszystkich pacjentow. Wyniki. Ze wzgledu niewystarczającą dla funkcji śledzenia markerow akustycznych jakośc obrazu z badania wykluczono 5 pacjentow. Analiza TMAD w jednej z projekcji koniuszkowych zajela przecietnie 10 ± 4 s. Średnia wartośc LVEF wyniosla 46,0% ± 12,3%. W grupie badanych pacjentow otrzymano istotną statystycznie korelacje miedzy LVEF a przemieszczeniem środka pierścienia mitralnego w kierunku koniuszka w projekcji koniuszkowej czterojamowej (r = 0,57; p < 0,0001) oraz procentowym przemieszczeniem pierścienia w kierunku koniuszka (r = 0,63; p < 0,0001). Porownywalne wyniki otrzymano dla przemieszczenia środka pierścienia mitralnego w kierunku koniuszka w projekcji koniuszkowej dwujamowej (r = 0,6; p < 0,0001) oraz jego wartości procentowej (r = 0,65; p < 0,0001). Wnioski. Pomiar skurczowego przemieszczenia pierścienia mitralnego przy uzyciu algorytmu TMAD koreluje z referencyjnym pomiarem LVEF 3D, ale technika ta wymaga zbioru danych bardzo dobrej jakości.

Awakening Neuropsychiatric Research Into the Stria Medullaris: Development of a Diffusion-Weighted Imaging Tractography Protocol of This Key Limbic Structure.

The Stria medullaris (SM) Thalami is a discrete white matter tract that directly connects frontolimbic areas to the habenula, allowing the forebrain to influence midbrain monoaminergic output. Habenular dysfunction has been shown in various neuropsychiatric conditions. However, there exists a paucity of research into the habenula’s principal afferent tract, the SM. Diffusion-weighted tractography may provide insights into the properties of the SM in vivo, opening up investigation of this tract in conditions of monoamine dysregulation such as depression, schizophrenia, addiction and pain. We present a reliable method for reconstructing the SM using diffusion-weighted imaging, and examine the effects of age and gender on tract diffusion metrics. We also investigate reproducibility of the method through inter-rater comparisons. In consultation with neuroanatomists, a Boolean logic gate protocol was developed for use in ExploreDTI to extract the SM from constrained spherical deconvolution based whole brain tractography. Particular emphasis was placed on the reproducibility of the tract, attention to crossing white matter tract proximity and anatomical consistency of anterior and posterior boundaries. The anterior commissure, pineal gland and mid point of the thalamus were defined as anatomical fixed points used for reconstruction. Fifty subjects were scanned using High Angular Resolution Diffusion Imaging (HARDI; 61 directions, b-value 1500 mm3). Following constrained spherical deconvolution whole brain tractography, two independent raters isolated the SM. Each output was checked, examined and cleaned for extraneous streamlines inconsistent with known anatomy of the tract by the rater and a neuroanatomist. A second neuroanatomist assessed tracts for face validity. The SM was reconstructed with excellent inter-rater reliability for dimensions and diffusion metrics. Gender had no effect on the dimensions or diffusion metrics, however radial diffusivity (RD) showed a positive correlation with age. Reliable identification and quantification of diffusion metrics of the SM invites further exploration of this key habenula linked structure in neuropsychiatric disorders such as depression, anxiety, chronic pain and addiction. The accurate anatomical localization of the SM may also aid preoperative stereotactic localization of the tract for deep brain stimulation (DBS) treatment.

Thermal Responses Associated with Prolonged Cycling in Cold Temperature Cody S. Dulaney, Adam R. Jajtner, Jeremiah

PURPOSE: To assess thermal responses to exercise in cold versus moderate temperature. METHODS: Recreationally active men (n=5, 23.4 ± 2.2 yrs; 183.1 ± 6.1 cm; 86.9 ± 11.9 kg; 4.44 ± 0.75 L[BULLET OPERATOR]min-1) completed a cycling protocol in 5°C (LT) and 22°C (MOD). The protocol consisted of 60-min cycling at 60% VO2max (CT60), 15-min rest, and a time to exhaustion at 90% VO2max (TTE). Mean skin (Tsk), and core temperature (Tre) were evaluated before CT60 (BL) and at 3, 20, 40, and 60 min. Metabolic heat production (M) was assessed at BL, 3, 15, 30, 45, and 60 min. Tissue insulation (I) was assessed at 3, 30, and 60 min.Tsk, Tre and I were measured before (PRE) and after (POST) TTE. M was measured at PRE, at the mid-point (MID), and POST TTE. Changes were analyzed using within-subjects repeated measures ANOVA. RESULTS: An interaction was observed for Tsk during CT60 (F = 64.00 p < 0.001, ηp2 = 0.941). Tsk was lower in LT versus MT (p ≤ 0.001) at 3 min (25.5 ± 0.7°C, 30.7 ± 0.6°C, respectively), 20 min (23.0 ± 0.7°C, 30.4 ± 0.8°C, respectively), 40 min (22.4 ± 0.6°C, 30.4 ± 0.8°C, respectively) and 60 min (21.9 ± 1.0°C, 29.9 ± 1.3°C, respectively). No interaction (F = 5.97; p = 0.071; ηp2 = 0.599) was observed for Tre. A time effect was observed for M during the TC60 (F = 25.8, p < 0.001, ηp2 = 0.866). M increased from 3 min (348.2 ± 36.9 W·m-2) at 15 min (375.8 ± 35.6 W·m-2; p = 0.006), 30 min (383.6 ± 37.6 W·m-2; p < 0.001), 45 min (384.6 ± 35.28 W·m-2; p < 0.001) and 60 min (391.2 ± 34.0 W·m-2; p = 0.004). An interaction was observed for M during TTE (F= 29.08 p < 0.001, η2 = 0.879), with M lower during LT versus MT at PRE (113.9 ± 28.7 W·m-2; 305.2 ± 100.7 W·m-2, respectively; p = p 0.016), MID (154.3 ± 54.3; 529.8 ± 65.3 W·m-2, respectively; p < 0.001), and POST (176.3 ± 26.6; 577.5 ± 59.6 W·m-2, respectively; p < 0.001). An interaction was observed for I during TC60 (F= 18.52; p = 0.001; η2 = 0.822). I was greater in LT compared to MT at 3 min (0.034 ± 0.005°C·m-2·W-1, 0.019 ± 0.028°C·m-2·W-1, respectively; p = 0.001), 30 min (0.045 ± 0.006°C·m-2·W-1, 0.019 ± 0.019°C·m-2·W-1, respectively; p = 0.001), and 60 min (0.48 ± 0.008°C·m-2·W-1, 0.022 ± 0.001°C·m-2·W-1, respectively; p = 0.003). CONCLUSION: As expected, I increased in 5°C compared to 23°C, while M increase during submaximal exercise. However, M decreased during exhaustive exercise perhaps due to fatigue.

Endoscopic anatomic study of the middle fossa via retromastoid keyhole approach through drilled petrous ridge

Objective To observe the range of exposure, indications and feasibility of retromastoid keyhole approach through drilled petrous ridge to the middle fossa. Methods The eight adult cadareric heads in this study were provided by the anatomy laboratory of the second affiliated hospital of Soochow Univer sity. Simulated surgeries via retromastoid keyhole approach with assistance of neuroendoscope were performed on 8 adult cadaveric heads (16 sides) fixed by formalin and the maximal ranges of exposure were observed. The neuroendoscope was used to observe anatomical structures in the middle fossa and identify the limits of the Parkinson's triangle. The distances from the posterior border of junction of lateral sinus and sigmoid sinus to middle fossa and the length of all sides of Parkinson's triangle were measured. Results Identified under endoscope, the exposure range of this approach included cerebellopontine angel (CPA), ventrolateral brainstem, tentorial incisure, petroclival region and lateral wall of cavernous sinus. The exposed anatomical structures in the middle fossa included trigeminal ganglion, cavernous segment of trochlear and abducent nerve, petroclinoid segment of oculomotor nerve, posterior curve segment of internal carotid artery (ICA) in cavernous sinus, communicating segment of ICA and posterior communicating artery (PCoA). Measurement results suggested that the distances from the midpoint of posterior border of sigmoid sinus to suprameatal tubercle, trigeminal ganglion, posterior curve segment of ICA were 34.4±2.1 mm, 54.5±2.9 mm and 65.2±3.1 mm, respectively. The lengths of all sides of Parkinson’s triangle were 19.0±2.9 mm, 16.2±2.0 mm and 8.0±2.3 mm, respectively. Conclusion The retromastoid keyhole approach via drilled petrous ridge leads to feasible exposure of the middle fossa under neuroendoscope, which could be applied in operations of most lesions in the posterior fossa such as tumors and aneurysms as well as those mainly in the posterior fossa and minorly affecting the middle fossa. Key words: Mastoid; Anatomy; Neurosurgical procedures

Effect of periodontal therapy on maxillary sinus mucous membrane thickening in chronic periodontitis: A split-mouth study.

Background. This study evaluated the effect of periodontal therapy on mucous membrane thickening in maxillary sinus in chronic periodontitis patients using radiovisiography (RVG) and cone-beam computed tomography (CBCT). Methods. The study population included 30 patients diagnosed with chronic periodontitis, exhibiting bilateral mucosal thickening of maxillary sinus. The selected sites were randomly assigned to group I (control group - not receiving periodontal therapy) and group II (test group - receiving periodontal therapy). The clinical parameters and mucosal thickening of the maxillary sinus were evaluated at baseline and after 9 months. Results. There was a significant decrease in the PPD, CAL as well as mucosal thickening in group II while, group I showed an increase in these parameters. In group II at the end of 9 months the mean mucosal thickening reduction as assessed by CBCT was 0.76±0.18, 0.73±0.24, 0.88±0.42 and 1.13±0.43 mm at the most anterior point (AP), the most posterior point (PP), the mid-point (MP), point of maximum thickness (MT) as well as in the length of the thickened mucosal lining, respectively. Conclusion. The results of our study indicated a reduction in the mucosal thickening of the maxillary sinus after surgical periodontal therapy. The trial was registered with the Clinical Trial Registry of India (Trial REF/ 2016/02/010805).

STUDY OF NOISE POLLUTION DUE TO THE SOUND AMPLIFIERS:- CASE STUDY COMPARISON BETWEEN LOCAL AND MODERN MARKET IN DIWANEYAH CITY

The objective of this study is to identify the effect of the noise that result from sound amplifiers which have been used in Local markets on the healthy and psychology of population (vendors and pedestrian). Therefore, we measured the noise level in Local and Modern markets to identify the difference in noise level that create by sound amplifiers where we chose three points in each market at (North, Mid and South) and for a period of seven days and comparison the readings of noise level of both markets with the Iraqi standard. two questionnaires have been carried out in this study, the firs questionnaire is for the vendors. The second questionnaire represents the pedestrians.For a period of seven days, the average of the noise levels (Leq) in Local market for North, Mid and South points were (77.2, 80.2 and 73.4) decibel (dB) respectively while in the Modern market were (66.2, 69.1 and 64.8) dB respectively. The results of the first questionnaire showed that the vendors in Local marked are more harmful than the ones in the Modern market where most of them suffered from hear losing, annoying, boredom, mood flocculation, weakness of focus and other psychological effects but the harm ratio with hypertension was low in both markets. The results of the second questionnaire showed that the harm ratio of shoppers in Local and Modern markets with annoying equal to (92%, 17%), headache (58%, 25%), nervous(25%,25%), boredom (33%,25%), Weakness of focus (58%,42%), nausea (67%,58%), respectively. These results give an impression that the sound amplifiers were the essential reason for increasing the noise level in local markets and the noise level higher than 70 dB cause healthy and psychological effects for the vendors.

Multiplicity anomalies of an optimal fourth-order class of iterative methods for solving nonlinear equations

There is a few number of optimal fourth-order iterative methods for obtaining the multiple roots of nonlinear equations. But, in most of the earlier studies, scholars gave the flexibility in their proposed schemes only at the second step (not at the first step) in order to explore new schemes. Unlike what happens in existing methods, the main aim of this manuscript is to construct a new fourth-order optimal scheme which will give the flexibility to the researchers at both steps as well as faster convergence, smaller residual errors and asymptotic error constants. The construction of the proposed scheme is based on the mid-point formula and weight function approach. From the computational point of view, the stability of the resulting class of iterative methods is studied by means of the conjugacy maps and the analysis of strange fixed points. Their basins of attractions and parameter planes are also given to show their dynamical behavior around the multiple roots. Finally, we consider a real-life problem and a concrete variety of standard test functions for numerical experiments and relevant results are extensively treated to confirm the theoretical development.

Study on correlation of waist circumference with intra-abdominal fat area

To explore the best measurement of waist circumference related with intra-abdominal fat area evaluated by magnetic resonance imaging (MRI). Totally 207 participants aged 20-60 years were enrolled. Waist circumference were measured at the levels of navel (WC1) and the midpoint between costal brim and iliac cest (WC2). Intra-abdominal fat area was evaluated by MRI scan. Intra-abdominal fat area was significantly higher in men than in women [(132.17±59.49 vs 70.56±35.33)cm2,P<0.01]. Pearson correlation analysis showed that WC1 and WC2 were positively correlated with intra-abdominal fat area (r=0.779, r=0.809, both P<0.01). Multiple linear stepwise regression analysis demonstrated that WC1 and WC2 were independently associated with intra-abdominal fat area(β=0.553, R2=0.714, P<0.01; β=0.603, R2=0.735, P<0.01). All of the two different measurements of waist circumference parameters may reflect intra-abdominal fat area, while WC1 seems to be the simpler one. (Chin J Endocrinol Metab, 2017, 33: 745-747) Key words: Waist circumference; Intra-abdominal fat area; Magnetic resonance imaging; Intima-media thickness

Some methods of parameter estimation for stochastic differential equations

We propose three methods of parameter estimation based on discrete observation data for stochastic differential equations (SDEs). The first method is designed for linear stochastic differential equations (SDEs). For these equations we deduce distribution of certain operation of the exact solution and assume that the relevant operation of the observed data obey this distribution, from which we estimate the unknown parameters in the drift and diffusion coefficients. In the second method, we suppose that certain operation of the observation data and that of the numerical solution arising from the Euler-Maruyama scheme for the SDEs of Ito sense obey the same distribution, from which the unknown parameters can be estimated. We use the third method for SDEs of Stratonovich sense. For these equations we derive the distribution of relevant operation of the numerical solution produced by the midpoint scheme and let the same operation of the data obey this distribution to get estimation of the unknown parameters. Numerical results show validity of the proposed methods, and illustrate that the estimation error produced by the Euler-Maruyama scheme is about of order O(h0.5) while that by the midpoint scheme is about of order O(h), with h being the time step size of the numerical methods. Furthermore, the numerical results show that our methods are more accurate than the existing EM-MLE estimator.