Proper Position Research Articles

Database of 4 Million Medicinal Chemistry-Relevant Ring Systems.

Central ring systems are the most important part of bioactive molecules. They determine molecule shape, keep substituents in their proper positions, and also influence global molecular properties. In the present study, a database of 4 million medicinal chemistry-relevant ring systems has been created, not by crude random enumeration but by applying a set of rules derived by analyzing rings present in bioactive molecules. The aromatic properties and tautomer stability of generated rings have also been considered to ensure that the rings in the database are stable and chemically reasonable. 99.2% of these rings are novel and not included in molecules in the ChEMBL or PubChem databases. This large database of ring systems has been created with the goal to provide support for bioisosteric design and scaffold hopping as well as to be used in generative chemistry applications. The complete set of created rings is available for download in the SMILES format from https://peter-ertl.com/molecular/data/.

Comparison of photon energies and field techniques for ovarian dose reduction in volumetric modulated arc therapy

For fertility preservation in young female patients undergoing pelvic radiotherapy for cervical cancer, lateral ovarian transposition (LOT) is a procedure that moves the ovaries away from the radiation field. However, it is still challenging to fully protect the ovaries from radiation damage in volumetric modulated arc therapy (VMAT). In this study, we optimized VMAT techniques and simulated the effect of the LOT position on the ovarian dose. Ten cervical cancer patients who received pelvic radiotherapy after LOT were retrospectively analyzed. A restricted arc plus split field technique, which incorporated beam avoidance sectors, split field, fixed jaw, and orthogonal collimator orientation with 10 MV energy (rasf-10MV-VMAT), was designed to minimize the dose to the ovaries. This technique was compared with dual-arc conventional VMAT (dac-6MV-VMAT) and restricted arc and field VMAT (raf-6MV-VMAT) techniques with 6 MV energy. Ovarian dose, target coverage, and organs at risk (OAR) sparing were compared. The location of the ovaries in the anterior-posterior and superior-inferior directions was changed to simulate the effect of the LOT position on the ovarian dose. Compared to dac-6MV-VMAT and raf-6MV-VMAT, rasf-10MV-VMAT decreased the ovarian dose significantly more, especially for a low-dose volume. Both ovaries, received a 44.0–52.1 % lower volume of >3 Gy dose, and (0.5–1.9 Gy) lower maximum and mean doses with rasf-10MV-VMAT (p < 0.05). Rasf-10MV-VMAT also improved target conformity and coverage more than raf-6MV-VMAT (p < 0.05) and reduced the bladder mean dose more than dac-6MV-VMAT (p < 0.05). The ovarian dose decreased with the distance from the target contour, and placing the ovaries near the mid-frontal plane or as high as possible after the LOT lowered ovarian exposure. This technique, using 10 MV photon energy combined with field technique optimization, reduced the ovarian dose, particularly by decreasing the low-dose exposure of ovarian tissue and improving the target conformity simultaneously. The ovarian dose could be minimized by a proper LOT position. This optimized technique could enhance ovarian protection and fertility preservation for young female survivors of cervical cancer.

Autonomous imaging scheduling networks of small celestial bodies flyby based on deep reinforcement learning

AbstractDuring the flyby mission of small celestial bodies in deep space, it is hard for spacecraft to take photos at proper positions only rely on ground-based scheduling, due to the long communication delay and environment uncertainties. Aimed at imaging properly, an autonomous imaging policy generated by the scheduling networks that based on deep reinforcement learning is proposed in this paper. A novel reward function with relative distance variation in consideration is designed to guide the scheduling networks to obtain higher reward. A new part is introduced to the reward function to improve the performance of the networks. The robustness and adaptability of the proposed networks are verified in simulation with different imaging missions. Compared with the results of genetic algorithm (GA), Deep Q-network (DQN) and proximal policy optimization (PPO), the reward obtained by the trained scheduling networks is higher than DQN and PPO in most imaging missions and is equivalent to that of GA but, the decision time of the proposed networks after training is about six orders of magnitude less than that of GA, with less than 1e−4 s. The simulation and analysis results indicate that the proposed scheduling networks have great potential in further onboard application.

Designing and Manufacturing an Affordable and Easy to Use Visual Bio Feedback Device to Fix Forward Head Posture: A Pilot Study Involving Female Students

Forward Head Posture (FHP) is when the head leans forward due to factors such as heavy backpacks or poor computer ergonomics. FHP can lead to neck strain and discomfort as well as potential long-term issues such as arthritis. Treatment options include specialized exercises, orthopedic devices, manual therapy, physical exercises, and visual feedback techniques, along with guidance from specialists in physical medicine and rehabilitation. In this study, a visual feedback-based approach was used to address FHP in female students. The study spanned ten days and included a visual feedback group and a control group. The results showed significant improvements in maximum head angle deviation in the visual feedback group compared to the control group; however, there was no significant change in the DFA number, indicating stability in policy control by the central nervous system. The study demonstrated that visual feedback sessions led to immediate benefits, with participants progressively acquiring skills involving the maintenance of proper head positioning. The test results indicated that the neck angle decreased to less than 15 degrees, indicating a return to a normal state. The versatility of the developed affordable and easy-to-use device and the potential for using smartphone motion sensors for similar visual feedback systems are discussed in this paper as well. The study suggests the promising potential of visual feedback in healthcare, including remote monitoring and smartphone-based solutions.

A Systematic Review of Cochlear Implant-Related Magnetic Resonance Imaging Artifact: Implications for Clinical Imaging.

To conduct a systematic review of the existing literature with the aim of evaluating and consolidating the present understanding of strategies for mitigating magnetic resonance imaging (MRI) artifacts related to cochlear implants in adult and pediatric patients, covering both in-vivo and ex-vivo investigations. A systematic review of MEDLINE-Ovid, Embase, Google Scholar, The Cochrane Library, and Scopus was performed from inception through April 2022. The protocol was registered with PROSPERO before commencement of data collection (CRD CRD42022319651). The data were screened and collected by two authors independently, and eligibility was assessed according to Cochrane Handbook and Preferred Reporting Items for Systematic Review and Meta-Analysis recommendations, whereas the quality of the articles was evaluated using the NIH Study Quality Assessment. The search yielded 2,354 potentially relevant articles, of which 27 studies were included in the final review. Twelve studies looked at 1.5-T MRI, four studies looked at 3-T MRI, eight studies looked at both 1.5 and 3 T, one study looked at 0.2 and 1.5 T, and one study looked at 3- and 7.0-T MRI. Nineteen studies focused on MRI sequences as a means of artifact reduction, nine studies focused on implant magnet positioning, two studies focused on head positioning, and one study focused on both magnet and head positioning. In terms of MRI sequences, diffusion-weighted imaging produced larger artifacts compared with other sequences, whereas fast spin echo/turbo spin echo sequences and fat suppression techniques produced smaller artifacts. The position of the magnet was also found to be important, with a magnet position more than 6.5 cm posterior to the external auditory canal producing the best images with the least distortion. The angle at which the magnet is placed also affects visibility of different brain structures. Proper head positioning, magnet placement at a distance of over 6.5 cm from the external auditory canal, use of spin echo sequences, and fat suppression techniques reduce the size and shape of MRI artifacts.

Simple use of Y-connector for proper positioning and contrast aspiration in biliary metal stent placement.

Simple use of Y-connector for proper positioning and contrast aspiration in biliary metal stent placement.

Fusing Direct Manipulations into Functional Programs

Bidirectional live programming systems (BLP) enable developers to modify a program by directly manipulating the program output, so that the updated program can produce the manipulated output. One state-of-the-art approach to BLP systems is operation-based, which captures the developer's intention of program modifications by taking how the developer manipulates the output into account. The program modifications are usually hard coded for each direct manipulation in these BLP systems, which are difficult to extend. Moreover, to reflect the manipulations to the source program, these BLP systems trace the modified output to appropriate code fragments and perform corresponding code transformations. Accordingly, they require direct manipulation users be aware of the source code and how it is changed, making "direct" manipulation (on output) be "indirect". In this paper, we resolve this problem by presenting a novel operation-based framework for bidirectional live programming, which can automatically fuse direct manipulations into the source code, thus supporting code-insensitive direct manipulations. Firstly, we design a simple but expressive delta language DM capable of expressing common direct manipulations for output values. Secondly, we present a fusion algorithm that propagates direct manipulations into the source functional programs and applies them to the constants whenever possible; otherwise, the algorithm embeds manipulations into the "proper positions" of programs. We prove the correctness of the fusion algorithm that the updated program executes to get the manipulated output. To demonstrate the expressiveness of DM and the effectiveness of our fusion algorithm, we have implemented FuseDM, a prototype SVG editor that supports GUI-based operations for direct manipulation, and successfully designed 14 benchmark examples starting from blank code using FuseDM.

On the issue of diagnostic accuracy of methods for analyzing the parameters of regular astigmatism

This study evaluates the diagnostic accuracy of various methods for measuring the parameters of regular astigmatism. The study included 83 patients (122 eyes) with regular astigmatism exceeding 1.0 D. Three groups were formed depending on the type of astigmatism. Spherical and cylindrical (power and axis) components of refraction were determined using automatic refractometry. The results were refined with subjective tests: power and axis tests with a cross-cylinder. The criterion for diagnostic accuracy was the level of corrected visual acuity. To assess the impact of cylinder position on visual acuity, discrete deviations of the axis of trial astigmatic lenses from the correct position (determined based on subjective tests) were modeled at 5, 10, and 15 degrees in both clockwise and counterclockwise directions. In the overall sample of observations, coincidence of results was found only in one-third of cases, with a tendency for discrepancies in data between the two methods in nearly 70% of cases. Statistical processing revealed significant differences only in the magnitude of the cylinder in the group with against-the-rule astigmatism (p<0.0005). An increase in maximum visual acuity corrected based on subjective test data was noted. With a deviation of the cylinder axis from the correct position by 10-15 degrees, regardless of the type of astigmatism, a significant tendency for a decrease in visual acuity was identified. At the same time, with a deviation of the cylinder axis within 5 degrees, a significant decrease in visual acuity was noted only in with-the-rule astigmatism and counterclockwise deviation. To achieve maximum visual acuity in the correction of regular astigmatism, objective method data must be refined with subjective tests. The results of modeling the deviation of the axis of the corrective lens from the proper position can be considered when evaluating the functional outcomes of TIOL implantation.

The role and position of universities in the provincial ecosystem of knowledge-based development:Theoretical framework and its application for West Azarbaijan province

National development is the result of local and provincial development. In today's era, which is known as the age of knowledge, local and provincial development takes place only within the framework of the provincial ecosystem of knowledge-based development. In many developed countries, universities are the most important actors and beneficiaries of this ecosystem. But the role and position of Iranian universities in this type of ecosystem is not very clear and it seems that they do not have a favorable role and position. Therefore, the purpose of this article is to verify this hypothesis. For this purpose, the technique of "stakeholder interaction analysis" and the study data of West Azarbaijan province have been used. The findings of the research show that the universities of West Azarbaijan province do not have a proper role and position in the knowledge-based development ecosystem of this province. In fact, such an ecosystem is very poorly formed in this province.

Diagnostic Accuracy of 3T Magnetic Resonance Imaging and Arthroscopy in Triangular Fibrocartilage Complex Injury

Abstract Introduction: The advances in the understanding of wrist instability have enhanced the need for improved diagnostic modalities. 3T magnetic resonance imaging (MRI) with a small joint coil has emerged as a promising tool in determining ligamentous wrist injuries. Although arthroscopy remains the gold standard for diagnosis, the economics of the procedure, health insurance penetrance, and indemnity concerns, a noninvasive diagnostic tool with high accuracy is the need of the hour. Materials and Methods: Here, we have compared the accuracy of a 3T MRI for the diagnosis of triangular fibrocartilage complex (TFCC) tears against diagnostic wrist arthroscopy. Results: We found that 3T MRI with small joint coils has high sensitivity and specificity in the diagnosis of foveal avulsions of TFCC. By virtue of direct visualization, arthroscopy has the ability to differentiate scar, enema, and/or hematoma from an intact ligament as compared to MRI. Conclusion: Therefore, a good quality MRI (3T MRI, small joint coil, taken in proper plane and position with thin cuts) would improve the likelihood of an accurate diagnosis and reduce the burden on the health-care system.

FCVM(i): Integrated FCNP-VWA-MCDM(i) Methods for On-Demand Charging Scheduling in WRSNs

On-demand charging schemes have been recently proposed to make efficient charging schedules of mobile chargers by introducing MCDM methods in wireless rechargeable sensor networks (WRSNs). However, most of the existing schemes use analytic hierarchy process (AHP) or fuzzy AHP (FAHP) of paired ratio scale (PRS) to exaggerate the actual paired difference between multi-criteria, thereby very likely producing misapplications such as inappropriately ranking the charging locations or inaccurately drawing the partial charging time in charging scheduling (CS) of WRSNs. In addition, in case of using FCNP of paired interval scale (PIS) for weight assignment of multi-criteria, weight compensation has not been considered. In particular, it is still unknown which is the best method for integrating FCNP with several MCDM approaches. This paper proposed novel CS methods by integrated FCNP-VWA-MCDM(i) called FCVM(i) which solves all of these problems. The proposed methods first assign the weights to multiple criteria discriminating charging request nodes (cRNs) using FCNP and make compensation of them to be relatively exact weights with VWA. Then, on the basis of these weights, MCDM(i) is used to elect the best proper next charging position. In this way, drawing up the recharging schedule, at the selected charging locations, we decide the reasonable partial charging time using the assigned weights with FCNP-VWA. Extended experiment results prove that the FCVM(1) using TOPSIS gives the best performance among FCVM(i) methods.

Combined cataract and vitreoretinal surgery

Combined cataract surgery and vitrectomy is a surgical technique used to address both cataract and vitreoretinal disorders. With the advances in surgical tools, simultaneous removal of cataract associated with vitreoretinal disorders is gaining popularity. This technique offers several advantages over separate surgeries, including reduced surgical time and anaesthesia exposure, as well as quicker visual rehabilitation. However, the optimal timing and approach for combined cataract surgery and vitrectomy remain controversial.Indications for combined cataract surgery and vitrectomy include various vitreoretinal conditions, such as retinal detachment, diabetic retinopathy, macular holes, and epiretinal membranes. The timing of surgery depends on the severity of the cataract and the vitreoretinal pathology, as well as the surgeon's preference. The most common surgical techniques include phacoemulsification with posterior chamber intraocular lens implantation, followed by pars plana vitrectomy. The filling of the vitreous cavity is possible with several types of tamponades, such as different gases, but in extreme cases even with silicone oil. After gas tamponade, proper positioning of the patient is of great importance.Complications associated with combined cataract surgery and vitrectomy include posterior capsule rupture, intraocular lens dislocation, postoperative inflammation, and intraocular pressure elevation. However, the overall complication rate is low, and the visual outcomes are generally favourable.In conclusion, combined cataract surgery and vitrectomy is a useful technique for managing various vitreoretinal conditions. Proper patient selection, careful surgical planning, and close postoperative monitoring are critical for achieving optimal outcomes.

Video-Laryngoscope For Difficult Paediatric Airway Management In A Case Of Meningomyelocele For Emergency Ventriculo Peritoneal Shunt Surgery

Administering anaesthesia in the pediatric population is challenging because of various physiological and anatomical changes in them compared to adults. It becomes more difficult when associated with congenital anomalies. One of the major anaesthetic challenges in meningomyelocele (MMC) includes securing the airway with proper positioning of the child. The airway becomes a challenge, especially in small babies with associated congenital anomalies, raised intracranial pressure (ICP), and in emergency presentations with upper airway obstruction. Here is a case report of a 5-month-old 6 kg baby with big lumbar MMC and hydrocephalus, raised intracranial pressure with grunting noise indicating upper airway obstruction with respiratory distress for emergency ventriculo-peritoneal shunt placement. Video laryngoscopy (C-MAC)® with pediatric Millers blade was used as the first choice as a difficult airway was anticipated and helped us secure a difficult airway within seconds without any rise in ICP. The baby was placed supine for surgery while avoiding any pressure on the swelling to prevent its rupture, cerebrospinal fluid leak, or increase in ICP. Apart from airway control, intraoperative anaesthetic management in this case of V-P shunt also included proper positioning of large MMC, prevention of any rise in ICP, and prevention of hypothermia. Keywords: Video-laryngoscope, Pediatric millers blade, Difficult pediatric airway, Meningomyelocele, Ventriculo-peritoneal shunt.

Awareness of malocclusion and attitude towards orthodontic treatment among trainee dental surgery technicians in Nigeria

Objective: Malocclusion affects aesthetics, the physical, psychological and social life of a person. The aim of this study was to evaluate the awareness of malocclusion and attitude towards orthodontic treatment among trainee dental surgery technicians in Nigeria.&#x0D; Materials and Methods: This was a descriptive cross-sectional study carried out among 68 final year (sixty-eight) trainee dental surgery technicians in Nigeria. The research instrument was a self-administered close ended questionnaire. Data was analyzed using SPSS version 20. P value (P&lt;0.05) was regarded as significant.&#x0D; Results: Sixty-one (89.7%) of the respondents were females, while 7 (10.3%) were males. Fifty-seven (83.8%) have heard of the term malalignment of teeth, 53 (77.9%) of the students think malalignment is due to external habits. 61 (89.7%) are aware that few teeth may have to be removed for proper positioning of irregular teeth and 51 (75.0%) were aware that the irregular teeth can be corrected even after 40 years of age. More females were aware of malocclusion and had positive attitude towards orthodontic procedures when compared to the males, but the difference was not statistically significant (P&gt;0.05).&#x0D; Conclusion: Majority of the respondents in this study were aware of the term malalignment and had positive attitude towards orthodontic treatment. More females constituted the study population.

A New Concept of Direct Oil Cooling System for AFPM Machines, Numerical Analysis and Optimization

Given the strong growth of the electric drive industry, the automotive sector needs to increase the power density of its motors, leading to a size decrease and, consequently, to economic savings. The increase in power density brings with itself the consequence of increasing the Joule effect losses in the active conductors of the machine. For this reason, the problem of cooling turns out to be of utmost importance precisely because of its direct coupling with mechanical and electromagnetic design. This paper has the aim to perform a CFD analysis concerning the cooling system of a permanent magnet axial flux electric machine. The innovative cooling system studied is a direct one which takes advantage of oil to cool down the DC powered coils. The innovation brought by the present research lays in both the direct axial ejection and the use of oil as coolant. At the current state of art, the coolant flows tangentially and, moreover, water is usually employed instead of oil. The main aim of this analysis will be, after a validation of the numerical code by comparison of the literature data, to minimize the maximum temperature of the coil by means of the proper positioning of the nozzle.

Nursing care for adult patients with chest drainage: a scoping review.

ABSTRACT Objective: To map the nursing care recommended for adult patients undergoing chest drainage. Method: Scoping review. Included studies in Portuguese, English and Spanish, with no time frame, which answered the research question: what nursing care is indicated for adult patients with chest drainage admitted to intensive care? Selection in the MEDLINE/PubMed, Embase/Elsevier, Web of Science/Clarivate, Scopus/Elsevier, CINAHL/Ebsco and LILACS/BVS databases. No data from gray literature was included. Results: Of the 973 articles identified, 21 were selected. The most frequently cited precautions included: filling the collection bottle with distilled water or saline solution, leaving the distal end of the stem submerged 1.5 to 2.5 centimeters; monitoring vital signs; pain management; and proper positioning of the system. There were differences in the indication for clamping the system and milking the drain/drainage system. Conclusion: 60 nursing tasks were mapped, 13 of which were carried out prior to inserting the drain, nine during insertion and 38 after insertion of the chest drain.

Aberration control-based design for freeform monolith

The development of space optical and optomechanical projects demands a large number of optical elements in the form of conventional, non-conventional, or both types, including surfaces and bodies. With a greater number of elements in a system comes the high cost, significant weight, complexity in assembly, and the challenge of maintaining precise alignment. To overcome these challenges, economical and efficient solutions, in terms of monolithic optical design, are preferred. When compared to typical multi-element designs, monolithic systems have a higher level of stability. A novel design methodology for modern multi-facial optics is presented, which starts with designing the surfaces individually, controlling the aberration of the succeeding surface, and then multiple optical surfaces are integrated using the analytical tools preserving the combined optical functionality of the four surfaces. With the first surface having a clear aperture of 90 mm with an opening of 33.458 mm and the proper position of the other surfaces, the focal length of 83.077 mm is achieved. We believe that our designed freeform multi-facial optical component illustrates the fascinating potential of the monolith and opens up new opportunities for fields utilizing large optical systems, including earth monitoring, planetary observation, geosciences, and astronomical studies.

Performance Evaluation of QT-RR Adaptation Time Lag Estimation in Exercise Stress Testing.

Slower adaptation of the QTinterval to sudden changes in heart rate has been identified as a risk marker of ventricular arrhythmia. The gradual changes observed in exercise stress testing facilitates the estimation of the QT-RR adaptation time lag. The time lag estimation is based on the delay between the observed QTintervals and the QTintervals derived from the observed RRintervals using a memoryless transformation. Assuming that the two types of QTinterval are corrupted with either Gaussian or Laplacian noise, the respective maximum likelihood time lag estimators are derived. Estimation performance is evaluated using an ECG simulator which models change in RR and QT intervals with a known time lag, muscle noise level, respiratory rate, and more. The accuracy of T-wave end delineation and the influence of the learning window positioning for model parameter estimation are also investigated. Using simulated datasets, the results show that the proposed approach to estimation can be applied to any changes in heart rate trend as long as the frequency content of the trend is below a certain frequency. Moreover, using a proper position of the learning window for exercise so that data compensation reduces the effect of nonstationarity, a lower mean estimation error results for a wide range of time lags. Using a clinical dataset, the Laplacian-based estimator shows a better discrimination between patients grouped according to the risk of suffering from coronary artery disease. Using simulated ECGs, the performance evaluation of the proposed method shows that the estimated time lag agrees well with the true time lag.

Nursing Care Practice in Neonatal Care Units of Tertiary Hospitals of Nepal: An Exploratory Qualitative Study

Preterm infants (PTIs) require special care in neonatal care units (NCUs) for their survival, growth, and development. Nurses are in a pivotal position to provide quality care to those infants in NCUs. Available literature indicates that care practice needs to be improved in developing countries. This study aimed to explore the nursing care practice for PTIs in NCUs. An exploratory qualitative study was conducted in NCUs of three public tertiary care hospitals in Kathmandu, Nepal, from November 2019 to February 2020. Data were collected through six focus group discussions among 40 nurses working in NCUs. The thematic analysis of qualitative data revealed standardized and inadequate care practices for PTIs in NCUs. Standard practices regarding thermal care, oxygen administration, nutritional care, and infection prevention were found. Inadequate care was identified regarding sleep protection, proper positioning, supportive sensory environment, and pain management. The study reported the standard care practice areas and areas for improvement to enhance nursing care in NCUs, such as pain management, sleep promotion, breastfeeding support, kangaroo mother care, and a supportive sensory environment. The findings have important implications for enhancing care practices for PTIs in NCUs, which is important for promoting the short- and long-term outcomes among PTIs.

Identification and Characterization of Xanthomonas spp. Affecting Fruit Crops Cultivated in Assam, India

The present study was carried out to identify the bacterial pathogens affecting different fruit crops and to consign them in proper taxonomic position following different morphological, biochemical and molecular protocols. Diseased samples exhibiting typical symptoms on pomegranate (Punica granatum), mango (Mangifera indica), peach (Prunus persica), and plum (Prunus domestica) were gathered from two locations in Assam (Jorhat and Sonitpur). Through morphological, biochemical, and molecular characterization, the bacterial isolates were identified within the genus Xanthomonas, displaying a broad host range encompassing pomegranate, mango, peach, and plum. Phylogenetic analysis of 16S rRNA gene sequences indicated the isolates as Xanthomonas citri pv. Mangiferae indicae (causing bacterial canker in mango), Xanthomonas axonopodis pv. punicae (responsible for bacterial blight in pomegranate), and Xanthomonas arboricola pv. pruni (associated with bacterial leaf spot in stone fruits). The findings underscore the importance of Xanthomonas in impacting diverse fruit crops, highlighting potential threats to their production.