Resolution Research Articles

Randomized controlled trial of functional outcome of periarthritis of shoulder (Adhesive Capsulitis) in a group of 60 patients using intraarticular triamcinolone vs. intraarticular platelet rich plasma

Background: Periarthritis shoulder is the most common cause of shoulder pain and stiffness encountered in day to day practice. Though the condition is self-limiting it may not be practical to wait for spontaneous resolution as it is associated with significant morbidity hampering routine activities. The various treatment options available include simple physiotherapy, intra articular injections, manipulation under general anaesthesia and surgical intervention. This study was undertaken to compare the efficacy and safety of two intraarticular injections that is triamcinolone acetonide and platelet rich plasma (PRP). Materials and Methods: Patients with periarthritis shoulder were randomly allocated into two groups. Group A receiving intraarticular triamcinolone acetonide injection and Group B receiving intra articular platelet rich plasma. Patients were followed up every four weeks for 24 weeks. And outcome was assessed using SPADI score before treatment and at every visit. Results were assessed using Epi Data version 2.2.2.186. Results: PRP treatment resulted in statistically significant improvement over triamcinolone acetate therapy in both SPADI and VAS scale. Conclusion: Intraarticular PRP is more effective and safe in treatment of periarthritis shoulder. Keywords: Periarthritis shoulder, Triamcinolone acetonide, Platelet rich plasma.

Vancomycin Induced Thrombocytopenia Complicating Permanent Pacemaker Placement: A Case Report

Introduction: Vancomycin is widely used in patients with methicillin resistant staphylococcus aureus (MRSA) infections or with other infections unresponsive to other antibiotics. Vancomycin-related adverse effects, including nephrotoxicity, ototoxicity, red-man syndrome, and neutropenia have been reported. Vancomycin induced thrombocytopenia is a rare complication of vancomycin that many physicians are unaware of. When an acute decline in platelet count or bleeding occur in patients on vancomycin, vancomycin- induced thrombocytopenia should be considered. Case: We present a case of acute severe thrombocytopenia that occurred within 12 hours after vancomycin infusion in a patient that received permanent pacemaker placement. Vancomycin was discontinued and patient’s platelets returned to baseline five days after vancomycin was discontinued. Conclusion: This case report highlights the importance of physicians being aware of vancomycin induced thrombocytopenia, a rare but reversible complication of vancomycin, which if diagnosed early will lead to early discontinuation of vancomycin, early resolution of thrombocytopenia and reduced hospital stay.

A Case study on flipped learning: focused on value conflict resolution teaching-learning model of moral education

A Case study on flipped learning: focused on value conflict resolution teaching-learning model of moral education

Rapid Resolution Liquid Chromatography with Tandem Mass Spectrometry on Pharmacokinetics of Type 2 Diabetic Rats with Oral Administration of Sijunzitang Decoration

Rapid Resolution Liquid Chromatography with Tandem Mass Spectrometry on Pharmacokinetics of Type 2 Diabetic Rats with Oral Administration of Sijunzitang Decoration

Employment of Ethnography Research to Ensure Effective Delivery of Medical Education and Clinical Training

Ethnography is one of the qualitative approaches, wherein the researcher gets submerged into the study setting that has to be explored. An extensive search of all materials related to the topic was carried out in PubMed and a total of five articles were selected based upon the suitability with the current review objectives. The ethnography approach gives a sense of freedom to the researchers to understand in depth the multiple variables in clinical settings or in the delivery of medical education, as the approach remains open ended. In fact, the generated evidence helps the administrators or teachers to understand the dynamics and the root cause of the problem, which then can be effectively sorted out. In conclusion, the application of ethnography empowers the administrators to get a better understanding of the issues in the delivery of medical education and health care. The need of the hour is to encourage training of faculty members in qualitative research, as a trained ethnographer can utilize their skills for the better understanding and effective resolution of the issues impacting effective curriculum delivery.

A fast image-stitching algorithm for characterization of cracks in large-scale structures

Visual inspection of concrete cracks has been widely used in structural health monitoring (SHM). Capturing highresolution images is an effective method to visualize a complete crack, but it is difficult to show a whole crack from a single high-resolution image. One feasible method is using image stitching technique to stitch several images into a complete crack map. However, the current image stitching method is a computationally intensive process. Numerous images are required to cover large-scale structures with sufficient resolution, this can be computationally prohibitive. To address this problem, an improved image stitching method for crack damage evaluation is proposed, which can quickly stitch the crack images without affecting the quality of the stitching or the resulting images. Rather than first stitching the images together and then determining the crack maps, we propose to first develop the crack maps for the individual images and then stitch them together. The proposed method reduces the number of redundant matching points between the original images by combining their characteristics during image stitching, so it can reduce the calculation time without affecting the quality. Also, the results will not be influenced by the image stitching seam, which can reduce the complexity of the algorithm. Several experimental results are provided in this article to demonstrate that the proposed method can reduce the calculation time without affecting the quality of image stitching and have better robustness than the current method in use.

Deliberative Democracy and Public Conflict Resolution

Deliberative Democracy and Public Conflict Resolution

Gallbladder Torsion Masking as Acalculus Cholecystitis: A Review of Two Cases Including Unsuccessful Management With Percutaneous Cholecystostomy

Gallbladder torsion is a rare cause of abdominal pain; however, it is important to diagnose pre-operatively. We report two cases of gallbladder torsion, both of which were not recognized until the time of surgery. Both patients were elderly thin females, presenting with right upper quadrant pain, and on examination had a positive Murphy’s sign, and pre-operative imaging was suggestive of acalculus cholecystitis. One patient was initially managed by percutaneous insertion of a cholecystostomy tube, with progression to a laparoscopic cholecystectomy after a failure of resolution of symptoms. The second patient was taken to theater shortly after presentation, with the gallbladder torsion recognized intra-operatively. In both cases, the gallbladder was distorted and a routine laparoscopic cholecystectomy was performed with good recovery following. These two cases highlight the need for gallbladder torsion to be considered as a diagnostic possibility in those presenting with right upper quadrant pain, particularly those groups at most risk, including elderly thin females. Whilst other causes of cholecystitis can be managed non-operatively, at least in the acute phase, gallbladder torsion requires urgent operative intervention. J Med Cases. 2021;12(6):223-225 doi: https://doi.org/10.14740/jmc3683

Effects of re-solution and re-aging treatment on mechanical property, corrosion resistance and electrochemical behavior of 2196 Al-Cu-Li alloy

The effects of re-solution (RST) and re-aging (RA) treatment on the mechanical property, microstructure, corrosion resistance and electrochemical behavior of 2196 Al-Cu-Li alloy were investigated by tensile testing, conductivity testing, intergranular corrosion and electrochemical corrosion testing. The results show that RST and RA treatment can improve the corrosion resistance without sacrificing the strength compared to T6 temper. The aging precipitation process is reversible, and the number and distribution of δ’, T1 and θ’ precipitates can be effectively regulated by the RA treatment, so that the strength of the alloy approximately reaches the level of T6 temper and the ductility is improved. The corrosion mode of the alloy changed from pitting into intergranular corrosion during RST and RA treatment. The coarsening and discontinuous distribution of grain boundary precipitates as well as the increase of precipitate-free zone (PFZ) width inhibit the generation and propagation of stress corrosion cracking and thereby improve the corrosion resistance of the alloy. The increase of Cu content in grain boundary reduces the electrochemical corrosion sensitivity of the alloy. The optimal process parameters of RST and RA treatment for 2196 Al-Cu-Li alloy are finally determined to be 515 °C for 90 min and 170 °C for 24 h.

Luminous spot distribution of vacuum arc discharge with deuteride cathode

Vacuum arc discharges with deuteride cathode have many applications, such as nondestructive examination, oil logging, and neutron activation analysis. Deuteride cathode releases many gases during discharge, which is quite different from metal cathode. The discharges display some unique characteristics. A maguifying lens and an ICCD camera are used to observe the luminous spots of vacuum arc discharge. The space resolution of this system is about 5 μm, and the time resolution is about 2 ns. The arc current has a full width at half maximum (FWHM) of about 0.9 μs, and its waveform is half cycle sinusoidal. The results show that the luminous spots merge together into a big one in most cases. Sometimes there are two or more luminous spots due to droplets. The area of the luminous spot grows as arc current increases. The cathode spots’ merging is helpful to increase plasma density and improve discharge efficiency.

Subcapsular Hepatic Hematoma Post-Endoscopic Retrograde Cholangiopancreatography Requiring Surgical Necrosectomy

Cholelithiasis is a common gastrointestinal pathology with a prevalence of over 6% in the USA. Symptomatic patients can develop cholangitis, biliary colic, pancreatitis and cholecystitis. Surgical management involves laparoscopic or open cholecystectomy. Stones within the common bile duct can be treated with endoscopic retrograde cholangiopancreatography (ERCP). Well-known ERCP complications include pancreatitis, perforation, bleeding and cholangitis. Hepatic hematomas as a complication of ERCP are extremely rare, with fewer than 50 reported cases in the literature. Approximately 22% have required operative management. We present an extremely rare case of ERCP-associated subcapsular hepatic hematoma in a 43-year-old lady that was initially non-operatively managed. She did not improve with antibiotics alone and underwent attempted interventional radiology drainage. Despite this, due to on-going sepsis, the patient underwent laparoscopic necrosectomy and drain placement with continued post-operative irrigation. After a long course of antibiotics and drain irrigation, the patient was discharged with repeated computed tomography imaging showing almost total resolution of the infected collection. This case highlights the extreme rarity of surgical management for post-ERCP subcapsular hepatic hematoma and its successful outcome. J Med Cases. 2021;12(5):186-189 doi: https://doi.org/10.14740/jmc3672

Pancreatic VIPoma as a Differential Diagnosis in Chronic Pediatric Diarrhea: A Case Report and Review of the Literature

Chronic diarrhea is a common chief complaint in the pediatric population with a wide range of diagnostic differentials; as such, whilst suspecting common causes, less prevalent conditions tend to be overlooked, such as neuroendocrine tumor pathologies. VIPomas are characterized by hypersecretion of the vasoactive intestinal peptide (VIP), causing watery diarrhea, hypokalemia, and achlorhydria. Nonetheless, its low incidence rate in children makes it an easily unnoticed pathology. Herein, we report a case of a 14-year-old female patient and a review of relevant literature. The patient complained of 7-month history of watery diarrhea, multiple emetic episodes, and relevant past medical history of multiple hospitalizations. Chronic diarrheal disease work-up studies, including a high VIP scintigram, showed a lesion suggestive of a VIPoma-type neuroendocrine pancreatic tumor. A distal pancreatectomy was performed with a complete resolution of the symptoms. When faced with a pediatric patient presenting with chronic secretory diarrhea and whose work-up studies rule out the most common pathologies, the possible presence of a neuroendocrine tumor as VIPoma should be considered. J Med Cases. 2021;12(5):195-201 doi: https://doi.org/10.14740/jmc3535

A “Legal Eccentricity”: The European Parliament, its Non-binding Resolution, and the Legitimacy of the EU’s Trade Agreements

The European Union is pursuing an ambitious trade agenda despite the increased controversy over the negotiating process and substance of trade agreements. This controversy raises questions about the legitimacy of trade agreements, as Cecilia Malmstrom, former European Commissioner for Trade, has acknowledged. This paper seeks to evaluate the legitimacy of the EU’s agreements, with a focus on the role of the European Parliament as a legitimating actor, given its position as the democratic representative of the public. It argues that the Treaties do not provide for sufficient legitimacy and then considers whether Parliament has been able to use its informal governance tools, particularly the non-binding resolution, to narrow the legitimacy deficit.

Advances in single-cell whole genome sequencing technology and its application in biomedicine.

The advent and development of single-cell whole-genome sequencing (scWGS) technology has shed lights on the genomic heterogeneities within biosamples at the single-cell resolution. The technology is particularly well-established in the recent decade and witnesses a variety of clinical applications, such as circulating tumor cell (CTC) detection and preimplantation genetic diagnosis/screening (PGD/PGS). In this review, we summarize the latest practical breakthroughs of scWGS in the field of biomedicine, with the hope of providing a guideline to apply single-cell genomic sequencing in clinical researches.

Energy window optimization for Bremsstrahlung Y90 SPECT-CT imaging : a phantom study

Introduction: In Yttrium-90 SPECT imaging, the energy window and collimator used during acquisition can have a major effect on image quality. In this work, we used a new and independent method to verify the prevoius results suggest different energy ranges, but all centered at 130 keV. Materials and method: We used Siemens Symbia SPECT-CT system fitted with High Energy General Purpose (HEGP), Medium Energy General Purpose (MEGP) and Low Energy High Resolution (LEHR) to acquire data from NEMA IEC PET Body Phantom with its 6 different spheres of 3.7, 2.8, 2.2, 1.7, 1.3, 1.0 cm diameter. Results:HEGP collimator is the most suitable for acquisitions of 90Y bremsstrahlung radiation from the point of view of the correct volume reproduction. For the bigger sphere’s study, the optimum ISO-counting curves is related to the energy range centred in 130 keV.Conclusion: The results obtained are consistent with previous studies. The Iso Counting Curves method can help to improve image quality.

Lack of Association between C1236T, G2677T/A and C3435T Variants of the ABCB1 Gene and Imatinib Response in Iranian Chronic Myeloid Leukemia Patients

Imatinib introduction caused to improve the clinical outcomes of chronic myeloid leukemia (CML) patients. Despite the significant effects of Imatinib, pharmacogenetic variables induced treatment resistant is also observed.. Imatinib is known as a P-glycoprotein (P-gp) efflux pump substrate encoded by the ABCB1 gene. The ABCB1 C1236T, G2677T/A and C3435T variants are possibly correlated with interindividual variation in pharmacokinetic response to Imatinib therapy. The present study aimed to examine the effect of ABCB1 gene variants on the therapeutic response of Imatinib in CML patients. Sixty-nine Iranian CML patients treated with Imatinib or Nilotinib were selected and divided into two groups of sensitive and resistant to Imatinib. C1236T and G2677T/A variants were genotyped by high resolution melting (HRM) analysis, and C3435T variant was genotyped using polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP). Then, the results were compared between the two groups of patients. Our results showed that there were no significant differences between C1236T, G2677T/A and C3435T variants of ABCB1 gene and clinical response to Imatinib in the Iranian CML patients. According to the results of this study, genotyping of ABCB1 C1236T, G2677T/A and C3435T variants couldn’t help to predict the outcomes of Imatinib treatment in CML patients. So, these variants are not useful to make decisions about treatment, but it is suggested to do further investigations.

Eficiência de sabonetes comerciais antissépticos contra bactérias patogênicas e análise dos rótulos

Os sabonetes em barra com ação antisséptica são destinados à limpeza de resíduos presentes no corpo, sua utilização tem crescido significativamente em decorrência da preocupação da população com determinadas doenças causadas por contaminação microbiológica. Com isso, têm surgido no mercado diferentes marcas de sabonetes garantindo a eliminação de 99,9% das bactérias. O objetivo deste estudo foi realizar a análise comparativa do pH, atividade antibacteriana e rótulos de 5 diferentes marcas de sabonetes antibacterianos em barra, identificados como A, B, C D e E. Realizou-se a determinação do pH com auxílio de pHmetro digital, e na análise microbiológica utilizou-se a metodologia de disco difusão, com o intuito de observar a presença ou ausência da multiplicação das bactérias Streptococcus pyogenes, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus epidermidis, Staphylococcus aureus e Escherichia coli frente aos diferentes sabonetes testados. Durante a análise da rotulagem dos sabonetes foi avaliada a presença do requisito “composição”, exigido pela resolução vigente. Nos testes realizados constatou-se que o pH de todas as marcas testadas encontraram-se fora dos parâmetros estabelecidos. Na análise microbiológica observou-se que apenas a marca E, demonstrou efeito antisséptico frente às bactérias testadas. Os demais sabonetes apresentaram menor e até mesmo nenhum potencial de inibição do crescimento desses microrganismos. Os produtos analisados neste estudo apresentam em suas formulações duas substâncias ativas, o triclosan e o triclocarban, porém os mesmos podem ser nocivos para a saúde humana e meio ambiente, e induzirem a resistência bacteriana, por isso, alguns países já proibiram o uso destes ativos. Segundo os resultados obtidos é possível concluir que os rótulos presentes das embalagens destas diferentes marcas analisadas estão em desacordo com o estabelecido pelos fabricantes.

Quick assessment of chicken spoilage based on hyperspectral NIR spectra combined with partial least squares regression

Pseudomonas spp. and Enterobacteriaceae are dominant spoilage bacteria in chicken during cold storage (0°C-4°C). In this study, high resolution spectra in the range of 900-1700 nm were acquired and preprocessed using Savitzky-Golay convolution smoothing (SGCS), standard normal variate (SNV) and multiplicative scatter correction (MSC), respectively, and then mined using partial least squares (PLS) algorithm to relate to the total counts of Pseudomonas spp. and Enterobacteriaceae (PEC) of fresh chicken breasts to predict PEC rapidly. The results showed that with full 900-1700 nm range wavelength, MSC-PLS model built with MSC spectra performed better than PLS models with other spectra (RAW-PLS, SGCS-PLS, SNV-PLS), with correlation coefficient (RP) of 0.954, root mean square error of prediction (RMSEP) of 0.396 log10 CFU/g and residual predictive deviation (RPD) of 3.33 in prediction set. Based on the 12 optimal wavelengths (902.2 nm, 905.5 nm, 923.6 nm, 938.4 nm, 946.7 nm, 1025.7 nm, 1124.4 nm, 1211.6 nm, 1269.2 nm, 1653.7 nm, 1691.8 nm and 1693.4 nm) selected from MSC spectra by successive projections algorithm (SPA), SPA-MSC-PLS model had RP of 0.954, RMSEP of 0.397 log10 CFU/g and RPD of 3.32, similar to MSC-PLS model. The overall study indicated that NIR spectra combined with PLS algorithm could be used to detect the PEC of chicken flesh in a rapid and non-destructive way. Keywords: hyperspectral NIR spectra, chicken, dominant spoilage, partial least squares regression, quick assessment DOI: 10.25165/j.ijabe.20211401.5726 Citation: Jiang S Q, He H J, Ma H J, Chen F S, Xu B C, Liu H, et al. Quick assessment of chicken spoilage based on hyperspectral NIR spectra combined with partial least squares regression. Int J Agric & Biol Eng, 2021; 14(1): 243–250.

Resolution of Respect Joseph Hurd Connell (1923–2020)

Resolution of Respect Joseph Hurd Connell (1923–2020)

Aplicação dos instrumentos de gestão e manejo integrado da bacia hidráulica do açude Sumé, Paraíba

Está pesquisa tem como objetivo discutir e analisar as formas de manejos integrados de uma bacia hidráulica no município de Sumé, fazendo levantamento de informações recentes com a finalidade de manter em equilíbrio os recursos hídricos. Para tanto, utilizou-se o recurso metodológicos de levantamento bibliográfico e aplicação de manejo integrado subdividido em plano diretor dos recursos hídricos, sistemas de informações, enquadramento dos corpos hídricos, outorgado e cobranças. Como resultado obtido destaca-se que a água não encontra-se em conformidade com os padrões de potabilidade para consumo preestabelecido pela Portaria 29147/11 do MS e a Resolução 357/05 do CONAMA, segundo estudo realizado com amostra de água da bacia, além disso segundo uma pesquisa realizada com os consumidores da água provinda da bacia de Sumé, segundo eles a água apresenta alterações perceptíveis na sua composição segundo o cheiro e a turbidez da água oferecida pelo sistema de abastecimento e Companhia de Águas e Esgotos da Paraíba-CAGEPA. Diante dos resultados alcançados em toda a pesquisa, conclui-se que é possível, dentro do quadro ambiental existente, mudar a forma de apropriação e uso dos recursos ambientais sem deixar de fornecer esse recurso aos seres humanos com a qualidade necessária para o consumo, sem encontrar irregularidades no abastecimento segundo a qualidade da água.