Correct Time Research Articles

Dogs neutered prior to perineal herniorrhaphy or that develop postoperative fecal incontinence are at an increased risk for perineal hernia recurrence.

To identify risk factors for recurrence and surgical site infection (SSI) after perineal hernia repair surgery in dogs. Medical records of male dogs undergoing perineal herniorrhaphy from 2008 to 2023 at a single institution were retrospectively reviewed. Data pertinent to patient signalment, surgical repair methods, risk factors for SSI, and risk factors for recurrence were collected. Follow-up was obtained via referring veterinarian records and/or owner interviews. Dogs without 12 months of postoperative follow-up were excluded. Statistical analysis was performed with descriptive statistics and compared between groups by use of a combination of univariable analyses. 84 dogs were included in this study. Recurrence occurred in 13 cases (15%), and SSIs occurred in 6 cases (7%). Dogs neutered prior to surgical correction of a perineal hernia were 4.4 times as likely to have a recurrence of the hernia after surgery compared to dogs neutered at time of surgical correction, and dogs that developed fecal incontinence postoperatively were 3.4 times as likely to have a recurrence. There were no other significant associations between perineal hernia recurrence or the development of SSIs and the associated risk factors evaluated. No risk factors for the development of SSI could be identified in this group. Dogs neutered prior to perineal herniorrhaphy compared to dogs neutered at time of surgical correction as well as dogs that developed fecal incontinence postoperatively may have both been at increased risk for recurrence after surgical hernia correction. Owners of dogs undergoing perineal herniorrhaphy after a prior castration should be educated on the possible increased risk of hernia recurrence postoperatively, and owners of dogs that develop fecal incontinence postoperatively should be informed of the possible increased risk for hernia recurrence.

A Meta-Analysis of Mitral Surgery in Patients Undergoing Surgery for Anomalous Left Coronary Artery: When to Perform Repair?

The present study is the first meta-analysis comparing long-term outcomes in patients undergoing correction for anomalous left coronary artery (ALCAPA) regarding concomitant mitral valve surgery. A systematic literature review was conducted to identify all relevant studies with comparative data on mitral valve surgery performed during surgery for ALCAPA correction. Predefined primary end points included mortality and mitral valve (re)operation. Echocardiographic outcomes were assessed when available (including severity of mitral regurgitation). Fifty-three relevant retrospective studies with comparative data for ALCAPA patients with concomitant mitral valve surgery were identified from the existing literature. The study population included 3,851 patients, of whom 55% were girls. The mean age at surgery was 6months [0-99months]. The mean follow-up after surgery was 22.7years [6.3-37.2]. Among patients with available echocardiographic data at the time of ALCAPA correction, 283 had no mitral regurgitation (13%), 642 had mild mitral regurgitation (30%), 756 had moderate mitral regurgitation (36%), and 437 had severe mitral regurgitation (21%). A subgroup of patients who underwent mitral valve surgery (yMVS; n = 753; 19.5% of the total population) was identified. A total of 228 patients died during follow-up (5.9%), with no differences among patients who underwent vs those who did not undergo mitral valve concomitant surgery at baseline (p = ns). Among the 1,536 patients with available follow-up echocardiographic data, 519 had no mitral regurgitation (34%), 663 had mild mitral regurgitation (43%), 268 had moderate mitral regurgitation (17%), and 86 had severe mitral regurgitation (6%). Overall, during follow-up, 91 patients underwent mitral valve surgery (first MVS for 20 pts and reintervention for 71 pts, representing a 10% reintervention rate). In regression analysis, we found no association between the mean age at first surgery and the need for reoperation (p = 0.458). Mitral valve surgery is performed in about 20% of patients undergoing ALCAPA correction. Indications for MVS vary among centers, although the severity of MV regurgitation was the most common criterion (more than 50% of the yMVS group). Of yMVS patients, approximately 10% underwent a second MVS during follow-up, regardless of age at first surgery. Overall, long-term mortality in these patients is over 5%, with no evident impact related to concomitant MV surgery.

Surgical treatment of scoliosis in patients with osteogenesis imperfecta: a single institution case series.

Osteogenesis imperfecta (OI) is a connective tissue disorder characterized by skeletal deformities, bone fragility, and spinal complications. Various studies' insights underscored the impact of scoliosis on pulmonary function, positive outcomes with spinal fusion, and improved functional abilities post-surgery. However, partial loss of correction remains inevitable. This study examines six surgically treated OI patients with scoliosis. Surgical intervention using a posterior approach with pedicle screws and hooks aimed to correct spinal deformities. Preoperative, postoperative, and follow-up radiological assessments were conducted, revealing significant reductions in scoliotic angles post-surgery. Complications included infections and proximal junctional kyphosis requiring revision surgeries. Despite the challenges posed by poor bone quality and implant stability, no implant failures occurred in this series. Ponte osteotomies at the apex of deformity aided in corrective maneuvers. Surgical treatment of scoliosis in patients affected by OI is challenging and may be associated with perioperative and postoperative complications. Ponte osteotomy may improve the correction and reduce necessary force at the time of correction.

Benefit of isolated surgical valve repair or replacement for functional tricuspid regurgitation and long-term outcomes stratified by the TRI-SCORE.

Severe tricuspid regurgitation is associated with increased mortality rates, but benefit of its correction and ideal timing are not clearly determined. This study aimed to identify patient subsets who might benefit from the surgery. In TRIGISTRY, an international cohort study of consecutive patients with severe isolated functional tricuspid regurgitation (33 centres, 10 countries), survival rates up to 10 years were compared between patients who underwent isolated tricuspid valve surgery (repair or replacement) and those conservatively managed, overall and according to TRI-SCORE category (low: ≤3, intermediate: 4-5, and high: ≥6). One thousand and two hundred seventeen were managed conservatively, and 551 underwent isolated tricuspid valve surgery (200 repairs and 351 replacements). TRI-SCORE distribution was 33% low, 32% intermediate, and 35% high. At 10 years, survival rates were similar between surgical and conservative management [41% vs. 36%; hazard ratio (HR) .97; 95% confidence interval (CI) .88-1.08, P = .57]. Surgery improved survival compared with conservative management in the low TRI-SCORE category (72% vs. 44%; HR .27; 95% CI .20-.37, P < .0001), but not in the intermediate (36% vs. 37%; HR 1.17; 95%CI .98-1.40, P = .09) or high categories (20% vs. 24%; HR 1.06; 95% CI .91-1.25, P = .45). Both repair and replacement improved survival in the low TRI-SCORE category (84% and 61% vs. 44%; HR .11; 95% CI .06-.19, P < .0001, and HR .65; 95% CI .47-.90, P = .009). Repair showed benefit in the intermediate category (59% vs. 37%; HR .49; 95% CI .35-.68, P < .0001) while replacement was possibly harmful (25% vs. 37%; HR 1.43; 95% CI 1.18-1.72, P = .0002). Higher survival rates were observed with repair than replacement and benefit of intervention declined as TRI-SCORE increased with no benefit of any type of surgery in the high TRI-SCORE category. These results emphasize the importance of timely intervention and patient selection to achieve the best outcomes and the need for randomized controlled trials.

Interplay Between Atmospheric Correction and Fusion Techniques Enhances the Quality of Remote Sensing Image Fusion

Remote sensing image fusion technology integrates observational data from multiple satellite platforms to leverage the complementary advantages of the different types of remote sensing images. High-quality fused remote sensing images provide detailed information on surface radiation, climate, and environmental conditions, thereby supporting governmental policies on environmental changes. Improving the quality and quantitative accuracy of fused images is a crucial trend in remote sensing image fusion research. This study investigates the impact of atmospheric correction and five widely applied fusion techniques on remote sensing image fusion. By constructing four fusion frameworks, it evaluates how the choice of fusion method, the implementation of atmospheric correction, the synchronization of atmospheric parameters, and the timing of atmospheric correction influence the outcomes of remote sensing image fusion. Aerial flights using remote sensors were conducted to acquire atmospheric parameter distribution images that are strictly synchronous with the remote sensing images. Comprehensive and systematic evaluations of the fused remote sensing images were performed. Experiments show that for the remote sensing images used, selecting the appropriate fusion method can improve the spatial detail evaluation metrics of the fused images by up to 2.739 times, with the smallest deviation from true reflectance reaching 35.02%. Incorporating synchronous atmospheric parameter distribution images can enhance the spatial detail evaluation metrics by up to 2.03 times, with the smallest deviation from true reflectance reaching 5.4%. This indicates that choosing an appropriate fusion method and performing imaging-based synchronous atmospheric correction before fusion can maximize the enhancement of spatial details and spectral quantification in fused images.

A Comparative Study between Early and Late Correction of Cases of Anorectal Malformation, Assessed by Fecal and Urinary Functional Outcome

Abstract Background Anorectal malformation (ARM) includes a wide spectrum of anomalies of the anorectal and urogenital region. They are not rarely associated with orthopedic, spinal, and neurologic abnormalities effecting the short- and long-term outcome. anorectoplasty at an early age is important for obtaining a better life quality in ARM patients. Aim Aim of the work to study defecation and urinary functional outcome according to timing of correction of ARM. Patients and Methods This was a cross sectional study conducted at patients with anorectal malformations (perineal fistula, rectourethral fistula, rectovesical fistula, vestibular fistula, no fistula, anal stenosis), at the Ain Shams pediatric surgery department and Qena pediatric surgery unit. Results bowel function and quality of life were significantly higher in early correction group compared to late correction group(p &amp;lt; 0.001). The mean of the quality of life in the early and late correction groups was 12.83± 0.59 and 11.13± 2.73 respectively. Conclusion Early anorectoplasty and early appropriate bowel management is advisable, as that is essential for less fecal and urinary functional complications, and for proper life quality.

P005 CHILDREN WITH REPAIRED COARCTATION OF THE AORTA: FOLLOW-UP AND HYPERTENSIO5

Background and objective: Coarctation of the aorta (CoA) is a congenital heart disease with high morbidity and mortality due to cardiovascular disease even after adequate therapeutic management. A fundamental factor is the development of high blood pressure over the years. The objective of this work is to analyze the blood pressure phenotype of the population under follow-up in a high blood pressure clinic. Methods: Retrospective review of medical records of patients aged 0 to 22 years with CoA corrected by surgery or interventional catheterizations, which were followed up between January 2017 and February 2023 in the high blood pressure clinic of a pediatric center. Variables to analyze: age at the time of correction, technique, time since correction, associated cardiac or extracardiac pathologies, office blood pressure, left ventricular hypertrophy. In patients with adequate height and tolerance to the procedure: Ambulatory Blood Pressure Monitoring (ABPM) and pulse wave velocity study were performed. Results: 142 medical records were reviewed (see table 1). Two groups were formed according to the age of the patients due to the possibility of performing ABPM. There were no significant differences between the age of surgical approach and the association with complex heart diseases between the groups. The younger population presented a greater number of extended terminal anastomosis technique and increased concentric remodeling. The prevalence of hypertension and overweight obesity increased over the years. The older group had 25% masked hypertension and 25% increased pulse wave velocity Conclusion: Our population has 28% of hypertension among those under 8 years of age and it increases to 46% among the eldest, coinciding with international reports that indicate that the evolution towards arterial hypertension in this population is progressive. Lifelong follow-up of these patients with corrected CoA is important to detect recoarctation or the development of hypertension and act accordingly to improve morbidity and mortality.

Topography-guided Anatomical Reassembly for Distal Penile Hypospadias Without Chordee: A Comprehensive Illustration and Midterm Results of a Novel Approach

ObjectivesTo provide a comprehensive illustration of the newly introduced ‘topography-guided anatomical reassembly’ approach, which has shown promising early results, and to report the mid-term outcomes of an extended series. MethodsThis is a prospective cohort study of all patients presenting to the author’s facility with distal penile hypospadias without chordee between June 2018 and January 2023. Redo cases, circumcised cases, and cases with non-preservable plates are excluded. The procedure follows the most recently introduced principle of the topography-guided anatomical reassembly approach for distal penile hypospadias, that is, the exclusive zipping-up of the unfolded spongiosal plate. ResultsA subset of 97 boys met the enrolment criteria. The hypospadias meatus was coronal or sub-coronal in 35 boys, distal penile in 45 boys, and mid-penile in 17 boys. The mean age at the time of surgical correction was 8.11 months. The mean operative time was 66.7 min. After a mean follow-up of 27 months, five urethrocutaneous fistulae were reported: three glanular and two sub-coronal. Meatal disfigurement with downward stream deviation was reported in two more patients. Two more occurrences of meatal recession were identified, yet surgical correction was not necessary. The overall reoperation rate settled at 7%. ConclusionsThe proposed topography-guided anatomical reassembly technique for distal hypospadias is simple, effective, and highly feasible at mid-term follow-up of the given series. Maintaining the integrity of well-developed penile tissues eliminates the possibility of unforgivable tissue damage and avoids the need for challenging revision procedures.

Phase-type distribution models for performance evaluation of condition-based maintenance

ABSTRACT Condition-based maintenance (CBM) is gaining attention due to sensor and cloud-based analytics advancements, but research on its impact on system-level performance is limited. Insufficient understanding during CBM implementation can lead to confidence issues and failures. This study introduces a class of models using phase-type distribution to assess three maintenance strategises: run-to-failure (RTF), time-based preventive maintenance (TBM), and CBM. Employing machine health-index, the framework characterizes production performance by estimating effective process times. The model demonstrates how adjusting CBM thresholds influences process time variations and assesses the impact of changing maintenance frequency for TBM. Applied to a smart cellular manufacturing system, the model shows CBM’s early-stage implementation. Findings indicate CBM with optimized thresholds boosts maximum throughput by 6.77%. Further, CBM achieves an additional 6.84% increase assuming corrective maintenance time can be reduced by 20%. This approach can help manufacturing become smarter through smarter maintenance in the Industry 4.0 era and beyond.

Do low-density screws influence pelvic incidence in adolescent idiopathic scoliosis correction?

Low-density screw constructs yield significant radiographic and clinical improvements with reduced risk of neurological complications. This study aimed to investigate the relationship between coronal Cobb angle and pelvic incidence (PI) in the correction of adolescent idiopathic scoliosis (AIS) using a low-density construct, as well as the association between PI and functional outcomes. This prospective cohort study involved 60 posteriorly instrumented AIS patients, aged 10-16 years, with Cobb angles ranging from 45° to 90° of various Lenke types. Radiological assessments were conducted pre- and postsurgery at 1, 3, 6, 12, and 24 months. Functional evaluation utilized the Scoliosis Research Society score form (SRS-30). A positive correlation was observed between screw density and operation time, blood loss, and degree of correction with SRS change (P = 0.004). No correlation was found between screw density and hospital stay, loss of correction, correction rate, SRS change, change in PI, or Cobb angle. Correction of AIS through a posterior approach using a low-density construct can lead to satisfactory curve correction, impacting spinopelvic parameters. However, PI alone does not directly influence patient functional outcomes assessed by SRS-30. Low-density implant constructs reduce operative time, blood loss, costs, and complication risks.

Application of locally regularized extremal shift to the problem of realization of a prescribed motion

Abstract A controlled system of differential equations under the action of an unknown disturbance is considered. The problem discussed in the paper consists in constructing algorithms for forming a control that provides the realization of a prescribed motion for any admissible disturbance. Namely these algorithms should provide the closeness in the metric of the space of differentiable functions of a phase trajectory of a given controlled system and some etalon trajectory of an analogous system functioning when any outer actions are absent. As the space of admissible disturbances, we take the space of measurable square integrable (with respect to the Euclidean norm) functions. The cases of inaccurate measurements of phase trajectories of both systems at all times and at discrete times are under study. Two computer oriented algorithms for solving the problem are designed. The algorithms are based on the (well-known in the theory of guaranteed control) method of extremal shift. In the process, its local (at each time of control correction) regularization is performed by the method of smoothing functional (the Tikhonov method). In addition, estimates for algorithm’s convergence rate are presented.

Early approach for the iatrogenic vesico-vaginal fistula repair: a video case report.

Vesico-vaginal fistula (VVF) is a rare but debilitating condition, characterised by an abnormal connection between the bladder and vagina. While obstetric-related cases prevail in developing countries, iatrogenic fistulas are more common in industrialised ones, often resulting from pelvic surgeries. The optimal timing for surgical correction of VVF remains debated, often leaning towards delayed intervention. Here we report a successful early laparoscopic repair of an iatrogenic VVF following hysterectomy. The patient, a 54-year-old woman, presented with VVF after a hysterectomy. The laparoscopic repair was performed promptly upon diagnosis. To assess the feasibility and effectiveness of an early repair of a gynaecological-related VVF. First, cystoscopy identified the bladder edge of the VVF. Second, laparoscopy was performed and the vesico-vaginal dissection was carried out. The excision of the previous stitches and of the fibrotic tissue was undertaken to create free flaps for suturing. The bladder was repaired in a double layer, and a single layer was applied to the vagina. Finally, the omentoplasty was done. The patient was discharged on postoperative day 5. No complications occurred. This successful case demonstrates the feasibility and safety of early laparoscopic repair for gynaecological surgery-related vesico-vaginal fistulae. While acknowledging the need for further studies to standardise techniques, this report contributes to the evolving understanding of optimal management for this complex condition.

Prevalence of Gastroesophageal Reflux Disease in Congenital Diaphragmatic Hernia Survivors From Infancy to Adulthood

BackgroundGastroesophageal reflux disease (GERD) is a common comorbidity associated with congenital diaphragmatic hernia (CDH), with reported cases of Barrett's esophagus (BE) and esophageal adenocarcinoma before the age of 25. The prevalence and natural course of GERD in CDH survivors remain uncertain due to variations in diagnostic methods. We aimed to analyse the GERD prevalence from infancy through young adulthood. MethodsWe retrospectively analyzed pH-impedance measurements and endoscopic findings in 96 CDH survivors evaluated as routine care using well established clinical protocols.GERD was defined as an abnormal acid exposure time for pH-MII measurements and as presence of reflux esophagitis or BE at upper endoscopy. Clinical data including symptoms at time of follow-up and use of antireflux medication were collected. ResultsGERD prevalence remained consistently low (≤10%) across all age groups, yet many patients experienced GER symptoms. Histological abnormalities were observed in 80% of adolescents and young adults, including microscopic esophagitis in 50%. BE was diagnosed in 7% before the age of 18, all had GER symptoms. CDH severity, anatomy at the time of CDH correction, alcohol usage, and smoking did not emerge as significant risk factors for GERD. ConclusionsGiven the low GERD prevalence in CDH survivors, a symptom-driven approach to diagnosis and follow-up is warranted. We advise long-term follow-up for all adult patients due to the early onset of BE and the limited evidence available. The longitudinal course and impact of GERD on other long-term CDH-related comorbidities should be explored in larger cohorts. Level of EvidenceNot applicable

'Suspension Palatoplasty' - A method of surgical correction of VPI post Cleft Palate repair.

To design the technique of 'Suspension Palatoplasty' for Velopharyngeal Insufficiency (VPI) post Cleft Palate (CP) based on optimal spatial positioning of palate at the time of VPI correction, by using a non-obstructive, high, midline pharyngeal flap for predictable velopharyngeal closure and normal speech. To evaluate the results of CP patients with VPI operated using the technique of 'Suspension palatoplasty'. An ambi-spective longitudinal clinical study. Comprehensive cleft care clinic in a private trust hospital. Patients operated using the 'Suspension Palatoplasty' technique for VPI post CP repair between 2014 and 2018 with a minimum follow-up period of 5 years. 'Suspension Palatoplasty' - Double Opposing Z (DOZ) plasty with palatal myoplasty is used to revise soft palate and a narrow superiorly based pharyngeal flap is used to suspend it for a dynamic velopharyngeal closure. Speech outcome and surgical complications. 70 out of 119 studied were found to have normal speech (59%), and another 25 patients (21%) had acceptable speech. Thus 95 out of 119 patients (80%) had normal or near-normal speech and did not require any further speech therapy or surgeries. 12 patients had snoring without difficulty in breathing. One patient had symptoms suggestive of obstructive sleep apnea. Younger patients had a higher percentage of normal speech outcomes. Many of our adult patients also attained normal speech. 'Suspension Palatoplasty' aims to achieve normal speech with little effort. It has minimal side effects. The author has performed 403 cases to date.

Primary frequency control optimization of coal-fired power plants with high-low position shafts: Employing a revised strategy with power-decoupling and feedforward-compensating

Coal-fired units play a critical role in peak-shaving and frequency regulation with high penetration of renewable energy. The coal-fired unit arranged by high-low position shafts applied in power stations will participate in these regulation processes. In this study, the dynamic model of the 1100 MW supercritical coal-fired unit is built and verified, dynamic characteristics of the primary frequency regulation process are analyzed and a poor control effect of the original control strategy is illustrated. Then, the dynamic coupling relationship between high and low-level units is obtained, and there is a 14-s time delay between the two power outputs, and a revised regulation strategy that employs load distribution factor and flow-rate feedforward-compensating is proposed. Compared with the original control strategy, the revised control strategy can effectively lower fluctuations of the steam parameters by approximately 50%, and the corrective regulation time decreases from 25.1 s and 15.8 s to 6.9 s and 12.1 s under positive and negative load disturbance, respectively. Moreover, it can improve the control effect of low-level unit, whose regulation time under positive and negative load disturbance decreases from 45.7 s and 27.7 s to 9.4 and 20.6 s, respectively. This research can provide technical guidance for the operation of coal-fired units.

Conformation Effect on the Mechanical and Microbiological Behavior of Invisible Orthodontic Aligners.

Invisible orthodontic aligners are having a great impact on tooth movement in an aesthetic and effective way. Different techniques, models, and clinical aspects have been studied for their proper use. However, the aim of this research has been to determine the effect of the shaping process on mechanical properties and their bacterial behavior. For this study, 40 original polyurethane plates and 40 identical models, obtained by hot forming the original plates, were used. The static tensile mechanical properties were studied with a Zwick testing machine using testing speeds of 5 mm/min at a temperature of 37 °C. The original plate and the aligner have been studied with a creep test by subjecting the samples to a constant tension of 30 N, and determining the elongation using a long-distance, high-resolution microscope at different time periods between 1 and 720 h. Studies of water absorption has been realized with artificial saliva for 5 h. Bacterial cultures of Streptococcus oralis and Actinomyces viscosus strains were grown on the original plates and on new and used models, to determine the proliferation of each bacterium through metabolic activity, colony-forming units, and LIVE/DEAD assays. The mechanical results showed an increase in the strength of the inserts with respect to the models obtained from 3.44 to 3.95 MPa in the elastic limit and a lower deformation capacity. It has been proven that the transition zone in the creep curves lasts longer in the original plate, producing the rapid increase in deformation at a shorter time (400 h) in the aligner. Therefore, the shaping process reduces the time of dental correction exerted by the aligner. The results of the bacterial culture assays show an increase in the number of bacterial colonies when the aligners have been used and when the polyurethane is conformed due to the internal energy of the model, with respect to the original polyurethane. It has been observed that between the original plate and the aligner there are no statistically significant differences in water absorption and therefore the forming process does not affect water absorption. A slight increase in water absorption can be observed, but after five hours of exposure, the increase is very small.

Time-varying propagation model and dynamic-feedback-phase correction for multiplexed orbital angular momentum beams in atmospheric turbulence.

Freespace optical (FSO) communication in an outdoor setting is complicated by atmospheric turbulence (AT). A time-varying (TV) multiplexed orbital angular momentum (OAM) propagation model to consider AT under transverse-wind conditions is formulated for the first time, and optimized dynamic correction periods for various TV AT situations are found to improve the transmission efficiency. The TV nature of AT has until now been neglected from modeling of OAM propagation models, but it is shown to be important. First, according to the Taylor frozen-turbulence hypothesis, a series of AT phase screens influenced by transverse wind are introduced into the conventional angular-spectrum propagation analysis method to model both the temporal and spatial propagation characteristics of multiplexed OAM beams. Our model shows that while in weak TV AT, the power standard deviation of lower-order modes is usually smaller than that of higher-order modes, the phenomena in strong TV AT are qualitatively different. Moreover, after analyzing the effective time of each OAM phase correction, optimized dynamic correction periods for a dynamic feedback communication link are obtained. An optimized result shows that, under the moderate TV AT, both a system BER within the forward-error-correction limit and a low iterative computation volume with 6% of the real-time correction could be achieved with a correction period of 0.18 s. The research emphasizes the significance of establishing a TV propagation model for exploring the effect of TV AT on multiplexed OAM beams and proposing an optimized phase-correction mechanism to mitigate performance degradation caused by TV AT, ultimately enhancing overall transmission efficiency.

Adult versus adolescent idiopathic scoliosis surgery: a meta-analysis of clinical and radiographic outcomes.

While the natural history of adolescent idiopathic scoliosis (AIS) and adult idiopathic scoliosis (AdIS) is well documented in the literature, the impact of age on postoperative outcomes remains an active area of research. We performed a systematic review and meta-analysis to compare patients undergoing surgery for AIS and AdIS with respect to: (1) postoperative Cobb correction, (2) perioperative variables, and (3) postoperative complications. A systematic literature search was performed in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. studies published between 2002 and 2022, retrospective, and comparing AIS vs. AdIS patients undergoing deformity surgery. The primary outcome was postoperative Cobb correction. Secondary outcomes included estimated blood loss (EBL), operative time, total instrumented levels, length of stay (LOS), and postoperative complications. Random-effects models were performed according to the method of DerSimonian and Laird. Of 190 identified articles, 14 fit the inclusion criteria. A total of 1788 patients were included, 1275(71.3%) with AIS, and 513(28.7%) with AdIS. There was a significant age difference between AIS and AdIS (15.3 vs. 36.7years, mean difference (MD) = 21.3years, 95%CI = 14.3-28.4,p < 0.001). Mean postoperative Cobb percentage correction was reported in 5 articles and was significantly higher in AIS (68.4%) vs. AdIS (61.4%) (MD = -7.2, 95%CI = -11.6,-2.7,p = 0.001). EBL was not significantly different between AIS and AdIS (695.6mL vs 817.7mL,p = 0.204). Furthermore, no difference was found in operative time (MD = 37.9min,95%CI = -10.7;86.6,p = 0.127), total instrumented level (MD = 0.88,95%CI = -0.7,2.4,p = 0.273), and LOS (MD = 0.5, 95%CI = -0.2;1.2, p = 0.188). Four articles reported postoperative complications in AIS vs AdIS, with no difference in neurological deficit, instrumentation-related complications, and medical complications. AIS patients had better radiographic correction compared to AdIS. Though no difference was found in perioperative outcomes and complications, these findings emphasize the importance of counseling patients regarding the optimal timing of surgical correction.

High-Frequency Surface Wave Radar Current Measurement Corrections via Machine Learning and Towed Acoustic Doppler Current Profiler Integration

High-Frequency Surface Wave Radar Current Measurement Corrections via Machine Learning and Towed Acoustic Doppler Current Profiler Integration

A Study on the Impact of Pradhan Mantri Mathru Vandhana Yojana Among Rural Women in Kerala

Pradhan Mantri Mathru Vandhana Yojana is a maternity benefit programme started in 2017, for transfering financial benefits to pregnant lactating women to solve the problem of undernourishment in women. It is playing a prominent role in solving this issue by giving timely assistance for their first living child to pregnant women and mothers who are lactating. Pradhan Mantri Mathru Vandhana Yojana has been a helping hand to the rural women of kerala especially in Wayanad, Kasargode, Quilon and Kozhikode districts. Many rural women in kerala especially tribal women are suffering from one major problem undernourishment. Most of them work till their delivery date. Many of the problems of this rural women are solved by this scheme. Since their financial problems are solved at the correct time they are able to take rest and give birth to healthy babies who are the promises of tomorrow. Women in urban area working in daily wages are also taken care under this scheme.