Strikes and stripes of the Saw-scaled Viper in the Western Ghats-A case series.

We describe 5 cases of envenomation and complications related to saw scaled viper (Echis carinatus) bites from the Western Ghats region of Karnataka over a period of 5 years (December 2019-May 2023). Although the smallest member of the Big Four, Saw Scaled viper envenomation is associated with significant morbidity. In our region, envenomation appears to be rare. The careful review of all these cases has suggested VICC with one patient having persistent coagulopathy despite adequate ASV administration, and three patients developing anaphylaxis. It needs to be brought to notice that the complications due to envenoming run high, despite timely administration of ASV. Through these cases, we want to contribute evidence suggesting variable efficacy of Indian polyvalent ASV for Echis carinatus bites and the need for updating protocols for the same.

"The Jigsaw Puzzle Locking Technique" to Augment the Stabilization between the Septal Cartilage and Extension Graft in End-to-End Suture Fixation.

INTRODUCTION: Nasal tip stability is crucial for long-lasting results. Usage of the extension graft is one of the most reliable stabilization techniques. With a septum in the midline, the extension graft is fixed end to end. The "jig-saw puzzle technique" reinforces this end-to-end fixation. The specific protrusion on one piece of the puzzle is inserted in a groove on adjacent piece. This settlement provides stabilization between the pieces. Application of this philosophy between the nasal septum and extension graft may provide a long-term fixation. MATERIAL METHOD: Between April 2022 and March 2024, the "jig-saw puzzle technique" was applied in 26 female patients. Trapezoid-shaped protrusion was created at the septum. Similar indentation was created at the extension grafts. The protrusion is then settled in the indentation. The preop, immediate postoperative and one-year postoperative pictures are compared to assess the rotations and projections with Adobe Photoshop Program. RESULTS: All 26 patients were females with mean age 27.5 years (20-32). Satisfactory graft stabilization was obtained without loss of projection and rotation in all patients. Statistically significant difference was found between the preoperative, immediate postoperative and postoperative 1-year projection and rotation assessments of the patients (p = 0.001; p < 0.01). The results were evaluated at a 95% confidence interval and significance was evaluated at p < 0.05 level. These statistical analyses verify that both projection and rotation were preserved with jig-saw puzzle technique. CONCLUSION: The jigsaw puzzle technique may provide suture-independent, long-term end-to-end fixation opportunity of the septal cartilage and the extension graft. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Investigation of the effectiveness of prehospital amputation devices on cadavers.

Amputations take place in the operating rooms. At dangerous sites, circumstances may necessitate on-site amputation to save lives. Currently, there are no evidence-based guidelines for the execution of the amputation or the instruments to be chosen. Furthermore, there are no widely accepted criteria for the standardized characterization of amputation devices. The present study examined the effectiveness of commercially available cutting tools and instruments used by rescue services as possible on-site amputation tools. Five different tools (Holmatro type hydraulic cutter, with two cutting attachments, reciprocating saw, hacksaw, Gigli saw) were used to carry out amputations on designated locations on cadavers (brachial, antebrachial, femoral, and crural regions). During the experiment, the time required for amputation and the number of necessary cutting attempts to detach limbs were recorded. The proximal cut surfaces were analyzed with the help of post-amputation CT scan-based 3D models. An Amputation Index (AI) was determined for each device in each examined region based on the cut surface quality. An Amputation Score (AS) was calculated using the time required for cutting, the number of cutting attempts, and the AI. With the help of AS, the usability of the used devices was determined. According to our scoring system, the reciprocating saw proved the most effective tool. Based on our results, we recommend the consideration and further investigation of the reciprocating saw as a possible on-site amputation device, as well as the introduction of the Amputation Score as an objective and quantitative indicator in the future characterization of on-site amputation devices.

Miniaturized Antenna Design for Wireless and Powerless Surface Acoustic Wave Temperature Sensors.

This paper presents the introduction, design, and experimental validation of two small helical antennae. These antennae are a component of the surface acoustic wave (SAW) sensor interrogation system, which has been miniaturized to operate at 915 MHz and aims to improve the performance of wireless passive SAW temperature-sensing applications. The proposed antenna designs are the normal-mode cylindrical helical antenna (CHA) and the hemispherical helical antenna (HSHA); both designed structures are developed for the ISM band, which ranges from 902 MHz to 928 MHz. The antennae exhibit resonance at 915 MHz with an operational bandwidth of 30 MHz for the CHA and 22 MHz for the HSHA. A notch occurs in the operating band, caused by the characteristics of the SAW sensor. The presence of this notch is crucial for the temperature measurement by aiding in calculating the frequency shifting of that notch. The decrement in the resonance frequency of the SAW sensor is about 66.67 kHz for every 10 °C, which is obtained by conducting the temperature measurement of the system model across temperature environments ranging from 30 °C to 90 °C to validate the variation in system performance.

I saw the "hook" sign of median arcuate ligament syndrome.

The hook sign is a radiologic finding best appreciated on a sagittal view of the celiac artery with computed tomography (CT) that indicates compression of the celiac artery. It refers to the hooked-shape of the proximal celiac artery caused by extrinsic compression by the median arcuate ligament. When seen in a patient with concurrent abdominal symptoms, it suggests median arcuate ligament syndrome (MALS). We saw the sign in a 15-year-old male via duplex ultrasonography and abdominal CT. He underwent laparoscopic release of the median arcuate ligament and had full resolution of his symptoms at follow-up.

Temperature Effect on Deformation Mechanisms and Mechanical Properties of Welded High-Mn Steels for Cryogenic Applications.

High-manganese steel (high-Mn) is valuable for its excellent mechanical properties in cryogenic environments, making it essential to understand its deformation behavior at extremely low temperatures. The deformation behavior of high-Mn steels at extremely low temperatures depends on the stacking fault energy (SFE) that can lead to the formation of deformation twins or transform to ε-martensite or α'-martensite as the temperature decreases. In this study, submerged arc welding (SAW) was applied to fabricate thick pipes for cryogenic industry applications, but it may cause problems such as an uneven distribution of manganese (Mn) and a large weldment. To address these issues, post-weld heat treatment (PWHT) is performed to achieve a homogeneous microstructure, enhance mechanical properties, and reduce residual stress. It was found that the difference in Mn content between the dendrite and interdendritic regions was reduced after PWHT, and the SFE was calculated. At cryogenic temperatures, the SFE decreased below 20 mJ/m2, indicating the martensitic transformation region. Furthermore, an examination of the deformation behavior of welded high-Mn steels was conducted. This study revealed that the tensile deformed, as-welded specimens exhibited ε and α'-martensite transformations at cryogenic temperatures. However, the heat-treated specimens did not undergo α'-martensite transformations. Moreover, regardless of whether the specimens were subjected to Charpy impact deformation before or after heat treatment, ε and α'-martensite transformations did not occur.

Isolation and Characterization of Exosomes from Cancer Cells Using Antibody-Functionalized Paddle Screw-Type Devices and Detection of Exosomal miRNA Using Piezoelectric Biosensor.

Exosomes are small extracellular vesicles produced by almost all cell types in the human body, and exosomal microRNAs (miRNAs) are small non-coding RNA molecules that are known to serve as important biomarkers for diseases such as cancer. Given that the upregulation of miR-106b is closely associated with several types of malignancies, the sensitive and accurate detection of miR-106b is important but difficult. In this study, a surface acoustic wave (SAW) biosensor was developed to detect miR-106b isolated from cancer cells based on immunoaffinity separation technique using our unique paddle screw device. Our novel SAW biosensor could detect a miR-106b concentration as low as 0.0034 pM in a linear range from 0.1 pM to 1.0 µM with a correlation coefficient of 0.997. Additionally, we were able to successfully detect miR-106b in total RNA extracted from the exosomes isolated from the MCF-7 cancer cell line, a model system for human breast cancer, with performance comparable to commercial RT-qPCR methods. Therefore, the exosome isolation by the paddle screw method and the miRNA detection using the SAW biosensor has the potential to be used in basic biological research and clinical diagnosis as an alternative to RT-qPCR.

Suppression of Transverse Modes in 50°YX-LiTaO3/SiO2/Si POI SAW Resonator with Groove Configuration.

With the rapid development of mobile communication technology, the POI (piezoelectric on insulator) structure has gained recognition in the field of RF filtering. However, transverse modes remain in the passband of corresponding surface acoustic wave (SAW) devices, which impedes their application in crowded spectra. This article introduces a groove configuration to suppress transverse modes for POI SAW resonators employing a 50°YX-LiTaO3/SiO2/Si multilayered structure. First, the response of conventional POI SAW resonators was calculated by the 3D periodic FEM method, and the results indicate that transverse modes caused by energy leakage to busbar regions are serious in POI SAW resonators. Then, the groove configuration was adopted to confine energy within the aperture region by reducing the velocity at the end of IDT electrodes, and the groove dimension was optimized to achieve a nearly spurious-free response in the passband. Finally, experimental results of fabricated one-port SAW resonators with optimal groove configuration were provided to validate the suppression of transverse modes and the enhancement of the Q factor in the POI SAW resonator.

Clinical outcomes of guider-assisted osteotomy compared to conventional pendulum-saw osteotomy in open wedge high tibial osteotomy: a propensity score-matched cohort study.

PURPOSE: We developed a novel guider-assisted osteotomy (GAO) procedure to improve the safety of open wedge high tibial osteotomy (OWHTO) and aimed to compare its efficacy and complications with the conventional pendulum-saw osteotomy (PSO). METHODS: This is a retrospective cohort study of patients undergoing either GAO or PSO procedure in the OWHTO to treat varus knee osteoarthritis, who had a minimum of 2 years of follow-up. Patients were propensity score matched (PSM) in a 1:1 ratio based on demographic and clinical data with a caliper width of 0.02. The outcomes assessed involved the hospital for special surgery (HSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and the Intraoperative and postoperative complications. RESULTS: 199 patients were included in each group after PSM. The mean duration of follow-up was 38.3 ± 8.9 months. The GAO group had a shorter operation duration (104.5 ± 35.7 vs. 112.1 ± 36.0 min, p = 0.027) and fewer times of intraoperative fluoroscopy (4.2 ± 1.4 vs. 6.0 ± 1.4, p < 0.001). At the last follow-up, clinical scores for knee achieved significant improvements in both GAO and PSO groups: HSS (67.5 ± 10.5 vs. 90.2 ± 7.0, p < 0.001; 69.4 ± 8.2 vs. 91.7 ± 6.8, p < 0.001) and WOMAC (65.7 ± 11.6 vs. 25.2 ± 10.4, p < 0.001; 63.3 ± 12.2 vs. 23.8 ± 9.5, p < 0.001). However, no significant difference was observed between groups for any measures (p > 0.05). In addition, the intraoperative complications (0.5% vs. 3.5%, p = 0.068) and the postoperative bone delayed union and nonunion (1.0% vs. 4.5%, p = 0.032) were marginally or significantly reduced in the GAO versus PSO group. CONCLUSION: GAO demonstrates improvements in intraoperative radiation exposure and complications, with comparable short-term efficacy to PSO, and could be considered a viable alternative in clinical practice.

A Surface Acoustic Wave-Based PM 1.0 Fine Dust Detection System Using Full Digital Time-Interleaved Counters.

This paper proposed a fine dust detection system using time-interleaved counters in which surface acoustic wave (SAW) sensors changed the resonance point characteristic. When fine dust was applied to the SAW sensor, the resonance point decreased. The SAW oscillator made of the SAW sensor and radio frequency (RF) amplifier generated an oscillation frequency that was the same as the resonance frequency. The oscillation frequency was transferred to digital data by a 20-bit asynchronous counter. This system has two channels: a sensing channel and a reference channel. Each channel has a SAW oscillator and a 20-bit asynchronous counter. The difference of the two channel counter results is the frequency difference. Through this, it is possible to know whether fine dust adheres to the SAW sensor. The proposed circuit achieved 0.95 ppm frequency resolution when it was operated at a frequency of 460 MHz. This circuit was implemented in a TSMC 130 nm CMOS process.

The Application of Commercial Surface Acoustic Wave Radio Communication Filters as Transducers for DMMP Sensors.

In the present study, we used two popular radio communication SAW resonators as a base for gas sensors and tested their performance. Taking into account issues related to sensor sensitivity, the possibility of applying a sensor layer, the availability of devices, and other related issues, we selected two popular single-port resonators with center frequencies of 315 and 433 MHz (models R315 and R433, respectively) for testing purposes. Both resonators were equipped with a sensitive film of hexafluoroisopropanol-substituted polydimethylsiloxane, a material that selectively absorbs molecules with a high ability to form basic hydrogen bonds. Fabricated sensors were used to detect trace amounts of dimethyl methylphosphonate (DMMP) vapor, which has often been used in similar studies as a nerve chemical warfare agent simulant. Sensors using both devices loaded with sensor layers of an optimal thickness rapidly reacted to a gas containing DMMP at a concentration of 3 mg/m3, generating a stable analytical signal ranging from several to several dozen kilohertz. In the case of R433, the frequency signal was 20.5 kHz at 1 min from the beginning of exposure to DMMP. The obtained results showed that the used transducers exhibited good performance as a base for gas sensors. Finally, their suitability for sensing applications was confirmed by a comparison with the results obtained in previous similar studies.

Beneficial effects of saw palmetto (Serenoa repens) fruit extract on the urinary symptoms of healthy Japanese adults with possible lower urinary tract symptoms: A randomized, double-blind, placebo-controlled study.

Saw palmetto extract (SPE) is the most commonly used supplement for the treatment of lower urinary tract symptoms (LUTS), but most evidence is for those with LUTS, and little data is verifying its effectiveness for those who do not have the disease but are troubled by symptoms. The purpose of this study was to examine the effect of SPE on the improvement of urinary frequency problems that present stress due to urinary urgency in daily life, among healthy Japanese adults aged ≥50 years who are not diagnosed with benign prostatic hyperplasia or overactive bladder. They were randomly assigned to the SPE group or placebo group (34 participants per group) using a computerized random number generator. Each participant was instructed to take one capsule containing SPE (320 mg) or placebo every day for 12 weeks. Subjective symptoms were assessed using the overactive bladder questionnaire, and the score of symptom bother by frequent urination during the daytime hours was set as the primary outcome. The other outcomes were subjective urinary symptoms and urinary frequencies. The final efficacy analysis dataset was per protocol set, and 33 participants in each group were analyzed. After SPE intervention for 12 weeks, the score of symptom bother by frequent urination during the daytime hours was significantly improved and the daytime frequency of urination assessed using the urinary log was significantly decreased. The consumption of SPE improved urinary frequency-related quality of life such as bother of urinary symptoms in healthy Japanese adults (UMIN000045334).

Network pharmacology and experimental validation to explore the pharmacological mechanism of saw palmetto and its core ingredients in benign prostatic hyperplasia treatment.

Benign prostatic hyperplasia (BPH) is a prevalent urological condition that predominantly affects the geriatric male population, resulting in lower urinary tract symptoms. Saw palmetto is a traditional Chinese medicine for treating BPH. This study aimed to investigate the potential therapeutic mechanisms of saw palmetto in BPH treatment. The active ingredients and potential targets of saw palmetto were obtained through the TCMSP database. BPH-related targets were retrieved from the GeneCards database. PPI, GO, and KEEG analyses were performed to predict the potential therapeutic mechanism. The active ingredient-common target and common target-pathway networks were constructed by Cytoscape software. Molecular docking and cellular experiments were carried out to further validate the potential mechanism. We obtained 13 active components in saw palmetto and 56 common targets in BPH treatment. KEEG analysis showed that the estrogen signaling pathway was the most enriched and exhibited a close association with BPH. PPI analysis, along with ingredient-target and target-pathway network analyses, indicated that stigmasterol was the core ingredient and PGR, NCOA1, and NCOA2 were identified as the hub genes mediating the effects of saw palmetto against BPH. In addition, molecular docking showed that stigmasterol had strong binding to PGR, NCOA1, and NCOA2. Cellular experiments revealed that stigmasterol significantly increased the percentage of BPH-1 cells in the G0/G1 phase and inhibited cell viability and division. Furthermore, it notably reduced the expression of PGR, NCOA1, and NCOA2. Saw palmetto might inhibit cell viability and division by suppressing the expression of PGR, NCOA1, and NCOA2, thereby playing a therapeutic role in treating BPH.

Hiding the evidence: Preliminary investigation of heat-induced alterations to pre-existing saw mark trauma.

Dismemberment and subsequent burning are common methods employed in an attempt to conceal or destroy evidence. While kerf characteristics can be utilised to identify tool(s) used for dismemberment, further research is necessary to assess the effect of burning on these characteristics. In this study, a back (tenon) saw (13 teeth per inch) was used to manually inflict trauma on Ovis aries de-fleshed femur bones (n = 18). Three different cut marks (shallow false start, incomplete cut and complete transection) were made on the mid-shaft of each bone. Subsequently, the bones were burned for 20 minutes in a muffle furnace. Three burn temperatures were assessed: 400 °C, 600 °C and 800 °C. Saw mark characteristics of each cut type were assessed and compared pre- and post-burning. All pre-existing trauma was recognisable post-burning; however, metric and morphological alterations were apparent. An increase in kerf width was observed at 600 °C in false start lesions and 800 °C in incomplete cuts. Breakaway spur thickness decreased post-burning (at 400 °C and 800 °C) but length was not significantly affected. Mean inter-striation distance decreased post burning at all temperature groups. Saw marks were distinguishable from heat-related fractures across all temperature groups. One false start lesion was obliterated at 800 °C. Exit chipping, pull-out striae as well as striation regularity appeared to be more enhanced after heat exposure. These alterations indicate a temperature-dependent impact on these characteristics. Further research is necessary to assess the role of burn duration.

Finite element modeling of active cracking in actively reinforced concrete pavement slab exposed to fluctuating temperature.

The continuously reinforced concrete pavement (CRCP) system grapples with challenges such as non-uniform transverse crack patterns and the need for substantial reinforcement. Field research on the Belgian CRCP sections along motorway E313 indicates that active cracking induced by partial surface saw-cuts consistently leads to transverse crack patterns. This study introduces an innovative modification to the CRCP: the actively reinforced concrete pavement design (ARCP). The ARCP leverages partial surface saw-cuts to reduce reinforcement needs by replacing continuous-length steel bars with partial-length counterparts. The main objective of the present study is to develop a 3D finite element (FE) model capturing the active cracking behavior of ARCP under realistic external temperature variations. Comparative analysis with CRCP considers early-age crack patterns, crack strain development, and the distribution of maximum steel stress for different steel ratios (0.67%, 0.75%, and 0.85%). FE simulation results align with field data, indicating that ARCP exhibits similar early-age cracking behavior to CRCP but with a significant 24 to 42% reduction in total reinforcement. This innovation presents a promising avenue for addressing CRCP challenges while optimizing material usage in pavement construction.

Complete and Immediate Resolution of See-Saw Nystagmus Following Pituitary Macroadenoma Resection: Case Report and Review of the Literature.

See-saw nystagmus (SSN) is a rare form of nystagmus characterised by alternating elevation with incyclotorsion of one eye and concomitant depression with excyclotorsion of the other eye, often due to abnormalities involving the midbrain and parasellar region. Herein, we highlight a rare case of pendular SSN, which demonstrated complete resolution following resection of a pituitary macroadenoma. A patient in their 40s was identified to have SSN and was diagnosed with a pituitary macroadenoma. They underwent an endoscopic endonasal transsellar approach for resection of the pituitary adenoma. Their nystagmus resolved immediately after surgery. From a review of the literature, resolution and/or significant improvement in SSN occurred in 74% of cases following treatment, with 100%, 86% and 50% following treatment for medication-induced, neurological infarcts, and mass-effect aetiologies of SSN, respectively. SSN is a rare entity with a wide array of aetiologies. Identification of the causative aetiology and appropriate treatment can lead to significant improvement or resolution of the nystagmus in most cases.

Recycling of Ti and Si from Ti-bearing blast furnace slag and diamond wire saw silicon waste by flux alloying technique.

Two industrial solid wastes, Ti-bearing blast furnace slag (TBFS) and diamond wire saw silicon waste (DWSSW), contain large amounts of Ti and Si, and their accumulation wastes resources and intensifies environmental pollution. In the present study, DWSSW was used as the silicon source to reduce titanium oxide in TBFS by electromagnetic induction smelting, and meanwhile Na3AlF6 was added as a flux to improve the recycling of the wastes. Ti and Si of the two wastes were simultaneously recovered in the form of alloy. The effects of different addition amount of Na3AlF6 flux in the mixture of DWSSW and TBFS on chemical composition, viscosity, basicity and structure of slag were investigated. The dissolution behavior of SiO2 in Na3AlF6 flux was theoretically deduced and experimentally verification. The optimized recovery rate of Ti and Si were obtained, and the research realizes the efficient recycling of DWSSW and TBFS simultaneously.

SAW Humidity Sensing with rr-P3HT Polymer Films.

In the present paper the humidity sensing properties of regioregular rr-P3HT (poly-3-hexylthiophene) polymer films is investigated by means of surface acoustic wave (SAW) based sensors implemented on LiNbO3 (1280 Y-X) and ST-quartz piezoelectric substrates. The polymeric layers were deposited along the SAW propagation path by spray coating method and the layers thickness was measured by atomic force microscopy (AFM) technique. The response of the SAW devices to relative humidity (rh) changes in the range ~5-60% has been investigated by measuring the SAW phase and frequency changes induced by the (rh) absorption in the rr-P3HT layer. The SAW sensor implemented onto LiNbO3 showed improved performance as the thickness of the membrane increases (from 40 to 240 nm): for 240 nm thick polymeric membrane a phase shift of about -1.2 deg and -8.2 deg was measured for the fundamental (~78 MHz operating frequency) and 3rd (~234 MHz) harmonic wave at (rh) = 60%. A thick rr-P3HT film (~600 nm) was deposited onto the quartz-based SAW sensor: the sensor showed a linear frequency shift of ~-20.5 Hz per unit (rh) changes in the ~5-~50% rh range, and a quite fast response (~5 s) even at low humidity level (~5% rh). The LiNbO3 and quartz-based sensors response was assessed by using a dual delay line system to reduce unwanted common mode signals. The simple and cheap spray coating technology for the rr-P3HT polymer films deposition, complemented with fast low level humidity detection of the tested SAW sensors (much faster than the commercially available Michell SF-52 device), highlight their potential in a low-medium range humidity sensing application.

Real-time biofilm detection techniques: advances and applications.

Microbial biofilms, complex assemblies enveloped in extracellular matrices, are significant contributors to various infections. Traditional in vitro biofilm characterization methods, though informative, often disrupt the biofilm structure. The need to address biofilm-related infections urgently emphasizes the importance of continuous monitoring and timely interventions. This review provides a focused examination of advancements in real-time biofilm detection techniques, specifically in electrochemical, optical and mechanical systems. The potential applications of real-time detection in managing and monitoring biofilm growth in industrial settings, preventing medical infections, comprehending biofilm dynamics and evaluating control strategies highlight the necessity for it. Crucially, the review emphasizes the importance of evaluating these methods for their accuracy and reliability in real-time biofilm detection, offering valuable insights for precise interventions across various applications.

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Wireless Temperature Measurement for Curved Surfaces Based on AlN Surface Acoustic Wave Resonators.

In this paper, we propose a novel method for temperature measurement using surface acoustic wave (SAW) temperature sensors on curved or irregular surfaces. We integrate SAW resonators onto flexible printed circuit boards (FPCBs) to ensure better conformity of the temperature sensor with the surface of the object under test. Compared to traditional rigid PCBs, FPCBs offer greater dynamic flexibility, lighter weight, and thinner thickness, which make them an ideal choice for making SAW devices working for temperature measurements under curved surfaces. We design a temperature sensor array consisting of three devices with different operating frequencies to measure the temperature at multiple points on the surface of the object. To distinguish between different target points in the sensor array, each sensor operates at a different frequency, and the operating frequency bands do not overlap. This differentiation is achieved using Frequency Division Multiple Access (FDMA) technology. Experimental results indicate that the frequency temperature coefficients of these sensors are -30.248 ppm/°C, -30.195 ppm/°C, and -30.115 ppm/°C, respectively. In addition, the sensor array enables wireless communication via antenna and transceiver circuits. This innovation heralds enhanced adaptability and applicability for SAW temperature sensor applications.