Whole-body magnetic resonance angiography.

Vascular disease, whether it be atherosclerosis, inflammatory, or hereditary vasculitide, is a systemic disorder with disease in one territory predictive of disease in another. Despite this, current approaches focus on single-territory assessment ignoring the global burden of disease. Advances in MRI have enabled us to surmount previous limitations and expand our approach to such conditions with the ability to simultaneously assess the entirety of the arterial tree in a single examination, allowing a staging examination as it were, of the vascular health in its totality. This review will cover the acquisition technique, reporting, clinical utility, and current evidence base for such an approach.

Smartphone geospatial apps for dengue control, prevention, prediction, and education: MOSapp, DISapp, and the mosquito perception index (MPI).

India has the largest number of dengue cases in the world, contributing approximately 34% of the global burden. The framework for a geospatially enabled early warning and adaptive response system (EWARS) was first proposed in 2008. It was meant to be a decision support system for enhancing traditional surveillance methods for preventing mosquito-borne diseases in India by utilizing remote sensing data and fuzzy logic-based mathematical predictive modeling. This conceptual paper presents a significant evolution of EWARS such that it synthesizes inputs from not only traditional surveillance and reporting systems for dengue but also from the public via participatory disease surveillance. Two smartphone-based applications have been developed to support EWARS. The first-MOSapp-allows field health workers to upload surveillance data and collect key data on environmental parameters by both direct observation and via portable microclimate stations. The second-DISapp-collects relevant information directly from the community to support participatory disease surveillance. It also gives the user a real-time estimate of the risk of exposure to dengue in proximity to their home and has an educational component that provides information on relevant preventive measures. Both applications utilize a new mosquito abundance measure-the mosquito perception index (MPI)-as reported by the user. These data streams will feed into the EWARS model to generate dynamic risk maps that can guide resource optimization and strengthen disease surveillance, prevention, and response. It is anticipated that such an approach can assist in addressing gaps in the current system of dengue surveillance and control in India.

Utilizing adaptive deformable convolution and position embedding for colon polyp segmentation with a visual transformer.

Polyp detection is a challenging task in the diagnosis of Colorectal Cancer (CRC), and it demands clinical expertise due to the diverse nature of polyps. The recent years have witnessed the development of automated polyp detection systems to assist the experts in early diagnosis, considerably reducing the time consumption and diagnostic errors. In automated CRC diagnosis, polyp segmentation is an important step which is carried out with deep learning segmentation models. Recently, Vision Transformers (ViT) are slowly replacing these models due to their ability to capture long range dependencies among image patches. However, the existing ViTs for polyp do not harness the inherent self-attention abilities and incorporate complex attention mechanisms. This paper presents Polyp-Vision Transformer (Polyp-ViT), a novel Transformer model based on the conventional Transformer architecture, which is enhanced with adaptive mechanisms for feature extraction and positional embedding. Polyp-ViT is tested on the Kvasir-seg and CVC-Clinic DB Datasets achieving segmentation accuracies of 0.9891 ± 0.01 and 0.9875 ± 0.71 respectively, outperforming state-of-the-art models. Polyp-ViT is a prospective tool for polyp segmentation which can be adapted to other medical image segmentation tasks as well due to its ability to generalize well.

FEM wear prediction of ceramic hip replacement bearings under dynamic edge loading conditions.

Hard-on-Hard hip implants, specifically ceramic tribo-pair, have produced the highest in-vivo wear resistance, biocompatibility, superior corrosion resistance, and high fracture toughness. However, this ceramic tribo-pair suffers from edge loading, sharply increasing wear and accelerating early implant failures due to micro-separation. Even though in-vitro studies have tested the occurrence of wear due to dynamic edge loading, the Finite Element Method (FEM) gives the advantage of accurately estimating the wear, minimizing the experimental time and cost. A new fundamental FEM model is developed to predict wear for ceramic hip replacement bearings under dynamic edge loading conditions for a fixed separation and fixed inclination angle. The model is directly validated with the existing hip simulator data up to 3 million cycles in terms of wear depth, wear scar and volumetric wear rate. The results from the model show that the accuracy in wear prediction was more than 98% for the wear depth and volumetric wear rate for the dynamic edge loading condition. A stripe wear scar is captured, depicting the edge loading conditions. The developed model from this study can predict wear under pure standard and dynamic edge loading conditions.

Classification of COVID-19 with Belief Functions and Deep Neural Network.

At present, the entire world has suffered a lot due to the spike of COVID disease. Despite the world has been developed with so much of technology in the domain of medicine, this is a very huge challenge in all over the world. Though, there is a rapid development in medical field, those are not even sufficient to diagnose the symptoms of this COVID in earlier stage. Since the spread of this disease in all over the world, it affects the livelihood of the human. Computed Tomography (CT) images have given necessary data for the radio diagnostics to detect the COVID cases. Therefore, this paper addressed about the classification techniques to diagnose about the symptoms of this virus with the help of belief function with the support of convolution neural networks. This method initially extracts the features and correlates the features with the belief maps to decide about the classification. This research work would provide classification of more accuracy than the earlier research. Therefore, compared with the traditional deep learning method, this proposed procedure would be more efficient with desirable results achieved for accuracy as 0.87, an F1 of 0.88, and 0.95 as AUC.

Rare survival of high-tension electrocution shock in a crossbred Jersey cattle: a complete profile on critical care monitoring.

Background: Accidental electrocution was more common in animals and death was mostly due to shock and cardiac arrest. Survival of animals or humans could be possible if victims receive immediate medical support. Case description: A 3-year-old crossbred Jersey heifer was presented to the Emergency and Critical Care Medicine Referral Clinic of the Veterinary College and Research Institute, Orathanadu, with a history of accidental electrocution by broken high-tension overhead power transmission line during grazing in the paddy fields. The animal was dull and depressed, dark red, and some areas were charred in appearance on the dorsum and limbs. The animal showed difficulty walking due to the electrocution burn injury and was poorly responding to the surroundings. Clinical examination revealed subnormal temperature, polypnea, pale mucous membranes, ruminal atony, and arrhythmias on auscultation. Findings/treatment and outcome: On point of care (PoC) hematology testing, leukocytosis, neutrophilia, and microcytosis were observed. PoC electrolyte analysis revealed hypocalcemia (ionized calcium 0.89 mmol/L), mild hypochloremia, and severe hypokalemia (2.81 mmol/L). PoC biochemistry revealed hypoglycemia (41 mg/dl). PoC elevated levels of serum cardiac troponin (0.33 ng/dl) indicated cardiac damage. Aspartate aminotransferase (1794 U/L), CK-MB (699 U/L) and LDH (6.7 U/L) were also elevated. On PoC urinalysis, proteinuria, myoglobinuria, and glucosuria were observed. Evident clinical recovery, wound healing, and improvement in animal activities were observed. Conclusion: High-voltage electrocution injury is a serious type of accident with the potential risk of multi-organ damage and death. Early diagnosis of electrocution and immediate management enhances the expectancy of complete recovery.

Total neoadjuvant chemotherapy: a silver lining during the COVID pandemic for a patient with locally advanced diffuse distal gastric adenocarcinoma.

Perioperative oncological therapies resulting in pathological complete response (pCR) in diffuse-type distal gastric adenocarcinoma are extremely rare. We report a case of locally advanced (cT3 N2 M0) diffuse-type distal gastric adenocarcinoma treated with 'total neoadjuvant' FLOT (eight cycles), due to the COVID-19 pandemic, and laparoscopic radical subtotal gastrectomy with D2 lymphadenectomy. The patient demonstrated a progressive radiological response on positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-d-glucose integrated with computed tomography (18F-FDG PET-CT) and pCR in the resected specimen (ypT0 N0). As far as we are aware, this is the first case of pCR in locally advanced T3 N2 diffuse distal gastric cancer to be reported in the literature. It introduces a novel approach of total neoadjuvant chemotherapy with 18F-FDG PET-CT to assess response, combined with radical minimally invasive surgical management to provide optimal care for patients with gastric cancer.

Reliability of corticospinal excitability estimates for the vastus lateralis: Practical considerations for lower limb TMS task selection.

Transcranial magnetic stimulation (TMS) is increasingly used to examine lower extremity corticospinal excitability (CSE) in clinical and sports research. Because CSE is task-specific, there is growing emphasis on the use of ecological tasks. Nevertheless, the comparative reliability of CSE measurements during established (e.g. knee extensions; KE) and more recent ecological (e.g. squats; SQT) lower extremity tasks has received less attention. The aim of this study was to compare the test-retest reliability of CSE, force, and muscle activity (EMG) during isometric SQT and KE. 19 right-footed men (age: 25 ± 5 yrs) with similar fitness and body composition performed SQT (N = 7) or KE (N = 12) on two consecutive days. Force and EMG were recorded during maximum voluntary isometric contractions (MVC). Corticospinal excitability was determined in the dominant leg during light (15% MVC) contractions based on motor evoked potential (MEP) stimulus-response-curves (SRC). Test-retest reliability, absolute agreement, and consistency were determined for force, EMG, and SRC MEP maximum (MEPMAX) and rising phase midpoint (V50). As a secondary analysis, all outcomes were compared between groups with mixed-methods ANCOVAs (Task × Time, covariate: body-fat-percentage). Compared with SQT, KE displayed better test-retest reliability and agreement for MEPMAX whereas V50, force, and EMG were similarly reliable. Force (p = 0.01) and MEPMAX (p = 0.02) were also greater during KE despite a similar V50 (p = 0.11). Differences in test-retest reliability, absolute agreement, and between-group comparisons highlight the need to carefully select lower limb TMS assessment tasks and encourage future efforts to balance ecological validity with statistical sensitivity.

Optimization of the contrast dose and injection rates in whole-body MR angiography at 3.0T.

PURPOSE: To optimize the contrast agent dose and delivery rate used in a novel whole-body magnetic resonance angiography (MRA) protocol using a 3.0T MR scanner. MATERIALS AND METHODS: Six groups of 20 consenting volunteers underwent whole-body MRA, with each group receiving a different contrast dose and contrast delivery rate. The arterial tree was divided into 16 segments and the image quality at each of the anatomical locations, covering the whole body, was assessed. Qualitative analysis was carried out using a scoring assessment of image quality, and quantitative assessments were performed by measuring contrast-to-noise (CNR) and a signal-to-noise (SNR) index. RESULTS: Reducing the contrast dose from 40 mL to 25 mL was found to significantly increase the CNR in several vessels of interest in the arterial tree. There was also a significant increase in the qualitative image quality score (P < 0.001). CONCLUSION: This study demonstrates that reducing the contrast dose at 3.0T can result in an increase in the CNR in the vessels of interest without significantly affecting the SNR.

Prevalence of haemoprotozoan diseases in cattle of Cauvery delta region of Tamil Nadu.

A study was carried out to determine the prevalence of haemoparasites in cattle in Cauvery delta region over a period of one year. A total of 228 giemsa stained blood smears were screened for the presence of haemoprotozoa, out of which 34 animals were found to be positive. An overall prevalence of haemoparasites in the sampled cattle were 14.9%, among this Anaplasma sp (8.3%), Babesia sp (3.95%), Theileria sp (2.19%) and Trypanosoma sp (0.44%) as single or mixed blood parasitic infections. In this study Anaplasmosis (14%) was highly prevalent during the winter season and Babesiosis (13.73%) was highly prevalent during summer months followed by Anaplasmosis (9.8%) and Theileriosis (7.8%), the lowest prevalence of Trypanosomiasis was observed during the rainy season. The seasonal variation in prevalence of haemoprotozoan disease might be due to influence of climatic factors on density of vector population in that geographical area. Haemogram revealed decreased level of haemoglobulin, packed cell volume and total erythrocyte count. The serum biochemistry revealed elevated level of liver enzyme Asparate transaminase enzyme. All haemoparasitaemic animals were treated with specific drugs and recovered successfully.

Patient-reported outcome measures after total knee arthroplasty: a systematic review.

OBJECTIVES: A lack of connection between surgeons and patients in evaluating the outcome of total knee arthroplasty (TKA) has led to the search for the ideal patient-reported outcome measure (PROM) to evaluate these procedures. We hypothesised that the desired psychometric properties of the ideal outcome tool have not been uniformly addressed in studies describing TKA PROMS. METHODS: A systematic review was conducted investigating one or more facets of patient-reported scores for measuring primary TKA outcome. Studies were analysed by study design, subject demographics, surgical technique, and follow-up adequacy, with the 'gold standard' of psychometric properties being systematic development, validity, reliability, and responsiveness. RESULTS: A total of 38 articles reported outcomes from 47 different PROMS to 85 541 subjects at 26.3 months (standard deviation 30.8) post-operatively. Of the 38, eight developed new scores, 20 evaluated existing scores, and ten were cross-cultural adaptation of existing scores. Only six of 38 surveyed studies acknowledged all 'gold standard' psychometric properties. The most commonly studied PROMS were the Oxford Knee Score, New Knee Society Score, Osteoarthritis Outcome Score, and Western Ontario and McMaster Universities Osteoarthritis Index. CONCLUSIONS: A single, validated, reliable, and responsive PROM addressing TKA patients' priorities has not yet been identified. Moreover, a clear definition of a successful procedure remains elusive. Cite this article: Bone Joint Res 2015;4:120-127.

The effect of indigenous Neem Azadirachta indica [correction of (Adirachta indica)] mouth wash on Streptococcus mutans and lactobacilli growth.

Neem is one of the most widely researched tropical tree, with almost all it's parts being put for a variety of uses. In the present study, the antibacterial effect of Neem mouthwash against salivary levels of streptococcus mutans and lactobacillus has been tested over a period of 2 months. Also it's effect in reversing incipient carious lesions was assessed. While streptococcus mutans was inhibited by Neem mouthwashes, with or without alcohol as well as chlorhexidine, lactobacillus growth was inhibited by chlorhexidine alone. The initial data appears to prove it's effect in inhibiting S. mutans and reversing incipient carious lesions, longer term clinical trials are essential.

Epidemiological and clinical profile of dog bitten children and side effects of anti rabies vaccine

Background: Rabies is one of the commonest zoonotic diseases due to Lyssa virus. Rabies is a 100% fatal disease. Understanding the epidemiological and clinical profile of the victims helps in the prevention of dog bite. But rabies is 100% preventable by pre and post exposure prophylaxis vaccination. Evaluation of side effects of anti-rabies vaccine (ARV) is helpful in the pre and post exposure prophylaxis.Methods: Authors did a descriptive study of 1450 dog-bitten children. Using the pro-forma, authors interviewed the parents, examined the children. Using W.H.O classification, authors classified the dog bite wounds. Anti-rabies vaccination was administered to category 2 dog bite wounded children. Side effects of vaccination are recorded.Results: Out of 1450 children, significantly more number of boys (67%) in the age group of 10-12 years (31%), from class IV socioeconomic category (52%), nuclear families (80%), sustained category III dog bite (52%) in the lower limb (48%) by unvaccinated (82%) stray dogs (60%) while playing or walking (52%) in the street (60%) during night (72%). Purified Vero cell culture rabies vaccine is having rare mild local side effects (2%), rare mild systemic side effects (4.16%) and very rare systemic allergic reaction (0.14%) but no major side effects.Conclusions: Dog bites can be prevented by not allowing the children to play or walk alone in the street especially during night. The severity of wound can be minimized by wearing fully covered extremities. Vaccination of dogs and population control of stray dogs will reduce rabies. There were no major side-effects or adverse events following vaccination (AEFI) with anti-rabies vaccination. Rare mild local side effects and very rare mild systemic side effects may happen.

The effect of indigenous Neem Azadirachta indica [correction of (Adirachta indica)] mouth wash on Streptococcus mutans and lactobacilli growth.

Neem is one of the most widely researched tropical tree, with almost all it's parts being put for a variety of uses. In the present study, the antibacterial effect of Neem mouthwash against salivary levels of streptococcus mutans and lactobacillus has been tested over a period of 2 months. Also it's effect in reversing incipient carious lesions was assessed. While streptococcus mutans was inhibited by Neem mouthwashes, with or without alcohol as well as chlorhexidine, lactobacillus growth was inhibited by chlorhexidine alone. The initial data appears to prove it's effect in inhibiting S. mutans and reversing incipient carious lesions, longer term clinical trials are essential.