Touch or click friendly: Towards adaptive user interfaces for complex applications

This study evaluated the usability of a direct manipulation device (touchscreen) vs. indirect manipulation devices (mouse and touchpad) on the selected Microsoft (MS) Word tasks as per ISO-9241-11 standard. MS Word was taken as an example of a complex application. The tasks were evaluated in terms of touch-friendly or click-friendly using efficiency, effectiveness, and satisfaction parameters to propose a customized task menu. The experiment was conducted with fifty-four participants, divided into three MS Word usage-based expertise groups. Each participant performed fifty-six tasks using a mouse, a touchpad, and a touchscreen. To assess task-level usability, individual one-way ANOVAs were performed for each task to gauge both efficiency and effectiveness. It's worth noting that the touchscreen significantly outperformed other input methods in just one specific task regarding effectiveness. Consequently, an ANCOVA was employed, with task completion time as the independent variable and the number of errors as a covariate, to further investigate effectiveness. A total of 19 (34%) of the total tasks were found to be significantly efficient with a mouse, while 21 (37.5%) were significantly efficient with a touchscreen. Based on the results, a customized menu is recommended for MS Word-like applications that combine actions in touch-friendly tasks and mouse-friendly tasks separately.

A two-fold SPR-SERS sensor utilizing gold nanoparticles and graphene thin membrane as a spacer in a 3D composite structure

Localized surface plasmonic resonance (LSPR) biosensing using optical fibers has gained popularity due to its label-free approach and high sensitivity to changes in the nanoparticle surface's local index of refraction. However, improving sensitivity remains a challenge. In this study, a two-step approach was employed to fabricate a composite structure using gold nanoparticles and monolayer graphene (Gr-AuNPs). The combination of AuNPs and graphene membrane demonstrated high potential for Surface-enhanced Raman scattering (SERS) and surface plasmonic resonance (SPR) fiber sensors. The Gr-AuNPs sensor successfully detected R6G molecules with a low detection limit of 10-12 M, indicating promising SERS activity. Numerical simulations confirmed that the graphene generated densely hot spots in the nanogap region between plasmonic layers. It's interesting that the proposed SPR-SERS Sensor can detect both glucose and thiram. This demonstrates the sensors practicality and can help with a basic environmental need to find leftover pesticides in the soil. The combination of SPR-SERS dual-mode detection provides more options for detecting and verifying data, increasing the precision and repeatability of experiments.

Evaluation of medication errors in patients with kidney diseases in Quetta, Pakistan

BACKGROUND

Medication errors represent a significant challenge in healthcare, as they can lead to enduring harm for patients and impose substantial financial burdens on the healthcare system. To effectively mitigate medication errors, it is imperative to gain a comprehensive understanding of their frequency and the contributing variables. Thus, the primary objective of this study was to evaluate the occurrence of medication errors among patients with kidney diseases in Quetta, Pakistan.

METHODS

The objective of this study was to assess medication errors in patients diagnosed with kidney diseases in Quetta, Pakistan. The research was conducted at the Balochistan Institute of Nephro-Urology Quetta (BINUQ) Hospital, which serves as a tertiary care center specializing in the treatment of kidney diseases. A cross-sectional descriptive study design was employed over a period of six months. The study population consisted of patients admitted to the Nephro-urology wards at BINUQ Hospital during the specified duration. Data collection encompassed various methodologies, including checklist-guided observation, review of prescription order forms, documentation of drug administration, and comprehensive analysis of patient medical records. Descriptive and analytical analyses were conducted using SPSS version 23. Univariate analysis was employed to identify independent variables associated with medication errors, employing a significance level of p<0.01. The multivariate logistic regression analysis incorporated variables that exhibited a significant association with medication errors during the univariate analysis. Only those variables demonstrating a p-value of less than 0.05 at a 95% confidence level were considered significant predictors of medication administration errors within the final multivariate model.

RESULTS

Among the 274 medication errors identified in the study, documentation errors accounted for 118 cases (12.06%), administration errors for 97 cases (9.91%), prescribing errors for 34 cases (3.47%), and dispensing errors for 25 cases (2.55%). Statistical analysis revealed significant associations (p<0.05) between forgetfulness and duty shift, and medication errors in the documentation process. Similarly, inattention was significantly associated (p<0.05) with both prescribing and dispensing errors. Furthermore, the number of medications received emerged as the most influential factor associated with medication errors. Patients receiving 4-6 medications exhibited an odds ratio of 9.08 (p<0.001) compared to patients receiving 1-3 medications, while patients receiving more than 6 medications had an odds ratio of 4.23 (p<0.001) in relation to patients receiving 1-3 medications.

CONCLUSION

In conclusion, this study determined that documentation errors were the most prevalent medication errors observed in patients with kidney disease in Quetta, Pakistan. Forgetfulness and duty shift were associated with documentation errors, whereas inattention was linked to prescribing and dispensing errors. The significant risk factor for medication errors was found to be a high number of prescribed medications. Therefore, strategies aimed at reducing medication errors should prioritize enhancements in documentation practices, alleviating medication burden, and increasing awareness among healthcare providers.

A review on extraction, composition, structure, and biological activities of polysaccharides from different parts of Nelumbo nucifera

Nelumbo nucifera (lotus plant) is an important member of the Nelumbonaceae family. This review summarizes the studies conducted on it since the past 15 years to provide an understanding on future areas of focus. Different parts of this plant, that is, leaves, roots, and seeds, have been used as food and for the treatment of various diseases. Polysaccharides have been extracted from different parts using different methods. The manuscript reviews the methods of extraction of polysaccharides used for leaves, roots, and seeds, along with their yield. Some methods can provide better yield while some provide better biological activity with low yield. The composition and structure of extracted polysaccharides have been determined in some studies. Although monosaccharide composition has been determined in various studies, too little information about the structure of polysaccharides from N. nucifera is available in the current literature. Different useful biological activities have been explored using in vivo and in vitro methods, which include antioxidant, antidiabetic, antitumor, anti-osteoporotic, immunomodulatory, and prebiotic activities. Antitumor activity from polysaccharides of lotus leaves is yet to be explored, besides lotus root has been underexplored as compared to other parts (leaves and seeds) according to our literature survey. Studies dedicated to the successful use of combination of extraction methods can be conducted in future. The plant provides a therapeutic as well as nutraceutical potential; however, antimicrobial activity and synergistic relationships of polysaccharides from different parts of the plant need further exploration.

LSP-SPP Coupling Structure Based on Three-Dimensional Patterned Sapphire Substrate for Surface Enhanced Raman Scattering Sensing

Although the fabrication of controllable three-dimensional (3D) microstructures on substrates has been proposed as an effective solution for SERS, there remains a gap in the detection and manufacturability of 3D substrates with high performance. In this study, photolithography is adopted to obtain a pyramid-like array on a patterned sapphire substrate (PSS), with Al₂O₃ as the dielectric layer. In addition, silver nanoparticles (AgNPs) are used to decorate Au films to obtain mass-producible 3D SRES substrates. In the case of low fluorescence, the substrate realizes the coupling of localized surface plasmon polaritons (LSPs) and surface plasmon polaritons (SPPs), which is consistent with the simulation results obtained using the finite element method. The performance of the SERS substrate is evaluated using rhodamine 6G (R6G) and toluidine blue (TB) as probe molecules with detection limits of 10^-11 M and 10^-9 M, respectively. The substrate exhibits high hydrophobicity and excellent light-capturing capability. Moreover, it shows self-cleaning ability and long-term stability in practical applications. Allowing for the consistency of the composite substrate in the preparation process and the high reproducibility of the test results, it is considered to be promising for mass production.

π-Conjugated Small Organic Molecule-Modified 2D MoS2 with a Charge-Localization Effect Enabling Direct and Sensitive SERS Detection

Organic semiconductors have been discovered to exhibit impressive surface-enhanced Raman scattering (SERS) activity recently. However, owing to the underdeveloped candidate materials and relatively low SERS sensitivity, practical application of SERS detection based on organic materials is still a challenge. Herein, we explored ways to further enhance the SERS sensitivity of π-conjugated fluorinated 7,7,8,8-tetracyanoquinodimethane derivatives (F_nTCNQ, n = 2, 4) by utilizing the charge-localization effect induced by two-dimensional (2D) MoS₂ flakes. A strong Raman signal enhancement in SERS has been realized via an organic/2D heterostructure constructed by F_nTCNQ nanostructures grown on a 2D MoS₂ flake. Moreover, F₂TCNQ and F₄TCNQ show different SESR sensitivities due to different numbers of cyano groups leading to different charge transfer (CT) directions. The SERS enhancement factor (EF) of methylene blue (MB) molecules on the optimal F₄TCNQ/MoS₂ nanocomposite substrate can reach as high as 2.531 × 10⁶, and the concentration of the limit of detection (LOD) is as low as 10^-10 M. The SERS results for MB, rhodamine 6G (R6G), and 4-aminothiophenol (4-ATP) molecules demonstrate that high versatility, low cost, good stability, and easy preparation will make the F_nTCNQ/MoS₂ SERS platform promising for the detection of trace molecules. The studies on the complex microscopic interaction of organic/2D composite nanomaterials will provide some novel insights into improved SERS performance and mechanisms.

SERS Sensing Using Graphene-Covered Silver Nanoparticles and Metamaterials for the Detection of Thiram in Soil

Multilayer hyperbolic metamaterial (HMM)-based SERS substrates have received special consideration because they accommodate various propagation modes such as surface plasmonic polaritons (SPP). However, the SPP modes are difficult to generate in HMM due to their weak electric field enhancement. In this article, we designed novel SERS substrates consisting of graphene-covered AgNPs and HMM. The graphene-covered AgNPs work as an external coupling structure for hyperbolic metamaterials due to this structure exhibiting significant plasmonic effects as well as unique optical features. The localized surface plasmonic resonance (LSPR) of the graphene-covered AgNPs excited the SPP and thus formed a strong hot spot zone in the nanogap area of the graphene. The Raman experiment was performed using rhodamine 6G (R6G) and crystal violet (CV), which showed high stability and a maximum enhancement factor of 2.12 × 10⁸. The COMSOL simulation further clarified that enhanced SERS performance was due to the presence of monolayer graphene and provided an atomically flat surface for organic molecules in a more controllable manner. Interestingly, the proposed SERS structure carries out quantitative detection of thiram in soil and can satisfy the basic environmental need for pesticide residue in the soil.

Plasmonic optical fiber gratings based on few-layer Ta2C MXenes for refractive index sensing

Tilted fiber Bragg grating (TFBG) is a widespread approach for developing refractive index (RI) sensors. The unique optoelectronic properties exhibited by MXene are expected to enhance the performance of TFBG-SPR sensors. In this study, a Ta₂C coating appropriate for sensing was obtained by optimizing the photo-deposition time, which addressed the challenge of preparing large areas of MXene. The uniform coating of the few-layer Ta₂C increases the wavelength sensitivity and FOM of the sensor to 229.5 nm/RIU and 2228.15 respectively. This significant enhancement was attributed to an ordered MXene phase of the grown Ta₂C. The energy band theory verified the metallic nature of the Ta₂C and the amplification effect on the RI response. Finite element analysis demonstrated that the stronger absorption band of Ta₂C facilitated the generation of surface plasmon polariton. Based on the above benefits, the sensor detected melamine in milk with a detection limit of 7.9 × 10^-9M. The TFBG/Au/Ta₂C sensor is a promising approach for biochemical analysis and trace detection.

SERS enhancement induced by the Se vacancy defects in ultra-thin hybrid phase SnSex nanosheets

Improving the photo-induced charge transfer (PICT) efficiency by adjusting the energy levels difference between adsorbed probe molecules and substrate materials is a key factor for boosting the surface enhanced Raman scattering (SERS) based on the chemical mechanism (CM). Herein, a new route to improve the SERS activity of two-dimensional (2D) selenium and tin compounds (SnSe_x, 1 ≤ x ≤ 2) by the hybrid phase materials is researched. The physical properties and the energy band structure of SnSe_x were analyzed. The enhanced SERS activity of 2D SnSe_x can be attribute to the coupling of the PICT resonance caused by the defect energy levels induced by Se vacancy and the molecular resonance Raman scattering (RRS). This established a relationship between the physical properties and SERS activity of 2D layered materials. The resonance probe molecule, rhodamine (R6G), which is used to detect the SERS performance of SnSe_x nanosheets. The enhancement factor (EF) of R6G on the optimized SnSe_1.35 nanosheets can be as high as 2.6 × 10⁶, with a detection limit of 10^-10 M. The SERS result of the environmental pollution, thiram, shows that the SnSe_x nanosheets have a practical application in trace SERS detection, without the participation of metal particles. These results demonstrate that, through hybrid phase materials, the SERS sensitivity of 2D layered nanomaterials can be improved. It provides a kind of foreground non-metal SERS substrate in monitoring or detecting and provide a deep insight into the chemical SERS mechanism based on 2D layered materials.

Identification of homozygous missense variant in SIX5 gene underlying recessive nonsyndromic hearing impairment

Hearing impairment (HI) is a heterogeneous condition that affects many individuals globally with different age groups. HI is a genetically and phenotypically heterogeneous disorder. Over the last several years, many genes/loci causing rare autosomal recessive and dominant forms of hearing impairments have been identified, involved in various aspects of ear development. In the current study, two affected individuals of a consanguineous family exhibiting autosomal recessive nonsyndromic hearing impairment (AR-NSHI) were clinically and genetically characterized. The single affected individual (IV-2) of the family was subjected to whole-exome sequencing (WES) accompanied by traditional Sanger sequencing. Clinical examinations using air conduction audiograms of both the affected individuals showed profound hearing loss across all frequencies. WES revealed a homozygous missense variant (c.44G>C) in the SIX5 gene located on chromosome 19q13.32. We report the first case of autosomal recessive NSHI due to a biallelic missense variant in the SIX5 gene. This report further supports the evidence that the SIX5 variant might cause profound HI and supports its vital role in auditory function. Identification of novel candidate genes might help in application of future gene therapy strategies that may be implemented for NSHI, such as gene replacement using cDNA, gene silencing using RNA interference, and gene editing using the CRISPR/Cas9 system.

An Urdu speech corpus for emotion recognition

Emotion recognition from acoustic signals plays a vital role in the field of audio and speech processing. Speech interfaces offer humans an informal and comfortable means to communicate with machines. Emotion recognition from speech signals has a variety of applications in the area of human computer interaction (HCI) and human behavior analysis. In this work, we develop the first emotional speech database of the Urdu language. We also develop the system to classify five different emotions: sadness, happiness, neutral, disgust, and anger using different machine learning algorithms. The Mel Frequency Cepstrum Coefficient (MFCC), Linear Prediction Coefficient (LPC), energy, spectral flux, spectral centroid, spectral roll-off, and zero-crossing were used as speech descriptors. The classification tests were performed on the emotional speech corpus collected from 20 different subjects. To evaluate the quality of speech emotions, subjective listing tests were conducted. The recognition of correctly classified emotions in the complete Urdu emotional speech corpus was 66.5% with K-nearest neighbors. It was found that the disgust emotion has a lower recognition rate as compared to the other emotions. Removing the disgust emotion significantly improves the performance of the classifier to 76.5%.

Composite substrate of graphene/Ag nanoparticles coupled with a multilayer film for surface-enhanced Raman scattering biosensing

In this paper, we designed a surface-enhanced Raman scattering (SERS) substrate for graphene/Ag nanoparticles (Ag NPs) bonded multilayer film (MLF) using the hybrid nanostructures composed of graphene and plasmonic metal components with significant plasmonic electrical effects and unique optical characteristics. This paper achieved the advantages of efficient utilization of electromagnetic field and reduction of fluorescence background based on the electromagnetic enhancement activity of Ag NPs and unique physical/chemical properties of graphene with zero gap structures. Au/Al₂O₃ was stacked periodically to construct MLF. As indicated by the electric field intensity at the Au/Al₂O₃ interface of the respective layer, bulk plasmon polariton (BPP) in the MLF was excited and coupled with localized surface plasmon (LSP) in the Ag NPs, which enhanced the electromagnetic field on the top-layer of SERS substrate. To measure the performance of the SERS substrate, rhodamine 6G (R6G) and malachite green (MG) were used as the probe molecules, with the detection limits of 10^-11 M and 10^-8 M, respectively. The SERS substrate had high sensitivity and uniformity, which indicated that it has a broad application prospect in the field of molecular detection.

LSPR optical fiber sensor based on 3D gold nanoparticles with monolayer graphene as a spacer

Localized surface plasmon resonance (LSPR) optical fiber biosensing is an advanced and powerful label-free technique which gets great attention for its high sensitivity to refractive index change in surroundings. However, the pursuit of a higher sensitivity is still challenging and should be further investigated. In this paper, based on a monolayer graphene/gold nanoparticles (Gr_m/Au NPs) three-dimensional (3D) hybrid structure, we fabricated a D-shaped plastic optical fiber (D-POF) LSPR sensor using a facile two-step method. The coupling enhancement of the resonance of this multilayer structure was extremely excited by the surface plasmon property of the stacked Au NPs/Gr_m layer. We found that the number of plasmonic structure layers was of high importance to the performance of the sensor. Moreover, the optimal electromagnetic field enhancement effect was found in three-layer plasmonic structure. Besides, the n*(Gr_m/Au NPs)/D-POF sensor exhibited outstanding performance in sensitivity (2160 nm/RIU), linearity (linear fitting coefficient R²= 0.996) and reproducibility. Moreover, the sensor successfully detected the concentration of glucose, achieving a sensitivity of 1317.61 nm/RIU, which suggested a promising prospect for the application in medicine and biotechnology.

On the effectiveness of multi-feature evacuation systems: an agent-based exploratory simulation study

Evacuation modeling and simulation are usually used to explore different possibilities for evacuation, however, it is a real challenge to integrate different categories of characteristics in unified modeling space. In this paper, we propose an agent-based model of an evacuating crowd so that a comparative analysis of a different sets of parameters categorized as individual, social and technological aspects, is made possible. In particular, we focus on the question of rationality vs. emotionalism of individuals in a localized social context. In addition to that, we propose and model the concept of extended social influence, thereby embedding technological influence within the social influence, and analyze its impact on the efficiency of evacuation. NetLogo is used for simulating different variations in environments, evacuation strategies, and agents demographics. Simulation results revealed that there is no substantial advantage of informational overload on people, as this might work only in those situations, where there are fewer chances of herding. In more serious situations, people should be left alone to decide. They, however, could be trained in drills, to avoid panicking in such situations and concentrate on making their decisions solely based on the dynamics of their surroundings. It was also learned that distant connectivity has no apparent advantage and can be ruled out while designing an evacuation strategy based on these recommendations.

Surface-enhanced Raman scattering by the composite structure of Ag NP-multilayer Au films separated by Al2O3

In the present study, a nanoparticle-multilayer metal film substrate was presented with silver nanoparticles (Ag NPs) assembled on a multilayer gold (Au) film by employing alumina (Al₂O₃) as a spacer. The SERS performance of the proposed structures was determined. It was suggested that the SERS effect was improved with the increase in the number of layers, which was saturated at four layers. The SERS performance of the structures resulted from the mutual coupling of multiple plasmon modes [localized surface plasmons (LSPs), surface plasmon polaritons (SPPs), as well as bulk plasmon polaritons (BPPs)] generated by the Ag NP-multilayer Au film structure. Furthermore, the electric field distribution of the hybrid system was studied with COMSOL Multiphysics software, which changed in almost consistency with the experimentally achieved results. For this substrate, the limit of detection (LOD) was down to 10^-13 M for the rhodamine 6G (R6G), and the proposed SERS substrate was exhibited prominently quantitatively detected capability and high reproducibility. Moreover, a highly sensitive detection was conducted on toluidine blue (TB) molecules. As revealed from the present study, the Ag NP-multilayer Au film structure can act as a dependable SERS substrate for its sensitive molecular sensing applications in the medical field.

Composite Structure Based on Gold-Nanoparticle Layer and HMM for Surface-Enhanced Raman Spectroscopy Analysis

Hyperbolic metamaterials (HMMs), supporting surface plasmon polaritons (SPPs), and highly confined bulk plasmon polaritons (BPPs) possess promising potential for application as surface-enhanced Raman scattering (SERS) substrates. In the present study, a composite SERS substrate based on a multilayer HMM and gold-nanoparticle (Au-NP) layer was fabricated. A strong electromagnetic field was generated at the nanogaps of the Au NPs under the coupling between localized surface plasmon resonance (LSPR) and a BPP. Additionally, a simulation of the composite structure was assessed using COMSOL; the results complied with those achieved through experiments: the SERS performance was enhanced, while the enhancing rate was downregulated, with the extension of the HMM periods. Furthermore, this structure exhibited high detection performance. During the experiments, rhodamine 6G (R6G) and malachite green (MG) acted as the probe molecules, and the limits of detection of the SERS substrate reached 10⁻¹⁰ and 10⁻⁸ M for R6G and MG, respectively. Moreover, the composite structure demonstrated prominent reproducibility and stability. The mentioned promising results reveal that the composite structure could have extensive applications, such as in biosensors and food safety inspection.

Genetic structure of Octopus minor around Chinese waters as indicated by nuclear DNA variations (Mollusca, Cephalopoda)

Octopus minor is an economically important resource commonly found in Chinese coastal waters. The nuclear gene (RD and ODH) approach of investigation has not reported in this species. Rhodopsin (RD) and octopine dehydrogenase (ODH) genes were used to elaborate the genetic structure collected from eight localities ranging from the northern to the southern coast of China. In total, 118 individuals for the RD gene and 108 for the ODH were sequenced. Overall (RD and ODH) genes resulted in high (0.741±0.032; 0.805±0.038) haplotype and low nucleotide (0.01261±0.00165; 0.00747±0.00086) diversity. Molecular variance displayed higher values among the populations and lower values within the population where the fixation index FST denoted 0.880 and 0.584 in RD and ODH genes respectively. The Dongshan population clustered separately in a phylogenetic tree as in the haplotype networking assessment. The current data suggests that the Dongshan population needs separate management.

Investigating the Influence Relationship Models for Stocks in Indian Equity Market: A Weighted Network Modelling Study

The socio-economic systems today possess high levels of both interconnectedness and interdependencies, and such system-level relationships behave very dynamically. In such situations, it is all around perceived that influence is a perplexing power that has an overseeing part in affecting the dynamics and behaviours of involved ones. As a result of the force & direction of influence, the transformative change of one entity has a cogent aftereffect on the other entities in the system. The current study employs directed weighted networks for investigating the influential relationship patterns existent in a typical equity market as an outcome of inter-stock interactions happening at the market level, the sectorial level and the industrial level. The study dataset is derived from 335 constituent stocks of 'Standard & Poor Bombay Stock Exchange 500 index' and study period is 1st June 2005 to 30th June 2015. The study identifies the set of most dynamically influential stocks & their respective temporal pattern at three hierarchical levels: the complete equity market, different sectors, and constituting industry segments of those sectors. A detailed influence relationship analysis is performed for the sectorial level network of the construction sector, and it was found that stocks belonging to the cement industry possessed high influence within this sector. Also, the detailed network analysis of construction sector revealed that it follows scale-free characteristics and power law distribution. In the industry specific influence relationship analysis for cement industry, methods based on threshold filtering and minimum spanning tree were employed to derive a set of sub-graphs having temporally stable high-correlation structure over this ten years period.

Interpretation of Post-operative Distal Humerus Radiographs After Internal Fixation: Prediction of Later Loss of Fixation

PURPOSE

Stable fixation of distal humerus fracture fragments is necessary for adequate healing and maintenance of reduction. The purpose of this study was to measure the reliability and accuracy of interpretation of postoperative radiographs to predict which implants will loosen or break after operative treatment of bicolumnar distal humerus fractures. We also addressed agreement among surgeons regarding which fracture fixation will loosen or break and the influence of years in independent practice, location of practice, and so forth.

METHODS

A total of 232 orthopedic residents and surgeons from around the world evaluated 24 anteroposterior and lateral radiographs of distal humerus fractures on a Web-based platform to predict which implants would loosen or break. Agreement among observers was measured using the multi-rater kappa measure.

RESULTS

The sensitivity of prediction of failure of fixation of distal humerus fracture on radiographs was 63%, specificity was 53%, positive predictive value was 36%, the negative predictive value was 78%, and accuracy was 56%. There was fair interobserver agreement (κ = 0.27) regarding predictions of failure of fixation of distal humerus fracture on radiographs. Interobserver variability did not change when assessed for the various subgroups.

CONCLUSIONS

When experienced and skilled surgeons perform fixation of type C distal humerus fracture, the immediate postoperative radiograph is not predictive of fixation failure. Reoperation based on the probability of failure might not be advisable.

TYPE OF STUDY/LEVEL OF EVIDENCE

Diagnostic III.

Hypertriglyceridemia-Induced Pancreatitis: A Decade of Experience in a Community-Based Teaching Hospital

INTRODUCTION

Hypertriglyceridemia is the third most common cause of acute pancreatitis. The current evidence on the management of hypertriglyceridemia-induced pancreatitis (HTGP) is mainly derived from case series. It has been suggested that insulin, and plasmapheresis have a role in the management of acute HTGP. We present a retrospective review of patients seen at a community-teaching hospital between 2005 and 2015.

RESULTS

Out of the 549 admissions for acute pancreatitis, fourteen patients met our inclusion criteria. The mean age of presentation was 39± 8 years and there was a predominance of men (57%). More than two-thirds of the patients were admitted to the intensive care unit. The majority of the patients were treated with insulin drip (n=8), and the rest by subcutaneous insulin (n=3) and insulin drip + plasmapheresis (n=3). In the insulin drip group we noted a gradual decrease of the admission serum triglycerides by 50.6 ±16.0 % at 24 hours, 65.9±16.9% at 48 hours, and then 85.2± 7.1% at discharge. Serum triglycerides decreased by 79.8% and 92.6%, at discharge in the subcutaneous insulin and insulin + plasmapheresis cohorts, respectively. The insulin + plasmapheresis cohort stayed in the hospital longer (20.7±3.1 days) compared to the insulin drip (10.3±5.4 days) and subcutaneous insulin (5.7 ± 1.2 days) cohorts.

CONCLUSION

Our study strengthens the evidence for using insulin (infusion or subcutaneous) with or without plasmapheresis in the treatment of hypertriglycerimia-induced pancreatitis.

Frequency of tracheobronchial foreign bodies and their management in urban population of Sindh

OBJECTIVE

To assess the common foreign bodies in urban areas of Sindh, and the presentation, problems and complications during their removal through rigid bronchoscopy.

METHODS

The descriptive study was conducted at the Ear, Nose and Throat Department and the Department of Head and Neck Surgery of Liaquat University Hospital, Hyderabad, and Abbasi Shaheed Hospital, Karachi, from April 2009 to October 2010. Fifty patients with strong suspicion of foreign body inhalation in whom rigid bronchoscopy was done were included in the study. A definitive diagnostic protocol was applied and rigid bronchoscopy was done to search and remove the foreign bodies. The data was fed into SPSS version 15 for descriptive analysis.

RESULTS

In our study,28(56%) cases were male and 22(44%) were female. The age range was 1-7 years. Most of the victims (n=21; 42%) were over 3 years of age. Commonest symptom of presentation was dyspnoea (n=34; 68%) and the commonest sign of presentation was decreased unilateral air entry (n=25; 50%). Most of the foreign bodies were impacted in the right main bronchus (n=26; 52%). The most retrieved foreign body was betel nut (n=23; 46%). The commonest complication of bronchoscopy was airway oedema which occurred in 13 (26%) patients. The successful removal of exogenous foreign body was achieved in 41 (82%), and the mortality rate was 3 (6%).

CONCLUSION

Delay in the diagnosis of foreign body inhalation translates into a higher risk of complications. Therefore, early bronchoscopy should be done on suspicion. Early recognition at both parental and clinical levels should be promoted through public awareness.

Inferior paralabral ganglion cyst of the shoulder with labral tear -- a rare cause of shoulder pain

INTRODUCTION

Paralabral ganglion cysts of the shoulder are rare, and their pathogenesis is similar to that of meniscal cysts. The paralabral cysts are most frequently reported along the posterior, superior, and anterior aspects of the glenohumeral joint and are uncommon inferiorly to the joint. These cysts rarely become evident clinically, unless they cause compression of surrounding structures, i.e. nerve.

PATIENTS AND METHODS

We report a retrospective series of five patients with inferior paralabral ganglion cysts of the shoulder without compression of the surrounding nerve which were treated during the period from March 2007 to December 2009. All these patients presented with only chronic shoulder pain as their chief complaint, and preoperative MRI showed the cyst over the inferior aspect of a torn glenoid labrum. All patients were treated by arthroscopic cystic decompression with labrum repair. All patients were re-evaluated with MRI performed at an average of 15 months postoperatively. The clinical outcome, including the Constant score, was assessed for all patients at a median of 16 months postoperatively.

RESULTS

All the five patients had remission of pain and were satisfied with the shoulder function. The postoperative MRI in all patients showed no labral cyst recurrence. The median Constant score improved from a preoperative level of 81.5 points to 98.0 points at last follow-up.

CONCLUSION

This study demonstrates that, in the absence of any nerve compression symptoms around the shoulder joint, inferior paralabral cysts with labral tear also be considered in the differential diagnosis of chronic shoulder pain. Arthroscopic repair of the cyst with repair of the labrum can lead to the disappearance of symptoms. Knowledge of this clinical condition and its imaging features is critical for a correct diagnosis of this uncommon cause of chronic shoulder pain.

LEVEL OF EVIDENCE

Level IV. Retrospective therapeutic study.

Electrical characterisation of deep level defects in Be-doped AlGaAs grown on (100) and (311)A GaAs substrates by MBE

The growth of high mobility two-dimensional hole gases (2DHGs) using GaAs-GaAlAs heterostructures has been the subject of many investigations. However, despite many efforts hole mobilities in Be-doped structures grown on (100) GaAs substrate remained considerably lower than those obtained by growing on (311)A oriented surface using silicon as p-type dopant. In this study we will report on the properties of hole traps in a set of p-type Be-doped Al0.29Ga0.71As samples grown by molecular beam epitaxy on (100) and (311)A GaAs substrates using deep level transient spectroscopy (DLTS) technique. In addition, the effect of the level of Be-doping concentration on the hole deep traps is investigated. It was observed that with increasing the Be-doping concentration from 1 × 1016 to 1 × 1017 cm-3 the number of detected electrically active defects decreases for samples grown on (311)A substrate, whereas, it increases for (100) orientated samples. The DLTS measurements also reveal that the activation energies of traps detected in (311)A are lower than those in (100). From these findings it is expected that mobilities of 2DHGs in Be-doped GaAs-GaAlAs devices grown on (311)A should be higher than those on (100).

Post-coital bleeding in young women: the role of genitourinary medicine

Recently published Department of Health (DoH) guidelines and National Health Service Cervical Screening Programme guidelines recommend referral to a genitourinary (GU) medicine or sexual health clinic as part of the management pathway for young women with post-coital bleeding (PCB). The objectives of this questionnaire study were to ascertain whether GU medicine practitioners agreed with these recommendations and to assess which skills were considered necessary regarding the diagnosis and management of cervical pathology in departments of GU medicine and sexual health and also, therefore, in training in the specialty. The majority of respondents considered it important to check for cervical infection in determining the cause of PCB, but few GU medicine practitioners now perform colposcopy and many consider themselves insufficiently trained to assess the cervix in more detail. Since the colposcope is the optimal tool for examining the anogenital tract, we suggest that colposcopy, in its broadest sense, should be reconsidered as an essential part of GU medicine training.

Deep-level Transient Spectroscopy of GaAs/AlGaAs Multi-Quantum Wells Grown on (100) and (311)B GaAs Substrates

Si-doped GaAs/AlGaAs multi-quantum wells structures grown by molecular beam epitaxy on (100) and (311)B GaAs substrates have been studied by using conventional deep-level transient spectroscopy (DLTS) and high-resolution Laplace DLTS techniques. One dominant electron-emitting level is observed in the quantum wells structure grown on (100) plane whose activation energy varies from 0.47 to 1.3 eV as junction electric field varies from zero field (edge of the depletion region) to 4.7 × 10(6) V/m. Two defect states with activation energies of 0.24 and 0.80 eV are detected in the structures grown on (311)B plane. The E(c)-0.24 eV trap shows that its capture cross-section is strongly temperature dependent, whilst the other two traps show no such dependence. The value of the capture barrier energy of the trap at E(c)-0.24 eV is 0.39 eV.

Variability in neuronal activity in primate cortex during working memory tasks

Persistent elevated neuronal activity has been identified as the neuronal correlate of working memory. It is generally assumed in the literature and in computational and theoretical models of working memory that memory-cell activity is stable and replicable; however, this assumption may be an artifact of the averaging of data collected across trials, and needs experimental verification. In this study, we introduce a classification scheme to characterize the firing frequency trends of cells recorded from the cortex of monkeys during performance of working memory tasks. We examine the frequency statistics and variability of firing during baseline and memory periods. We also study the behavior of cells on individual trials and across trials, and explore the stability of cellular firing during the memory period. We find that cells from different firing-trend classes possess markedly different statistics. We also find that individual cells show substantial variability in their firing behavior across trials, and that firing frequency also varies markedly over the course of a single trial. Finally, the average frequency distribution is wider, the magnitude of the frequency increases from baseline to memory smaller, and the magnitude of frequency decreases larger than is generally assumed. These results may serve as a guide in the evaluation of current theories of the cortical mechanisms of working memory.