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Objective : The purpose of this study is to report the effectiveness of a long-term Korean Medicine Treatment on 1035 atopic dermatitis patients Methods : Objective SCORAD Index(OSI) is used for measuring the degree of atopic dermatitis with photos of total 1035 atopic dermatitis patients who has visited oriental clinic from January 9, 2011 to October 31, 2013. Then, OSI was estimated according to gender, age, period of treatment and intensity. Results:1.The ratio of male to female was 44.4 : 55.6. All patients were constituted with 26.5% of 0~11 year-old group, 15.7% of 12~18 year-old and 57.9% of 19 and more year-old. 2.The ratio of OSI improvement was significantly higher in women than in men after 3 month treatment, but there was no significant difference after 6, 9 and 12 months. 3.The OSI improvement of 0~11 year-old group was significantly higher than the other groups after 3 month treatment. But at the other periods of treatment, there was no significantly difference of the improvement among 3 different groups of age. 4.After 3, 6, 9 and 12 month treatment, the score of OSI was significantly lower than before treatment. After 12 month treatment, the score of OSI was lowest compared to the other periods of treatment. 5. The final OSI score of 87.7% patients was decreased compared to the initial.

To determine the functional outcomes of adjustable continence therapy (ACT™) balloons in elderly women suffering from stress urinary incontinence (SUI) caused by intrinsic sphincter deficiency (ISD). A monocentric retrospective study included all non-neurological women aged >80 years who suffered from SUI due to ISD and undergoing ACT™ balloon placement between 2000 and 2013. Early post-operative complications were reported according to the Clavien–Dindo classification. Continence was assessed subjectively by the patients. A total of 52 female patients were included, median age 83 years (IQR 81–85). Among them, 35 (67.3 %) had already undergone previous surgery for SUI. Balloon implantations were achieved under local anaesthesia for 33 (63.5 %) patients. Clavien grade I–II early post-operative complications occurred in five (9.6 %) patients. Median follow-up was 10.5 months (IQR 3–24.25). Eleven patients (21.1 %) were lost to follow-up. At last follow-up, seven patients (13.5 %) declared themselves fully continent after the first implantation, 13 patients (25 %) had an >80 % improvement rate (10 patients after first implantation, two after second implantation and one after third implantation). Four patients (7.7 %) found the procedure unsuccessful even after several consecutive implantations. Ten patients (19.2 %) reported a partial result and were still having successive balloon inflations. Explantation occurred in 22 patients, caused by infection, erosion or balloon migration. In intention-to-treat analysis, the failure rate was 42.3 %. Although the success rate of ACT™ balloons in women aged >80 years is lower than that reported for younger women, it remains satisfactory because these patients would not otherwise have benefited from another surgical treatment.

Background: We retrospectively evaluated the cure & improvement rate and complications incidence following transobturator approach of mid urethral sling surgery (MUS) for stress urinary incontinence (SUI). Methods: Of the total 52 patients who underwent transobturator approach of midurethral sling surgery for stress urinary incontinence at Dr. Ramesh Hospital, Bangalore, India, between January 2006 – December 2009, 48 women were available for clinical follow-up investigation. At follow-up, all 48 patients underwent a cough test, a pad test, and sonographic postvoid residual volume measurement. Women rated their subjective continence status (continent, slightly incontinent, incontinent). Objective cure was defined as a pad weight 0–1 g and a negative cough test. Results: The minimum and median follow-up was 12 months & 24 months respectively. Subjectively, 93.75 % of the patients rated themselves as continent, 2.08% as slightly incontinent, and 4.16 % as severely incontinent. The objective cure rate was 93.75%. The surgery failed in 3 patients (6.25%). 2 patients (4.16%) underwent repeat surgery. There was one case (2.08%) of vaginal erosion of mesh which required excision of the exposed part and one case (2.08%) of urinary retention requiring incision of the mesh at the center. Conclusions: Transobturator approach of mid urethral sling surgery is a safe, effective and minimally invasive procedure for SUI with a very low rate of complications.

The aim of this systematic review was to determine the anatomical outcome—macular hole (MH) closure rate—and functional outcome—visual acuity (VA) improvement rate—of the inverted internal limiting membrane (ILM) flap technique for large MH. We searched for articles on large MH (> 400 μm) treated with inverted ILM flap technique in databases as of December 1, 2017. And single-arm meta-analysis was performed for the primary outcome of MH closure rate and the secondary outcome of VA improvement rate. In addition, we searched and pooled studies treating large MH with indocyanine green (ICG)-assisted ILM peeling as the reference. R software (version 2.15.2) was used for analysis. This review includes eight studies that used inverted ILM flap technique to treat large MH (> 400 μm). Based on the single-arm meta-analysis performed in R 2.15.2, the pooled MH closure rate and VA improvement rate following inverted ILM flap technique were 95% (95% CI, 88 to 98%) and 75% (95% CI, 62 to 85%), respectively, in fixed-effect models. There was no substantial methodological heterogeneity. In addition, we selected four studies on large MH treated with ICG-assisted ILM peeling as the reference. The fixed-model pooled MH closure rate and VA improvement rate were 87% (95% CI, 79 to 92%) and 57% (95% CI, 46 to 68%), respectively. Inverted ILM flap technique should be an effective and safe method for treating large MH, with high closure rates and good VA improvement. However, further studies in large randomized controlled trials on minimizing surgical complications and understanding the mechanism of this technique are necessary.

Morbid obesity and type-2 diabetes mellitus (T2DM) are both major public health problems. Bariatric surgery is a proven and effective treatment for these conditions; laparoscopic Roux-en-Y gastric bypass (RYGB) is currently the gold-standard treatment. One-anastomosis gastric bypass (OAGB) is described as a simpler, safer, and non-inferior alternative to RYGB to treat morbid obesity. Concerning T2DM, experts of the OAGB procedure report promising metabolic results with good long-term remission of T2DM; however, heterogeneity within the literature prompted us to analyze this issue. OAGB has gained popularity given its safety and long-term efficacy. Concerning the effect of OAGB for the treatment of T2DM, most reports involve non-controlled single-arm studies with heterogeneous methodologies and a few randomized controlled trials. However, this available literature supports the efficacy of OAGB for remission of T2DM in obese and non-obese patients. Two years after OAGB, the T2DM remission and improvement rate increased from 67 to 100%. The results were improved and stable in the long term. The 5-year T2DM remission rate increased from 82 to 84.4%. OAGB is non-inferior compared with RYGB and even superior to other accepted bariatric procedures, such as sleeve gastrectomy and adjustable gastric banding. OAGB is an efficient, safe, simple, and reversible procedure to treat T2DM. The literature reveals interesting results for T2DM remission in non-obese patients. High-level comparative studies are required to support these data.

Patients with severe acquired brain injury (SABI) may evolve towards different outcomes. The primary aim was to evaluate the clinical evolution of a large population of patients with SABI admitted to post-acute rehabilitation from 2001 to 2016, diagnosed with severe brain injury (GCS ≤ 8) in the acute phase and a coma duration of at least 24 h. The possible changes between the admission time to a post-acute rehabilitation hospital and the discharge time were measured by means of Glasgow Outcome Scale (GOS), Level of Cognitive Functioning (LCF), and Disability Rating Scale (DRS). We also correlated the improvement rate with some sociodemographic and clinical features of the individuals with SABI enrolled. Data of 890 patients were analyzed (54% TBI, length of stay = 162 ± 186 days, GCS = 7.46 ± 1.28); time interval from the SABI (OR = 0.246, CI 95% = 0.181 – 0.333), scores at admission of LCF (OR = 2.243, CI 95% = 1.492 – 3.73), GOS (OR = 0.138, CI 95% = 0.071 – 0.266), DRS (OR = 0.457, CI 95% = 0.330 – 0.632), and etiology (OR = 2.273, CI 95% = 1.676 – 3.084) played a significant role (p

Erosion is so widespread and undesirable in various engineering applications such that it is so incumbent to find anti-erosion means to address it. In previous researches (Han et al. in J Bionic Eng 7(09):S50–S58, 2010; J Wuhan Univ Technol Mater Sci Ed 26(2):305–310, 2011; Langmuir 28(5):2914–2921, 2012; Adv Colloid Interface Sci 234:27–50, 2016; Surf Coat Technol 313:143–150, 2017; Zhang et al. in Adv Mater Sci Eng 2013(5):1–9, 2013), people found that the surface of desert scorpion Androctonus australis, which belonged to the parabuthus, had very complex microstructures that had the strong anti-erosion qualities in the blown sand environment. Here, through further research, a new microstructure, hexagonal pit structure, was firstly discovered on the back of desert scorpion. These microstructures were applied in the design of biomimetic samples, which were fabricated by 3D printer using EOS stainless steel GP1. These biomimetic samples were used to test the erosion rate under the impact of quartz sand of three different sizes. The experiment was carried out using a blasting jet machine with injection angle, velocity and time of 30°, 25 ms−1 and 90 s, respectively, and the results showed that the biomimetic samples with different microstructures had better anti-erosion performance. The hexagonal pit structure, whose depth was 200–300 μm and the length was 200–500 μm, had also good anti-erosion performance. The physical model was established to express the mechanism of anti-erosion by controlling the motion direction and impacting velocity of the particles. The anti-erosion performance of all these biomimetic samples can be quantified by the erosion rate and improvement rate. On the whole, these microstructures all have good anti-erosion effect; hence, this paper research is of great practical significance.

Degree of resection and visual outcome are the main concerns in the surgical resection of tuberculum sellae meningioma (TSM). In addition to the transcranial approach (TCA), the endoscopic endonasal approach (EEA) has been used increasingly. However, the controversy regarding the optimal surgical approach is not clearly resolved.We compared the surgical outcomes of each approach for TSMs from 44 patients receiving EEA and 40 patients receiving TCA in 2 institutions between 2004 and 2015. We analyzed the surgical outcomes and affecting factors for the relapse of tumor and visual outcome.Gross total resection rates and relapse-free survival were not different between the 2 groups; however, the locations of residual or recurred tumor definitely differed. All recurrences in the TCA group were in the sella turcica, whereas residual tumors in EEA group were mainly located at lateral or superior to the clinoid process. The complete or partial improvement rate of visual function in the EEA group was 97.7%, but 9 patients (23.7%) in the TCA group experienced visual deterioration after surgery. EEA and younger age (55 years) were associated with favorable visual outcome. Cerebrospinal fluid leakage occurred in only one case in the EEA group.Surgical approaches do not affect the gross total resection rates, but the locations of residual tumor or recurrence differ according to surgical approaches. EEA is superior to TCA in visual outcome. At least in pure TSMs, the trend seems to be shifting in favor of EEA, considering the huge difference in visual outcome.

The study aimed to measure the effect of teaching programming using Scratch on Self-motivation towards learning programming for primary school students in Riyadh. Twenty-five 4th-grade students participated in the study. A quasi-experimental design was applied. Pre and post-tests were utilized using a motivational scale towards learning programming designed by the researchers to include three dimensions: perseverance, ambition and enjoyment. Participants received Scratch lessons for the duration of a semester. The results showed significant differences in favor of the post-test in all dimensions of the scale. In addition, students' self-motivation towards learning programming has improved by 22.8% in the average rate of the scale. The results showed the improvement rate of students' self-motivation towards learning programming to the scale axes (perseverance, ambition, enjoyment) as follows: 20.9%, 23.8%, and 23.6% respectively. Moreover, the order of items and the improvement rate were different according to the pre-test and post-test; although all the items were positive.

In this study, a hybrid multi-cup electric cupping system (HMECS) was proposed, based on the ancient cupping method. HMECS consisted of several cups that could be used simultaneously to treat different areas of the patient’s body. Each cup was equipped with its own pump and pressure-monitoring system. Moreover, the vacuum pressure of the cups was controlled using fuzzy logic. Through automated control of the vacuum pressure, long-term relief of muscle tightness was achieved. To develop a scientific foundation for this alternative treatment, we compared the VAS(Visual Analog Scale) and ODI(Oswestry Disability Index) scores from conventional basic cupping to the VAS and ODI scores for our proposed HMECS. The improvement rate in the VAS and ODI scores using HMECS after three treatments was higher than that achieved by basic cupping. These results, combined with the convenience offered by enhanced IT capabilities, should increase the popularity of this device among an aging society, and facilitate the opportunity to further explore the potential of Oriental medical practices.

Individuals with autism spectrum disorders (ASD) and complex communication needs often rely on augmentative and alternative communication (AAC) as a means of functional communication. This meta-analysis investigated how individual characteristics moderate effectiveness of three types of aided AAC: the Picture Exchange Communication System (PECS), speech-generating devices (SGDs), and other picture-based AAC. Effectiveness was measured via the Improvement Rate Difference. Results indicated that AAC has small to moderate effects on speech outcomes, and that SGDs appear to be most effective when considering any outcome measure with individuals with ASD without comorbid intellectual/developmental disorders (IDD). PECS appears to be most effective when considering any outcome measure with individuals with ASD and IDD. SGDs and PECS were the most effective type of AAC for preschoolers, when aggregating across outcome measures. No difference was found between systems for elementary-aged and older individuals.

Retrospective Study about the Effectiveness of a Korean Medicine Treatment on 69Infant and Young Child Atopic Dermatitis Patients Min Deul Le․Han Myeong Hwa․Park Gun․Seo San․Han Su RyunFreehug Oriental Medicine ClinicObjectivesThe purpose of this study is to report the effectiveness of Korean medicine treatment on 69 infant and young child atopic dermatitis patients.Methods 69 infants and young child atopic dermatitis patients who had visited oriental medical clinics from 2011.1.9 to 2012.1.31 were studied. All of them were continually treated for 3 to 9 months, and were analyzed by Objective SCORAD Index (OSI). A detailed analysis of OSI was done according to gender, age, using of topical steroid ointment, family history of atopic disease, treatment period, and intensity.Results1. Male and female percentage of the study group was 56.5%: 43.5%. The average period of treatment was 6.09 months. 71.0% used topical steroid ointment, and 65.2% had family history of atopic disease.2. The average period of treatment was significantly longer in patients who used topical steroid ointment, or who had family history of atopic disease. 3. 95.7% of total patients reported decrease in OSI score at the final visit. OSI was significantly lowered after 3, 6, and 9 months of treatment. The longer period of treatment, the lower average post-treatment OSI.4. 85.5% of the study group had severe dermatitis, and 14.5% was moderate case based on the OSI intensity assessment at initial visit. These percentages got changed at the final visit as 34.8% of severe, 58.0% of moderate, and 7.2% of mild cases. The average treatment period of patients who were diagnosed as severe at the initial visit was 6.18 months, and their final OSI improvement rate was 39.58%. 58% of them were improved to be mild or moderate at the final visit.ConclusionThe Korean medicine treatment is effective in treating infant and young child atopic dermatitis patients. There was significant decrease in OSI score after 3, 6, and 9 months of treatment. The difference increase with the treatment period.Key words : Atopic dermatitis, Infant and young child, Korean medicine treatment, Objective SCORAD Index (OSI)

Introduction Several studies have demonstrated subpar chest compression (CC) performance by trained health care professionals. The objective of this study was to determine the immediate and sustained effect of instantaneous audiovisual feedback on CC quality. Methods A prospective, randomized, crossover study measuring the effect of audiovisual feedback training on the performance of CCs by health care providers and medical students in a simulated cardiopulmonary arrest scenario was performed. Compression rate, hand placement, depth, and recoil were collected using 60-second epochs of CC on a simulation mannequin. Results Data from 200 initial enrollments and 100 tested 1 year later were analyzed by evaluators using standard criterion. At initial testing, feedback trainees demonstrated significantly improved depth compliance, recoil compliance, and accuracy of hand placement. One year later, the previous year's control group now receiving feedback demonstrated immediate improvement in depth, hand placement, and rate. In the feedback group, the only statistically significant improvement from initial baseline to the baseline 1 year later was an 18% improvement in depth compliance. However, the same improvement rate was seen in the control group. Improved depth compliance performance was correlated to the number of cardiopulmonary resuscitation training sessions received external to the study. Conclusions Instantaneous audiovisual feedback training on CC quality produces immediate improvements in compression rate, hand placement, as well as depth and recoil compliance. These improvements, however, are not retained 1 year later. Improved depth performance may be correlated to an increased training frequency.

Background Data: Lumbar spondylolisthesis is a common condition. Indications for surgery other than failure of conservative treatment include progressive neurological deficits, intractable and symptomatic spinal instability. Surgical options include posterior interbody fusion and posterolateral fusion. Purpose: To compare the difference in results between lateral inter-transverse fusion (PLF) alone and posterior lumbar interbody fusion (PLIF) regarding clinical outcome and fusion rate. Study Design: This is a retrospective randomized comparative study. Patients and Methods: Between May 2009 and April 2014 there were 132 patients with various degrees of lumbar spondylolisthesis. Fifty eight (43.9 %) patients were treated by pedicle screws and PLIF and 74 (56.1%) patients treated with pedicle screws and inter-transverse fusion. This study included 87 female patients (65.9 %) and 45 male patients (34.1 %) with average age 52.2 (age ranged from 43-62). There were 69 patients (52.2 %) had one segment fusion and 63 cases (47.8 %) had 2 segments fusion. All patients were evaluated clinically by Japanese Orthopedic Association Score (JOAS) for preoperative and postoperative and follow-up evaluation. Radiological assessment using plain X-ray and MRI was performed for assessment before and after the procedure. Flexion and extension plain X-ray films were obtained and depended upon for confirmation of fusion/stability. The mean follow up period was 18 months. Results: There was significant improvement in the final outcome of both groups as there mean improvement rate (IR) for Group A was 89.08±%10.6 (ranged from 60-100 %). However Group B at the final outcome had a mean IR of 81.813.8%± ranged from (45-100). Fusion rate was 82% for group A compared to 89% for group B. Patients satisfaction was 89% for Group A while in Group B 94% of patients were satisfied. Conclusion: There were no significant differences in results between lateral intertransverse fusion and PLIF regarding clinical outcome or fusion rate. Cost effectiveness may be considered as an important factor for decision making in treatment of degenerative spondylolisthesis. (2013ESJ063)

An interventional study was carried out in the department of Dermatology and Venereology, Faridpur Medical College Hospital, Bangladesh from January, 2010 to June 2010 to evaluate the efficacy of topical doxepin cream in eczematous dermatoses. We included ninety three patients with moderate to severe pruritic eczematous dermatoses, in this study. Improvement of pruritus was assessed at day 3 and at day 7 by both Visual analogue scale (VAS) and Itch severity) scale (ISS). By VAS at day 3, 61.3% patients showed improvement and at day 7 improvement rate increases to 84.9%. By ISS, improvement at day 3 was 68.9%, and increased to 90.3% at day 7. Improvement was experienced by all types of eczema patients. By visual analogue scale (VAS) mean pruritus reduction at day 3 was 2.25 (± 1.93) and at day 7 was 4.30 (± 1.99). By ltch Severity Scale (ISS) mean pruritus reduction at day 3 was 3.76 (± 2.91), and at day 7 was 8.18 (± 3 42). An average of 27.27% (29.88% by VAS and 24.65% by ISS) reduction of pruritus noticed at the end of day 3 and at the end of study, response increases to 55.58% (57.10% by VAS and 54.06% by ISS) Paired sample t test was done and found that pruritus reduction was statistically significant at day 3 and day 7 both by VAS & ISS We can conclude that doxepin cream is highly effective in relieving pruritus associated with eczematous dermatoses but it has little effect on eczema itself. DOI: http://dx.doi.org/10.3329/bmj.v41i3.18955 Bangladesh Medical Journal 2012 Vol.41(3): 28-32

Ultimamente as indústrias estão passando por grandes desafios em busca de conquistarem seus lugares no mercado e conseguir mantê-los, saber utilizar de suas falhas para melhorar é algo que gera uma grande vantagem e pode ser usado como um diferencial, os setores de manutenção e produção devem estar alinhados para reduzir o número de ocorrências reincidentes. O presente trabalho apresenta um estudo de campo com o objetivo de implantar uma metodologia de análise de falhas em uma indústria de polietileno de baixa densidade, reduzindo assim o impacto negativo causado pela manutenção. A pesquisa é do tipo exploratória, de caráter quanti-qualitativo. Foi realizado um estudo de caso sobre abordando a utilização de ferramentas de análise e solução de problemas, um exemplo de como são aplicadas e a estrutura do processo de análise, os resultados a partir da aplicação foram otimista e trouxeram a indústria muitas oportunidades de melhoria em seus planos de manutenção, ressaltando assim a importante de manter registros das ocorrência e captar as informações de falhas para serem geradas melhorias a partir de sua análise. Nos meses posteriores a implantação da metodologia os resultados na redução de tempo manutenção no período de julho a outubro foram perceptíveis, saindo de 51,07% para 55,15%, índice de melhoria de OEE em 4,05, com uma tendência de que a cada nova análise surgem oportunidades de melhorar os processos e evitar a perda de OEE.

This paper presents the design and analysis of a new micro-electro-mechanical system (MEMS) tuning fork gyroscope (TFG), which can effectively improve the mechanical sensitivity of the gyroscope sense-mode by the designed leverage mechanism. A micromachined TFG with an anchored leverage mechanism is designed. The dynamics and mechanical sensitivity of the design are theoretically analyzed. The improvement rate of mechanical sensitivity (IRMS) is introduced to represent the optimization effect of the new structure compared with the conventional one. The analytical solutions illustrate that the IRMS monotonically increases with increased stiffness ratio of the power arm (SRPA) but decreases with increased stiffness ratio of the resistance arm (SRRA). Therefore, three types of gyro structures with different stiffness ratios are designed. The mechanical sensitivities increased by 79.10%, 81.33% and 68.06% by theoretical calculation. Additionally, FEM simulation demonstrates that the mechanical sensitivity of the design is in accord with theoretical results. The linearity of design is analyzed, too. Consequently, the proposed new anchored leverage mechanism TFG offers a higher displacement output of sense mode to improve the mechanical sensitivity.

Background: To study the efficacy of intratympanic injection of dexamethasone in cases of subjective idiopathic tinnitus.Methods: Prospective interventional study at the Department of ENT, JSS Medical College and Hospital, Mysore, in which 45 patients diagnosed clinically as subjective idiopathic tinnitus, for a duration of 2 years from October 2016 were included in the study. The patients were subjected to 3 intratympanic injections of dexamethasone once in a week for 3 weeks. They received a 0.5 ml intratympanic injection of 4mg/ml dexamethasone solution. After topical anaesthesia, using a 2 ml syringe and a spinal needle no. 22, the assigned solution was administered under direct vision using an endoscope in the postero- inferior quadrant of the tympanic membrane. They were followed up at the end of 1 and 3 months from the last injection. Tinnitus handicap inventory was repeated during the follow up and was compared to the value at presentation. Results: There was a statistically significant improvement in the THI at the first follow up compared with the baseline THI. Whereas there was no statistically significant change in improvement rate from the 1st follow up to the 2nd follow up (p=0.7), however there is decrease in the improvement, which means the improvement is temporary, and starts reverting by the second visit to some extent.Conclusions: It was observed that the improvement in the tinnitus was for a short term after intratympanic injection of dexamethasone.

OBJECTIVES: 1. To evaluate the effectiveness of Trans-Obturator vaginal tape in the treatment of genuine female urinary stress incontinence. 2. To analyze functional results and quality of life after 12 months follow up. DESIGN: Prospective Observational study. METHODS: 25 women with clinical and urodynamic features of genuine stress incontinence fulfilling the inclusion and exclusion criteria were enrolled in this study and underwent TOT operation. The follow-up was done upto 12 months subjectively by UDI-6 and objectively by UDS and physical examination. Chi square test, Wilcoxan matched pair test was used for statistical analysis. A value was considered statistically significant at p < 0.05. RESULTS: Our objective assessment demonstrated 100% cure rate after 12 months. However, the subjective assessment using the UDI-6 demonstrated 90% cure or improvement rate after 12 months. CONCLUSION: The outside to in Trans-Obturator approach is a

This paper assesses the global emission reduction target of halving CO2 emissions by 2050. First, future GDPs with specific uncertainty ranges were developed. The Kaya identity and the developed GDP outlook indicate that halving global CO2 emissions by 2050, which corresponds to almost 450 ppm-CO2eq. stabilization, requires an improvement approximately four times as large as the historical CO2 intensity improvement rate on average up to 2050, if GDP loss should remain within a few percent of potential baseline GDP. In addition, the global energy-related CO2 emission reductions were assessed by using an energy systems model. Marginal abatement cost of CO2 is over 470 $/tCO2 for halving global CO2 emissions by 2050 relative to 2005 even under the lower GDP scenario and technology improvements. Great challenges will have to be met for achieving the 450 ppm-CO2eq. Realistic alternative emission reduction scenarios should be explored in two ways; 1) more innovative technological development than any present imaginable development, and/or drastic social innovations are needed for cheaper carbon costs, e.g., within a few tens of US$ per tonne of CO2, and 2) more modest emission reduction targets, e.g., 550 ppm-CO2eq., and adaptation measures are considered. Keywords: Emission reduction target, GDP, Kaya identity

OBJECTIVE The present study aimed at determining the quantitative accuracy of phase-based respiratory-gated PET/CT imaging using phantom and clinical studies. METHODS The effects of target size, target-to-background ratio (TBR), and respiratory motion on PET images were estimated using a NEMA body phantom comprising six spheres (diameter 10-37mm) in a solution of F-18 of three different TBRs (4, 6, 8). The phantom was moved in a superior-inferior direction at motion displacements of 0, 10, 20 and 30 mm. Stationary images of the phantom as well as non-gated (3D) and gated (4D) images of the phantom while moving were reconstructed and the recovery coefficient (RC) of individual spheres was calculated from each image. We then determined the RC improvement rate to evaluate improvements conferred by 4D-PET/CT. We retrospectively analyzed data from 14 patients with lung cancer who were examined by 3D- and 4D-PET/CT. Each lesion on the 3D-PET/CT and each of the five phases of the 4D-PET/CT were analyzed. RESULTS Larger motion displacement and TBR resulted in increased RC degradation for small spheres. The RC improvement rate showed that 4D acquisition improved the RC of spheres with larger motion displacement exceeding 13 mm in diameter. 4D-PET/CT alone can reduce the effects of motion blurring, but partial volume effects may still be the dominant source of quantitative inaccuracy for small lesions. The trends of phantom and clinical studies for evaluating the improvement rate were similar. CONCLUSIONS 4D-PET/CT significantly improved the quantitative accuracy of PET images particularly when larger motion displacement exceeded 17mm in diameter such as in lung cancer.

The aim of this work was to ascertain any differences in the effectiveness of rehabilitation therapy in relation to the presence or absence of a known negative reinforcement responsible for the tinnitus-related pathology. Between 1 January 2001 and 31 December 2008, we recruited 294 subjects suffering from incapacitating tinnitus and/or hyperacusis. The patients underwent tinnitus retraining therapy (TRT) according to the methods described by Jastreboff and Hazell [Tinnitus Retraining Therapy: Implementing the Neurophysiological Model. Cambridge, Cambridge University Press, 2004, pp 121-133]. We clinically assessed the presence or absence of known phenomena of associative learning, regarding the presence of adverse events temporally correlated with tinnitus and the treatment outcome. The separate analysis of the 2 subgroups shows a statistically significant difference in the improvement rate between the group with a known triggering factor and the group without a triggering factor, with a preponderance of the former with a 91% improvement rate versus approximately 56% for the latter. In our study, the inability to identify factors triggering bothersome tinnitus negatively affected the treatment outcome in TRT.

A reliable investigation-triggering mechanism is critical for airlines in managing aircraft fleet reliability. This study developed a simulation model to evaluate the performance of various investigation-triggering mechanisms in various scenarios of aircraft fleet reliability. Factors that affect performance include flight delay costs, investigation costs, the costs of corrective actions, the accuracy of investigations, the effectiveness of corrective actions, and the monthly improvement rate. Nine investigation-triggering mechanisms were evaluated. The simulation results show that the monthly improvement rate significantly influences performance. The subject airline’s original investigation-triggering mechanism is not outstanding in most scenarios. This study recommends two of the nine investigation-triggering mechanisms for airlines when they select investigation-triggering mechanisms in various scenarios. Thus, useful guidance for adjusting airlines’ investigation-triggering mechanisms can be effectively provided.

This paper considers a reentrant scheduling problem on parallel primary machines with a remote server machine, which is required to carry out the setup operation. In this problem, each job has three operations. The first and last operations are performed by the same primary machine, implying the reentrance, and the second operation is processed on the single server machine. The order of jobs is predetermined in our context. The challenge is to assign jobs to the primary machines to minimize the makespan. We develop a genetic algorithm (GA) to solve this problem. Based on a simple strategy of assigning jobs in batches on the parallel primary machines, the standardized random key vector representation is employed to split the jobs into batches. Comparisons among the proposed algorithm, the branch and bound (BB) algorithm and the heuristic algorithm, coordinated scheduling (CS), which is only one heuristic algorithm to solve this problem in the literature, are made on the benchmark data. The computational experiments show that the proposed genetic algorithm outperforms the heuristic CS and the maximum relative improvement rate in the makespan is 1.66%.

The article presents the results of a large-scale Russian program of the follow-up and treatment of acne patients with Isotretinoin (Roaccutane). The analysis of the results included information about 1,349 acne patients. In 71% of patients, the therapy was initiated at the dose of 0.5-1.0 mg/kg of the body weight. The average duration of treatment was 21.5±0.16 weeks while the average course dose was 119.9±0.8 mg/kg of the body weight. As many as 96% of patients achieved a positive result; women demonstrated a higher improvement rate than men. On the whole, Roaccutane was well-tolerated while adverse effects included dry lips (43.4%), dry skin in different areas (12.45%), retinoid dermatitis (6.45%), epistaxis (2.45%), conjunctivitis (1.41%) and hoarseness (0.22%). The Russian experience of using Roaccutane confirmed high efficacy of the systemic therapy for severe forms of acne.

Objective To evaluate the therapeutic effect and safety of time-oriented points opening of Linggui Bafa for Bell's palsy and provide a new idea for the clinical treatment of this problem. Methods Fifty-four cases included in the study were randomized into two groups, and the treatment group was treated with the routine acupuncture combined with time-oriented points opening of Linggui Bafa. The control group was treated with the routine acupuncture only, Hegu ( LI 4), Kūnlun ( BL 60), Jiachē ( ST 6), Dicāng ( ST 4), Xiaguān ( ST 7), Cuanzhu ( BL 2), Yangbai ( GB 14), and Quanliao ( SI 18) were selected as the main points. The manipulation and time of retaining needles were as same as the treatment group. Both groups were treated once a day, 5 days made one session and 4 sessions were required in all. Modified Portmann's scale, Horse-Brackmann grading scale (H-B), FDIP and FDIS were used to assess the therapeutic effect after the treatment. Results The curative and improvement rate in the treatment group was 80.8% (22/26), and that in the control group was 66.7% (16/24), with the statistically significant difference ( P P Conclusion The method of time-oriented points opening of Linggui Bafa for Bell's palsy is better than the routine acupuncture for Bell's palsy.

Objective. To analyze the factors influencing quality of acute myocardial infarction, and improve the treatment and management level of the disease. Methods. A total of 226 cases of acute myocardial infarction with disease quality control in 2012 were selected as a control group, and 193 cases of acute myocardial infarction without quality control at the same time in 2011 were selected as a non-control group. The result quality indicators and the link quality indicators were compared and evaluated comprehensively. Results. The rates of serious cases in the control group and the non-control group are the same (P > 0.05). The cure and improvement rate, average length of stay, low density lipoprotein cholesterol assessment, health education and so on of the control group are better than those of the non-control group (P > 0.05). The average cost, drug thrombolysis time, left ventricular function evaluation finishing rate within 24 h of patients having thrombolysis and general treatments are also seen...

The purpose of this study was to evaluate the efficacy of percutaneous laser disc decompression (PLDD) in the treatment of lumbar disc herniation (LDH) and identify the relationship between PLDD efficacy and age.Many articles have shown that the short-term clinical outcome of PLDD was fairly good. However, the continuous follow-up results over 3 years of PLDD for LDH treatment are rarely reported, and little is known about the relationship between PLDD efficacy and age.Forty-two LDH patients who had undergone PLDD with an Nd:YAG laser from July 2003 to August 2007, were divided into two groups according to age, with 19 cases in the ≤45-year-old age group and 23 cases in the45-year-old group. All the patients were evaluated with the Japanese Orthopaedic Association (JOA) Scores before and after the PLDD to calculate the improvement rate of lumbar JOA scores, according to which the follow-up results were graded as excellent, good, fair, or poor.Eighty affected discs in 42 patients were treated successfully with no complications in this study. The favorable outcomes of the 42 patients at 1-, 3-, 6-, 12-, 24-, and 36-month follow-up were separately 45.24%, 66.67%, 71.43%, 76.19%, 80.95%, and 76.19%. The favorable outcome significantly improved from 45.24% at 1-month follow-up to 66.67% at 3-month (p0.05). There was no significant difference of favorable outcome at 3-, 6-, 12-, 24-, and 36-month follow-up (p0.05).The preoperative lumbar JOA scores in two groups was not different (p0.05), and no between-group differences were noted in favorable outcome at the same follow-up time (p0.05).The clinical outcome of PLDD improved significantly within 3 months, and can maintain a higher level in 3 years. The efficacy of treatment with PLDD is fairly good for both selected younger and older patients.

In this study, the efficacy of a novel Chinese herbal formula, cure rot and flat sore ointment (CRFSO), in the management of stage IV pressure ulcers, and the effect of simultaneous comprehensive rehabilitation in improving the outcome were evaluated. A total of 35 paraplegic patients with stage IV pressure ulcers who underwent reconstruction and inpatient rehabilitation from January 2004 to September 2010 were included in the study. Arnebia root oil (ARO) was used on 16 patients with 11 ulcers (stage IV). The remaining 19 patients with 20 ulcers (stage IV) received a traditional Chinese herbal formula (CRFSO). After 28 days of treatment, the wound healing results, in particular, the healing rate, effectiveness rate, improvement rate and no response rate were evaluated. Six patients from the ARO group sought other types of therapy due to their own consideration of poor efficacy. After 28 days of treatment, the wound healing result and no response rate demonstrated a statistically significant difference (P

Background: Dentin hypersensitivity (DH) in one of the most common causes of patient discomfort in the general population and its prevalence is higher in patients who have received basic or surgical periodontal treatment. Efficiency of the diode laser with different wavelengths has been studied by several authors, showing an improvement rate of the DH between 60-98%. The aim of the present study was to evaluate the effect of photobiomodulation (PBM) treatment on the reduction of DH after non surgical periodontal treatment. Material and methods: A randomized split mouth clinical trial was performed involving 30 patients (120 teeth) diagnosed with DH after scaling and root planning. Two teeth of the experimental side were treated with the laser and 2 teeth of the control side were treated without activating the laser. The laser treatment parameters for each tooth were 660nm, 200mW, CW, illuminated area 1.15cm2, 173mW/cm2, 60 seconds, 12 J, 10.4J/cm2. Age, gender, smoking, plaque index, gingival recession, probing and VAS (for tactile and thermal stimulation) were registered before the laser treatment, immediate post treatment (after 2 minutes), 2 weeks, 1 month and 2 months after treatment. Results: There was significant difference (p

We aim to develop a scoring method for expressing directional dominance in the images. It is predicted that this score will give an information of how much improvement in system performance can be achieved when using a directional total variation (DTV)-based regularization instead of total variation (TV). For this purpose, a dataset consists of 85 images taken from the noise reduction datasets is used. The DTV values are calculated by using different sensitivities in the direction of the directional dominance of these images. The slope of these values is determined as the directional dominance score of the image. To verify this score, the noise reduction performances are examined by using direction invariant TV and DTV regulators of images. As a result, we observe that the directional dominance score and the improvement rate in noise reduction performance are correlated. Therefore, the resulting score can be used to estimate the performance of DTV method.

Alopecia areata (AA) is a common disease of hair follicles. Cryotherapy has been employed to stimulate hair regrowth. We decided to evaluate the efficacy of this method in patchy AA. Forty patients of age >5 years and with 120 recalcitrant patches were enrolled in this study. AA had covered less than 25% of patients’ scalps. In each individual, one lesion was treated with nitrogen cryotherapy once weekly for a period of 6 weeks; meanwhile another lesion was treated with topical 0.1% betamethasone lotion. All patients were followed up from weeks 2 to 14. Thirty-nine out of forty patients completed therapy. The overall response rate was 88% for patches treated with cryotherapy and 90% for patches treated with betamethasone lotion. Complete recovery (>90% terminal hair growth) was not obtained in any patient. Chi-square test showed no significant difference between improvements of alopecia in the two groups (reliability 95%). Pearson measurement showed a significant reverse relationship between diameter and duration of patches and the improvement rate in both groups. Liquid nitrogen cryotherapy can be a helpful modality in the treatment of AA. Key words: Alopecia areata, treatment, liquid nitrogen cryotherapy, betamethasone lotion.

Background: Doxepin hydrochloride is a dibenzoxepin tricyclic, has a potent H 1 & H 2 receptor blocking actions. If topical doxepin can effectively control pruritus associated with eczematous dermatoses, we can use it as adjunctive therapy and can reduce the drawbacks of topical steroids and antihistamines. Methods: An interventional study from january 2010 to june 2010 has done in the department of dermatology and venereology, Faridpur Medical College Hospital, Bangladesh to evaluate the efficacy of topical doxepin cream in eczematous dermatoses. We included moderate to severe pruritic eczematous dermatoses patient in this study. Results: Improvement of pruritus was assessed at day 3 and at day 7 by both Visual analogue scale (VAS) and Itch severity scale (ISS). At day 3 by VAS 61.3 %( 57) patients showed improvement and at day 7 improvement rate increases to 84.9% (79). By ISS improvement at day 3 was 68.9% (64) and increased to 90.3% (84) at day 7. Improvement was experienced by all types of eczema patients. An average of 27.27% (29.88% by VAS and 24.65% by ISS) reduction of pruritus noticed at the end of day 3 and at the end of study, response increases to 55.58% (57.10% by VAS and 54.06% by ISS). Paired sample t test was done both for visual analogue scale (VAS) and itch severity scale (ISS) that compare the mean pruritus reduction at day 3 and day 7 with baseline pruritus (day-0). Pruritus reduction was statistically significant at day 3 and day 7 both by VAS & ISS. Conclusion: Doxepin cream is highly effective in relieving pruritus associated with eczematous dermatoses but it has little effect on eczema itself. DOI: http://dx.doi.org/10.3329/updcj.v2i1.13955 Update Dent. Coll. j: 2012; 2 (1): 14-20

Objective : To observe effects of TKM (Traditional Korean Medicine) treat ment for psoriasis vulgaris. Methods : We did retrospective chart review for 32 psoriasis vulgaris patients who had been treated by TKM. TKM treatment included acupuncture, herb med, external herbal s olution and moxibustion. Result : PASI (Psoriasis Area and Severity Index) 75 responding rate at treatment week 16 was 71.9%. Mild symptom patients' improvement rate and moderate to severe sympt om patients' improvement rate was similar. Mean PASI score was increased until treatment week 4 to 8, and after that period, mean PASI score was decreased. Conclusion : This study suggest that TKM may be an effective treatment for psoriasis vulgaris. Key words : Traditional Korean Medicine; Psoriasis; Herb; Acupuncture; PASI ⓒ 2013 the Society of Korean Medical Ophthalmology & Otolaryngo logy & DermatologyThis is an Open Access journal distributed under the terms of t he Creative Commons Attribution Non-Commercial License (http://creativecommons.org/license/by-nc/3.0/) which permits u nrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Purpose: To determine the outcome of trabeculectomy in African countries. Design: This is a review of literature for trabeculectomy conducted in Africa from 2000 to December 2012. Methods: We conducted an electronic search from the following databases: PubMed, Science Direct, Google, and Google scholar websites for the articles of original studies on trabeculectomy conducted in Africa. Results: A total of 109 articles, published from 2000 to December 2012 were retrieved. Only 12 articles met our inclusion criteria and were included in the study. The follow-up duration ranged from 6 months to 60 months. The post-trabeculectomy IOP range was 10 mmHg to 22 mmHg with rates varying from 61.8% to 90%. The visual acuity was unchanged among 19% to 30% of the participants in the last follow-up, and the improvement rate was 36% to 81.5% while those whose condition worsened ranged from 8.9% to 30.8%. The cup-disc ratio was ≤0.5 in 13% and ≥0.8 in 83% of the participants. The failure rate of the c/d ratio was 0.9 and it increased by 0.027 units. There was a follow-up of only one study on the visual field. Conclusion: Trabeculectomy with or without application of antimetabolite appears to be a good way to lowering the IOP in Africa. In addition, the combined effect of trabeculectomy and cataract surgery produces visual benefits for the patients.

Objective: To assess the effectiveness of intravaginal pressure biofeedback (P-BF) and perineal electromyographic biofeedback (EMG-BF) assisted pelvic floor muscle (PFM) exercises in women with stress urinary incontinence (SUI). Material and Methods: Fifty-three women with SUI were randomized into three groups as follows: the Group 1 received PFM home exercise program alone (n:18); the Group 2 received PFM home exercise program plus intravaginal P-BF assisted PFM exercise program (n:17); and the Group 3 received PFM home exercise program plus perineal EMG-BF assisted PFM exercise program (n:18). Subjects were also assessed with the 1-h pad test (severity of incontinence), perineometer (PFM strength), social activity index (SAI), IIQ7 (quality of life associated with incontinence), treatment success (cure and improvement rate) and treatment satisfaction. Results: A statistically significant improvement was found in all parameters for all groups at 4th week and 8th week compared to the baseline values. It was found that severity of incontinence, PFM strength, and SAI scores were significantly improved in both BF groups compared to the Group 1 at 8th week. Also, statistically higher cure and improvement rate and treatment satisfaction values were detected in both BF groups compared to the Group 1. There was no statistically significant difference between Group 2 and Group 3 in all parameters evaluated at the follow-up period. Conclusions: We conclude that both the home exercises plus intravaginal P-BF and home exercises plus perineal EMG-BF are superior to home exercises in women with SUI. Intravaginal P-BF and perineal EMG-BF were similarly effective and they can be used as their alternatives. © 2017 Wiley Periodicals, Inc.

Tension-free suburethral tapes have become the first-line surgical treatment for female stress urinary incontinence. Single-incision midurethral slings (SIMS) were introduced with the aim of offering similar efficacy with reduced morbidity, particularly postoperative pain. The objective of this study was to compare the effectiveness and complications of the Ajust™ SIMS and the Align™ transobturator tape sling. We performed a randomized controlled trial with a noninferiority design. Women with pure stress urinary incontinence or stress-predominant mixed urinary incontinence were eligible. The primary outcome was the cure/improvement rate at 1 year, defined according to combined objective and subjective criteria. Rate differences for cure/improvement with the two procedures were calculated along with their 95% confidence intervals. The Sandvik incontinence severity index and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) were completed before surgery and at 1 year. Complications were also reported. We randomized 30 women to the Ajust™ group and 28 to the Align™ group. At 1 year the cure/improvement rates were 93.3% in the Ajust™ group and 96.4% in the Align™ group. The rate difference for cure/improvement was of −3.1% (95% CI −14.4 % to 8.2%). The study was sufficiently powered to conclude the noninferiority of Ajust™ SIMS under the pre-established criteria. Three women in the Ajust™ group reported persistent thigh pain 1 year after surgery, but none in the Align™ group reported pain. At 1 year, the Ajust™ SIMS showed non-inferior effectiveness compared with the Align™ transobturator sling. Although not statistically significant, unexpectedly, more women reported persistent thigh pain in the Ajust™ group.

Large hiatal hernias are notorious for their high recurrence rates after conventional repair. Recurrence rates have been described to be higher in obese patients due to increased intraabdominal pressure. We hypothesized that patients who undergo hiatal hernia repair (HHR) with bariatric surgery (BAR) will have a lower hernia recurrence rate when compared to patients who undergo HHR with fundoplication (FP) due to the decrease in intra-abdominal pressure observed with weight loss. This was an Institutional Review Board approved retrospective review. The outcomes of patients who underwent HHR+BAR as well as patients who had HHR+FP only from 2007 to 2014 were reviewed. Patients who had small hiatal hernias (

Facial aging along the periocular area has led to the development of new non-surgical therapies. The lower periorbital area is a vital region for facial rejuvenation and several procedures have been studied to treat it, especially procedures with dermal fillers for volume rebuilding. This manuscript aims to describe a filling technique with hyaluronic acid (HA) along the superficial layer of the lower periorbital area, presenting its effectiveness and safety. Our assessment was made by autonomous observers with pictures of before and after treatment, rated from 0 (no enhancement) to 100 (maximum enhancement). Patients’ self-assessment was also performed using a visual analog scale (VAS) based on a 100-mm ruler affording a 0–100 rating. Thirty patients were enrolled in this study. The autonomous observers’ evaluation presented a 78.4 mean improvement rate. Patients’ self-assessments after the treatment were 0% reporting no improvement, 6.7% mild improvement, 23.3% moderate improvement, 66.7% great improvement, and 3.3% maximum improvement. Restylane Vital Skinbooster infiltration at the lower periorbital area proved to be a safe treatment. The described technique is also simple to execute, has a low rate of complications, and produces a high satisfaction rate.

To assess the clinical efficacy and safety of a treatment based on one cycle versus two cycles of intra-articular injections of plasma rich in growth factors (PRGF-Endoret) on patients with knee osteoarthritis (OA). Ninety patients with knee OA were included and evaluated. A total of 48 patients received one cycle (OC group) (3 injections on a weekly basis), while 42 patients received two cycles of PRGF-Endoret (TC group) spaced 6 months between them. Patients were evaluated with LEQUESNE and WOMAC scores before treatment and after 48 weeks. Safety assessment was also performed. A significant reduction of all assessed outcome measures was shown for both groups at 48 weeks compared with baseline values (P

International audience; INTRODUCTION AND HYPOTHESIS:We report retrospective data on the long-term safety and efficacy of the retropubic midurethral sling (MUS) in a large series of women with stress urinary incontinence.METHODS:In all, 517 patients were treated during the period January 2005 to June 2012 at a single centre in France. The Urinary Symptoms Profile score was used to identify women who were subjectively cured or improved or in whom treatment had failed. The rates of peroperative, and early (

In this study, we examine the impact of the 2008 Global Crisis on the Human Development Index (i.e. HDI) values of Developed versus Developing Countries. We have a comprehensive sample of 174 countries. Over the 1980 to 2013 period, while there has been a gradual and consistent improvement in the index values, this improvement has slowed down sharply after the 2008 crisis. Our tests for the overall sample confirm that there is a significant slowdown in the rate of improvement in HDI values after 2008. When we divide our sample into “Very high HDI”, “High HDI”, “Medium HDI”, and “Low HDI” country groups, and run our tests, we are seeing that for all subgroups, there has been a significant slowdown in the improvement rate. Our findings show that while the slowdown is sharper for “Very high HDI”, “High HDI”, and “Medium HDI” groups, for “Low HDI” group the slowdown is relatively softer. We conclude that it is essential for both developed and less developed countries to take precautions regarding human development issues before a crisis hits.

BACKGROUND To evaluate the surgical outcomes of tumor resection with or without total thymectomy for thymic epithelial tumors (TETs) using the Chinese Alliance for Research in Thymomas (ChART) retrospective database. METHODS Patients without preoperative therapy, who underwent surgery for early-stage (Masaoka-Koga stage I and II) tumors, were enrolled for the study. They were divided into thymectomy and thymomectomy groups according to the resection extent of the thymus. Demographic and surgical outcomes were compared between the two patients groups. RESULTS A total of 1,047 patients were enrolled, with 796 cases in the thymectomy group and 251 cases in the thymomectomy group. Improvement rate of myasthenia gravis (MG) was higher after thymectomy than after thymomectomy (91.6% vs. 50.0%, P

Introdução: A eficácia e segurança da radiação UVB no tratamento da psoríase infantil e da adolescência encontra-se bem descrita na literatura. Contudo, existem poucos dados no que concerne à utilização de psoraleno e UVA (PUVA) nesta faixa etária. O objectivo do presente trabalho é avaliar a eficácia e segurança a curto prazo da terapêutica com PUVA numa população de adolescentes com psoríase.Métodos: Revisão e análise retrospectiva dos dados clínicos relativos aos doentes com psoríase com idade entre 13 e 17 anos. A população analisada incluiu 20 doentes, dezoito com psoríase em placas moderada a grave e dois com psoríase gutata.Resultados: Nove doentes foram tratados com apenas um ciclo de PUVA, e os restantes com dois. Foram associadas terapêuticas sistémicas em 52%. A taxa de resposta total foi de 86,2%, com uma média global de 16,7 tratamentos de PUVA e uma dose cumulativa total média de 174,0 J/cm2. O tempo até recidiva foi de 4,3 meses, e em 2 doentes (10%) não houve recidiva durante um ano de seguimento. Observaram-se efeitos secundários em 3 doentes (15%), nomeadamente náuseas e eritema cutâneo.Conclusões: A fotoquimioterapia demonstrou boa eficácia na nossa população de adolescentes. Os efeitos secundários foram reduzidos e não motivaram suspensão da terapêutica. O potencial carcinogénico da radiação UVA poderá ser uma limitação importante desta modalidade terapêutica, pelo que são necessários mais estudos que avaliem a sua segurança a longo prazo.