<strong>Purpose:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">We harvested bilateral Internal Mammary Arteries and made LIMA-R...<strong>Purpose:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">We harvested bilateral Internal Mammary Arteries and made LIMA-RIMA Y in all the patients undergoing OPCAB at our center irrespective of the presence or absence of various risk factors for sternal dehiscence. The purpose of this study was to find an effective way of sternal closure in patients undergoing OPCAB with both the Internal Mammary Arteries harvested for grafting. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">The patients who did not have any risk factors were placed in group I and all of them had a standard six wire closure of sternotomy. The patients having any risk factors were placed in group II. The patients in group II were randomized by including every alternate patient from group II to subgroup II A and every other alternate patient from group II to subgroup II B. Patients in subgroup II A again had a standard closure of sternotomy while in patients of subgroup II B bilateral Robiscek repair and four-five interlocking figure of eight wires were used for closure of sternotomy. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The patients who had risk factors for sternal dehiscence had higher risk for sternal dehiscence as compared to patients without any risk factors if bilateral Internal Mammary Arteries were harvested for OPCAB. But if we used bilateral Robiscek repair with four to five interlocking figure of eight wires for sternal closure then the rate of sternal complications in the patients with risk factors for sternal dehiscence was not more than the patients without risk factors. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> We can harvest bilateral Internal Mammary Arteries for OPCAB without fear of sternal complications even in patients with high risk for sternal dehiscence if we use bilateral Robiscek repair with four to five interlock展开更多
In this paper we investigate the effectiveness of ensemble-based learners for web robot session identification from web server logs. We also perform multi fold robot session labeling to improve the performance of lear...In this paper we investigate the effectiveness of ensemble-based learners for web robot session identification from web server logs. We also perform multi fold robot session labeling to improve the performance of learner. We conduct a comparative study for various ensemble methods (Bagging, Boosting, and Voting) with simple classifiers in perspective of classification. We also evaluate the effectiveness of these classifiers (both ensemble and simple) on five different data sets of varying session length. Presently the results of web server log analyzers are not very much reliable because the input log files are highly inflated by sessions of automated web traverse software’s, known as web robots. Presence of web robots access traffic entries in web server log repositories imposes a great challenge to extract any actionable and usable knowledge about browsing behavior of actual visitors. So web robots sessions need accurate and fast detection from web server log repositories to extract knowledge about genuine visitors and to produce correct results of log analyzers.展开更多
We report here for the first time the composition and mineralogical studies on a new meteorite, which fell in Dhayala ki Chappar (24°58°N, 73° 48°27°E) 5 km NW of Nathdwara in south Rajastha...We report here for the first time the composition and mineralogical studies on a new meteorite, which fell in Dhayala ki Chappar (24°58°N, 73° 48°27°E) 5 km NW of Nathdwara in south Rajasthan, India, on Dec. 25th, 2012. Mineralogical and compositional studies were carried out on a representative piece of the Nathdwara meteorite sample. The mineralogical composition of the meteorite has been found to be olivine (42 45 vol.%), feldspar (10-15 vol.%), orthopyroxene (23-25 vol.%), troilite (6 8 vol.%), and titanium bearing minerals (6-8 vol.%). Our investigations show that the Nathdwara meteorite belongs to H6 group of ordinary chondrites.展开更多
Pulmonary embolism following upper limb surgery is a very rare complication. Here we present a unique case report of a 54-year-old young, fit and healthy, and non-smoker male who developed bilateral pulmonary embolism...Pulmonary embolism following upper limb surgery is a very rare complication. Here we present a unique case report of a 54-year-old young, fit and healthy, and non-smoker male who developed bilateral pulmonary embolism (PE) 26 days post-operatively with no associated upper or lower limb Deep Vein Thrombosis (DVT). This patient had minimal preoperative as well as intra-operative risk factors. He did not develop any thromboembolic symptoms until the 26th-day post-surgery when he developed sudden, sharp, pleuritic chest pain and laboured breathing. Initial baseline bloods showed a raised D-Dimer and the patient subsequently had a CT pulmonary angiogram that confirmed the presence of bilateral massive PEs. However, subsequent extremity ultrasound showed no upper or lower deep venous thrombosis. Thorough review of literature suggests that sudden development of PEs after upper limb surgery is possible, with a few cases being reported in the past. Symptoms such as sudden upper limb swelling, troubled breathing and systemic symptoms should be evaluated aggressively with a CT pulmonary angiogram, given the fact that an ultrasound of the extremities may be negative for deep venous thrombosis.展开更多
Lumbar vertebral body(VB) fractures are increasingly common in an ageing population that is at greater risk of osteoporosis and metastasis. This review aims to identify different models, as alternatives to bone minera...Lumbar vertebral body(VB) fractures are increasingly common in an ageing population that is at greater risk of osteoporosis and metastasis. This review aims to identify different models, as alternatives to bone mineral density(BMD), which may be applied in order to predict VB failure load and fracture risk. The most representative models are those that take account of normal spinal kinetics and assess the contribution of the cortical shell to vertebral strength. Overall, predictive models for VB fracture risk should encompass a range of important parameters including BMD, geometric measures and patient-specific factors. As interventions like vertebroplasty increase in popularity for VB fracture treatment and prevention, such models are likely to play a significant role in the clinical decision-making process. More biomechanical research is required, however, to reduce the risks of post-operative adjacent VB fractures.展开更多
文摘<strong>Purpose:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">We harvested bilateral Internal Mammary Arteries and made LIMA-RIMA Y in all the patients undergoing OPCAB at our center irrespective of the presence or absence of various risk factors for sternal dehiscence. The purpose of this study was to find an effective way of sternal closure in patients undergoing OPCAB with both the Internal Mammary Arteries harvested for grafting. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">The patients who did not have any risk factors were placed in group I and all of them had a standard six wire closure of sternotomy. The patients having any risk factors were placed in group II. The patients in group II were randomized by including every alternate patient from group II to subgroup II A and every other alternate patient from group II to subgroup II B. Patients in subgroup II A again had a standard closure of sternotomy while in patients of subgroup II B bilateral Robiscek repair and four-five interlocking figure of eight wires were used for closure of sternotomy. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The patients who had risk factors for sternal dehiscence had higher risk for sternal dehiscence as compared to patients without any risk factors if bilateral Internal Mammary Arteries were harvested for OPCAB. But if we used bilateral Robiscek repair with four to five interlocking figure of eight wires for sternal closure then the rate of sternal complications in the patients with risk factors for sternal dehiscence was not more than the patients without risk factors. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> We can harvest bilateral Internal Mammary Arteries for OPCAB without fear of sternal complications even in patients with high risk for sternal dehiscence if we use bilateral Robiscek repair with four to five interlock
文摘In this paper we investigate the effectiveness of ensemble-based learners for web robot session identification from web server logs. We also perform multi fold robot session labeling to improve the performance of learner. We conduct a comparative study for various ensemble methods (Bagging, Boosting, and Voting) with simple classifiers in perspective of classification. We also evaluate the effectiveness of these classifiers (both ensemble and simple) on five different data sets of varying session length. Presently the results of web server log analyzers are not very much reliable because the input log files are highly inflated by sessions of automated web traverse software’s, known as web robots. Presence of web robots access traffic entries in web server log repositories imposes a great challenge to extract any actionable and usable knowledge about browsing behavior of actual visitors. So web robots sessions need accurate and fast detection from web server log repositories to extract knowledge about genuine visitors and to produce correct results of log analyzers.
文摘We report here for the first time the composition and mineralogical studies on a new meteorite, which fell in Dhayala ki Chappar (24°58°N, 73° 48°27°E) 5 km NW of Nathdwara in south Rajasthan, India, on Dec. 25th, 2012. Mineralogical and compositional studies were carried out on a representative piece of the Nathdwara meteorite sample. The mineralogical composition of the meteorite has been found to be olivine (42 45 vol.%), feldspar (10-15 vol.%), orthopyroxene (23-25 vol.%), troilite (6 8 vol.%), and titanium bearing minerals (6-8 vol.%). Our investigations show that the Nathdwara meteorite belongs to H6 group of ordinary chondrites.
文摘Pulmonary embolism following upper limb surgery is a very rare complication. Here we present a unique case report of a 54-year-old young, fit and healthy, and non-smoker male who developed bilateral pulmonary embolism (PE) 26 days post-operatively with no associated upper or lower limb Deep Vein Thrombosis (DVT). This patient had minimal preoperative as well as intra-operative risk factors. He did not develop any thromboembolic symptoms until the 26th-day post-surgery when he developed sudden, sharp, pleuritic chest pain and laboured breathing. Initial baseline bloods showed a raised D-Dimer and the patient subsequently had a CT pulmonary angiogram that confirmed the presence of bilateral massive PEs. However, subsequent extremity ultrasound showed no upper or lower deep venous thrombosis. Thorough review of literature suggests that sudden development of PEs after upper limb surgery is possible, with a few cases being reported in the past. Symptoms such as sudden upper limb swelling, troubled breathing and systemic symptoms should be evaluated aggressively with a CT pulmonary angiogram, given the fact that an ultrasound of the extremities may be negative for deep venous thrombosis.
文摘Lumbar vertebral body(VB) fractures are increasingly common in an ageing population that is at greater risk of osteoporosis and metastasis. This review aims to identify different models, as alternatives to bone mineral density(BMD), which may be applied in order to predict VB failure load and fracture risk. The most representative models are those that take account of normal spinal kinetics and assess the contribution of the cortical shell to vertebral strength. Overall, predictive models for VB fracture risk should encompass a range of important parameters including BMD, geometric measures and patient-specific factors. As interventions like vertebroplasty increase in popularity for VB fracture treatment and prevention, such models are likely to play a significant role in the clinical decision-making process. More biomechanical research is required, however, to reduce the risks of post-operative adjacent VB fractures.