A 25-year-old female presented with sudden onset diminution of vision in the right eye (oculus dextrus OD) following blunt trauma after a sports injury. Ocular examination revealed best-corrected ...visual acuity (BCVA) of 20/30 in OD and fundus revealed commotio retinae, localized preretinal bleed, and a large choroidal rupture (CR). She was managed conservatively at that moment. Three months following trauma, she returned with further deterioration of BCVA (20/80) in OD. Optical coherence tomography angiogram (OCTA) confirmed the presence of choroidal neovascular membrane (CNVM). She was treated with single intravitreal ranibizumab injection. Repeat OCTA after 6 weeks showed the regression of CNVM. Her BCVA improved to 20/30 at 6 months of follow-up. In the index report, we present a unique OCTA guided the diagnosis of posttraumatic CR-associated CNVM and its successful management with single intravitreal ranibizumab.
In today’s cyber warfare realm, every stakeholder in cyberspace is becoming more potent by developing advanced cyber weapons. They have equipped with the most advanced malware and maintain a hidden ...attribution. The precocious cyber weapons, targeted and motivated with some specific intention are called as Advanced Persistent Threats (APT). Developing defense mechanisms and performing attribution analysis of such advanced attacks are extremely difficult due to the intricate design of attack vector and sophisticated malware employed with high stealth and evasive techniques. These attacks also include advanced zero-day and negative-day exploits and payloads. This paper provides a comprehensive survey on the evolution of advanced malware design paradigms, APT attack vector and its anatomy, APT attack Tactics, Techniques, and Procedures (TTP) and specific case studies on open-ended APT attacks. The survey covers a detailed discussion on APT attack phases and comparative study on threat life-cycle specification by various organizations. This work also addresses the APT attack attribution and countermeasures against these attacks from classical signature and heuristic based detection to modern machine learning and genetics based detection mechanisms along with sophisticated zero-day and negative day malware countermeasure by various techniques like monitoring of network traffic and DNS logs, moving target based defense, and attack graph based defenses. Furthermore, the survey addresses various research scopes in the domain of APT cyber-attacks.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Atrial fibrillation (AF) is a substantial burden on health care. Combined specialist and nurse-based AF clinics are associated with improved outcomes. However, Canadian data on the cost-effectiveness ...of this integrated management approach to AF care are lacking.
We evaluated health care costs and outcomes of 413 patients with newly-diagnosed AF in 3 emergency departments in Nova Scotia between January 1, 2011 and January 31, 2014. Using a before-after study design, patients were divided into usual care (228 patients) and intervention (185 patients) groups. The intervention was a nurse-run, physician-supervised AF clinic. Costs and quality-adjusted life years (QALYs) were compared between usual care and intervention. Costs were those incurred because of the clinical outcome, bleeding events, medications, and cardiovascular-related procedures. Probabilistic analysis was conducted to assess uncertainty.
The AF clinic was associated with an average cost reduction of CAD$210.83 and an average improvement in QALY of 0.0007 per patient. The AF clinic was dominant over usual care despite higher operational and medication costs over 1 year. It provided greater cost-saving in approximately 66% of probabilistic analysis simulations and generated more QALYs in approximately 92% of simulations. An incremental cost-effectiveness ratio < $50,000 was found in 68% of simulations.
The present study provides guidance regarding the cost-effectiveness of an integrated management approach compared with usual specialty care of AF in a Canadian setting. We recommend further study be undertaken that prospectively plans for economic evaluation before definitive assessments of cost-effectiveness can be made.
La fibrillation auriculaire (FA) est un fardeau important pour les soins de santé. Les cliniques de FA constituées d’infirmières et de spécialistes sont associées à de meilleurs résultats cliniques. Toutefois, les données canadiennes sur le rapport coût-efficacité de cette approche intégrée de prise en charge de la FA sont insuffisantes.
Nous avons évalué les coûts des soins de santé et les résultats cliniques de 413 patients ayant récemment reçu un diagnostic de FA dans 3 services d’urgence en Nouvelle-Écosse entre le 1er janvier 2011 et le 31 janvier 2014. À partir d’un plan d’étude avant-après, nous avons réparti les patients en 2 groupes : soins habituels (228 patients) et intervention (185 patients). L’intervention consistait en une clinique de FA dirigée par une infirmière et supervisée par un médecin. Nous avons comparé les coûts et les années de vie pondérées par la qualité (QALY, de l’anglais quality-adjusted life year) entre les soins habituels et l’intervention. Les coûts représentaient les coûts engendrés en raison des résultats cliniques, des événements hémorragiques, des médicaments et des interventions liées aux maladies cardiovasculaires. Nous avons réalisé une analyse probabiliste pour évaluer les incertitudes.
Nous avons associé la clinique de FA à une réduction moyenne des coûts de 210,83 $ CA et à une amélioration moyenne des QALY de 0,0007 par patient. La clinique de FA prédominait dans les soins habituels en dépit des coûts plus élevés d’exploitation et de médicaments sur 1 année. Elle a permis d’offrir une plus grande réduction des coûts dans approximativement 66 % des simulations d’analyse probabiliste et généré plus de QALY dans approximativement 92 % des simulations. Nous avons observé un rapport coût-efficacité différentiel de < 50 000 $ CA dans 68 % des simulations.
La présente étude donne des orientations sur le rapport coût-efficacité d’une approche intégrée de prise en charge par rapport aux soins spécialisés habituels de la FA dans un contexte canadien. Nous recommandons d’entreprendre d’autres études qui permettent d’établir de manière prospective des plans d’évaluation économique avant de faire les évaluations finales du rapport coût-efficacité.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Kinetics of glass transition of Ge
y
Se
94-y
In
6
(y = 10, 15 & 20) glassy alloys has been studied under non-isothermal condition using Differential Scanning Calorimetery (DSC). The glassy alloys ...have been prepared by rapid quenching of melt technique. For structure characterization, XRD and EDAX techniques have been used. DSC thermograms have been recorded at heating rates 5, 10, 15 and 20 K/min. from room temperature to 823 K. Lasocka's empirical relation has been used to study the heating rate dependence of glass transition temperature. Activation energy of glass transition, evaluated from Kissinger Peak shift method, increases with increase of Ge content in Ge
y
Se
94-y
In
6
(y = 10, 15 & 20) glassy series.
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BFBNIB, GIS, IJS, KISLJ, NUK, PNG, UL, UM, UPUK
Background:
Although good short-term and midterm outcomes are reported for mini-open rotator cuff repair, few prospective studies have investigated long-term results.
Hypothesis:
Function and ...health-related quality of life (HRQL) outcomes would be maintained 10 years after mini-open rotator cuff repair.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients with a confirmed full-thickness rotator cuff tear who underwent mini-open repair between April 1997 and July 2000 were evaluated preoperatively as well as 1 year and 10 years postoperatively for (1) pain, function, and HRQL using the American Shoulder and Elbow Surgeons (ASES) score and Western Ontario Rotator Cuff Index (WORC) score; (2) active shoulder range of motion (ROM) using goniometry; and (3) satisfaction by an independent evaluator. Changes in function, HRQL, and ROM over time were analyzed using repeated-measures analysis of variance.
Results:
A total of 84 patients were enrolled, of which 61 (73%) were men; the mean (±SD) age was 53.0 ± 9.9 years. At 10 years, 4 (5%) patients were deceased, and 4 (5%) had symptomatic retears. Fifty-nine (74%) patients were evaluated, composed of 43 (73%) men; 26 (44%) were younger than 60 years. Function and HRQL significantly improved over the course of follow-up (P < .001), primarily within the first postoperative year. At 10 years, the mean ASES score was 90.4 ± 19.4, similar to the 1-year score of 91.1 ± 12.0 (P = .83). The mean WORC score at 10 years was 88.7 ± 17.8, with no change from the 1-year score of 88.4 ± 13.6 (P = .93). This relationship did not change after adjusting for age and tear size. Shoulder ROM was also maintained over 10 years. Flexion ROM improved in the first postoperative year, and this improvement was sustained at 10 years after surgery (P ≥ .30). External rotation ROM was slower to improve postoperatively, and significant improvements were seen between 1 and 10 years (P < .01). Fifty-three patients (90%) were satisfied or very satisfied with their results. Tear size, workers’ compensation board claimant status, sex, and smoking status did not influence HRQL or shoulder ROM (P > .06).
Conclusion:
Postoperative improvements in function and HRQL after mini-open rotator cuff repair were retained at 10 years.
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FSPLJ, NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
The effect of uniaxial-strain, band-structure, mobility, effective masses, density of states, channel orientation and high-field transport on the drive current, off-state leakage and switching delay ...in nano-scale, Silicon (Si) and Germanium (Ge), p-MOS DGFETs is thoroughly and systematically investigated. To accurately model and capture all these complex effects, different simulation techniques, such as the Non-local Empirical Pseudopotential method (bandstructure), Full-Band Monte-Carlo Simulations (transport), 1-D Poisson-Schrodinger (electrostatics) and detailed Band-To-Band-Tunneling (BTBT) (including bandstructure and quantum effects) simulations, were used in this study.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The present research work includes non-isothermal crystallization kinetics of poly(ethylene terephthalate) (PET)–titanium dioxide (TiO
2
) nanocomposites as well as structural and chemical properties ...of these nanocomposites. The average grain size of chemically synthesized TiO
2
nanoparticles has been calculated 19.31 nm by TEM and XRD. The morphology and structural analysis of PET–TiO
2
nanocomposites, prepared via solution casting method, has been investigated using SEM and XRD, respectively. The nature of chemical bonds has been discussed on the basis of FTIR spectra. The effect of TiO
2
nanoparticles and cooling rates on non-isothermal crystallization kinetics of PET was examined by differential scanning calorimetry at various heating and cooling rates. It has been observed that TiO
2
nanoparticles accelerate the heterogeneous nucleation in PET matrix. The crystallization kinetics could be explained through Avrami–Ozawa combined theory. TiO
2
nanoparticles cause to make molecular chains of PET easier to crystallize and accelerate the crystallization rates during non-isothermal crystallization process; this conclusion has also been verified by Kissinger model for crystallization activation energy.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
In the recent past, various factors have led to an increase in the use of renewable energy sources, among which, the depleting fossil fuel reserves, increasing fuel prices, and rising environmental ...concerns are the most prominent. With this increasing reliance on renewable energy sources, a proper assessment of the suitable sites becomes necessary for the optimum utilization of these resources. The present study investigates the spatial suitability of the solar and wind farms locations in India based on the technical, economic, and socio-environmental perspectives. The analysis is performed with the coupled use of the Geographical Information System (GIS) and Multi-Criteria Decision Making (MCDM) approaches. Analysis of present research work shows that 4.13% of the study area (133,874 km2) is highly suitable for the deployment of solar plants while 0.91% of the total area (29,457 km2) is highly suitable for the wind farms. The study further concludes that the Rajasthan state in India has the highest suitable land for the installation of solar plants (20,881 km2) as well as wind farms (6323 km2). The proposed model can be used for the development of policies related to renewable energy resources and the assessment of suitability of already sanctioned projects.
•Investigated suitable sites for the installation of solar and wind farms in India.•Explored the potential area in different states and union territories of India.•Total 133,874 km2 land area identified as the highly suitable for the solar farms.•Total 29,457 km2 land area identified as the highly suitable for the wind farms.•Rajasthan state has the highest highly suitable land for both solar and wind farms.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Nonvenereal dermatoses tend to create confusion from venereal dermatoses. This may be responsible for considerable concern to the patient as well as may cause diagnostic dilemma to the physicians. ...Nonvenereal dermatoses may not be restricted to genitalia alone; it may affect skin and mucous membrane also. Most of the patients with genital lesions had apprehension of suffering from some venereal disorders.
The aim was to determine clinical and epidemiological pattern of nonvenereal dermatoses of male external genitalia.
This was a descriptive study of 100 consecutive adult male patients with nonvenereal genital dermatoses attending skin and STD OPD at J A Group of Hospitals, Gwalior. Cases having any venereal dermatoses were excluded from this study.
The study included 100 male patients with nonvenereal genital lesions. A total of sixteen nonvenereal genital dermatoses were noted. The most common nonvenereal genital dermatoses were vitiligo (18%), pearly penile papule (16%), fixed drug eruptions (12%), scabies (10%), scrotal dermatitis (9%) and lichen planus (9%). Other dermatoses included sebaceous cyst, psoriasis, lichen sclerosus, plasma cell balanitis or Zoon's balanitis, granuloma annulare, lichen nitidus, lymphangioma circumscriptum, papulo-necrotic tuberculid, squamous cell carcinoma and tinea infections. The age ranged from 18 years to 65 years with majority in the age group of 21-30 years (40%).
This study highlights the importance of diagnosing common nonvenereal genital dermatoses. It also helps in avoiding the general misconception that all genital lesions are sexually transmitted.
The authors present compact analytical thermal models for estimating the temperature rise of multilevel VLSI interconnect lines incorporating via effect. The impact of vias has been modeled using (1) ...a characteristic thermal length and (2) an effective thermal conductivity of ILD (interlayer dielectric), k/sub ILD,eff/, with k/sub ILD/,/sub eff/=k/sub ILD//spl eta//, where /spl eta/ is a physical correction factor, with 0</spl eta/<1. Both the spatial temperature profile along the metal lines and their average temperature rise can be easily obtained using these models. The predicted temperature profiles are shown to be in excellent agreement with the three-dimensional (3-D) finite element thermal simulation results. The model is then applied to estimate the temperature rise of densely packed multilevel interconnects. It is shown that for multilevel interconnect arrays, via density along the lines can significantly affect the temperature rise of such interconnect structures.
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