Modeling of springback on air bending process of interstitial free steel sheet using multiple regression analysis

This paper describes the development of regression based mathematical models for the prediction of springback in air bending process of interstitial free (IF) steel sheet. Punch travel (d), strain hardening exponent (n), punch radius (r _p), punch velocity (v _p) and width of the sheet (w) have been considered as input parameters and springback as output parameter to develop the model. Based on experimental results, various regression models namely, linear, linear-square, linear-interaction and quadratic terms for the springback prediction were developed for IF steel sheets. It is found that, the results obtained from the quadratic model are accurate in prediction of springback than others.     

On-table Endoscopy Following Laparoscopic Fundoplication

Background Laparoscopic fundoplication represents the gold standard in the surgical management of gastro-esophageal reflux disease (GERD). The achievement of long-lasting symptomatic and physiological control of reflux is the goal of therapy, as well as the minimization of troubling sequelae, in particular, dysphagia. On-table endoscopy after fundoplication was introduced in this Unit as a quality initiative in an attempt to minimize dysphagia and technical errors, and the aim of this study is to report the experience to date, and compare outcomes with the previous 100 cases performed by an experienced team. Methods Eighty patients who underwent laparoscopic Rosetti-Nissen fundoplication and on-table endoscopy (group 2) were compared with 100 consecutive prior cases (group 1). Patients were prospectively evaluated and had pre- and postoperative symptom scoring and analysis of complications (all patients), and manometry and 24-h pH testing in 120 patients (60 in each group). Results Both groups were similar with respect to demographics, esophagitis, pH score, and dysmotility. No bougie was used in either group. On-table endoscopy resulted in technical modifications in 4 (5%) patients. Early grade 2 or 3 dysphagia was evident in 4 (5%) patients in group 2, compared with 15 (15%) in group 1 (p < 0.001). Late dysphagia was evident in one patient (1.5%) in group 2 compared with 7 (7%) in group 1 (p < 0.05). Dilatation was performed in four patients (5%) in group 2, compared with 11 (11%) in group 1 (p < 0.05). Conclusions These data suggest that on-table endoscopy may be a useful quality assurance adjunct in laparoscopic anti-reflux surgery, in particular, reducing the incidence of dysphagia and reinterventions.     

Spirituality and learning disabilities: a qualitative study

This article describes a unique empirical study where critical incidents were obtained from learning disability nurses to understand how they attempt to meet the spiritual needs of the people for whom they care. Following analysis, the nurses' approaches to meeting spiritual needs were categorized as 'personal' and 'procedural', and each of these is described in turn. There then follows a discussion on the effects of these nurses' interventions on both clients and their families, and nurses themselves. The findings of the study illuminate how these learning disability nurses attempted to meet the spiritual needs of people with learning disabilities in their care. The findings may help nurses ensure that spiritual needs are identified in the construction of the personal care plans of people with learning disabilities.     

Mosquito larvicidal, ovicidal, and repellent properties of botanical extracts against Anopheles stephensi, Aedes aegypti, and Culex quinquefasciatus (Diptera: Culicidae)

Mosquito-borne diseases have an economic impact, including loss in commercial and labor outputs, particularly in countries with tropical and subtropical climates; however, no part of the world is free from vector-borne diseases. In mosquito control programs, botanical origin may have the potential to be used successfully as eggs, larvae, and adult. The larvicidal, ovicidal, and repellent activities of crude benzene and ethyl acetate extracts of leaf of Ervatamia coronaria and Caesalpinia pulcherrima were assayed for their toxicity against three important vector mosquitoes, viz., Anopheles stephensi, Aedes aegypti, and Culex quinquefasciatus (Diptera: Culicidae). The larval mortality was observed after 24 h of exposure. All extracts showed moderate larvicidal effects; however, the highest larval mortality was found in benzene extract of E. coronaria against the larvae of Anopheles Stephensi, Aedes aegypti, and Culex quinquefasciatus with the LC₅₀ and LC₉₀ values were 79.08, 89.59, and 96.15 ppm and 150.47, 166.04, and 174.10 ppm, respectively. Mean percent hatchability of the ovicidal activity was observed 48 h posttreatment. The percent hatchability was inversely proportional to the concentration of extract and directly proportional to the eggs. The leaf extract of E. coronaria was found to be most effective than Caesalpinia pulcherrima against eggs/egg rafts of three vector mosquitoes. For E. coronaria, the benzene extract exerted 300, 250, and 200 ppm against Anopheles stephensi, Aedes aegypti, and Culex quinquefasciatus, respectively. The results of the repellent activity of benzene and ethyl acetate extract of E. coronaria and Caesalpinia pulcherrima plants at three different concentrations of 1.0, 2.5, and 5.0 mg/cm² were applied on skin of fore arm in man and exposed against adult female mosquitoes. In this observation, these two plant crude extracts gave protection against mosquito bites without any allergic reaction to the test person, and also, the repellent activity is dependent on the strength of the plant extracts. These results suggest that the leaf solvent plant extracts have the potential to be used as an ideal ecofriendly approach for the control of mosquitoes. This is the first report on the mosquito larvicidal, ovicidal, and repellent activities of the reported E. coronaria and Caesalpinia pulcherrima plants.     

Management of gastro-bronchial fistula complicating a subtotal esophagectomy: a case report

Background  

The development of a fistula between the tracheobronchial tree and the gastric conduit post esophagectomy is a rare and often fatal complication.     

Endoscopic T-tube placement in the management of lye-induced esophageal perforation: Case report of a safe treatment strategy

Background

The use of bariatric surgery in the management of morbid obesity is rapidly increasing. The two most frequently performed procedures are laparoscopic Roux-en-Y bypass and laparoscopic gastric banding. The objective of this short overview is to provide a critical appraisal of the most relevant scientific evidence comparing laparoscopic gastric banding versus laparoscopic Roux-en-Y bypass in the treatment of morbidly obese patients.

Results and discussion

There is mounting and convincing evidence that laparoscopic gastric banding is suboptimal at best in the management of morbid obesity. Although short-term morbidity is low and hospital length of stay is short, the rates of long-term complications and band removals are high, and failure to lose weight after laparoscopic gastric banding is prevalent.

Conclusion

The placement of a gastric band appears to be a disservice to many morbidly obese patients and therefore, in the current culture of evidence based medicine, the prevalent use of laparoscopic gastric banding can no longer be justified. Based on the current scientific literature, the laparoscopic gastric bypass should be considered the treatment of choice in the management of morbidly obese patients.     

Agonistic effect of polyunsaturated fatty acids (PUFAs) and its metabolites on brain-derived neurotrophic factor (BDNF) through molecular docking simulation

ABSTRACT: BACKGROUND: Brain-derived neurotrophic factor (BDNF) is a potent neurotrophic factor that is implicated in the regulation of food intake and body weight. Polyunsaturated fatty acids (PUFAs) localised in cell membranes have been shown to alter the levels of BDNF in the brain, suggesting that PUFAs and BDNF could have physical interaction with each other. To decipher the molecular mechanism through which PUFAs modulates BDNF's activity, molecular docking was performed for BDNF with PUFAs and its metabolites, with 4-Methyl Catechol as a control. RESULTS: Inferring from molecular docking studies, lipoxin A4 (LXA4), and a known anti-inflammatory bioactive metabolite derived from PUFAs, with a binding energy of -3.98 Kcal/mol and dissociation constant of 1.2mM showed highest binding affinity for BDNF in comparison to other PUFAs and metabolites considered in the study. Further, the residues Lys 18, Thr 20, Ala 21, Val 22, Phe 46, Glu 48, Lys 50, Lys 58, Thr 75, Gln 77, Arg 97 and Ile 98 form hot point motif, which on interaction enhances BDNF's function. CONCLUSION: These results suggest that PUFAs and their metabolites especially, LXA4, modulate insulin resistance by establishing a physical interaction with BDNF. Similar interaction(s) was noted between BDNF and resolvins and protectins but were of lesser intensity compared to LXA4.     

Evaluation of a training curriculum for nursing assistants

This is the report of a study undertaken as part fulfilment of the nurse tutor's course at Huddersfield Polytechnic. The purpose of the study was to evaluate nursing assistant training programmes at a mental illness unit in the Trent Region. The results suggest that the training curriculum in the unit where the study took place is effective in terms of teaching methods, lesson contents and consumer satisfaction (nursing assistants and charge nurses). The questionnaire survey supplied helpful comments on the training needs of nursing assistants. The conclusion is that it is not a waste of time to teach some elementary notions of nursing to nursing assistants.     

Incidence of burn wound sepsis in 600 burned patients treated in a developing country

Infection is the most important problem in the treatment of burns in a developing country. A burn compromises a major body protective mechanism, namely the skin. Hence, the susceptibility to local infection increases at these sites. The incidence of burn wound sepsis is very high in south India as the socio-economic conditions and the standard of personal hygiene are poor and the hot moist climatic conditions encourage bacterial growth. These three factors are rarely present in the temperate zone countries of Europe and North America. This study was undertaken to identify more clearly the factors that are responsible for the higher incidence of burn wound infection and to formulate methods of treatment which are appropriate for our patient population living in a tropical country.     

Effects of Pygidial Secretion (Zoopesticide) on Histopathological Changes in the Male Accessory Reproductive Glands of Adult Male Insect Odontopus varicornis in Relation to Reproduction

Indiscriminate use of pesticides for the eradication of pests causes tremendous changes to the environment and also to other nontarget organisms. To prevent such contamination of the environment and save nontarget species, zoopesticides are increasingly used as they are cost effective, eco-friendly, safe, and sustainable in the field of agriculture. The present study was undertaken to find out the effect of pygidial secretion (zoopesticide) on Odontopus varicornis. The insects were exposed to pygidial secretion for 24, 48, 72, and 96 hours and its sublethal concentration was found to be about 2.8% for 48 hours. When the insects were injected with sublethal concentration 2.8% for 48 hours, the study revealed certain remarkable changes in the histopathology of the male accessory reproductive glands (MARGs) such as disintegration of epithelial cell wall, swollen nucleus, vacuolization of cytoplasm, highly pycnotic and necrotic epithelium, enlargement of epithelial cells, and disorganized tissues. It is suggested that zoopesticide causes several histopathological damages in the MARGs of O. varicornis and affects the reproductive potentiality of O. varicornis.