Comparison of Block Design Nonparametric Subset Selection Rules Based on Alternative Scoring Rules

This article compares the size of selected subsets using nonparametric subset selection rules with two different scoring rules for the observations. The scoring rules are based on the expected values of order statistics of the uniform distribution (yielding rank values) and of the normal distribution (yielding normal score values). The comparison is made using state motor vehicle traffic fatality rates, published in a 2016 article, with fifty-one states (including DC as a state) and over a nineteen-year period (1994 through 2012). The earlier study considered four block design selection rules—two for choosing a subset to contain the “best” population (i.e., state with lowest mean fatality rate) and two for the “worst” population (i.e., highest mean rate) with a probability of correct selection chosen to be 0.90. Two selection rules based on normal scores resulted in selected subset sizes substantially smaller than corresponding rules based on ranks (7 vs. 16 and 3 vs. 12). For two other selection rules, the subsets chosen were very close in size (within one). A comparison is also made using state homicide rates, published in a 2022 article, with fifty states and covering eight years. The results are qualitatively the same as those obtained with the motor vehicle traffic fatality rates.

Combined APACH Ⅱ score and arterial blood lactate clearance rate to predict the prognosis of ARDS patients

Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome（ARDS）.Methods:Blood and biochemical tests and bloodgas analyses were performed upon entry into the ICUs,12 h,24 h,48 h and 72 h after that in 72 ARDS patients（who were admitted to the ICUs of our hospital from January 2000 to December 2009）.Then APACHEⅡscores were achieved by combining relevant physiological parameters and laboratory results.Results:There was a statistical difference between the death group and survival group at different time points upon entering the ICUs in terms of APACHEⅡscore, alveolar-arterial oxygen difference and arterial blood lactate clearance rate.PaO2/FiO2 values were recorded to be statistically different between the death group and survival group 24 h,48 h and 72 h,respectively after entry into the ICUs.In addition,registered linear regression existed between APACHEⅡscore,alveolar-arterial oxygen difference or PaO2/FiO2 value and time. APACHEⅡscore 24 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve（AUC） standing respectively at 0.919 and 0.9SS.Arterial blood lactate clearance rate 12 h, 24 h,48 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve （AUC） at 0.918,0.918,0.909 and 0.991,respectively.Conclusions:APACHEⅡscore applied in combination with arterial blood lactate clearance rate is of clinical significance in assessing the prognosis of ARDS patients.

Applying the WHO instead of CDC growth charts may double obesity rates

Aims: This study compares the WHO (2007) and the National Health Examination Survey (NHANES III) reference intervals and investigates the differences when applied on a Canadian cohort of older children and adolescents. Methods: We calculated height, weight and BMI z-scores of 4375 consecutive patients (1993 female, 45.6%) aged 5 - 20 years attending outpatient clinics at a single tertiary care centre using reference data of the latest NHANES (III) survey and the WHO (2007) growth charts. To address age dependency, data was stratified into age groups. Results: Using the NHANES III reference intervals, medians of weight (+0.46), height (+0.29) and BMI z-scores (+0.46) were significantly non-zero. The WHO (2007) growth charts yielded medians of +2.05, +0.32, +0.53 for weight, height and BMI z-scores respectively, all significantly non-zero. When comparing both growth charts, Canadian children had significantly different weight and BMI z-scores (p 95th percentile) doubled from 8.6% to 16.0%. A significant age dependency was observed with higher WHO (2007) weight z-scores (>7 years) and higher BMI z-scores (7 to 13 years) and no significant difference was observed for height z-scores across all age groups. Gender differences were observed for weight z-scores (>9 years) and BMI (males: 9 - 11 years, p = 0.0118;11 - 13 years, p = 0.0069) whereas no significant difference was found in height z-scores across all age groups. Conclusion: Our results reveal substantial differences between both reference populations and thus interpretation needs be done with caution, especially when labelling results as abnormal.

Comparison of intraosseous access and central venous catheterization in Chinese adult emergency patients: A prospective, multicenter, and randomized study

BACKGROUND: It is challenging to establish peripheral intravenous access in adult critically patients. This study aims to compare the success rate of the first attempt, procedure time, operator satisfaction with the used devices, pain score, and complications between intraosseous(IO) access and central venous catheterization(CVC) in critically ill Chinese patients.METHODS: In this prospective clustered randomized controlled trial, eight hospitals were randomly divided into either the IO group or the CVC group. Patients who needed emergency vascular access were included. From April 1, 2017 to December 31, 2018, each center included 12 patients. We recorded the data mentioned above.RESULTS: A total of 96 patients were enrolled in the study. There were no statistically significant differences between the two groups regarding sex, age, body mass index, or operator satisfaction with the used devices. The success rates of the first attempt and the procedure time were statistically significant between the IO group and the CVC group(91.7% vs. 50.0%, P<0.001;52.0 seconds vs. 900.0 seconds, P<0.001). During the study, 32 patients were conscious. There was no statistically significant difference between the two groups regarding the pain score associated with insertion. There were statistically significant differences between the two groups regarding the pain score associated with IO or CVC infusion(1.5 vs. 0.0, P=0.044). Complications were not observed in the two groups.CONCLUSIONS: IO access is a safe, rapid, and effective technique for gaining vascular access in critically ill adults with inaccessible peripheral veins in the emergency departments.

Positive effects of music therapist's selected auditory stimulation on the autonomic nervous system of patients with disorder of consciousness: a randomized controlled trial

The current randomized controlled trial was performed at the China Rehabilitation Science Institute, China to test the hypothesis that musical auditory stimulation has positive effects on the autonomic nervous system of patients with disorder of consciousness.Although past studies have recommended that patients with disorder of consciousness listen to patient-preferred music, this practice is not universally accepted by researchers.Twenty patients with severe disorder of consciousness listened to either therapist-selected(n = 10, 6 males and 4 females;43.33 ± 18.76 years old) or patient-preferred(n = 10, 5 males and 5 females, 48.83 ± 18.79 years old) musical therapy, 30 minutes/day, 5 times/week for 6 weeks.The results showed no obvious differences in heart rate variability-related parameters including heart rate, standard deviation of normal-to-normal R-R intervals, and the root-mean-square of successive heartbeat interval differences of successive heartbeat intervals between the two groups of patients.However, percentage of differences exceeding 50 ms between adjacent normal number of intervals, low-frequency power/high-frequency power, high-frequency power norm, low-frequency power norm, and total power were higher in patients receiving therapist-selected music than in patients receiving their own preferred music.In contrast, this relationship was reversed for the high-frequency power and very-low-frequency band.These results suggest that compared with preferred musical stimulation, therapist-selected musical stimulation resulted in higher interactive activity of the autonomic nervous system.Therefore, therapist-selected musical stimulation should be used to arouse the autonomic nervous system of patients with disorder of consciousness.This study was approved by the Institutional Ethics Committee of China Rehabilitation Research Center, China(approval No.2018-022-1) on March 12, 2018 and registered with the Chinese Clinical Trial Registry(registration number Chi CTR1800017809) on August 15, 2018.

Effects of the information–knowledge–attitude–practice nursing model combined with predictability intervention on patients with cerebrovascular disease

BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with CVD.Studies have shown that predictive nursing can improve the quality of care and that the information–knowledge–attitude–practice(IKAP)nursing model has a positive impact on patients who suffered a stroke.Few studies have combined these two nursing models to treat CVD.AIM To explore the effect of the IKAP nursing model combined with predictive nursing on the Fugl–Meyer motor function(FMA)score,Barthel index score,and disease knowledge mastery rate in patients with CVD.METHODS A total of 140 patients with CVD treated at our hospital between December 2019 and September 2021 were randomly divided into two groups,with 70 patients in each.The control group received routine nursing,while the observation group received the IKAP nursing model combined with predictive nursing.Both groups were observed for self-care ability,motor function,and disease knowledge mastery rate after one month of nursing.RESULTS There was no clear difference between the Barthel index and FMA scores of the two groups before nursing(P>0.05);however,their scores increased after nursing.This increase was more apparent in the observation group,and the difference was statistically significant(P<0.05).The rates of disease knowledge mastery,timely medication,appropriate exercise,and reasonable diet were significantly higher in the observation group than in the control group(P<0.05).The satisfaction rate in the observation group(97.14%)was significantly higher than that in the control group(81.43%;P<0.05).CONCLUSION The IKAP nursing model,combined with predictive nursing,is more effective than routine nursing in the care of patients with CVD,and it can significantly improve the Barthel index and FMA scores with better knowledge acquisition,as well as produce high satisfaction in patients.Moreover,they can be widely used in the clinical setting.

A Harmonic Approach to Handwriting Style Synthesis Using Deep Learning

The challenging task of handwriting style synthesis requires capturing the individuality and diversity of human handwriting.The majority of currently available methods use either a generative adversarial network(GAN)or a recurrent neural network(RNN)to generate new handwriting styles.This is why these techniques frequently fall short of producing diverse and realistic text pictures,particularly for terms that are not commonly used.To resolve that,this research proposes a novel deep learning model that consists of a style encoder and a text generator to synthesize different handwriting styles.This network excels in generating conditional text by extracting style vectors from a series of style images.The model performs admirably on a range of handwriting synthesis tasks,including the production of text that is out-of-vocabulary.It works more effectively than previous approaches by displaying lower values on key Generative Adversarial Network evaluation metrics,such Geometric Score(GS)(3.21×10^(-5))and Fréchet Inception Distance(FID)(8.75),as well as text recognition metrics,like Character Error Rate(CER)and Word Error Rate(WER).A thorough component analysis revealed the steady improvement in image production quality,highlighting the importance of specific handwriting styles.Applicable fields include digital forensics,creative writing,and document security.

Slope mass rating and kinematic analysis of slopes along the national highway-58 near Jonk, Rishikesh, India

The ro ad n etw o rk in th e H im alayan terrain , connecting re m o te areas e ith e r in th e valleys o r on th e hillslopes, plays a pivotal role in socio-econom ic d e v elo p m en t ofIn d ia. The planning, d ev elo p m en t an d evenm ain ten an ce o f ro ad an d rail netw o rk s in such precarious terrain s are alw ays a challenging task becauseo f com plexities p osed by topography, geological stru ctu res, varied lithology an d neotectonics. Increasingp o p u latio n an d c o n stru ctio n o f roads have led to destab ilisatio n o f slopes, th u s leading to m ass w astingand m ovem ent, fu rth e r aggravation d u e to recen t events o f cloud bu rsts and u n p re c e d e n te d flash floods.V ulnerability analysis o f slopes is an im p o rta n t co m p o n e n t for th e ＂Landslide H azard A ssessm ent＂ and＂Slope Mass C h aracterisation＂ guide p lan n ers to p red ict an d choose suitable w ays for c o n stru ctio n ofroads and o th e r en g in eerin g stru ctu res. The pro b lem o f landslides along th e n ational highw ay-58 （NH-58） from Rishikesh to D evprayag is a co m m o n scene. The slopes along th e NH-58 b e tw e e n Jonk andRishikesh w ere investigated, w h ich experienced v ery heavy traffic especially from M arch to A ugust dueto pilgrim age to K edarnath shrine. On th e basis o f slope m ass rating （SMR） investigation, th e area falls instable class, an d landslide susceptibility score （LSS） values also indicate th a t th e slopes u n d e r investigationfall in low to m o d erate v ulnerability to landslide. More atte n tio n s should be paid to th e slopes toachieve g reater safe an d econom ic b enefits along th e highw ay.

Clinical profile and outcome of obstetric ICU patients. APACHE II, SOFA, SAPS II and MPM scoring systems for prediction of prognosis

Objectives: To evaluate the various scoring systems, APACHE II, SOFA, SAPS II and MPM for the prediction of prognosis of the obstetric critically ill patients admitted in a well supported ICU unit. Material and methods: A prospective, observational study was conducted among all the obstetric patients admitted to the ICU between October 2011 and December 2012, during a period of 15 months. The data collected were of three categories: demographic, obstetric and ICU related. Results and Analysis: The patients admitted in the postpartum period (n = 28, 53.84%) were more than the antenatal admissions (n = 24, 46.16%). 32.69% of admissions were in the third trimester. The most common mode of delivery was emergency caesarean section (n = 27/40, 67.5%). Total caesarean deliveries were 35/40 = 87.5% in ICU patients. The mortality prediction scores were calculated for 41 patients only as acid blood gas analysis was not available for the rest. Patients required ventilation—51.92%, hemodialysis—19.23%, inotropic support—38.46%, blood transfusion—50%. Analysis of the statistical data for ICU parameters has shown that hospital stay (p = 0.011) and ventilation days (p = 0.014) are significant predictors of maternal outcome. Age (p = 0.789), ICU stay (p = 0.701) and RRT (p = 0.632) are not significant. Among the obstetric ICU admissions, hypertensive disorders of pregnancy (30.76%) was the predominant cause followed by obstetric haemorrhage (23.07%). Discussion: HELLP syndrome and eclampsia (n = 4, 57%) were the major causes of maternal deaths with anaesthetic mishaps accounting for 29% (n = 2). One (14%) death was due to Eisenmenger’s syndrome. In one case of H1N1 admitted with ARDS, caesarean section was done in MICU for worsening respiratory distress. The maternal mortality in this series of cases was 7/52 = 13.46%, excluding the unavoidable cases of maternal death (3 cases brain dead at admission and one cardiac arrest in emergency room), our maternal mortality rate is 3/48 = 6.25%. The predicted mortality as measured by all scoring systems (for 41 patients) was between 17% and 30%. The observed mortality was around 17%. Hence a reduction in mortality of 40% has been achieved due to intensive care. Conclusions: Leading cause of maternal mortality was HELLP syndrome. Hypertensive disorders of pregnancy were the most common cause of admission to ICU. In this study, all the scores were equally significant in predicting maternal mortality. Amongst the interventions done for these patients mechanical ventilation seems to have an influence on the overall outcome.

Discovery and validation of potential drug targets based on the phylogenetic evolution of GPCRs

Target identification is a critical step following the discovery of small molecules that elicit a biological phenotype. G-protein coupled recaptors (GPCRs) are among the most important drug targets for the pharmaceutical industry. The present work seeks to provide an in silico model of known GPCR protein fishing technologies in order to rapidly fish out potential drug targets on the basis of amino acid sequences and seven transmembrane regions (TMs) of GPCRs. Some scoring matrices were trained on 22 groups of GPCRs in the GPCRDB database. These models were employed to predict the GPCR proteins in two groups of test sets. On average, the mean correct rate of each TM of 38 GPCRs from two test sets (ST23 and ST24) was found 62% and 57.5%, respectively, using training set 18 (SLD18);the mean hit rate of each TM of 38 GPCRs from ST23 and ST24 was found 68.1% and 64.7%, respectively. Based on the scoring matrices of PreMod, the mean correct rate of each TM of GPCRs from ST23 and ST24 was found 62% and 62.04%, respectively;the mean hit rate of each TM of GPCRs from ST23 and ST24 was found 67.7% and 68.0%, respecttively. The means of GPCRs in ST23 based on SLD18 is close to those based on PreMod;whereas the means of GPCRs in ST24 based on?SLD18 is less than those based on PreMod. Moreover, the accuracy (“2”) and validity (“2 + 1”) rates of prediction all seven TMs of 38 GPCRs by the scoring matrices of PreMod are more than those by SLD18, SLA14 and SLA3;whereas the hit rates (94.74% and 97.37%) by PreMod are less than those of?SLA3 but bigger than those of?SLD18 and SLA14, respectively. This is the reason that we choose PreMod to predict some potential drug targets. 22 GPCR proteins in the sense chain of chromosome 19 constructing validation set were predicted and validated by PreMod whose hit rate is up to 90.91%. Further evaluation is under investigation.

Effect of non-pharmacological treatment on the full recovery of social functioning in patients with attention deficit hyperactivity disorder

BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.

血乳酸水平和SOFA评分对急诊严重脓毒症患者的评估作用

目的探讨SOFA评分和动脉血乳酸在急诊严重脓毒症患者中的变化及其与预后的关系。方法检测我院急诊重症观察室中的28例严重脓毒症患者入院时和正规治疗6h的动脉血气分析、血常规、血肝。肾功能，监测入院时和正规治疗6h后平均动脉压、心率、体温和尿量变化。比较两组SOFA评分、血乳酸和6h乳酸清除率。结果治疗前血乳酸水平死亡组（7．98±4．24）mmol/L明显高于存活组（3．99±4．09）mmol/L，差异有统计学意义（P〈0．05）。治疗前死亡组SOFA评分（7．55±2．67）分明显高于存活组（4．94±3．49）分，差异有统计学意义（P〈0．05）。应用治疗前SOFA评分判断严重脓毒症患者预后的ROC曲线下面积（AUC）是0．798，治疗前血乳酸的AUC是0．847。结论严重脓毒症患者的初始血乳酸水平和SOFA评分越高，患者预后越差。早期监测患者血乳酸水平，进行SOFA评分是急诊判断严重脓毒症患者病情严重程度和预后的良好方法。

血乳酸清除率对重症感染患者预后的影响及其与SOFA评分的关系

目的:探讨血乳酸清除率对重症感染患者预后的影响及其与脓毒血症相关器官功能障碍评分(SOFA)的关系。方法:回顾性分析本院2014年1月-2015年1月重症感染患者98例,根据住院期间的预后状况将患者分为生存组53例与死亡组45例,同时根据血乳酸清除率将患者分为高清除率组(血乳酸清除率>10%,60例)与低清除率组(血乳酸清除率≤10%,38例),比较入院时血乳酸水平、治疗6 h血乳酸水平、SOFA评分与乳酸清除率的差异,采用Pearson相关性分析血乳酸清除率与SOFA评分的关系。结果:生存组患者入院时血乳酸水平、治疗6 h血乳酸水平与SOFA评分明显低于死亡组患者,乳酸清除率明显高于死亡组患者,比较差异具有统计学意义(P<0.05)。高清除率组患者入院时血乳酸水平、治疗6 h血乳酸水平、SOFA评分和死亡率明显低于低清除率组,比较差异具有统计学意义(P<0.05)。Pearson相关性分析显示,血乳酸清除率与SOFA评分具有明显的负相关(r=-0.524,P<0.05)。结论:血乳酸清除率越高,重症感染患者预后越佳,SOFA评分越低,血乳酸清除率与SOFA评分具有紧密的负相关,两者均对疾病预后状况具有重要的评估意义。

Quality of life following laparoscopic Nissen fundoplication: Assessing short-term and long-term outcomes

AIM: To investigate the quality of life following lapa-roscopic Nissen fundoplication by assessing short-term and long-term outcomes. METHODS: From 1992 to 2005, 249 patients under-went laparoscopic Nissen fundoplication. Short-term outcome data including symptom response, side effects of surgery, endoscopy, and patient's perception of over-all success were collected prospectively. Long-term out-comes were investigated retrospectively in patients witha median follow-up of 10 years by assessment of reflux symptoms, side effects of surgery, durability of antire-flux surgery, need for additional treatment, patient's perception of success, and quality of life. Antireflux sur-gery was considered a failure based on the following criteria: moderate to severe heartburn or regurgitation; moderate to severe dysphagia reported in combination with heartburn or regurgitation; regular proton pump inhibitor medication use; endoscopic evidence of erosive esophagitis Savary-Miller grade 1-4; pathological 24-h pH monitoring; or necessity to undergo an additional surgery. The main outcome measures were short-and long-term cure rates and quality of life, with patient sat-isfaction as a secondary outcome measure. RESULTS: Conversion from laparoscopy to open sur-gery was necessary in 2.4% of patients. Mortality was zero and the 30-d morbidity was 7.6% (95%CI: 4.7%-11.7%). The median postoperative hospital stay was 2 d [interquartile range (IQR) 2-3 d]. Two hundred and forty-seven patients were interviewed for short-term analysis following endoscopy. Gastro-esophageal reflux disease was cured in 98.4% (95%CI: 95.9%-99.6%) of patients three months after surgery. New-onset dysphagia was encountered postoperatively in 13 patients (6.7%); 95% reported that the outcome was better after antireflux surgery than with preopera-tive medical treatment. One hundred and thirty-nine patients with a median follow-up of 10.2 years (IQR 7.2-11.6 years) were available for a long-term evalu-ation. Cumulative long-term cure rates were 87.7% (81.0%-92.2%) at 5 years and 72.9% (64.0%-79.9%) at 10 years. Gastrointestinal symptom rating scores and RAND-36 quality of life scores of patients with treatment success were similar to those of the general population but significantly lower in those with failed antireflux surgery. Of the patients available for long-term follow-up, 83% rated their operation a success. CONCLUSION: For the long-term, our results indicate decreasing effectiveness of laparoscopic antirefluxsurgery, although most of the patients seem to have an overall quality of life similar to that of the general population.

Antiviral therapy for hepatitis B virus-related hepatocellular carcinoma after radical hepatectomy

Objective： To assess the effect of antiviral therapy for hepatitis B virus （HBV）-related hepatocellular carcinoma （HCC） after radical hepatectomy. Methods： A total of 478 HBV-related HCC patients treated by radical hepatectomy were retrospectively collected. Patients in the treatment group （n=141） received postoperative lamivudine treatment （100 rag/d）, whereas patients in the control group （n=337） did not. Recurrence-free survival （RFS） rates, overall survival （OS） rates, treatments for recurrent HCC and cause of death were compared between the two groups. Propensity score matching （PSM） analysis was also conducted to reduce confounding bias between the two groups. Results： The 1-, 3-, and 5-year RFS rates didn＇t significantly differ between the two groups （P=0.778）; however, the 1-, 3-, and 5-year OS rates in the treatment group were significantly higher than those in the control group （P=0.002）. Similar results were observed in the matched data. Subgroup analysis showed that antiviral treatment conferred a significant survival benefit for Barcelona Clinical Liver Cancer stage A/B patients. Following HCC recurrence, more people in the treatment group were able to choose curative treatments than those in the control group （P=0.031）. For cause of death, fewer people in the treatment group died of liver failure than those in the control group （P=0.041）. Conclusion： Postoperative antiviral therapy increases chances of receiving curative treatments for recurrent HCC and prevents death because of liver failure, thereby significantly prolonging OS, especially in early- or intermedian-stage tumors.

Efficacy of Bladder Neck Incision (BNI) Versus Transurethral Resection of Prostate (TURP) in Management of Benign Prostatic Hyperplasia (BPH) Causing Obstruction: A Randomised Controlled Study

Objective: To compare the efficacy of bladder neck incision (BNI) with transurethral resection of prostate (TURP) in the treatment of patients with urinary obstruction caused by benign prostatic hyperplasia (BPH) on the basis of short term follow up of 4 months. Patient and Methods: The study was conducted in Department of General Surgery in Maulana Azad Medical College, New Delhi. 60 men with proven clinical diagnosis of BPH of size 30 grams and less presenting with symptoms of bladder outlet obstruction (BOO) were randomised prospectively to undergo either of the two operative modalities. Preoperatively size of the prostate, symptom scoring (IPSS), peak flow rate (Qmax) were assessed. Postoperatively and during 4 months follow up the following data were collected—operative time, catheterisation period, hospital stay, blood loss, Qmax and IPSS. Results: Preoperative parameters in both the groups showed no statistically significant differences with respect to prostate size, Qmax and IPSS Scoring. At 4 months follow up Qmax increased from (6.35 ± 4.49) to (16.41 ± 2.28) in TURP group and (4.51 ± 3.57) to (15.95 ± 2.58) in BNI group. IPSS decreased from 18.70 to 5.7 in TURP group and 18.90 to 6.00 in BNI group. All differences were statistically significant. There was a statistically significant difference in operative time, blood loss, hospital stay, catheterisation timing favouring BNI. Conclusion: TURP and BNI are equally effective in providing symptomatic improvement. BNI has an upper hand in reference to operative time, hospital stay, duration of catheterisation and blood loss.

Effect of Daikenchuto (TJ-100) on abdominal bloating in hepatectomized patients

AIM: To evaluate the clinical usefulness of Daikenchuto (DKT) in hepatecomized patients. METHODS: Twenty patients were enrolled with informed consent. Two patients were excluded because of cancelled operations. The remaining 18 patients were randomly chosen for treatment with DKT alone or combination therapy of DKT and lactulose (n = 9, each group). Data were prospectively collected. Primary end points were Visual Analogue Scale (VAS) score for abdominal bloating, total Gastrointestinal Symptoms Rating Scale (GSRS) score for abdominal symptoms, and GSRS score for abdominal bloating. RESULTS: The VAS score for abdominal bloating and total GSRS score for abdominal symptoms recovered to levels that were not significantly different to preoperative levels by 10 d postoperation. Combination therapy of DKT and lactulose was associated with a significantly poorer outcome in terms of VAS and GSRS scores for abdominal bloating, total GSRS score, and total daily calorie intake, when compared with DKT alone therapy. CONCLUSION: DKT is a potentially effective drug for postoperative management of hepatectomized patients, not only to ameliorate abdominal bloating, but also to promote nutritional support by increasing postoperative dietary intake.

Evaluation and Relevance of Indications for Primary Caesarean Section: A Five-Year Experience Report from Nevers Hospital Center

Context: The caesarean section rate continues to increase in our different health structures specially for women who have not had a scar in the uterus. Objectives: The aim of this study was to analyze the key factors and main indications for primary caesarean sections and to find ways to reduce the increasing rates. Patients and Method: This is a longitudinal and retrospective study carried out from June 1, 2018 to July 31, 2022. The study included all patients who had a cesarean-section for the first time (primary caesarean). An anterior uterine scar was a non-inclusion criterion. Data were collected prospectively using Synfonievre and Agopra software via patients’ files and information collection sheet. Data were analyzed with SPSS 21 software, Mac version. Averages were calculated for quantitative data and percentages for qualitative data. The statistical tests used were the Pearson Chi2 test. The observed differences were considered significant when the p-value was less than 0.05. Results: During the study period, we recorded 8832 deliveries and 3148 caesarean sections (35.6%). Primary CS concerned 70% of overall C-section rate. The main indications were FHR Fetal Heart Rate abnormalities (FHRA) (27%), followed by the other indications (including preterm delivery, umbilical cord dystocia, malpresentation of fetus, foetal abnormalities, elective CS, triple gestation, mother abnormalities);dystocia or prolonged labor (18.7%), breech presentation in a twin pregnancy with 11.3% and 9.6% respectively. We recorded more vaginal deliveries with labor induction: 81.4% against 75.2%. An obstetrical audit led to better labor management and a reduction in the cesarean section rate. Conclusion: We need to focus on diagnosis of fetal distress, management of breech presentation during of a twin birth and a singleton. Induction of labor can be an effective alternative in certain indications. An obstetrical audit is needed to reverse the caesarean section rate.

Rank-Me: A Java Tool for Ranking Team Members in Software Bug Repositories

In this paper a team member ranking technique is presented for software bug repositories. Member ranking is performed using numbers of attributes available in software bug repositories, and a ranked list of developers is generated who are participating in development of software project. This ranking is generated from the contribution made by the individual developers in terms of bugs fixed, severity and priority of bugs, reporting newer problems and comments made by the developers. The top ranked developers are the best contributors for the software projects. The proposed algorithm can also be used for classifying and rating the software bugs using the ratings of members participating in the software bug repository.

2017—2021年西藏高原SWC-WARMS模式降水预报产品的检验与评估

选用2017—2021年西藏高原39个观测站24 h降水资料,对SWC-WARMS模式降水预报产品按照数值预报业务检验评估指标进行检验与评估。结果表明:西藏高原降水主要集中在暖季(降雨时段),以小雨为主。SWC-WARMS模式24 h累积降水预报年平均准确率、命中率和成功率分别为78%、83%和60%,预报效果较好,但整体的空报率和偏差均较大。西藏高原暖季的小雨及以上TS平均值为0.63,中雨及以上TS平均值较小,其空报率、漏报率随海拔高度落差增大而增大;冷季(降雪时段)降水日数较少,TS小于暖季、空报率高,但个别区域的SWC-WARMS模式大量级降雪预报TS超过0.30。