Purpose: The time course of muscle stiffness of muscles around the shoulder joint and the scapula was investigated according to the degree of muscle weakness. This study was conducted to clarify the recovery process of muscle hardness of the muscles surrounding the shoulder joint and the scapula after the shoulder internal and external rotational exercises. Methods: Participants were 7 healthy men (23.6 ± 1.4 yr), repeated internal and external rotations of the shoulder joint until the mean work of three internal and external rotations each was less than 90%, 80%, or 70% of the standard. Muscle hardness of the supraspinatus muscle, the infraspinatus muscle, and the rhomboideus muscle was measured before, immediately after, and 1to 72 hr after each bout of exercise. Muscle hardness was measured as Strain ratio using an ultrasound real-time tissue elastography. In addition, the rates of change were calculated using muscle hardness before exercise as the standard, to compare differences in the rate of change after exercise between conditions. Results: The rates of change of the Strain ratio between measurements taken before and after exercise were compared among conditions for the infraspinatus muscle. Results were -7.1 ± 5.3, -15.2 ± 10.3, and -25.0 ± 8.8, respectively, at 90%, 80%, and 70%, with a significant difference between a decrease to 90% and to 70% (p < 0.05). Significant difference was found in the change over time for the infraspinatus muscle only between values obtained immediately after exercise and after 72 hr at a decrease to 70% (p < 0.05). Conclusion: Those results described above demonstrated that the infraspinatus muscle and the supraspinatus muscle were harder immediately after exercise when the shoulder joint was at a higher degree of muscle weakness, and demonstrated that the change was likely to be recovered after 72 hr.

The field of Otolaryngology-Head and Neck Surgery (ENT) has seen tremendous progress in the development of advanced treatments for various ENT disorders in recent years. This progress has been driven by advances in technology and research, which have led to the development of new and improved surgical techniques, medications, and devices. As a result, patients with ENT disorders now have more treatment options than ever before, and the quality of care that they receive has improved significantly.

It is planned to carry out a comprehensive experimental and theoretical study on the high temperature of low calorific gas combustion with oxygen-deficient oxidizers. The experimental research will be performed using the experimental facility with a combustion chamber. The oxygen concentration in combustion oxidizers will be varied from 21% by volume (normal) air to 2%. The test combustion chamber will be fed with propane or methane as the reference fuel, then with low calorific fuels as test gases obtained by mixing various combustible components, e.g. H2, CH4, CO, and neutral gases, e.g. N2, CO2. Gaseous fuels prepared in this way will be burned in the atmosphere of a deficient oxidizer with a temperature changing from 800 °C to 1100 °C. Oxidizers will be heated up to a certain temperature using two methods: by flue gas heat exchanger and kanthal rod electric preheater. Different burner geometry will be used. The burner will be equipped with annular swirl vanes for co-axial or under different angles, fuel, and oxidizers flow to have a high swirl number achieved by flow aerodynamics and mixing. Experimental data will be verified with numerical simulations with the use of ANSYS CFD Fluent code.

This study was carried out to investigate the rotational structure of even-even 166Hf isotopes using the phenomenological fitting, Sood’s semi-empirical formula. The rotational energies from the calculated values were compared to the experimental spectrum. The result shows that in 166Hf, calculated energies fit the experimental values to a remarkable degree of accuracy.

In natural convection, the fluid motion occurs by natural means such as buoyancy. Heat transfer by natural convection happens in many physical problems and engineering applications such as geothermal systems, heat exchangers, petroleum reservoirs and nuclear waste repositories. These problems and phenomena are modeled by ordinary or partial differential equations. In most cases, experimental solutions cannot be applied to these problems, so these equations should be solved using special techniques. In this paper, natural convection of a non-Newtonian fluid flow between two vertical flat plates is investigated analytically and numerically. Collocation Method (CM) and fourth-order Runge -Kutta numerical method (NUM) are used to solve the present problem. These methods are powerful and convenient algorithms in finding the solutions for the equations. While these are capable of reducing the size of calculations. In order to compare with exact solution, velocity and temperature profiles are shown graphically. The obtained results are valid with significant accuracy.

Introduction: Radioiodine therapy is a standard procedure in thyroid autonomy treatment. Discrepancies in the visual comparisons of the scintigraphies prepared for this purpose using Tc-99m-O4- and I-131 have been known for years. In this study a new method is used to calculate and perform a quantitative comparison of both uptakes using subtraction analysis and 3D imaging. The results and their causes are discussed together with practice-relevant conclusions for better clinical results. Material and Methods: The new method was used in 38 patients with thyroid autonomies for the subtraction analysis of standardized pretherapeutic and intratherapeutic scintigraphies. The parametric distribution of activity was calculated absolutely and as a percentage and displayed three-dimensionally. These results were compared with the visual assessment of the different scintigraphies by the experts. Inclusion criteria were pretherapeutic and intratherapeutic hyperthyroidism without medication affecting the thyroid. The time difference between acquiring the scintigraphies was 28 days maximum. Results: Activity distribution was visually discrepant in 39.5% of cases. 60.5% displayed comparable uptake. The calculated values showed reversed results after applying the new method. The results using our method show a higher rate of calculated discrepancies compared with visual analysis. Conclusion: Accurate functional imaging of the thyroid is next to further aspects very important in establishing the diagnosis and deciding about the therapy activity for thyroid treatment. In combination with clinical symptoms and laboratory values, Tc-99m-O4 - scintigram can be used for an orientated, preliminary assessment of functional disorders of the thyroid. But because of the higher rate of found discrepancies, the solely use of Tc-99m-O4 - scintigram is not always capable for exact and reliable diagnosis. The known reason for this is most probably due to the different biokinetics of both radiopharmaceuticals, which can be imaged more sensitively with this method. Consequently, a scintigram should be performed in the pretherapeutic radioiodine uptake test. Despite higher costs and radiation exposure, alternatively, pretherapeutic use of other diagnostic iodine isotopes like I-123 or -124 should be discussed, because they could overcome the limitation of the different biokinetics. Following this approach the preliminary assessment using Tc-99m-O4 - scintigraphy can be precised and double checked to improve diagnostic confi dence and treatment results for a better outcome of the patients.  

In engineering, all moving rotating objects exhibit gyroscopic effects resulting from the action of an external torque on a rotating object. Gyroscopic effects are the action of a set of inertial moments and movements of an object around three axes of a three-dimensional Cartesian coordinate system. Moments of inertia are created by centrifugal and Coriolis forces, as well as the moment of change in angular momentum, which is expressed by their kinetic energy. The values of the moments of inertia directly depend on the speed of rotation of the object and its rotation around the axes. A short-term effect of an external load on a running gyroscope with displaced support can be manifested by its oscillations. The physics of gyroscope oscillations is not well explained in publications. This article describes the oscillations of a gyroscope by the action of the external torque which is its potential energy converting into kinetic energy of the inertial torques of the gyroscope. The conversion is carried out by the principle of mechanical energy conservation which is the same as for oscillations of a spring with a load.

Desensitization allows successful transplantation of patients with a positive crossmatch (PXM) against their live donor. We evaluated outcomes following PXM renal transplant despite failure to convert to negative flow cytometric crossmatch (FCXM) after desensitization. Patients that underwent desensitization before PXM transplant between 1/1/00 and 11/1/11 were identified for analysis. Patients who received a transplant despite failure to convert to negative FCXM were identified as the not converted group. Patients who converted to negative FCXM after desensitization comprised the converted group control arm. 108 patients were desensitized before PXM transplant, (not converted group=42; converted group=66). Mean eGFR was comparable between groups at all time points, and 3-year eGFR was 57.8 mL/min vs. 57.1 mL/min, p=0.91. Patients with eGFR < 30mL/min at 3 years did not differ significantly (28% vs. 14%, p=0.15). Biopsy-proven rejection rates were numerically higher within the not converted group for each type of rejection and time point, but the values did not differ significantly. Opportunistic infections rates were comparable. Patient survival (95% vs. 91%) and death-censored allograft survival (84% vs. 95%, p=0.07) were similar between arms at 3 years post-transplant.

Background: There is enough evidence to suggest that vancomycin increases the risk of acute kidney injury (AKI) but the exact mechanism is not well understood. This study aims to understand the incidence of vancomycin-associated acute kidney injury (VA-AKI) among hospitalized patients and to identify the risk factors for VA-AKI. Methods: Patients aged 18 and above who received a minimum of 24 hours of intravenous vancomycin and who had serial creatinine measurements over a 13-month period were identified through electronic records. Patients with pre-existing AKI, or eGFR of less than 30ml/min, and patients with end stage kidney disease were excluded. Results were analyzed using t-test and Fisher’s test. A logistic regression model was used to identify the predictors for VA-AKI. Results: From the 598 patients who met the inclusion criteria, 70 developed AKI. Compared to those without AKI, patients with VA-AKI had higher mean serum vancomycin trough levels (22.6 mg/L vs. 14.6 mg/L), and a statistically significant longer duration of vancomycin use (6.7 vs. 5.2 days). Multivariate analysis revealed that serum vancomycin level of > 20 mg/L was associated with a six-fold increase in odds of VA-AKI when compared to those with vancomycin levels < 15 mg/L. The presence of hypotension, iodinated contrast use, and concomitant use of piperacillin-tazobactam were all associated with increased odds of VA-AKI. Conclusion: The incidence of VA-AKI in hospitalized patients with eGFR > 30 ml/min was 11.7%. Serum vancomycin levels of > 20 mg/L, hypotension and administration of iodinated contrast significantly increased the risk of VA-AKI. Piperacillin-tazobactam, when used with vancomycin, was noted to be an independent predictor of AKI, regardless of serum vancomycin trough levels, prompting a reevaluation of the safety of this widespread practice as empiric therapy. Close monitoring of kidney function, avoiding high serum vancomycin levels, maintaining hemodynamic stability, and avoiding unnecessary use of iodinated contrast seem to be essential for the prevention of VA-AKI.

Background: Acute kidney injury (AKI) is a major health problem affecting millions of people worldwide. Effective preventative and therapeutic treatments remain to be produced. We aim to determine the association between blood glucose and mortality in critical patients with AKI. Method: This cohort study included 18,703 patients with AKI. The exposure of interest was baseline blood glucose. The outcome was 30-day mortality. Multivariable Cox regression analyses and smooth curve fitting were adopted to assess the independent association between blood glucose and 30-day mortality. Results: We identified 18,703 consecutive individuals with AKI. The average age of the participants was 66.8 ± 16.0 years, and about 42.7% of them were female. The overall 30-day mortality was 16.9%. Through the multivariate COX regression model and smooth curve fitting, we observed that the correlation between blood glucose and 30-day mortality is nonlinear. An inflection point was found at about 5.93 mmol/L. On the left side of inflection point, the effect size was 0.81 (HR: 0.81, 95% CI 0.74-0.89, p < 0.001). On the right side of inflection point, the effect size was 1.02 (HR: 1.02,95% CI 1.01-1.03, p < 0.001). Conclusion: Our study suggested that, among patients with AKI, there was a nonlinearity relationship between blood glucose and mortality in patients with AKI. The optimal of blood glucose associated with the lowest risk of 30-day mortality was around 5.93 mmol/L.