Explore the vast range of titles available.

A total of 4752 patients were randomly assigned to CABG with (on-pump) or without (off-pump) cardiopulmonary bypass. At 1 year, there was no significant difference in neurocognitive function or quality of life or in the composite of death, MI, stroke, or renal failure. Coronary-artery bypass grafting (CABG) reduces mortality among patients with extensive coronary artery disease. 1 CABG is usually performed with the use of cardiopulmonary bypass (on-pump CABG). With this approach, perioperative mortality is about 2%, and myocardial infarction, stroke, or renal failure requiring dialysis develop in an additional 5 to 7% of patients. The technique of performing CABG on a beating heart (off-pump CABG) was developed to reduce perioperative complications, some of which may be related to the use of cardiopulmonary bypass and to the cross-clamping of the aorta associated with the on-pump CABG procedure, and to improve long-term outcomes. A number . . .

A total of 4752 patients for whom CABG was planned were randomly assigned to undergo the procedure on-pump or off-pump. At 30 days, the rates of death, myocardial infarction, stroke, or renal failure requiring dialysis did not differ significantly between the two groups. Coronary-artery bypass grafting (CABG) reduces mortality in patients with extensive coronary artery disease. 1 CABG has generally been performed with the use of cardiopulmonary bypass (on-pump). With this approach, perioperative mortality is about 2%, with an additional 5 to 7% of patients having complications such as myocardial infarction, stroke, and renal failure requiring dialysis. The technique of operating on a beating heart (off-pump) for CABG was developed to decrease perioperative complications, some of which may be related to the use of cardiopulmonary bypass and to cross-clamping of the aorta associated with the on-pump CABG procedure. Several previous trials have compared off-pump . . .

BACKGROUND AND OBJECTIVESClavicular fracture is one of the most common injuries of the skeleton, representing 3% to 5% of all fractures and 45% of shoulder injuries. Midshaft fractures have traditionally been treated non-operatively. Prevalence of nonunion or mal-union in displaced midshaft clavicular fractures after conservative treatment is higher than previously presumed and fixation methods have evolved. Surgery is accepted as primary treatment for displaced midshaft clavicular fractures.We have taken up this study to gain a deeper understanding of results and problems associated with functional outcome of clavicle fractures treated by operative and non operative methods.MATERIAL AND METHODSIt is a prospective study which was carried out from November 2014 to November 2016 in chalmeda anand rao Institute of Medical Sciences, karimnagar. In this study period 40 cases of midshaft clavicle fractures, meeting the inclusion and exclusion criteria were treated by operative and non operative methods.RESULTSIn our study of 40 cases average age group of the patients was between 18- 70 years of which 30 were male patients and 10 were female patients. Majority of the cases were due to RTA 29 cases and 11 cases were due to fall. The mean time of fracture healing was shorter in the operative group (15.1 weeks) than non operative group (20 weeks). The difference is statistically highly significant (P< 0.001). There was no non union in the operative group and 15% non union in the non operative group. A significant difference between the two groups in terms of DASH and Constant Shoulder Scores after the six months follow up was not found.INTERPETATION AND CONCLUSIONBy the analysis of the data collected in the present study, operative fixation of the clavicle fractures results in improved function, shorter time for union and early return to activity compared with non operative treatment. Primary operative intervention in clavicle fracture in active adults may be of immense importance.

Software Quality is a major concern in software engineering development in order to be competitive. Such a quality can be achieved by a possible technique called Refactoring where the systems external behavior of the system is not changed. Initially we present our work by analyzing the case studies of ongoing researches of DMARF and GIPSY by understanding their needs and requirements involving the major components in their respective systems. Later sections illustrate the conceptual architecture of these case studies, for this we have referenced the original architecture to draw the important candidate concepts presented in the system, and analyzing their associations with other concepts in the system and then compared this conceptual architecture with the original architectures. Later the document throws light on identifying the code smells exist in the architectures to find them and resolve to minimize the deeper problems. JDeodorant, SonarQube are the tools which we go across for identification and analyzing the source code quality, both these tools are available as an IDE plugin or as an open source platforms. Next is to identify the design patterns exist in the architectures along with their importance and need for existence in respective systems. Finally, the implication is towards introducing refactoring methods onto the smells which have been identified and possibly refactor them accordingly by applying appropriate refactoring methods and showcasing the respective tests to ensure that changes in the architecture does not change the behavior much.

Vascular trauma, though rare posses a grave threat to life and limb. Early recognition and treatment of these injuries increases the limb salvage.Two hundred and twenty one cases of vascular injuries operated during the last 17 years and 3 months were studied. An attempt was made to study the mortality and morbidity patterns and factors affecting it. The mortality rate was 8.59% and the limb loss rate was 9.04% .

Non-coding antisense transcripts arise from the strand opposite the sense strand. Over 70% of the human genome generates non-coding antisense transcripts while less than 2% of the genome codes for proteins. Antisense transcripts and/or the act of antisense transcription regulate gene expression and genome integrity by interfering with sense transcription and modulating histone modifications or DNA methylation. Hence, they have significant pathological and physiological relevance. Indeed, antisense transcripts were found to be associated with various diseases including cancer, diabetes, cardiac and neurodegenerative disorders, and, thus, have promising potentials for prognostic and diagnostic markers and therapeutic development. However, it is not clearly understood how antisense transcription is initiated and epigenetically regulated. Such knowledge would provide new insights into the regulation of antisense transcription, and hence disease pathogenesis with therapeutic development. The recent studies on antisense transcription initiation and its epigenetic regulation, which are limited, are discussed here. Furthermore, we concisely describe how antisense transcription/transcripts regulate gene expression and genome integrity with implications in disease pathogenesis and therapeutic development.

BackgroundDespite a sevenfold decline in the number of postoperative nights (21–3) after a total knee arthroplasty (TKA) over the last four decades, predictors of length of stay (LOS) are not fully understood. We attempted to ascertain these factors by analyzing a large cohort of patients.MethodsProspectively collected data between January 2016 and March 2017 were retrospectively analyzed at our institute. Charts of 1663 consecutive, simple primary unilateral and bilateral TKAs were reviewed for the LOS excluding staggered bilateral, complex primary and revision knees. Statistical analysis: Preoperative variables [demographics, cash/credit status, historical, clinical, laboratory findings, Knee Society Function Scores and Oxford Knee Scores (OKSs)] were scrutinized by multivariate regression to identify significant factors affecting LOS and formulate model equations for patients and health caregivers. Results were incorporated into an iOS application, which was tested for accuracy.ResultsAmong 1524 unilateral and 139 bilateral TKAs, mean LOS was 4.4 and 5.2 days, respectively. Five factors, namely insurance, flexion/hyperextension deformity, preoperative OKS and a rheumatoid etiology, were significantly associated with prolonged LOS in unilateral knees. The impact of these independent variables on LOS could be calculated by: \\[{\\text{LOS}} = 5.6 - (0.39 \\times {\\text{CI}}) + (0.04 \\times {\\text{FFD}}) - (0.03 \\times {\\text{PREOPOKS}}) + (0.06 \\times {\\text{HE}}) - \\left( {0.71 \\times {\\text{ET}}} \\right)\\]For bilateral cases, the only significant variable extending LOS was a low preoperative OKS and the equation is given as follows: \\[{\\text{LOS}} = 7.71 - (0.15 \\times {\\text{PREOPKS}})\\]The iOS-app-predicted LOS and actual LOS were similar (p > 0.05) for 115 prospectively operated knees.ConclusionPoor preoperative OKS, rheumatoid etiology, flexion and hyperextension deformity and delays in insurance affected unilateral TKR LOS, while poor preoperative OKS alone affected LOS in bilateral cases.