The widest used modality for detection of breast cancer is Mammography. Automated cancer detection is a tedious work because there are many types of high intensity artifacts found in MLO views of mammograms. So, preprocessing here becomes an essential step for successful classification. To get the region of interest, we carried out all the steps including removal of pectoral muscle as it has high intensity level similar to the intensity level of abnormalities already present in the mammogram so if we will take the input image as it is including the pectoral muscle and other artifacts it will give inaccurate results. This paper proposes a methodology for segmenting and removing the pectoral muscles using a technique named information gain based fcm. The proposed algorithm combines fuzzy C mean and neutroscopic L-means methods for correctly extracting the pectoral muscle. To validate the work, the proposed methodology is tested on different mammographic images of MIAS database and the results obtained nearly follows that marked by an expert radiologist. The performance of the proposed approach is evaluated using several quantitative metrics, including Hausdorff Distance (HD), Mean Error (ME1), Relative Foreground Area Error (RFAE), Misclassification Rate (ME2), Extraction Error Rate (EER), and Region Non-Uniformity (RNU).
Background: Perioperative anemia is a common and consequential comorbidity in elderly patients with hip fracture, yet the optimal management strategy between transfusion and alternative therapies remains a critical clinical dilemma. Objective: This systematic review synthesizes contemporary evidence (2016-2026) on transfusion thresholds and perioperative anemia management in geriatric hip fracture patients, focusing on clinical outcomes and guideline recommendations. Methods: A systematic literature search was conducted in PubMed, Embase, and the Cochrane Library. Randomized controlled trials, meta-analyses, cohort studies, and clinical guidelines were included. Data were extracted and synthesized narratively. Results: Perioperative anemia affects 40-46% of patients and is an independent predictor of increased mortality, delirium, prolonged hospitalization, and functional decline. High-level evidence supports a restrictive transfusion strategy (hemoglobin threshold <8 g/dL for asymptomatic patients), which reduces transfusion exposure without increasing mortality or impairing recovery compared to liberal strategies. Liberal transfusion is associated with higher risks of infection, acute kidney injury, and cardiovascular events. Adjunctive strategies, particularly intravenous iron and tranexamic acid, significantly reduce transfusion requirements safely. Conclusion: Management should prioritize a restrictive, symptom-guided transfusion policy integrated within a multimodal Patient Blood Management protocol. Preoperative optimization, blood conservation techniques, and targeted pharmacotherapy are essential to improve outcomes and minimize avoidable transfusions in this frail population.
This study aimed to evaluate the pressure exerted on mandibular soft tissues by the removable components of two different extracoronal precision attachment systems in distal extension cases (Kennedy Class II). A total of 10 patients presenting with bilateral mandibular edentulous areas were included. The first and second premolars were prepared as abutment teeth. A rigid attachment system (MK1) was applied on one side, while a resilient attachment system (ASC 52) was placed on the opposite side. Pressure measurements were obtained immediately after prosthesis placement and after six months of function. Small perforations were created in the removable components at both proximal and distal points. These areas were analyzed using an optical microscope connected to a digital imaging system, allowing measurements in microns. The findings indicated no statistically significant differences between proximal and distal points in both attachment systems immediately after insertion. However, after six months, significant differences were observed in the rigid attachment system (MK1), particularly at distal points. Within the limitations of this study, resilient attachment systems demonstrated a more favorable pressure distribution on soft tissues compared to rigid attachment system.
Background: At present, clinical practice teaching in nursing is confronted with challenges such as inaccurate goal positioning, lack of systematic design and effective evaluation system. As a systematic instructional design framework, the ADDIE model, when combined with the nurse-mini-CEX which has the function of teaching assessment, can optimize the teaching process and enhance the clinical practice ability and comprehensive quality of trainee nurses. Objective: To explore and analyze the effect of ADDIE combined Nursing-Mini-CEX teaching model in the clinical teaching of undergraduate nursing students in the department of nephrology. Methods: Fifty-eight undergraduate Nursing interns in the Department of Nephrology from December 2023 to November 2024 were selected into the study and divided into control group and observation group, 29 in each group according to random number table method. The control group was taught by traditional teaching methods, and the observation group was taught by ADDIE combined nursing -Mini-CEX teaching mode. The results and teaching satisfaction of two groups of undergraduate nursing interns were evaluated. Results: The theoretical knowledge, clinical practice test scores and teaching satisfaction of the observation group were better than those of the control group (P<0.05). Conclusion: The application of ADDIE combined Nursing-Mini-CEX teaching mode in the practice teaching of renal department nursing undergraduates can improve the theoretical knowledge and clinical practice assessment scores, and thus enhance the teaching satisfaction, which is worthy of promotion.
Background: The Prevention of Mother-to-Child Transmission (PMTCT) of HIV programme was introduced as a comprehensive package of interventions to reduce Mother–to–Child Transmission (MTCT) of HIV. The programme offers an opportunity to identify pregnant women and their partners to prevent the transmission of HIV to the baby. This study is aimed at assessing the knowledge and practices of married HIV positive male partners towards PMTCT. Method: A descriptive cross-sectional study that interviewed 220 HIV positive male partners using an interviewer-administered, pre-testeds questionnaire. Results: The study revealed that 145 respondents (65.9%) were between the age group of 31 and 40 years. More than half 130 (59%) of the respondents were Knows of PMTCT, while 135 (61.4%) of the respondents had good practice of PMTCT. Respondents with formal education were 1.5 times more odds to be Knows of the PMTCT programme than those having informal education [p=0.03, AOR=1.53, 95%CI = (1.08-4.54)]. Similarly, respondents with formal education were 2.5 times more likely to practice the PMTCT programme than those having informal education [p=0.03, AOR=2.53, 95%CI = (1.63-4.54)]. In addition, Male partners who were above 30 years of age were 3 times more likely to participate in PMTCT activities compared to those who were less than 30 years [p=0.02, AOR=2.17, 95%CI = (0.01-4.12)]. Conclusion: While many male partners know about the PMTCT program, significant gaps exist in both their knowledge and active participation. To improve PMTCT uptake and decrease MTCT, it is essential to strengthen male involvement through targeted, culturally sensitive interventions.
