Wireless sensor networks (WSNs) are becoming one of the demanding platforms, where sensor nodes are sensing and monitoring the physical or environmental conditions and transmit the data to the base station via multihop routing. Agriculture sector also adopted these networks to promote innovations for environmental friendly farming methods, lower the management cost, and achieve scientific cultivation. Due to limited capabilities, the sensor nodes have suffered with energy issues and complex routing processes and lead to data transmission failure and delay in the sensor-based agriculture fields. Due to these limitations, the sensor nodes near the base station are always relaying on it and cause extra burden on base station or going into useless state. To address these issues, this study proposes a Gateway Clustering Energy-Efficient Centroid-(GCEEC-) based routing protocol where cluster head is selected from the centroid position and gateway nodes are selected from each cluster. Gateway node reduces the data load from cluster head nodes and forwards the data towards the base station. Simulation has performed to evaluate the proposed protocol with state-of-the-art protocols. The experimental results indicated the better performance of proposed protocol and provide more feasible WSN-based monitoring for temperature, humidity, and illumination in agriculture sector.

Granulomatous mastitis is a chronic inflammatory breast disease with an enigmatic clinical presentation that can delay diagnosis and perpetuate ineffective treatments. We report our experience with the diagnosis and management of eighteen cases of granulomatous mastitis in the setting of an urban public hospital. The patients were identified after a retrospective review of pathology and surgery databases. Demographic, clinical, radiographic, histopathological data and treatment responses were reviewed. Out of a total of 18 patients, 8 patients were noted to be from Mexico. The mean age at presentation was 35 years and 11 of the 18 patients reported a pregnancy in the last four years. Most cases were unsuccessfully managed as bacterial breast infections initially; definitive treatment involved surgical excision and steroids. A complete symptomatic and radiographic resolution was documented in 8 of the 18 patients. Despite posing a challenge for the unsuspecting physician, an early diagnosis of granulomatous mastitis improves patient outcomes.

Hidden obligatory fluids constitute a major source of the fluid intake among patients in a critical care unit. Up to 1.5 L should be taken into account during daily decision making to effectively regulate their volumes.

In human pancreatic cancers, promoter CpG island hypermethylation is observed in both benign and malignant tumors. It is thought that silencing of key growth-controlling genes by promoter hypermethylation may play a role in pancreatic oncogenesis. We have shown previously that sufficient levels of DNA methyltransferase (Dnmt) 1 expression are required for the development of murine intestinal tumors. Here, we report the results of a large-scale triple cross (progeny n = 761) between Apc(Min/+), Trp53(-/-) and Dnmt1 hypomorphic mice to investigate the role of Dnmt levels in the Apc(Min/+), Trp53(-/-) mouse models of acinar cell pancreatic cancer. Mutations of both APC and TP53 are observed in human pancreatic cancer. We found that tumor burden, but not tumor size, is significantly reduced with decreasing Dnmt1 levels, suggesting that DNA methylation is involved in pancreatic tumorigenesis in this mouse model. Detailed analyses showed that the reduction in tumor burden is the result of a decrease in both early- and late-stage lesions. We observed decreased levels of DNA methylation at candidate genes in the normal pancreas of Dnmt1 hypomorphic mice. Some of these genes showed increased methylation associated with tumorigenesis, suggesting that the tumor-suppressive effects of Dnmt1 hypomorphic alleles may be mediated in part through reduced promoter hypermethylation. Our work is the first in vivo study to show the effects of reduced Dnmt levels on pancreatic tumor development.

Background:The management of cerebrospinal fluid (CSF) rhinorrhea has evolved over the last two decades. We present here a review of our 11-year data on CSF rhinorrhea and its management at a tertiary care hospital in a developing country, with particular reference to the diagnosis, surgical management and outcome of the disease.Methods:The medical charts of all patients with a diagnosis of CSF rhinorrhea over an 11-year period were reviewed. The etiology of CSF rhinorrhea was classified into three categories: spontaneous, iatrogenic and traumatic. All the patients were divided into three categories based on the type of management as conservative, intracranial and transnasal endoscopic groups.Results:A total of 43 patients fulfilled our inclusion criteria and were included in the final analysis. Eleven of the 43 patients were managed conservatively, while 22 underwent intracranial repairs; 10 patients had transnasal endoscopic repairs. The primary success rate for the transnasal approach was 70% compared to 86% for the intracranial repair. Blood loss, special care unit (SCU) stay and total cost were found to be significantly less in the transnasal endoscopic group. Computed tomography (CT) cisternography was found to have the highest sensitivity and specificity. Further, no postoperative complications were found in the transnasal endoscopic group, while five patients from the intracranial group developed various complications.Conclusions:We conclude that the transnasal endoscopic approach has comparable success rates with the intracranial approach and significantly lower morbidity.