This article presents a test based on quadratic form using Type-2 with replacement-censored sample for testing exponentiality against weibull IFR/DFR alternative. The percentile points and powers are simulated. The proposed test is compared with that of Bain and Engelhardt (1986) test. An example based on Type-2 censoring is also discussed.

Introduction: Distal femur fractures are a common fracture seen in both high and low-energy traumas in young and elderly patients. The standard of care in healthy, mobile, younger patients remains open reduction and internal fixation (ORIF) through various fixation devices. However, the standard of care for comorbid and elderly patients remains unclear. In these patients, rates of nonunion vary between 6% and 20%, requiring revision surgery. Our study sought to identify patients who have gone endoprosthesis conversion to a distal femur replacement following failed ORIF. Methods: This descriptive study includes a total of eight patients who underwent a revision distal femoral replacement (DFR) following failure of primary distal femur ORIF and data were gathered through chart review. Patient comorbidities, demographic characteristics, hospital disposition, complications, and mortality were collected and described. Results: The average age of this cohort was 52. 1 years, with 6 being female, and with a follow-up mean of 3. 02 years. The most common medical comorbidities present in these patients at the time of ORIF were diabetes, hypertension, obesity, smoking, and renal insufficiency. 87. 5% of patients were able to tolerate weight bearing following DFR conversion, compared to 62. 5% tolerating weight bearing before revision. Complications requiring revision surgery occurred in 3/8 patients, which included: aseptic loosening, prosthetic joint infection, and patellar maltracking. Conclusion: DFR in a revision setting following acute distal femur ORIF can be an acceptable treatment options with outcomes similar to primary DFR. Further investigation is warranted to determine optimal timing and indications for primary DFR in a fracture setting.

Background: Extensive use of antimicrobial agents such as Cotrimoxazole has been associated with rising of antimicrobial resistance. In the current study, we focused on assessing the prevalence of Salmonella spp. resistance to Cotrimoxazole and the frequency of its genes.Methods: Forty- nine Salmonella spp. isolates were identified from Mar.2011 to Apr.2013 in Milad hospital of Tehran. The antibiotic susceptibility test for screening the resistant isolates was done by Kirby-Bauer method. The sul1, sul2, sul3, DFRA1, DFRA5, and Int1, genes were detected by Multiplex- PCR amplification.Results: Among 49 Salmonella isolates, the frequency of sul1 was 62.5 (10 isolates) and the number of other genes were; DFRA1: 25% (4 isolated), DFRA5: 18.75 (3 isolated), sul1: 81.25 (13 isolated), sul2: 56.25 (9 isolated), and sul3: 0% (none).7 isolates had sul1 and sul2 simultaneously (43.75%), and 3 isolates (18.75%) had int1 and DFRA1.Conclusion: Our study illustrated high frequency of Cotrimoxazole resistance genes in Milad hospital of Tehran. Sul genes have major roles in Cotrimoxazole resistance ofSalmonella isolates.

Superficial tumours can be treated with megavoltage electron beams. The underlying tissue can be spared through the steep dose fall-off gradients over a range of a few centimetres. An accurate Monte Carlo model for an Elekta Precise was determined and dose distribution was simulated. Dosimetric parameters were calculated to set guidelines for tumour irradiation. Elekta Precise multi-leaf collimators (MLC), which shaped electron fields were investigated using a benchmarked Monte Carlo model. BEAMnrc modelled the Elekta Precise and results were benchmarked against measurements. Percentage depth dose and beam profile data were simulated within 2% / 2 mm accuracy of the measured data. The DOSXYZnrc code simulated the 3-D dose data in water between 4 and 15 MeV. The relative (P80-20) penumbra, percentage depth dose (PDD), range to 90% of dose maximum (R90), dose fall-off range R80-20 (DFR), and the percentage bremsstrahlung dose (BSD), were extracted from the simulated data. The relative penumbra ranged from 90% to 10% at 6 MeV and 15 MeV, respectively. R90 values ranged between 0. 8 cm at 4 MeV and 4. 5 cm at 15 MeV. The DFR ranged between 0. 8 cm at 4 MeV and 3. 5 cm at 15 MeV. The BSD was the highest for low beam energies and small fields. Developed guidelines indicated that intermediate-sized MLC fields are most suited for therapy since they have lower BSD, longer R90, shorter DFR but larger P80-20. The DFR increases and R90 decreases for small fields at higher beam energies and more distal tissue will receive doses > 20%.

Aims: This study aimed to investigate class 1 integrons and biofilm formation in multi‑, drug resistance (MDR) Uropathogenic Escherichia coli (UPEC) isolated from patients with urinary tract infection (UTI). Materials and Methods: Three hundred and eighty positive cultures were collected from patients with UTI referred to Shohadaye Qom hospital from 2018 to 2019. Suitable tests were done to diagnose UPEC, and confirmed by usp gene polymerase chain reaction (PCR). Antibiotic susceptibility testing was performed using Kirby Bauer disk diffusion. Analysis of biofilm production was conducted using microtiter plate assay. Next, the presence of Class 1 integrons and DFR‑, 17 gene was surveyed by PCR. Data analyzed using Chi‑, squared and Fisher’, s exact tests in SPSS software, P < 0. 05 was considered statistically significant. Findings: In total, 166 isolates of UPEC were retrieved. Among them, 120 isolates were MDR. The highest resistance of MDRs was observed against ampicillin. Among MDRs, 71, 18, 15, and 16 isolates were negative, weak, moderate, and strong biofilm producers, respectively. Meanwhile, 47. 5% of the isolates were positive for int‑, 1 gene and 25. 8% of the isolates were positive for DFR‑, 17‑, gene cassette. Out of 57 int‑, 1 positive MDRs, 15 isolates (26. 3%) showed strong biofilm which indicated a significant correlation (P < 0. 001). Furthermore, among 31 MDRs with the positive DFR‑, 17, 8 isolates (25. 8%) had strong biofilm which statistically was significant (P < 0. 001). Conclusion: The present study reported a significant correlation between cassettes genes, Class 1 integrons, and biofilm formation with antibiotic resistance pattern. Hence, continuous screening for antibiotics resistance is vital for infection control and prevention.

Using distributed generations (DGs) with optimal scheduling and optimal distribution feeder reconfiguration (DFR) are two aspects that can improve efficiency as well as technical and economic features of microgrids (MGs). This work presents a stochastic copula scenario-based framework to jointly carry out optimal scheduling of DGs and DFR. This framework takes into account non-dispatchable and dispatchable DGs. In this paper, the dispatchable DG is a fuel cell unit and the non-dispatchable DGs with stochastic generation are wind turbines and photovoltaic cells. The uncertainties of wind turbine and photovoltaic generations, as well as electrical demand, are formulated by a copula-based method. The generation of scenarios is carried out by the scenario tree method and representative scenarios are nominated with scenario reduction techniques. To obtain a weighted solution among the various solutions made by several scenarios, the average stochastic output (ASO) index is used. The objective functions are minimization of the operational cost of the MG, minimization of active power loss, maximization of voltage stability index, and minimization of emissions. The best-compromised solution is then chosen by using the fuzzy technique. The capability of the proposed model is investigated on a 33-bus MG. The simulation results show the efficiency of the proposed model to optimize objective functions, while the constraints are satisfied.

Background: Escherichia coli, a gram-negative bacterium, is the causative agent for approximately 80% of urinary tract infections (UTIs). UTI treatment has resulted in the overuse of antibiotics in hospitals and communities, and subsequently the increase of antimicrobial resistance. The emergence of extensively drug resistance (XDR) strains has become a costly and dangerous challenge in the treatment of most bacterial infections and UTIs. Objective: This study aimed to determine the frequency of XDR isolates and investigate the distribution of common sulfonamide-(sul1, sul2, & sul3) and trimethoprim (DFRA1, DFRA12, & DFRA14)-related resistance genes among E. coli isolates from UTI patients. Furthermore, the isolates were sought for the presence of class 1 and class 2 integrons (Int1 & Int2) among XDR E. coli isolates. Materials and Methods: 120 uropathogenic-E. coli isolates recovered from UTI cases in Mashhad were assessed in 2017-2019. Overall, 39 out of 120 isolates were identified as XDR isolates as they were resistant to all classes of tested antibiotics, except for two or fewer comprising quinolones (first and second generation), cephalosporins (first and third generation), penicillins, tetracyclines, and sulfonamide-trimethoprim. Results: The antimicrobial susceptibility testing (AST) results determined a substantial resistance rate against cloxacillin (98. 3%), oxacillin (98. 3%), and cephalexin (94. 17%). According to polymerase-chain reaction results, sul1 and DFRA14 genes with the frequency of 35 (89. 74%) and 28 (71. 79%) were identified as the most prevalent resistant genes among XDR isolates. In addition, int1 and int2 genes were detected among 23 (58. 9%) and 8 (20. 5%) XDR isolates, respectively. In conclusion, the substantial distribution of sul1 and DFRA14 genes was highlighted among XDR E. coli isolates recovered from UTI. Conclusion: Based on the present research findings, class I integrons play a major role in the dissemination of resistance gene cassettes, including sul and DFR in XDR isolates, and should be investigated in the future.