Search results for: Sleeve gastrectomy

Authors: Misbah Nizamani, Saira Malik

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Introduction: Bariatric surgery is the most effective treatment for patients suffering from morbid obesity. Laparoscopic sleeve gastrectomy (LSG) accounts for over 50% of total bariatric procedures. The aim of our meta-analysis is to investigate the effectiveness and safety of Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing laparoscopic sleeve gastrectomy. Method: To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials and cohort studies involving adult patients (≥18 years) undergoing bariatric surgeries, i.e., Laparoscopic sleeve gastrectomy. Outcome measures included LOS, postoperative narcotic usage, postoperative pain score, postoperative nausea and vomiting, postoperative complications and mortality, emergency department visits and readmission rates. RevMan version 5.4 was used to analyze outcomes. Results: Three RCTs and three cohorts with 1522 patients were included in this study. ERAS group and control group were compared for eight outcomes. LOS was reduced significantly in the intervention group (p=0.00001), readmission rates had borderline differences (p=0.35) and higher postoperative complications in the control group, but the result was non-significant (p=0.68), whereas postoperative pain score was significantly reduced (p=0.005). Total MME requirements became significant after performing sensitivity analysis (p= 0.0004). Postoperative mortality could not be analyzed on account of invalid data showing 0% mortality in two cohort studies. Conclusion: This systemic review indicated the effectiveness of the application of ERAS protocols in LSG in reducing the length of stay, post-operative pain and total MME requirements postoperatively, indicating the feasibility and assurance of its application.

Keywords: eras protocol, sleeve gastrectomy, bariatric surgery, enhanced recovery after surgery

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Authors: Ashu Rastogi, Uttam Thakur, Jimmy Pathak, Rajesh Gupta, Anil Bhansali

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Introduction: Liraglutide is known to induce weight loss and metabolic benefits in obese individuals. However, its effect after sleeve gastrectomy are not known. Methods: People with obesity (BMI>27.5 kg/m2) underwent LSG. Subsequently, participants were randomized to receive either 0.6mg liraglutide subcutaneously daily from 6 week post to be continued till 24 week (L-L group) or placebo (L-P group). Patients were assessed before surgery (baseline) and 6 weeks, 12weeks, 18weeks and 24weeks after surgery for height, weight, waist and hip circumference, BMI, body fat percentage, HbA1c, fasting C-peptide, fasting insulin, HOMA-IR, HOMA-β, GLP-1 levels (after standard OGTT). MRI abdomen was performed prior to surgery and at 24weeks post operatively for the estimation of intrapancreatic and intrahepatic fat content. Outcome measures: Primary outcomes were changes in metabolic variables of fasting and stimulated GLP-1 levels, insulin, c-peptide, plasma glucose levels. Secondary variables were indices of insulin resistance HOMA-IR, Matsuda index; and pancreatic and hepatic steatosis. Results: Thirty-eight patients undergoing LSG were screened and 29 participants were enrolled. Two patients withdrew consent and one patient died of acute coronary event. 26 patients were randomized and data analysed. Median BMI was 40.73±3.66 and 46.25±6.51; EBW of 49.225±11.14 and 651.48±4.85 in the L-P and L-L group, respectively. Baseline FPG was 132±51.48, 125±39.68; fasting insulin 21.5±13.99, 13.15±9.20, fasting GLP-1 2.4± .37, 2.4± .32, AUC GLP-1 340.78± 44 and 332.32 ± 44.1, HOMA-IR 7.0±4.2 and 4.42±4.5 in the L-P and L-L group, respectively. EBW loss was 47± 13.20 and 65.59± 24.20 (p<0.05) in the placebo versus liraglutide group. However, we did not observe inter-group difference in metabolic parameters between the groups in spite of significant intra-group changes after 6 months of LSG. Intra-pancreatic fat prior to surgery was 3.21±1.7 and 2.2±0.9 (p=0.38) that decreased to 2.14±1.8 and 1.06±0.8 (p=0.25) at 6 months in L-P and L-L group, respectively. Similarly, intra-pancreatic fat was 1.97±0.27 and 1.88±0.36 (p=0.361) at baseline that decreased to 1.14±0.44 and 1.36±0.47 (p=0.465) at 6 months in L-P and L-L group, respectively. Conclusion: Liraglutide augments extra body weight loss after sleeve gastrectomy. A decrease in intra-pancreatic and intra-hepatic fat is noticed after bariatric surgery without additive benefit of liraglutide administration.

Keywords: sleeve gastrectomy, liraglutide, intra-pancreatic fat, insulin

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Authors: Hyun-Woo Jun, In-Gun Kim, Hyun Seok Hong, Dong-Woo Kang, Ju Lee

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In high-speed SPMSM design, the rotor-retaining sleeve is inserted into rotor to prevent permanent magnet’s damage. It is quite efficient way considering manufacturability, but the sleeve becomes major source of ohm loss in high-speed operation. In this paper, the high-speed motor for turbo-blower at the rating of 100kW was introduced. To improve its efficiency, the retaining sleeve’s optimal design was needed. Within the range of satisfies the mechanical safety, sleeve’s some design variables have been changed. The effect of changing design variables of the sleeve was studied. This paper presents the optimized sleeve’s advantages in electrical efficiency from the result of electromagnetic FEA (finite element analysis) software. Finally, it suggests the optimal sleeve design to reduce eddy current loss, which is related to motor shape.

Keywords: SPMSM, sleeve, eddy current, high efficiency

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Authors: Basma Hussein Abdelaziz Hassan, Kareem Kamel, Philobater Bahgat Adly Awad, Karim Fahmy

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Background: Laparoscopic adjustable gastric band was one of the most applied and common bariatric procedures in the last 8 years. However; the failure rate was very high, reaching approximately 60% of the patients not achieving the desired weight loss. Most patients sought another revisional surgery. In which, we compared two of the most common weight loss surgeries performed nowadays: the laparoscopic sleeve gastrectomy and laparoscopic one- anastomosis gastric bypass. Objective: To compare the weight loss and postoperative outcomes among patients undergoing conversion laparoscopic one-anastomosis gastric bypass (cOAGB) and laparoscopic sleeve gastrectomy (cSG) after a failed laparoscopic adjustable gastric band (LAGB). Patients and Methods: A prospective cohort study was conducted from June 2020 to June 2022 at a single medical center, which included 77 patients undergoing single-stage conversion to (cOAGB) vs (cSG). Patients were reassessed for weight loss, comorbidities remission, and post-operative complications at 6, 12, and 18 months. Results: There were 77 patients with failed LAGB in our study. Group (I) was 43 patients who underwent cOAGB and Group (II) was 34 patients who underwent cSG. The mean age of the cOAGB group was 38.58. While in the cSG group, the mean age was 39.47 (p=0.389). Of the 77 patients, 10 (12.99%) were males and 67 (87.01%) were females. Regarding Body mass index (BMI), in the cOAGB group the mean BMI was 41.06 and in the cSG group the mean BMI was 40.5 (p=0.042). The two groups were compared postoperative in relation to EBWL%, BMI, and the co-morbidities remission within 18 months follow-up. The BMI was calculated post-operative at three visits. After 6 months of follow-up, the mean BMI in the cOAGB group was 34.34, and the cSG group was 35.47 (p=0.229). In 12-month follow-up, the mean BMI in the cOAGB group was 32.69 and the cSG group was 33.79 (p=0.2). Finally, the mean BMI after 18 months of follow-up in the cOAGB group was 30.02, and in the cSG group was 31.79 (p=0.001). Both groups had no statistically significant values at 6 and 12 months follow-up with p-values of 0.229, and 0.2 respectively. However, patients who underwent cOAGB after 18 months of follow-up achieved lower BMI than those who underwent cSG with a statistically significant p-value of 0.005. Regarding EBWL% there was a statistically significant difference between the two groups. After 6 months of follow-up, the mean EBWL% in the cOAGB group was 35.9% and the cSG group was 33.14%. In the 12-month follow-up, the EBWL % mean in the cOAGB group was 52.35 and the cSG group was 48.76 (p=0.045). Finally, the mean EBWL % after 18 months of follow-up in the cOAGB group was 62.06 ±8.68 and in the cSG group was 55.58 ±10.87 (p=0.005). Regarding comorbidities remission; Diabetes mellitus remission was found in 22 (88%) patients in the cOAGB group and 10 (71.4%) patients in the cSG group with (p= 0.225). Hypertension remission was found in 20 (80%) patients in the cOAGB group and 14 (82.4%) patients in the cSG group with (p=1). In addition, dyslipidemia remission was found in 27(87%) patients in cOAGB group and 17(70%) patients in the cSG group with (p=0.18). Finally, GERD remission was found in about 15 (88.2%) patients in the cOAGB group and 6 (60%) patients in the cSG group with (p=0.47). There are no statistically significant differences between the two groups in the post-operative data outcomes. Conclusion: This study suggests that the conversion of LAGB to either cOAGB or cSG could be feasibly performed in a single-stage operation. cOAGB had a significant difference as regards the weight loss results than cSG among the mid-term follow-up. However, there is no significant difference in the postoperative complications and the resolution of the co-morbidities. Therefore, cOAGB could provide a reliable alternative but needs to be substantiated in future long-term studies.

Keywords: laparoscopic, gastric banding, one-anastomosis gastric bypass, Sleeve gastrectomy, revisional surgery, weight loss

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Authors: Melissa Mattos, Camila Lima, Ibraim Castro, Augusto Carioca, Saulo Magalhães, Paula Freitas, Keciany Oliveira

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Obesity is a chronic, multifactorial, relapsing disease that has increased dramatically over the years. Its control is considered a public health issue, and more and more treatments and interventions are being studied to reduce its prevalence. When interventions in lifestyle and the use of drugs do not generate lasting results, bariatric procedures emerge as a resource for obesity control. The main guidelines for the treatment of obesity emphasize the need for pre-procedure and post-procedure nutritional monitoring to avoid nutritional deficiencies that may occur. The individual who undergoes bariatric surgery needs to understand the changes that will be necessary for life in view of the intense anatomical and metabolic changes that result from surgical techniques. To assess the nutritional profile of patients who undergo bariatric surgery, we analyzed data from the medical records of all people who underwent sleeve-type bariatric surgery from January to June 2022 at a clinic in the City of Fortaleza. 38 patients were analyzed, 32 women and 6 men in the pre-surgical period, 6 and 12 months after surgery. The data showed an average weight loss of 24.45% at 6 months and 30.85% at 12 months, with a reduction of 21.32% and 30.41%, respectively, in the fat percentage, also indicating that 13.15% used drugs for weight loss during this period, leading to reflection on the isolated long-term efficacy of bariatric surgery, requiring multidisciplinary follow-up for a change in lifestyle. Only 12 individuals, corresponding to 31.57%, reached eutrophic BMI 12 months after surgery, 20 individuals remained overweight, corresponding to 52.63% of the sample, and 6 individuals (15.78%) remained in the BMI obese class I. As for body composition, there was a 52.39% reduction in fat mass and a 12.82% reduction in muscle mass, and 21% of individuals underwent cholecystectomy. Sleeve-type bariatric surgery promoted significant weight loss after 1 year of the procedure, with a reduction in body fat percentage and fat mass. Most patients were still overweight and had a significant reduction in muscle mass.

Keywords: bariatric surgery, sleeve gastrectomy, obesity, sleeve

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Authors: Ihab Saad Ahmed

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Background For Siewert type I and II gastroesophageal junction tumor (GEJ) laparoscopic proximal gastrectomy can be performed. It is associated with several perioperative benefits compared with open proximal gastrectomy. The use of laparoscopic proximal gastrectomy (LPG) has become an increasingly popular approach for select tumors Methods We describe our technique for LPG, including the preoperative work-up, illustrated images of the main principle steps of the surgery, and our postoperative course. Results Thirteen pts (nine males, four female) with type I, II (GEJ) adenocarcinoma had laparoscopic radical proximal gastrectomy and D2 lymphadenectomy. All of our patient received neoadjuvant chemotherapy, eleven patients had intrathoracic anastomosis through mini thoracotomy (two hand sewn end to end anastomoses and the other 9 patient end to side using circular stapler), two patients with intrathoracic anastomosis had flap and wrap technique, two patients had thoracoscopic esophageal and mediastinal lymph node dissection with cervical anastomosis The mean blood loss 80ml, no cases were converted to open. The mean operative time 250 minute Average LN retrieved 19-25, No sever complication such as leakage, stenosis, pancreatic fistula ,or intra-abdominal abscess were reported. Only One patient presented with empyema 1.5 month after discharge that was managed conservatively. Conclusion For carefully selected patients, LPG in GEJ tumour type I and II is a safe and reasonable alternative for open technique , which is associated with similar oncologic outcomes and low morbidity. It showed less blood loss, respiratory infections, with similar 1- and 3-year survival rates.

Keywords: LPG(laparoscopic proximal gastrectomy, GEJ( gastroesophageal junction tumour), d2 lymphadenectomy, neoadjuvant cth

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Authors: Seo Soo-Yeon, Kim Sang-Ku, Noh Sang-Hyun, Lee Ji-Eun, Kim Seol-Ki, Lim Jong-Wook

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This paper presents a test result to find the structural capacity of Hollow-Precast Concrete (HPC) column with Head-Splice Sleeve (HSS) for the connection of bars under horizontal cyclic load. Two Half-scaled HPC column specimens were made with the consideration of construction process in site. The difference between the HPC specimens is the location of HSS for bar connection. The location of the first one is on the bottom slab or foundation while the other is above the bottom slab or foundation. Reinforced concrete (RC) column was also made for the comparison. In order to evaluate the hysteretic behavior of the specimens, horizontal cyclic load was applied to the top of specimen under constant axial load. From the test, it is confirmed that the HPC columns with HSS have enough structural capacity that can be emulated to RC column. This means that the HPC column with HSS can be used in the moment resisting frame system.

Keywords: structural capacity, hollow-precast concrete column, head-splice sleeve, horizontal cyclic load

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Authors: Mogens Saberi

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The focus of this article is to present the experience gained from the design of a grouted pile-sleeve connection and to present simple design expressions which can be used in the preliminary design phase of such connections. The grout pile-sleeve connection serves as a connection between an offshore jacket foundation and pre-installed piles located in the seabed. The jacket foundation supports a wind turbine generator resulting in significant dynamic loads on the connection. The connection is designed with shear keys in order to optimize the overall design but little experience is currently available in the use of shear keys in such connections. It is found that the consequence of introducing shear keys in the design is a very complex stress distribution which requires special attention due to significant fatigue loads. An optimal geometrical shape of the shear keys is introduced in order to avoid large stress concentration factors and a relatively easy fabrication. The connection is analysed in ANSYS Mechanical where the grout is modelled by a non-linear material model which allows for cracking of the grout material and captures the elastic-plastic behaviour of the grout material. Special types of finite elements are used in the interface between the pile sleeve and the grout material to model the slip surface between the grout material and the steel. Based on the performed finite element modelling simple design expressions are introduced.

Keywords: fatigue design, non-linear finite element modelling, structural dynamics, simple design expressions

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Authors: Kamal Upadhyay, Zhou Hua, Yu Rui

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This paper aims to improve the streamline linked with the flow field and cavitation on the valve sleeve. We observed that local pressure fluctuation produces a low-pressure zone, central to the formation of vapor volume fraction within the valve chamber led to air-bubbles (or cavities). Thus, it allows simultaneously to a severe negative impact on the inner surface and lifespan of the valve sleeves. Cavitation reduction is a vitally important issue to pressure control valves. The optimization of the flow field is proposed in this paper to reduce the cavitation of valve sleeves. In this method, the inner wall of the valve sleeve is changed from a cylindrical surface to the conical surface, leading to the decline of the fluid flow velocity and the rise of the outlet pressure. Besides, the streamline is distributed inside the sleeve uniformly. Thus, the bubble generation is lessened. The fluid models are built and analysis of flow field distribution, pressure, vapor volume and velocity was carried out using computational fluid dynamics (CFD) and numerical technique. The results indicate that this structure can suppress the cavitation of valve sleeves effectively.

Keywords: streamline, cavitation, optimization, computational fluid dynamics

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Authors: S. M. P Manjula, Ishara Amarathunga, Aryan Nath Koura, Jaideepraj Rao

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Background: Laparoscopic D2 Gastrectomy for non metastatic advanced Gastric cancer (AGC) has become a controversial topic as there are confronting ideas from experts in the field. Lack of consensus are mainly due to non feasibility of the dissection and safety and efficacy. Method: Data from all D2 Gastrectomies performed (both Subtotal and Total Gastrectomies) in our unit from 2009 December to 2013 December were retrospectively analysed. Computor database was prospectively maintained. Pathological stage two A (iiA) and above considered advanced Gastric cancers, who underwent curative intent D2 Gastrectomy were included for analysis(n=46). Four patients excluded from the study as peritoneal fluid cytology came positive for cancer cells and one patient exempted as microscopic resection margin positive(R1) after curative resection. Thirty day morbidity and mortality, operative time, lymph nodes harvest and survival (disease free and overall) analyzed. Results: Complete curative resection achieved in 40 patients. Mean age of the study population was 62.2 (32-88) and male to female ratio was 23: 17. Thirty day mortality (1/40) and morbidity (6/40). Average operative time 203.7 minutes (185- 400) and average lymphnodes harvest was 40.5 (18-91). Disease free survival of the AGC in this study population was 16.75 months (1-49). Average hospital stay was 6.8 days (3-31). Conclusion: Laparoscopic dissection is effective feasible and safe in AGC.

Keywords: laparoscopy, advanced gastric cancer, safety, efficacy

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Authors: Ahuja Ashish, Nain Prabhdeep Singh

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Introduction: Polycystic ovarian syndrome(PCOS) is the most common endocrine disorder among women of reproductive age.Pcos encompasses a broad spectrum of signs&symptoms of ovary dysfunction,obesity,blood pressure,insulin resistance & infertility. Bariatric Surgery can be an effective means of weight loss in Pcos & curing infertility. Materials and Methods: 15 female patients were enrolled in the study from 2012-2014.66%(n=10) were in age group of 20-25 years,33%(n=5) were in age group of 25-33 years who underwent. Bariatric surgery in form of Laproscopic sleeve Gastrectomy(LSG)& Roux-en-Y gastric bypass. LSG 73%(n=11), RYGB26% (n=4). Results: There was a significant improvement in obesity (60% excess weight loss)over 1 year after bariatric surgery, in 12 patients there was gross improvement in restoration of menstrual cycle who had irregular menstrual cycle. In 80% patients the serum insulin level showed normal value. Over two years 8 patients become pregnant. Conclusions: 1)Obese women with Pcos maybe able to conceive after Bariatric Surgery. 2) Women with Pcos should only consider bariatric surgery if they were already considering it for other reasons to treat obesity, blood pressure & other co-morbid conditions.

Keywords: obesity, bariatric surgery, polycystic ovarian syndrome, infertility

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Authors: Wenmin Qu

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A capacitance level sensor with a segmented film electrode and a thin-film volume flow sensor with an innovative by-pass sleeve is presented as industrial products for the application in a harsh environment. The working principle of such sensors is well known; however, the traditional sensors show some limitations for certain industrial measurements. The two sensors presented in this paper overcome this limitation and enlarge the application spectrum. The problem is analyzed, and the solution is given. The emphasis of the paper is on developing the problem-solving concepts and the realization of the corresponding measuring circuits. These should give advice and encouragement, how we can still develop electronic measuring products in an almost saturated market.

Keywords: by-pass sleeve, charge transfer circuit, fixed ΔT circuit, harsh environment, industrial application, segmented electrode

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Authors: Chanoknart Mayusoh

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The research about Formal Thai National Costume in the reign of King Bhumibol Adulyadej is an applied research that aimed to study the accurate knowledge concerning to Thai national costume in the reign of King Rama IX, also to study origin of all costumes in the reign of King Rama IX and to study the style, material used, and using accasion. This research methodology which are collect quanlitative data through observation, document, and photograph from key informant of costume in the reign of King Rama IX and from another who related to this field. The formal Thai national costume of the reign of King Bhumibol Adulyadej originated from the visit of His Majesty the King to Europe and America in 1960. Since Thailand had no traditional national costume; Her Majesty the Queen initiated the idea to create formal Thai national costumes. In 1964, Her Majesty the Queen selected 8 styles of formal Thai national costume. Later, Her Majesty the Queen confered another 3 formal Thai national costume for men. There are 8 styles of formal Thai national costume for women: Thai Ruean Ton, Thai Chit Lada, Thai Amarin, Thai Borom Phiman, Thai Siwalia, Thai Chakkri, Thai Dusit, and Thai Chakkraphat. There are 3 styles of formal Thai national costume for men: short-sleeve shirt, long-sleeve shirt, and long-sleeve shirt with breechcloth. The costume is widely used in formal ceremony such as greeting ceremony for official foreign visitors, wedding ceremony, or other auspicious ceremonies. Now a day, they are always used as a bridal gown as well. The formal Thai national costume is valuable art that shows Thai identity and, should be preserved for the next generation.

Keywords: formal Thai national costume for women, formal Thai national costume for men, His Majesty King Bhumibol Adulyadej the Great King Rama IX, Her Majesty Queen Sirikit Queen

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Authors: Surita Maini

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There are many perceived advantages of microwave ablation have driven researchers to develop innovative antennas to effectively treat deep-seated, non-resectable hepatic tumors. In this paper a coaxial antenna with a miniaturized sleeve choke has been discussed for microwave interstitial ablation therapy, in order to reduce backward heating effects irrespective of the insertion depth into the tissue. Two dimensional Finite Element Method (FEM) is used to simulate and measure the results of miniaturized sleeve choke antenna. This paper emphasizes the importance of factors that can affect simulation accuracy, which include mesh resolution, surface heating and reflection coefficient. Quarter wavelength choke effectiveness has been discussed by comparing it with the unchoked antenna with same dimensions.

Keywords: microwave ablation, tumor, finite element method, coaxial slot antenna, coaxial dipole antenna

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Authors: Majid Rashidi, Shahrbanoo Farkhondeh Biabnavi

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The hydrodynamic instability phenomenon in a journal bearing may occur by either a reduction in the load carried by journal bearing, by an increase in the journal speed, by change in the lubricant viscosity, or a combination of these factors. The previous research and development work done to overcome the instability issue of journal bearings, operating in hydrodynamic lubricate regime, can be categorized as follows: A) Actively controlling the bearing sleeve by using piezo actuator, b) Inclusion of strategically located and shaped internal grooves within inner surface of the bearing sleeve, c) Actively controlling the bearing sleeve using an electromagnetic actuator, d)Actively and externally pressurizing the lubricant within a journal bearing set, and e)Incorporating tilting pads within the inner surface of the bearing sleeve that assume different equilibrium angular position in response to changes in the bearing design parameter such as speed and load. This work presents an innovative design concept for a 'smart journal bearing' set to operate in a stable hydrodynamic lubrication regime, despite variations in bearing speed, load, and its lubricant viscosity. The proposed bearing design allows adjusting its radial clearance for an attempt to maintain a stable bearing operation under those conditions that may cause instability for a bearing with a fixed radial clearance. The design concept allows adjusting the radial clearance at small increments in the order of 0.00254 mm. This is achieved by axially moving two symmetric conical rigid cavities that are in close contact with the conically shaped outer shell of a sleeve bearing. The proposed work includes a 3D model of the bearing that depicts the structural interactions of the bearing components. The 3D model is employed to conduct finite element Analyses to simulate the mechanical behavior of the bearing from a structural point of view. The concept of controlling of the radial clearance, as presented in this work, is original and has not been proposed and discuss in previous research. A typical journal bearing was analyzed under a set of design parameters, namely r =1.27 cm (journal radius), c = 0.0254 mm (radial clearance), L=1.27 cm (bearing length), w = 445N (bearing load), μ = 0.028 Pascale (lubricant viscosity). A shaft speed as 3600 r.p.m was considered, and the mass supported by the bearing, m, is set to be 4.38kg. The Summerfield Number associated with the above bearing design parameters turn to be, S=0.3. These combinations resulted in stable bearing operation. Subsequently, the speed was postulated to increase from 3600 r.p.mto 7200 r.p.m; the bearing was found to be unstable under the new increased speed. In order to regain stability, the radial clearance was increased from c = 0.0254 mm to0.0358mm. The change in the radial clearance was shown to bring the bearing back to stable an operating condition.

Keywords: adjustable clearance, bearing, hydrodynamic, instability, journal

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Authors: Rohit Vashistha, Amit Kumar Gupta, G. P. Ravishankar, Mahesh P. Padwale

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Accurate thrust measurement is required for aircraft during takeoff and after ski-jump. In a developmental aircraft, takeoff from ship is extremely critical and thrust produced by the engine should be known to the pilot before takeoff so that if thrust produced is not sufficient then take-off can be aborted and accident can be avoided. After ski-jump, thrust produced by engine is required because the horizontal speed of aircraft is less than the normal takeoff speed. Engine should be able to produce enough thrust to provide nominal horizontal takeoff speed to the airframe within prescribed time limit. The contemporary low bypass gas turbine engines generally have three mounts where the two side mounts transfer the engine thrust to the airframe. The third mount only takes the weight component. It does not take any thrust component. In the present method of thrust estimation, the strain gauging of the two side mounts is carried out. The strain produced at various power settings is used to estimate the thrust produced by the engine. The quarter Wheatstone bridge is used to acquire the strain data. The engine mount assembly is subjected to Universal Test Machine for determination of equivalent elasticity of assembly. This elasticity value is used in the analytical approach for estimation of engine thrust. The estimated thrust is compared with the test bed load cell thrust data. The experimental strain data is also compared with strain data obtained from FEM analysis. Experimental setup: The strain gauge is mounted on the tapered portion of the engine mount sleeve. Two strain gauges are mounted on diametrically opposite locations. Both of the strain gauges on the sleeve were in the horizontal plane. In this way, these strain gauges were not taking any strain due to the weight of the engine (except negligible strain due to material's poison's ratio) or the hoop's stress. Only the third mount strain gauge will show strain when engine is not running i.e. strain due to weight of engine. When engine starts running, all the load will be taken by the side mounts. The strain gauge on the forward side of the sleeve was showing a compressive strain and the strain gauge on the rear side of the sleeve shows a tensile strain. Results and conclusion: the analytical calculation shows that the hoop stresses dominate the bending stress. The estimated thrust by strain gauge shows good accuracy at higher power setting as compared to lower power setting. The accuracy of estimated thrust at max power setting is 99.7% whereas at lower power setting is 78%.

Keywords: engine mounts, finite elements analysis, strain gauge, stress

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Authors: Zhu Xinxin, Wang Hui, Yang Kai

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Heat flux is one of the most important test parameters in the ground thermal protection test. Slug calorimeter is selected as the main sensor measuring heat flux in arc wind tunnel test due to the convenience and low cost. However, because of excessive lateral heat transfer and the disadvantage of the calculation method, the heat flux measurement error of the slug calorimeter is large. In order to enhance measurement accuracy, the heat insulation structure and heat flux calculation method of slug calorimeter were improved. The heat transfer model of the slug calorimeter was built according to the energy conservation principle. Based on the heat transfer model, the insulating sleeve of the hollow structure was designed, which helped to greatly decrease lateral heat transfer. And the slug with insulating sleeve of hollow structure was encapsulated using a package shell. The improved insulation structure reduced heat loss and ensured that the heat transfer characteristics were almost the same when calibrated and tested. The heat flux calibration test was carried out in arc lamp system for heat flux sensor calibration, and the results show that test accuracy and precision of slug calorimeter are improved greatly. In the meantime, the simulation model of the slug calorimeter was built. The heat flux values in different temperature rise time periods were calculated by the simulation model. The results show that extracting the data of the temperature rise rate as soon as possible can result in a smaller heat flux calculation error. Then the different thermal contact resistance affecting calculation error was analyzed by the simulation model. The contact resistance between the slug and the insulating sleeve was identified as the main influencing factor. The direct comparison calibration correction method was proposed based on only heat flux calibration. The numerical calculation correction method was proposed based on the heat flux calibration and simulation model of slug calorimeter after the simulation model was solved by solving the contact resistance between the slug and the insulating sleeve. The simulation and test results show that two methods can greatly reduce the heat flux measurement error. Finally, the improved slug calorimeter was tested in the arc wind tunnel. And test results show that the repeatability accuracy of improved slug calorimeter is less than 3%. The deviation of measurement value from different slug calorimeters is less than 3% in the same fluid field. The deviation of measurement value between slug calorimeter and Gordon Gage is less than 4% in the same fluid field.

Keywords: correction method, heat flux calculation, heat insulation structure, heat transfer model, slug calorimeter

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Authors: Piotr Tylec, Julia Wierzbicka, Natalia Gajewska, Krzysztof Przeczek, Grzegorz Torbicz, Alicja Dudek, Magdalena Pisarska-Adamczyk, Mateusz Wierdak, Michal Pedziwiatr

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Introduction: Many patients have described changes in taste perception after weight loss surgery. However, little data is available about short term changes in taste after surgery. Aim: We aimed to evaluate short-term changes in taste preference after bariatric surgeries in comparison to colorectal surgeries. Material and Methods: Between April 2018 and April 2019, a total of 121 bariatric patients and 63 controls participated. Bariatric patients underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric by-pass. Controls underwent oncological colorectal surgeries. Patients who developed clinical complications requiring restriction of oral intake after surgery or withdraw their consent were excluded from the study. In the end, 85 bariatric patients and 44 controls were included. In all of them, the 16-item ERAS Protocol was applied. Using 10-points Numeric Rating Scale (1-10) patients completed questionnaire and rated their appetite and thirst (1 - no appetite/not thirsty, 10 – normal appetite/very thirsty) and flavoured standardized liquids' taste (1- horrible, 10-very tasty) and food images for the 6 group of taste (sweet, umami, sour, spicy, bitter and salty) (1 - not appetizing, 10 - very appetizing) preoperatively and on the first postoperative day. Data were analysed with Statistica 13.0 PL. Results: Analysed group consist of 129 patients (85 bariatric, 44 controls). Mean age and BMI in a research group was 44.91 years old, 46.22 kg/m² and in control group 62.09 years old, 25.87 kg/m², respectively. Our analysis revealed significant differences in changes of appetite between both groups (research: -4.55 ± 3.76 vs. control: -0.85 ± 4.37; p < 0.05), ratings bitter (research: 0.60 ± 2.98 vs. control: -0.88 ± 2.58; p < 0.05) and salty (research: 1.20 ± 3.50 vs. control: -0.52 ± 2.90; p < 0.05) flavoured liquids and ratings for sweet (research: 1.62 ± 3.31 vs. control: 0.01 ± 2.63; p < 0.05) and bitter (research: 1.21 ± 3.15 vs. control: -0.09 ± 2.25; p < 0.05) food images. There were statistically significant results in the ratings of other images, but in comparison to the control group, they were not statistically significant. Conclusion: The study showed that bariatric surgeries quickly decreases appetite and desire to eat certain types of food, such as salty. Moreover, the bitter taste was more desirable in the research group in comparison to control group. Nevertheless, the sweet taste was more appetible in the bariatric group than in control.

Keywords: bariatric surgery, general surgery, obesity, taste preference

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Authors: Yuan Wan, Shumei Cui, Shaopeng Wu

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Toroidal windings were taken advantage of to reduce of axial length of the motor, so as to match the applications that have severe restrictions on the axial length. But slotting in the out edge of the stator will decrease the heat-dissipation capacity of the water cooling of the housing. Besides, the windings in the outer slots will increase the copper loss, which will further increase the difficult for heat dissipation of the motor. At present, carbon-fiber composite retaining sleeve are increasingly used to be mounted over the magnets to ensure the rotor strength at high speeds. Due to the poor thermal conductivity of carbon-fiber sleeve, the cooling of the rotor becomes very difficult, which may result in the irreversible demagnetization of magnets for the excessively high temperature. So it is necessary to analyze the temperature rise of such motor. This paper builds a computational fluid dynamic (CFD) model of a toroidal-winding high-speed permanent magnet synchronous motor (PMSM) with water cooling of housing and forced air cooling of rotor. Thermal analysis was carried out based on the model and the factors that affects the temperature rise were investigated. Then thermal optimization for the prototype was achieved. Finally, a small-size prototype was manufactured and the thermal analysis results were verified.

Keywords: thermal analysis, temperature rise, toroidal windings, high-speed PMSM, CFD

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Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

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Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

Procedia PDF Downloads 63

Authors: Usman Abubakar, Xiaoyuan Wang, Sayyed Haleem Shah, Sadiq Ur Rahman, Rabiu Saleh Zakariyya

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High-speed Permanent magnet synchronous machine (HSPMSM) uses in different industrial applications like blowers, compressors as a result of its superb performance. Nevertheless, the over-temperature rise of both winding and PM is one of their substantial problem for a high-power HSPMSM, which affects its lifespan and performance. According to the literature, HSPMSM with a Hybrid cooling configuration has a much lower temperature rise than non-hybrid cooling. This paper presents the design 185kW, 26K rpm with two different cooling configurations, i.e., hybrid cooling configuration (forced air and housing spiral water jacket) and non-hybrid (forced air cooling assisted with winding’s potting material and sleeve’s material) to enhance the heat dissipation of winding and PM respectively. Firstly, the machine’s electromagnetic design is conducted by the finite element method to accurately account for machine losses. Then machine’s cooling configurations are introduced, and their effectiveness is validated by lumped parameter thermal network (LPTN). Investigation shows that using potting, sleeve materials to assist non-hybrid cooling configuration makes the machine’s winding and PM temperature closer to hybrid cooling configuration. Therefore, the machine with non-hybrid cooling is prototyped and tested due to its simplicity, lower energy consumption and can still maintain the lifespan and performance of the HSPMSM.

Keywords: airflow network, axial ventilation, high-speed PMSM, thermal network

Procedia PDF Downloads 231

Authors: Piotr Tylec, Alicja Dudek, Grzegorz Torbicz, Magdalena Mizera, Natalia Gajewska, Michael Su, Tanawat Vongsurbchart, Tomasz Stefura, Magdalena Pisarska, Mateusz Rubinkiewicz, Piotr Malczak, Piotr Major, Michal Pedziwiatr

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Introduction: Quality of life after bariatric surgery is an important factor when evaluating the final result of the treatment. Considering the vast surgical options, we tried to globally compare available methods in terms of quality of following the surgery. The aim of the study is to compare the quality of life a year after bariatric intervention using network meta-analysis methods. Material and Methods: We performed a systematic review according to PRISMA guidelines with Bayesian network meta-analysis. Inclusion criteria were: studies comparing at least two methods of weight loss treatment of which at least one is surgical, assessment of the quality of life one year after surgery by validated questionnaires. Primary outcomes were quality of life one year after bariatric procedure. The following aspects of quality of life were analyzed: physical, emotional, general health, vitality, role physical, social, mental, and bodily pain. All questionnaires were standardized and pooled to a single scale. Lifestyle intervention was considered as a referenced point. Results: An initial reference search yielded 5636 articles. 18 studies were evaluated. In comparison of total score of quality of life, we observed that laparoscopic sleeve gastrectomy (LSG) (median (M): 3.606, Credible Interval 97.5% (CrI): 1.039; 6.191), laparoscopic Roux en-Y gastric by-pass (LRYGB) (M: 4.973, CrI: 2.627; 7.317) and open Roux en-Y gastric by-pass (RYGB) (M: 9.735, CrI: 6.708; 12.760) had better results than other bariatric intervention in relation to lifestyle interventions. In the analysis of the physical aspects of quality of life, we notice better results in LSG (M: 3.348, CrI: 0.548; 6.147) and in LRYGB procedure (M: 5.070, CrI: 2.896; 7.208) than control intervention, and worst results in open RYGB (M: -9.212, CrI: -11.610; -6.844). Analyzing emotional aspects, we found better results than control intervention in LSG, in LRYGB, in open RYGB, and laparoscopic gastric plication. In general health better results were in LSG (M: 9.144, CrI: 4.704; 13.470), in LRYGB (M: 6.451, CrI: 10.240; 13.830) and in single-anastomosis gastric by-pass (M: 8.671, CrI: 1.986; 15.310), and worst results in open RYGB (M: -4.048, CrI: -7.984; -0.305). In social and vital aspects of quality of life, better results were observed in LSG and LRYGB than control intervention. We did not find any differences between bariatric interventions in physical role, mental and bodily aspects of quality of life. Conclusion: The network meta-analysis revealed that better quality of life in total score one year after bariatric interventions were after LSG, LRYGB, open RYGB. In physical and general health aspects worst quality of life was in open RYGB procedure. Other interventions did not significantly affect the quality of life after a year compared to dietary intervention.

Keywords: bariatric surgery, network meta-analysis, quality of life, one year follow-up

Procedia PDF Downloads 159

Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

Procedia PDF Downloads 297

Authors: Piotr J. Skusiewicz, Johnathan Saul, Ijhar Rusli, Svetlana Aleksandrova, Stephen. F. Benjamin, Miroslaw Gall, Steve Pierson, Carol A. Roberts

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The application of turbocharging in automotive engines leads to swirling flow entering the catalyst. The behaviour of this type of flow within the catalyst has yet to be adequately documented. This work discusses the effect of swirling flow on the flow distribution in automotive exhaust catalysts. Compressed air supplied to a moving-block swirl generator allowed for swirling flow with variable intensities to be generated. Swirl intensities were measured at the swirl generator outlet using single-sensor hot-wire probes. The swirling flow was fed into diffusers with total angles of 10°, 30° and 180°. Downstream of the diffusers, a wash-coated diesel oxidation catalyst (DOC) of length 143.8 mm, diameter 76.2 mm and nominal cell density of 400 cpsi was fitted. Velocity profiles were measured at the outlet sleeve about 30 mm downstream of the monolith outlet using single-sensor hot-wire probes. Wall static pressure was recorded using a multi-tube manometer connected to pressure taps positioned along the diffuser walls. The results show that as swirl is increased, more of the flow is directed towards the diffuser walls. The velocity decreases around the centre-line and maximum velocities are observed close to the outer radius of the monolith for all flow rates. At the maximum swirl intensity, reversed flow was recorded near the centre of the monolith. Wall static pressure measurements in the 180° diffuser indicated no pressure recovery as the flow enters the diffuser. This is indicative of flow separation at the inlet to the diffuser. To gain insight into the flow structure, CFD simulations have been performed for the 180° diffuser for a flow rate of 63 g/s. The geometry of the model consists of the complete assembly from the upstream swirl generator to the outlet sleeve. Modelling of the flow in the monolith was achieved using the porous medium approach, where the monolith with parallel flow channels is modelled as a porous medium that resists the flow. A reasonably good agreement was achieved between the experimental and CFD results downstream of the monolith. The CFD simulations allowed visualisation of the separation zones and central toroidal recirculation zones that occur within the expansion region at certain swirl intensities which are highlighted.

Keywords: catalyst, computational fluid dynamics, diffuser, hot-wire anemometry, swirling flow

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Authors: Adam Janásek, Marek Pagáč

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The article is looking for an experimental determination of tool life tests for ceramic cutting inserts. Mentioned experimental determination should provide an added information about cutting process. The mechanism of tool wear, cutting temperature in machining, quality machined surface and machining process itself is the information, which are important for whole manufacturing process. Mainly, the roughness plays very important role in determining how a real object will interact with its environment. The main aim was to determine the number of machined inserts, tool life and micro-geometry, as well. On the basis of previous tests the tool-wear was measured at constant cutting parameter which is more typical for high volume manufacturing processes.

Keywords: ceramic, insert, machining, surface roughness, tool-life, tool-wear

Procedia PDF Downloads 494

Authors: Isik Cetintav, Cenk Misirli, Yilmaz Can, Damla Gunel

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This work investigates experimental and numerical analysis of open die forging of multimetallic materials. Multimetallic material production has recently become an interesting research field. The mechanical properties of the materials to be used for the formation of multimetallic materials and the mechanical properties of the multimetallic materials produced will be compared and the material flows of the use of different lubricants will be examined. Furthermore, in this work, the mechanical properties of multimetallic metallic materials produced using different materials will be examined by using different lubricants. The advantages and disadvantages of different lubricants will be approached with the bi-metallic material to be produced. Cylindrical specimens consisting of two different materials were used in the experiments. Specimens were prepared as aluminum sleeve and copper core and upset at different reduction. This metal combination present a material model of which chemical composition is different. ABAQUS software was used for the simulations. Simulation and experimental results have also shown reasonable agreement.

Keywords: multimetallic, forging, experimental, numerical

Procedia PDF Downloads 278

Authors: DaeHae Kim, MinJun Kwon, Sewon Kim

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This study is aimed to develop ultra-low NOₓ burner using the internal recirculation of flue gas inside the combustion chamber that utilizes the momentum of intake fuel and air. Detailed experimental investigations are carried out to study these fluid dynamic effects on the emission characteristics of newly developed burner in industrial steam boiler system. Experimental parameters are distance of Venturi tube from burner, Coanda nozzle gap distance, and air sleeve length at various fuel/air ratio and thermal heat load conditions. The results showed that NOₓ concentration decreases as the distance of Venturi tube from burner increases. The CO concentration values at all operating conditions were negligible. In addition, the increase of the Coanda nozzle gap distance decreased the NOₓ concentration. It is experimentally found out that both fuel injection recirculation and air injection recirculation technique was very effective in reducing NOₓ formation.

Keywords: Coanda effect, combustion, burner, low NOₓ

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Authors: Lim Kar Sing, Siti Nur Afifah Azraai, Norhazilan Md Noor, Nordin Yahaya

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Polymeric composites are being increasingly used as repair material for repairing critical infrastructures such as building, bridge, pressure vessel, piping and pipeline. Technique in repairing damaged pipes is one of the major concerns of pipeline owners. Considerable researches have been carried out on the repair of corroded pipes using composite materials. This article attempts a short review of the subject matter to provide insight into various techniques used in repairing corroded pipes, focusing on a wide range of composite repair systems. These systems including pre-cured layered, flexible wet lay-up, pre-impregnated, split composite sleeve and flexible tape systems. Both advantages and limitations of these repair systems were highlighted. Critical technical aspects have been discussed through the current standards and practices. Research gaps and future study scopes in achieving more effective design philosophy are also presented.

Keywords: composite materials, pipeline, repair technique, polymers

Procedia PDF Downloads 509

Authors: Ghada E. Esheba, Ghufran Kheshaifaty, Kholoud Al-Harbi, Wafa'a Al-Harbi, Ala'a Al-Orabi, Moayad Turkistani

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Krukenberg tumor is a rare metastatic ovarian carcinoma that usually occurs in female between 30 - 40 year old and rarely seen after menopause. Stomach is the most common primary site. Histopathological features of krukenberg tumors appear as diffuse stromal proliferation, mucus-production, and numerous signet-cells and these tumors spread mostly by lymphatic route. Treatment and prognostic factors are not well established. This study describes a 34 year old female with a unilateral ovarian mass discovered accidentally during cesarean section delivery and it was misdiagnosed as luteoma of pregnancy, but histopathological examination showed a diffuse infiltration of the ovary and omentum by signet ring cells. These findings were not correlated with luteoma of pregnancy or any other types of primary ovarian tumors like surface epithelial tumor, sex cord stromal tumor or germ cell tumor. However, after the analysis of immunohistochemical results (negative CK7, positive CK20 and CDX-2), the finding was the diagnostic of metastatic krukenberg tumor. Two weeks later, the patient was evaluated and a large gastric tumor was found in her stomach and she underwent gastrectomy.

Keywords: CK7, CK20, CDX-2, Krukenburg tumor, metastatic ovarian tumor

Procedia PDF Downloads 315

Authors: Sahil Kumar, Surinder Pal, Rahul Kapoor

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This paper is focused on to define the basic difference between hot and cold chamber high pressure die casting process which is not fully defined in a research before paper which we have studied. The pressure die casting is basically defined into two types (1) Hot chamber Die Casting (2) Cold chamber Die Casting. Cold chamber die casting is used for casting alloys that require high pressure and have a high melting temperature, such as brass, aluminum, magnesium, copper based alloys and other high melting point nonferrous alloys. Hot chamber die casting is suitable for casting zinc, tin, lead, and low melting point alloys. In hot chamber die casting machine, the molten metal is an integral pan of the machine. It mainly consists of hot chamber and gooseneck type metal container made of cast iron. This machine is mainly used for low melting alloys and alloys of metals like zinc, lead etc. Metals and alloys having a high melting point and those which are having an affinity for iron cannot be cast by this machine, which could otherwise attack the shot sleeve and damage the machine.

Keywords: hot chamber die casting, cold chamber die casting, metals and alloys, casting technology

Procedia PDF Downloads 618