Search results for: open surgical wound model
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 19653

Search results for: open surgical wound model

19353 IT-Based Global Healthcare Delivery System: An Alternative Global Healthcare Delivery System

Authors: Arvind Aggarwal

Abstract:

We have developed a comprehensive global healthcare delivery System based on information technology. It has medical consultation system where a virtual consultant can give medical consultation to the patients and Doctors at the digital medical centre after reviewing the patient’s EMR file consisting of patient’s history, investigations in the voice, images and data format. The system has the surgical operation system too, where a remote robotic consultant can conduct surgery at the robotic surgical centre. The instant speech and text translation is incorporated in the software where the patient’s speech and text (language) can be translated into the consultant’s language and vice versa. A consultant of any specialty (surgeon or Physician) based in any country can provide instant health care consultation, to any patient in any country without loss of time. Robotic surgeons based in any country in a tertiary care hospital can perform remote robotic surgery, through patient friendly telemedicine and tele-surgical centres. The patient EMR, financial data and data of all the consultants and robotic surgeons shall be stored in cloud. It is a complete comprehensive business model with healthcare medical and surgical delivery system. The whole system is self-financing and can be implemented in any country. The entire system uses paperless, filmless techniques. This eliminates the use of all consumables thereby reduces substantial cost which is incurred by consumables. The consultants receive virtual patients, in the form of EMR, thus the consultant saves time and expense to travel to the hospital to see the patients. The consultant gets electronic file ready for reporting & diagnosis. Hence time spent on the physical examination of the patient is saved, the consultant can, therefore, spend quality time in studying the EMR/virtual patient and give his instant advice. The time consumed per patient is reduced and therefore can see more number of patients, the cost of the consultation per patients is therefore reduced. The additional productivity of the consultants can be channelized to serve rural patients devoid of doctors.

Keywords: e-health, telemedicine, telecare, IT-based healthcare

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19352 Visual and Clinical Outcome in Patients with Corneal Lacerations

Authors: Avantika Verma

Abstract:

In industrialized nations, corneal lacerations are one of the most common reason for hospitalization. This study was designed to study visual and clinical outcome in patients presenting with full thickness corneal lacerations in Indian population and to ascertain the impact of various preoperative and operative factors influencing prognosis after repair of corneal lacerations. Males in third decade with injuries at work with metallic objects were common. Lens damage, hyphema, vitreous hemorrhage, retinal detachment and endophthalmitis were seen. All the patients underwent primary repair within first 24 hours of presentation. At 3 months, 74.3% had a good visual outcome. About 5.7% of patients had no perception of light.In conclusion, various demographic and preoperative factors like age, time of presentation, vision at presentation, length of corneal wound, involvement of visual axis, associated ocular features like hyphaema, lenticular changes, vitreous haemorrhage and retinal detachment are significant prognostic indicators for final visual outcome.

Keywords: corneal laceration, corneal wound repair, injury, visual outcome

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19351 Effect of Non-Surgical Periodontal Therapy According to Periodontal Severity

Authors: Jungbin Lim, Bohee Kang, Heelim Lee, Sunjin Kim, GeumHee Choi, Jae-Suk Jung, Suk Ji

Abstract:

Nonsurgical periodontal therapies have, for several decades, been the basis of periodontal treatment concepts. The aim of this paper is to investigate the effectiveness of non-surgical periodontal therapy according to the severity of periodontitis disease. Methods: Retrospective data of patients who visited Department of periodontics in Ajou University Medical Center from 2016 to 2022 were collected. Among the patients, those who took full mouth examination of clinical parameters and non-surgical periodontal therapy were chosen for this study. Selected patients were divided into initial, moderate, and severe periodontitis based on severity and complexity of management (2018 World Workshop EFP/AAP consensus). Recall visits with clinical periodontal examination were scheduled for 1,2,3 months or 1,3,6 months after the treatment. The results were evaluated by recordings of mean probing pocket depth (mean PD), mean clinical attachment levels (mean CAL), bleeding on probing (BOP%), mean gingival index (mean GI), mean regression, mean sulcus bleeding index (mean SBI), mean plaque scores (mean PI). All statistical analyses were performed with R software, version 4.3.0. A level of significance, P<0.05, was considered to be statistically significant. Results: A total of 92 patients were included in this study. 15 patients were diagnosed as initial periodontitis, 14 moderate periodontitis, and 63 severe periodontitis. The all parameters except for mean recession decreased over time in all groups. The amount of mean PD decreased were the greatest in severe periodontitis group followed by moderate and initial, which was found to be statistically significant. The changes of mean PD were 0.15±0.05 mm, 0.37±0.06 mm, and 1.01±0.07 mm (initial, moderate, and severe, respectively, P<0.001). When comparing before and after treatment, the reductions in BOP(%), mean GI, mean SBI, and mean PI were statistically significant. Conclusion: All patients who received non-surgical periodontal therapy showed periodontal healing in terms of improvements in clinical parameters, and it was greater in the severe group.

Keywords: periodontology, clinical periodontology, oral treatment, comprehensive preventive dentistry, non-surgical periodontal therapy

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19350 Trends in Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome in Rheumatoid Arthritis Patients

Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte

Abstract:

Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results:  Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients. 

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome

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19349 Treatment of NMSC with Traditional Medicine Method

Authors: Aferdita Stroka Koka, Laver Stroka, Juna Musa, Samanda Celaj

Abstract:

Non-melanoma skin cancers (NMSCs) are the most common human malignancies. About 5.4 million basal and squamous cell skin cancers are diagnosed each year in the US and new cases continue to grow. About eight out of ten of these are basal cell cancers. Squamous cell cancers occur less often. NMSC usually are treatable, but treatment is expensive and can leave scars. In 2019, 167 patients of both sexes suffering from NMSC were treated by traditional medicine. Patients who have been diagnosed with Basal Cell Carcinoma were 122 cases, Squamous Cell Carcinoma 32 cases and both of them 13 cases. Of these,122 cases were ulcerated lesions and 45 unulcerated lesions. All patients were treated with the herbal solution called NILS, which contains extracts of some Albanian plants such as Allium sativum, Jugulans regia and Laurus nobilis. The treatment is done locally, on the surface of the tumor, applying the solution until the tumor mass is destroyed and, after that, giving the necessary time to the wound to make the regeneration that coincides with the complete healing of the wound. We have prepared a collection of photos for each case. Since the first sessions, a shrinkage and reduction of the tumor mass were evident, up to the total disappearance of the lesion at the end of treatment. The normal period of treatment lasted 1 to 2 weeks, depending on the size of the tumor, then take care of it until the closure of the wound, taking the whole process from 1 to 3 months. In 7 patients, the lesion failed to be dominated by treatment and they underwent standard treatment with radiotherapy or surgery, while in 10 patients, the lesion recurred and was treated again. The aim of this survey was to put in evidence the good results obtained by treatment of NMSC with Albanian traditional medicine methods.

Keywords: local treatment, nils, NMSC, traditional medicine

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19348 Development of Biodegradable Wound Healing Patch of Curcumin

Authors: Abhay Asthana, Shally Toshkhani, Gyati Shilakari

Abstract:

The objective of the present research work is to develop a topical biodegradable dermal patch based formulation to aid accelerated wound healing. It is always better for patient compliance to be able to reduce the frequency of dressings with improved drug delivery and overall therapeutic efficacy. In present study optimized formulation using biodegradable components was obtained evaluating polymers and excipients (HPMC K4M, Ethylcellulose, Povidone, Polyethylene glycol and Gelatin) to impart significant folding endurance, elasticity, and strength. Molten gelatin was used to get a mixture using ethylene glycol. Chitosan dissolved in acidic medium was mixed with stirring to Gelatin mixture. With continued stirring to the mixture Curcumin was added with the aid of DCM and Methanol in an optimized ratio of 60:40 to get homogenous dispersion. Polymers were dispersed with stirring in the final formulation. The mixture was sonicated casted to get the film form. All steps were carried out under strict aseptic conditions. The final formulation was a thin uniformly smooth textured film with dark brown-yellow color. The film was found to have folding endurance was around 20 to 21 times without a crack in an optimized formulation at RT (23°C). The drug content was in range 96 to 102% and it passed the content uniform test. The final moisture content of the optimized formulation film was NMT 9.0%. The films passed stability study conducted at refrigerated conditions (4±0.2°C) and at room temperature (23 ± 2°C) for 30 days. Further, the drug content and texture remained undisturbed with stability study conducted at RT 23±2°C for 45 and 90 days. Percentage cumulative drug release was found to be 80% in 12h and matched the biodegradation rate as tested in vivo with correlation factor R2>0.9. In in vivo study administration of one dose in equivalent quantity per 2 days was applied topically. The data demonstrated a significant improvement with percentage wound contraction in contrast to control and plain drug respectively in given period. The film based formulation developed shows promising results in terms of stability and in vivo performance.

Keywords: wound healing, biodegradable, polymers, patch

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19347 An Empirical Study Comparing Industry Segments as Regards Organisation Management in Open Innovation - Based on a Questionnaire of the Pharmaceutical Industry and IT Component Industry Segment

Authors: Fumihiko Isada, Yuriko Isada

Abstract:

The aim of this research is to clarify the difference by industry segment or product characteristics as regards organisation management for an open innovation to raise R&D performance. In particular, the trait of the pharmaceutical industry is defined in comparison with IT component industry segment. In considering open innovation, both inter-organisational relation and the management in an organisation are important issues. As methodology, a questionnaire was conducted. In conclusion, suitable organisation management according to the difference in industry segment or product characteristics became clear.

Keywords: empirical study, industry segment, open innovation, product-development organisation pattern

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19346 A Test Methodology to Measure the Open-Loop Voltage Gain of an Operational Amplifier

Authors: Maninder Kaur Gill, Alpana Agarwal

Abstract:

It is practically not feasible to measure the open-loop voltage gain of the operational amplifier in the open loop configuration. It is because the open-loop voltage gain of the operational amplifier is very large. In order to avoid the saturation of the output voltage, a very small input should be given to operational amplifier which is not possible to be measured practically by a digital multimeter. A test circuit for measurement of open loop voltage gain of an operational amplifier has been proposed and verified using simulation tools as well as by experimental methods on breadboard. The main advantage of this test circuit is that it is simple, fast, accurate, cost effective, and easy to handle even on a breadboard. The test circuit requires only the device under test (DUT) along with resistors. This circuit has been tested for measurement of open loop voltage gain for different operational amplifiers. The underlying goal is to design testable circuits for various analog devices that are simple to realize in VLSI systems, giving accurate results and without changing the characteristics of the original system. The DUTs used are LM741CN and UA741CP. For LM741CN, the simulated gain and experimentally measured gain (average) are calculated as 89.71 dB and 87.71 dB, respectively. For UA741CP, the simulated gain and experimentally measured gain (average) are calculated as 101.15 dB and 105.15 dB, respectively. These values are found to be close to the datasheet values.

Keywords: Device Under Test (DUT), open loop voltage gain, operational amplifier, test circuit

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19345 Antiplatelets and Anticoagulants in Rural Emergency General Surgery

Authors: Jeong-Moh John Yahng, Angelika Na

Abstract:

Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

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19344 Turbulence Measurement Over Rough and Smooth Bed in Open Channel Flow

Authors: Kirti Singh, Kesheo Prasad

Abstract:

A 3D Acoustic Doppler velocimeter was used in the current investigation to quantify the mean and turbulence characteristics in non-uniform open-channel flows. Results are obtained from studies done in the laboratory, analysing the behavior of sand particles under turbulent open channel flow conditions flowing through rough, porous beds. Data obtained from ADV is used to calculate turbulent flow characteristics, Reynolds stresses and turbulent kinetic energy. Theoretical formulations for the distribution of Reynolds stress and the vertical velocity have been constructed using the Reynolds equation and the continuity equation of 2D open-channel flow. The measured Reynolds stress profile and the vertical velocity are comparable with the derived expressions. This study uses the Navier-Stokes equations for analysing the behavior of the vertical velocity profile in the dominant region of full-fledged turbulent flows in open channels, and it gives a new origination of the profile. For both wide and narrow open channels, this origination can estimate the time-averaged primary velocity in the turbulent boundary layer's outer region.

Keywords: turbulence, bed roughness, logarithmic law, shear stress correlations, ADV, Reynolds shear stress

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19343 Spontaneous Eruption of Impacted Teeth While Awaiting Surgical Intervention

Authors: Alison Ryan, Himani Chhabra, Mohammed Dungarwalla, Judith Jones

Abstract:

Background: Impacted and ectopic teeth present in 1-2% of orthodontic patients and often require joint surgical and orthodontic management. The authors present two patients undergoing orthodontic treatment, where the impacted teeth, in a hopeless position, spontaneously erupted during the period of cessation of general anaesthetic lists during the COVID-19 pandemic. Patient information: A healthy 11-year-old boy was referred to the Department of Oral and Maxillofacial Surgery for the management of a mesioangular impacted LR7. The patient was seen by the joint oral surgery/orthodontic team, who planned for the removal of the LR7 under general anaesthetic. A healthy 13-year-old boy was referred to the same Department and team for surgical extraction of unerupted and buccally impacted UL3 and UR3 under general anaesthetic. Management and outcome: The majority of elective dental-alveolar work ceased as a result of the global pandemic. On resumption of activity, the first patient was reviewed in July 2021. The LR7 had spontaneously erupted in a favourable position, and following MDT review, a decision was made to forgo any further surgical intervention. The second patient was reviewed in July 2021. The UL3 had clinically erupted, and there was radiographic evidence of favourable movement of UR3. Due to the nature of the patient’s malocclusion, the decision was made to proceed with the extractions as previously planned. Key Learning Points: Severely impacted teeth do have a prospect of spontaneous eruption or alignment without clinical intervention, and current literature states the initial location, axial inclination, degree of root formation, and relation of the impacted tooth to adjacent teeth roots may influence spontaneous eruption. There is potential to introduce a period of observation to account for this possibility in the developing dentition, with the aim of reducing the unnecessary need for surgical intervention. This could help prevent episodes of general anaesthetic and allocate theatre space more appropriately.

Keywords: spontaneous eruption, impaction, observation, hopeless position, surgical, orthodontic, change in treatment plan

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19342 Ankaferd Blood Stopper (ABS) Has Protective Effect on Colonic Inflammation: An in Vitro Study in Raw 264.7 and Caco-2 Cells

Authors: Aysegul Alyamac, Sukru Gulec

Abstract:

Ankaferd Blood Stopper (ABS) is a plant extract used to stop bleeding caused by injuries and surgical interventions. ABS also involved in wound healing of intestinal mucosal damage due to oxidative stress and inflammation. Inflammatory Bowel Disease (IBD) is a common chronic disorder of the gastrointestinal tract that causes abdominal pain, diarrhea, and gastrointestinal bleeding, and increases the risk of colon cancer. Inflammation is an essential factor in the development of IBD. The various studies have been performed about the physiological effects of ABS; however, ABS dependent mechanism on colonic inflammation has not been elucidated. Thus, the protective effect of ABS on colonic inflammation was investigated in this study. The Caco-2 and RAW 264.7 murine macrophage cells were used as a model of in vitro colonic inflammation. RAW 264.7 cells were treated with lipopolysaccharide (LPS) for 12 hours to induce the inflammation, and a conditional medium was obtained. Caco-2 cells were treated with 15 µl/ml ABS for 4 hours, then incubated with conditional medium and the cells also were incubated with 15 µl/ml ABS and conditional medium together for 4 hours. Tumor necrosis factor alpha (TNF-α) protein levels were targeted in testing inflammatory condition and its level was significantly increased (25 fold, p<0.001) compared to the control group by using Enzyme-Linked Immunosorbent Assay (ELISA) method. The COX-2 mRNA level was used as a marker gene to show the possible anti-inflammatory effect of ABS in Caco-2 cells. RAW cells-derived conditional medium significantly (3.3 fold, p<0.001) induced cyclooxygenase-2 (COX-2) mRNA levels in Caco-2 cells. The pretreatment of Caco-2 cells caused a significant decrease (3.3 fold, p<0.001) in COX-2 mRNA levels relative to conditional medium given group. Furthermore, COX-2 mRNA level was significantly reduced (4,7 fold, p<0.001) in ABS and conditional medium treated group. These results suggest that ABS might have an anti-inflammatory effect in vitro.

Keywords: Ankaferd blood stopper, CaCo-2, colonic inflammation, RAW 264.7

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19341 Surgical School Project: Implementation Educational Plan for Adolescents Awaiting Bariatric Surgery

Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

Abstract:

Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

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19340 Open Jet Testing for Buoyant and Hybrid Buoyant Aerial Vehicles

Authors: A. U. Haque, W. Asrar, A. A. Omar, E. Sulaeman, J. S Mohamed Ali

Abstract:

Open jet testing is a valuable testing technique which provides the desired results with reasonable accuracy. It has been used in past for the airships and now has recently been applied for the hybrid ones, having more non-buoyant force coming from the wings, empennage and the fuselage. In the present review work, an effort has been done to review the challenges involved in open jet testing. In order to shed light on the application of this technique, the experimental results of two different configurations are presented. Although, the aerodynamic results of such vehicles are unique to its own design; however, it will provide a starting point for planning any future testing. Few important testing areas which need more attention are also highlighted. Most of the hybrid buoyant aerial vehicles are unconventional in shape and there experimental data is generated, which is unique to its own design.

Keywords: open jet testing, aerodynamics, hybrid buoyant aerial vehicles, airships

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19339 The Cost-Effectiveness of Pancreatic Surgical Cancer Care in the US vs. the European Union: Results of a Review of the Peer-Reviewed Scientific Literature

Authors: Shannon Hearney, Jeffrey Hoch

Abstract:

While all cancers are costly to treat, pancreatic cancer is a notoriously costly and deadly form of cancer. Across the world there are a variety of treatment centers ranging from small clinics to large, high-volume hospitals as well as differing structures of payment and access. It has been noted that centers that treat a high volume of pancreatic cancer patients have higher quality of care, it is unclear if that care is cost-effective. In the US there is no clear consensus on the cost-effectiveness of high-volume centers for the surgical care of pancreatic cancer. Other European countries, like Finland and Italy have shown that high-volume centers have lower mortality rates and can have lower costs, there however, is still a gap in knowledge about these centers cost-effectiveness globally. This paper seeks to review the current literature in Europe and the US to gain a better understanding of the state of high-volume pancreatic surgical centers cost-effectiveness while considering the contextual differences in health system structure. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, “Europe” “socialized medicine”, “privatized medicine”, “for-profit”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

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19338 Vertical Accuracy Evaluation of Indian National DEM (CartoDEM v3) Using Dual Frequency GNSS Derived Ground Control Points for Lower Tapi Basin, Western India

Authors: Jaypalsinh B. Parmar, Pintu Nakrani, Ashish Chaurasia

Abstract:

Digital Elevation Model (DEM) is considered as an important data in GIS-based terrain analysis for many applications and assessment of processes such as environmental and climate change studies, hydrologic modelling, etc. Vertical accuracy of DEM having geographically dynamic nature depends on different parameters which affect the model simulation outcomes. Vertical accuracy assessment in Indian landscape especially in low-lying coastal urban terrain such as lower Tapi Basin is very limited. In the present study, attempt has been made to evaluate the vertical accuracy of 30m resolution open source Indian National Cartosat-1 DEM v3 for Lower Tapi Basin (LTB) from western India. The extensive field investigation is carried out using stratified random fast static DGPS survey in the entire study region, and 117 high accuracy ground control points (GCPs) have been obtained. The above open source DEM was compared with obtained GCPs, and different statistical attributes were envisaged, and vertical error histograms were also evaluated.

Keywords: CartoDEM, Digital Elevation Model, GPS, lower Tapi basin

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19337 Functional Slow Release of Encapsulated Ibuprofen in Cross-linked Gellan Gum Hydrogel for Tissue Engineering Application

Authors: Nor Jannah Mohd Sebri, Khairul Anuar Mat Amin

Abstract:

Dication cross-linked gellan gum hydrogel loaded with Ibuprofen with excellent mechanical properties had been synthesized as potential candidate for non-toxic biocompatible polymer material in tissue engineering. The gellan gum hydrogel with 5% Ibuprofen had produced a slow release profile with total drug release time of 25 hours as a resulting low swelling value recorded at 22+0.5%. Its compressive strength, 200.13+21 kPa was highest of all other hydrogel ratio of 0.5% and 1.0% Ibuprofen incorporation. Young’s Modulus of the hydrogel with 5% Ibuprofen was recorded at 1.8+0.01 MPa, indicating good gel strength in which it is capable of withstanding a fair amount of subjected force during topical wound dressing application. Excellent mechanical properties, together with slow release profile, make the ibuprofen-loaded hydrogel a prospect candidate as biocompatible extracellular matrices in wound management.

Keywords: gellan gum, ibuprofen, slow drug release, hydrogel

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19336 Implementation of an Open Source ERP for SMEs in the Automotive Sector in Peru: A Case Study

Authors: Gerson E. Cornejo, Luis A. Gamarra, David S. Mauricio

Abstract:

The Enterprise Resource Planning Systems (ERP) allows the integration of all the business processes of the functional areas of the companies, in order to automate and standardize the processes, obtain accurate information and improve decision making in time real. In Peru, 79% of medium and small companies (SMEs) do not use any management software, this is because it is believed that ERPs are expensive, complex and difficult to implement. However, for more than 20 years there have been Open Source ERPs, which are more accessible and have the same benefit as proprietary ERPs, but there is little information on the implementation process. In this work is made a case of study, in order to show the implementation process of an Open Source ERP, Odoo, based on the ASAP methodology (Accelerated SAP) and applied to a company of corrective and preventive maintenance services of vehicles. The ERP allowed the SME to standardize its business processes, increase its productivity, reducing up to 40% certain processes. The study of this case shows that it is feasible and profitable to implement an Open Source ERP in SMEs in the Automotive Sector of Peru. In addition, it is shown that the ASAP methodology is adequate to carry out Open Source ERPs implementation projects.

Keywords: ASAP, automotive sector, ERP implementation, open source

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19335 The Role of Interactive White Boards towards Achieving Transactional Learning in the Context of Open Distance Learning

Authors: M. Van Zyl, M. H. A. Combrinck, E. J. Spamer

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Due to the need for higher education in South Africa, the country experiences a rapid growth in open distance learning, especially in rural areas. It is difficult for people to enrol fulltime at contact universities, owing to work and financial constraints. The Unit for Open Distance Learning (UODL) at the North-West University (NWU), Potchefstroom campus, South Africa was established in 2013 with its main function to deliver open distance learning programmes to 30 000 students from the Faculties of Education Sciences, Theology and Health Sciences. With the use of interactive whiteboards (IWBs), the NWU and UODL are now able to deliver lectures to students concurrently at 60 regional open learning centres across Southern Africa as well as to an unlimited number of individuals with Internet access worldwide. Although IWBs are not new, our initiative is to use them more extensively in order to create more contact between lecturers and students. To be able to ensure and enhance quality education it is vital to determine students’ perceptions on the delivery of programmes by means of IWBs. Therefore, the aim of the study is to explore students’ perceptions for the use of IWBs in the delivery of programmes in terms of Moore’s Theory of Transactional Distance.

Keywords: interactive white board, open distance learning, technology, transactional learning

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19334 Biotechnology Approach: A Tool of Enhancement of Sticky Mucilage of Pulicaria Incisa (Medicinal Plant) for Wounds Treatment

Authors: Djamila Chabane, Asma Rouane, Karim Arab

Abstract:

Depending of the chemical substances responsible for the pharmacological effects, a future therapeutic drug might be produced by extraction from whole plants or by callus initiated from some parts. The optimized callus culture protocols now offer the possibility to use cell culture techniques for vegetative propagation and open minds for further studies on secondary metabolites and drug establishment. In Algerian traditional medicine, Pulicaria incisa (Asteraceae) is used in the treatment of daily troubles (stomachache, headhache., cold, sore throat and rheumatic arthralgia). Field findings revealed that many healers use some fresh parts (leaves, flowers) of this plant to treat skin wounds. This study aims to evaluate the healing efficiency of artisanal cream prepared from sticky mucilage isolated from calluses on dermal wounds of animal models. Callus cultures were initiated from reproductive explants (young inflorescences) excised from adult plants and transferred to a MS basal medium supplemented with growth regulators and maintained under dark for for months. Many calluses types were obtained with various color and aspect (friable, compact). Several subcultures of calli were performed to enhance the mucilage accumulation. After extraction, the mucilage extracts were tested on animal models as follows. The wound healing potential was studied by causing dermal wounds (1 cm diameter) at the dorsolumbar part of Rattus norvegicus; different samples of the cream were applied after hair removal on three rats each, including two controls (one treated by Vaseline and one without any treatment), two experimental groups (experimental group 1, treated with a reference ointment "Madecassol® and experimental group 2 treated by callus mucilage cream for a period of seventeen days. The evolution of the healing activity was estimated by calculating the percentage reduction of the area wounds treated by all compounds tested compared to the controls by using AutoCAD software. The percentage of healing effect of the cream prepared from callus mucilage was (99.79%) compared to that of Madecassol® (99.76%). For the treatment time, the significant healing activity was observed after 17 days compared to that of the reference pharmaceutical products without any wound infection. The healing effect of Madecassol® is more effective because it stimulates and regulates the production of collagen, a fibrous matrix essential for wound healing. Mucilage extracts also showed a high capacity to heal the skin without any infection. According to this pharmacological activity, we suggest to use calluses produced by in vitro culture to producing new compounds for the skin care and treatment.

Keywords: calluses, Pulicaria incisa, mucilage, Wounds

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19333 Open-Loop Vector Control of Induction Motor with Space Vector Pulse Width Modulation Technique

Authors: Karchung, S. Ruangsinchaiwanich

Abstract:

This paper presents open-loop vector control method of induction motor with space vector pulse width modulation (SVPWM) technique. Normally, the closed loop speed control is preferred and is believed to be more accurate. However, it requires a position sensor to track the rotor position which is not desirable to use it for certain workspace applications. This paper exhibits the performance of three-phase induction motor with the simplest control algorithm without the use of a position sensor nor an estimation block to estimate rotor position for sensorless control. The motor stator currents are measured and are transformed to synchronously rotating (d-q-axis) frame by use of Clarke and Park transformation. The actual control happens in this frame where the measured currents are compared with the reference currents. The error signal is fed to a conventional PI controller, and the corrected d-q voltage is generated. The controller outputs are transformed back to three phase voltages and are fed to SVPWM block which generates PWM signal for the voltage source inverter. The open loop vector control model along with SVPWM algorithm is modeled in MATLAB/Simulink software and is experimented and validated in TMS320F28335 DSP board.

Keywords: electric drive, induction motor, open-loop vector control, space vector pulse width modulation technique

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19332 Analysis of Reliability of Mining Shovel Using Weibull Model

Authors: Anurag Savarnya

Abstract:

The reliability of the various parts of electric mining shovel has been assessed through the application of Weibull Model. The study was initiated to find reliability of components of electric mining shovel. The paper aims to optimize the reliability of components and increase the life cycle of component. A multilevel decomposition of the electric mining shovel was done and maintenance records were used to evaluate the failure data and appropriate system characterization was done to model the system in terms of reasonable number of components. The approach used develops a mathematical model to assess the reliability of the electric mining shovel components. The model can be used to predict reliability of components of the hydraulic mining shovel and system performance. Reliability is an inherent attribute to a system. When the life-cycle costs of a system are being analyzed, reliability plays an important role as a major driver of these costs and has considerable influence on system performance. It is an iterative process that begins with specification of reliability goals consistent with cost and performance objectives. The data were collected from an Indian open cast coal mine and the reliability of various components of the electric mining shovel has been assessed by following a Weibull Model.

Keywords: reliability, Weibull model, electric mining shovel

Procedia PDF Downloads 482
19331 R Software for Parameter Estimation of Spatio-Temporal Model

Authors: Budi Nurani Ruchjana, Atje Setiawan Abdullah, I. Gede Nyoman Mindra Jaya, Eddy Hermawan

Abstract:

In this paper, we propose the application package to estimate parameters of spatiotemporal model based on the multivariate time series analysis using the R open-source software. We build packages mainly to estimate the parameters of the Generalized Space Time Autoregressive (GSTAR) model. GSTAR is a combination of time series and spatial models that have parameters vary per location. We use the method of Ordinary Least Squares (OLS) and use the Mean Average Percentage Error (MAPE) to fit the model to spatiotemporal real phenomenon. For case study, we use oil production data from volcanic layer at Jatibarang Indonesia or climate data such as rainfall in Indonesia. Software R is very user-friendly and it is making calculation easier, processing the data is accurate and faster. Limitations R script for the estimation of model parameters spatiotemporal GSTAR built is still limited to a stationary time series model. Therefore, the R program under windows can be developed either for theoretical studies and application.

Keywords: GSTAR Model, MAPE, OLS method, oil production, R software

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19330 Innovating and Disrupting Higher Education: The Evolution of Massive Open Online Courses

Authors: Nabil Sultan

Abstract:

A great deal has been written on Massive Open Online Courses (MOOCs) since 2012 (considered by some as the year of the MOOCs). The emergence of MOOCs caused a great deal of interest amongst academics and technology experts as well as ordinary people. Some of the authors who wrote on MOOCs perceived it as the next big thing that will disrupt education. Other authors saw it as another fad that will go away once it ran its course (as most fads often do). But MOOCs did not turn out to be a fad and it is still around. Most importantly, they evolved into something that is beginning to look like a viable business model. This paper explores this phenomenon within the theoretical frameworks of disruptive innovations and jobs to be done as developed by Clayton Christensen and his colleagues and its implications for the future of higher education (HE).

Keywords: MOOCs, disruptive innovations, higher education, jobs theory

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19329 Cybersecurity Challenges in the Era of Open Banking

Authors: Krish Batra

Abstract:

The advent of open banking has revolutionized the financial services industry by fostering innovation, enhancing customer experience, and promoting competition. However, this paradigm shift towards more open and interconnected banking ecosystems has introduced complex cybersecurity challenges. This research paper delves into the multifaceted cybersecurity landscape of open banking, highlighting the vulnerabilities and threats inherent in sharing financial data across a network of banks and third-party providers. Through a detailed analysis of recent data breaches, phishing attacks, and other cyber incidents, the paper assesses the current state of cybersecurity within the open banking framework. It examines the effectiveness of existing security measures, such as encryption, API security protocols, and authentication mechanisms, in protecting sensitive financial information. Furthermore, the paper explores the regulatory response to these challenges, including the implementation of standards such as PSD2 in Europe and similar initiatives globally. By identifying gaps in current cybersecurity practices, the research aims to propose a set of robust, forward-looking strategies that can enhance the security and resilience of open banking systems. This includes recommendations for banks, third-party providers, regulators, and consumers on how to mitigate risks and ensure a secure open banking environment. The ultimate goal is to provide stakeholders with a comprehensive understanding of the cybersecurity implications of open banking and to outline actionable steps for safeguarding the financial ecosystem in an increasingly interconnected world.

Keywords: open banking, financial services industry, cybersecurity challenges, data breaches, phishing attacks, encryption, API security protocols, authentication mechanisms, regulatory response, PSD2, cybersecurity practices

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19328 Formulation of a Submicron Delivery System including a Platelet Lysate to Be Administered in Damaged Skin

Authors: Sergio A. Bernal-Chavez, Sergio Alcalá-Alcalá, Doris A. Cerecedo-Mercado, Adriana Ganem-Rondero

Abstract:

The prevalence of people with chronic wounds has increased dramatically by many factors including smoking, obesity and chronic diseases, such as diabetes, that can slow the healing process and increase the risk of becoming chronic. Because of this situation, the improvement of chronic wound treatments is a necessity, which has led to the scientific community to focus on improving the effectiveness of current therapies and the development of new treatments. The wound formation is a physiological complex process, which is characterized by an inflammatory stage with the presence of proinflammatory cells that create a proteolytic microenvironment during the healing process, which includes the degradation of important growth factors and cytokines. This decrease of growth factors and cytokines provides an interesting strategy for wound healing if they are administered externally. The use of nanometric drug delivery systems, such as polymer nanoparticles (NP), also offers an interesting alternative around dermal systems. An interesting strategy would be to propose a formulation based on a thermosensitive hydrogel loaded with polymeric nanoparticles that allows the inclusion and application of a platelet lysate (PL) on damaged skin, with the aim of promoting wound healing. In this work, NP were prepared by a double emulsion-solvent evaporation technique, using polylactic-co-glycolic acid (PLGA) as biodegradable polymer. Firstly, an aqueous solution of PL was emulsified into a PLGA organic solution, previously prepared in dichloromethane (DCM). Then, this disperse system (W/O) was poured into a polyvinyl alcohol (PVA) solution to get the double emulsion (W/O/W), finally the DCM was evaporated by magnetic stirring resulting in the NP formation containing PL. Once the NP were obtained, these systems were characterized by morphology, particle size, Z-potential, encapsulation efficiency (%EE), physical stability, infrared spectrum, calorimetric studies (DSC) and in vitro release profile. The optimized nanoparticles were included in a thermosensitive gel formulation of Pluronic® F-127. The gel was prepared by the cold method at 4 °C and 20% of polymer concentration. Viscosity, sol-gel phase transition, time of no flow solid-gel at wound temperature, changes in particle size by temperature-effect using dynamic light scattering (DLS), occlusive effect, gel degradation, infrared spectrum and micellar point by DSC were evaluated in all gel formulations. PLGA NP of 267 ± 10.5 nm and Z-potential of -29.1 ± 1 mV were obtained. TEM micrographs verified the size of NP and evidenced their spherical shape. The %EE for the system was around 99%. Thermograms and in infrared spectra mark the presence of PL in NP. The systems did not show significant changes in the parameters mentioned above, during the stability studies. Regarding the gel formulation, the transition sol-gel occurred at 28 °C with a time of no flow solid-gel of 7 min at 33°C (common wound temperature). Calorimetric, DLS and infrared studies corroborated the physical properties of a thermosensitive gel, such as the micellar point. In conclusion, the thermosensitive gel described in this work, contains therapeutic amounts of PL and fulfills the technological properties to be used in damaged skin, with potential application in wound healing and tissue regeneration.

Keywords: growth factors, polymeric nanoparticles, thermosensitive hydrogels, tissue regeneration

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19327 Clinical Outcomes and Surgical Complications in Patients with Cervical Disk Degeneration

Authors: Mirzashahi Babak, Mansouri Pejman, Najafi Arvin, Farzan Mahmoud

Abstract:

Introduction: There are several surgical treatment choices for cervical spondylotic myelopathy (CSM). The aim of this study is to evaluate clinical outcomes and surgical complications in patients with cervical disk degeneration (CDD) undergoing either anterior cervical discectomy with or without fusion or cervical laminectomy and fusion. Methods: This prospective case series study included 45 consecutive patients with cervical spondylotic myelopathy between January 2010 and November 2014. There were 28 males and 17 females, with a mean age of 47 (range 37-68) years. The mean clinical follow-up was 14 months (range 3-24 months). The Neck Disability Index (NDI), visual analog scale (VAS) neck and arm pain, Short Form-36 (SF-36) were used as the functional outcome measurements. All of the complications in our patients were recorded. Results: In our study group, 26 patients underwent only one or two level anterior cervical discectomy. Ten patients underwent anterior cervical discectomy and fusion (ACDF) and nine cases underwent posterior laminectomy and fusion. We have found a statistically significant improvement between mean preoperative (29, range 19-43) and postoperative (7, range 0-12) NDI scores following surgery (P < 0.05). Also, there was a statistically significant difference between pre and post-operative VAS and SF-36 score (p < 0.05). There was a 7% overall complication rate (n = 3). The only complication in our patients was surgical site cellulitis which has been managed with oral antibiotic therapy. Conclusion: Both anterior cervical discectomy with or without fusion or posterior laminectomy and fusion are safe and efficacious treatment options for the management of CSM. The clinical outcomes seem to be fairly reproducible.

Keywords: cervical, myelopathy, discectomy, fusion, laminectomy

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19326 Surgical Collaboration in Managing Spinal Cord Compression Due to a Pre-Vertebral Chordoma: A Case Report

Authors: Rose Virginy S. Bautista, Ida Marie Tabangay-Lim, Helen Bongalon-Amo, Jose Modesto B. Abellera

Abstract:

Chordomas, particularly those of the spine and the head and neck region, represent a rare and locally aggressive group of malignancies. The complexity of these tumors -given the rarity, location, and involvement of neurovascular structures- imposes a challenge in the diagnosis and management. We herein report a case of spinal cord compression due to a prevertebral cervical chordoma. The patient presented with a gradually enlarging lateral neck mass, with progressive bilateral extremity weakness and urinary incontinence; preoperative biopsy showed chordoma. A multidisciplinary approach for the management of this case was made, involving neurosurgery, head and neck surgery, and radiation oncology services. Surgical collaboration between the two cutting services was done to have a radical excision of the tumor and spinal cord decompression. The patient was then referred for adjuvant radiation therapy. With this collaborative treatment strategy, more comprehensive and quality care could be provided to our patients.

Keywords: chordoma, surgical collaboration, spinal cord compression, neurosurgery, head and neck surgery

Procedia PDF Downloads 52
19325 Providing Open Access for Scholarly Information in Libya

Authors: Mohamed Abolgasem Arteimi, Ahlam Al-Tajori

Abstract:

This paper describes an ongoing project at the Libyan Academy. The project aims to build digital library for thesis and dissertations (ETD). The researchers developed a system based on Greenstone open source systems for building ETD digital library. A metadata for theses and dissertations was developed. The paper addresses issues related to project design, development and user satisfaction. Conclusions highlighted some important lessons learned to date.

Keywords: digital library, electronic theses and dissertations, open access, ETD, metadata

Procedia PDF Downloads 292
19324 Optimal Tuning of RST Controller Using PSO Optimization for Synchronous Generator Based Wind Turbine under Three-Phase Voltage Dips

Authors: K. Tahir, C. Belfedal, T. Allaoui, C. Gerard, M. Doumi

Abstract:

In this paper, we presented an optimized RST controller using Particle Swarm Optimization (PSO) meta-heuristic technique of the active and reactive power regulation of a grid connected wind turbine based on a wound field synchronous generator. This regulation is achieved below the synchronous speed, by means of a maximum power point tracking algorithm. The control of our system is tested under typical wind variations and parameters variation, fault grid condition by simulation. Some results are presented and discussed to prove simplicity and efficiency of the WRSG control for WECS. On the other hand, according to simulation results, variable speed driven WRSG is not significantly impacted in fault conditions.

Keywords: wind energy, particle swarm optimization, wound rotor synchronous generator, power control, RST controller, maximum power point tracking

Procedia PDF Downloads 430